And men do need connection just as much as women, but it's the how. That is often very different and how that manifests. Sure, because they may need to feel accepted and that they're good enough, right?

That what they have provided or done or built is acceptable, right? They're gonna spend most of their time building the thing, not, you know, nurturing a relationship with someone.

Your health is shaped by more than symptoms. Through real stories and expert insights, we explore how your genetics, environment, and daily choices affect your wellbeing.

We uncover root causes and share practical tools to help you find the healing you need. Welcome to the Forum Health Integrative Medicine Podcast. Welcome back.

My name is Amanda. I am here with Dr. Peterson and Erica Shepherd, nurse practitioner in Forum Health Denver, and we are continuing our discussion on burnout.

Welcome back. Well, I'm excited for this second episode of burnout. You actually said something last time that was really I don't know, it connected to me and maybe that was the point, it's connectedness.

How much our connectedness to other people makes a difference in our physiology. It's not just the non-human environment, it's our human environment and it just makes so much sense, right?

One of the things that we sort of chatted about after we finished that episode was how, how this affects the men and women a little bit differently. I think Amanda, you brought that up and I'd love to dive into that right before we talk about what we're going to do to fix it.

Because if there is a difference, fixing it might be different. Yeah. Well, we were unpacking last time about why burnout goes so much deeper than self-care.

And I think it's interesting that we do see a higher rate of burnout in women than we do it with men. And we do know that men traditionally under-report symptoms and things like that.

But I think that there's more to the story of why women do experience burnout in higher rates. And I think there's societal factors to that. And I think that there's also a lot of biology factors to that as well.

when we look at society, it was really created with a 24-hour rhythm in mind. It's get up, go to work, produce, come home, and repeat the next day. And that kind of work culture and hustle doesn't always meet the needs of women in our cycles, Even in different eras of our life, we go through different cycles, but we're on a 28-day cycle where we're moving through different forms of focus, creativity, and energy throughout the month.

And I was thinking back to when I had turned 35, which is when I should have been acknowledging some of my signs and symptoms of burnout, but when you turn 35, That's around the age where hormones shift once again for women.

It's not necessarily perimetopause, but our fertility is shifting and our hormones are shifting once again. And it just kind of helps us. look at women a little bit differently.

We go through all these different eras and cycles where our stress tolerance and our resilience diminishes over time. But more specifically for women, it does diminish a lot that way as well.

I completely agree with you on that. Society has changed more in the last 50 years than in the last 500 years. Certainly seems like it. I wasn't alive for those 500, but it sure seems like it.

No firsthand account of the account, but I've been told. So with that, particularly for women, and Amanda's right that we do have different hormonal cycles and how our body operates cyclically does impact our energy levels to different degrees.

And we are going full bore. Women are working more than ever, but still expected to do the same things of like, you know, keeping everything together, taking everybody everywhere, if you have kids, taking care of the kids.

And it's like, now, not only do you have that much more responsibility than before, but do it all with a smile on your face and tell everybody how what a boss lady you are, you know?

It's exhausting. To men, I want to just say this, like my husband and you know, they step up, they're doing a lot more, but women are still doing a lot more today too.

It's not like, it's not that the men aren't contributing in most cases, but it's still, there's still just a lot that women are doing that I hesitate to step into this conversation.

I think it's an important conversation. Yes, it is. I think that obviously there are biological differences between men and women that play a big role in this because of how hormones change for women throughout the month and they don't change for men.

A man's hormones are pretty much the same regardless of what day of the month it is. There's a little bit of variation, but sort of like your sleep-wake cycle.

I mean, it doesn't change day to day. It just changes night to day, right? So, we don't have that same impact. We also, like you pointed out, don't have as much of a change depending on where we are in the cycle of life.

Should I be, you know, making humans, right? Is my body tuned to becoming pregnant or is my body now starting to slow down and that still has the capacity or has it completely turned off that capacity, right?

