554: Dr. Robin Berzin on State Change & Parsley Health to: End Anxiety, Burnout, and Gain More Energy

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Katie: Hello, and welcome to the “Wellness Mama,” podcast. I’m Katie from wellnessmama.com and wellnesse.com, that’s wellness with an E on the end. And I’m here today with Dr. Robin Berzin, who is the founder and CEO of Parsley Health, which is America’s leading holistic medical practice, specifically designed to help women overcome chronic conditions. And she founded this company to help Americans combat the rising tide of chronic disease through, really, personalized holistic medicine. And she’s also the author of a new book called, “State Change,” which we talk about today.

And in this episode, we go into a lot of different things, root cause, functional medicine, why mental health struggles aren’t just in our head, they can start in our bodies, and how to do a self-assessment to get a baseline, how to get inexpensive labs, poor actions versus habits and why the difference is important, why she tests thyroid levels in every single patient, why average is not optimal and how to understand your lab results, why women were excluded from medical research until 1993 and so lab ranges still don’t reflect accurate ranges for women because of this, what to know about metabolic syndrome in blood sugar, the amazing science of meditation, and so much more.

Very practical episode. She’s a lot of fun to talk to, and I know you’ll enjoy this as much as I did. So without further ado, let’s join Dr. Berzin. Robin, welcome. Thanks so much for being here.

Robin: Thank you for having me.

Katie: I feel like this is a long-overdue conversation, and I’m so excited we finally get to chat. And I feel like some of your current work is extremely relevant to our audience of women and moms who are listening. So I can’t wait to jump in. But for background, for those who aren’t familiar with you, I would guess many people are, but can you just kind of give us an overview of your background, and what led you to your current work path into starting Parsley Health?

Robin: Yeah. Well, thank you for having me. Long overdue, for sure. Excited for this conversation. I’m a mom of three. My youngest is six months. I’m a doctor. And I’m not only trained in internal medicine, kind of conventional medicine, trained in New York City, but I also trained in something called functional medicine, which is about getting to the root cause, getting to the why. And those two trainings combined together led me to see that there is a powerful need for all of us to have a form of medicine that is truly holistic, that looks at us as a whole person, that understands our past and our childhoods and the trauma that we’ve been through, and the context of our lives and what we’re eating and how we’re moving, and whether or not we have meaning and purpose, and needs to factor all of that into our plan for health and wellness.

And so, all of that kind of came together for me, and I started the company called Parsley Health to bring that kind of medicine, the best of conventional primary care plus the best of a more functional, holistic approach together, so you didn’t have to choose, so that we could help a lot of people heal, especially women, heal from the most common issues we have today, which are the autoimmune, the GI, the mental health, the hormone, the fertility, the heart issues, the blood sugar issues, and that women really need a different form of care. So, that’s why I’m here.

Katie: I definitely had my own journey with that in the early stages of Hashimoto’s, and trying to get answers from doctors. And a lot of the conventional doctors looked at everything kind of in isolation. And the thyroid is its own kind of isolated part of the body that wasn’t connected to your gut, or wasn’t connected to anything else. And it was a journey of lots of learning for me to uncover that. And I agree with you completely. I think the best outcomes happen when we can use the best of both worlds, and when we have informed patients, who are working with providers who are in alignment. I’ve said a lot of times on here, we’re each our own primary health care provider, and we have responsibility for our health, but the best outcomes happen when we have a practitioner who understands root cause, and who knows what they’re doing, to guide us.

And I know some of your recent work, you are talking a lot about the relationship between chronic illness and mental health. And I know this, like, that mental-emotional side was an overlooked piece for me for a long time. That it was so funny when I realized it, because it really was right there the whole time. But let’s talk about that, because I feel like this is something that we’re starting to understand more and more recently.

Robin: So, I forgot to also mention, I’m the author of a book called “State Change,” that came out recently, which is all about the physical barriers to peak mental health. And for so many of us, we feel like our mental health is in our heads. And yet, for many of us, our mental health is actually starting in our bodies. And in our medical system, literally, mental health is its own department. And the doctors who are focused on mental health don’t focus on the physical. And the doctors focused on the physical don’t focus on mental health. And that’s not working, because there’s no magic concrete wall between our heads and our bodies. And what’s happening in your body is happening in your brain, and vice versa.

And when I started Parsley, you know, I didn’t start it explicitly as a mental health service. It was really for anyone suffering from a chronic condition, multiple chronic conditions, or just symptoms they couldn’t figure out. And what I saw over and over again that was kind of magical was that we were addressing nutrient deficiencies, high blood sugar, thyroid issues, like you had, that weren’t diagnosed, hormone issues. Helping people change how they treated their body during the day when it came to food or movement, supplementation. And how, along the way, people were getting off their psych drugs, people were feeling better, people were feeling more in control. Like, they knew how to support themselves when it came to mental health.

And whether you have a family history of mental health disorder or a personal history of trauma, or whether you’re suffering from the burnout and chronic fatigue and anxiety, depression that we’ve all lived through for the past couple years, no matter where you fall in that, if you don’t address what’s happening in the body, it’s like trying to climb Everest and not getting to base camp. And so, I wanted to create a roadmap for people to get to base camp, because we have to find our mental health, as you know, over and over and over again right now. It’s not something you pick off the mental health tree and walk away with. It’s something we have to cultivate every single day.

Katie: Yeah, and it makes sense that that is a back-and-forth relationship, that our physical health affects mental health. Also, our mental health influences our choices with our physical health and vice versa. What are some of the mechanisms physically that can influence mental health? Like, I know we hear about the gut-brain connection, and how gut health can influence mental health. And I know there’s a lot more to it than that, but just kind of give us an overview of some of these things.

