 Well, hello everybody and welcome to another episode of Resiliency Radio with Dr. Jill. As you know, you can find all our previous episodes on YouTube, iTunes, or anywhere you listen to podcasts. And if you like this episode or some of the previous ones, please be sure and stop by and leave us a review that helps us to reach more people. Today I have a new friend here. I'm super excited to introduce her and we'll go diving into our topic today, Prevention of Neurological Disease and Chronic Illness. And we're going to hear the story behind Kavita Desai's interest in this topic. So I can't wait to dive in, but let me first introduce you. So Dr. Kavita Desai received her doctorate of pharmacy from Ohio Northern University and has had a multifaceted career spanning several areas of expertise. She's headed a large teaching hospital pharmacy department as clinical coordinator, started her own cardiovascular risk factor prevention clinic, and ultimately owned a multidisciplinary medical clinic with a pharmacy specializing in pain care, including fibromyalgia. Her experience in healthcare has underscored the importance of disease prevention and the ongoing struggle women in particular face in assessing healthcare. Despite these challenges, Dr. Desai remained committed to her work until the personal event changed her outlook. After her mother was diagnosed with early Alzheimer's in 2013, she moved away from her clinical practice and now focuses on brain health, primary prevention of disease and how neurological disease and many other inflammatory infections and conditions affect women. So welcome, welcome to the show. And thank you so much for having me. You're welcome, Kavita. So like I said, I would love to start with your back story and obviously with your mother's health as a fact, I want to hear all about that. But let's go back to pharmacy school and kind of your interest in this field. How did that happen? Where did you grow up? How did you get into that trajectory? Yeah, so I actually grew up in Brantford, Ontario, Canada, which is the home of Wayne Gretzky. That was our claim to fame. Always a medicine keener. I always wanted to go into healthcare. A lot of family members are in medicine. So for me, the first step was pharmacy school. I went to Ohio and loved it so much. And the Farm D program at that time, which is what I ended up doing rather than going to med school, was very immersed. And I was very privileged to have amazing preceptors and phenomenal rotations that focused a lot on prevention, really immersed the pharmacists in a healthcare team. And I just loved that, just the whole genre. So that's the how I ended up in my career. And then I think it was just I got very fortunate in getting the right positions early on in my career. So my first hospital based job was in the cardiology, was on the cardiology team and oncology team, which was a great experience that led to actually becoming the clinical coordinator of a teaching hospital department. And then I think I liked it, but the lifestyle was difficult. It meant a lot of weekends, a lot of being on call, just long hours. And I really wanted to go more into the preventative side. So I ended up starting my own healthy heart clinic, which was addressing risk factors for cardiovascular disease and looking at a younger population and trying to prevent disease rather than band aid treatment after the fact. So we were diagnosing diabetes and people that didn't even realize they had blood sugar issues and giving them lifestyle management tips and looking at blood work and all of that. And it made such an impact and that was a great stepping stone I think into just being my own, running my own clinic, which is what we ended up doing. And we started like an integrated medical center where we were actually addressing a lot of pain and addiction patients trying to reduce the narcotic load. So we were trying to reduce opioid use by doing things like lidocaine infusions and trigger point injections and trying to get people to start using more lifestyle therapies as opposed to medication for their pain. And in that population, we saw we were starting to get referred hundreds of patients with fibromyalgia because nobody knew what to do with it. It's a diagnosis that's not really, that's kind of difficult to diagnose. And so we became a champion for patients with fibromyalgia of which I would say 90, 95% of those patients were women and they happened to be in their perimenopausal years. So I noted that at that point in my career. And then that was around the same time that my mom was diagnosed with early onset Alzheimer's. So now I'm dealing with chronic pain patients who happen to be perimenopausal women. My mom is in her fifties diagnosed with early onset. Well, she was diagnosed at 60, which is still considered early onset, but symptomatic in her early fifties for sure. Like I started to notice it wasn't memory loss. It was personality changes that we noticed first and no family history. She was otherwise eight well, non-smoker, mostly non-drinker, didn't have the classic lifestyle habits that we might correlate with such a terrible disease state. So that's when I think the whole pivot happened for me. It all just kind of came full circle in terms of how important