Breathing & Skull’s Impact on Energy Production

Cheng-Huai Ruan, M.D.

Hey, hey, how’s it going?

Laura Frontiero, FNP-BC

Good, you have the best background I’ve ever seen on an interview. It’s so cheerful and fun, so good.

Cheng-Huai Ruan, M.D.

For those who are listening to audio right now, it’s basically like a pink background. I have three daughters, so they have a lotta say in my set design.

Laura Frontiero, FNP-BC

And what did they say? You’re like a, they compared you to what?

Cheng-Huai Ruan, M.D.

Oh, I’m like a Twitch streamer, which basically is a live online gaming streaming thing, which I’m not familiar with, but they are.

Laura Frontiero, FNP-BC

Which means you’re totally cool. And I think you’re cool, too.

Cheng-Huai Ruan, M.D.

I hope so, thank you.

Laura Frontiero, FNP-BC

Well, let’s introduce you to our audience. You are a board-certified internal medicine physician and founder of the Texas Center for Lifestyle Medicine in Houston. You’re also the host of the 2022 Better Brain Health Summit. It’s coming up later this year. And you’re an expert at linking brain and mitochondrial health with impaired airway and breathing disorders. And this is fascinating, and we’re gonna get into this today. You’re the only person on the summit talking about this. You like to link how neurocognitive health relates to things outside the brain. So you help tie together symptoms and health problems that don’t necessarily seem to be connected to the brain. Do I have that right?

Cheng-Huai Ruan, M.D.

That’s correct, yes.

Laura Frontiero, FNP-BC

Okay, well, let’s jump into this topic. And first off, can you share with us how, well, first off, tell me why you have this interest ’cause I know you are a specialist in all things, functional medicine, but why brain health?

Cheng-Huai Ruan, M.D.

Yeah, that’s a really good question. I struggle with my own concussive injuries, playing sports. And I had a really terrible accident during my residency. my intern year, with snowboarding. I was knocked unconscious. I had three days of amnesia. I still don’t remember what happened those three days. And a lot of bad stuff happened afterwards. I’m not gonna get into it but I had a lot of neurological issues. And they were mysteries for it many, many years. But I think it took a lot of self discovery and self education to figure out what was going on that, you know I wasn’t necessarily taught in medical school or residency training. So I turned to the most reliable person I know, who’s my mother, she’s a board-certified Chinese medicine doctor and acupuncturist and herbalist. And then she’s like, duh. And then she taught me a whole lot of stuff about myself after that. So it’s been sort of a personal thing and I just kind of landed into it. In 2008, a year after the practice was started, we were approached by special interest groups representing special forces, SOCOM, to look at PTSD and worked with some veterans hospitals locally to look at what is the root cause of the PTSD and started getting into neuroimaging and brain mapping. And then after that, there were just so many things I found to be super interesting that I kind of tied together with my team. And I’m a data guy. I like to look at how things tie together that we weren’t really seeing before, but becomes obvious after we kind of peel back the layers.

Laura Frontiero, FNP-BC

All right, so you kind of fell into this brain love while you fixed your own brain.

Cheng-Huai Ruan, M.D.

That’s right, brain love!

Laura Frontiero, FNP-BC

All right, let’s jump in about skull formation, tongue and teeth, and how that affects your daily energy levels. Really?

Cheng-Huai Ruan, M.D.

Gosh. Yeah. So, you know, one of the things, so at Texas Center for Lifestyle Medicine, because we take insurance and Medicare plans and everything like that for integrative and functional health, we tend to end up with people who’ve seen a bazillion different doctors, and functionalism doctors, maybe high-dollar doctors, kind of run out of cash and they have nowhere else to go, right? And so we’re left with a very interesting dynamic where most of the patients coming in with binders full of information. And you know our job is to figure out well what’s missing from that piece of the puzzle, whether it’s just regular doctors or other integrative health doctors. It’s been five years of a discovery process since the practice started. But I think for you to understand why skull is really important, I’ll just tell you a story. And this is a made up patient, but this is a very typical story of someone coming to the office. They come in, usually with a family member, and they just feel like really depleted, really fatigued at the medical system. They have maybe some brain fog and fatigue issues, maybe some hormonal issues that were there and then maybe some joint pains and back pains. And a lot of doctors just kind of brush ’em off, and can’t really figure out what’s going on. So they’ve been on this self-discovery process. 

