THINKWELL
AGEWELL
The Biology of Resilience and Nervous System Regulation
AGEWELL
The Biology of Resilience and Nervous System Regulation
In this episode, I talk with Dr. Negin Rajaipour about why burnout and inconsistent follow-through may reflect nervous-system dysregulation rather than a lack of discipline. We explore how childhood and adult adversity can affect cognitive function, hormones, inflammation, identity, and resilience. Dr. Rajaipour also shares practical ways to help the body move out of survival mode, including extended-exhale breathing, gentle movement, and choosing regulation practices that match your current state.
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Dr. Heather Sandison, ND (00:01.077)
Welcome back to the Think Well Age Well podcast. I am your host, Dr. Heather Sandison, and we’re exploring the science and stories behind building healthier brains that last li longer and allow us to live more vibrant lives. Today I’m joined by someone who brings together an extraordinary combination of experiences as a board-certified physician, US Navy veteran, entrepreneur, and researcher of human performance. Dr. Nigin Rajipur.
Is the founder of Vita Regen Medical, co-author of the Amazon number one best-selling book, The Resurrection Algorithm, and creator of the E3 method, a clinical framework that views the nervous system, hormones, trauma history, and identity as one interconnected system rather than separate problems to solve. Her work challenges the idea that burnout, chronic stress, underperformance are issues of willpower.
Negin Rajaipour, MD (00:54.046)
You have the idea that
Dr. Heather Sandison, ND (01:00.575)
And instead, she asks a deeper question. What if your biology is determining far more of your potential than you realize? Today we’re going to explore the nervous system as the missing link in health, resilience, leadership, and even cognitive longevity. So whether you’re an entrepreneur, a caregiver, a healthcare practitioner, or someone just simply s striving to perform at your best, I think you’re going to find this conversation both fascinating and deeply practical.
Negin Rajaipour, MD (01:05.136)
the cheek.
Yeah.
We get
Dr. Heather Sandison, ND (01:30.279)
Welcome to the show.
Negin Rajaipour, MD (01:32.256)
Thank you for the warm welcome and intro. I appreciate you.
Dr. Heather Sandison, ND (01:36.455)
I am so curious about your journey just to start with. you left conventional medicine after building a very successful career. And I’m curious what experiences with your patients left you convinced that the healthcare system was missing something fundamental. And also if you had any personal experience in that.
Negin Rajaipour, MD (01:55.952)
Yeah, of course. what I kept seeing in patients was that they had normal labs, but they were clearly suffering. They were exhausted, inflamed, anxious, and disconnected. So the system had nothing to offer them because technically there’s nothing wrong. So I realized that the system, our model, was built to deal with acute illness, not for the chronic.
cumulative physiological issues that we see with chronic stress and trauma. So I could not keep handing prescriptions over and manage people’s symptoms. So I decided to build a model that can go deeper.
Dr. Heather Sandison, ND (02:38.89)
That’s amazing. And what about you personally? Did you experience any burnout?
Negin Rajaipour, MD (02:45.607)
Yes, throughout my career I had some challenges myself. when I was in medical school, I went through a toxic divorce and custody battle so that dragged on into residency. And I after finishing my interneer
You know, I at the peak of my career I had made it. I made it through medical school. I’d made it made it through the toughest year of residency. And it it just hit me. I was flat on my face. I couldn’t function. My body shut down. I had to take two months off of the life I had worked decades to build. So that really opened my eyes to the toll stress and trauma can take. And gradually over the years.
I kept seeing recurring themes, not only in myself and also in my colleagues and my patients. And that’s basically the foundation of my work.
Dr. Heather Sandison, ND (03:51.682)
Many of our listeners are focused on preventing cognitive decline and optimizing brain health. You believe that the nervous system deserves a much larger role in these conversations around brain health. And I agree with you. I I can think of a handful of patients just off the top of my head where the nervous system, the chronic stress I can see is clearly ha playing a role in their cognitive changes.
And I think we can all relate to that feeling of being under a lot of stress and not remembering things and not not feeling clear, feeling distracted. But also there’s more to it than that. So can you help us connect the dots between chronic stress, trauma, and cognitive function?