prevention is because we don't have cures for some of these diseases. Women are at higher risk for so many, you know, very detrimental chronic illnesses. And we don't always know why and we're certainly not addressing it. And I think my mom was a good example of that. So that's how I ended up on this path. And I just kind of, I think it was meant to be, maybe she led me there, I kind of believe that's right. She has passed away since, but I think I've ended up where I belong because I truly believe in this. I think women are an underservice population in medicine and I'm just trying to highlight those things and prompt women to prioritize their own health earlier on. I love that. And I love that you're driven by this true experience with your mother that had to be shocking in the beginning. And of course, you had to learn to deal with that and everything. And then your observation, so often that curiosity is what drives us, like the curiosity of the fibromyalgia and then seeing that, oh, it's all these menopausal women. So let's talk a little bit about what are some of the, because I've just done work on nitric oxide and decreasing in how the women as menopause kind of out surpass the men with cardiovascular disease all of a sudden at menopause and then the brain health. And so there's so many areas. Do you want to do just like a fly-by overview of like auto immunity, it's more prevalent in women. Cardiovascular disease after menopause is more prevalent in women. And then dementia, I don't know what the rates are men and women, but obviously this is a big deal in our menopausal group. Do you want to just kind of do an overview about some of the things you've observed and seen for women that are menopausal with these chronic complex diseases? Yeah, so for Alzheimer's it's about a 60% chance in women versus men, which is frightening, right? And we don't know why, but they're all inflammatory diseases of some sort, right? Whether we talk about auto immune diseases, cardiovascular, even osteoporosis, right? They all stem from some sort of inflammation in the body and then dementia for sure, right? We know that the brain becomes quite damaged in this process. So it's one of those things that I think, we don't know for sure. I think there's a strong correlation to hormonal changes, right? Or we're far more biologically complex. We know that as we enter perimenopause and our estrogen and progesterone start to go down, we become quite inflamed, not to mention all the other disruptions in the body, that I think it's a cascade effect in terms of increasing our risk of long-term disease. So I think it's multifaceted in how we have to look at it. There is no magic bullet to fixing the problem except for addressing all of those risk factors. Well, that makes sense. And in just one thing in particular, we know without immunity testosterone definitely decreases the inflammation, which is one of the reasons I think it's four times or more common in women. And of course women have a lot less testosterone than men. So what's your thoughts on hormone replacement? Because in my experience, in especially perimenopausal and menopausal women in that early decade is absolutely critical for brain health, for bone health. I'd love to hear your thoughts on it. I 100% agree. It's very sad, the number of women that contact me and message, saying that they're reaching out to their primary care practitioner rather and getting the old rhetoric, right? That it causes cancer, it's dangerous, we shouldn't be using it. Or this is normal, what you're going through. And although, yes, biologically, this is a normal process, we cannot stop menopause, but we can certainly treat it the way we would for any other disease state, right? Or any other chronic condition where we're looting hormones and then our body is therefore impacted by that. And so I'm a huge advocate for hormone replacement. If it's not contraindicated for you, I think it's a discussion that all women should be having with their practitioners and at least being offered it. And then it's a personal choice, right? But there's certainly growing evidence about how protective it is for the brain and the body and mental health even, right, as we age. Yeah, so I don't know if you know my history, but 25 years old diagnosed with aggressive breast cancer. And so I'm a few years out and I'm menopausal now. But it's interesting, because even someone like me who has a history of breast cancer, not just a risk, I have no problem doing bioidentical hormones because the evidence is so far out. Now there's a few cases where you're really close to the cancer. You have a, so you need to talk to your doctor if you're listening to this, this is not a blanket, but I could not agree more, even for those of us who are survivors of breast cancer. And then you agree with someone like your mother who got early onset dementia. And one of the very first things I do, Dale Bredesen protocol, I've worked with him for years. And one of the very first things we do, even if the patient is on the elderly side with dementia is think about hormones because estrogen and the brain is so connected. Do you wanna talk as a person just a little bit about estrogen and brain and like why it's so critical or just the importance