Season 6, Episode 3: The Intersection of Cardiovascular Health and Gut Wellness with Dr. Pedi Mirdamadi

Evelyne: I am so excited you’re here. It’s been a long time coming, right?

Dr. Pedi Mirdamadi: It has been.

Evelyne: I’m so excited to have you here to talk about gut health, cardiometabolic health, and some business talk as well. You have a large social media following, so I definitely want to hear more about how you grew that. Before we start, what’s lighting you up this week?

Dr. Pedi Mirdamadi: Regaining my health. I feel like in the last couple of months, I went through a little bit of a dip in my health. I broke my thumb, and I got really sick with this nasty bug. So, rebuilding my health, feeling healthy and well and back to 100% is a blessing. We take our health for granted until it slightly dips, and then we start appreciating it. So, I’m just grateful for health, and hoping to continue that energy into the new year.

Evelyne: I love that. Yes, health is such a blessing, and we don’t realize it until it’s gone sometimes. So, Dr. Pedi Mirdamadi is a licensed naturopathic doctor in the state of California, and was voted the top naturopathic doctor in La Jolla. He earned his doctorate from Bastyr University California, and was voted the top naturopathic doctor in La Jolla. He earned his doctorate from Bastyr University, California, and is a certified functional medicine practitioner through IFM. He majored in psychology at the University of Toronto, and got his master of science in kinesiology at York University where he conducted and published research in an exercise physiology and obesity lab. So, Pedi, I’m curious, what drew you to medicine? How did you end up here?

Dr. Pedi Mirdamadi: It was a very organic path for me. In my early 20s, I started off with being a personal trainer. I started a personal training company, and I had great success with it. My business grew, and slowly from there, I went to nutrition school, became a holistic nutritionist. So, I started off teaching my clients about the benefits of lifestyle, and then from there, teaching my clients about the benefits of food and using food as medicine. So, it was very organic, but what ended up happening to me is my clients came to me with health issues that not only was I not qualified to answer, but I didn’t know how to answer and how to help.

So at the time, I was doing pre-med to go to dental school, and the universe is an interesting way of working because my path to dental school didn’t work. Meanwhile, I was developing so much passion about helping my clients get to optimal health. So from there, I learned about naturopathic medicine, functional medicine, and I learned about Bastyr. So, I decided to apply, and I got in. From there, the rest was history. So, the universe sometimes closes doors for you, and opens up others. So at the time, I was really defeated that dental school didn’t work, but I realized that I wasn’t being rejected, but I was simply being redirected to a path that was better for me.

I’m very grateful to be on this journey. I love what I do, and really passionate about bringing this medicine to the world.

Evelyne: I love that. Were you always drawn to fitness and health? Was there anything that happened when you were younger, or you just were always interested in it?

Dr. Pedi Mirdamadi: No, I was always interested in optimal health and athletics. I was very athletic doing fitness competitions for seven, eight years. So, I was always trying to figure out ways on how to biohack my health. So, it was just innate, this desire to want to learn more.

Evelyne: That’s really cool. So, I’d love to talk about digestive health first, because that’s one of your specialties. I’m curious, what are some common patterns that you’re seeing in your practice right now?

Dr. Pedi Mirdamadi: What I’m noticing is a lot of people, because of the stress going on in their world and their lives, it’s impacting their gut health, and stress has a detrimental effect on gut health because when we’re in a state of stress, we’re not absorbing very well. We’re in a state of fight or flight, which is the opposite of rest and digest. So, our body is not producing digestive enzymes or stomach acid or adequately moving the food through the gut effectively. That can manifest as a lot of digestive issues for people.

So, I’m constantly educating my patients about the importance of working on their nervous system, stabilizing stress as best as they can. Because if we only focus on what’s going on in the gut, and don’t pay attention to the nervous system and how that impacts digestive health, we’re missing an important part of the process.

Evelyne: For sure. Is there something in particular that you’re seeing? I know you’re running a lot of lab work.

Dr. Pedi Mirdamadi: So, one thing that I’ve been seeing a lot of is H. pylori. H. pylori is a bacteria that can overgrow in the stomach, and cause a lot of issues for people, and, in worst case scenarios, can cause stomach ulcers. I’m seeing a lot of that. To be honest, I would say three out of every 10 stool tests I run, it’s coming back positive on that. That’s people that have GI issues already. I think part of that has to do with the stress that we’re experiencing as humans these days, because it creates a more opportunistic environment for H. pylori to thrive.

