Given both her background in acute care along with her focus on gut health and immune system resilience, she is uniquely qualified to share with us today. As we embark on this year’s fall and winter seasons, achieving and maintaining optimal health is top of mind for us all.
We talked with Dr. Arora about her philosophy, her experience treating patients during the pandemic, and how she helps her clients restore balance and resilience to their bodies.
Can you tell us about your background and credentials?
I am dual board certified in both internal medicine and integrative holistic medicine. I’ve been practicing as a hospitalist in the acute care and intensive care wards across the country for about 12 years. And I’ve also been practicing integrative holistic medicine in the outpatient world for the past eight years.
What I’ve learned from the acute care and intensive care world is that Western medicine is amazing in that space. When you have a heart attack, are in a car accident, or if you’re really, really sick with COVID and you can’t breathe, for example—the hospital system and the Western medical model is exactly where you want to be.
But over the last 8-10 years—actually, even before that—I’ve learned to really appreciate the role of integrative medicine in taking people off of their prescribed medications and in building the resilience of their immune and nervous systems. Integrative medicine allows us to take care of patients in a preventative way, as well as in the chronic disease world. Overall, I believe that integrative medicine is the best approach.
As an MD with board certification in internal medicine, what led you to also pursue board certification in integrative medicine? How do you merge the two?
I grew up with parents who had only seen an Ayurvedic doctor. My parents are immigrants from India, and my mom has been an Ayurvedic cooking teacher forever, since I was born. I always understood the power of Ayurveda, which is traditional Indian medicine. It brings a lot of herbs, spices, and different ways of being—including breathing, exercise, yoga, and meditation—into helping people prevent disease as well as treat chronic illness.
When I decided to go to medical school to pursue a medical degree, my parents wondered why I would take that approach. Because I’ve always loved Ayurveda, they questioned whether I should be an Ayurvedic doctor instead. I went to medical school because I do have a lot of respect for the Western medical model, and the acute care and intensive care settings are where I believe that Western medicine is really needed and well utilized. However, a lot of the way that Western medicine is practiced ends up underemphasizing preventative care, which can lead to chronic disease.
When I saw that challenge with Western medicine, I started deep diving into the roots of Ayurveda, but even more so the roots of Western herbal medicine. I began studying the sympathetic and parasympathetic nervous system response, and the body’s ability to protect us by using the immune system. What I realized was that integrating both Eastern and Western medicine was the perfect way of not only preventing disease, but treating disease that had been diagnosed, getting people off of pharmaceuticals, and relying on their body’s resilience to heal.
So, I utilize Western medicine or acute care medicine to treat people in the hospital, and I really rely on integrative approaches using the immune system, the digestive system, and building resilience in the outpatient setting to not only prevent disease but to treat chronic disease, and to take people off of pills and put them on resilience-increasing supplements.
How do you help your patients proactively build and support their nervous and immune systems?
I believe that health is in everybody’s hands, and even when we’re dealing with a serious disease, there are certain things that can help build our body’s systems.
I am all about pharmaceuticals when they are needed, but I do believe that our body has an innate ability to heal. Integrative medicine helps us tune into that ability to heal by relying on the resilience of our body. When I say resilience, I think about an elastic band. When an elastic band is stretched beyond its capacity to come back, then it’s not as bouncy and doesn’t come right back to its original shape. Our bodies are meant to be like an elastic band: With stress it stretches, and then when you’re in a state of well-being it relaxes and comes right back to its original form. What I realized is, in the Western model we forget about how to do that, and in integrative medicine I really focus on the nervous system.
There are two parts of the nervous system: the sympathetic and the parasympathetic. The sympathetic nervous system is your fight or flight response. When you’re being chased by a bear, when you have a virus, or when you’ve eaten something that is high in sugar, your body responds to that because your immune system fires up and gets quite interested in what’s going on and becomes preoccupied with trying to make sure your body stays healthy.
Now, here’s what’s interesting—it can be activated if it’s real stress or perceived stress, and responds the same way for both. So, if you have a cold, versus if you’re stressed out at work, or even if you’re just always busy or always “on” (living in a heightened state), your immune system will be triggered, and your body will respond to the stress. Your heart might start racing, blood flow switches from your gut into your legs so you can run away from that “bear” that’s chasing you. Your brain goes from a state where it can make decisions to where it’s purely reflexive and just wants to run away. And many of us are caught in a cycle of spending most of our lives in this state, even though it’s not how our bodies were designed to function. You can imagine the effects this could have on your health over time.