Robin: Yeah. You know, first of all, I always say you can’t know where you’re going till you know where you’ve been. And I don’t know about you, but I don’t remember what I had for lunch last Tuesday, let alone, like, how anxious or foggy or tired I was. Or how bloated I was, or how much my right knee ached or my left hip ached, you know, a month or two ago. And so what we start off with in the book, and what we offer at Parsley as well, is this self-assessment. That’s a total body symptom score, and you give yourself a score. And it’s a number, because, again, we can’t remember these things. We got too much going on.

And so, when you give yourself that number, and then you start to make some of these interventions, you start to see, “Oh, when my gut’s really flaring up, and my bloating and my reflux and my constipation and my gas are really bad, my brain fog and my headaches are really bad too.” And you start to connect the dots across the body. So that’s actually where we start, is this initial assessment of where you’re at from a symptom perspective, from your female hormones to your mental health, to your gut health to your musculoskeletal health, because it’s all connected.

And then what I recommend in the book when we talk about sort of figuring this out is also some testing. And I list out the blood work that you can take to your regular doctor, you can see us at Parsley, nationwide or online, or you can go to your regular doctor, be like, “Test these things.” Because let’s talk about your Hashimoto’s, right? Thyroid disorders. One in five women will be diagnosed or have a thyroid condition in her lifetime. Most of that is hypothyroid, so low functioning thyroid as opposed to hyper, or high functioning. And when you have hypothyroid, you get constipation, you get bloating, you get high cholesterol, you get weight gain, you get dry skin, you get exhaustion, and you get depression.

And I cannot tell you how many women have come to see us and were put on an antidepressant or told they were depressed, and no one had tested their thyroid for Hashimoto’s, which is a type of thyroid, autoimmune-based hypothyroidism, or just regular variety, there’s two kinds. And when we found that they just had a thyroid disorder, we could treat that, and everything else cleared up. And so we walk you through some of the testing. And we can talk more about this, but your blood sugar, if your blood sugar is high, your brain is inflamed, you will be anxious. And more than 50% of Americans have metabolic syndrome, or dysfunctional ability to manage their own blood sugar, right? We eat, like, a, I think it’s a 94% refined diet, ultra-refined diet. This is our flours, our sugars or processed foods. Anything that came in a bag that you, like, pop open, or crinkles, like, didn’t grow out of the ground, wasn’t an animal you could recognize walking around.

Like, you know, those foods are creating inflammation in the body, are creating high levels of blood sugar that we can’t control very well, because our bodies weren’t designed to eat those kinds of foods. And none of this is about shaming food or calling a food bad or good. But it might be impacting your body in a way that’s making you feel foggy, anxious, depressed. And so, we walk through the things to test for when it comes to your thyroid, your female hormones, your blood sugar, your adrenals, your heart health, inflammation. And you can take that list, or like, rip the page out in the book and take it to your doctor.

And then we also, and we can get into this, we talk about some of the things that we do every single day. Foods, movements, how we look at technology. Scrolling our social media, last time I checked, is not helping anybody out. When it comes to mental health, and the research is really there that it doesn’t. It’s actually really depleting our mental health. And so, then we talk in the book about assessing your symptoms, assessing your blood work, and then assessing your core actions. And I call them core actions, not habits, because what you eat every day, and whether you sit for 11 hours a day, or you get up and move, those things aren’t habits. Habits, is, like, biting your nails. Those things are, like, core actions that are defining how you feel.

Katie: I love that distinction. And to just go a little deeper on a couple of the things you said, because there were so many good points you just made. On the thyroid side, I know, in my experience, and I don’t have Hashimoto’s now, all my levels are normal and I don’t have antibodies, so I’m considered completely Hashimoto’s-free. But when I was in the early stages, I would go to a doctor and they would test things, and they would tell me, “Oh, your levels are normal.” And what I eventually realized was, A, there seems to be some discrepancy depending on who you work with on what is actually considered normal levels. And unfortunately, people who have thyroid problems are the ones that are getting tested that they’re basing the levels on.

As well as they didn’t test my antibodies, or they tested, like, two things, and they decided those were normal and didn’t test anything else. And so, this is the thing I love to explain, because if you think you might have a thyroid issue, and your doctor’s only testing a couple variables, they might not actually be identifying an underlying problem. But I would love for you to explain that better. Like, what do you test when it comes to thyroid?

Robin: So, day one, when you come to Parsley, and when I say come, I mean, see us online and we order tests, your local LabCorp, Quest, whoever we’re working with, or you’re working with for your insurance. But what we do is we have a baseline panel, the Parsley baseline, and we test the full thyroid panel, including antibodies, as a part of that, in every single person. Because this is so underdiagnosed, and it’s rampant. And when we test, you know, a lot of people say, “Well, I got a TSH done, and my doctor said it was normal.” Well, first of all, oftentimes, I’ll see people come in with TSHs of four and five, their doctor said, “Ah, that’s okay, it’s borderline.”

And there’s a difference between normal and optimal. And we have to understand that the reference ranges, the ranges of normal on our lab tests, are based on the average of our population today. And our average population in the United States, 60% of people have a diagnosed chronic condition. Forty percent have two or more. Tens of millions more have a chronic condition, don’t know it yet, because we test reactively. We wait till you feel horrible and then we test. We don’t proactively test for these things, which is wrong. We’ve made ourselves up as, I call it a story. It’s like a Greek myth. Remember the Greek myths from, like, elementary school? I call it a Greek myth that lab testing is expensive. It’s a lie that the labs have pulled over the insurance companies, but testing all this blood work is, like, really cheap, and it’s getting cheaper every day.