Negin Rajaipour, MD (04:35.248)
Absolutely. The ACE is landmark research. So it proved that childhood adversity has measurable biological consequences. But my patients weren’t just carrying childhood wounds. They were carrying divorce, financial collapse, career challenges, betrayal, and identity erosion, adult experiences that weren’t being measured by the ACE
And I was seeing the same biological marks that nobody was measuring them. That’s why I expanded on the ACE and created the AAE score. That gives us a way to look at the full picture, a person’s adversity, not just before 18, but after 18 as well.
Dr. Heather Sandison, ND (05:27.893)
So you created the adult or the adverse adult experiences, kind of like the ch the yeah, this score, adverse adult experience, the AAE score, as an extension of that childhood ACE framework. And the gap that you were hoping to fill, from what I understand, is about, yeah, just taking into consideration the adult experiences, traumatic experiences. And what have you learned about?
Negin Rajaipour, MD (05:33.156)
Score.
Dr. Heather Sandison, ND (05:53.154)
How these adult experiences continue shaping our biology later in life. You said that there are biological ways to measure that. Is that right?
Negin Rajaipour, MD (06:02.4)
yes, they show up as hormonal dysregulation. The most important thing, I think the most important marker is that n chronic stress when the body is constantly running in survival mode, it it basically makes the prefrontal cortex to go offline. The part of the brain that’s responsible for planning, for decision making, for follow-through, for creativity. So this isn’t
metaphorical. It’s actually functionally, we can see that in our patients. They are not executing at the same level of functioning that they their businesses or their lives require of them. So when the high performers cannot follow through on what they know they need to do, the problem is not a character flaw or a motivation problem. It’s biology. So telling the person to try harder
discipline more, change their mindset actually is like telling someone with broken legs to run faster.
Dr. Heather Sandison, ND (07:09.733)
I think there’s a lot of people who can really relate to this, right? There’s a lot of high performing people who I think they also have this idea I they know what they should be doing, right? Sleeping better, exercising more, eating better, and that they struggle with this consistent follow-through. And so can you describe what’s happening biologically when our actions aren’t aligning with our intentions because of this dysregulation?
Negin Rajaipour, MD (07:33.924)
So our well one part of it is our nervous system, which is in fight fight or flight mode. So it already adding another layer of discipline or a new program into the life, it actually triggers the nervous system. You you may be able to stick to that plan for a few days or a few weeks, but it’s it’s not gonna land. It’s not gonna be sustainable because
The nervous system is already up here, so you’re adding more on top of that, dysregulated nervous system. And the other part of it is identity. So identity is something we leave out in medicine. So who are you from this moment forward? What are you building towards? That’s something that needs to be recalibrated for any change to really be sustainable.
Dr. Heather Sandison, ND (08:24.223)
Yeah, identity can be very stressful to let go of, right? But there’s also this this potential to create a new identity, right? There’s there’s so much creativity there. yeah, I’d love can we double click on that? How do you think about identity in your in your approach?
Negin Rajaipour, MD (08:35.554)
So let me.
Negin Rajaipour, MD (08:43.499)
I think about identity is built mostly in our childhood and also reinforced through our adulthood experiences. So when we have significant childhood trauma that shatters our identity, and sometimes people don’t even have, you know, they have had really amazing childhoods, but they have certain adulthood adversity, you know, like a betrayal wound or a business collapse or something that really shatters.
their identity and the they start making decisions based off of their trauma, not the r real environment that they’re in currently.
Dr. Heather Sandison, ND (09:23.925)
Fascinating. And you know, trauma, there’s trauma, you know, with a capital T. And then there’s our kind of day-to-day traumas. Also burnout. I feel like burnout is almost synonymous with modern life, right? Do we all have trauma? Do we all have burnout? How do you define these? And and where when is it pathological? And when is it, you know, just part of life?
Negin Rajaipour, MD (09:50.175)
Right. Well, it it is, I think to some degree it it it is part of life, honestly, especially in this day and age with everything going on globally, domestically, you know, financial hardship, inflation, r raising cost of living, and and just a host of other things that happen on an individual level. You know, a divorce, a loss, collapse, just it it’s just so much.
It’s yeah, I and
Dr. Heather Sandison, ND (10:20.405)
Many people in our audience are they’re struggling to care for a loved one with dementia or they’re they’re concerned about their own Yeah.
Negin Rajaipour, MD (10:25.83)
Absolutely. Yeah. Chronic illness. Mm-hmm. Yeah, that is another burden. So basically when well basically so medicine thinks of burnout as a workplace phenomenon. So too much stress, not enough rest, take a vacation. That’s the prescription. But what I think burnout is.