Evelyne: I was just going to ask you what do you think is behind that? I’m curious especially with H. pylori, because I feel like this is where a lot of practitioners get stuck a little bit because it seems like the treatment time is a lot longer than certain other gut issues. So, I’m curious if you could share a bit more about what that looks like for you, like what supplements you use. What dietary changes do you implement? How long do you implement that, things like that?

Dr. Pedi Mirdamadi: Absolutely. It is a longer journey. Typically, what I see is it takes about eight to 12 weeks to treat someone with natural therapies. The conventional treatment approach for H. pylori is triple antibiotics, three different things in two weeks. So, they hit it hard as well. So when it comes to using more natural treatment options, in my experience, it takes usually eight to 12 weeks. I like to use multiple antimicrobials stacked on top of one another including things like DGL, mastic gum. There’s strains of bacteria that help with that, so hitting multiple things for a long period of time.

But more importantly, at the same time, stabilizing the person’s stress levels, and supporting their immune system and just trying to give them more resilience so that we tip into a healthier environment, and it creates a more less likely opportunistic environment for the H. pylori to thrive. So, this ensures that it doesn’t come back as well. Once we treat it, we want to make sure it doesn’t come back. That’s why it’s important to address the individual holistically to increase the chances of this not coming back.

Evelyne: Then I’m curious about the sequence of everything that you do too. So with H. pylori, it seems like you go after it a little harder, right? Then you said that you want to reestablish that good terrain, that good microbiome so that the H. pylori can’t then regrow. I’m curious, do you do that part like the gut healing and reestablishing that microbiome at the same time, or do you focus on killing the H. pylori first, and then that?

Dr. Pedi Mirdamadi: No, I do alternative support as well, supporting the microbiome, immune system, gut lining if there’s any signs of inflammation in the gut, leaky gut, working on that as well because that’s effectively going to support the immune system. The more we can balance the healthy microbiome, replace some of the beneficial bacteria if they’re deficient in, or support the gut lining. All of that’s going to reduce the strain on the immune system, and the immune system could have more of a targeted approach to kill off the bacteria on the H. pylori that’s overgrown.

Evelyne: Since you just mentioned the immune system, we know that the gut is such a huge part of that. From what I have seen, and I’m sure you see this in your patients obviously, is it seems like people are more and more sick, right? So, people’s immune systems are weaker. Do you think it’s related to the infections? There have been more infections in the last couple of years, and so we’re weaker, or do you think it’s that we have worse GI tracts, and so we have more GI issues, and that’s why there’s this immune issue, or is it both?

Dr. Pedi Mirdamadi: I think it’s combination of both and other variables. Yes, there’s been a lot of gnarly viruses, infections, fevers, suspicious things over the last few years that have been going around, all of which adds to the body’s inflammatory load, right? So, combine that with gut issues, the standard American diet that most people are consuming as well as stressors, and stress doesn’t just mean psychological stress. Stress could also mean physiological stress. So, a lot of people nowadays are attached to their mobile devices, cell phones, tablets, TV. So, that is impacting sleep, and sleep is one of the most important things for strong immune support.

So, combine the sleep, poor nutrition, nutrient-deprived people and diets as well as all these nasty bugs that have been going around causing inflammation, immune dysregulation, you pair all that together, and then the result is a more susceptible individual. So, it’s always holistic these things. I feel like we can never just hone in on one aspect. We got to look at the whole picture, because there’s always multiple areas that could be optimized.

Evelyne: So when it comes to gut health, what are some of your favorite other nutrients that you like to use in people?

Dr. Pedi Mirdamadi: It’s always personalized for me. Some patients benefit greatly from glutamine. That could be good for the gut lining, whereas other patients react adversely to glutamine. They feel actually more anxious, or it could ramp up any type of histamine reactions that they have. That’s usually due to the fact that there’s some metabolism issues with histamine breakdown. So, it’s always very personalized, but I really like glutamine. I really like enzymes. I think digestive enzymes is definitely a place for that, because if we’re not adequately breaking down the food that we’re eating, it’s going to create a breeding ground for the bacteria in our gut.

