203: Insights of a Neurosurgeon | Peptides, Minimally Invasive Surgery & the Holistic Approach to Healing with Dr. Amir Vokshoor
Hi friends! I have a brand new episode live and today I’m joined by a neurosurgeon with some AMAZING insights on brain health, spine health, and really just whole-body healing. Dr. Amir Vokshoor is a board-certified MD and Chief of Surgery at Providence Saint John’s Health Center in Santa Monica, and he specializes in minimally invasive spine surgery with a genuinely integrative, whole-body approach to brain and spine health. If you’ve ever dealt with back pain, are thinking about longevity, or just want to keep everything moving well as you get older, I think you’re going to love this one.
Here’s what we chat about:
- Why Dr. Vokshoor’s go-to tagline is “there’s no health without brain health” — and what that actually means for your daily life
- The three key areas of spinal mobility he recommends everyone work on (cervical, thoracic, lumbar – plus hips and ankles!)
- His simple daily movement routine for spinal health that takes just minutes and doesn’t require any equipment
- What minimally invasive spine surgery actually looks like
- How AI is changing his practice right now — including letting him actually touch his patients again during visits
- The promise and honest limitations of peptides
- Why chronic pain becomes a brain disease — and what that means for treatment
And so much more!!
203: Insights of a Neurosurgeon | Peptides, Minimally Invasive Surgery & the Holistic Approach to Healing with Dr. Amir Vokshoor
This episode is a great reminder that your brain health isn’t separate from the rest of your wellness. Whether you’re postmenopausal and thinking about bone health, dealing with chronic pain, or just want to move well as you age, Dr. Vokshoor brings a refreshingly human and holistic perspective to neurosurgery.
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Do Potatoes Shorten Your Life?
Do potato eaters live longer or shorter lives than non-potato eaters?
Is there a link between potato intake and the incidence of hypertension? Harvard researchers followed the diets and diseases of more than 100,000 men and women for decades and found that those who ate potatoes on most days—not only French fries and potato chips, but even mashed, boiled, or baked—appeared to be at higher risk of developing high blood pressure. But what do people put on potatoes? Salt, not to mention butter, so might the potatoes just be innocent bystanders? The researchers made attempts to tease out the effects of salt and saturated fat, and there still seemed to be a link between potato consumption and high blood pressure.
Maybe potato eaters are meat-and-potatoes people. After all, these same Harvard researchers found that meat, including poultry, seemed to be associated on its own with an increased risk of hypertension, and the same goes for even a moderate amount of canned tuna. So, in the potato study, they were careful to try to factor out any effects from the consumption of all types of animal flesh. Yet, they still found an increased risk and became concerned that associating potato intake with hypertension could be a “critical public health problem.” It was assumed potatoes might actually decrease high blood pressure, given their high potassium content, but they found evidence of the opposite effect.
As I discuss in my video Do Potatoes Increase the Risk of High Blood Pressure and Death?, two similar studies performed in Mediterranean Europe did not find any association between potato consumption and high blood pressure, though. Perhaps this is because they don’t smother their potatoes in butter and sour cream in that neck of the woods and instead eat potatoes with other vegetables. Now, the Harvard researchers tried to control for the salty and fatty dietary components associated with eating potatoes in the West, just like these researchers tried to factor out all the extra vegetables, but you can’t control for everything.
One of the main reasons we care about blood pressure is because we care about the consequences. In two studies done in Sweden, where they primarily eat their potatoes boiled, no evidence was found that potato consumption was associated with the risk of major cardiovascular disease. No relationship between potato consumption and risk of premature death was found in Southern Italy either. In the United States, however, potato consumption was associated with increased mortality: a whopping 65% increased risk of dying from heart disease, a 26% increased risk of fatal stroke, a 50% increased risk of dying from cancer, and an increased risk of dying from all causes put together. However, this association disappeared after adjusting for confounding factors. In other words, it wasn’t the potatoes at all. Potato eaters must just smoke more, drink more, or eat more saturated fat or something. Once you control for all these other factors, the link between potatoes and death disappears.