of that? Yeah, so we have receptors in the brain for estrogen and they link to so many things, whether it's inflammation, glucose control in the brain, even in terms of mood, right? Without the estrogen, we don't have the same, we don't have the same neurotransmitters functioning. Like it just, it impacts, it's a cascade effect without estrogen, not only on our body but also on our brain. So I think the importance of it is not being adamantly, I think, told to women the way it should be, the importance of it. And like you said earlier, I think the critical thing is women are living in fear. And so I often, even for me with my history, I always think, okay, if I had to choose, I don't feel like I do, but if I had to choose between risk of breast and brain, I'm gonna choose my brain. And I think that's the thing, unless you've been impacted in your family or closed circles with someone that has had dementia or Alzheimer's, I think maybe the fear factor is not there but it's a terrible disease. And like I can speak from personal experience that my mom, it was heartbreaking to watch somebody who was so intelligent and so lively and lovely turn into somebody like I didn't even recognize, right? And you can't, this is gonna sound terrible but I would have wished any other disease on her than that. Because I think the minute the brain is impacted which is our computer system, right? Without your main computer system, we can't function. So she couldn't have a conversation. She couldn't have any quality of life at all. And that's terrible. I wouldn't wish that on anyone. And I think the only thing we can do for our brain is to prevent disease from happening. There's nothing we can do once it's impacted, right? There's no reversing it. So that, definitively reversing it that we know of. So I think it means we're making a much bigger change earlier on. And we know that these symptoms and if you do have Alzheimer's, it can be starting 15, 20, 30 years earlier. And that's even scarier. So let's stop there for a moment. I think that what you said is so critical because there's something called subjective cognitive decline in our medical ICD-10s versus like early onset dementia or moderate dementia or severe dementia in the classifications. I deal a lot with chronic complex illness and toxicity. So I am not your expert in Alzheimer's. So I'll just frame that. I know how to treat it. I'd help people in clinic but I'm not a neurologist in that field. So I'm not as technical maybe as that discussion would be. But having said that, again, what I see, I see is these 30s and 40s and 50s, these young people, women especially, that have this subjective cognitive decline. And what that means is they subjectively feel, I know I am not remembering details, things, names, places where my keys are like I was before and it's significantly impacting my life. And when that starts to happen, it's almost like a pre-dementia condition. And the good news is what you said is so true. Even with Bredesen work, we know the moderate to severe Alzheimer's, there is almost nothing we can do. However, if we find these women when they are either in subjective cognitive decline where they're having symptoms, but maybe nobody else hardly notices, they can still focus on the work that's not affecting their quality of life before they get into early, moderate or severe dementia. That's when I do believe we came first, right? Yes, I agree. Because we also don't know, right? When it's really, really early on and women are just saying, oh, I feel like I have brain fog. I walk into a room and I'm not entirely sure why. Is it also perimenopausal symptoms? Because with the loss of estrogen, you're gonna get the same thing. And I've been asked this before that, with your mom, is there anything you would do differently? And I was like, it was hard to say. She was perimenopausal. So her mood changes, she actually interesting what you, exactly what you said she said to me once, where she's like, I feel like I forget things. And that was it. It was in passing. There was no real discussion around it. I just remember her saying that. But I mean, I was fairly young at the time. It didn't mean anything to me other than, she was perimenopausal. And she even herself didn't put that much weight on it. I don't know at what point she realized this was something more than just a little bit of forgetfulness, but so many women complain of that. But that is exactly the time you're right. We can reverse it or at least try to reverse it. Hey everybody, I just stopped by to let you know that my new book, Unexpected, Finding Resilience Through Functional Medicine, Science and Faith is now available for order wherever you purchase books. In this book, I share my own journey of overcoming life-threatening illness and the tools and tips and tricks and hope and resilience I found along the way. This book includes practical advice for things like cancer and Crohn's disease and other autoimmune conditions, infections like Lyme or Epstein Bar and mold and biotoxin-related illness. What I really hope is that as you read this book, you find transformational wisdom for health and healing. If you wanna get your own copy, stop by readunexpected.com. There you can also collect your free bonuses. So