They’re going to feed and create further imbalance instead of us feeding in our cells, getting nourished. So, I think digestive enzymes could be very, very beneficial. Another reason for that is because a lot of people, they’re eating in a rush, not chewing well. They don’t have sufficient stomach acid. So, stomach acid signals the production of digestive enzymes. So, when all of that is compromised, we don’t have enough digestive capacity, and the food isn’t being broken down very well. That could contribute to further bacterial imbalance or dysbiosis.

Additionally, if there’s leaky gut in the person, those undigested food particles could go through and hit the immune system, and that could trigger the immune system. So, there’s multiple reasons why paying attention to digestion and digestive capacity is very important. I also think there is a place for probiotics, postbiotics, because they’re very important for the gut lining, microbiome, that crosstalk that happens from the gut to the immune system. Then also immunoglobulins, I think there’s a time and a place for those as well. If we’re looking to bind some of the toxins that are potentially being produced by the overgrowth microbes or pathogenic microbes, because they’re always pumping out toxins, LPS. So, the immunoglobulins could bind some of that, and prevent them from impacting the body.

Evelyne: Thank you for all the points too that you made about the digestive enzymes. I feel like digestive enzymes are one of those things where people really do feel a difference sometimes just after one meal or just having them with one meal. So, that’s great. You mentioned the postbiotics. What are some of the applications in which you would steer towards using those?

Dr. Pedi Mirdamadi: So, anytime the gut lining needs support, there’s inflammation in the gut, or there’s leaky gut. I think the postbiotics are a great idea. The main one I use is a form of short chain fatty acids called butyrate. That can have really beneficial effects on the gut. It’s pretty much fuel for the enterocytes, which is the cells of the gut, and it allows them to heal and repair. If there’s any inflammation, it can help with that.

Evelyne: Great. I want to shift directions here. So, heart health is upon us again. We know that heart disease is the number one cause of death in men and women. So, it’s always important, but at least once a year, we shine more of a spotlight on it. Something I don’t think we’ve really gotten into on this show before is the connection between cardiovascular and GI health. I would love to hear from you some of the areas in which those are connected.

Dr. Pedi Mirdamadi: So, GI Health could impact cardiovascular health in multiple areas. The main one that comes to my mind working with cardiologists and something that we checked when I worked with Dr. Mimi Guarneri, who’s the pioneer in integrative medicine, was something called TMAO, trimethylamine N-oxide. This has been linked to increased risk of atherosclerosis, heart attack, stroke. That is usually a byproduct when there is an imbalance in the gut microbiome, and foods that contain choline, lecithin and carnitine are consumed. These can be found in somewhat decently healthy foods like eggs, meat.

So if there’s significant bacterial imbalance, and we consume these foods that contain those ingredients or those nutrients that I had mentioned, the bad bacteria or the dysbiosis can result in an increase in TMAO. So, that’s one thing that is cardiovascular risk that we want to pay attention to make sure the bacteria is balanced, so we’re not overproducing TMAO. TMAO is actually checked. It could be checked. So, we do test for that sometimes. So, that’s one thing that I always keep in mind. Then the other is making sure that the gut lining is healthy, because if the gut lining is not healthy, bacterial toxins like LPS, lipopolysaccharides, they could enter the bloodstream, and that could cause systemic inflammation, which is a key driver for hypertension, metabolic disease, atherosclerosis.

So, we always want to make sure that the gut lining is sealed, so none of these toxins like LPS are entering systemic circulation, and promoting inflammation. So, that’s another area that I pay attention to. Then the other one that is very important and often overlooked is the gut-brain axis, the connection between the gut and the brain. So if the gut’s not happy, chances are the brain won’t be happy. A lot of time, people that have IBS, irritable bowel, constipation, some of these uncomfortable gut symptoms, that could impact their gut-brain axis, and as a result through the vagus nerve, which regulates the stress response, they could be more prone to high blood pressure, increased heart rate, those things because the nervous system is rattled.

So, that’s another way that we want to be mindful of supporting the stress response system by keeping that gut-brain axis in mind.

