Rachel Carlton Abrams, MD: Listening To Your Body’s Intelligence

We are all innately gifted with something called body intelligence — an intuitive sense of what best serves our mental, physical and emotional well-being. However, most of us disconnect from our bodies' persistent efforts to communicate, muting it out to favor the breakneck pace of our modern lives. Left unchecked, this leaves us at serious risk of what this week's guest calls chronic body depletion – a crisis of mind, body and spirit that can lead to everything from weight gain and chronic pain to high blood pressure, heart disease, depression, autoimmune disease and more. This week Rachel Carlton Abrams, MD, MHS, ABIHM joins the podcast to help us better cultivate our body intelligence, so that we can begin to properly treat the cause of what ails us and set a better trajectory for optimum healing and lifelong health. Dr. Abrams is a board-certified primary care, family practice physician, integrative health expert and author with over two decades of experience in preventive and comprehensive care medicine. She graduated Phi Beta Kappa from Stanford University, received her medical degree from UC San Francisco, earned her master’s degree in Holistic Health and Medical Sciences from UC Berkeley, and has been voted the “Best Doctor” in Santa Cruz County every year from 2010 to 2016. In the scope of her dynamic practice, she works with many of the world’s most influential people, from CEOs to billionaire entrepreneurs to Nobel Peace laureates, and has spent countless hours addressing everyday patients with chronic health conditions. The author of several books on holistic health, relationships and sexuality, her latest offering, BodyWise: Discovering Your Body’s Intelligence for Lifelong Health and Healing*, skillfully and accessibly guides the reader on a journey of discovery towards creating the vibrant, balanced, healthy life you have always deserved. This is a fun and super informative conversation packed with knowledge nuggets and practical wisdom takeaways all designed to cultivate your own body intelligence. An intelligence that will help you take better responsibility for yourself, your environment, your behaviors, your relationships, and your health so that you can fuel your body’s natural predisposition to heal and thrive. Specific topics covered include: * the concept of chronic body depletion * reconnecting with our bodies/nature * mind, body & spirit connection * taking responsibility for yourself * the business of healthcare * sense, feel & discernment * the body’s natural predisposition to heal * the benefits of integrative medicine * link inflammation and disease * the importance of positive feedback loops * adaptogenic herbs & essential oils It was an absolute joy talking to Dr. Abrams and I'm delighted to bring you our conversation. I sincerely hope you enjoy it. Peace + Plants, Rich Learn more about your ad choices. Visit podcastchoices.com/adchoices

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Rich Roll?

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• 1:05Speaker 01

  You know, I talk about this explicitly in the book, but I feel like, once you're really actually connected to and listening to your body, and you get a sense of being in touch with your own nature, that it is a natural extension to realize how connected you are to other people, and how connected you are to the earth. Because there really is no separation. It's a crazy idea that we're separate from the earth we live on, right? Everything we are comes from the earth, and everything we're exposed to, from a health point of view, all the toxins and the pesticides, the things people, you know, clean their houses with, and, you know, the food we eat, all deeply connect to our bodies, right? The microbiome, the bacterial population of the earth, and everything we do to the

• 1:46Speaker 01

  earth, whether it's, you know, tearing down trees and, you know, creating a loss of oxygen and global warming, or it's the toxins that we're using, it all impacts us directly, directly. And if you look at the emerging illnesses, allergy, autoimmune, learning disorders, neurologic disease, cancer, it's all related to our environment. So we ourselves are an ecosystem, and we're intimately connected to the earth that we live on, and everything we do to it.

• 2:18Rich Roll?

  That's Rachel Carlton Abrams, M.D., and this is the Rich Roll Podcast.

• 2:33Rich Roll?

  The Rich Roll Podcast. Hey everybody. How you guys doing? What is going on? Welcome or welcome back to the show. My name is Rich Roll. I am your host and this is my podcast, the show where I go deep and I go long form with some of the world's most inspiring, positive paradigm-breaking changemakers all across the globe. Thanks for tuning in today. Really appreciate it. Today's guest is Rachel Carlton Abrams, MD, MHS, A B I H M. I don't know what all those abbreviations mean, but they're very impressive. And the thrust of today's conversation is all about how to take better care and more responsibility for your health and your wellbeing by learning how to essentially

• 3:18Rich Roll?

  listen to your body's intelligence. So who is Dr. Abrams? Well, Dr. Abrams is a board-certified primary care family practice physician and integrative health expert and author with over two decades of experience. She graduated Phi Beta Kappa from Stanford University, where we went to school together. We were in the same class along with Rachel's husband, Doug, who is a literary agent and he's also a celebrated author in his own right. He wrote a recent book called The Book of Joy, which is an amazing book. If you haven't heard of it, check it out. I also interviewed Doug and that's coming up in a few weeks. In any event, in addition to graduating from Stanford, Dr. Abrams also received her

• 4:02Rich Roll?

  medical degree from UC San Francisco. She earned her master's degree in holistic health and medical sciences from UC Berkeley. And she's also steeped in a variety of more eastern perspectives on health and healing, including studying with a Taoist master. And she's also been voted the best doctor in Santa Cruz County every year from 2010 to 2016. Very, very impressive person. And in the scope of her practice, which is very interesting, very dynamic and Very much focused on preventive and extremely comprehensive care. She works with many of the world's most influential people, from CEOs to billionaire entrepreneurs,

• 4:44Rich Roll?

  to Nobel Peace Laureates, and has spent countless hours addressing everyday patients with chronic health conditions. She's written a couple of books on holistic health, on relationships, and even on sexuality. And her latest offering just hit shelves. It's called Body Wise: Discovering Your Body's Intelligence for Lifelong Health and Healing. And it offers a really new and very practical and accessible approach to decode your symptoms so that you can create vibrant, lasting health and healing for yourself. A couple more things I want to say about Dr. Abrams before we get into the conversation. But first.

• 5:32Rich Roll?

  All right, so let's just get into it. I think that I've been long-winded in these intros. I'm trying to really cut them down and keep them short. So I'm just going to say this. This one is super fun. It's super informative. Not only is Rachel a total delight, this conversation is packed with awesome takeaways that I think are going to really arm you with a battery of tools to help you take better responsibility for yourself, for your environment, for your behaviors, for your relationships, and your health, so that you can fuel your body's natural predisposition to heal and thrive. So this is my conversation with Dr. Rachel Carlton Abrams.

• 6:14Rich Roll?

  Let's do it. You ready to go? Let's go! All right, Rachel. Thank you so much. You opened up your home to me. I appreciate it. Such a pleasure to have this opportunity to talk to you. It was really great running into you at our mutual friend's wedding. Yes. Was that like a month ago, six weeks ago, or something like that? Yeah. It's funny, because at our age, it's unusual to go to any wedding. Yes. But a wedding of somebody that we went to college? Usually people are like getting divorced and stuff.

• 6:43Speaker 01

  Yes.

• 6:43Rich Roll?

  It was nice to reconnect with a bunch of old friends.

• 6:47Speaker 01

  Yeah.

• 6:48Rich Roll?

  Enjoyed it and here we are. I get to talk to you and then I get to talk to your husband. And you guys have such a beautiful, on a relationship aside, like professionally, you're so simpatico with the work that you do.

• 7:01Speaker 01

  Yeah.

• 7:02Rich Roll?

  It fits together like these beautiful puzzle pieces of, you know, left brain, right brain, east meets west, science meets, you know, eastern philosophy and mysticism and all these good things. So it's really cool to talk to you.

• 7:16Speaker 01

  Oh, I'm so happy to be here and you know, Doug and I feel pretty damn fortunate because we knew each other in college, right? So we're all almost 50.

• 7:24Rich Roll?

  Right.

• 7:24Speaker 01

  Believe it or not.

• 7:25Rich Roll?

  And you guys, did you, you guys met in college and have been together ever since?

• 7:28Speaker 01

  We met in college and have been together ever since.

• 7:30Rich Roll?

  You're too young to have like an empty nest on the horizon that I know that you're facing right now.

• 7:34Speaker 01

  Thank you. I agree with you. But you know, Doug and I really grew each other up is what I want to say. We did a ton of spiritual exploration together. He, you know, was with me during medical school and medical training. And I was with him as he launched his book business and his agency and wrote all the books that he's written. And so it's, it's not surprising that even though our fields are really different. I'm a physician, he's an agent, writer, editor, that our work really kind of coalesces.

• 8:03Rich Roll?

  Right.

• 8:04Speaker 01

  You know, in my opinion, the fundamental reason that our marriage works is that we really believe that we're together to support each of us, to give better gifts in the world, right? To do better work.

• 8:14Rich Roll?

  Yeah, that's beautiful. It's, you haven't met my wife, but it's, it's similar. I have a similar relationship with my wife. We haven't been together, we've been together 18 years, but not since college.

• 8:23Speaker 01

  Well, that's a long time.

• 8:24Rich Roll?

  And we're very different people and we're involved in different things, but we come together to collaborate on certain projects and that seems to work really well. We have our independent lives, but at times that Venn diagram overlaps really nicely to be of service to people in unique ways.

• 8:39Speaker 01

  Yes.

• 8:39Rich Roll?

  And I see that's what you guys are doing. It's really cool.

• 8:41Speaker 01

  Yeah.

• 8:42Rich Roll?

  So let's unpack it a little bit. The book is great. Congratulations on that.

• 8:46Speaker 01

  Thank you.

• 8:47Rich Roll?

  And I want to get into all of that kind of stuff.

• 8:49Speaker 01

  Having a lot of fun with it.

• 8:50Rich Roll?

  Yeah, nice. And it's not your first book. You've been writing for a while. But maybe the best way to kind of launch into it in a general sense is, you know, this is kind of a recurring theme on the podcast, and I say this all the time, but it's really true, and I'm interested in your response to this. You know, we live in this incredibly prosperous country. We have unbelievable opportunity available to us and resources and information and great food and all these sorts of things. And yet, we've never been more obese, more sick, more anxious, more depressed, more medicated in the history of humankind, right? And so I think that the work that you do, trying to help people grapple with this

• 9:35Rich Roll?

  and find healthier ways to live is more important than ever. So before we even get into it, I commend you for that.

• 9:41Speaker 01

  Yeah, thank you.

• 9:41Rich Roll?

  And perhaps we can start to begin the process of unpacking what is exactly going on and how we can kind of get on a better trajectory. So, you know, maybe explain a little bit about the book and why you decided to write it.

• 9:55Speaker 01

  Yeah, well, I decided to write it for that reason, honestly. And it's interesting, I was just reviewing all the blogs that I've written in the past three or four months, and quite a few of them are on anxiety and depression. And that's not because that's my favorite topic to write about, even though I don't mind writing about it. It's because it's so common. And it's one of a cluster of five symptoms that I am seeing off the charts in my practice. And I call it chronic body depletion because it really feels to me. And, you know, some of the other books I've written are on Taoism and sexuality. And this is really almost a Chinese medicine concept, that we can deplete our vital energy, or an Ayurvedic medicine concept from the Indian tradition.

• 10:39Speaker 01

  But that we, as a culture, because we live in these finely crafted, beautiful bodies, capable of Phenomenal things, right? I mean, you're a perfect example of that. And this body is created for an environment that is really wildly different than the one that we live in. We're created to live in, you know, light and dark and not a lot of artificial light. We're created to intimately know about 150 people. So if you look at humans in the last, you know, 10,000 years ago, 5,000 years ago, that's how most people lived. And to know the deaths and the births and the tragedies of those people, not to be bombarded all the time with Twitter,

• 11:19Speaker 01

  to be outside a lot, to be exposed to natural light, to be physically active all the time, because you had to be or you would die. Right? You had to gather your food, you had to, you know, hunt your food, you had to actually work at creating food and shelter and clothing and raising children. And then we live in this world where we can almost do none of those things and survive. And, you know, there is this phenomenon in Japan, I don't know if you've heard about this, we both have sort of young adults as kids. And there's this phenomenon of young Japanese men who take a vow, there's a Japanese word for them that I'm not remembering right now, but they live in their bedrooms, they never leave, they never leave, and their whole life is online.

• 12:03Rich Roll?

  Oh, this is, you mean, I thought you were going to talk about some kind of traditional way of rite of passage.