A man can have 400 until he's 70. He doesn't have to do any of the work, right? But I think there's also something else that is really important and research bears this out.

Women are connected to people and men are connected to things. Men think about things and women think about relationships and conversations. And so if that is such a large part of burnout, then it makes perfect sense that women would be more sensitive to that because if I have only one friend and I probably have only one friend, I'm okay.

I got one friend, right? I have a whole bunch of acquaintances. If my wife has only one friend and she doesn't feel connected, It's no good, right? And certainly, I'm not enough to be the one friend because I'm a guy, right?

And so I think that connectedness is different between the sexes. And I think it's important for us to recognize that. And quite honestly, it's a blessing, right?

The fact that my wife is as connected as she is to me, partly connects me to my kids in a way that I otherwise wouldn't be. And I don't want to take anything away from fathers that are connected to their children without the aid and support of a spouse.

But women keep the world connected in an emotional way that I don't think men do. right? We wouldn't go to war with all women. What's that? I said, we do.

And it's our superpower. That's right. And it's a superpower that we should champion instead of say, no, we're all the same. We're exactly the same. No, we're not.

That's absurd. Research has a lot to catch up on too. I mean, research is primarily done on men. And it's you know, that's starting to get corrected. We're seeing more research being and women being represented in that also.

And so there's just a lot we don't know about women too. You know what, what I love about that and what is both rich and ironic is that if we are in fact the same, it won't matter.

We can do all the research on men. But we're not the same. So let's stop pretending we are, and let's champion the thing about our counterpart that is so amazing, right?

My admiration for the strengths that women have doesn't mean that I don't think men contribute, but it means I don't think I could contribute that way, right?

They do that better than I do. And thank goodness, right? So just the fact that we want more research on women implies they must be different. Right. And I will say this too, men, you're right on those differences between men and women.

Men do need connection just as much as women, but it's the how that is often very different and how that manifests. Sure, because they may need to feel accepted and that they're good enough, right?

That what they have provided or done or built is acceptable, right? They're going to spend most of their time building the thing, not, you know, nurturing a relationship with someone, but they still need that acceptance and they still need that care.

And I think that men who are in a relationship of some sort, if they have a significant other in their life, I know I kind of control the social calendar in my household, right?

100%. I don't even know what the calendar is. I just show up and say, where are we going? And, you know, my husband had to, when I was going through my period of time, he had to develop his own social calendar and that was out of his comfort zone and it started to affect him too.

So I do think that like women contribute to their partner's overall sense of wellbeing and connectedness because it's one of our, you know, callings or it's, it's part of our nature.

Yeah. to be that for. Yes. And you two just brought up a great point because you're talking about your partners and together you create an ecosystem, right?

Together you create an environment. And when you guys share that load, like how great that feels. And also you know what the gap would be or have experienced the gap or they've experienced the gap when that's not there and how much more that is life-wise.

And right now I don't have a partner. I moved here by myself to Colorado and I'm not here to say what was me, but I've really had to use this time and opportunity to really be selective about the ecosystem I'm creating.

Right. And how? You can't, you're not going to get it by default. You have to be proactive, more proactive. Exactly. And I'm like, listen, I might not have a husband right now, but I do have DoorDash that can bring me a delicious hot meal.

And I'm, it feels so nurturing, you know, something healthy and delicious. And it's like, it's like, you're the collective boyfriend that I'm making. It probably helps if you talk to the DoorDash person and say thank you, because then you're emotionally connected too.

And then I'm emotionally connected, exactly. But it is getting creative about, okay, even if you're not technically like part of an ecosystem, you're always inherently part of one.

So how are you going to create that and make your life feel balanced? Because again, when you try to do everything and whatnot, that's when that burnout starts to accumulate.

I think that's important too. How are you going to build those relationships if you're not in one or if you've just moved? I have got a lot of friends and in my previous life, I had made a big move and was solo in that move too.