Evelyne: Great. I want to go back to what you said about TMAO. I don’t think we’ve talked about TMAO here, and I find it to be somewhat controversial. I think it’s also interesting, because I feel like so many more people are eating more meat and more protein. I do think that eggs are healthy. I had a show on hemochromatosis so people know how I feel about red meat in general. I think it just depends on the person, right? But with TMAO, because you mentioned choline also, and I know that people with genetic SNPs and PEMT are very deficient in choline, and so it can be very useful to actually take supplemental choline. So, I guess, well, the part that you said that struck me was if their microbiome is unbalanced, then it becomes a problem. So, can you talk a little more about that?

Dr. Pedi Mirdamadi: So, it’s the gut bacteria that convert those foods into TMAO, right? It’s usually the pathogenic bacteria or microbes that are not commensal or beneficial. So just like they pump out more LPS, they will shunt or shuttle some of these ingredients which are technically beneficial for us into pathways that aren’t very beneficial for us. So, again, that comes back to paying attention to the bacterial imbalance, because if that’s off, our detox is impaired. Blood sugar is impaired. So much more is impacted, and the metabolism of some of these nutrients will not be optimal and will actually be negative in some ways if there is a significant degree of bacterial imbalance.

Evelyne: Okay, thank you for expanding on that. Then that leads me to ask you about diets. So, what are your thoughts on what a good diet entails?

Dr. Pedi Mirdamadi: That is probably the most common question I get as a holistic nutritionist and naturopathic doctor, and it fascinates me because it’s 2025 now. Technology has advanced so much. Artificial intelligence is replacing the jobs of thousands of people worldwide, and we’re still confused about the simple most important topic about human health, which is diet. What is the best diet? There are so many diets out there, keto, paleo, vegan, vegan, vegetarian, carnivore. They just… There’s so much. So at the end of the day, it’s personalized. What may work for one person may not work for another.

So, I don’t think there is one-size-fits-all diet. I think that’s a complete myth. However, there are some general principles which I think apply to everyone. The main one being, and a tip that I give all my patients that are overwhelmed with their nutrition and their diet, is ask yourself, “Was the food made by nature, or was the food made by humans in a factory?” If the food was made by humans in a factory, chances are it’s highly processed. It’s got a list of ingredients, most of which probably I can’t even pronounce. So, chances are it’s stripped of nutrients, and not very good for you. On the other side of the equation, if it was made by nature, has no ingredient list, it’s in its whole food state like avocados, berries, nuts, olives, eggs, turkey, some of these things.

Chances are it’s better for you, because it’s in its real whole food state. So as an overarching theme, that’s what I recommend to everyone. I think that is a good starting point when it comes to addressing what a healthy diet is, but then we want to pay attention to some of the top inflammatory foods, and avoid them, things that are fried. Some people don’t do well with dairy, wheat. Some people don’t do well with some nuts or soy, and so might want to experiment removing some of those if you have any uncomfortable digestive symptoms. But things like fried foods, I think, are a no-go. High fructose corn syrup, no go. We want to avoid those.

The liquid sugars, we really want to avoid. Then we also want to be mindful of pesticides and toxins in foods as some foods contain higher levels of pesticides and toxins compared to the others.

Evelyne: So, I’m curious in your practice when it comes to personalizing a nutrition plan for your patient, some practitioners I work with too, genetic testing. I’m just curious, what are the top lab markers maybe, or tests that you take into consideration when you personalize a plan?

Dr. Pedi Mirdamadi: I pay attention to food sensitivity testing, food allergy testing, sometimes IgA, IgG, because those tell me, “Okay, is the food nourishing the person, or is it causing some form of inflammation?” So, that right there is a good starting point. I like to use that. Oftentimes, foods like sugar and dairy, some of those inflammatory foods that most people with digestive issues can’t tolerate pop up. So, it’s a good supporting evidence that patient sees, and it gets them to buy in. They’re like, “Oh, okay, this test suggests that these foods aren’t good for me. Let’s maybe avoid them for a bit.”

So, it could be very good supportive data to get people to buy in to remove some of these bad foods, because the tests show that it is causing some degree of an IgG response. These tests are only accurate if the person doesn’t have leaky gut. So, it’s important to keep that in mind, because some people will come back and say, “Oh, if there’s leaky guts, it’s not accurate. If there’s a histamine reaction, it’s not accurate,” which is true, but when there isn’t, it could be helpful. What happened for me was really interesting. I was having gut issues a few years ago, many years ago. In the morning, I would have a protein shake with chocolate whey protein, almond milk, almond butter, and a banana.