This was confirmed in the NIH-AARP study, the largest such study of diet and health in human history. If you separate out just the potatoes, researchers find they are not associated with increased risk of death, with the possible exception of French fries, which are associated with an increased risk of dying from cancer. Put all the studies together—20 in all—and no significant association has been found between potato consumption and mortality, though again, fried potatoes may be the exception. Even just twice a week, fries may double one’s risk of dying prematurely, independently of other factors, but the consumption of unfried potatoes seemed to be neutral.
I’ve talked a lot about how all plant foods are not created equal, as well as healthy versus unhealthy plant-based diets. To this end, researchers created not only an overall plant-based diet index (PDI)—just scoring plant versus animal foods—but also a healthy plant-based diet index (hPDI) and an unhealthy plant-based diet index (uPDI). The healthy index puts a greater emphasis on whole plant foods, whereas the unhealthy index scores how much low-quality plant foods you’re eating, grouping potatoes along with soda, cake, and Wonder Bread. When you run the numbers, the more plant-based you eat, the longer you live, and the lower your risk of cardiovascular disease. In other words, more plant foods and less animal foods are associated with a significantly lower risk of dying prematurely. This benefit was limited, though, to those eating the healthier plant-food diets. However, the researchers were surprised that those eating the less healthy plant-based diets with processed plant-based junk did not live significantly shorter lives. Maybe that’s just because they were eating fewer animal products, and that’s really the primary determinant of lifespan here, or maybe the lack of an association between less healthy plant-based diets and mortality is because potatoes were kind of coming to the rescue. And indeed, higher intake of potatoes did appear protective; so, given these conflicting results, future studies may consider just resigning fried potatoes to the unhealthy list.
Now, in terms of mortality, fried potatoes may not be as bad as fried meat—fried chicken and fried fish—but that’s not really saying much. The French fry/death data gave the industry trade group Potatoes USA a bit of a chip on its shoulder, reminding readers that observational studies can only prove correlation, not causation, to which the authors replied, “Our data add to the pressing public health calls to limit fried potato consumption.” French fries may be so bad for you that it wouldn’t be ethical to do an interventional study and randomize people to eat them.
Doctor’s Note
This is the second in a five-part series on potatoes. The first installment was Do Potatoes Increase the Risk of Diabetes?.
Aside from French fries, potato consumption is not associated with mortality. Potato eaters tend to live just as long as non-potato eaters. That’s actually bad news. A whole plant food that’s not associated with living longer? One that has a neutral effect on lifespan? That’s a lost opportunity. But what if you really like white potatoes? Then you should chill and reheat them, as I explain in my next video.
Coming up:
For more on preventing and treating high blood pressure, see related posts below.
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How to Do Vegetarian Keto – The Complete Guide
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References
https://pubmed.ncbi.nlm.nih.gov/17384344/
https://pubmed.ncbi.nlm.nih.gov/16441942/
https://pubmed.ncbi.nlm.nih.gov/17162326/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4042564/
https://pubmed.ncbi.nlm.nih.gov/24607306/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213178/
https://pubmed.ncbi.nlm.nih.gov/14600563/
https://pubmed.ncbi.nlm.nih.gov/21118604/
https://faseb.onlinelibrary.wiley.com/doi/full/10.1096/fasebj.24.1_supplement.939.12
https://academic.oup.com/ajcn/article/87/5/1558S/4650426
https://www.sciencedirect.com/science/article/abs/pii/S0939475309000660?casa_token=NHKkXZqtbpoAAAAA:o9EIlsN3olsZUVsW3p8d3Gm4bBUQHPYr1O0J1E2WQJ_Cj39Wm6FVw65k3U4ebg4PcaEbe5Z0Zg
https://pubmed.ncbi.nlm.nih.gov/25772196/
https://pubmed.ncbi.nlm.nih.gov/21139125/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5877547/
Timestamps ⏱
0:00 – Intro to Vegetarian Keto
0:27 – Mediterranean Principle – Monounsaturated Fat
2:22 – Non-Starchy and Leafy Vegetables
3:57 – Protein
6:32 – Vitamin B12
9:00 – Vitamin D3
9:31 – Creatine
10:47 – Omega-3s
11:34 – Thiamine (B1)
12:20 – Overconsumption of Nuts
source
Sushruta Samhita Uttaratantra Chapter 53 Svarabheda Pratiședha (Treatment of Hoarseness)
AIAPGET POINTS
– Acharya Sushruta has described Swarabheda and its treatment in Chapter 53 of Uttara Tantra.
