Maggie McKay (Host): Welcome to Conversations Like No Other: presented by Valley Health System in Paramus, New Jersey. Our podcast goes beyond broad everyday health topics to discuss very real and very specific subjects impacting men, women, and children. We think you'll enjoy our fresh take. Thanks for listening. I'm Maggie McKay.

Today, we have with us Dr. Lori Nuzzi, Director of Integrative Medicine, and acupuncturist Daniel Yoo, to talk about the early warning signs of imbalance when your body whispers before it screams. Thank you both for being here today.

Dr. Lori Nuzzi: Thank you.

Daniel Yoo: Thank you. Glad to be here.

Host: Let's start out with how do you define imbalance from an integrative health perspective?

Dr. Lori Nuzzi: Thank you, Maggie. Thank you for that question. From an integrative perspective or from a broader health and wellness perspective, imbalance is the loss of harmony between different parts of our lives, whether that be the physical activity, our states of recovery, nutrition, stress, sleep, emotional well-being, relationships, and our purpose.

Daniel Yoo: In addition, like with that, following up with Dr. Nuzzi, an imbalance from a TCM perspective is a deviation from physiological function. So, anything that where if our body's function is not optimized, we kind of see that as an imbalance. And any subtle imbalances, those signs and symptoms that people may not notice, slowly accumulating cause a particular disease state later down the road.

Host: How is this different from how conventional medicine typically approaches symptoms?

Dr. Lori Nuzzi: Conventional medicine, a term that is probably not used that often anymore because medicine has evolved, evolved over the last several decades to an integrative or whole-person approach. So, conventional medicine as we think of it, or more traditional medicine, where there was maybe a management of symptoms through the utilization of medicine, we have evolved. We have evolved to recognizing through science, that lifestyle and the implementation of healthier habits is a more holistic approach at healthcare. And here at Valley, we take that approach. We recognize we want to transform lives through healing, caring, and wellness.

Daniel Yoo: And just because we have even from a traditional Chinese medicine perspective, the philosophies may be different. And just because they're different, we're not totally divorced from those systems of medicine. It is truly filling in those gaps, when they occur and making sure that patients are feeling better from these particular treatments and supporting them along the way, making sure that their body functions are truly harmonized.

Host: What are some subtle, often overlooked signs that the body is out of balance?

Dr. Lori Nuzzi: Some subtle signs, we call them the seven silent signs of stress or imbalance. And it could be headache, neck pain, lower back pain, sleep disruption, difficult menses, digestive issues, mood swings. The body will definitely be talking to us and communicating with us when there is imbalance. And the signs can begin somewhat subtly, and we can normalize these symptoms.

So, we can say, "It's that headache, that's the normal headache" or "The stiffness, that's every day I have that." So, you start to normalize and make things appear that they are happening and they should be happening, like I'm getting older or I've never been flexible. We don't want to take something that's abnormal and normalize it because it's commonly happening. Or maybe you've been in an adaptive and compensatory state for a long period of time and you haven't quite reached the crisis point.

Daniel Yoo: And essentially, I kind of look at it as if you're waking up in the morning and you're not feeling at 100%, there's a chance that that pretty much points to an imbalance in your body, that these particular symptoms are there as warnings for the body and something should be done to address them.

Host: You touch on this a little bit, but what are some everyday symptoms that people tend to dismiss but shouldn't?

Dr. Lori Nuzzi: It could be subtle signs of, as Daniel was saying, waking up not feeling refreshed, feeling like you just don't have that same movement pattern you once had, or you don't feel the same energy, you don't have that bounce, that pep in the step kind of feeling. We just take the subtle signs the body is giving us, and we tend to just push them aside. We have tremendous ability to override signaling systems. And I'll often tell patients it's like being hungry, and you just push that aside, or having to go to the bathroom, and you just push that aside. It's this override mechanism. We have great ability to override until we can no longer override, and that's when the body will start to tell us with more pain or a level of dysfunction that we simply can't avoid.

So, we want to start to tune in early, and that's where integrative medicine tries to bridge the gap in with conventional medicine or traditional medicine that we want to recognize there are subtle signs. And before we hit the crisis point, we can be making changes and utilizing non-pharmacological technologies and tools to influence a person's health.

Daniel Yoo: And going off of Dr. Nuzzi's comments, it's those situations where a lot of these signs and symptoms can be quite fleeting. We could sit down, let's say perhaps have a meal, and you could experience some minor gas and bloating, which you could easily dismiss as something like that just happens and it just happens with the foods that I eat.

And while our bodies are capable of addressing it, over time, if we have more of those warning signs show up, then there's this inflammatory process that starts, and then acute conditions arise, and then later down the road, chronic conditions arise as a result. So, it's just being very, very aware, almost hyper-aware what our bodies are experiencing and how our bodies are reacting to certain things like this, such as food or the environment, how our sleep is changing.

So all in all, this is kind of how we're able to take control of our health and get better for the future.