They’ve tried different diets, you know, vegan, pegan, paleo, whatever it is. And they just sit down, here’s all the labs I’ve done, you know, a thousand tubes of blood over the last five years that I’ve done. I’ve all these results. Here’s my hormone labs. My saliva labs, my urine labs. Right. And then as they’re talking to me, I’m already noticing things by the time I’m in the room, I see how they’re actually addressing me. When they turn their head are they turning their head or are they just using the whole upper torso to turn their head? It tells me how much of an issue their spine and the alignment is, right. And when they’re talking to me, what is the position? A lot of them are doing this. A lot of them are actually holding up their heads like it’s almost too heavy for them. That’s a red flag for me. Right? Some people really enunciate with their T H’s and S’s And that’s when I say, “Hey, do you maybe have a tongue tie or something like that that’s in there?” So as they’re talking to me, I’m basically observing them. And then when they’re finished talking, I’m like, you know what, just stand up for a second, open your mouth, let me just take a look at something. 

And so through the observation of them talking to me, there’s a lot of things that are very apparent that no one really addressed. And things maybe that their dentists brought up, things maybe if they’ve been to ENT that their ear, nose, throat doctor brought up. And so the missing link for complex self disorders or people who maybe have gotten better, maybe 50%, but the rest of the 50% is so hard to achieve really relies on the fact that most people have impacted or impaired like airway than breathing mechanisms within the sinuses. Or maybe they have soft tissue structures, tongue ties, maybe they have a overbite or underbite that’s causing issues. Maybe that their alignment with their TMJ is causing issues. And all these things, all these things are not separate from brain health or mitochondrial health, because they’re all connected together. And literally the way that we hold our head on our shoulders determines our daily hormone balance, that takes us to our mitochondrial balance, how much energy we produce per day. And that is something that I think is the sort of the biggest missing piece in medicine. Not just integrated health, but like all of medicine.

Laura Frontiero, FNP-BC

Okay, connect it deeper. So you’re saying that our posture and what’s going on anatomically in our mouth with our tongue and our teeth, we haven’t talked about that yet. So you’re saying,

Cheng-Huai Ruan, M.D.

Yeah.

Laura Frontiero, FNP-BC

that’s connected, But dig deeper in there and explain how.

Cheng-Huai Ruan, M.D.

Let’s do it. So we look at the way that our body comes into balance or homeostasis. We can appreciate that there’s cellular balance, there’s hormonal balance, there’s balance of like minerals or balance of nutrition, but there’s also a balance of symmetry. So someone’s in my office and they’re sitting there and their right shoulder is two inches higher than their left, or the vice versa that’s a big issue, right. And so this comes from the world of my mother who is acupuncturist, right? And so if that’s off balance, it already tells us a lot of different things about how the person is maybe sleeping or not sleeping. How the person is behaving. Are they getting early afternoon crashes? And so what ties it together are three main factors. Okay, there are four main factors.

Laura Frontiero, FNP-BC

Okay.

Cheng-Huai Ruan, M.D.

One is blood flow. So we can appreciate that we have blood vessels that connect the body. In order for these blood flows to flow through different channels, all the highways have to be open, right. And if there’s any asymmetry or any imbalance in the way that our neck or spine or lower back, or skull structured, like you’re off kilter, there’s gonna be a redirection of flow. And that’s going to turn into a lot of symptoms, especially brain fog and neck pain and even allergies. So that’s blood flow. Number two is the neurological system. So we have this beautiful nerve in our body called the vagus nerve. And the vagus nerve comes from the bottom part of our brain called the brain stem. And it’s called a vagus nerves, because it travels like a vagabond. It travels all over our body. And there’s different branches and different settings of the vagus nerves, but they all require, once again, symmetry. Okay. So that’s the second part. Number three is a topic that’s controversial up until 2012 that we’re no longer controversial. And this topic is lymphatic flow. So we know that the lymph nodes drain toxins, et cetera, et cetera. But recently there’s this other system called the glymphatics that actually drains a lot of toxins from the central nervous system and the brain and stuff like that. And that’s also dependent on symmetry, neck, tongue face, skull structures as well.