– Ati Uchcha Bhashana, Visha, Adhyayana, Gita, Shitadi – are the Nidanas of Swarabheda.
– In the Samprapti of Swarabheda, SWARAVAHA SROTAS are damaged by aggravated Vatadi doshas.
– There are six types of Swarabheda – Vataja, Pittaja, Kaphaja, Sannipataja, Kshayaja and Medoja Swarabheda.
– Gadgadavat Swara – is a feature of Vataja Swarabheda.
– Digdha Gala Oshta Talu are the special features of Medoja Swarabheda.
– Shvasa-Kasa-Vidhi has been mentioned amongst treatment principles of Swarabheda.
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The 53rd chapter of Uttaratantra of Sushruta Samhita is named as Svarabheda Pratiședha. This chapter deals with Treatment of Hoarseness.
अथातः स्वरभेदप्रतिषेधमध्यायं व्याख्यास्यामः ||१||
यथोवाच भगवान् धन्वन्तरिः ||२||
We will now expound Svarabhedapratisedha – treatment of hoarseness of voice; as revealed by the venerable Dhanvantari.
Nidāna- samprāpti – causes and pathogenesis
अत्युच्चभाषणविषाध्ययनातिगीतशीतादिभिः [१] प्रकुपिताः पवनादयस्तु |
स्रोतःसु ते स्वरवहेषु गताः प्रतिष्ठां हन्युः स्वरं भवति चापि हि षड्विधः सः ||३||
Causes –
– Talking in high pitch, for prolonged periods of time,
– Affliction by poisons,
– Studying in loud voice
– Singing in loud voice
– Excessive use of cold things
Pathogenesis –
Due to the above said causes, Vata and other doshas get aggravated. These aggravated doshas get lodged and localized in the svaravaha srotas i.e. channels of voice and destroy the voice of the person. This is called Svarabheda.
Types – Swarabheda is of six types.