• 12:08Speaker 01

  No, no, no. You mean currently, yeah. It's the new tradition, which is, I don't make food, I don't gather food, I don't work, I don't go outside, I don't, I'm not physically active. I do, I sit like a machine inside all day. Now, that's an extreme version, but you and I have both worked in versions of that. Right? I'm inside all day, I'm sitting at a desk, I'm stressed out, and then I sit in my car, and then I drive home in traffic, and then I'm home and I'm, you know, blown by my day, and so I watch television, sitting on the couch. And that life where you're not physically active, you're typically not sleeping enough for a variety of reasons, but in part because of our culture's driven need to be productive.

• 12:50Rich Roll?

  Well, we've created these environments that immunize ourselves from the natural cycles of what it means to live, and we've convinced ourselves, or perhaps a better word would be deluded ourselves, to believe that we've opted out or exempted ourselves from nature, and we refuse to believe that even though we're under a roof and we're under artificial light, that we're still in nature.

• 13:14Speaker 01

  Yeah.

• 13:14Rich Roll?

  You know, and the idea of going to bed when it gets dark and maybe sleeping a little bit more in the wintertime, and all these things that are part of the natural circadian rhythms of what it means to be an animal, which is what we are.

• 13:26Speaker 01

  Yes.

• 13:26Rich Roll?

  Have been completely divorced from our existence. So, the extreme example being those Japanese boys, I mean, you become a battery in The Matrix, right?

• 13:34Speaker 01

  Exactly.

• 13:35Rich Roll?

  And then it becomes such a struggle to try to recreate the circumstances under which we are sort of naturally inclined to simply thrive and operate in our optimal capacity.

• 13:47Speaker 01

  Exactly, and that is exactly why I wrote Bodywise, because I'm really trying to help people reconnect. I mean, a lot of people, a lot of my patients, walk around like they're really smart heads, you know, with this little thing dangling from their neck, you know? They're so completely disconnected from their bodies that they can't even feel what's going on most of the time, and a lot of us live our lives that way. But when you do that, we get sick. We get all these symptoms. We get anxious, we get depressed, we get tired, we lose our sex drive, you know? We end up with diseases, heart disease, diabetes, thyroid issues, autoimmune disease, allergy. So, you know, in my opinion, the way out of that is to really get body intelligence.

• 14:32Speaker 01

  And, you know, we talk about IQ, our intellectual intelligence, and we talk about EQ even, being emotionally intelligent, also very important. But this is BQ, right? And it's kind of hilarious that we even need to talk about this, right? Because we are, we are animals. Or, or the, or the idea that we could actually be separate from nature. I mean, it's hilarious. We are nature, right? We're a walking microbiome of intestinal bacteria, like a little rainforest. We have more bacterials, 10 times more bacterial cells in our guts than human cells. So we ourselves are an ecosystem. And we're intimately connected to the earth that we live on and everything we do to it.

• 15:12Rich Roll?

  Yeah, and I think, I think further exacerbating that is the fact that, that we don't take responsibility for, for our BQ or our physical, you know, well-being. And we've divested that responsibility or perhaps invested it in, in the medical community, right? Like, we just assume that our doctor knows best. We go to our doctor, we get diagnosed with something, we're given a medication, we're giving a, we're given a pill, which, you know, I would venture to guess 99% of the time isn't dealing with the underlying cause of whatever brought you to that office in the first place. And it's just masking symptoms so that you're perpetuating whatever imbalance led to that in the first place.

• 15:54Speaker 01

  Absolutely, absolutely.

• 15:56Rich Roll?

  And, and I think in your, to, to kind of lay this with, with context, I mean, this was not always, I mean, you came up in a very traditional educational, medical educational system, right? So your kind of epiphany or, you know, gradual sort of awareness about all of these issues was not, you know, that wasn't the initial path, right? You practiced traditional family medicine.

• 16:19Speaker 01

  I did.

• 16:19Rich Roll?

  You went to Stanford, you went to UCSF, you did the whole deal, the medical residency and internship and all that kind of craziness. So maybe walk me through kind of your evolution to this perspective, because I think that lends credence to the, you know, wisdom that you're sharing.

• 16:34Speaker 01

  Yeah, absolutely. So.

• 16:37Speaker 01

  You know, I was one of those driven, high achieving people. Otherwise, I wouldn't have met you at Stanford, right? You had to be that person to get in. And I do want to say, I am not someone who thinks modernity is evil, nor do I think technology is evil, nor do I think the medical system is evil, but...

• 16:55Rich Roll?

  Even though you live in Santa Cruz.

• 16:57Speaker 01

  Okay, I choose to live in Santa Cruz. But, um...

• 17:01Rich Roll?

  Excuse me.

• 17:01Speaker 01

  No, not a problem. But I do think that you can't just assume that we're going to be in each of those contexts and it's all going to be fine and well taken care of. I think we really have to have our eyes open. And I'm trying to educate people with BodyWise, how to be their own best advocates, and sometimes even their own doctors. Because, you know, you educate these physicians intensively. And by the way, society pays for us to educate physicians because it's so expensive, so intensive. And then they come out and you've got these very talented people. And you say, okay, you're going to sit in this box, in this room, and you're going to see people for 10 minutes at a time, and you're going to see 35 people a day. And you're going to make an accurate diagnosis and write prescriptions.

• 17:43Rich Roll?

  And beyond that, the sort of process by which you get to that point is antithetical to what ultimately you are preaching. You're working 100-hour weeks, you're not sleeping.

• 17:54Speaker 01

  Yes.

• 17:55Rich Roll?

  You know, your sort of BQ is not fostered or, you know, sort of emphasized. Like, you can't... There's no way that you can live these principles that you're advocating as a process of becoming this person who can then share this knowledge, right?

• 18:10Speaker 01

  Yeah, so, right now, I'm some...

• 18:12Rich Roll?

  The irony of that.

• 18:12Speaker 01

  Yeah, I haven't had a lot of time in my life to watch television because I've just been busy working, writing, and raising three kids. But recently, I've had a little more leisure and my daughter and I have been watching Grey's Anatomy for the first time. Okay?

• 18:25Rich Roll?

  Okay.

• 18:26Speaker 01

  And she keeps saying to me, "Oh, my God, is it really like that?" And I keep saying,

• 18:32Rich Roll?

  Everybody's having affairs with each other.

• 18:33Speaker 01

  Well, that part is exaggerated. Okay, it is not really paying place in the hospital, usually. But the hours, the intensity, the criticism, the shutting down of your humanity, it's exactly like that. It's exactly like that.

• 18:47Rich Roll?

  Does it have to be that way? Like, I've always, I've always been confused, like, why? Like, I don't want, I don't want to go into the hospital and have some internist come in and attend to me who hasn't slept in four days.

• 18:58Speaker 01

  Yeah, but you-

• 18:59Rich Roll?

  What is that trial by fire all about? Can't we create a better system?

• 19:03Speaker 01

  Right, so, so this is, and again, it's a nuanced answer. So, you know, when you asked me originally, like, how'd I get here? Right? So, here's what I would say about it. You have to have enough practical, hands-on, live patient experience to be able to do medicine. And the point of residency is to really give you as much of that as possible. And surgical residency, which is what Grey's Anatomy is about, is, is really the pinnacle of that. So, it is not untrue that you need to put in a lot of hours. I'm not arguing against that. I think that the, and I would also say that if you've got someone who is being a trauma surgeon or even a, you know, trauma physician, you need to have an order, a pecking order,

• 19:47Speaker 01

  where one person's in charge, they tell everybody else what to do, everybody else has their place. It's run like the military. And the reason the military is run that way is that's how you efficiently get a job done. So, I think that there is a place for, you know, that kind of pecking order power dynamic. And I think there is a place for being able to shut out your feelings because you've got a 15-year-old bleeding out from motorcycle accident in front of you. What I object to is that that real need to be able to separate your emotions from the task at hand becomes global in medicine. And that's not only wrong or difficult or painful,

• 20:30Speaker 01

  it's actually contributes to the dysfunction of American medicine and the failure of American medicine. Because I will tell you, I did do training, it was totally brutal. I did residency with a toddler. I don't know what I was thinking, that was particularly brutal. I had my-

• 20:48Rich Roll?

  You were pregnant with your twins, right, during residency?

• 20:50Speaker 01

  And then I was pregnant with my twins during my third year of residency. And ended up on bedrest weirdly, right? My body was saying, Right. Look lady, you know, are you nuts? Right? You're pregnant with twins and you cannot be running around the hospital and being on call at night. No. So I was on bedrest for two and a half months and I had healthy twins. Wow, right. But that's an extreme example. And I could give you some more. I was at UCSF and I was working the liver transplant program, which is famous and amazing program. And the surgeries are six hours long, nine hours long. They're very, very long. And one of the surgeons, this amazing woman, you know, at the time, one of the top liver transplant surgeons

• 21:31Speaker 01

  in the world and female. So just imagine what she had to go through. So this is 20 years ago, 25 years ago. And she was pregnant and she had scrubbed into surgery and her water broke and she went into labor and she refused to scrub out. So she stayed? She labored. In, oh my god. She labored with a broken bag of water. During, while she was performing surgery? And finished her liver transplant surgery. Oh my god. So excellent example of how physicians, and not just physicians, physicians, stockbrokers, military people, lawyers, business people, financial people, are high tech people, are

• 22:14Speaker 01

  all trained that their success depends upon ignoring their bodies. And I'm going to argue that there are moments when you need to, like in the middle of the night when your infant is crying and you're, you know, you're tired and you might be getting sick. Well, it just doesn't matter because you have to get up and take care of the infant, right? So there are times when you're going to put your body's needs aside. But if you are disconnected, 100% disconnected from your body, you will fail at what you want to do. You will crash and burn and be miserable and get sick. You know, I often say that when the body first starts talking to you, it's knocking, right? It's like knocking on the door. And then if you're not listening, the body gives you a shove. And then if you're still not listening,

• 22:56Speaker 01

  it just whops you upside the head. A friend of mine, Nikki Silvestri, calls this a bitch slap from the universe. Right. Right? I've had a few of those. Yeah, so have I.

• 23:08Speaker 01

  That would be the pregnant Rachel with twins on bedrest.

• 23:11Rich Roll?

  Right.

• 23:12Speaker 01

  With premature labor.

• 23:13Rich Roll?

  It goes back to what we were saying before, this idea that you can opt out of these rhythms, right? You know, the way that we live is a constant incurring of a debt that we can't possibly repay. And to cultivate the awareness that if you do wake up in the middle of the night to tend to your infant, or you have to do, stay up really late to get a project done, or something like that, that's okay, that's life. But to understand, okay, I'm incurring some debt here, I'm gonna have to repay that debt later.

• 23:39Speaker 01

  Yeah.

• 23:39Rich Roll?

  If you consistently refuse to repay that debt by resting, or you know, other strategies to, you know, refuel and replenish your body, that that knock will turn into a bitch slap eventually. And you're gonna get sick, and you're gonna pay either way, one way or the other. And the interest on that debt accrues at a pretty high percentage.

• 23:58Speaker 01

  Right. I would agree with you.

• 24:00Rich Roll?

  So, I'm sorry, go ahead.

• 24:01Speaker 01

  And more so, the older you get.

• 24:03Rich Roll?

  Right. Yeah, yeah, yeah. You can't, yeah, you can't get away.

• 24:05Speaker 01

  Less leeway as you get older.

• 24:08Rich Roll?

  When you're 20, okay, you know, it's easier to, it's harder to catch the attention of young people with that, because it's like, oh, they can eat whatever they, you can, it seems like, you know, the repayment terms are so far off in the distance that maybe you can get away with it. But eventually, right?

• 24:26Speaker 01

  Right.

• 24:26Rich Roll?

  So in your own experience, your own professional experience, when did you kind of come into this awareness that there has to be a better way of practicing medicine? I mean, you set up shop, and you were practicing family medicine, right?

• 24:37Speaker 01

  Right.

• 24:37Rich Roll?

  And doing kind of like what everybody does.

• 24:39Speaker 01

  Yeah.

• 24:40Rich Roll?

  And I'm interested in your experience with that, and also, kind of giving people who are listening, a sense of, of, you know, the positives and the negatives of how the whole system is erected around healthcare.

• 24:53Speaker 01

  Yeah. So I did, you know, multi-specialty clinic, like most docs do, straight out. I had three small children at the time. I wasn't really ready to be in private practice. But I was always interested in the mind-body-spirit connection. I actually wrote my Stanford admission essay on that topic.