Laura Frontiero, FNP-BC

What happened in 2012, Cheng?

Cheng-Huai Ruan, M.D.

Oh, I forgot to mention that. So in 2012, this article came out, NYU Langone. They actually looked at what is really the definition of the glymphatics. These are not like visible things that people can see, but it’s a system that’s mapped out during that time. And at that time as well, they discovered, well, when I say discovered, they didn’t really discover it. I think those were really documented really well in Chinese medicine thousands of years ago, but they discovered that there’s this other highway, this system, and they call it the extracellular matrix. So the extracellular matrix. So basically protein on the outside of cells that communicate with each other. And their communication is much faster than blood flow, much faster than nerves, much faster than hormones. And when you map out sort of this extracellular matrix, a lot of the anchor points of the extracellular matrix are actually acupuncture points and et cetera, et cetera. But now like we call it a thing, right. And we discover that cells can transfer information through the extracellular matrix. For example, if your tummy hurts, right, and then that causes a lot of disruptions in the tummy. 

And then the gut microbiome uses its own extracellular matrix to send its signal directly to his brain. And it is fast. I mean, it is super fast, right? And that’s through that communication. Because we didn’t know before how it actually communicated, but there is a gut-brain connection there. Right. And then the fourth thing is hormones. So hormones also depend on symmetry. And there’s a master hormone in the body that I like to call melatonin. And melatonin, everyone knows, it increases when you sleep, which is great. But melatonin controls like everything else. When melatonin goes up, cortisol goes down, which is a stress hormone. But what actually controls that whole cortisol-melatonin stress cycle, the entire hormone cycle, is this wonderful substance called nitric oxide. And nitric oxide is this wonderful thing that not only does it deliver blood flow to the body, it also conducts what the hormones do as well. 

So how’s nitric oxide produce, as it turns out nitric oxide is produced when air goes into the nose, not the mouth, the nose, into what’s called the paranasal sinuses, which basically are these holes around the actual skull. And we have receptors in there that then our body produces our own versions of nitric oxide and then hormone balance happens. And then the mitochondria gets activated, because you need nitric oxide to activate mitochondria. And then all our systems become far more efficient at running. And then that’s when optimal performance actually happens. So nasal breathing is exceptionally important and that’s why we now know that mindfulness and meditation with breathing exercises, different types of breathing, has the huge implication on blood pressure, blood sugar regulation, stress reduction, et cetera, et cetera. But now we know what that system is and it all relies on skull formation, sinuses, symmetry, tongue, tongue positioning, et cetera, et cetera.

Laura Frontiero, FNP-BC

Okay, yeah. So if all this stuff is affecting our energy levels and fatigue, what can we do to help it? How can we fix it?

Cheng-Huai Ruan, M.D.

Yeah, there’s this book called “Breath” by James Nestor. And he got really famous when he went on Joe Rogan a couple years ago and the it’s a fabulous book. And James, he’s a journalist. He’s not a scientist and not a doctor, he’s a journalist. And all he’s doing is observing skulls. He goes to different places and he does experiments on himself. And the book is fabulous if anyone wants to read it, but it’s all about how breath relates to everybody’s physiologic function. That’s one of the main things that we avoid looking at. And so one in four humans have some sort of a airway restriction like impaired formation. And the question is, well how do we get there? Well, we got there because you know, right now we eat food with knives and forks and for me chopsticks. I’m not like ripping the backbone off of a boar with my mouth so I have underdeveloped jaw formation as most developed humans do now. And our frontal lobes of our brain are actually getting bigger and it’s actually crowding out our sinuses. So humans become the only natural species to have like this obstructive airway disease. And when I say natural, I mean that there’s dogs like pugs that are bred to have short snouts. They actually have obstructive airway disease as well. But you know, it’s not natural. They’re hybridized to be that way. But we humans have have like, we developed that issue. And now-

Laura Frontiero, FNP-BC

Wait, wait. Let me, let me understand this. So we’re eating with a fork, knife, or chopsticks now, so we’re not using our muscles. So they’re atrophying, right? And then you said our frontal lobe is getting bigger. But what’s causing that?

Cheng-Huai Ruan, M.D.