Lakşana – clinical features
वातेन कृष्णनयनाननमूत्रवर्चा भिन्नं शनैर्वदति गद्गदवत् स्वरं च |
पित्तेन पीतवदनाक्षिपुरीषमूत्रो ब्रूयाद्गलेन परिदाहसमन्वितेन ||४||
कृच्छ्रात् कफेन सततं कफरुद्धकण्ठो मन्दं शनैर्वदति चापि दिवा विशेषः |
सर्वात्मके भवति सर्वविकारसम्पदव्यक्तता च वचसस्तमसाध्यमाहुः ||५||
धूप्येत वाक् क्षयकृते क्षयमाप्नुयाच्च वागेष चा(वा)पि हतवाक् परिवर्जनीयः |
अन्तर्गलं स्वरमलक्ष्यपदं चिरेण मेदश्चयाद्वदति दिग्धगलौष्ठतालुः ||६||
| Type of Svarabheda | Symptoms |
| Vataja Svarabheda – hoarseness of voice produced by vata | Blackish discolouration of the eye, face, urine and faeces of the patient
Speaks with broken voice, slowly Speech associated with stammering |
| Pittaja Svarabheda – hoarseness of voice produced by pitta | Yellowish discolouration of the face, eyes, faeces and urine of the patient
Speech comes from deep inside the throat i.e. the person speaks from the throat Speech associated with burning sensation |
| Kaphaja Svarabheda – hoarseness of voice produced by kapha | Person speaks with difficulty, continuously, slowly and during the day
Obstruction of throat by kapha at night |
| Sannipataja Svarabheda – hoarseness of voice produced by simultaneous aggravation of all the three doshas | Symptoms of all the doshas will be present
Voice of the person will not be manifested, not audible It is incurable |
| Kshayaja Svarabheda – hoarseness of voice caused by Kshaya – consumption or pthisis | Voice is decrease or
Voice is completely lost It is incurable |
| Medoja Svarabheda – hoarseness of voice caused by accumulation of medas – fat | Sound of the voice lurks in the throat of the patient,
Words do not come clearly, Voice of the patient comes out slowly The person’s throat, lips and palate are coated with fat |
क्षीणस्य वृद्धस्य कृशस्य चापि चिरोत्थितो यश्च सहोपजातः |
मेदस्विनः सर्वसमुद्भवश्च स्वरामयो यो न स सिद्धिमेति ||७||
Treatment done for hoarseness of voice do not succeed in the below mentioned conditions (i.e. it would become incurable) –
– In persons who are weak
– Aged people
– Emaciated persons
– That which has become chronic
– That which is congenital
– That occurring in obese individuals
– That produced by all the doshas together
Samāñya cikitsā – general treatment
स्निग्धान् स्वरातुरनरानपकृष्टदोषान् न्यायेन तान् वमनरेचनबस्तिभिश्च |
नस्यावपीडमुखधावनधूमलेहैः सम्पादयेच्च विविधैः कवलग्रहैश्च ||८||
यः श्वासकासविधिरादित एव चोक्तस्तं चाप्यशेषमवतारयितुं यतेत |९|
वैशेषिकं च विधिमूर्ध्वमतो वदामि तं वै स्वरातुरहितं निखिलं निबोध ||९||
Below mentioned are the treatment principles for Svarabheda –
Snehana – firstly, the patient suffering from voice disorders or hoarseness of voice should be administered with oleation therapy.
Swedana – After oleation, sudation therapy should be administered.
Shodhana – After oleation and sudation, purificatory therapies should be administered in the form of vamana – emesis, virechana – purgation and vasti – enema.
Nasya etc – Other therapies should be done according to the usual procedure should be done, including
– nasya – errhines and avapida – type of nasal drops,
– mukha dhavana – mouthwashes,
– dhuma – inhalation of medicated smoke,
– leha – electuaries and
– kavala – various types of gargles
Shvasa Kasa Vidhi – Therapies mentioned in the treatment of dyspnoea and cough can also be administered to treat svarabheda.
After this, special treatments beneficial for patients suffering from different types of disorders of voice / hoarseness of voice will be described.
Vātaja svarabheda cikitsa
स्वरोपघातेऽनिलजे भुक्तोपरि घृतं पिबेत् |
कासमर्दकवार्ताकमार्कवस्वरसे शृतम् ||१०||
पीतं घृतं हन्त्यनिलं सिद्धमार्तगले रसे |
यवक्षाराजमोदाभ्यां चित्रकामलकेषु वा ||११||
देवदार्वग्निकाभ्यां वा सिद्धमाजं समाक्षिकम् |
सुखोदकानुपानो वा ससर्पिष्को गुडौदनः ||१२||
In vataja svarabheda
Ghee prepared with the below mentioned ingredients should be given to the patient to drink –
– kasamarda
– vartaka and
– juice of markava
Alternatively, ghee prepared with juice of artagala should be given. This cures vataja svarabheda.