The second part of your nervous system is called the parasympathetic nervous system. That’s the rest and digest state. We’re usually only there for a few minutes to maybe an hour during deep sleep. Naturally, before modern culture took hold and we began to experience a constant state of stimulus, when we didn’t have phones and LED lights on all the time, we did have time to rest. We were in our parasympathetic state a lot more.
So, my primary focus in the way that I practice is to help my patients find their way back to that state where they can rest and digest, where they can stimulate their vagus nerve and get into a mode where they actually digest their food because the blood flow isn’t just in the tops of their legs, but also goes into their organ systems to absorb all the nutrients from their food.
Now, that being said, another thing that stimulates our parasympathetic nervous system is nutritious food and supporting our immune system. Most of our immune system is based in our gut. So, whenever we put food into our bodies, our gut—including our immune system—has to figure out if what we’ve just eaten is really good for us or not. That is where the importance of boosting the resilience of your gut comes in, with prebiotics, probiotics, hydration, and sometimes other supplements for a short time.
How is the pandemic affecting people’s parasympathetic nervous systems?
For many of us, the pandemic has our sympathetic nervous system in overdrive (even more so than before).
Even if we completely disconnect from the news, it’s difficult for the stress of so much change and uncertainty that’s happening in the world and in our lives to not have an impact. Having worked in the intensive care unit during the peak of the pandemic here in New York City, I also understand that there is a real sense of fear. And while we absolutely need to maintain an understanding of how bad it is, it’s all the more important for us to understand and mitigate the ramifications on our nervous systems.
By intentionally stimulating the parasympathetic nervous system, we can give our bodies the space they need to get rid of old cells, regenerate, and function at their best. So, if the perceived threat of COVID becomes real, we are more resilient and equipped to deal with it.
Is optimizing gut health an important part of your holistic treatment plan for your patients?
Gut health is incredibly important. Our gastrointestinal system is our primary immune system and it’s also the primary organ that makes neurotransmitters that support our mental health. So, I take a long time really optimizing gut health with my clients, including focusing on nutrition, prebiotics, probiotics, and certain foods. I utilize elimination diets and talk about what type of nutrition is best for each individual client.
I combine Ayurveda into the way that I practice, and Ayurveda focuses highly on the constitution of a person as well as gut health. So yes, both gut health optimization as well as understanding my patient or client and the state of their digestive system is really important.
Can you tell us about your experience treating COVID-19 patients in New York City?
When the pandemic began, I had been in outpatient medicine concentrating on my integrative work. I’ve worked all over the world, but when it was all happening in my backyard, I knew I needed to go help. I ended up working in a hospital in Harlem, where I opened and closed an intensive care unit during the peak of the pandemic. The main thing I noticed was that there was very little resilience left in the immune systems of my patients. Everything that I do with integrative medicine is built on resilience. Now, we all go through stress—I’m not saying that we need to live a stress-free life. Stress is good. Stress builds muscle, tolerance, and the ability to go from a stress state back down to a non-stress state, which is very important.
Immune system resilience is like a bouncy rubber ball. Just like how a bouncy ball bounces right back up after it hits the ground, a resilient immune system should bounce right back. When you’re sick, and especially in the ICU even with sepsis, there’s a little bit of a delayed resilience, but people generally get better. With COVID, there was no resilience. It was like a wet cement blob that was being thrown on the ground and there was no bounce. It was just flat on the ground. This experience further highlighted for me the importance of working on the resilience of people’s immune systems. It’s never mattered more than right now.
The work that I do in integrative medicine is all based on working on the resilience of my patients’ immune systems and nervous systems so that they can go from that state of stress to relaxation, and they can work with their bodies to make sure that they have that extra bounce.
Did working with patients during the pandemic change any of your views on either allopathic or integrative holistic medicine (or both)?
One of the main things I realized when I was working during the pandemic was that it made me really appreciate my knowledge of integrative medicine. In the hospital, there was finally some use of supplements to help build the immune system. There’s a lot of things we can do to the immune system to help it build resilience proactively. My knowledge of that reinforced again for me why I chose to not only practice medicine based in the Western model but also medicine based on an integrative level—taking into account sympathetic, parasympathetic, and immune responses and gut health.
All of these things are so important to build strength when we’re sick. As I walked out of that hospital on the last day, I was overwhelmed with emotion, grief, and even anxiety...but I must say, I felt even more appreciative of integrative medicine.
Is there one common thread, a positive lifestyle change, you see that most people can make to improve their health, no matter what challenges they’re facing?
There are three positive lifestyle changes I recommend to absolutely every one of my clients.