So there’s many theories on what’s causing that. But part of it is the evolutionary development of the brain. Higher order cognitive processing and stuff like that. So that’s really up for debate. I’m not sure why that’s happening. But the problem is we have crowded airways and crowded sinuses now.

Laura Frontiero, FNP-BC

Okay, so crowded airways, crowded sinuses. This causes fatigue, mitochondria dysfunction, cellular dysfunction. Hormone imbalances, all of it, right?

Cheng-Huai Ruan, M.D.

Yeah. Autoimmune. Yeah. All of it. Mm hmm. And so in answer to your question, of what can we do about it? We really have to now go back into our traditional methods of different breathing techniques. There’s breathing techniques that are independently developed in different cultures. That are really, really far apart in ancient times, but they all came up with very similar things. The breathing frequencies, the alternate nostril breathing, that’s in many different cultures as well. Box breathing strategies are also in different cultures, you know, a world apart as well. So there’s a lot of congruences in the history of what we perceive to be beneficial breathing that’s now lost in this world of chaotic science, I think. Right. And that’s what we’d like to bring back, especially at Texas Center for Lifestyle Medicine. So during the pandemic, we wanted to kind of share this. So we developed our online course, which is www.tclmuniversity.com. And on there is a mind sculpting master workshop. And on the mind sculpting master workshop is the entire workshop dedicated to mind-body medicine and how we’re able to utilize the tools that we already have to optimize our brain mitochondrial cellular function. Not really needing to buy a new supplement or a new device or anything like that. But hey, let’s optimize our breathing mechanisms first, and then the supplements, and then the PMF, and all those different things are actually very beneficial. But we’ve got to set that foundation first.

Laura Frontiero, FNP-BC

Got it, got it. Okay. So let’s bring in and talk a little bit more about mitochondria and traumatic experiences, because I know that plays a big role as well. So what say you about that?

Cheng-Huai Ruan, M.D.

Man. Okay. So this, we’re still on the same topic, actually. So mitochondria and traumatic experiences. So we can appreciate that our brain development is mostly complete by the age of eight years old. So between three and eight years old, we’re really developing the way our physiologic function is. So we experienced trauma, especially at a early, early childhood, we react to things very differently. We can all appreciate that, right? So there’s multiple studies showing that childhood trauma equals specific type of behavioral disorder or something like that in adults. So as it turns out, this is genetic triggering and signaling that happens earlier on. And so our mitochondria are basically, you know, the battery pack of every cells in the body, minus red blood cells. Our mitochondria is designed for a specific purpose, which is survival. Okay. And so if we, as a human, our definition of survival is something that we experience early on in childhood, the rest of our lives our bodies can be triggered in that manner. So we see this even being inherited multiple generations down. So for example, the grandchildren and the great grandchildren of the people who are Holocaust survivors tend to have higher cortisol spikes, higher stress responses when they hear loud noises like bombs and stuff like that, even though they’ve never really been in the Holocaust. And it’s interesting because a lot of the studies are done on people who, half of them didn’t even know that grandpa or grandma was actually part of the Holocaust as well, but they still have the same responses. So we see that in animal studies, we see that in human studies and as it turns out, our mitochondria is always primed to avoid some sort of trauma or go towards excitement, right? That’s that’s the job of mitochondria.

Laura Frontiero, FNP-BC

Are you saying trauma is inherited then? Or trauma response?

Cheng-Huai Ruan, M.D.

It can be inherited. Yes, it can be inherited. But yes, it’s the actual response of trauma that can be inherited into the genetic code. It’s called micro DNA. So we know that this actually exists and that this is perplexing because, you know, I start talking to patients about this, like, wow, it really didn’t start with me. But even the way that we breathe is inherited, because if we have small airways and facial structures, I usually find that the rest of the family has it as well, like multiple generations down.

Laura Frontiero, FNP-BC

Right.

Cheng-Huai Ruan, M.D.