Host: Dr. Nuzzi, how can imbalances show up differently in body systems like digestion, sleep, hormones, or immune health?

Dr. Lori Nuzzi: I'll use the musculoskeletal system as an example, which I see almost every day in practice. I'll use an example of somebody coming in with a slouched posture, rounded shoulders, forward head posture, this tech neck posture that many of us are suffering from as we use our devices more and more. It may seem so subtle, and it may seem as though it's just a stiff neck or a headache or a mid-back pain, or maybe your shoulders ache. But what's happening is with the rounding of the back and the forward head posture, you're decreasing your lungs' capacity to infiltrate with oxygen. Take a deep breath. You're compressing your gut. You're compressing your stomach. You will slow digestion.

With the loss of oxygen as a result of lower respiratory function, your heart rate and your respiratory rate will go up. That will also signal your brain that you are in a state of stress and anxiety. So, I've come full circle. In just creating a postural change, I'm signaling a respiratory change, a digestive change, a mental change. The entire body is in constant communication. It's not one system. All of the systems are communicating with each other. They may express in one system initially, but it will eventually affect the others.

Daniel Yoo: And even from an acupuncture standpoint, looking at the body holistically is very helpful in figuring out some of these connections. While the system itself can present issues in digestion and sleep and hormones and immune health, for a practitioner of Chinese medicine and acupuncturist, you kind of see the connections between all of these.

So, a person coming in with digestive issue who has gas and bloating may also have sleep issues just because if they have any type of indigestion, it will prevent you from going to sleep because the tightness is actually pushing on the solar plexus of your body, irritating the heart, so your heart can't even settle when you're going to sleep.

Nutritional deficiencies from digestive issues may cause hormone changes. You're not getting the right nutrition, so your hormones are not being efficiently created or being underutilized or overutilized as a result of compensation. Immune health, we go back to that digestive example. If we're not able to extract the maximum amount of nutrients, we're more prone to frequent colds, allergies, takes longer for us to get better after a cold. So, all of these things can be well interconnected with, from different systems of our body.

Host: And speaking of stress, how does chronic stress manifest physically in the body?

Dr. Lori Nuzzi: Stress in and of itself is not our enemy. Stress is actually, in some degree, helpful. It's beneficial, and we need stress. We need stress to build our muscles. We need stress to build bones. We need stress to move air in and out of our lungs, to pump blood around our body.

Our bodies need stress in order to maintain a sense and state of health. So, stress in and of itself is not the enemy. The enemy is when the stress is too long, the stress is exceeding our capacity to function and when the stress is beyond our ability to adapt and recover from. So, we do see the signs of stress, and they could be through trauma, through different areas that are repetitive sprain-strain. But once the body reaches a threshold where it can no longer tolerate stress, it will then go into a maladaptive state which becomes dysfunctional and unhealthy. So, we say it goes from a state of dis-ease to disease.

Daniel Yoo: And again, like, it's a matter of figuring out exactly how is that stress manifesting in the body. Our bodies are great about and capable of addressing these as long as it's tolerable. As long as our bodies are able to handle it, it should be okay. However, when there's too much of it or we're chronically exposed to stress, that's when if it goes beyond a certain threshold and our bodies start developing signs and symptoms, it starts developing diseases.

We could experience insomnia, we could experience digestive issues, headaches, muscular tension arise. All these things can arise, and it's really dependent on the individual how it manifests. And again, going with our philosophies in integrative medicine is looking at the root cause and looking at the individual. How is it manifesting and what can it be done to address it? And we have to use whatever tools we have available to us according to our scope of practice, but also relying upon other medical providers to assist in this effort.

Host: And in your practices, what are the most common root causes of imbalance you see today?

Dr. Lori Nuzzi: In the chiropractic side of the practice, I would say they start with structural imbalances, or that's what the individual perceives is happening, is some type of structural imbalance. So, we'll typically see this as postural changes, reduced range of motion, restricted mobility, a different sense of muscle tension, tightness, uneven loading of the body.

However, that may just be how the body's expressing it. It may not necessarily be the root cause. The root cause can be the emotional stresses that they're under, the social situations that they're in, as Daniel had alluded to, a nutritional situation that may be affecting the physical state of the body.

So, recognizing we are a physical body, an emotional body, a social, chemical, spiritual body, our imbalances can start anywhere. Our root causes can be any of those things. How the body chooses to express is quite individual. It could be part of your individual genetics, it could be part of your lifestyle. So, we do want to find the root cause, but oftentimes it's quite complex, it's nuanced, it's very individual, and it takes time and us listening and doing a thorough examination in order for us to really come to that place where we can identify one root cause.

Because most of the time it's probably a little bit of everything. So when I'll have a patient, I'll tell them, "It's probably the perfect storm." It's not one thing. It may be the things happening in your life at this moment. And given a different opportunity, given a different equation, you'll have a different outcome. So, I really think we need to take that as a much more individual approach.