I did a food sensitivity test. I was reacting to whey, chocolates, almond, and banana. So, everything I was putting in my smoothie was causing inflammation in my body. So, I switched the bananas to blueberries, switched the chocolate whey protein to vanilla plant protein, switched the almond milk to coconut milk, and then the almond butter to a handful of walnuts, and my gut felt better. So, these foods are some things that appear healthy on the surface, but they weren’t working for my immune system. So, when I trusted the data and modified things based on what the data suggested, I started feeling better because I reduced that inflammatory load on my immune system and my gut.

Evelyne: Do you find that you can eat those again? You were just eating them too much at the time.

Dr. Pedi Mirdamadi: Exactly. You just want to take a break, and give the immune system a chance to calm down, and now I can tolerate them.

Evelyne: Great. Then you’ve mentioned histamine twice now, which is another issue that I feel like is just exploding, histamine intolerance. I know that we can treat the symptoms, but I’m curious, how are you looking at the whole picture of histamine intolerance?

Dr. Pedi Mirdamadi: So, this is a booming area, like you said, and a lot of people are experiencing issues with this. I look at the whole picture, right? First and foremost, very important for me is stabilizing that mast cell response. So obviously, there’s ingredients and nutrients, antioxidants, vitamin C, glutathione, quercetin, all of which are helpful in stabilizing that response, which is important. But my job is always to peel the layers of the onion back to get to the root cause. At a root cause level, what’s going on that’s contributing to this histamine issue?

Histamine metabolism is another thing we got to think about. So, there’s, a, where the histamine is coming from, and then B, how is it being metabolized? There’s certain things that are very important for histamine metabolism, and we want to make sure all of those pathways are open and so that the histamine is not building up and it’s being metabolized, because histamine issues can actually impact mental health as well. Because if there’s histamine issues, it could cause an increase in dopamine, epinephrine, norepinephrine in the central nervous system, which could cause people to feel anxious.

So, it has central nervous system effects as well as digestive effects. So, it’s important to pay attention to that. But most importantly is why is there a histamine imbalance? Where is this coming from? Oftentimes, that’s coming from the gut, and the bacteria in the gut is imbalanced, or if there’s leaky gut, very, very important for us to pay attention to in order to prevent the production of histamine, and then make sure that the different metabolic pathways are opening so that they’re being processed properly and while stabilizing the mast cell response in order to get the immune system calm again.

Evelyne: Right. Great. Thank you for sharing. So, you mentioned Dr. Mimi Guarneri, who’s here in San Diego with us. I think that’s how you and I first met was at her office. She’s a world renowned integrative cardiologist. You worked directly alongside her. I’m curious how that shaped your journey as a doctor.

Dr. Pedi Mirdamadi: I owe a lot to Dr. Mimi Guarneri. She is one of the reasons I am where I am. I’ve known her for many years. I was blessed enough to meet her at first year university, which was the biggest blessing for me. I remember I was going home for lunch, because I always went home for lunch. When I was in med school, I lived down the street, and then one day, there was our… Our receptionist was holding a sign in the rain, holding an umbrella, and it said, “Reserved for Dr. Guarneri.” She was reserving a parking spot for her.

I was like, “Huh, this must be an important person if our receptionist is out here in the rain holding the sign.” So, I went to the talk, the only talk I attended at lunch. She blew me away, because it was the first time that I saw an MD, a medical doctor, who had such a strong understanding and respect for naturopathic and functional medicine, but also was extremely compassionate and gifted in the way she interacted with people. It’s very rare to see the combination of those three skills. So right there, I knew that I wanted to learn from her, and hopefully one day work for her. So, that became my goal.

So first year university, I started attending some of her talks and her events at her center. One day, I was the only student that would go. One day, she told me that she’s the president of the Academy of Integrative Health and Medicine, which is an organization where practitioners from different parts of the world come together that all believe in integrative medicine, that we all have unique skills and toolkits, that if we work collaboratively, we really do effective work. She suggested that I create a similar integrative medicine organization student level. So, I knew that was my in.