And I used like BumbleBFF and I met the coolest group of women in my area that today are my second family. Yep. I used to coach a lot of people in how to engage with your community and how do you create that space for yourself and going to the workout classes and making a new friend or what are the interests that you have, go take a class.

Someone I know loves pretzels and he just moved to Seattle and so he went and took a pretzel making class. There's so many fun things that you can do, but we're also in this era where like everything's on your phone and it's really easy, really, really easy to be an introvert and not put yourself out there.

We've made it really easy. Hence, why we're seeing so much burnout. I mean, we are seeing that after we shut the world down in 2020 and had to go isolate.

Like, I don't think it's a surprise that four years later, we're seeing higher rates of burnout now. I want to throw out one more thing. I'm sure you guys will agree with this.

There's something unique about the interaction with other people being one that is service to them. Now, when I say service, it doesn't mean that it has to be at the soup kitchen, right?

You could teach the pretzel class. And if you teach the pretzel class, you're having a different experience than if you take the pretzel class. right?

Because you're giving something of yourself to these other people. And you could be, quite honestly, it could be a business, but you are serving them, right?

And that's a different experience than just saying, oh, what am I going to do because I enjoy doing this? I could, you know, join the silver sneakers and walk around the mall and talk to people, and that'd be great.

But I could also start the silver sneakers, and then it's a different experience. And I think it treats our disconnectedness in an entirely different way.

And we don't have to lead everything, and we don't have to serve every time. But if that's not part of what we're doing, I think we're missing one of the pieces of that connectedness.

All right, well, let's jump to the medicine because I don't I think our listeners. That was a fun. That was a fun detour. But I also think I think it was such a good topic to discuss too.

It needs to be talked about more. Right. But so. At Forum Health, we uncover the why behind your symptoms. With advanced lab testing, hormone optimization, and cutting-edge therapies, we help you heal and perform your best.

And now, through shopforumhealth.com, you can access physician-grade supplements trusted by our providers, supporting everything from adrenal health to focus and longevity.

Learn more at forumhealth.com and explore supplements at shopforumhealth.com. Last episode, we talked about what is burnout, why self-care isn't enough, and how it shows up in our lifestyle, our community, mind-body connection, and our cellular health.

Erica, I have a question. If I were on this journey all over again and I had known it was burnout What could I do to measure it or like, what would you look at as a provider to say, to confirm, Amanda, you've got burnout and here's some of the results.

What they've reported, I want to take a full functional medicine blood panel. I want to look at their cortisol levels. I want to look at, you know, just their entire blood count.

I want to look at their different hormone levels. And just see where their body processes are on that front. The other thing that I want to check for some people.

I really love working with the gut. And so burnout can really manifest in the gut in a lot of ways. It's like, what was first, the chicken or the egg?

You know, a lot of times we're not going to know, but we want to see how things are functioning on that level. What tests do you like for the gut? Is there a specific, do you do the gut zoomer?

Do you do genovas? Is there something where you'd say, oh, when I see this. Yeah. Especially with the fatigue. Because I think patients want to know, well, what test should I do?

Right. I get so many patients that are like, I'm fatigued, right? And I like the Genova three-day stool test and the SIBO test. Mind you, a lot of my patients do not complain of gut symptoms.

They do not. They're not… I know. I have to tell people, we're going to do this test, but my gut's fine. Well, we'll find out with the test. We'll find out.

And I have yet to see anybody… We'll be like telling me, I don't have cancer. Well, how do we know? Let's look. So what tends to happen with prolonged stress is that it affects the microbiome and it is a big reducticebo, just small intestinal bacterial overgrowth because when you're stressed, that gut motility slows down and the bacteria are like, yay, and they crawl up into your small intestine because they can, and that can cause a lot of imbalance.

Again, the price of prolonged stress. Even if you finally fix your life, you're in good relationships, you got the dream job and everything else, and you're still feeling kind of, ugh.

then it's like the damage has been done and we need to go into the body now and fix whatever the long-term repercussions of that stress was. Okay, so I'm looking at the blood work and I'm looking at the gut.