It’s a dysregulated nervous system. It’s somebody who’s been running at high performance for so long that chronic stress has become their identity. And they have never learned to recalibrate their nervous system to come back to a state of safety and creativity.
Dr. Heather Sandison, ND (11:18.515)
And so how do you get back there?
Negin Rajaipour, MD (11:20.959)
That’s that’s the work. That’s really the work. That’s why I developed the E3 model and the AAE assessment so people can really take a look at the burdens they’re carrying and start going deeper and working on releasing those traumas and working on their biology and their physiology at the same time, teaching the body to feel safe again for the nervous system to calm down again.
Dr. Heather Sandison, ND (11:51.98)
So we we often think of trauma as an emotional issue. And you’re kind of, I guess, alluding to the fact that if we have unresolved trauma, that can start to play a role in inflammation and in our hormonal regulation and neuroplasticity and long-term health, both physical and mental. And so how do take us through what is the impact on
inflammation and hormones of unresolved trauma and then what does it look like to resolve trauma?
Negin Rajaipour, MD (12:24.189)
So I I think what happens the heart going back to the high cortisol state, right? The sympathetic state, we know about cortisol steel. So it steals the precursors that we need to have optimal hormonal health. A lot of individuals, men over 40, women over 40, they suffer with suboptimal hormones, especially testosterone. And that shows up in their workplace as how fast they can recover from stress.
from difficult decisions, from just day-to-day grind. So it it takes a toll and we know the link between trauma and stress and chronic inflammation. It raises inflammation. It puts the person at higher risk for a whole host of issues, including autoimmune and cardiovascular disease, heart disease.
So these are these have been very well studied with respect to the ACE model.
Dr. Heather Sandison, ND (13:26.389)
You’ve also described what some what you call the guardian state. What is that and why do so many successful driven people have such limited access it access to that guardian state despite accomplishing so much?
Negin Rajaipour, MD (13:41.806)
The Guardian state, I think of it as the parasympathetic state, the physiological condition of safety, rest, connection, and repair. So it is the state where healing happens, where creativity lives, where genuine connection is possible. So most high performers who have been performing at chronic sympathetic overactivation, they lose that access. So
How that shows up, stillness, rest feels threatening, feels unsafe.
Dr. Heather Sandison, ND (14:18.143)
So how do we get back to that? Is that a muscle that we can flex? How do we how do we do that?
Negin Rajaipour, MD (14:22.682)
Absolutely. Yes. Working on nervous system regulation is key. First of all, understanding that you’re in this state by looking at the trauma history and then taking action, daily action to reset the nervous system. For instance, first thing in the morning, instead of hopping on your phone or on your laptop to check your emails, take a few minutes to breathe and to connect.
So, one of the forms of breathing that I really enjoy, and I think it’s the quickest way to tell our nervous system it is safe is the long exhale. All the breath work programs they focus on the inhale, which is activating, right? But what I recommend is focusing on the exhale. So inhaling for four seconds and then exhaling for eight seconds.
Exhale, the long exhale, it tells the nervous system that it’s safe and they can connect, they can bring their prefrontal cortex online before jumping into the day.
Dr. Heather Sandison, ND (15:34.923)
That’s fantastic. Do you have any other quick tips on things that we can add to our routine that are simple like that that will help with nervous system regulation?
Negin Rajaipour, MD (15:45.162)
Absolutely doing the long XL three times a day before a difficult conversation, before a meeting, anytime that you feel like, okay, my cortisol is getting high, my heart rate is increasing, I’m getting stressed, I’m getting anxious. I think it’s a great way to quickly shift our state from a fight or flight to the rest and creativity. And then the other thing is.
cold exposure is great. they can you know somebody can start the day with like a cold shower or cold water on the face or throughout the day you can use ice or ice water or a cold drink in your hand to bring you back into your body and help you connect to your nervous system and feel safe.
Dr. Heather Sandison, ND (16:35.937)
So are you a fan of cold plunging?
Negin Rajaipour, MD (16:38.327)
I am, yes. Yes. It’s it’s amazing. It’s amazing to see what stress does because sometimes we’re not even conscious. We’re so used to operating at a high level in an anxious state that we’re not even realizing. So when you do cold plunge, in that second when you hit the water suddenly, that cold temperature shows you, my God, this is what stress.