And so we test reactively and we look at these averages. And average is not optimal. And our nation doesn’t feel good, it feels sick. And women are disproportionately, under 65, experiencing the vast majority of the mental health issues, the GI issues, the autoimmune and inflammation issues, the fertility and hormone issues. And women were excluded from medical research until 1993. And so, we have a really sort of problematic set of reference ranges. And so, people will come to me and say, “Well, my TSH was fine.” And I will say, “Well, I don’t care if it was fine. Was it good? And did they test your free T4, free T3, anti-thyroglobulin antibody, anti-TPO?” These are the antibodies.

Antibodies, for everyone, are part of your immune system that’s really natural and important, and it’s how we fight off colds and flus, but it can go haywire, and it can get triggered and attack part of your own body. And 80% of autoimmune disease, which is some form of antibodies are attacking some part of your body, is in women, for reasons that are not well understood. And Hashimoto’s, which you had and got rid of, and I wanna hear how you did that, because that’s awesome, you know, is really, really common. And so, when our antibodies, our immune system, attacks our thyroid, our thyroid’s ability to function well goes down.

We also test for nutrient levels, because, how well your thyroid operates and how well those hormones operate in your body also depends on selenium, zinc, vitamin D, which the vast majority of Americans are deficient in, iodine, iron, right? So we wanna look at some of these other things that we can then correct. We also look at food allergies, because gluten, for instance, in wheat can be a big trigger for Hashimoto’s. And for some people, not everyone, but some people, that can be a problem. So we test all of this day one. And it can be a massive unlock for people to really understand not just what is “within the normal range,” but what is optimal, and optimal for them.

Katie: Yeah, that’s such an important point. And I’d love to also talk more about the blood sugar and the metabolic syndrome thing, because I feel like this isn’t talked about enough, despite the vast majority of Americans having some of these markers for metabolic syndrome. And the good news is, it seems like a lot of the things that can help influence these are very much within our control. But can you kind of give us an overview of what are the markers that define metabolic syndrome, how we can use blood sugar to our advantage? I’ve loved using a continuous glucose monitor a few times to get data on my own body and what it reacts to with different foods. And now, like, my fasting glucose is 73 or 74 every single day, and that’s helpful data I wouldn’t have known if I hadn’t tracked it. So, can you give us an overview and a primer on all things blood sugar and metabolic syndrome?

Robin: Yeah. So, metabolic syndrome is basically the step before diabetes. And for most people, diabetes is type 2 diabetes, which is the kind that we develop through diet and lifestyle. So, sitting all day, eating too much sugar. The average American should be eating less than 25 grams of total sugar a day, but they’re eating 75. Oftentimes, one soda has 50 grams. And that’s like throwing a grenade in your digestive tract and watching it explode. That’s how it feels to the body when you eat something like that.

And so, the metabolic syndrome issues are really rampant, and it’s where your body’s having a hard time managing your blood sugar. And we tend in medicine to look, again, reactively, i.e. when it’s a little too late, at hemoglobin A1C, which is a measure of whether or not you have diabetes or metabolic syndrome. And if you’re at 5.7 or above, it’s metabolic syndrome, and 6.5 or above is type 2 diabetes. And I’m gonna skip type 1 out there for right now. For all of you who have type 1, I hear you, I see you, but we’re gonna talk about type 2 for a moment.

And the reality is that 5.7 being that cutoff is a little bit arbitrary, and a little bit late. And I don’t like to see a hemoglobin A1C of even 5.4, or 5.5, because it tells me we’re on our way. But again, these are normal ranges. And what the A1C marker doesn’t do is tell you if you’re on your way. And so what we test at Parsley is fasting insulin and fasting glucose, which are early markers. And we wanna see that fasting insulin, ideally, well on, around 2 or undetectable, but definitely well under 10. And we wanna see our fasting glucose, meaning first thing in the morning, haven’t eaten anything, what’s that blood sugar level? We wanna see that around 80, 70s and 80s. We don’t wanna see it too low. Like, 50 is not good. So don’t keep…it’s not like golf, where you just want to keep going down.

But we wanna see it around 70s and 80s. And you would not believe the people who think that they are Mr. and Mrs. Healthy, eating all the right things, moving, who have a fasting glucose of, like, 95, 100. And that tells us that our body’s having trouble managing blood sugar. And when blood sugar is perpetually high, your insulin goes up, you start storing more fat, especially around the belly. You start getting more inflammation and immune dysfunction in the body, your testosterone goes up. So, polycystic ovarian syndrome, which is really just, not a disease, but a syndrome, is the number one cause of fertility troubles today, after age. And that’s largely a metabolic issue. So, our blood sugar impacts our hormones, and our blood sugar also impact our brains and our anxiety levels. And it’s something that we need to be a lot more proactive about.

Katie: And I love your use of the word, like, the core actions versus habits. I think that’s a very…and it also speaks to us having more control over it. And it seems more fun than just habits. I’d love for you to talk about some of the maybe negative ones that we have, that are the most negatively impactful, and also some of the positive ones we can build that are gonna be kind of 80/20 best things we can do.

Robin: So, we live really different lives today, right? I mean, I think about myself as a kid in the ’80s, and then what my kids are living as little ones, like my five-year-old today, and just what a different world it is. And I think sometimes we have to take a step back for ourselves and recognize that. We’re, like, battling through the day. Be the mom, do the work, get through all of it, right, get to bed, have a social life, do your job, like… And sometimes I think we forget that the way which we’re living all day, every day has been radically transformed in the past few decades. And that’s putting a level of pressure on us that I think that we’re cracking under.

So when we talk about the lives we’re living and the rampant burnout and depression and anxiety that many of us are experiencing, we also have to remember that that isn’t just coming from inside. It’s coming from outside. But to your point, we do have control over it. So, the biggest ones are what we eat, how we move, and our relationship with technology, which are not habits, again, because these dominate our waking life.