Also, goat’s ghee boiled with below mentioned herbs added with honey should be given –
– yavakshara
– ajamoda
Goat’s ghee boiled and prepared with the below mentioned herbs should be given mixed with honey –
– amalaka
– devadaru
– agnika
Gudodana is boiled rice added with jaggery. This should be served with ghee for consumption. Comfortably warm water should be given as an after-drink.
Pittaja svarabheda cikitsa
क्षीरानुपानं पित्ते तु पिबेत् सर्पिरतन्द्रितः |
अश्नीयाच्च ससर्पिष्कं यष्टीमधुकपायसम् ||१३||
लिह्यान्मधुरकाणां वा चूर्णं मधुघृताप्लुतम् |
शतावरीचूर्णयोगं बलाचूर्णमथापि वा ||१४||
In pittaja svarabheda
Ghee should be given for consumption followed by milk for drinking.
Yashtimadhu Payasa – milk pudding prepared with licorice should be given to drink added with ghee.
Powder of herbs of sweet taste i.e. Kakolyadi Gana group of herbs should be given to lick mixed with honey and ghee.
Alternatively, powder of Satavari or Bala shall be given mixed with honey and ghee to lick.
Kaphaja svarabheda cikitsā
पिबेत् कटूनि मूत्रेण कफजे स्वरसङ्क्षये |
लिह्याद्वा मधुतैलाभ्यां भुक्त्वा खादेत् कटूनि वा ||१५||
In kaphaja svarabheda
Powder of herbs tasting pungent like Trikatu etc should be given, mixed with cow urine.
The same powder of pungent herbs shall be given to lick after mixing it with honey and oil.
It can also be consumed after taking food.
Medaja svarabheda cikitsa
स्वरोपघाते मेदोजे कफवद्विधिरिष्यते |
सर्वजे क्षयजे चापि प्रत्याख्यायाचरेत् क्रियाम् ||१६||
In medoja svarabheda
Treatment should be done on the same lines of kaphaja svarabheda treatment explained above.
In trioshaja and ksayaja svarabheda
Treatment should be done after intimating the patient and his family about the incurability of these conditions.
शर्करामधुमिश्राणि शृतानि मधुरैः सह |
पिबेत् पयांसि यस्योच्चैर्वदतोऽभिहतः स्वरः ||१७||
Milk boiled with sweet tasting herbs added with sugar and honey should be given for consumption to the patients suffering from hoarseness caused by speaking or studying loudly.
इति सुश्रुतसंहितायामुत्तरतन्त्रान्तर्गते कायचिकित्सातन्त्रे छर्दिप्रतिषेधो नाम (पञ्चदशोऽध्यायः, आदितः) त्रिपञ्चाशत्तमोऽध्यायः ||५३||
Thus ends the fifty-third chapter by name Svarabheda pratişedha in Uttara sthana of Suśruta Samhita.
Struggling with nighttime snacking? Try this instead.
I got a question from a reader named Rick this week:
If this sounds familiar, you’re definitely not alone.
When people join Nerd Fitness Coaching, over 70% tell us they struggle with stress eating, emotional eating, or nighttime snacking.
I recorded a short video explaining why simply “trying to stop snacking” usually backfires – and what tends to work better.
WATCH: STRUGGLING WITH NIGHTTIME SNACKING? TRY THIS INSTEAD
If you’d rather read than watch, here’s the short version:
1. Eating at night isn’t the problem.
If you genuinely need more calories or nutrients for the day, eating at night is completely fine! (Contrary to popular belief.)
The challenge most people run into is when they find themselves snacking even when they’re not hungry, often as a way to decompress after a long day.
2. Going cold turkey rarely works.
If nighttime snacking has become your main way to relax or reward yourself at the end of the day, simply removing it often leaves a gap that’s hard to sustain.
3. Build a “decompression menu.”
Instead of trying to eliminate the habit immediately, come up with a few other things you genuinely enjoy that help you relax at the end of the day.