Those are my big things and I like the Genova 3-day school. What are you going to find in the blood work? What do you typically see with their cortisol or their hormones?

What are you seeing? Yeah. So either their cortisol can be really high or it could be tanked. Like it could be one of the one or two ways on that. Sometimes their cortisol is okay.

A lot of times I'll see their. their hormones are out of balance. For men, it's the lower testosterone. For women, it's a whole hodgepodge of how that can shake out.

More complicated. Just a hodgepodge. I know it's the medical term too. It's a hodgepodge. Well, I think patients want to know because they can go online and order some labs and more power to them than they should.

But then what are we going to look for? How are we going to say, oh, this is what we're going to do? So those are great details. I appreciate that. Absolutely.

Totally. And I also definitely checking the thyroid because stress can do a number on the thyroid. So I'm always checking their thyroid levels too. around that and everybody's different.

So some people, you know, they come back with, you know, their gut looks okay, but they have SIBO, you know, like they don't have dysbiosis, but they have SIBO and then we treat the SIBO and they're like, oh my gosh, I feel so much better, you know, but I will say the people that don't take care of that relational piece and their external environment will fix all their problems and then be back six months later, you know, I'm starting to feel not great again.

Right, and so it's both. Yeah, you gotta keep both sides. You can't just say hi to the DoorDash guy and thank you. You can't just have a good relationship with your kids.

If you have, you know, hormone dysfunction, that has to be treated too. What I like about what you had brought up last time is that I think functional medicine does focus much better on people's hormones or their thyroid or their gut.

We do those things and people probably know we do those things. But I hope we also pay attention to our psychological and spiritual health because if we neglect those, then we'll stay sick.

When people listen to a podcast, they want to know the medicine. So we're going to stay there for a little bit. I was able to identify what areas to address, correct from that psychological standpoint.

And I started to feel better, but you know, it's corrected. Why don't I feel you? We didn't get here overnight. Our relationships and our stress did not land us to the edge of burnout or at the point of burnout because we got here overnight.

And I think that that's why I think getting labs and things like that has been really validating for me. I did have my hormones were kind of all over the place, a little bit wacky.

I had low testosterone, all that stuff. And you know, it's starting to help but it's seeing the progress in the labs because I know what I've been able to do from a self-care from What's in my control of my life?

Yeah, I also know that like I'm still seeing the results and I'm still getting better even though there's things that are corrected I still have to give my body time to correct what was damaged or influenced by all of this.

I have to give that an appropriate timeframe. What if someone is, let's say me, I've been on this journey since the beginning of the year. I think I got a little bit of a late start with the functional and integrative side of it.

Right. And I think recovery and healing does look different for everybody, but how long are you looking for somebody to stick with you when you're correcting some of the biology with the gut stuff and the cellular medicine and the health?

Like, how long should people expect to be going through a treatment process for burnout? I give people the expectation, give me six months to a year. to work on the different pieces.

When do they first start to see some improvement? I mean, I'm sure that varies, but what would you expect? I'd expect with giving some of the therapies that we give that you should start to feel at least a little something within a month.

You know, that's what I would say. Yeah. And that's what I want listeners to hear because they should, this is not six, 12 months from now, you'll feel better.

This is, you're going to feel better, but you can't stop too soon. Exactly. We got to keep going, making the baby steps. And you know, my approach. So for example, I had a patient coming in today.

His, the only thing he's really here for is fatigue. He wants to feel more optimal, not as fatigued. And he's taken amazing care of himself actually. Somebody who's doing all the right things.

But. I gave him, you know, we want to test your gut, your blood. And when we get the results, we'll come up with a response. But the place I always want to start with people who are especially experiencing the fatigue and the like, oh, I know I could have more gas in my tank is the mitochondria.

All right, go into that. What are you going to do for that guy? Or what did you do for him? Yep. So the mitochondria, I really love to juice them up with some supplementation that's to help heal it.