And so, on the food side, we talked about sugar, and refined and processed foods. If you remove those foods from your diet, and also get rid of the omega-6 fats, these are the canola oils, vegetable oils, grapeseed, rapeseed oils. We’re supposed to eat about a four-to-one ratio of omega-6s to omega-3s. That’s what’s healthy for our body. Average person’s eating 26 to 1. Because all those vegetable oils are in all the processed foods and all the deli bars, and all the things that we eat, and they are interrupting our brain’s ability to use the serotonin we have.

We always hear about this, the feel-good hormone, and it’s like, be, why is everyone, you know, so shy of serotonin today? Well, part of it’s that we’re eating foods that make it impossible for our brains to use the serotonin we have. So, cutting out those processed foods, cooking your meals, even cooking two out of three meals a day, I know we’re busy, I know we gotta grab and go sometimes. I do it too. But that is the number one thing you can do.

And again, what you put in your mouth every day is information for every single cell in your body, and the microbes that live in your gut. And what you eat is impacting how you feel, not 20 years from now, but right now. And so, I think for a lot of people, that’s a really exciting wake-up call, and I know for me it’s cheaper to cook, and batch cook, than it is to eat out and buy processed foods today, because those prices have really gone up. That’s number one.

The second one is we sit, on average, 11 hours a day. We sit on our bottoms. And we have legs. And we were not meant to do that. And the body is designed to process emotions through movement. The body is designed to process our emotions through movement. And so, when you sit, those emotions get stuck. So, I might be sitting here right now thinking, “Wow, this is a really big podcast. I’m really nervous. Katie’s so amazing, and I wanted to meet her forever.” And I may not even consciously, like, think that thought. It may not even sort of go across the, you know, the TV screen in my brain, but I sort of have it in a flash. And then I have an emotional reaction to that thought, which is a little bit of fear.

And the second I have that emotional reaction, a wave of neurotransmitters and hormones cascades through my body, touching every single cell. And that cascade, that wave, takes about 48 hours to clear. So, imagine you’re feeling stressed and scared, and angry, and all the emotions we feel a million times a day. And you’re sitting, and you’re not processing those emotions. That’s how… We talk about emotions getting stuck in the body as if it’s this, like, I’m gonna use an unpopular word, but, like, woo-woo thing. And what we talk about in the book is that it’s very scientifically-backed reality. And this cascade of neurotransmitters and hormones can ultimately impact your cells’ ability to function, impacts your blood sugar, impacts your immune system, makes it harder to heal. And that’s how we get weakness and disease over time, right.

So, emotions translate through the body, and when we’re moving, we wash that wave out. And yet we sit 11 hours a day. So, getting up and moving, every single hour, making sure you’re spending 30 minutes to an hour a day. Could be walking, it could be dancing, it could be jumping on a trampoline. I know, for myself, and I know from so many of our female patients, like, movement has been attached to shame, and sort of “shoulds,” and the last thing we need as moms is another “should.” And so, in the book, I write a lot about movement and exercise. In studies, in 95% of patients, anxiety and depression improved with regular exercise. And only 40% to 50% improved with medication. Doesn’t mean we don’t need the medication. Medication is a beautiful tool, but it’s not enough.

And so, we put exercise in that way on the prescription pad, not because it’s about getting fit or looking hot. This book is not about that. It’s about feeling good, right now. And these are things that we can do for free. There’s so many great workouts on YouTube and Instagram and all the places, that I take advantage of. So, these are the things that are in our control, that can help us create a state change, a shift in how we feel, every single day.

Katie: Yeah. And I think you’re right. There’s a different societal expectation now, especially on women. And I’ve heard it said, you know, moms are expected to work like they don’t have kids, and then parent like they don’t have to work. And we carry so much more than we used to. And I love also that you brought up the idea that emotions store in the body. Reading “The Body Keeps the Score” was a really, like, mind-opening for me. And I started to actually understand things on a deeper level when I started making those connections and paying attention to both emotions, and where I was feeling them in my body.

And I think you’re right. It doesn’t have to be an extensive process, often, to unpack those. It’s, movement is so helpful. And for me, it was helpful to unpack and have a distinction between, like, exercise and movement, which I kind of define as almost like play. Because you’re right, I think we have some negative societal things attached to exercise. And it’s like a thing we should do, and I would argue there’s even a lot of misinformation about the way we “should” do it, and what we do in the gym, that’s not even that effective. And so, I think, like, exercise and strength training and sprinting, those are important things and those are great tools. But movement is a much broader category. And just things like going outside, you’re getting all those benefits of sunlight and fresh air and movement.

And then also, the idea that we think we shape our environment. And we do, but our environment also shapes us, to your point. And so, if we can modify our environments to be more friendly to just movement, like constant movement versus exercise, that’s led to my house having, and I’ve mentioned this before, but, like, a gymnastics mat in the hallway, and a climbing hang board in the kitchen, and yoga swings in the kid’s room, just because if it’s there, and it’s in our way, we tend to use it more.

Robin: Yeah. Absolutely. Like, take the yoga mat out of the closet and just lie it down on your floor, so it’s always right there. And, you know, for me, like, I’m not a gym person. Like, I’m that person who… I think I went recently, because occasionally I’ll go. And the little, you know, card reader says, “Congratulations. You were last here 63 days ago,” and I’m like, “Oh. Great.” But, you know, I like to do yoga, I like to do weight training at home. I like being outside and being in nature. And so, these are things that, you know, make me feel good. And it has nothing to do with that sort of punishment mentality that I think we all got schooled on in, like, the ’90s somehow. The ’90s were, like, the era of, like, go to the gym, punish yourself.