And so, yeah. So when I, you know I don’t see pediatrics, but I’m identifying adults, the next question is, “Hey, do you have kids?” And do they have ADD as a kid? Or do they have any bedwetting and stuff like that? Do they have any speech issues as a kid? And these are the same structures that causes disease states in adults, like memory loss, Alzheimer’s, dementia, and hormonal imbalances and stuff like that. Right. And so we can’t ignore trauma being the thing that we just get over, because we don’t. Because it’s innately within us. And so I feel like this sort of Western culture has a way of kind of suppressing emotional trauma as something that’s separate from medical. It’s not separate from medical. It’s part of our human physiology. And we really have to honor that. So sometimes we work with people and they eat better and then they exercise and they have plenty of energy and they’re still just as sad because all the mitochondrial support was supporting them avoiding from the trauma they experienced before they’ve never really dealt with before in the past. So we have to kind of address that in the past. Does that make sense?

Laura Frontiero, FNP-BC

Yeah. Yeah. So this is something that you support people through in your practice with your patients in your clinic as well.

Cheng-Huai Ruan, M.D.

Right, so I have a whole team that does this and Jenny, she’s my mind-body medicine practitioner would do this in groups and as well as one-on-one. And one of the things that we identify first, before we get into the labs and numbers is let’s identify like what your goals really are, right? Yes, we can help optimize the mitochondria and get your gut health better. But what do you really want? Are you here because of a trigger of a relationship that’s either happening or has happened in the past? Are you here because you’ve left the relationship and now you’re ready to focus on yourself. What is the underlying reality in which you live in and let’s choose a path for you to use your mitochondria to go towards rather than just optimize a specific physiologic function. Does that make sense?

Laura Frontiero, FNP-BC

Got it. Yeah. So while we build on this conversation about fatigue and energy and our body structure and our inherited trauma. and we didn’t even go down the hole of the trauma that occurs in this lifetime.

Cheng-Huai Ruan, M.D.

Correct, yeah.

Laura Frontiero, FNP-BC

But can you, take us now to what spine alignment has to do with energy?

Cheng-Huai Ruan, M.D.

This is a great segue because if we look at people who are traumatized, their spine looks a certain way. If they take a deep breath, they’re rising their shoulders up instead of expanding the belly, right. So for those of you listening at home, take a deep breath right now, and if you’ve been taught to expand your chest up and not your belly down then what’s happening here is that this is a source that you’re keeping of a breath breathing mechanism that doesn’t allow the lungs to fill up on the very bottom. And so a lot of people who are traumatized, tend to always suck their gut in almost like they’re ready to punch somebody, right. They’re ready to run some people over.

Laura Frontiero, FNP-BC

That’s how I’m breathing right now. It’s like, oh my gosh, Cheng, that’s how I breathe.

Cheng-Huai Ruan, M.D.

Well, that’s, that’s true for most people. And even a lot of times when patients in the clinic and they’re like, “Oh my God, “my blood pressure’s super high, can you measure it again?” I was like, all right, I want you to take 10 deep breaths. And then people will, and then I’m like, no, you have to expand your belly. “Like, what do you mean?” No, you have to expand your guts to take a deep breath in. They’re like, “Oh, this is weird.” I’m like, yeah, that’s how you breathe. And then, you know, 10 breaths later, the blood pressure’s down 20 points. I’m like, okay, I’m gonna put this in the chart. And not your original blood pressure you came in with.

Laura Frontiero, FNP-BC

I’m trying to breathe like that right now and I feel hypoxic. I feel like I’m short of breath trying to breathe like that.

Cheng-Huai Ruan, M.D.

Well you’re sitting down too, that makes a little bit harder. But yeah.

Laura Frontiero, FNP-BC

Oh my God.

Cheng-Huai Ruan, M.D.

But the actual trauma causes physiologic changes. So that’s one really simple example. Another really simple example to understand, like when I was a kid, when I moved from China to the U.S., I happened to watch this movie called “It.”

Laura Frontiero, FNP-BC

Oh my god.

Cheng-Huai Ruan, M.D.

I think I was eight at the time. That was a terrible introduction into American culture. ‘Cause til this day I’m terrified of clowns because of it. Right? And so that’s a trauma I had. It’s it’s funny, but it’s a source of trauma. So what happens during the movie is I see the movie and then something pops up when I get scared, really terrified. Well, what happens to my face? My face goes white. Why does your face go white? Well, you just shut down all your nitric oxide. You hold your breath. All the blood flow goes away from your capillaries of your face. And it’s going into where? Your shoulders. You’re about to beat the clown up or run away. It goes to the proximal muscles of your thighs so you can run away. So we can appreciate that even a scary scene in the movie, your brain can’t tell if it’s real or not, but it’s a physiologic function that occurs for the body. And when the body responds to that over and over and over again, if I’m at night, I’m dreaming about that movie over and over again. And now it’s 30 years later, I’m still dreaming by the movie over and over again. I’m basically receiving the same level of assault as when I first saw the scene in that movie. Maybe even more so. But what if what someone who went through, maybe I’m a combat veteran and I see really terrible things happen in Vietnam, right? Same thing. I’m reimagining that. 