So I love ATP360 from Research Nutritionals that helps heal the cell wall of the mitochondria, which is where the energy cycle happens. And so if that's beat up, you need to heal the cell wall.

I also love using NAD injectables here. I experienced so much improvement from that myself. And so from my own personal experience, I'm like, okay, we want that, but we also want to heal the cell wall itself.

So I like to combine those two and then poly-MGA. I think it might be valuable for listeners to understand why that cell wall is so important. And I don't want to put you on the spot.

I'm happy to if you want to explain that or I can explain it, but there's something important that happens at a cell wall. And so you can't just give people energy.

It would be sort of like saying, I need more gas in my tank. Yeah, there's holes in your gas tank. Exactly. It won't matter how much we pour in there.

Right. And so that membrane, the mitochondrial membrane is where the energy is actually created. That's where the ATP is being created. And that's why fixing that matters.

And that's actually partly why toxins make such a big impact. Because if you have toxins in your cell membrane, it can't work like it's supposed to. Exactly.

And so anyway, I think that because when you say ATP 360, fantastic product. Why does it work? Oh, the membrane. What does that do? Exactly. Dr. Peterson is exactly right.

I love that metaphor is like you're filling up a gas tank with holes in it and you got to patch up the hole. So that what that supplement does is it patches the holes in your cell membranes, which is very important.

Yeah. Totally. All right. What else? So you're going to give them NAD. Now, how do you like to do NAD? You give it IV? We do it IV here as well. And we do have the sublingual because it gets too eaten up in the digestive tract by taking it straight up orally.

So we do recommend either sublingual or twice a week injections, which is what I did. And I mean, I can feel it. I was like, whoa, I'm going to throw this out there.

Who knows whether it stays or not, but I have one patient in particular who he kept trying NAD all, you know, he'd suck on it. He'd swallow it. He finally, he got his capsules.

He took them rectally and he was like, God finally works. There is a first best effect. You will break it down. So not recommending that approach, but it does work.

Again, bypassing the digestive tract. That's right. You got to avoid that liver first pass metabolism. Exactly. Exactly. So yeah, fantastic. And then another supplement we like is called Poly-MBA and it's a combination of minerals, vitamins, and aminos.

And those can really help the ATP production within the mitochondria. So I'm always combining what's going to fix the cell membrane because a lot of people got them leaks.

No matter even how clean you eat or how non toxic you are, we live in a very toxic world that is just bombarded. So I'm like, I know you try so hard and you're probably not avoiding the toxins you're doing.

And not to say you should throw caution to the wind, do everything you can to avoid toxins. But we still live in a modern world with 80,000 chemicals that have been added to the MSD data sheet in the last 50 years, which is bananas.

Yeah. So thank goodness. Cause I really like things like my iPhone and I don't know my shoes, right? Like my basketball shoes would not work so good with leather soles, right?

So I'm not, I'm not criticizing the modern world, but it is polluted. Right. We just need to take care of, of ourselves. So talking about, you know, our bodies not being able to communicate properly.

So this goes back to connection. But it's like now we're talking about connection on a cellular level. And so if you're not connecting right on a cellular level, then you're also going to get burned out and that feeling of like exhaustion, fatigue, because again, these cells are not connecting properly.

So addressing that mitochondrial health and the cellular health is huge. And so for that guy, we're going to address that. I have another patient who has been dealing with fatigue again, doing all the right things and her, her gut test, she doesn't have gut issues, but she came back for seven out of 10 dysbiosis on the Genova three-day stool and you know, methane dominant SIBO.

And she's like, so when you say she doesn't have gut issues, you mean she doesn't have symptoms. Correct. She's got issues. Thank you. She's got more issues than sports illustrated, but she doesn't have any symptoms.

Correct on that front. Exactly. And so that's why it's so important. Cause she's like, is this why I'm feeling so fatigued? And I'm like, yeah, this is, this is part of it.