And we have so much power to shift how we feel in these moments with these little things. And so, what I’ve really focused on in the book was the science of that. Because I think that, you know, even in the wellness community, sometimes there’s a little bit dismissiveness of the medical research behind these things. And there’s massive dismissiveness of these practices in the medical community. So I write about the science of meditation. Meditation is proven. It’s free. It’s proven to rewire your brain, reduce your cortisol, help your digestion, help your blood sugar, your high blood pressure, help you focus, help you sleep better.

And this is all there. It actually rebuilds gray matter in the brain, that the social media and news feeds that we stare at all day are depleting. Those tools are actually negatively transforming the structure of your brain. And meditation is, like, building in the other direction, and forming new connections. Exercise helps your brain form new connections. Meditation does as well. And so, you know, in the medical community, we’re not using some of these proven tools. And so what’s really fun, for me, you know, I know the research and I’ve read the research, but it was really fun in the book to dive in and say, “All right, let me go back and, like, reread and revisit some of these studies.” And just, even I was blown away all over again by how compelling the research is behind exercise for mental health, meditation, nutrition. And, you know, nutrition is the number one thing on our prescription pad at Parsley. It’s like, it should be the number one prescription pad everywhere, because of its power to transform how we feel today, and the top chronic conditions we’re all living with.

Katie: Yeah, and I love your point about food being basically like chemical inputs into the body, not just calories. I think that was another negative side effect of the ’90s and the limiting calories. And there have been, of course, well-talked-about negative side effects of diet culture on women, and the relationship we have with food, and, like, having fear or guilt or shame related to food. For me, it was helpful to shift to a mindset of how, like, what’s the most nourishment per calorie or per volume that I can get for a food? Not, like, what’s the lowest calorie thing I can eat? And that alone helps you avoid so many processed foods. But what are some of your nutritional guidelines that you give women? Because my general take is just that we are sometimes overeating, for women, often undereating…but for sure, under-nourishing ourselves. Like, we’re almost, like, malnourished, even if we’re consuming enough calories.

Robin: Yes. We are overfed and undernourished. And that’s in part because the food industry has done a number on all of us. I mean, you walk through the airport, and I just marvel at, like, the junk, the literal anti foods, the toxic crap, that is everywhere. And it’s positioned as just, like, this is a normal thing to eat. And you look at the label… I was at the airport the other day, and I looked at the label on a green juice. A green juice. And it had 50-something grams of sugar in one little bottle, which is twice as much sugar that we should have in an entire day. And so, we’ve just been sold something that is wrong. And so that’s part of it, along with the sort of inaccurate information about calories.

I’ll put it this way. A cup of broccoli and a cup of soda, same volume, gonna have two very different impacts in your body. Gonna grow different microbes in your gut, gonna have different impacts on your blood sugar. One’s gonna create inflammation, headaches, and a crash. One’s gonna fuel you and help you detoxify your hormones through your liver, and keep you full and satiated. And so, for us, at least in our eating philosophy around mental health and physical health, it’s around, we call it plant-based paleo, which doesn’t mean that you can’t have animal products. But it’s focusing on plants, whole foods, vegetables that you can recognize. They’re not pulverized into a cookie, cracker, bar, pretzel, something. You know, I see all these, like, cauliflower pretzels now. Even I, like, I bought this, right, at the health food store for my kids, and I’m like, “This is still junk food. This is still, like, processed grossness.” It’s not a cauliflower, people. It’s a pretzel. Let’s, like, own it.

But, you know, and so, eating those whole foods, lean protein, fish. Looking for well-sourced animal protein is also so important, not the factory farmed stuff. And if you can, if it’s possible, if it’s not possible in your budget, then eating some form of protein is way better than eating any form of sugar. And for a lot of people, not everybody, but being gluten-free and dairy-free can be really instructive. And I say instructive because these foods are not bad or good. We’ve made it very binary, and I don’t love that part of the space.

Dairy can be a beautiful food for some people. Dairy can taste really good, and be really well-sourced, and be the source of allergies, sinus infections, asthma, acne, eczema, digestive disorders, and be a really problematic food for other people. Wheat, and gluten, which is the protein in wheat, can be a really big autoimmune trigger, and even a mental health trigger for some people. It’s a trigger for brain fog, and headaches, and irritability. And so, people take gluten out of their lives for three or four weeks and are like, “Oh my god. My digestion feels exactly like it did before. I don’t have any digestive issues with gluten, but man, my head feels clear. And I don’t have my migraines anymore.”

And so, removing the refined and processed foods, getting those omega-3s, like your olive oil, your walnuts, your small fish, like your herring, sardines. And then, really focusing on checking out if, three, four weeks of no gluten, no dairy impacts you. Because if it does, it’s putting you in the driver’s seat around which foods are making you feel good or bad on a given day. And then you can choose. Like, today might be pizza day, and that’s awesome. But every day won’t be pizza day, because you know how pizza makes you feel.

Katie: Yeah, and I think you brought up another good point about protein. Because one of the other side effects of us eating this very processed food and carb-rich diet is, I found at least, many people are not getting enough protein, or at least this was certainly true for me. I assumed I was, and then when I actually started tracking what I was eating, I realized I’m not getting enough protein, especially with the amount of strength training I’m doing. And switching to more protein and a lot more, like, fibers, vegetables, I have days where I’m like, “Oh my gosh. I have to eat so much food.” But my body has so much energy and I’m so nourished, that it was, like, a shift out of that deprivation kind of diet mindset that I had had for so long.

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I’m also curious your take on supplements, because certainly, this is a topic with many, many opinions. And everybody’s, of course, going to be very bio-individual, and there’s personalization here. But it seems like there are also some categories where, in general, as a population, we tend to not…it’s harder to get some of these certain nutrients because of the food supply being what it is. What is your advice to people on supplements?