And so blood flow perpetually goes away from our face. And even our gut causes leaky gut issues. Away from our joints causes joint pain. Into this fight or flight stance. Well what happens when you’re constantly like that is that if you walk around like that, your hips are gonna hurt, right? Your legs are gonna hurt. It’s gonna be really hard for you to run. And when you take a deep breath, you almost feel like you can’t take a deep breath, because you’re constantly just tight, not just on your spine, but your entire body and your fascia, which is the outer covering of the muscles. And so we have to appreciate that if we are already born, we’re maybe not symmetric. We have some areas that were born with like scoliosis, which is curvatures with spine issues. Then any sort of trauma will be maybe even doubly detrimental to chronic joint pains and chronic fatigue and stuff like that. And so, yes, we’re born with the structures that we’re born with, born with the genes that we’re born with. But there’s also things that we experience in our lifetime, that’s creating a physiologic function and it’s up to us to identify what exactly is causing that issue and go back and deal with it. And by the way recently I saw “It” again, and it was like a silly movie. It was not scary whatsoever.

Laura Frontiero, FNP-BC

It’s a remake though, right? The new one’s, a remake. Was that?

Cheng-Huai Ruan, M.D.

I haven’t watched the new one yet. But, but that’s me kind of dealing with, oh, this is fun. And then when I watched it, I just started laughing. Now it became a comedy because it was very cheesy. You know, I’m like, I was really scared of this? And so my brain made it worse than it really is. Or maybe now my brain’s making it better than than what it really is, right? But either way, it’s something that we, it’s my perception that I choose to have for specific events. And that’s why I’m a huge believer in like trauma therapy, cognitive behavioral therapy and stuff like that for all sorts of things, for autoimmune disease, for gut health, et cetera, etcetera, because we can only change our diet so much. We can only drink clean water so much. We can only take so many supplements and eat organic food and stuff like that. But there’s a limit there. And then facing our experiences and recognizing that allows us to live in a specific way on a daily basis. That’s what we really have to focus on.

Laura Frontiero, FNP-BC

So what happens at the cellular level when we finally do do that work, focus on that, clear it, heal it, then what happens?

Cheng-Huai Ruan, M.D.

Really good question. So let’s look at data for a second. In 2017 and 2018, I was pretty obsessed at that time. I kinda guess I still am about what really works. What supplement works? what kind of diet works? Is it vegan? Is it paleo? Is it carnivore? What really works for people? Right? When we look at my actual data, it’s not supplements. People aren’t necessarily even eating the cleanest and yet they have dramatic results. Whether it’s like some miraculous thing like not having cancer anymore, which is now super common in our practice now. Or reversing autoimmune disease and Hashimoto’s and stuff like that. Well what are the commonalities in those patients that we see that it’s there. And I wish it was something really easy, but it’s not, it’s actually experiences. So what we noticed, especially in our mind-body medicine part of the practice is that when we were able to identify life experiences and help these people recognize these experiences, whether it’s traumatic or not traumatic and deal with them, they had the biggest improvements. So that could be a marriage. It could be a divorce. It could be death of a parent or another loved one, Or it could be moving to a specific area. It could be leaving the military or it could be entering the military. So these were like big life changes. And right afterwards their blood work looks different. They’re standing taller, their posture looks different, their breathing looks different. And so what we recognize is that we really have to identify life experiences as the X factor, all right, and then work our way from there. And so now I’m a little less obsessive about data, but probably because the fact that we tell patients in the very beginning this is what we value. We value your experiences. We value the journey you wanna take for yourself. And that comes first and not labs or anything like that, you know.

Laura Frontiero, FNP-BC

Thanks for breaking that down. Okay, bring us home with this. Why is hormonal balance directly affected by the way we breathe? So we’re back to that facial structure.