Dr. Heather Sandison, ND (16:41.175)
Hey. Yeah. Go ahead.
Negin Rajaipour, MD (17:07.698)
Actually feels like this is what I need to look out for, and then in that moment you connect with your breath and you regulate, right? So you start controlling your heart rate, your breathing, everything just starts calming down. Your body even stops shivering after some time because your nervous system is in a regulated state.
Dr. Heather Sandison, ND (17:34.25)
So it’s almost like flexing the muscle of nervous system regulation in a very stressful experience. Because I think sometimes people will say, wait, this doesn’t make sense. Why would I stress my body and my brain out even more when I’m already under stress? You know, like a an entrepreneur or somebody who’s push like pushing through a caregiver. You know, is it
Always a good idea for them to go do a cold plunge, or there are there people where maybe they’re already under so much stress that that additional stress doesn’t make sense.
Negin Rajaipour, MD (18:07.06)
Yes, I’ve also often wondered about that myself. So I think if someone has that awareness and self-reflection and they know that they’re under a lot of stress, so I wouldn’t recommend an activating practice like a cold plunge. I recommend more calming practices like breath work, yoga, meditation, things that
bring the system to a state of calm as opposed to activating it again.
Dr. Heather Sandison, ND (18:41.203)
Yeah, it’s so interesting. I mean, I have this debate for myself often because I there have been times when I’m feeling under the weather, burnt out, maybe like I’m about to get sick, or feeling a lot of stress. And then I’ll go and do a cold plunge and I actually feel way better. And for days afterwards I’ll feel a lot better. So it I always struggle though. It’s like it’s do I isn’t that worth
Negin Rajaipour, MD (18:42.845)
Yeah.
Dr. Heather Sandison, ND (19:06.347)
stressful on an already stressed out system. So it’s just yeah, we’re the expert on this stuff. I’m so cute.
Negin Rajaipour, MD (19:11.252)
Yeah, I’m glad you you’re seeing that connection too. I think even with workouts too, sometimes if our body is too stressed out, we shouldn’t be going and doing hard workouts. We should be opting for more calming exercises, Pilates, yoga, things like just walking itself, that bilateral calm movement, it helps the brain, it helps the nervous system to regulate.
Dr. Heather Sandison, ND (19:42.942)
You know, there’s I guess we’re talking about cold plunges, but the realm of industry is totally filled with like these quick fixes and optimization hacks. And I’m curious from your perspective, what do most people kind of misunderstand about lasting transformation? How do we create that? And what is what is it what’s required to have a true shift in the pattern?
Negin Rajaipour, MD (19:46.749)
Ha ha.
Negin Rajaipour, MD (19:51.091)
Yeah.
Negin Rajaipour, MD (20:09.651)
I think most of these programs they operate on the assumption that the baseline is stable. So do more, you know, push harder, change your mindset. But the problem isn’t discipline and mindset most of the time. The problem is nervous system activation where the person is not performing at their best. And on top of that, you know, the compounds with
Dr. Heather Sandison, ND (20:16.033)
Mm-hmm.
Negin Rajaipour, MD (20:38.03)
hormonal shifts that we see in stressful situations in people. Whether it’s their thyroid function, whether it’s testosterone, estrogen, progesterone, it could be inflammatory issues. So all of these things need to go into account.
Dr. Heather Sandison, ND (20:55.571)
And so do you recommend that people get labs done and work with the provider to replace those hormones or how do you evaporate that?
Negin Rajaipour, MD (21:01.923)
Absolutely. Yeah, absolutely. Before implementing any sort of mindset program or biohacking, cold flunge, they definitely should work with a physician to better understand their physiology and optimize their physiology before spending thousands of dollars in on these programs.
Dr. Heather Sandison, ND (21:25.439)
Curious, you know, I’m sure you’ve seen the spectrum of how people interpret labs, right? Even thyroid hormones. I if I have a patient whose TSH is over two, I’m asking them questions about hair loss and weight gain and constipation and feeling hot or cold. and I’m looking to understand, you know, is there an impact of a dysregulated thyroid on this person, even though their labs are within the normal?
range. So it and also with estrogen and progesterone, there’s quite a wide range of normal, right? Are for cycling females, their estrogen and progesterone, they are swinging between quite extremes throughout the month. so how do you help someone navigate what’s normal for them versus what’s within the normal range?