And so we're again, that whole addressing the whole person. I think that's worth mentioning here too, and I'm sure you know this, but we make our neurotransmitters in our gut.

And I don't know if the listeners all understand that. You make 90% of your serotonin in your gut. Well, if you've got gut dysbiosis, good luck making any of that neurotransmitter that's going to make you feel good.

Exactly. And that's why a lot of people after gastric bypass go into a depression, because you just took out a bunch of your… You removed the factory.

Yeah, you removed the factory. We've got addressing cellular health is one of your main focuses when you are working with somebody with burnout. Yeah.

And I was just going to say, what's, what's another strategy that we can work with? And Dr. Peterson took the words right out of my mouth. How about some peptides?

Right on time. Yes. Forum Health Denver. We use a lot of peptide therapy. to be able to enhance the body, what the body already does. So what peptides do is they are, is they assist the body in what it already does to help optimize and do it even better.

So there are multiple peptides that I, honestly, there's, I did a lot of research and not that these peptides are specifically for burnout, but they can help with mitochondrial repair.

They can help with, you know, neuro, how the body communicates with its neurotransmitters, it can improve that. And so it's not that they train burnout specifically, but they treat the damage that's been done by burnout so the body can heal itself.

And so there's different ones. There's epithelin. There's thymosin, alpha-1 and 2. There's all kinds. And then, you know, honestly, what's been really interesting is we do a lot of turzapetide here and we do it microdose for a lot of people.

And at a microdose, one of the benefits of turzapetide is it's anti-inflammatory. So the inflammation that's been caused by this long-term stress and burnout, we get a lot of patients reporting I want to, I want what I've loved most about the triseptide is my brain fog and fatigue are so much better, right?

They're not using it for weight loss. Let me have you, if you, if you don't mind, tell our listeners, what is a peptide? Just so they, cause they hear, I think that word people hear it all the time now and they're like, I don't know what it is.

Could you, could you explain that for them? Okay. So yes, a peptide is a compound of two or more amino acids, which are proteins. and they are linked in a chain.

And so these, when they're distributed, these proteins, amino acids, go into the body and they'll attach to certain receptor sites in the body to create a certain response.

So there's all kinds of peptides, which are these amino acid chains, and they do all kinds of things. People are most commonly knowing right now the GLP-1s, right?

And those are peptides. Sure. In fact, there's a peptide that everyone has heard about, but no one remembers that it's a peptide called insulin. Good old insulin, exactly.

And if anybody pays attention and understands something about digestion, the thing about amino acids in a string, if it's a long string of amino acids, it's called protein.

And if it's less than 50 amino acids in a string, it's called a peptide. Now, most peptides that are signaling molecules are much shorter than 50. Like you say, they could be two, they could be three, they could be nine.

As it turns out, if we take them orally, our body doesn't know what they are and it just digests them as though they were protein. Like a little piece of steak.

Yeah, they tried real hard to make a rebelsus work, but just, sorry, it's not gonna, right? Right. And that's why you do the injectables. And so we give these peptides, they're all in like subcutaneous injectables you do in your stomach area to, again, evoke the desired response that it gives inside the body.

There's one other thing that I think is worth our listeners knowing about peptides. Our body makes these. It's not like this is a drug that we invented and thank you Pfizer or Eli Lilly.

No, this is something that the body makes. It's a signaling molecule. It's like a hormone. In fact, sometimes when we say the word hormone, we are lumping peptides in with them.

Hormones are really these signaling molecules that are a ringed structure rather than a chain. Exactly. And so there's a lot of, I think we're just even scratching the surface of what peptide therapy can do to help optimize the body and biohacking and all of that, but especially in the realm of burnout.

And I've even been impressed since I've started working here of people who've been playing with peptides for a while, even before I joined the practice and how much they're like this helped.

my depression, this helped my brain fog, this helped my fatigue. And I'm like, oh man, this is powerful. Now, are you, are you, cause I imagine the answer is yes and yes.