• 25:11Rich Roll?

  Did you?

• 25:12Speaker 01

  Yeah.

• 25:12Rich Roll?

  Oh, my God. Do you still have it?

• 25:13Speaker 01

  Yes.

• 25:14Rich Roll?

  What was it specifically?

• 25:16Speaker 01

  It was about wanting to be a healer, and that my father was a pastor, and I was a strong believer that the mind, the body, and the spirit are connected, and that was the work I wanted to do in the world.

• 25:26Rich Roll?

  Wow. So you had that awareness very young.

• 25:27Speaker 01

  Yeah.

• 25:28Rich Roll?

  Interesting.

• 25:29Speaker 01

  Yeah. So, you know, I wouldn't say I'm typical in that I went into the process. Knowing that I wasn't going to lose my soul, no matter what. And then I think getting married was helpful because I also had to prioritize that. You know, my marriage had to be more, even though my husband wanted me to have my career, really, with everything in him. It was really clear to me that we both needed my commitment to be to the marriage first. Marriage first, everything else second, right? Otherwise, it doesn't work. It's hard enough as it is, right? And then, anyway, so I was in practice. I had three small kids. And at some point, it just broke my heart. And here are the moments, the kinds of moments that made me decide I couldn't do it anymore.

• 26:15Speaker 01

  You know, a patient would come see me for a 15-minute visit. And she had had, you know, let's say pelvic pain or chronic vaginal infections. And I would be talking to her about, who's your partner? What's going on? Blah, blah, blah. And for the first time in her life, at 14 minutes in, tears would well up in her eyes. And she would start telling me about childhood sexual abuse. Or a guy who has a hard time talking about his feelings. And at minute 14, he would start talking about the abuse he's taking from his boss. And so I'm finally getting at the nugget of why this person is ill, of why they're having repetitive illnesses. And I can't address it because I don't have enough time. And because every time, and then I couldn't help myself, right?

• 27:00Speaker 01

  Like, did I walk out at 15 minutes? You know I didn't.

• 27:02Rich Roll?

  Right, so you're running over.

• 27:04Speaker 01

  I can't. So then I'm late, and then I'm behind, and then I'm working, you know, 13-hour days. And I'm, I am physically depleted. So at some point, I knew I needed to leave. I knew, I had already been training in integrative medicine for years, really. I knew enough to leave and do integrative medicine. But I was terrified because it's hard to make a living in private practice. And I started getting migraine headaches for the first time in my life. And being a good, you know, doctor, I went to physical therapy. I thought it was my neck. I saw an osteopath who was doing craniosacral work with me. And the osteopath actually had to say to me, well, tell me when you're getting these headaches. And I would say, well, it's interesting. I get them when I'm at work. Because at the time, I was only working two or three days a week.

• 27:49Speaker 01

  She was like, you only get them at work? And I had to think about it. And I was like, actually, yeah, that's so interesting. She said, Rachel, that's not just interesting.

• 27:58Speaker 01

  I want you to think about the fact that you only get them at work. And I realized that it was my body talking to me.

• 28:06Rich Roll?

  Right, right.

• 28:07Speaker 01

  And so I quit, but I had a six month, I had a contract to work six more months with that business, with that clinic, and I did, but as soon as I quit, the day I quit, I didn't get any more headaches.

• 28:18Rich Roll?

  Wow, that's amazing. Yeah, I think it's, you know, you talked about having that awareness early on about wanting to be a healer and being, you know, having, holding that intention. And I think that that is probably, probably, you know, not unique among people that go to medical school and want to be doctors. I mean, in my own experience with being a lawyer, you know, I knew lots of people going to law school with similar aspirations of wanting to be of service and going into the nonprofit sector, but the sheer kind of just experience of going through the gauntlet of law school and all of that, and then, and then interview, and then suddenly the law firms come and they're dangling big, you know, salaries and then you're like, well, maybe I'll do it for a couple of years.

• 29:03Rich Roll?

  I got these huge loans I gotta pay off, but like, I'm not gonna stay, you know, I'm just gonna do it for a little bit. And slowly but surely, like that, that aspiration, just, you know, the pilot light goes out and then there, there they are in the job that they never really thought that they would be in, that they didn't really want, that they didn't necessarily consciously choose. And then they start compensating for that by spending money they don't have.

• 29:28Speaker 01

  Right, exactly.

• 29:29Rich Roll?

  Like acting out in other ways. And then they're just like, well, I guess this is my life.

• 29:32Speaker 01

  No, I have debt, right.

• 29:32Rich Roll?

  So to be able to hold that vision and have the wherewithal, the courage to, to like hit the brakes on it when you're midway through it, that's the unusual part. Like, I think most people don't get to that place. And maybe the bitch slap or the, you know, the little wake up call is, you know, is a blessing in that regard. Like the, the migraines, you know, as painful as they were, were, you know, I'm sure you look back on that now and say, thank you for those.

• 29:57Speaker 01

  Yes, of course I do.

• 29:58Rich Roll?

  Right.

• 29:58Speaker 01

  Of course I do. And, you know, I would say that for me personally,

• 30:04Speaker 01

  In my, in making decisions in my life, and this is what I try to teach in BodyWise, how to use, how to use what your body is speaking to you. And that could be a sensation, or that could be a physical experience, it could be painful, or it could be pleasurable. But the way that that is actually trying to guide your decision making, because in a way, it's the expression of your unconscious. It's, it's your inner wisdom speaking to you. And if you learn to interpret that language, you know, I said before that I think that if you really want to be successful in your, you could be successful in your field ignoring your body. But if you want to be a leader, if you want to be a groundbreaker, if you want to be truly inspirational, you need to be connected to your body. Because from

• 30:45Speaker 01

  there, you get leadership qualities, you get insights, you get, you know, inspiration for the people around you as a manager, as a leader, as, you know, as a business person, whatever you do in your life. And I think that the body intelligence is like the secret weapon, I really do, in the best way, right? That allows you to both live a life that gives you joy and vitality, but also allows you to do work in the world in a much bigger way. And when you meet those people who are doing that work, you know, not the people with huge egos who are maybe successful, but you meet them and go, Lord have mercy, you know?

• 31:22Rich Roll?

  You know it when you walk into a room. You can tell when somebody's got it dialed in. Like, they have that, like, that self-awareness, you know, to understand who they are. And there's like a grounded power in that, that defies language. You just, you can sense it, right?

• 31:38Speaker 01

  Right.

• 31:38Rich Roll?

  And one of the things you talk about in the book is, is kind of starting, learning how to read these signals, like, understanding that words like gut instinct and what my heart is telling me actually have great meaning.

• 31:50Speaker 01

  It's real.

• 31:50Rich Roll?

  Yeah, that these are real things, that this isn't just woo-woo, new age, Santa Cruz speak, right? And I know that you wrote this book predominantly for women, but I feel like women already are halfway there, if not most of the way there, in terms of having that language or having that aptitude for listening to their bodies in a way that men really aren't. Like, men are much more shut down. Like, I almost feel like this is really as much a book for men, even though it's really voiced to women. It's, men are the ones who really need to hear this more.

• 32:23Speaker 01

  I agree.

• 32:24Rich Roll?

  And I think culturally, we're kind of pushed further away from that, and it's less okay, or less comfortable for a guy to talk about how he's feeling, or what his heart is telling him, than it is for a woman.

• 32:35Speaker 01

  I agree with you. And to be honest, I see men in my practice, and boys, and I see babies, and I see older people. It's a typical family practice. I see everybody. And I love my male patients. And I regret, actually, not writing this book for men and women. It was a conscious decision, because it gets complex trying to talk about the body and women's physical experience of being embodied in our culture, and around trauma, and around sexuality. It's a little easier to speak to women directly, but for sure, the concept, really important for men, absolutely basic. And I know, in the current political

• 33:15Speaker 01

  climate, and in the last year, there's been a lot of talk about men and women and patriarchal values, and, you know, what are we gonna do about this? There's been a bit more of a shakeup. And I think that it's important, in my opinion, to keep in mind that, yeah, it's true that being male gets you some privilege, but it also buys you this whole system of oppression of men, a big piece of which is shutting down your body, right? That being a machine for making money, being a machine for making a name for yourself, and all these other things, that really is about ignoring your body intelligence, and not listening to those voices within. And I think that our way out is for all of us

• 33:58Speaker 01

  to be doing that. And, you know, I talk about this explicitly in the book, but I feel like, once you're really actually connected to and listening to your body, and you get a sense of... You know, being in touch with your own nature, that it is a natural extension to realize how connected you are to other people and how connected you are to the earth. Because there really is no separation. It's a crazy idea that we're separate from the earth we live on, right? Everything we are comes from the earth and everything we're exposed to from a health point of view, all the toxins and the pesticides, the things people, you know, clean their houses with and, you know, the food we eat, all deeply connect to our bodies, right? The microbiome, the bacterial population of the earth that

• 34:43Speaker 01

  our food has grown in influences our own microbiome inside of our own guts, which is such a fundamental part of health. I don't know if you've talked about this on podcasts.

• 34:51Rich Roll?

  Yeah, of course. Do you know Robin Shetcan? Yeah, so I had her on. She's wonderful.

• 34:55Speaker 01

  Yeah, and you can't separate them. We are intimately, and everything we do to the earth, whether it's, you know, tearing down trees and, you know, creating a loss of oxygen and global warming, or it's the toxins that we're using, it all impacts us directly, directly. And if you look at the emerging illnesses, allergy, autoimmune, learning disorders, neurologic disease, cancer, it's all related to our environment. It really is.

• 35:25Rich Roll?

  Now you're just crazy talking.

• 35:26Speaker 01

  Now I'm crazy. Yeah, I'm good crazy.

• 35:37Rich Roll?

  All right. So, I mean, these things are, they're patently obvious to me. But I think it's, you know, it's a reach for a lot of people to start to really connect with these ideas. That being said, it's rare to encounter somebody who isn't anxious, somewhat depressed, experiencing chronic fatigue or adrenal fatigue, who isn't dealing with some kind of autoimmune disorder, or some kind of skin irritation, or, I mean, everybody seems to have some form of these disorders and they have an awareness of that. So there's like a fundamental kind of baseline BQ, to use your language about that. But I think extending that or expanding that awareness to get to the root cause and start to address, you

• 36:21Rich Roll?

  know, lifestyle decisions around what might be leading to that, is where a lot of people start to just say, just give me the pill, you know, or just tell me, you know, or what is the like, the one food that I need to cut out? Like, we, the scientific method requires that we You know, sort of isolate variables and account for cofactors. And that's how we advance our understanding of the world. But at the same time, it belies a greater understanding of the interplay of all of these things and the incredibly complicated matrix, you know, in which we navigate our lives. Right? So it's not one thing. It's not one supplement. It's not, you know, one pill. It's not any one thing ever. Right?

• 37:06Speaker 01

  No, never. And so when I see people in my office, and really what I've tried to do in Bodywise is create this rubric in which you can access, learn how to access your body intelligence, but then also give them a ton of information. Right? Because I would say that, you know, the fundamentals of health that I talk about, eating, sleeping, moving, loving, and having a sense of purpose are really fundamental. And there is no patient in my office.

• 37:30Rich Roll?

  And it's not rocket science.

• 37:31Speaker 01

  No, it's not. And nobody's going to disagree with me. Right? I mean, this is not new knowledge, but it is true. And if you look at somebody with heart disease, let's say, and you don't talk to them about their relationships, you're missing the boat because a lack of love or a lack of community doubles your risk of heart attacks, regardless of what statin you're on. You know, it's actually more important than whether they smoke. So I am always looking at those fundamentals. And then, you know, I do have to say, once we get ourselves into these pickles, right? I've just had this week, two new patients with chronic fatigue syndrome, which is very, it's a rough disease, really rough disease. And it's somebody who has had, you know, we call it the shopping cart effect, right?