Number one is simply breathing. There’s a breathwork practice called 4-7-8 breathwork, which involves taking the time twice a day to breathe four deep conscious breaths. This kind of breathing almost tricks our body into feeling as though it’s in a space of relaxation. We often don’t breathe deeply enough, so when we do breathe deeply, it stimulates our vagus nerve and triggers our rest and relaxation state, which is a parasympathetic nervous system state that also helps digest food and helps us absorb more nutrients.
Number two is hydration. Unless there’s a kidney issue, we should be drinking adequate amounts of water. Our body is 70% water, and when we’re dehydrated or not hydrated enough—maybe not clinically but just not hydrated optimally—our body automatically goes into a stress response. And when we’re in a stress response, our immune system gets triggered, and we go into the sympathetic nervous system. So, I carry around a 74-ounce bottle of water, and I drink that every day. One thing that I hear all of my clients talk about is how much better they feel when they’re hydrated. It does take a little bit of time; it takes a few weeks for your body to adapt to really being hydrated well, but staying hydrated is the second thing that I think everybody needs to do.
And the third thing is cutting out any added sugar in the diet, including artificial sweeteners. Sugar causes a lot of inflammation and triggers your immune system, so cutting out sugar can help your body get into a state of parasympathetic. Our gut is the center of our main immune function, but sugar makes our guts “leaky” and basically stimulates our immune system. Cutting out sugars and artificial sweeteners decreases the inflammation in our body.
What does your personal daily wellness regimen look like?
The supplements I take during the fall and winter, especially now during COVID-19, are immune-boosting supplements. I don’t believe we need to take supplements every day—I tend to cycle them on for six weeks and off for three to four weeks and then cycle them on again.
For my immune system during the fall I take vitamin D3/K2, the dose is dependent on my lab vitamin D level. I take vitamin B6, anywhere between 50-100 mg a day depending on how my nervous system feels, and I bump the dose up a little bit before I get my period every month because it helps with the feeling of agitation during PMS.
I am vegetarian so I make sure that I take either methyl B12 daily or a B12 shot once every three months. I also take fish oil (I like the Nordic Naturals or Carlson’s brands), a multivitamin from MegaFood, and Hyperbiotics probiotics and Prebiotic Powder for my gut health.
I also take a vitamin C lipid formula, which is a little bit better absorbed—I take 500 mg twice a day, three times a day if I feel my defenses running low. I take 15mg of zinc daily as well as a number of medicinal mushrooms, all by Host Defense, including lion's mane, turkey tail, Stamets 7, cordyceps, Agarikon and reishi, depending on my energy levels, and a MycoShield immune support spray, also by Host Defense.
I take N-acetylcysteine (600 mg twice a day), and that helps with liver support and lung support and magnesium before bed— magnesium is so important in multiple areas of the body and blood vessels and helps the body relax before bed. I also regularly have lab work done and adjust my regimen accordingly.
I am very intentional about eating whole, clean, real foods so that means a lot of home-cooked meals with many spices, including turmeric and black pepper to help absorb the turmeric. I practice intermittent fasting as well. I currently follow a seven hour feeding window about five days a week and I've noticed a great improvement with my overall energy levels and I’ve been a lot clearer in thought.
I also do breathing exercises during the fall and winter season to make sure that I'm stimulating the parasympathetic nervous system. I do 4-7-8 breath work twice a day, which is three breaths twice a day. This breathing exercise, which involves inhaling through the nose for 4 seconds, holding the breath for 7 seconds, then exhaling through the mouth for 8 seconds, is very calming and works as a natural tranquilizer for the nervous system.
I know this is getting long and is quite personal, but as you can tell I take my personal health very seriously and my hope is that it will inspire others to do the same. I mean, it’s the foundation of our lives, isn’t it?
And so, each day, I also make sure I'm moving my body. I walk several miles a day and I incorporate resistance training including weight lifting a couple of times per week. If I am just doing a walk, I also do push-ups and yoga, mainly for the breath work and to move every part of my body.
Pre-COVID, I used to utilize float tanks, which is a really interesting way of getting into theta wave activity, and for prolonged stimulation of the parasympathetic nervous system. I also meditate daily—I personally like Transcendental Meditation.
When it comes to movement, sometimes just walking one block every two or three hours or getting up out of my chair and stretching for a few minutes while I’m working clears my mind and reconnects me with myself. It brings me back and reminds me to be in my body, not in my head. I don’t want to just think about things, I want to feel them in my body. I want to make sure I am listening to what my body is telling me day in and day out so it doesn’t need to shout at me in the form of illness.
How can people contact you?
If anyone would like more information about the way that I practice or want to inquire about private consultations, then they can reach out to me at geeta@aroraintegrative.com.