Robin: Yeah. So, you know, supplements, I love that you brought that up, like, get vilified. Like, “They’re useless and just make your pee really expensive,” or, “They’re really dangerous,” or… And I’m like, it’s really hard for something to be really both really dangerous and really, like, useless at the same time. So, you know, most medical providers are not supplement-literate. And we are, and supplements can be a really powerful tool. Most supplements on the shelf are useless, because it’s a poorly-regulated industry, and so, I see people… I remember being at, like, a health food grocery store in LA years ago. And this woman was standing, looking at this, like, wall of supplements, and everything said hormone this and hormone that. And there was probably, like, a 19-year-old, like, shop worker guy, and she’s looking at him and she’s like, “It’s my hormones. Which thing should I take?” And he’s like, “I think that one will work.” And I was just standing there, like, biting my nails, like, “No, no. Oh, God, don’t do it,” right.

So, there is a lot of useless stuff out there. That said, supplements can be really powerful tools. And the way I think about them is we’re not using them to correct a deficiency, largely. Like, typically, people aren’t so deficient in vitamin C that they’ll get scurvy, like a sailor from the 1800s. But we are not optimal. And we can use supplements as therapeutic tools. So, I might prescribe magnesium glycinate or magnesium threonate as a really beautiful sleep aid, or a really beautiful anxiety-calming supplement. And so, I’m not correcting a magnesium deficiency with that tool. I’m using it therapeutically for a mental health or sleep goal.

Similarly, many people like myself, 66% of people have some form of an MTHFR genetic variant. Its not a mutation, it’s just a variant. It changes how we make neurotransmitters like serotonin, dopamine, norepinephrine. And so, a regular B vitamin doesn’t work for me. But when I take, or my patients who have this variant, take a methylated B vitamin, methylated B12, or 5-MTHF, which is methylated folate, or ideally both, you make more serotonin, dopamine, norepinephrine, and it can be a very big mood enhancer.

Now, it’s not like a Xanax. You can’t take it once. You gotta take it every day. And that’s where I also see people go wrong. They got all these supplements on the kitchen counter, and they’re, like, lying there. And they’re like, “Well, some days I take a little of this, and some days I take a little…” And I’m like, that’s… It’s like taking a quarter of an antibiotic and wondering why your sinus infection doesn’t go away, right? It’s not gonna work. So, you gotta take them regularly.

And so, in the book, I write about some of the core, kind of kick starter supplements, like magnesium glycinate, like methylated B vitamins, which many people, many, many, many people benefit from. Like a probiotic, to help shift our gut bacteria, because our gut bacteria are actually helping shape which neurotransmitters are active in our brains. Like omega-3 fats, so we can shift that balance I spoke about earlier away from those vegetable oils and towards those omega-3s that really feed our brains. Our brains are made of fat. Our brains are about 70% made of fat. So getting those healthy fats in can be really helpful, also, in terms of lowering inflammation. And then, vitamin D.

Most people are lower in vitamin D. If you spend an hour a day outside totally naked, then more power to you. Like, you may not be low in vitamin D. But most of us have got the hat and the sunscreen and the clothes. And we’ve been educated that, you know, the sun is, like, dangerous. Which it’s not, but, you know, within reason. So, vitamin D deficiency, which the majority of Americans have some form of, it can mask as depression. And so we recommend vitamin D3 K2. So, some of those…those are some of the basics. And then there’s a lot of others where you can get a little bit fancy.

Katie: Yeah. That’s such an important thing, that distinction between it’s not just about deficiency. Like, we’re not just trying to get into, like, not actually clinically deficient in something, that some of these are tools to get into more optimal range. And at least from what I’ve read, there’s things like, for instance, that it’s difficult to test for magnesium levels, for instance. And the tests can be somewhat unreliable, or just confusing, I think. And, like, I’ve read that not a lot of magnesium is actually stored in the blood, so blood tests are kind of not necessarily a good marker of that, whereas most people tend to be low on magnesium anyway, and it’s not one that’s typically dangerous to take. So it’s kind of, to me, that’s, like, a great insurance policy. Like, I take magnesium all the time.

And I am… Vitamin D as well, I’ve seen it be life-changing for people. I’m am personally a naked-in-the-sun-for-an-hour-a-day type of person. But I live in an area where that’s possible. And I realize most people don’t necessarily have access to year-round sunshine. But I feel like both of those also point to another important topic, which is sleep. And this can for sure be a fall-down point, especially for moms. And it seems like sleep is a lever that absolutely impacts mental health, very directly, even very acutely. Like, one day of sleep deprivation, we are not mentally on our game the next day. So, what are some of the ways we can support sleep during the day, like, those core actions we can build?

Robin: Sleep is such a tough one, right? I feel like it’s a tough one for all of us. And I know, like, I have a six-month-old. I know if you have little ones, you’re just like, “Great, thanks. Thanks for the newsflash that I should be sleeping more,” you know. But within that, what you can focus on is quality sleep, because quality matters just as much as quantity. And so, that can mean everything for making sure… You know, I live in New York City, and I live under a large rock called kids and work, so I barely see the light of day a lot of the time. And that’s my reality. I wish I’m like gonna move down to where you live, so we can change that, or I’m here in Austin right now, and I’m like, “Ooh. Sunshine is amazing.” But back to sleep, getting outside in the morning, and getting exposure to sunshine in the morning can actually help really set that circadian clock, and get your body kind of ready for what is a normal day.