• 38:16Speaker 01

  They had some trauma and then they had some exposures to some toxins and then they had some stress and then they ate bad and then they, you know, a whole cascading number of events that led them to that moment that their body began to not function normally. And chronic fatigue is about, I cannot intercellularly produce enough energy. Right? It's an actual, it's a mitochondrial disease in some ways, and it's a very complex disease. And All those things we just talked about, fundamental. If they don't sleep, nobody gets better. If they don't have love or relationships or affection in their lives, they also don't get better. What they eat, hugely important, hugely important, especially because these people tend to be overly

• 39:01Speaker 01

  sensitive. So these are the folks, I mean, I really like everybody to be on a varied diet. I'm not someone who wants to restrict everyone. You should never eat gluten and you should never eat soy and you should never eat mead. And you know, I'm not one of those doctors. I feel like there are some things that we all agree on, like processed food's not great. And you know, chemicals in your food is not great, you know, better to eat organic, lots of fruits and vegetables. But people have different needs nutritionally, I think. And then those needs change, you know, throughout our lifetime. So it really is about paying attention to what works individually. But there are some people, like with autoimmune disease or chronic fatigue or fibromyalgia, who I will look at food allergies and food sensitivities and pull some things out and it can make a huge difference.

• 39:45Speaker 01

  But it's complex. And so in Bodywise, I'm trying to provide also a bunch of the integrative medicine secrets.

• 39:52Rich Roll?

  Right.

• 39:53Speaker 01

  By which we heal these diseases.

• 39:54Rich Roll?

  Yeah. And I think what's great about the book is it's very plain spoken. You know, you sort of, you relate your own experience and you bring in these case studies from all these patients that you've had and share their stories. And you explain these things in a way that's very digestible for anybody. And then you leave people with very practical tools for helping them, you know, sort of diagnose themselves, take greater responsibility, and then some really sort of tactical approaches for addressing it in your own life. But ultimately, like the theme that I see, you know, beneath the whole thing is, you have to take responsibility for this for yourself, right? Like you say, diet, not, you know, it's different for everybody.

• 40:36Rich Roll?

  You have to use yourself as a crucible of experimentation to find out what works for you. And you cannot divest yourself of that responsibility into a third party to just tell you what to do.

• 40:46Speaker 01

  No.

• 40:47Rich Roll?

  Right?

• 40:47Speaker 01

  Yeah. And in fact, you know, I would argue, part of the reason our healthcare system doesn't work is because it encourages people to do just that. Really? I'm diabetic? Okay. I'm not going to stop eating fast food, for goodness sakes. Or I'm a baker, so I'm not going to stop eating, you know, muffins and pie and cake, but you're going to give me some drugs that'll help me do that, right?

• 41:07Rich Roll?

  Right.

• 41:07Speaker 01

  It's insane. Because the drugs may bring the blood sugar down, but they drive the diabetes. A lot of them actually make diabetes worse. So we've got this person who, you know, is basically making a contract with their doctor to progress their disease and not change their behavior.

• 41:24Rich Roll?

  So back to like the systemic ills of this system. We all hear stories about, you know, big pharma pushing drugs and kind of how that's embedded with the medical profession. You go to these conferences and you get taken out to nice dinners and here's the samples and here's the nice pens and the coffee cups that you can have in your office. Like, how much of that is conspiracy theory versus reality, like in your experience?

• 41:49Speaker 01

  It is not conspiracy theory. That's just factually true. And if you are someone who thinks that the drug in the pharmaceutical industry should be any different in their decision making than a chemical company or a financial company or somebody who makes screwdrivers, I disagree. It is a company bent on making money for their shareholders and they do not have morality in their compass. I don't care what they say, they do not have it. So if they can charge more and a bunch of people get sick, they don't care. So, I mean, I think we have to change the way we think about it. It's not that they're evil, they're a business. This is capitalism. And by the way, so is the supplement industry.

• 42:31Speaker 01

  So, just in case you think, because when you look at, you know, there are integrative medicine doctors and naturopaths and chiropractors and acupuncturists, and by the way, I work with all of those people, but there are some who are functioning still in a paradigm where, oh, I'm going to go to a conference put on by a supplement company, right? Which is not evil because they're a supplement company and they're going to tell me how to treat fibromyalgia, let's say. And they're going to give me an algorithm that tells me what supplement to give the patient to fix that disease. Okay? This is the same problem. This is the same problem. So if you're going home and now you're taking, and I take supplements, so don't get me wrong, I also would take a medication if I needed it.

• 43:14Speaker 01

  But if you're still depending on your natural practitioner to cure you by giving you things, it's the same intrinsic problem, right? The supplement industry is also not necessarily moral. There, it's a business.

• 43:29Rich Roll?

  And also without any regulation. So it could be even worse. I think, you know, there's a lot of good supplements out there, but there's also a lot of supplements that, you know, the consumer would not, you have no, there's no transparency in how a lot of these supplements, most of these supplements are, you know, the vast majority of them are manufactured, right? So you don't know the purity of them. You don't know the circumstances under which they were put together and packaged and all of that. And it's just, it's rife with a lot of problematic products out there.

• 44:02Speaker 01

  Yes. So back to our fundamentals. If you eat really well, you're not going to need as many supplements.

• 44:09Rich Roll?

  Eat a lot of fruit and veg, drink a lot of water, get sleep, move your body, try to be a good friend, have healthy relationships, be involved in your community, and live a life of purpose.

• 44:22Speaker 01

  Yes. And by the way, if you get sick anyway, and I'm also a big advocate of saying shit happens sometimes, okay? You know, when my meditating vegan yoga teacher patient got breast cancer, you know, we all think that if we have perfect beha-, oh, you know, we're all terrified of death, for one, and we think if we have perfect behavior, we can avoid what that other person got. Oh, they got it because they, they eat french fries, you know, or that person has cancer because, you know, they stayed in that terrible relationship. We like to pretend we're somehow immune, and there isn't one of us that's immune. So we all can get sick at any time. And when you do, then we need help, you know? And it's okay to use Western medicine. In fact, I highly recommend it in many circumstances.

• 45:06Speaker 01

  But you want to go in. Knowing your own body and knowing what works for you and what doesn't and being very clear about that. You want to be the captain of your ship, no matter who you're seeing. And also, you want to pay attention to your intuition about the practitioners that you see. So I see plenty of people who'll go, yeah, I just, I don't really like my doctor, but I've been seeing them for 20 years. And I go, why? Why? Why are you seeing that doctor? You should never see a doctor you dislike. That doesn't make any sense.

• 45:35Rich Roll?

  Right. So BQ, Body Quotient, is about trying to do that math of the relationship between the foods you're eating and the way that you're living your life, and however you're feeling, or whatever, you know, is manifesting in you physically, mentally, emotionally, et cetera. And, and in the book, you talk about the difference between sense, feel, and discernment. And then shit happens. So like, how do you parse these different things? Like, developing a sense versus, you know, what your body is feeling, and then having discernment around that, and then understanding when sometimes stuff just happens, and maybe it's not related to some lifestyle habit that you're perpetrating.

• 46:19Speaker 01

  Right. So, so the steps you just mentioned are how I teach people how to pay attention to their bodies. So the first one is actually measure. So I'm not throwing out the baby with the bathwater here. We like lab testing, okay? We like blood pressure. We like basic measurements of our health, and it matters. And I do all of that with my patients. In fact, I do it probably much more than a regular doctor, preventative medicine testing. And there's lots of advanced testing that's kind of sexy and interesting.

• 46:47Rich Roll?

  So give me an example, like a taste of what some of those tests are.

• 46:50Speaker 01

  So, for example, my chronic fatigue patients that came in this week. And, and one of them, I think is going to get better very quickly, because I did some advanced nutritional testing on her. I did urinary amino acids. I looked at heavy metals. She's got extremely poor detoxification. Her liver detox, her glutathione, that's an all in integrative medicine nutrition test. I also did some genetic testing and she's got a bunch of SNPs. Now, SNPs are, this is not a genetic defect, like the gene itself doesn't work, but it does mean that the enzyme that it codes for, the protein that it codes for, is a little slow. It's sluggish. It doesn't work as well as the regular one. And she had a bunch of abnormal

• 47:32Speaker 01

  SNPs in her detoxification and methylation system.

• 47:36Rich Roll?

  So, in other words, like that genetic disposition is not expressing itself the way that it's meant to?

• 47:44Speaker 01

  Correct. So, and, I mean, the really good news here, and I'm not someone who thinks everybody needs to go out and do 23andMe necessarily. In fact, I would highly recommend you think very carefully about that because a lot of people are so paranoid and obsessive about their health that a test like that is dangerous for them. It's dangerous for their mental health. It's better not to know.

• 48:06Rich Roll?

  Well, it can lull you into this idea that you're just predetermined to suffer from X, Y, or Z, right? And that you can't do anything about it.

• 48:14Speaker 01

  And we know that our thoughts are powerful, right?

• 48:17Rich Roll?

  And there's that adage like genetics load the gun, but how you're living your life is what pulls the trigger or not, right?

• 48:24Speaker 01

  Yeah, genetics is like 5 to 10% at most, in terms of predicting disease. 5 to 10%. The rest of it's all lifestyle. A piece of this that I thought was super interesting is that it's true that the other 90 to 95% is lifestyle, but a good 25% is your experience in the womb.

• 48:45Rich Roll?

  How much? Wait.

• 48:47Speaker 01

  25%.

• 48:48Rich Roll?

  25%?

• 48:49Speaker 01

  25%.

• 48:50Rich Roll?

  All right, so unpack that a little bit.

• 48:53Speaker 01

  So, imagine that you're a developing embryo. And you know, everything's sort of coming together and the brain is being formed, for example, and all the structures of the brain. When that baby's born, many parts of that infant's physiology are complete, right? So yeah, everything's going to get a little bigger and some things like the brain, it's certainly going to develop as they get older. But let's just say that that mama who was pregnant with that baby was a refugee from Syria and was barely getting out and you know, the boat she was on collapsed, but she made it to shore and she shortly gave birth in a refugee camp.

• 49:34Speaker 01

  This is happening right now. Then the impact on that infant is that that infant got bathed in cortisol in utero, that infant got bathed in adrenaline in utero, and that actually increased the growth of the stress aspect of the brain that controls adrenal function permanently. So you, and this is sort of the field of epigenetics, or how our environment controls the genetics that we express. So you know, we used to think one gene, one protein, one enzyme, right? And it's just not true. There are often duplicate genes, you know, we've got 10 different ways to code for this particular protein and the

• 50:17Speaker 01

  one we pick depends on our environment. And then that happens to be passed down. So it may be that this baby, you know, of this refugee woman is now far more likely to be an anxious person, and they are, but that baby's baby and that baby's grandchild are more likely to be anxious.

• 50:39Rich Roll?

  That's amazing.

• 50:41Speaker 01

  It's generational.

• 50:42Rich Roll?

  Yeah, and it's, it's, it's coded in the experience of the mother less than in the actual sort of sequence of DNA, right?

• 50:51Speaker 01

  Right.

• 50:52Rich Roll?

  And then you have this other thing in the book about

• 50:55Rich Roll?

  Testing the embryonic fluid and, and the amount of like toxins and chemicals that are typically found in

• 51:02Speaker 01

  Yeah, it's

• 51:03Rich Roll?

  In that, like, it's just

• 51:04Speaker 01

  It's terrifying.

• 51:05Rich Roll?

  Crazy, right?

• 51:05Speaker 01

  It's terrifying. So we have added, I think it's 80,000 new chemicals to our environment since 1950. And only, people don't understand that you can make up chemical, you can make a chemical in the lab, find a purpose for it in industry, and have no testing on it whatsoever for safety. Especially, and if it's going to be, let's say, in a shampoo, or a lotion, or it's going to be in a human product, then it will get a little more testing, but not that much. It won't be tested in humans necessarily. Only if it's a medication, does it get really stiff testing. And we, the United States, think it's very smart to put things on the

• 51:49Speaker 01

  market and see what happens. You know, unlike, right?

• 51:53Rich Roll?

  Yeah.

• 51:54Speaker 01

  Unlike Europe, that says, "Look, if it's not proven to be safe, we're not going to put it on the market." What an intelligent way to approach life, right? In many countries, not just Europe. But no, we don't have that. We don't have that. We just put it on the market and see what happens. Like, one of the advanced tests that I do when I'm looking at detoxification, is I look for the gasoline additive MTBE. Do you remember that?

• 52:16Rich Roll?

  Mm-hmm.

• 52:16Speaker 01

  It's in gasoline

• 52:17Rich Roll?

  Yeah.