grab your copy today and begin your own transformational journey through Functional Medicine in Finding Resilience. For sure. Well, let me just talk to our listeners out there because we have a lot of women in this age group. I would say my primary population, although I see men and children too, is typically 35 to 65 year old women. That is the most of the women who see me, listen to me, talk to me, engage. So this is our population. So if you were listening out there and you have wondered, and I would say it's even worse post COVID because one in five men and women are having inflammatory brain symptoms. I mean, really a long COVID body, but it's like the brain related to inflammation post COVID. So if you're out there speaking like, and I'll just tell you my personal experience with mold related toxicity, I had times in my 20s and 30s with the mold exposure where I would just feel like I was off at brain fog is what we called it. So if you're out there listening, you're like, I know internally I am not as sharp as I used to having forgetfulness or mood issues or whatever, take that seriously and find a doc who will listen to you. Because those things are precursors and very, very early signs of something potentially going on. And it could be something like auto immunity, which can affect the brain. It could be something like long COVID, which can affect the brain. So it doesn't mean you have dementia. It doesn't even mean you're going to get Alzheimer's, but I think I just wanna speak to those listeners who are saying they resonate with what you said about your mother and what I said, because when you have the start of those symptoms, your doctor, your functional doctor who does root cause can look at toxic load. They can look at mold exposure, hormone status and all of these things. And actually we can make a change at that early state versus if you go 10, 20, 30 years into full-blown dementia. That's right. I totally agree. So obviously with your mother, and you just have a fascinating history as a pharmacist because you were really in clinical service, like not just in a pharmacy, dispensing medications that you were involved in sounds like protocols for cardiovascular disease. And then pain, I wanna talk a little bit about fibromyalgia because that's such a common thing and it's such a mysterious thing. Like, what does that really mean? So talk just a little bit about what did you learn in the clinic when you're dealing with pain and you saw the fibro patients and a lot of them were women? Any thoughts or wisdom pieces from that experience? Yeah, I think to be honest, like we did a lot of, as I mentioned, non-narcotic treatment for fibro, right? So it's a lot of like neurological pain, in men's because it is a neuropathic pain. And it's sad, but again, the symptoms, how similar they are to perimenopausal symptoms and the women are in that age bracket, right? It's brain fog, poor sleep, gut disruption. And then they just have widespread fatigue and just that generalized pain where some women couldn't even get out of bed in the morning. I've had them describe that it was like they were elderly, even though they're only in their 30s or 40s, potentially, and difficult, very difficult to treat. But a lot of the same things we recommend for perimenopausal women works in fibromyalgia as well. And I do believe there's a hormone connection there. I happen to have like one patient in mind, for instance, who she not only had full-blown fibromyalgia, but had a very difficult time functioning in her mid to late 30s. But then when she finally, you know, went and had her hormone-assisted, she had no estrogen production, no progesterone, no testosterone levels, like all bottomed out. She hadn't had a period in several years. Again, in her mid 30s, she already had gone five or six years without a period. And all she had been being told until she saw us was that, well, are you trying to conceive? And when she said no, they were like, well, then it doesn't matter. And so she was, yeah, so, which is, you know, now if I could go back after each of that practice, knowing what I know, I would probably have had all those women see what their hormone levels were doing because we didn't do that. But in hindsight now, I wouldn't be surprised if some hormone replacement may have helped as well. Some of those fibro symptoms. Oh gosh, I love that, because I think one of those areas is whether it's premature menopause or some sort of surgery hysterectomy, total urectomy, where you lose ovaries, your uterus, in your 30s or 40s even, those are definitely times when you absolutely should be talking to your doctor about bile, unless there's a reason otherwise, which is kind of rare in those younger women, the younger one especially, should be talking to their doctor about bioadjustable hormone replacement because it is night and day for someone in their 30s and 40s to not have hormone. So I love that you said that. And so, and again, please talk to your doctor. We are not giving medical advice. No, no, definitely not. Different and there are, there's a few cases where it would be contraindicated, but many cases there's a lot of fear. So what are the things do you look at with, again, our title here is about complex chronic disease and