Daniel Yoo: I take the same type of approach too. I also look at the individual, but I have in my head almost a framework of what to look out for. So, I look for any external stressors as well as internal ones. And I almost go through this checklist of making sure I'm hitting these boxes and addressing them and asking the patient to understand what are they coming in with, one, and how is it manifesting, and could these stressors potentially be the cause for their problems?

So, it could be diet. It could be environmental toxins, emotional suppression, sedentary lifestyles, overwork, obviously stress, injuries. All these are factored into an assessment to figure out what is truly going on in the body, and that tailors my approach to treating that patient.

Host: And what are some common misconceptions about "being healthy" that might actually mask imbalance?

Dr. Lori Nuzzi: We love this question. One of the biggest misconceptions we see is that individuals think health is simply the absence of symptoms. "I don't have pain today, I'm healthy." And that's far from the truth. Just because there's an absence of symptoms does not necessarily mean you are healthy.

And health is not just a one time. It's not a destination. It's a process. It's an adapting, it's a recovering, and it's a responding to our life's challenges. So, we're in constant seeking of that balance, of the harmony in our lives, and we should not strive to attain it just once. It should be something we strive to have an ongoing assessment and attainment in the lifestyles that we have attempting to get us there as best we can, as quickly as can, and as long as we can.

Daniel Yoo: And lot of the times, the things that we see within our patients are, for one example, a lot of patients will come in with, let's say, normal blood work. Everything looks great on blood, yet they're still symptomatic, which means that, for the patient, they almost have to be very, very hyper-aware, understand the symptoms that they're manifesting with.

Just because a test tells you it's not normal, but you're feeling things, is an indication that there is a potential imbalance. So, that doesn't necessarily mean that you're healthy when things on laboratory or labs says you're normal. It's how you're feeling truly, or do you feel at 100%? Do you notice that the symptom, right, when it's present, are you able to manage it? But does it go away? Does it get worse? I mean, it sometimes it's not sensitive enough to pick up on these things, but it's just being very, very hyper-aware of how your body's responding to certain stimuli, to how you're sleeping, what you're eating, and understanding that particular process. It puts you on a road to better health.

Host: So, the big question, how do we improve? What small realistic changes can someone make today to restore balance?

Dr. Lori Nuzzi: Maggie, you just said it correctly, what small and realistic changes we can make. And that's very important, is that we simplify some things. There's enough complicated things in our lives, and trying to create change that improves our health starts with small, little changes in our routine. And we don't want to be intense and drastic in this process. We want to make consistent, repetitive changes that eventually become part of our lifestyle. So, it could be simple things like, are you drinking enough water? Are you taking sugary foods out of your diet? Are you moving enough? Did you get up from the desk knowing you worked there for eight hours? Did you take a few what we call stretch snacks and getting up and just moving? Are you taking a few deep cleansing breaths because you recognize you're under some sense of stress or tension that you've got, you know, demands on you? Are you having positive thoughts? Are you changing those positive thoughts? So, starting with simple things of having a mantra that you say that affirms something positive or a gratitude list.

There are so many different ways, and there's so many self-help books that really try to give us a sense that we don't have to do expensive things. We don't have to do complicated things. We have to do things consistently and build a routine.

Daniel Yoo: I sometimes even go further, Dr. Nuzzi, even with the water example. Are you drinking enough water? Yes? What kind of water are you drinking? So, are you drinking alkaline water? Are you drinking something that's more acidic? Are you drinking neutral? I mean, these are a lot of the questions I ask some people, and it's hard for them to even answer it because they never put any thought behind it.

Take for example the alkaline water. I have patients who drink that consistently, and they develop more muscle cramps from it, especially runners. So, these are the kind of things I ask for in an intake as well as follow-ups. Any little deviation or any certain routines or habits that patients have, I question and I want to get a better sense of what's really going on.

And a lot of times these small details and just being very, very hyper-aware how your body's responding, what we're taking in, which is one of the crucial things that we can control. And if you look at food as medicine, small changes in our diet, how are you responding to the foods that you're eating?

If you're having, let's say, eggs or if you're having pasta, or even after that particular meal, are you feeling better? Are you feeling tired? Are you feeling sleepy? Do you feel more energy? If not, why is that happening? So, every little thing like this kind of puts me down a pathway to, again, figure out what's going on with the human body, what's going on with my patient in front of me, because those little changes like that have profound impacts on people's health and their lives.

Host: Well, this has been so informative and helpful. Thank you both so much for sharing your expertise. We really appreciate it, and you've given us a lot to think about.

Dr. Lori Nuzzi: Thank you so much, Maggie.

Daniel Yoo: Thank you, Maggie.

Host: absolutely. Thank you. Again, that's Dr. Lori Nuzzi and Daniel Yoo. For more information about integrative medicine at Valley, please visit valleyhealth.com/integrativemedicine. Thanks for listening to Conversations Like No Other, presented by Valley Health System in Paramus, New Jersey. For more information on today's topic or to be connected with today's guest, please call 201-746-9389. Again, that's 201-746-9389, or email valleypodcast@valleyhealth.com.