• 52:17Speaker 01

  For years, right? We didn't test that to see what it did. Or we tested a little bit, but not a lot. And it was in gasoline. It wasn't a human product, so it doesn't affect humans, right? We're idiots, right? Of course it affects humans. We're pumping the gas, it's in the air, it's on the ground, it's leaching into the groundwater. It causes defects in animals, and it affects humans. And it's in our groundwater supply, permanently, because it doesn't break down well.

• 52:42Rich Roll?

  Yeah.

• 52:43Speaker 01

  And so I'm looking at it in, in humans, I'm measuring it as a measure of, how well are you containing this toxin? That you're exposed to. And I can tell you, my chronic fatigue patient with the poor detoxification and the poor genetics for detoxification had really high levels of MTBE.

• 53:01Rich Roll?

  That's crazy. And when you think about all of those, all of those, those chemicals and those toxins that are found in the amniotic fluid or the embryonic fluid.

• 53:10Speaker 01

  Yep.

• 53:11Rich Roll?

  You know, how do you even begin to try to figure out what's doing what when there's so many of them?

• 53:16Speaker 01

  Right. And, and, and this is really what makes me crazy because we test each one for its toxicity by itself. Right? We don't think about how it actually occurs in nature, which is the thousands of toxins that that infant is exposed to before it's even born. And it's the thousands of toxins together, plus, you know, our Syrian refugee stress level, plus, you know, the, the lack of food she had during her pregnancy, or the poor quality of the food, or the lack of protein that influences that child's ultimate disease state. It's all of those things. It's not one thing.

• 53:54Rich Roll?

  It's amazing. We're not all just crazy sick all the time.

• 53:58Speaker 01

  Right.

• 53:58Rich Roll?

  I mean, I'm getting depressed.

• 54:00Speaker 01

  Well, okay. So let's be optimistic for a moment. So here's the really good news. You and I are not. We're not depressed and nor are we sick. Right? And that's because humans are unbelievably resilient. Unbelievably resilient. I always say, I'm so lucky as a doctor because I treat humans. Right? Because people who come to see me, they're very likely to get better. And it may have nothing to do with me. In fact, it probably has nothing to do with me. But I look good. Right? Makes me look good because the human body likes to heal. It likes to return to balance. Right? And I'm just like tweaking it a little bit here and a little bit there. But if I just create the right nest for that human body, the right environment, people heal beautifully. And I guarantee you, this patient I saw with

• 54:43Speaker 01

  chronic fatigue this week, because we identified what her particular vulnerabilities were, and by the way, her adrenals are shot and she's stressed out too and can't sleep. And, and as soon as we cover that territory, and I think we're close to it, she's going to get better. She's better this time than when I saw her two weeks ago.

• 55:00Rich Roll?

  Yeah, that's like a modern, Western approach to what is essentially Ayurveda, right? Like the idea of bringing the body's systems into balance so that the body can heal itself.

• 55:12Speaker 01

  Right. It's an ancient concept. But this concept isn't in Western medicine, and that's why we're talking about it. So it's in Chinese medicine, it's in Ayurvedic medicine, it's in the native healing cultures of almost every culture in the world, you know, as is this concept of Qi or prana or vital energy, whatever you want to call it. You know, it's in the Bible, it's in ancient Hebrew. You know, this concept that we have vital energy and that our body needs to come into balance, Greek, you know, medicine, Hippocrates, same thing.

• 55:45Rich Roll?

  It goes way back.

• 55:46Speaker 01

  It's only Western medicine that divorces, you know, your wellness, I mean, from your body to some degree. It's sort of crazy. It's not sort of crazy. It's completely crazy.

• 55:55Rich Roll?

  Yeah, socially, you're maligned for even talking about these sorts of things. And as somebody who has this amazing pedigree, you know, Stanford educated, UCSF, for you to then go and get your masters in holistic medicine from Berkeley, I mean, what did your peers make of this? Like, did you have to suffer some repercussions in, you know, socially as a result of kind of stepping out and trying to, you know, switch the lens on which you deal with health and disease?

• 56:25Speaker 01

  Well, I would say that a really hugely important thing to me was to find my tribe. So even if my tribe wasn't around me when I was practicing, even when I was still in that regular doctor job, I was going to integrative and holistic medical conferences. And I would go, ah, and I'd relax.

• 56:42Rich Roll?

  These are my people.

• 56:43Speaker 01

  These are my people, right? They don't think I'm crazy. They think I'm awesome. So, I mean, I think surrounding yourself with people who really support, you know, the best part of who you are is a big deal. And then there's something about, you know, I used to talk with people about, being at UCSF, a very competitive medical school, super smart people there, about what it was like to be a female, like when I was on that liver transplant service. It was with all men, I believe, except for that one female attending. And there is also just some-

• 57:13Rich Roll?

  The one who had the baby during surgery.

• 57:15Speaker 01

  Yeah, the baby during surgery. But there is also something about just not being cowed by it, you know, being, being-

• 57:25Speaker 01

  Quite confident that I'm not crazy, you know? And that loving people and being heartfelt and listening to people and, you know, believing that my patients know how to heal themselves and that really it's just my job to help them find it, you know? It's empowering and only that, it's successful. It works. Makes me look good.

• 57:45Rich Roll?

  Yeah, that's the thing. It works, right? I think it's a really great time because this is happening right now. This, in my opinion, this is the future of medicine.

• 57:53Speaker 01

  Yeah.

• 57:54Rich Roll?

  And, and I think consumers, citizens are increasingly, you know, turning to the kind of services that you provide because they're realizing like the other way is not working.

• 58:04Speaker 01

  Yeah.

• 58:05Rich Roll?

  They look around, like, all you have to do is travel a little bit. You can see how unhealthy people are everywhere you go. And it's, it's, it doesn't take that much of a leap of faith to think there's gotta be a better way.

• 58:15Speaker 01

  Yeah. Yeah. And, you know, miracles happen. I mean, this is the, this is the happy part of what I do, right? So I was telling you about you, my, telling you about my chronic fatigue patient. I had another patient about three weeks ago, three, four weeks ago, who came to see me with fairly severe rheumatoid arthritis. That's a terrible condition, absolutely debilitating and exhausting. A lot of people know about the pain, the joint pain, but they don't know that they also get just knocked out, both by the pain and the disease itself is exhausting. And, you know, I worked with her on diet. So she's someone, people who have allergy and autoimmune disease, the immune system is confused. It's attacking the wrong thing, right?

• 58:57Speaker 01

  It's either attacking something in the environment, allergies, that isn't actually dangerous, or it's attacking the body itself, autoimmune disease. It's a, it's a whoopsie of the immune system. But in this case, it's attacking the joints. And one thing we know about the immune system is it has specificity. So it'll attack the joints, but not attack, you know, the tendons or, you know, it'll attack in someone who's allergic, dust mites, but won't necessarily respond, you know, to all the pollens. So it's selective, but it's also has a general volume control. And if I take a patient, I mean, I had a, it was a little bit of a divergent topic, but I had a young man in my practice who was a competitive baseball player at, at a university, and he had horrific seasonal allergies.

• 59:40Speaker 01

  He's allergic to all grasses, all pollens, all trees. I mean, poor thing, totally miserable because he's out on the baseball field with the wind blowing and, you know? And he had acne on his back and on his face, attractive young man, but couldn't get rid of it. Got a lot of antibiotics for his acne. And when I saw him, I knew that what he eats and what and if he responds in an immune way inappropriately to what he eats, it adds to the burden. Right? So I did food allergy and food sensitivity testing on him and he was allergic to dairy, but he was sensitive, so not allergic, but producing immune response, IgG response against also gluten and eggs.

• 1:00:24Rich Roll?

  I knew you were gonna say that. Yeah.

• 1:00:26Speaker 01

  Right?

• 1:00:26Rich Roll?

  Yeah.

• 1:00:26Speaker 01

  So this poor guy eating at the dorms, but he said, yeah, I'll try it. So he went off amazingly dairy, gluten and eggs. And I saw him three weeks later, he had no acne, he had no congestion and he said, I haven't felt this good since I was five years old. Right?

• 1:00:42Rich Roll?

  That's amazing.

• 1:00:43Speaker 01

  So this is the power of integrative medicine because and so for my rheumatoid arthritis patient, one of the big things we did is we actually put her on, we tested her for food allergy and food sensitivity and we reduced her diet and we put her on great natural anti-inflammatories, green tea, fish oil, turmeric, boswellia, which is frankincense, like the baby Jesus got. And within a month, she went from five medications, okay? And rheumatoid arthritis medications are dangerous. They're like, they are chemotherapy drugs, right? So she was on methotrexate, she was on another nasty rheumatoid arthritis drug, she was on prednisone, which causes diabetes and muscle loss and makes you a crazy person and manic and unable to sleep.

• 1:01:28Speaker 01

  And she was on a non-steroidal anti-inflammatory and we got her off three of her medications, got her off prednisone and we got her off the two more serious autoimmune medications. And now she's still on, she takes, sometimes she takes a non-steroidal and she was on, continues on one of the lower level rheumatoid arthritis drugs, but she's otherwise controlled and it has everything to do with how she eats.

• 1:01:51Rich Roll?

  Hmm.

• 1:01:51Speaker 01

  Simple.

• 1:01:52Rich Roll?

  Amazing.

• 1:01:52Speaker 01

  Right?

• 1:01:53Rich Roll?

  Yeah.

• 1:02:02Rich Roll?

  So when you talk about chronic body depletion, I would imagine that sort of circle falls well within a larger circle on the Venn diagram of like chronic inflammation, right? Like the toxins we're exposed to, terrible foods that we're eating, the lack of sleep, the amount of stress in our jobs, and maybe dysfunctional relationships. All of these contribute to a state of chronic inflammation. And we're realizing now the relationship between chronic inflammation and all of these chronic lifestyle illnesses, right? So how much of what you do is oriented around reducing that inflammation? And maybe you could talk a little bit about how our immune system functions and what inflammation

• 1:02:46Rich Roll?

  really is, and what it means to reduce that inflammation, whether it's through lifestyle habits or anti-inflammatory foods and supplements.

• 1:02:54Speaker 01

  And I think it's important to put this in the context of where we started, which is our physiology is almost 10,000 years old, okay? So our human body is created for a world where there's a lot of bacteria, there's a lot of parasites, there's a lot of injuries and exposures, and we need a really kind of superpowered Amazon immune system to keep us healthy and well. And a huge part of that immune system, I mean, it's, right now it's flu season in California, and it's really pretty rampant. And when I see my patients with the flu, they come in and their noses are all red, you know, because their nose is running, the inside of their nose is swollen, they're coughing because the inside of their lungs is swollen, right?

• 1:03:39Speaker 01

  So those are inflammatory reactions, but they're appropriate inflammatory reactions because the body's trying to fight off a virus. And the body fights off a virus by identifying it, and then by the white blood cells basically dropping hydrogen peroxide or other toxic substances on that area. And it does in fact kill the virus. That's why the flu doesn't kill us, and colds generally don't kill us, and the human body's amazing. But when we dump those oxidative products, oxidative is almost like a chemical fire, that we create inflammation. So that's redness and swelling. And that redness and swelling would go on and on and on, except for that we have antioxidants, which has kind of come

• 1:04:22Speaker 01

  to put out the fire, that stop that reaction from going. Because when we dump those toxins, we don't just kill the virus, we kill the cells around the virus too. Right? We kill our own cells, which is okay, because we can make more. But in any case, that's a good example of there's tremendous inflammation in the nose and the lungs, but that's the person's immune system actually clearing that illness.

• 1:04:43Rich Roll?

  Right. It's healthy and it's treating in acute situations.

• 1:04:47Speaker 01

  And it's necessary. Right? Without it, it's like our, you know, our patients on chemotherapy or with HIV who have severely depleted immune systems, the smallest thing, fatal. Right? And keeping in mind, again, you know, we were created for a world in which the exposure to those challenges to our health and wellbeing, far more than we have currently.

• 1:05:09Rich Roll?

  Right.

• 1:05:10Speaker 01

  So we've got this really wicked, smart immune system. And then we've got this world that's very confusing. These chemicals we've never seen before that we might react to. We're, we've, back to the gut flora, right? So, so we started out, if we look even now, we look at tribes in the Amazon, or we look at the tribes in Africa that are still living in a fairly natural way. They have gut flora, far more bacteria in their gut, far more diversity of bacteria in their gut. You can have 800 species of bacteria in your gut. Right? But with the onset of antibiotics and also lifestyle, so what we eat, the chemicals in what we eat, and also the lack of fiber in what we eat, we have steadily depleted

• 1:05:54Speaker 01

  our microbiome, our bacteria in our gut, over the last, you know, 70 years.