And then, on the flip side, sun setting or evening, so, really dimming the lights, turning down the lights. And I recommend a screen-free 30, or 60, ideally, before bed. So, before bed is your time to stretch, meditate, read a hardcover book, prep lunch or prep food for the next day, meditate, breathe, take a long bath, right. But it’s not the time to be running, working, catching up, or scrolling your social media, because that really impacts our sleep. And we’ve heard a lot about the blue light emanating from phones, and now there’s, you know, apps and stuff that you can screen that blue light out. Blue light’s part of it, but it’s actually been shown that it’s just the pure stimulation of looking at TV, or phone, or computer before bed, that is telling your brain it’s time to rev, rev, rev and go, go, go, and then you don’t have quality sleep.

Cold, dark room. I can’t speak to this enough. A lot of people are sleeping in a really hot space. So, I know there’s these fancy… My husband got one. Like, the mattress covers that cool you down. He loves it. I feel like I’m sleeping, like, my reptilian brain makes me feel like I’m sleeping in a shallow pool of cold water, and I find it really disturbing. So, like, to each his or her own, right, on those things. But just cooling your room down at night if you can, to that 65 to 67 degree Fahrenheit really impacts your metabolism and your sleep quality. Darkness. I wear an eye mask. I wear earplugs a lot. Like, I don’t need to wake up every time the baby just has, like, fuss, fuss, fuss at this point, you know. He’s not, you know, in the first couple months anymore. If he’s really crying, I’ll still hear him, so it’s okay. But I think that, you know, really setting ourself up for that healthy sleep.

And then, alcohol, you know, if I see one more wine and mommy meme, I’m gonna lose it. But, like, you know, we need to learn constructive methods of managing our emotions. And in this culture, we are taught destructive methods of managing our emotions. Alcohol, overworking, drugs, looking at screens, looking at media. And it’s okay. Like, I had a cocktail last night at an event. And I’ll have a glass of wine here and there. But, like, if you’re drinking more days than you’re not, your sleep is disruptive, even if it’s a drink or two. And I think a lot of people, especially women, don’t realize that they’re drinking a little bit more than I think they think they are.

And so, really taking a look at that, and I write about that in the book. And it’s not to say, again, I still drink some alcohol periodically. So, if you can have it as a healthy part of your life, then okay, but I think we need to set clear boundaries around what that actually means, because alcohol, when it comes to sleep, it impairs your body’s ability to reach the lower resting heart rate and lower core body temperature that allow you to reach deep sleep and get through more of those REM cycles that you need to feel rested the next day. So when I hear, “Well, I just had that one glass of wine at 6:00 or 7:00, and I sleep eight hours, and, you know, I don’t get why I’m exhausted all the time,” I say, “Well, let’s take that one glass of wine at 6:00 or 7:00 or 8:00 to zero on at least four nights a week, or take a three-week hiatus and see how you feel.” And people can see a really big difference.

Katie: Yeah, I’m a big fan of cycling things. And especially going off alcohol in spurts for a couple months at a time. Or, like, I love to do, I don’t need to avoid gluten and dairy anymore, but I find that if I just reduce a lot of those kind of foods, and alcohol, for two or three weeks, it’s like a great reset, and I just really focus on gut health during that time. And that tends to, like… I don’t wanna ever get back into the Hashimoto’s zone, so that’s kind of one of my preemptive things.

I love that you brought up the screen time thing as well. I think one of the easiest things we could all do for our health is just stop engaging with the news altogether. But to your point about the stimulation of social media, I have those, like, red light filters on my phone. And I still don’t like to get on my phone at night, but there was a night when my team was like, “Hey, you need to check out these things on TikTok,” because we need to start putting content on TikTok. And I had never been on TikTok, and so I started scrolling through it right before bed, and I could not turn my brain off, because it had just been, like, shown all these hyper-stimulating things. And it was a terrible night of sleep.

The same with alcohol, though. That’s one of those things. Wearing a tracker all the time now, it’s like I have conclusive data for myself that even one drink, I get much less deep sleep, my HRV is lower, my resting heart rate is up, and I don’t recover. And so, I’ve had to, very similar to you, like, I still drink on occasion, but it certainly isn’t an overnight thing, or I just don’t recover from workouts and I don’t get good sleep. And it’s not worth that trade-off.

And I know from your personal experience, while you are writing this book, you had two kids already, I believe, and then got pregnant with your third, and are running a company, and I’ve been in that zone as well. So I’m curious what lessons you took for yourself, because I know when I am deep in research, I’m like, “Oh, I logically sort of knew this, but I need to apply this.”

Robin: Yes. I mean, listen, I can’t be my own doctor. And I know all the information, right? But, like, we can read a blog post about personal training. That doesn’t make us a personal trainer. I certainly am not equipped to be a personal trainer for myself. And, you know, I not only need all these reminders, I need support, right. And I think, as moms, we’re going through a period of time, and you said it amazingly earlier, like, we’re supposed to take care of our kids like we’re not working, and work like we don’t have kids. And that becomes really impossible. And so, setting boundaries, taking time out, especially in a world where for a lot of us, work from home, if that’s where you’re at. Not everybody is. But that can mean kind of being always on. There’s no clocking out. It’s just, your work is always right here in this little box that I’m sitting in front of.

And so, setting those boundaries, first of all, and setting those calendar invites. I’m a big fan of, like, calendar invites for myself. I block time every day for yoga on my calendar, that my team can’t schedule over. I block time in the evening certain nights of week, for, like, my self-care time. And I put it on like a meeting. It’s just as important as an investor meeting or a key hire, or whatever else I’m doing. I think that blocking those things out and treating your calendar for your life as seriously as you treat your calendar for your day job, if that’s what you’re doing, is really critical.