You're learning those sorts of things from some of the patients or from Dr. Grover or from some of the colleagues. Okay. That's what I would expect. Cause I have patients that come in and tell me, Hey, I'm using this.

Here's how it's phenomenal. Like, Oh, that's good. That's good to know. That's the beauty of the information age. I've learned so much from my patients.

I think on the balance, I've learned as much from them as they have from me. I'm just sharing the information with the next guy. Exactly. I'm like, oh, I'm going to use that on Joe Smith over here.

Thanks. Totally. 100%. Yeah. Awesome. All right. So there's this whole body approach. You're going to treat gut. You're going to treat the sort of cell membrane.

You're going to treat the fuel tank with NAD, peptides to help with signaling. Are there other things that we haven't mentioned yet? I'm a big fan of primal wisdom.

And so I've done a lot of world travels and I like to observe and see, okay, what has been, what have we been doing for thousands of years that is helpful to human health?

And so I love getting patients into habits of grounding, which is being barefoot on the ground. I recommend saunaing a lot because again, you want to be detoxing regularly.

So I do a lot of lymph. habits with people, like teaching them like dry brushing and doing these different body movements that can promote the lymph to, to move because your lymph system does not move on its own.

It has to go with circulation or a rebounder. Absolutely. Or just going up and down on the ground with your heels hitting the ground. If you've got nothing else to do while you're putting your makeup on or brushing your teeth, you can do that.

And that can stimulate lymph flow. And that's our, it's the, it's the dumpster of our body. So just think of the, you know, the lymph. That's probably why I've got so much edema is I'm not putting on my makeup long enough.

You're not putting your makeup on long enough, Dr. Peterson. Give it a few more minutes. So I really am into like grounding those practices and then saunaing.

I mean, most cultures in the world have some that I've been to, you know, over in Europe. I was just in Hungary. Everybody goes after school or work to the sauna houses and they sweat and they commune, right?

And what they're doing is detoxifying, right? Exactly. Like that's everything you just described. the lymphatic, all of these approaches, sauna is to detoxify.

Exactly. The ground is a little bit different because it's getting rid of oxidative stress in a way because it's diffusing electrons out of your body.

It'd be like when you ground your television or any other appliance in your house. But detoxing, it's obvious, it makes sense. What's the stress coming from?

Well, so many sources, but toxins are one. So do these detox things. We're not detoxing. Again, it's going to back up and it's going to cause those holes in the cell membrane from the damage.

So it's like, it's regular maintenance that is of these things that can really help make a difference long-term and the consistency. Cause you know, you can't just rebound once and think you're going to make, you know, the job.

And I'm always, I'm always about habit stacking. James Clare talks about this in Atomic Habits, like how can you kill two or three or four birds with one stone?

So how can you stack these things? I try to describe detoxing like vacuuming or dusting your house. You don't vacuum once. You don't vacuum when it's so dirty that you can't see the carpet anymore.

You vacuum every week, maybe three times a week. It depends on if you have toddlers, right? Like it's something you do all the time. Well, so I feel like we've talked about sort of the biological aspect to this.

If it's okay, tell me what things you are most impressed by when it comes to the connectedness. Are there programs that you recommend? Are you a fan of counseling or group therapy?

What sorts of things in the connectedness realm would you recommend on top of these physical things? As far as connectedness, there are certain things that I recommend to everybody.

One is internal family systems therapy or a type of somatic therapy. I find that much more effective for people to connect to themselves than just regular talk therapy.

And there's nothing wrong with regular talk therapy. That's why people, it's a great thing for a lot of people, but I just find it more effective to connect to self.

Group therapy is great too, because again, you have that other to reflect too. And even if you don't have problems in your life, I look at it as hygiene.

Like, you know, go for hygiene. The other thing is go into spaces and places that make you feel lit up. And so like CrossFit isn't for everybody. But it's where I feel connected to people with exercise, other people, it's Pilates.