neurological disease in particular. And then a pause, but say someone comes in, let's take a patient example. They are 52 years old. They haven't been having periods for two years. They're having a little bit of more achiness and pains or feeling the brain fog and the subjective cognitive decline. Maybe they have Hashimoto's or another autoimmune disease. What would you start to say to that person as far as root cause? And where would you go with her? Yeah, so I'm not actually currently diagnosing patients. Right now we, my main form is to educate that they know what's wrong with their body. Cause you said something earlier actually about how, you know, if anyone listening, you know, happens to have any symptoms to actually go speak to their practitioner. Because I think we don't and we're dismissed oftentimes. And I think my whole goal, especially after seeing my mom's trajectory, she didn't say anything. Like I, it's heartbreaking now to think that she must've been experiencing so many different things for years and never said anything to any one of us. That no one knows your body better than you and what's normal for you, right? Like we, there is no, there is no normal first of all. And there is no, you know, what's right for me is right for everybody else. Our levels are all different. Our, how we feel is different. And I think only we as women can know truly when something is amiss. And I think if we don't speak up, then we'll never get the treatment that we deserve. And I think that kind of, for me right now, that's what my goal is to make sure that women are, I think, recognizing when things change for themselves and then advocating for themselves. I love that so much. And what just came to mind is, I just posted a quote from the book I wrote last year and it's interesting exactly what you were saying. It's the patient tells themselves better than anyone and they're the sole owner of an important key to the healing reserve and immense potential, the subconscious mind. So you'd also say almost the intuition, like women by nature have a very deep intuitive sense about right and wrong in their body. And I think our culture has trained us to kind of suppress and ignore that sometimes. And I call it physical gaslighting, right? You can go to your doctor and be like, Doc, I'm just not feeling like I used to. I'm more tired. My brain isn't quite right. My skins weren't dry or whatever kinds of things. And the doc might listen and do some labs and like, well, everything looks okay. You must be fine. Would you like an indisputment? Right? Yes. Like, well, there must be depression here. And again, nothing wrong with antidepressants. I prescribe them. I use them for appropriate, but not everything that can't be determined on a basic lab panel is depression. And so like you said, how are those women listening? That if you don't feel like something is right, you keep seeking till you find someone that will listen and help you find the answers. Yeah. And we don't know even on a blood panel, for instance, like, you know, when we're like, oh, it's in the normal range. But what does that mean? And what is the standardized normal range? Who was it dependent? Who was used as the, you know, the population to determine what a normal range is? What ethnicity, what body size, what gender? We've probably not women, that's for sure. So I think we don't, we don't in medicine to date look at the full picture and that's disheartening. And I get that, you know, practitioners are overworked, it's underfunded. I mean, there's all of that, right? But I think that's why then it really does behoove a patient to advocate for themselves and to know when something's definitely not feeling right in regardless of what the blood work says. And finding a practitioner that will look at everything. Because like you said, there could be so many different causes for the same symptom, right? It's not always a singular diagnosis. So important and it sounds like I would love to hear your thoughts, but when you look back at your mother's experience and by the time things got significant, I bet you would love to go back and tell her mom, take your, like it sounds like she was very quiet about it until it got significant and you looking back probably wonder, did she have these things a lot sooner and could, you know, maybe she wasn't really sharing or that whole generation is so commonly long suffering, right? And they're not really... Yes, right. Yeah. And I don't know, was she telling my dad who's not very communicative and then he just dismissed it? I probably, right? I don't doubt that that is probably what happened. I wasn't living at home anymore. So when I visit with her, she didn't, she didn't, yeah, tell me, which is, which is very sad. And if I could, I would 100% wanna go back and intervene sooner. But I like to look at this overlining that I've taken something very terrible and hopefully trying to impact other women to maybe catch it sooner. Yeah, I love that. And I wanna just say as well, I think you've done an amazing job of taking the difficulties of life and like really transforming it into a passion and purpose that is helping so many women. And one of the things you've done is you've created some supplements and things that are related