Negin Rajaipour, MD (22:15.631)
Absolutely. So to me, normal range is typically an average, right? It doesn’t necessarily apply to high functioning individuals who are working in stressful environments. So we typically have to account for that. So for instance, I agree with you TSH over two. We need to ask more questions and also we need to do more testing, the looking at T3 and T four to kind of
get a more holistic picture of their thyroid function and really treating the person in front of us as opposed to the number. Because if they are having hair loss, eyebrow loss, cold intolerance, weight gain, we know these symptoms are directly linked to how well their thyroid is functioning. And most high performers because of stress, they their thyroid isn’t functioning properly.
Whether it’s at the thyroid gland itself or where the T3 and T four conversion takes place. So I hundred percent am with you. normal doesn’t mean, you know, optimal. So we have to optimize these things, especially after forty.
Dr. Heather Sandison, ND (23:30.567)
And for someone who’s recognizing them this in themselves in this conversation, they’re feeling chronically stressed, overwhelmed, and stuck despite doing all the right things. What are the first practical steps that they would take? We’ve talked about breath work, we’ve talked about even cold plunging, we’ve talked about getting labs done. Is there something else that we’re missing in there?
Negin Rajaipour, MD (23:52.499)
Yeah, I highly recommend going to my e3method.com and taking the ACE and the AAE assessments. These are all available for free. There’s also a free PDF copy of my book that if people are interested in learning more about how everything just kind of connects and how they can work with their doctor along with their mental health professional coaches, even to optimize not just.
their performance, but also their physiology and work on identity as well as trauma healing.
Dr. Heather Sandison, ND (24:29.909)
That’s fantastic and so hopeful. I before we ra wrap up, I you know, I always like to ask everyone personally, what brings you the most joy at this phase of life?
Negin Rajaipour, MD (24:44.5)
At this phase of life my work and my children. Yes. Well, I also have to add my pets, otherwise they’re giving me side eye over here. So I have two dogs and two cats and they can bring me a great deal of joy.
Dr. Heather Sandison, ND (24:56.065)
It’s
Dr. Heather Sandison, ND (25:01.749)
You’ve dedicated your career to helping people reconnect with their health and resilience. What are your daily practices to maintain your own health and resilience?
Negin Rajaipour, MD (25:11.331)
First and foremost, breathing, waking up in a state of calm. Not jumping on my phone, even though it’s very tempting. I want to see what’s going on on social media. I want to check my email. I want to see what’s going on in the world. But no, first I have to say no. Let’s connect. Let’s get the nervous system in a calm state. let’s look at
What I want to accomplish for the day, what kind of day do I want to step into? And when I make just a few minutes, it doesn’t even have to be a long, you know, stretched out hours. It can be just a few minutes of intentional breath work, long exhale and setting it intention for a wonderful day, I think it goes a long way.
Dr. Heather Sandison, ND (26:04.251)
Thank you so much for joining us today and sharing your perspective on how deeply our nervous system influences every aspect of our health, from our resilience and relationships to our leadership, our caregiving, and the health of our brain in particular. I think one of my biggest takeaways from this conversation is the power of breath work. I you know, as you were describing it, I was doing it. I was extending that exhale. And I’ve heard this before.
But it’s the reminder really that it’s it’s not about adding more or trying harder. It’s really about coming back to some of these things that we know and these practices that we know benefit us. And also understanding our biology that’s potentially driving our behavior and creating the conditions for our nervous system recovery, right? With that hormonal balance. And yeah, then doing the work that it takes to feel safe enough to heal and adapt and to thrive and to to resolve things.
Negin Rajaipour, MD (27:03.217)
Yes, I agree a hundred percent, beautifully put. Thank you.
Dr. Heather Sandison, ND (27:07.657)
Well, ac to all of our listeners, thank you for joining us. And if today’s conversation has resonated with you, please be sure to share this episode with someone else who can benefit from it. As always, remember that it’s never too early or too late to invest in your own brain health. Thank you so much, Dr. Nagin, for joining us today.
Negin Rajaipour, MD (27:28.508)
Thank you, Doctor Heather. I appreciate you.
Dr. Heather Sandison, ND (27:31.797)
Thank you for listening to the Think Well, Age Well podcast. Until next time, be well.
Dr. Heather Sandison, ND (27:39.986)
Okay.