I knew that… I’m like, “Okay, if I do this, Dr. Guarneri will hopefully be impressed, and maybe that could be my way of building a relationship with her.” So, I built that organization. I connected with students from San Diego State University Doctor of Physical Therapy program, UCSD Medical Doctor program, MD program, Specific College of Oriental Medicine, Doctor of Oriental Medicine program, and of course our Naturopathic Medicine program. We formed a student alliance that we called it. We started having events in different areas. We had guest speakers, and it was a huge success to the point where we formed the first San Diego chapter. Now, it’s being replicated in multiple other states based on the blueprint that we created.

So through that, I got to know Dr. Guarneri. Then in third year, second and third year medical school, I started preceptoring her and shadowing her. I remember I was sitting like a fly on the wall, and just learning from her. Then in fourth year medical school, she told me, “Hey, next year, we’re having a residency, and you would be a great fit for it.” I remember I was crying the whole time on the car ride home because I was like, “Wow, fine. This is what I was waiting for. This is what I sacrificed so much for,” because medical school was such a grind, and then building this organization on the side was extremely time-consuming and took a lot.

So, I was really spread thin, but that’s what ended up getting me into her practice. It was the biggest blessing for me professionally, because as naturopathic doctors, we don’t really get the intense residency that medical doctors get. So, this was a way for me to really learn about western medicine and the primary care and cardiovascular care, integrative cardiology, really see how MDs work and operate. There, it wasn’t just Dr. Guarneri. It was another fabulous cardiologist, Dr. Elizabeth Kaback and other MDs. So, I was fortunate enough to work with all of them, learn from them, and just be a sponge.

That really strengthened me as an naturopathic doctor, gave me the missing piece and the experience that I needed to really feel confident in my skills. To this day, day to day, if I feel I get stuck at any point, or I’m challenged, I simply ask myself, “What would Dr. Guarneri do?” I try to harness that inner Dr. Guarneri. She’s really been instrumental for me, and I couldn’t give her enough credit. So, I’m very grateful.

Evelyne: Oh, I love that. She is wonderful. What would you say one of your biggest takeaways was that you apply in practice today?

Dr. Pedi Mirdamadi: That you could know everything in medicine and every pathway drug, everything. But if you don’t have a good heart, and if you’re not a good human and can’t hold that space for people, the healing won’t facilitate. So, that’s what I really saw her embody, and that she brought her heart to the table, and did everything from love and compassion, and really held space beautifully. Yes, she’s a gifted cardiologist, and brilliant at what she does, but I feel like that was her secret sauce, just that she was such a good human, and the energy that she brought to the table, and treated her patients and treated that exam room as very sacred space and a privilege. That really touched me, and really molded me to embody that as well.

Evelyne: That’s beautiful. Thank you. We’re going to have to send her this episode for sure. I want to ask you a little bit more about that GI and cardiology connection. So, I’m curious, when you are doing stool testing, and you’re doing advanced cardiovascular testing, what are some interesting clinical patterns that you’ve noticed?

Dr. Pedi Mirdamadi: That a lot of times, if there’s inflammation in the gut, like systemic inflammation markers like HSCRP could be elevated too. So when I see inflammation markers that are up, I wonder. I’m like, “Where’s this coming from?” If they’re not sick and if it’s persisting, where is this coming from? Then usually when I take a look in the gut, there’s something going on. There’s something going on that’s promoting inflammation and eventually promoting systemic inflammation.

Evelyne: What do you think is one of the biggest overlooked issues when it comes to cardiovascular health?

Dr. Pedi Mirdamadi: Sleep apnea, because I feel like it’s not given the credit that it deserves, because the number one nutrient for our body by far, more important than food, vitamins, probiotics, water, is oxygen. It’s the quickest nutrient we die without. So if we have sleep apnea, or we’re experiencing dips in our oxygen levels at night when we’re sleeping, that is going to put a huge strain on the heart. A lot of times, a lot of people are diagnosed with sleep apnea, and given CPAPs, or told to lose weight, but they don’t see how important that is, and they don’t know how important that is.