And then, just really knowing, like, where I can push it and where I can’t. And listen, sometimes I push it too far, and my body shows up and tells me that I pushed it too far, like, energetically, and then I listen. I mean, I’ll tell you the story. Like, it’s really embarrassing, but last week, I’m here in Texas for a couple weeks, working remote. I flew early morning to Chicago for the day on Thursday, from Austin, back to Chicago the same day. Back at 1:00 in the morning. Next morning, I’m a big intermittent faster, works for me, doesn’t work for everybody, but I’m past breastfeeding and past pregnancy, and done having kids forever, woohoo. So I can, you know, get back to my biohacking. And I show up at a business lunch, and I got dizzy, and I had to put my head down on the table, and I told my husband to come get me.

And it was one of those days where it was just too much. And I cleared my calendar, and I just rested that afternoon. And it was like, I think sometimes we push through and push through and push through. And I’m somebody who tends to motor, motor, motor, go, go, go. And back to the calendaring and the setting limits, I’ve really cleared out my calendar for a couple of days this week, not just Friday, when I wasn’t feeling well. But through this week, because I was like, “Oh, I need to actually recover.” Not like a couple hours on a Friday, but I need to really give myself that time and space. And I think we as women just don’t give ourself that time and space, and then we’re running on empty. I have so many patients who are on kids two, three, and never kind of put the gas back in the tank between one and two, or between two and three. And then the depletion starts to really take over.

And so, a big thing that we do, we do a lot of preconception optimization, fertility work, helping women get pregnant. Supporting their bodies. They’re still on their own when it comes to actually getting pregnant. We do a lot of maternity support, we do a lot of postpartum optimization and healing, and, you know, dealing with all the stuff that’s happening there, from mental health to autoimmune, everything. And in that postpartum period, we really focus a lot on how are you rehabilitating yourself and putting gas back in your tank? Because if you didn’t do that between the last two kids, you’re gonna start to really run on empty.

And I think women don’t get that permission a lot. They just get, you know, take another pill, keep going. And at some point, no medication is gonna replace really taking a timeout and restoring, for, like, weeks at a time. And I will prescribe to my patients, I’m like, “You have to take a break.” And that is, like, on your prescription pad, not just with your refill.

Katie: Yeah, and that’s I feel like a hard shift to make, especially for moms. And one I’ve had to learn the hard way as well is to put… I now think of it as I’ve scheduled the most important things first on my calendar. And those things are the things that give me energy to do the work. So, before work meetings can go on my schedule, my workouts go on my schedule, family dinners go on my schedule, time with my kids goes on my schedule, and those are non-negotiable. And I learned… I was in a habit for a lot of years of kind of, like, caretaking, that I would never have considered not showing up for my kids when they needed me. But I wasn’t showing up for myself, which also made me less able to show up for my family. And so that was a lesson I had to teach myself.

And it’s funny. I think of a correlation based on what you said of, you know, I can know a lot about personal training. I’m not a personal trainer. That’s a great analogy. I also think of, like, I’m a doula. I’ve been through some of student midwifery school. And yet, when I was in labor, all of that went completely out the window, and I remembered nothing. And I was just, like, even though if someone else was in labor, and when they’re hitting that space of, like, “I can’t do it,” I would be like, “Oh, you’re almost there. This means this and this, and you’re in transition.” When I’m there, I’m like, “No, this is gonna last forever.” And when you’re in it, it’s hard to see the 10,000-foot view, so it’s always helpful to have those great sources of guidance from outside, which kind of loops back to the initial point about work with practitioners who are your partners, and who you can really align your goals and move toward where you wanna go.

And as we get very close to the end of our time, I can’t believe how fast this has blown by, a couple more questions I love to ask, the first being if there’s a book or a number of books that have profoundly influenced your life, and if so, what they are and why?

Robin: I love “The Power of Now,” by Eckhart Tolle. And I think, you know, we learn very early in life in our culture to kind of future trip and dwell on the past, and we don’t learn how to be here. And I’m certainly guilty of that. So that’s one that I come back to over and over and over, that really shifted my perspective on reality, that I highly recommend.

Katie: I love that one as well. I’ll put a link to that in the show notes at wellnessmama.fm, of course, with a link to your book as well. If people want to keep learning from you or maybe have specific questions related to preconception optimization, or postpartum, or any of these topics we’ve talked about, where is the best place to find you and keep learning from you online?

Robin: So, parsleyhealth.com. And we have an awesome newsletter, everyone, with amazing… I mean, I’m talking to the content queen here, so I don’t even know why should I say this. But we have an amazing newsletter, all physician authored and edited, health coach authored and edited, that gives lots of step-by-step tools. You can buy the book “State Change,” which is my simple roadmap for finding and re-finding better mental health every single day, in, anywhere books are sold, Amazon and Barnes & Noble and, of course, all the places.

If you’re looking to just do, get your symptom score, and do it online, I would check out parsleyhealth.com/insights. Anybody can just go there and get their symptom score, and kind of begin that process of that first step, which is, I need to know where I am right now in order to direct myself to a new place. And then it’s @Parsley_Health or @robinberzinmd on all the socials.

Katie: Awesome. Those links will be in the show notes as well. And any parting advice for the listeners today that could be related to something we’ve talked about, or entirely unrelated?

Robin: Don’t let perfect be the enemy of really good. Just start.

Katie: I love it. Well, we’ve gotten through so much today. This has been so helpful and practical. I know you’re a busy mom and a busy doctor. I am very grateful for you being here today and sharing your wisdom with us.

Robin: Oh, my, gosh. I’m so grateful to you. Thank you for all the work you do, and thank you for having me.

Katie: And thanks as always to all of you for listening, and sharing your most valuable resources, your time, your energy, and your attention with us today. We’re both so grateful that you did, and I hope that you will join me again on the next episode of “The Wellness Mama Podcast.”

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.