to women in their menopausal years. Do you wanna tell us a little bit about what you've done recently as a pharmacist and to help humanity and help these women? Yeah, so it's actually a supplement system that I created mostly from, I mean, for myself, to be honest, is how it all came to be after my mom was diagnosed and I became very concerned about my own brain health. And I wanted to make as many changes to my life as I could, right? That I knew based on what we know about the disease and what the risk factors are. A lot of them are lifestyle, right? Being active, reducing stress, improving sleep, all of those things. But we know also that vitamin D is low levels of vitamin D, which the majority of the population really has, right? We don't have optimized vitamin D levels. So things like that, getting enough omega-3. But as I started to do more research and I wanted to take enough supplements to make sure I was addressing all of these risk factors because I don't trust that my diet alone is going to do what I need to do for disease prevention, right? Because we don't know and we only have one chance at this, right? I can't 10 years from now say, oh, I should have fixed this, it's too late. So I'm trying to address everything, all at once as much as I can. So it means taking supplements that can help reduce my stress levels like adaptogens, taking some new tropics that help with brain function, taking magnesium and vitamin D and omega-3. And it ended up being handfuls of pills in doses that weren't always adequate. So now I'm taking a lot of filler to try to get all the dosing that I would like for disease prevention. So this is how essential it came to be, which is a supplement system that I've created where it's 48 ingredients that I wanted to be taking every day that's been blended down into like 14 tablets capsules and it has everything from functional mushrooms to omega-3s and magnesium and Uganda and all the ingredients that I would like to be taking every day. And then for women, I just, I wanted it to be easier because I think we're already stressed and we're already busy, we're taking care of everyone around us and who's taking care of us. And I think I want women to prioritize their health and make it as simple as possible for them. So that's kind of how this came into existence. Actually, I love that. And just to simplify, you're right, because if you look at the handful of stuff that I take every day, it's a lots of rightful. Yes. You're right. For those of us who really want to perform well and prevent disease, I just got done doing an interview with Dr. Jeff Bland and our soils are depleted. And so therefore the plant magnesium content of an apple today is about a fifth or less of that a few years ago. So even if you're eating good organic, clean diet, you're often eating a nutrient depleted diet just because of our cells. So that's- And also the chemical use, right? Like we've overspread in generations where we didn't realize how toxic it was through our ground soils contaminated, our waters contaminated and we don't realize. So I advocate for filtering water. And no matter how clean we try to eat and how many cruciferous vegetables I try to include in a day, I'm not confident that it's necessarily enough. It is definitely a good start for sure. But I kind of believe we have to address it from all angles. Otherwise we're not maybe necessarily getting enough of what we need. I could not agree more. I love saying, because sometimes it gets so complex, right? And I always say clean water, clean food. And even if you're doing clean air, clean water, clean food, the clean food that you're eating is probably not nutrient dense enough nowadays as it was. So I feel like a very, very pro supplements because we really want to get those. And often we're using nutrients as you know as a pharmacist, we're literally pushing a biochemical pathway in a certain direction. Give extra B6 or extra 12 or extra magnesium or zinc. Often we're actually, like for example, if someone has high copper and low zinc, you can give zinc and actually bring down the copper and that can affect hormones and all of those things. So a lot of times we're actually manipulating in a really positive way those chemical pathways. So I love that. And I love, you've tried to simplify it. So. Yeah, it was too complicated counting it all out every day. So. Super pharmacist, right? So what is, as we kind of close here, what is the one thing that you wish every menopausal woman would know or would take away? I think the, to get rid of that stereotypical statement that this is normal for you. Nothing's normal and nothing is the same from one woman to another. So know that, that if you're feeling something, you're right. That it's okay to be the squeaky wheel that demands care and proper care. So well said. And where can you go find you, find your products and your information? Give us a website to look at and include them wherever you're listening. Sure. Yeah, our website is Revival.com. So R-E-V-I-V-E-L-E.com and on Instagram we're at Revival.ink. Awesome. Kavita, thank you so much for taking difficulty suffering and transforming it into something that's helping so many women. And thank you for coming on today. Thank you so much for having me.