• 1:06:00Rich Roll?

  And the antibiotics in the food that we're eating.

• 1:06:02Speaker 01

  And the antibiotics in the food we're eating. Exactly. Not to get depressing again, but it's pretty awful. So yeah, so and then that decreased gut flora means that the immune system, in addition to not having the usual, you know, parasites and bacteria to fight off, it doesn't even have normal bacteria in the gut to deal with, right?

• 1:06:25Rich Roll?

  Right.

• 1:06:25Speaker 01

  And the bacteria in your gut may be healthy and normal for you, but if it were to escape the gut into the rest of your body, you would die, right?

• 1:06:33Rich Roll?

  Right.

• 1:06:33Speaker 01

  So the immune system is carefully monitoring that. But when, and in a situation like rheumatoid arthritis, where the body thinks the joints are the problem, they think the joints are trying to kill you, right? They think it's the infection. Now we're creating inflammation inappropriately and having the wrong gut bacteria make that more likely because the immune system isn't properly trained. It's a very flexible and reactive organism, the immune system. And in the wrong environment, too many toxins, inappropriate gut flora or infections, not enough exposure to bacteria. So there's also all these really interesting studies on the clean environment and how kids without, kids who live on farms and with pets and with animals and they're in

• 1:07:18Speaker 01

  the dirt, far less likely to get allergies.

• 1:07:20Rich Roll?

  Right.

• 1:07:21Speaker 01

  Kids in the clean environment with the Lysol cabinets, far more likely to have serious allergies.

• 1:07:26Rich Roll?

  Yeah, the backlash from that is unbelievable from, you know, a generation of Purell to, you know, to a situation now where, you know, I mean, when we were kids, nobody had a peanut allergy, allergy, and now you can't, you can't, you can't have peanuts on an airplane or, you know, it's like not allowed in schools and all of these conditions that just seem absolutely foreign when we were young people.

• 1:07:48Speaker 01

  Yeah.

• 1:07:49Rich Roll?

  Are epidemics.

• 1:07:50Speaker 01

  They are, and they're epidemics because of what we're doing to our planet and our food supply. It's, it's as simple as that.

• 1:07:56Rich Roll?

  We're getting depressed.

• 1:07:57Speaker 01

  Okay, so we're gonna stop that right now. So I mean, the other thing I want to say, and we started this by talking about inflammation.

• 1:08:03Rich Roll?

  Right. So the relationship between like sort of the chronic inflammation that we're getting from the terrible foods that we're eating, the lifestyles that we're, that we're living, and the impact of that on these chronic ailments that really are the, the epidemics of our, of our age.

• 1:08:18Speaker 01

  Yeah. And, you know, heart disease is an inflammatory condition, cancer is an inflammatory condition, stroke is an inflammatory condition. I mean, we could go on and on and on here. But here's the good news. Here's the really good news. Like my patient with rheumatoid arthritis, we all, if we have chronic inflammation, it is fixable. The body is resilient. It's amazing the kind of improvement we can have with simple things, you know, shifting how you eat just a little bit. Doesn't, and I don't think it has to be extreme. I think most people think what you and I are talking about is impossible because it's just too hard. And little things, little changes can make a huge difference.

• 1:08:55Rich Roll?

  Right. So it's back to BQ again, right? You have this beautiful example in the book from one of your patients who comes in and is talking about these crazy dreams that she's having. A snake attacking her neck. Can you talk about that a little bit?

• 1:09:12Speaker 01

  Sure. So this is-

• 1:09:12Rich Roll?

  That gets a little woo woo, but I think the point is really powerful.

• 1:09:16Speaker 01

  It is and it isn't. So if we didn't live in a culture that thought that sometimes the body communicates in images or in dreams, you know, we wouldn't be thought to be crazy. But the unconscious communicates that way. So, so this is a patient of mine who I saw as a young woman in her twenties, and she came to see me because she was sure something was wrong with her. And she was a young mom. She had a little toddler, like a 15 month old at the time. And she really, really, really loved children. She was one of these young women who really wanted to have a giant family and was so invested in, you know, had to go organic garden and, you know, such a beautiful human. And she said, I'm terrified I'm never going to be able to have another baby.

• 1:10:00Speaker 01

  And I'm thinking, she's 23. She can have another baby, right? Like, that's a little bit crazy. And then she says, you know, I've been a little bit tired and I'm a little embarrassed to tell you this, but I had this dream and I just can't shake it, that this snake came up and it bit me in my back. And it bit me in my neck and in my brain. And I don't know what to think about it.

• 1:10:26Rich Roll?

  Now, this is the point where a normal doctor would pat her on the head and say, that's nice.

• 1:10:32Speaker 01

  Right.

• 1:10:32Rich Roll?

  But your blood work's fine.

• 1:10:34Speaker 01

  Right. Well, if her blood work were fine, so but I went.

• 1:10:39Rich Roll?

  Your blood pressure, you know, I put the stethoscope up here, it's okay.

• 1:10:42Speaker 01

  And you're 23, so relax.

• 1:10:43Rich Roll?

  Yeah, don't worry about it.

• 1:10:44Speaker 01

  Right? And I was hoping that that was going to be the case, to be perfectly honest. And I was, I always pay attention because people tell you the darnedest things, you know, and it's not just that I'm an integrative doctor. Any, any doctor who listens will hear all kinds of amazing things from their patients. This is not actually an unusual story. So because she was tired, I did some blood work. Her thyroid wasn't normal, thyroid function wasn't normal. And then I did some more blood work and her sodium and potassium were off and it looked like there's some issue. Ultimately, we did a workup center to endocrinology. She had adrenal dysfunction and she unfortunately has multiple endocrine

• 1:11:24Speaker 01

  neoplasia, which is a syndrome of tumors in all the endocrine organs. And one of them was in the back in the adrenal gland, and one of them was in the thyroid, and one of them was in the pituitary gland in the head. So her dream was right. It's just snake had bitten her in all those places. And I mean, the, the good news about this, the sad part about the story is that she wasn't ever able to have another baby because of her hormonal condition and needing to treat it and remove tumors and sometimes endocrine organs. But she will live a healthy, full life. And it got diagnosed in her father as well, because it's a genetic syndrome in families and it saved his life. And then she opened a preschool.

• 1:12:07Rich Roll?

  Oh, that's nice.

• 1:12:09Speaker 01

  Yeah. And I don't even.

• 1:12:10Rich Roll?

  But that's, I mean, that is amazing. That, that, that, that sort of body intuition.

• 1:12:15Speaker 01

  Yeah.

• 1:12:16Rich Roll?

  You know, it was telling her, like her, her unconscious mind was trying to signal her to, to get her to pay attention to something.

• 1:12:23Speaker 01

  Yeah.

• 1:12:24Rich Roll?

  And you had the wherewithal to actually investigate that.

• 1:12:27Speaker 01

  Yeah. Well, you know, again, I think that. You have to listen to if you're if you're a provider, a health provider of any kind. Your number one tool is the patient in front of you, you know, the stories you hear. And any good clinician will will say that, not just me, regular, straight up. In fact, this is classic medicine. These are the people I was trained by when I, you know, I trained 25, 30 years ago. And the classic physicians who were 50 and 60 at that time. This is how they practiced medicine because they didn't have an MRI and they didn't have an ultrasound.

• 1:13:01Rich Roll?

  They had to listen.

• 1:13:02Speaker 01

  They had to listen and they had to have excellent observational skills about the person in front of them. And that's how they found their diagnoses. And that all really matters, you know? The patient will tell you what the problem is generally, if you listen carefully.

• 1:13:17Rich Roll?

  But ultimately, the road to wellness is paved with willingness on behalf of the patient, right? If they're coming to you and you're doing this really comprehensive evaluation that is going to then impact, you know, what they're going to eat, how they're going to sleep, how they're going to interact with people professionally and personally, what they're gonna, the supplements they're going to be taking, the herbs, the, you know, going to a chiropractor, acupuncture, yoga, meditation, like, it's a lot, right?

• 1:13:44Speaker 01

  It can be.

• 1:13:45Rich Roll?

  So, so do you have strategies to try to help people step into like a level of ownership of that where they're actually willing to do the work? Because if they don't, they can take all that information, but if they don't implement it, nothing is going to change, right?

• 1:14:01Speaker 01

  Right, so I'm thinking about, you know, four or five people in my practice who are overweight with high blood, this is a classic patient, right? Overweight, high blood pressure, a high cholesterol and a little bit of pre-diabetes. Typical American, actually.

• 1:14:14Rich Roll?

  Right, yeah, I was like, that's a lot.

• 1:14:15Speaker 01

  Typical American. And, you know, men and women, both. And I've got a number of them who are of that ilk, like, really? You know, you want me to walk every day? And what I do with, with, when those are the, when that's the patient showing up in my office, we have a discussion about it and I go, well, we have options here. You're in charge, you know, we can. I promise you, if you change the way you eat and if you exercise and we do a little stress reduction, we can reverse probably all of these. Probably. I can't guarantee it, but probably. But that's up to you. And if you're not ready for that, then we're going to treat them. And I give them medications. And I say, but here's the deal. As soon as

• 1:14:58Speaker 01

  you can actually do, I keep on it. Right? So I had a patient who, I was trying to get her to exercise and she just couldn't, wouldn't, couldn't figure out how to make it happen and couldn't get out of the, you know, couldn't wrap her head around it. And then her sister had a heart attack. And then she came back in to see me.

• 1:15:17Rich Roll?

  Right.

• 1:15:18Speaker 01

  And said, okay, now I'm worried. And I said, good. I'm not worried. Cause I'm worried.

• 1:15:23Rich Roll?

  Well, everybody has their, their line in the sand.

• 1:15:25Speaker 01

  Right.

• 1:15:26Rich Roll?

  And that's different for everybody.

• 1:15:27Speaker 01

  And we start small. I was like, okay, can you, can I walk to the mailbox? She lives in the country, so the mailbox is maybe a half a mile from her house. Can you walk to the mailbox once, you know, three times a week? So we start small. And, and I mean, the other, here's the other thing I love about the human body and what makes my job not that difficult, is that there's this positive feedback loop. Exercise is a good example. You do a little bit of something and it's hard in the first couple of weeks. Most things are. Most changes are hard for the first couple of weeks. And then the body gets on board. Right? So she comes back to see me and she goes, Dr. Rachel, I just, now I walk out the door, my body wants to go. She wasn't, she doesn't even want to come home. She just wants to go. In fact, I got my girlfriend and we're walking in

• 1:16:09Speaker 01

  the afternoon too. You know, so I mean, there is a positive feedback loop with eating well. Right? You, you put somebody on, like they're having a hard time. So maybe you do an eating program, like a cleanse. They come off that cleanse and they go eat at McDonald's. They feel terrible. They feel terrible. Or the person who's been off sugar for three weeks and now they eat it again. They feel the impact of what they're doing. So there is this, you know, this, this helpfulness we get. It's like the wellness elevator. You do a little bit and that feels really good. And then it's easier to keep doing it. Cause gosh, you feel better. And then you do a little bit more. And that's how most of us make changes. You know, we don't do it all at once.

• 1:16:48Rich Roll?

  Yeah.

• 1:16:49Speaker 01

  We pick one thing.

• 1:16:50Rich Roll?

  Yeah, I think there's this myth, the myth of perfection and the myth of the overnight permanent change that's just not rooted in reality. And I think you're right about the positive feedback loop. And I think, you know, positive action gets more positive action. That begins to spill into the other areas of your life. And I think it's about community support and accountability. And I would imagine in your practice, there's a lot of, there's much more engagement and follow-up than you typically might have in a traditional doctor's office where you're just on your own and come back in six months as opposed to checking in and, you know, giving people that level of sort of accountability so you can help them stay on track.

• 1:17:30Speaker 01

  Right. And, you know, nobody leaves my office without a little guidance list.

• 1:17:35Rich Roll?

  Right.

• 1:17:36Speaker 01

  Right? Here's the number one thing, here's the first thing you're gonna do. And then here's the second thing that we've agreed on, right? And I don't put anything on that list that the patient isn't invested in, right? Because otherwise change is unlikely.

• 1:17:47Rich Roll?

  Right.