My friend back home, she's secretly goes to Jazzercise because she still feels like the most connected. I love that. You know, so what makes you feel like most connected at home?

And it's different for everybody, but. And where you can also go into spaces that you think consistent meetup is also a great thing online where you can find an event.

Most cities have them meetup.com. I've recommended that to a lot of patients and you can find community events or spaces and places that align to you.

Some people like finding a spiritual home at a church. If that aligns for you, that can be great. But again, a place that makes you feel alive and feel most connected.

And so it's getting curious about that for yourself and making it consistent. Nice. Well, I feel like you've done a nice job helping people understand all the steps to this.

It's not just psychological. It's not just physical. And it's not going to be the same for everyone. And we can see this happen in our loved ones. And we have to be able to recognize that, you know, if it's happening for someone around me, maybe I need to understand their differences.

You know, my spouse and say, oh, well, you know, there is a difference between the genders. I would say too to that, Dr. Peterson, is don't be afraid to talk to somebody if you're noticing the signs and the symptoms.

I was too proud to notice it on my own. My friends had an intervention with me and told me that I was different. I wasn't as engaged. I was just not my normal self.

So don't be afraid to talk to somebody and help them see the signs and symptoms if they cannot see it at the time because they're exhausted right now.

They're on survival mode. And sometimes you'll save a life, but sometimes you'll save their joy. And we need to have joy in our lives, right? So don't wait until you're like, ooh, they're standing at the edge.

No, let's say because there's joy now. Well, this is really late to the game, but I thought your answer just helped me recognize the fifth most common symptom of withdrawal.

I know an hour later, but it's I'm sorry, burnout is withdrawal. The fifth most common symptom is starting to isolate and withdraw. And it matters. We need to be careful for each other.

Well, I feel a lot of hope. Tell us, before we finish, tell us just a little bit about your experience there in Denver and how people can come and connect with you, see you, and get your care.

Totally. Okay. You can hear me. So you can come see us in Denver. You can actually live anywhere in the US. We have multiple offerings and if you do end up being an annual member at the practice, you just have to be in Denver once a year.

So that's pretty, that's pretty nifty, but come find us. You can Google Forum Health Denver. You can find me on Instagram at nurse Erica Shepherd and connect with me.

And I would love to just have a 15 minute consultation, free consultation with you to discuss your, your symptoms and what you're looking to optimize your health and wellbeing.

I know you'll be well cared for. So don't hesitate to reach out to our Denver office. Thank you so much. Well, this was such a great episode. I learned so, so much.

One, for testing, it's going to look different for everybody because burnout affects everybody on a cellular level, and that's going to be unique to each person.

And some of the functional medicine approaches and strategies are treating the mitochondria, but not just the mitochondria, but also their cellular membrane is so important.

Discussing options like peptides with your integrative and functional provider can be life-changing for some of those symptoms to help support the body and those signals.

And prevention is key. And prevention is going to look like some of the self-care, being proactive, detoxing your body on a regular basis, getting those toxins out, whether it's a medically supervised detox, a sauna session, some lymphatic drainage or support.

But at the end of the day, burnout is not the end of your story or my story or anybody's story. because there is a path to regaining your vibrancy. So thank you so much, Erica, for showing that to us through these two episodes.

Yes, absolutely. And I would leave with just one last wisdom is that burnout is a teacher. It is not your end-all, be-all. It is simply a teacher. And it can be the opportunity to guide you to your best health ever.

I love that. Awesome. Great to talk to you guys. Thank you for joining us. Don't forget to subscribe and listen and stay tuned for our next episode. Thank you for joining us on the Forum Health Integrative Medicine podcast.

Each episode, we help you understand your health from every angle and inspire your lifelong wellness journey. Follow the show, share it with someone who needs hope, leave a review, and take the next step toward feeling your best at forumhealth.com.

Burnout Isn’t Just Stress: The Biology, Gut, and Cellular Damage Behind It

Amanda Kuehn-Grabot

Erika Shepard, FNP-C

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