Examples might include:
- making herbal tea
- reading
- stretching
- listening to music
- playing a game
- journaling
Even if you choose one of these alternatives some of the time, that alone can start shifting the habit.
The goal isn’t quit snacking at night, forever!
It’s to understand the habit and expand your choices. 💪
4. Upgrade your Batcave to make the alternative choice easier.
At the end of the day we’re usually tired, and that’s when we tend to default to the easiest and most familiar option.
A few small changes to your environment can make a big difference.
Things like keeping your go-to snack foods out of immediate reach, or setting out your book in a visible and easy to access place.
Heck, you could even try putting your book IN the pantry where the snacks usually are!
The goal is to rely less on willpower and more on an environment that gently nudges you in the direction you want to go.
—
So Rick, if you’re reading this, that’s where I’d start.
Instead of trying to eliminate the nighttime snacking overnight, experiment with adding a few other ways to decompress and adjust your environment so those choices are the easier ones.
Try it for a week or two and see what you notice.
Then we learn and adjust from there. 🔥
– Matt
P.S. If you want to submit a question like Rick, you can!
NAWs: the art of getting back on track
I got a message from a reader, Sabrina, this week – and she pointed out a pattern I think a lot of us know well.
“I allow myself to say sliding into bad habits is alright. After all, I’ve had a bad day. Well, my bad days have a tendency to become hard weeks and then months. It doesn’t take much for me to backpedal.”
I know I’ve been there. 🙋♂️
Here’s how we work through it.
Know the difference between an off-day and a repeated pattern.
Missing a workout or having a meal that’s not strictly on plan? Totally fine and expected. It’s not going to hurt your progress.
The problem isn’t the slip. It’s when the slip becomes the default.
Give yourself some grace on the hard days. And stay honest with yourself: is this a one-off, or a pattern forming? If it’s a pattern, call it out and reroute.
Rethink what taking care of yourself actually looks like.
Sometimes the perfect recovery from a hard day is to Netflix and chill. Rest absolutely counts as self-care.
But so does the workout you’ve been putting off, a solid meal, or putting down your phone and getting to bed at a reasonable hour.
Sometimes the most caring thing you can do for yourself is the thing you’re avoiding.
A hard day doesn’t have to mean opting out. It might mean doubling down on the things that you know are good for you.
Don’t try to play catch-up.
This is one of the most common traps I see. Someone misses a workout and suddenly feels like they need to do that one PLUS today’s to make up for it. That’s how you end up feeling like you’re pushing a boulder uphill before you’ve even started.
Forget what you missed. Focus on the plan for today. Do that. Then build from there.
Find your NAW (your Next Available Win).
When you realize you’re off track, the instinct is to overcommit.
“I need to work out five times a week.”
“I need to do a giant meal prep and reset the whole kitchen.”
Those things aren’t wrong, but they’re not your first step.
Your first step is the next available win. One thing that interrupts the current pattern.
Maybe it’s five minutes of stretching on the floor while you watch TV tonight. Maybe it’s grabbing some fruit as a quick snack.
Here’s the key: you don’t have to wait until tomorrow, or Monday. Reset the pattern as soon as possible.
I recently had a client come back from vacation feeling completely off track. We didn’t map out an elaborate return plan. We just asked one question: “OK – when’s the next workout?”
The next day she knocked out a short workout and hit a PR on her barbell rows.
That’s all it took. The next available win. (PR not required 🤪)
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The next time you catch yourself having an off-day, start with grace. These days are normal, expected, and they don’t erase all the hard work you’ve put in.
Then check in with yourself: “Am I falling into a pattern that’s working against me?“ If so:
- Reframe what self-care looks like
- Don’t play catch-up
- Find your NAW
Save this for the next time you need it:
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You got this. 💪
– Matt
P.S. If you’re in a backslide right now, we’re here to help. Take our Coaching Quiz to find your own personal fitness Yoda.