• 1:17:48Speaker 01

  But I mean, I've seen miracles. I've seen miracles, you know? I've seen people reverse high blood pressure, diabetes, high cholesterol, and in fairly short order sometimes, when they're really on board and ready, when they're ready to make those changes.

• 1:18:03Rich Roll?

  And understanding that there's no one size fits all, and there's so many protocols, like, you know, we touched on peripherally, you know, acupuncture, chiropractor, you know, supplements, herbs, sleep, exercise, diet. Like, we can't canvass all of this, but for somebody who's listening, who's like, okay, I'm ready, like, I need to really start looking at this a little bit more diligently than I have, like, what are some, what are like the big gaping, you know, kind of areas where you could give somebody some initial, like, marching orders to begin to look at this stuff and make some changes?

• 1:18:39Speaker 01

  Yeah. Well, actually, I mean, at the end of the book, I have a 28-day plan on purpose for that reason, right? Like, if you were gonna pick like a couple of things in each category of fundamental health to do, that's what that plan is all about. And, you know, the other thing about it is, that plan is supposed to be guided by your body intelligence. So when I've done it with people, some of them feel terrible because they didn't keep up their, you know, whatever, their sleep regimen or their exercise. And I'm like, you know, it's not really about that. It's about listening to yourself, you know? One of them said, oh, but I got sick, so I couldn't do my exercise. I feel so bad. I was like, why would you feel bad about that? You got sick, you listened to your body, you rested. Good job, right? That's what it's about. This is not about, I'm gonna do because she said so. It's the perfectionism

• 1:19:22Speaker 01

  thing, right? I'm not gonna do this because the doctor said so. And if I don't do it, I'm a bad person. You know, this is about being in touch with your own needs. So I would say in terms of eating, everybody can agree on fruits and vegetables. And honestly, sometimes all I can get people to do is eat some more vegetables. But eating more vegetables makes a huge difference. It feeds the gut flora, they get more antioxidants, they get more vitamins. And you know, the vitamins we get in food are way better than the vitamins we get in pills.

• 1:19:50Rich Roll?

  And that becomes, I think that's another positive feedback loop, because the more you do that, then the more you're gonna want to eat healthy. And I like that it's focused on including something more of something as opposed to most dietary protocols are focused on what you're not gonna eat, right? Why don't we just focus on eating more of the good stuff? And start there?

• 1:20:10Speaker 01

  Yeah, I agree with you. And I think that it's more important that you eat more fruits and vegetables than that you cut out. I mean, Lord have mercy, you know, there are so many restricted diets right now on the market. And I just had a patient in my office who's vegetarian, and she's on a diet for small intestinal bowel overgrowth, the FODMAP diet. Maybe you're familiar with that. Anyway, it's a gut healing diet. But between her vegetarianism and that diet, she eats almost, she's nothing. And I looked through her nutritional profile, it's terrible. It's absolutely terrible. I'd rather she eat-

• 1:20:43Rich Roll?

  Right, like a processed food vegetarian diet?

• 1:20:45Speaker 01

  You know, it's crazy. It's crazy. So I do think that it's possible to restrict your diet too much, and that it's dangerous. You know, ideally, we eat a varied diet. So more fruits and vegetables is where I'd start.

• 1:20:56Rich Roll?

  Like the Michael Pollan, how does it go again?

• 1:21:02Speaker 01

  Eat food.

• 1:21:03Rich Roll?

  Eat food, not too much, mostly plants.

• 1:21:05Speaker 01

  Mostly vegetables.

• 1:21:06Rich Roll?

  Basically, right. Alright, so diet aside, what are some of the other, like,

• 1:21:13Rich Roll?

  You know, most people have some deficiency or other, whether it's B or D or magnesium. Like, those are things I think people could- Those be the three most common. Yeah, that people need to look at. And what are some of the more, like, the herbs that you find yourself prescribing most frequently?

• 1:21:33Speaker 01

  Great question. So, I would say getting tested for vitamin D deficiency is really important because weirdly, 80% of the country is deficient in vitamin D. It's a big deal. Also, especially if you're vegan, because your sources of vitamin D are a little more limited. And supplementing vitamin D is really easy. And when your vitamin D is low, you have double the risk of autoimmune disease and double the risk of cancer. It has a huge impact, so worth doing. I actually think the story of vitamin D is not just a story of not enough sunshine and therefore not making enough in your skin. I think it's also a story of inflammation. So, vitamin D is one of the anti-inflammatory vitamins. It actually caps a TNF-alpha in the cell, which is the most inflammatory cytokine. And I think we consume it.

• 1:22:17Speaker 01

  So, I think that many of us get enough and we produce enough, but our body needs more because of the inflammatory condition that we're addressing.

• 1:22:25Rich Roll?

  I see. That's interesting.

• 1:22:27Speaker 01

  As a society.

• 1:22:27Rich Roll?

  Yeah.

• 1:22:29Speaker 01

  So, vitamin D, vitamin Bs, you know, of all, I'm always, I get mystery people, right? In my practices, this isn't, this isn't from now a regular family practice doc. This is someone getting all the "I can't get better with Western medicine" folks. But one of the most common deficiencies I find is B12. And it can be deficient for so many reasons, you know? Poor absorption, you can have an autoimmune disease called pernicious anemia. You cannot be eating enough. You can be eating enough, but you have problems with methylation and your body actually needs 10 times the normal amount to be able to do what most people do with what's in their diet. So, B12, really important, and something I frequently supplement. The B vitamins, especially in women, seem to be really important.

• 1:23:13Speaker 01

  They have an impact on stress, they have an impact on hormones, they have an impact on detoxification. And the other thing I would do is just give a shout out to methylated forms of B12 and folic acid. Because quite a few of us have genetics that can't activate B12 or folic acid.

• 1:23:30Rich Roll?

  So the methylcobalamin.

• 1:23:32Speaker 01

  Methylcobalamin, yes. Methylcobalamin, methyl folic acid. And then herbs. Really depends, really depends, you know, if you're a perimenopausal female, I love maca. If you're a menopausal female, I love black cohosh. If you've got adrenal fatigue, I like ashwagandha, rodeola. It's herbs, in my opinion, are, they're medicines, right? They're specific, so I wouldn't say there's one. Well, actually, if you consider turmeric an herb, it's a root. I would say, you know, many of my patients are on turmeric because it's such a phenomenal anti-inflammatory. It hits a lot of the same receptors and functions as non-steroidal anti-inflammatories like ibuprofen.

• 1:24:18Speaker 01

  So for my folks with arthritis, or headaches, or high inflammatory markers, or inflammatory bowel disease, or allergies. Love turmeric, really cool. And you can do it as a root in your smoothies, or you can take it as a capsule, lots of ways to do it.

• 1:24:33Rich Roll?

  Make tea out of it.

• 1:24:34Speaker 01

  Make tea out of it, yeah. I also love omega threes, however you get them. So for your vegan folks, nuts are actually really important, essential in the vegan diet. The only vegans I have trouble with are the ones who don't eat gluten or nuts because of allergies. And I go, my god, you know, how can you, how can you do that?

• 1:24:56Rich Roll?

  It narrows it definitely, but seeds, I mean, chia seeds, ground flax seeds, hemp seeds.

• 1:25:01Speaker 01

  Yep, exactly.

• 1:25:02Rich Roll?

  Pretty good for that.

• 1:25:03Speaker 01

  Absolutely, and some people make the mistake of not freshly grinding their flax.

• 1:25:08Rich Roll?

  Right, if you don't grind it, you're not digesting, it just passes right through you.

• 1:25:11Speaker 01

  Exactly, or if you grind it too, if you buy it ground, the omega threes have already come off because they're volatile. So you want to grind it fresh and use it. And then for folks who are not vegan, fish oil is an easier form for most people because it's the alpha-linoleic acid has to be transformed through three different enzymatic reactions to become EPA and DHA. And that's not as efficient as we think it should be for some folks. So depends on who they are.

• 1:25:40Rich Roll?

  There's algae based supplements also.

• 1:25:43Speaker 01

  There are.

• 1:25:43Rich Roll?

  For vegans.

• 1:25:44Speaker 01

  There are, and they're pretty good, actually. So the algae, that's how the fish do it, right? They eat the algae and then they concentrate the EPA and DHA.

• 1:25:52Rich Roll?

  Eating vegans is lower on the food chain.

• 1:25:54Speaker 01

  It's true. It's true. And it would be a better planet if most of us were 90% vegan.

• 1:26:00Rich Roll?

  Yeah.

• 1:26:00Speaker 01

  You know, if I got to vote, I would vote for that.

• 1:26:03Rich Roll?

  It would definitely be a better, better planet.

• 1:26:06Speaker 01

  Definitely.

• 1:26:06Rich Roll?

  Environmentally, ethically, consciously. Understanding that, that herbs are not, again, are not a one size fit all, but I think that the adaptogenic, adaptogenet, adaptogenic herbs are pretty safely prescribed for anybody because the body figures out what to do with them.

• 1:26:24Speaker 01

  Yeah.

• 1:26:25Rich Roll?

  And how to put them to work, right?

• 1:26:26Speaker 01

  Yeah, ashwagandha would be one of those. Maka, which is one of the other ones I mentioned. And then ginseng, which is the Chinese well-known adaptogenic. The only thing I would say about that is that ginseng, especially certain kinds of ginseng can be very stimulating. So they can actually increase anxiety and blood pressure in some people. So it'd be a little, little bit knowledgeable about how you feel when you take it.

• 1:26:46Rich Roll?

  What about probiotics?

• 1:26:48Speaker 01

  I love probiotics. Although probiotics are an interesting and emerging story.

• 1:26:52Rich Roll?

  There's, there's hype too, right?

• 1:26:54Speaker 01

  Yeah.

• 1:26:54Rich Roll?

  Like there's hype and truth and there's a lot of foods that boost or, or products, I should say, that, that boost their high probiotic content that I think in some respects, it could be fair to say are overhyped.

• 1:27:05Speaker 01

  Overhyped. I would agree.

• 1:27:07Rich Roll?

  So in terms of, of really addressing how to, how to best serve your gut ecology, what are the best ways of doing that?

• 1:27:15Speaker 01

  Well, the best way is fermented foods, which we're talking about, but you don't need to get a weirdly packaged fermented product. You can buy sauerkraut or tempeh or miso or kombucha, you know, or kefir of various kinds, you know, there are lots of ways to get fermented and you can make it at home. You know, I'm a big advocate for making it simple and making it cheap if you can.

• 1:27:36Rich Roll?

  Do you know, like when, I always wonder, With respect to kombucha, because they, however they have to package it for shelf life, the impact that that has on the live cultures, like I'm always like, is there really live cultures in this, or is that all dead by the time it reaches the grocery store?

• 1:27:53Speaker 01

  Great question. I mean, I'm sure it's not all dead, because you have to really work at it to kill it. You have to boil it or something. But, but you know, if you made your own, it would be better. You gotta be a little careful, but you can.

• 1:28:03Rich Roll?

  What about some of the products out there, like VSL3, that you like, you know, which is expensive, right?

• 1:28:10Speaker 01

  Well, it's expensive because it's so potent. And it's a great probiotic. So, I use probiotics regularly in my patients, say with inflammatory bowel disease, or often with irritable bowel syndrome, because we're dealing with a compromised gut that actually requires ongoing probiotics to function normally. Good studies on that, actually. And, again, there are 800 species in your gut, potentially. And there are pretty much two or three species that we have as a probiotic. So, we can't call that, like, oh yeah, I'm gonna fix all my gut problems by taking 400 billion, that's VSL3, lactobacillus bifidobacter, you know? And, and I'm not saying that that's not worth doing sometimes. But I tend to

• 1:28:53Speaker 01

  do it specifically medically in certain situations. Like, I've done gut testing on somebody, they have bacterial overgrowth, they've got parasites, they've got leaky gut type, type symptoms. And we treat the parasites, we actually herbally decrease the bacterial overgrowth, and then we plant the seeds. Then we put in the high dose lactobacillus bifidobacter. I love VSL3. It is grown on a dairy medium, just saying, for you vegans out there. But there are lots of potent, there's a raw probiotic that's also really high count like that.

• 1:29:23Rich Roll?