Cheng-Huai Ruan, M.D.

Yeah.

Laura Frontiero, FNP-BC

Yep.

Cheng-Huai Ruan, M.D.

So let’s talk about the facial structure. So earlier I told you that we’re born with specific features, but we can’t control that, To an extent we can. Let’s say if someone is born with super narrow sinus cavities and they have a lot of allergies, sometimes you can do a procedure called balloon sinuplasty, dilate some of them. Or people have sleep apnea. And one in four humans actually have sleep apnea. And so there’s ways to overcome that. I work biological dentists and ENTs to improve the upper airways, soft tissues, tongue tie releases. I work with myofunctional therapists to look at tongue positioning. And so there’s a lot of things that can be done. There’s a lot more that really came out in the last eight years than ever before in this field of what we call airway medicine. And so I think that we have to recognize that skull formation and skull structures in the way that we’re born is not something to ignore. And for the people listening to this, one of the things that people ignore the most, which I think is a huge deal, is allergies. Are you having sneezy, watery eyes, et cetera, et cetera like a Claritin commercial or something like that, right? That’s a huge deal. Because if you have that chronically, you have chronically obstructed upper airways. And then now we expect other things to happen. We expect your brain to be wired for that fight or flight. So maybe you have more anxiety. And you know that if you are having a really bad allergy day you just don’t feel good and you just wanna punch somebody in the face. Well, if you have that chronically, some people have that on a daily basis, they don’t even know it.

Laura Frontiero, FNP-BC

Right.

Cheng-Huai Ruan, M.D.

And so we a lot of times we identify these issues, but the patients don’t even know that they have it because they’ve been breathing like that their entire life. And then when it’s optimized, they’re like, “Oh, this, this is normal?” I’m like, yeah, this is normal. And so when all that happens we see big changes in hormone labs, right? Pregnenolone, progesterone, DHEA, cortisol, thyroid, you name it. They all change pretty dramatically. And so if we put together this concept of symmetry and skull formation, soft tissue formation, tongue, et cetera, that as the foundation, then we can actually explain most chronic disorders and diseases like high blood pressure and diabetes and why some people are marathon runners, but their blood work is pre-diabetic. ‘Cause they’re probably mouth breathers causing blood sugar spikes at nighttime. So there’s mechanisms there that is really been under the surface literally of our face. And that’s why my patients come in and they’re like, “Hey, my doctor told me it’s all in my head.” And that’s probably true, let me take a look at your skull. Right?

Laura Frontiero, FNP-BC

That is a great place to end. That was a funny thing.

Cheng-Huai Ruan, M.D.

Yeah.

Laura Frontiero, FNP-BC

Oh my gosh, thank you so much, Cheng, for coming on here, bringing your expertise. Any final words for our audience as they learn about how to solve cellular dysfunction, how to solve their health problems by focusing on mitochondrial health, cellular health.

Cheng-Huai Ruan, M.D.

Yeah, I do have a request for the people listening to this. There’s a lot of great, fantastic speakers on the Summit and you can Google the hell out of everything. But if you find that your perpetual Googling may be leading to obsession of trying to control something or figuring out something to control in your situation, I would suggest pausing, take a step back, and look around you, look at relationships, and look at life and be present in the moment. And that pause may be the best thing that you will ever do for yourself. So that’s my challenge.

Laura Frontiero, FNP-BC

That is great advice. Cheng, tell us where our audience can find your work, can find you, your programs.

Cheng-Huai Ruan, M.D.

Yeah, so the programs that my team and I design are on www.tclmuniversity.com. TCLM stands for Texas Center for Lifestyle Medicine. You can find me all over social media, LinkedIn, Instagram, Facebook, everywhere except TikTok. I’m not a huge TikToker. On my name, Cheng Ruan. C H E N G is my first name. Last name is R U A N. If you find MD afterwards, that’s probably me.

Laura Frontiero, FNP-BC

Thank you, Cheng, you enjoy the rest of your day. Thanks for being here.

Cheng-Huai Ruan, M.D.

Hey, thanks a lot. Appreciate you.

Laura Frontiero, FNP-BC

Take good care now. Bye.

Cheng-Huai Ruan, M.D.

Bye.