  Uh huh. And, and so basically what you're saying is that's more appropriate for somebody who has an acute condition with respect to gut issues, as opposed to somebody's, if you just, if you not have any kind of symptomology around poor gut health, is it something you would still recommend? Or should you just be eating fermented foods and eating sort of prebiotic type foods that are seeding your gut with, you know, that bacteria that can then flourish and grow from there?

• 1:29:52Speaker 01

  Yes. I don't think everyone needs to be on a probiotic. I don't think it's a, it should be a universal prescription, and that from someone who thinks gut health is absolutely central. But the other doctors who specialize in gut health, these days, it was different five or 10 years ago. But these days are suggesting maybe not a great idea to just blanket do it all the time. But to do it in specific circumstances, or you know, I have a patient who every time she goes off her probiotic, it's horribly constipated. Should she stay on her probiotic? Sure.

• 1:30:22Rich Roll?

  Right.

• 1:30:23Speaker 01

  She should stay on her probiotic.

• 1:30:24Rich Roll?

  Do you do fecal transplants?

• 1:30:26Speaker 01

  I guide people through fecal transplants.

• 1:30:29Rich Roll?

  Awesome.

• 1:30:29Speaker 01

  You can watch great videos on YouTube about how to do a home fecal transplant.

• 1:30:34Rich Roll?

  Well, when I had Robin on the podcast, she's like, I envision a day where there's going to be these spas, and they're going to be beautiful, and you're going to go in there, and you're going to have like your selection of curated artisanal fecal transplants to like, improve your health. And it was just hilarious.

• 1:30:49Speaker 01

  It is totally hilarious. I mean, it is unfortunate that the FDA has come down and now will only allow it for Clostridium difficile infections, for which it works really well. But you can get it in the UK, right outside of London, there's a clinic doing it. And then there's the people doing it at home. And you gotta be careful.

• 1:31:11Rich Roll?

  I would be careful of that.

• 1:31:13Speaker 01

  If you're doing it at home, you're getting a sample from somebody who you don't know what's in their gut. And you know, you can change all kinds of things with gut flora. You can change mood, you can change metabolic status, you can change obesity with gut flora. It's really kind of amazing. It's exciting. But it also means you could screw yourself up. So be careful.

• 1:31:33Rich Roll?

  Yeah. We gotta wind it down here pretty soon. But there was a couple more things I wanted to talk to you about.

• 1:31:37Speaker 01

  Go for it.

• 1:31:38Rich Roll?

  If you have time. There was an interesting thing that I read. I don't think this was in your book, but I read it in an article, and it was about You know, essential oils are like a big thing now. Everybody's using essential oils. But this article was about when not to use them, like to sort of, it was more of a cautionary tale, like not always and all the time, right?

• 1:31:58Speaker 01

  Yes.

• 1:31:58Rich Roll?

  So maybe you could shed a little bit of light on that because I'd never heard of any of this.

• 1:32:02Speaker 01

  Yes, because an essential oil you have to realize is a plant substance, like let's take an orange peel, for example, where they've squeezed it and squeezed it and squeezed it to get the oil out of the peel. Some people don't understand, this is really concentrated fruit or vegetable or plant matter that is extracted from that plant. So the amount of plant matter that goes into that tiny little bottle of essential oil is massive. And because, because plants are powerful, very powerful, that is a very potent liquid, right? So oregano oil is a good example of this. So oregano oil, I use medicinally. I use it for bacterial overgrowth. I use it for fungus sometimes. I would never want somebody on a regular dose of oregano oil or grapefruit seed extract or other antibacterial

• 1:32:47Speaker 01

  essential oils because you deplete your gut flora. You might as well be taking erythromycin on an ongoing basis, right? It's silly. You want to, you want to be mindful. So these are medicines. You got to treat them that way and respectfully, and they're powerful and they're wonderful. I love essential oils. But if you're going to take them internally, caution, caution, caution. You got to be careful. And then even externally. So essential oils are powerful and the great majority of them should never be applied to the skin without being diluted in an, in an oil, in a carrier oil, because they'll burn. You know, I'm one of these silly people who, I started to get really interested in essential oils like 10 or 15 years ago. And I came home from a conference and I had my essential oils and I was so excited and I was going to take a bath. And so I dropped some drops of my

• 1:33:31Speaker 01

  essential oil in the bath. I think it was eucalyptus because I was sick and I wanted to clear my respiratory passages. I wasn't thinking. I got in the bath and the oil, of course, not being diluted, is pure eucalyptus oil on my skin. I had little round burn marks.

• 1:33:45Rich Roll?

  But you diluted it in the, in the bathtub.

• 1:33:48Speaker 01

  Right, but I didn't because I diluted it in water and it doesn't dilute in water.

• 1:33:52Rich Roll?

  You have to dilute it in alcohol or?

• 1:33:54Speaker 01

  In oil.

• 1:33:55Rich Roll?

  Oh, in oil.

• 1:33:55Speaker 01

  In oil. Alcohol will help a little bit, but if you're going to apply it, you have to dilute it in an oil. Like grape seed oil, or olive oil, or sesame oil.

• 1:34:05Rich Roll?

  Right, that's interesting. Are there resources out there for people that are practitioners of the art of essential oils? Where they can get a little bit more in-depth understanding of that?

• 1:34:14Speaker 01

  Absolutely, absolutely. And people who really understand essential oils are really careful with them. You know, and some oils, like lavender is a good example, can be applied directly, say, to a burn. It's actually really good for that. But most oils you would never want to put onto the skin directly.

• 1:34:32Rich Roll?

  Right. All right, so let's recap. We need to get more sleep.

• 1:34:37Speaker 01

  Shocked.

• 1:34:37Rich Roll?

  We need to remove the toxic chemicals from our cleaning supplies and our beauty products. We need to eat more fruit and veg. We need to develop more acumen around our BQ, right? We need to listen to our bodies.

• 1:34:54Speaker 01

  Yeah.

• 1:34:55Rich Roll?

  We need to learn, we need to learn a language and around that as well, too. I think, I think cultivating that isn't an overnight thing. Like, this is an inside job.

• 1:35:04Speaker 01

  That's exactly right.

• 1:35:05Rich Roll?

  I mean, look, like I said, I think women are more sort of adept and inclined around these ideas. For men, they're shut down. It's like, what? You know, they're all up in their heads. I think that's a harder thing. But I think to give men the permission and to encourage them to pay greater attention and to understand that, you know, in this world where we're just, we're encouraged to burn it at both ends, that we're just a ticking time bomb. And if we, if we don't want to become a health statistic and become obese and diabetic and suffer from heart disease that claims the lives of one out of every three people, that these are things that we need to prioritize in our lives. And, and, you know, I love the book. Like I said, it's, it's very practical.

• 1:35:48Rich Roll?

  It's very eye-opening and it gives people, you know, copious tools to begin to educate themselves around what I think are really important ideas. So, thank you for writing it.

• 1:35:57Speaker 01

  Such a pleasure. Thank you so much for having me.

• 1:35:59Rich Roll?

  Cool. And the other thing is, Obviously, not that many people live in Santa Cruz that can come and visit you.

• 1:36:10Speaker 01

  Yes.

• 1:36:10Rich Roll?

  Book an appointment with you, right?

• 1:36:12Speaker 01

  Yes.

• 1:36:12Rich Roll?

  And I love that in your book, you have like robust dependencies with lots of resources that allow people to kind of take their education beyond the pages of the book. And one of those is, I think it's a, I don't know what the URL is, but it's a website where you can find an integrative medicine doctor in your area, right?

• 1:36:30Speaker 01

  Yes.

• 1:36:30Rich Roll?

  Would you know what that URL is?

• 1:36:31Speaker 01

  Yes, there are two. So one is the Academy of Integrative Health and Medicine, A I H M dot org. And the other one is the Functional Medicine Organization, and that's functionalmedicine.org.

• 1:36:43Rich Roll?

  Cool.

• 1:36:44Speaker 01

  And my website is DrRachel.

• 1:36:46Rich Roll?

  That's right.

• 1:36:46Speaker 01

  Dot com.

• 1:36:47Rich Roll?

  And the book is Body Wise. And anything else coming up you want to talk about?

• 1:36:53Speaker 01

  I've got.

• 1:36:54Rich Roll?

  What are you working on now? Are you working on another book?

• 1:36:55Speaker 01

  I've got lots of events coming up and I'm doing a live 28 day program.

• 1:36:59Rich Roll?

  Oh, you are? Cool. Yeah, you have an online course as well, right?

• 1:37:02Speaker 01

  I do. It's a, but it's a live course, so it's with me. So it's because you were saying you need community support to make these changes, right? Most people do. So this is actually creating an online program where I'm present and people can ask me questions and we can process and we can brainstorm about what they're doing next and then we move on to the next week.

• 1:37:19Rich Roll?

  All right, awesome. Is there, is that's all on your website as well?

• 1:37:22Speaker 01

  On my website, spelled out, DrRachel.com.

• 1:37:25Rich Roll?

  All right, cool. We did it. How do you feel?

• 1:37:28Speaker 01

  Fabulous.

• 1:37:29Rich Roll?

  Feel okay?

• 1:37:30Speaker 01

  Yeah, good.

• 1:37:30Rich Roll?

  All right, cool. Well, I gotta talk to Doug in a little bit. What should I ask him?

• 1:37:35Speaker 01

  Ask him how wonderful his wife is.

• 1:37:40Rich Roll?

  That I will do for sure. All right. Thanks, Rachel.

• 1:37:45Speaker 01

  You're so welcome.

• 1:37:46Rich Roll?

  Peace.

• 1:37:59Rich Roll?

  All right, we did it. What do you guys think? I thought it was pretty cool. Make a point of checking out Dr. Abrams' book, Bodywise.

• 1:38:08Rich Roll?

  It's a great book. I really enjoyed it. Quick aside, quick note, Dr. Abrams is not vegan, for all of you super hardcore vegans out there. So I wouldn't consider the book a vegan title per se, but she's extremely vegan friendly. And I think irrespective of whatever your dietary proclivities may be, there is just so much good stuff to glean from the read. So definitely pick that up. And while you're at it, use the Amazon banner ad at ritual.com for all your Amazon purchases, including your purchase of Bodywise. I really appreciate that. You can find that banner ad on any episode page on my website, or you can just type in ritual.com/Amazon. Does the same thing. Doesn't cost you anything extra, but Amazon supports us with some

• 1:38:53Rich Roll?

  with some commissions based on your purchases. So I really appreciate that. Make a point of checking out the show notes on the episode page for this episode. Lots of links and good stuff to learn more about Rachel and her work, including her TEDx talk, TEDx Santa Cruz. That's a good watch. You guys should all check that out as well. I appreciate you doing that. And I appreciate you sharing the show with your friends and on social media and all that good stuff. If you haven't done so already, please take a moment to leave a review on iTunes. Click that subscribe button if you haven't already. And just a shout of gratitude to everybody who has made a practice of using the Amazon banner ad for your purchases, and also has gone that extra step to support the work that I do

• 1:39:37Rich Roll?

  on Patreon. It means the world to me, and I really appreciate it. If you guys want to receive a free short weekly email from me, I send one out every Thursday. It's called Roll Call. No spam, no affiliate links. It's just good stuff. It's basically articles I've come across over the course of the week, whatever book I happen to be reading. If I saw a documentary that I enjoyed, came across an article or two, or a podcast that I listened to. Generally, stuff I don't share on social media. Sometimes I do. But not always. So if you're interested in receiving that, I've gotten a lot of great feedback. People seem to be enjoying it. You can subscribe on my website. There's plenty of places to just add your email. And again, I'm never going to spam you. And while you're at richroll.com, you can pick up your cool merch and schwag needs, all

• 1:40:21Rich Roll?

  things Plant Power. We got signed copies of Finding Ultra, signed copies of The Plant Power Way. We got t-shirts, we got tech tees, we got stickers, all kinds of good stuff. Thank you to everybody on my team who helped me put up this podcast. I can't do this stuff without you guys. Jason Camiolo for all your audio engineering wizardry, production wizardry. Shawn Patterson, he creates all the beautiful graphics and the look of the show. Chris Swan, who's kind of behind the scenes toiling to help me create the best product I can across all categories. He does extra production assistance. He helps put the show notes together. He helps design the webpage as well. So thanks all you guys. And theme music, of course, by Analemma. Appreciate the love. Have a great week, everybody. I'll see you guys

• 1:41:05Rich Roll?

  back here soon. Peace. Plants.