An example was my grandma. She had severe sleep apnea. Poor lady would sound like a dinosaur when she would sleep, love her to death. But ever since we were kids, we’re like, “There goes grandma again.” So, she would snore so loud. She knew she had sleep apnea. She had the CPAP, but she would never wear it. So, after I learned to appreciate the importance of sleep apnea by seeing Dr. Guarneri, how much weight she puts on that piece, it really allowed me to understand the importance of that. Because it’s so crucial for the mitochondria of the cells. The engines of the cells need oxygen, and the heart is the most dense mitochondrial organ in the body or one of the most dense mitochondrial organs in the body.

If the engines, if those mitochondria aren’t working well, that’s going to affect the heart. So, I sat my grandma down, and I talked to her about it. I’m like, “Look, grandma, you’re taking all these supplements. You’re eating this good food, taking all this medication, which are really, really important, but I don’t think any of them are as important as your CPAP and your oxygen for you.” So when I broke it down for her like that, and allowed her to understand the importance of oxygen, she started using the CPAP regularly. Then she had a followup at the cardiologist.

The cardiologist turned around and asked her, “What have you been doing? Areas of your heart that weren’t moving very well are moving again. Whatever you’ve been doing, keep it up.” That was evidence that, “Look, giving more oxygen to the heart would be beneficial.” She sleeps eight, nine hours a day, so if she’s desatting or oxygen is dropping for eight, nine hours a day every night, that’s a lot of accumulative stress on the body. That was a beautiful example of how properly educating person on the importance of why they’re doing what they’re doing, empowering her, “Look, this is why you’re doing it,” motivating that change so that she has sustainable lifestyle change was so incredibly important for her, and was reflected in her heart health.

Evelyne: Wow, that’s amazing. I love how you shared that, because I was going to ask you, it’s like, “How do you convince your patients to actually use it?” You just summed it up. It’s like a life or death thing, right?

Dr. Pedi Mirdamadi: We need to know why they’re doing what they’re doing. That’s why naturopathic medicine really shines. Western conventional medicine, unfortunately, they don’t have the time to do this education. The model is not incentivized for them to sit down and really teach people about why they’re doing what they’re doing. So, they just go out in the world, and eventually, they stop doing some of these things. But as a naturopathic doctor, my job is docere, which is doctor as teacher. That’s one of our principles.

So, my job is to teach them why they’re doing what they’re doing, because that way, they’re more engaged and more likely to comply in the long-term. That’s when they get the true added benefit of what we offer.

Evelyne: Absolutely. With your patients, when do you screen for sleep apnea, or is it standard for everybody who comes to you, and you’re going to run advanced cardio labs?

Dr. Pedi Mirdamadi: So anytime there’s uncontrollable blood pressure, hypertension, I can’t get their blood pressure under control, or if someone comes to me, their weight is normal. They’re not stressed, and their blood pressure is high. A lot of times, that’s suspicious for me. I had one young man who came to me, lovely guy, young man, and normal weight, stressed out a little bit, but he had such high bad blood pressure, really high pressure, like 200 over 120. So, I made a referral right away to his car… I’m like, “See, you need to see a doctor. We need to work on this.”

He was medicated and everything, but I was shocked. I’m like, “Why does this guy have such high blood pressure?” Then I found out that he can’t really breathe through his nose, and because of he was hit in the face when he was a kid. So, I did the sleep study. I’m like, “I bet you’re not breathing well. You’re not getting enough oxygenation.” He has severe sleep apnea. So, he went and saw an ENT. They cleaned up his nose, made sure that the canals are nice and patented, and his airflow was better, and his blood pressure improved.

So, anytime there’s uncontrollable high blood pressure, or someone’s waking up really tired and with headaches in the morning, or they’re waking up really anxious or high heart rate tells me something’s going on overnight, or if they have cognitive decline because not only will lack of oxygen affect the heart, the brain is also very high density in mitochondria. So, anytime there’s cognitive issues, I also pay attention to sleep apnea.

Evelyne: I see a lot more people using nose strips and mouth taping. Does that even do the same thing as a CPAP or no?

Dr. Pedi Mirdamadi: Well, a CPAP is needed when there is severe sleep apnea, moderate sleep apnea. Those things are not going to do anything for severe sleep apnea. There’s also mouth devices. Dental devices might work for mild to moderate sleep apnea, but definitely not severe sleep apnea.

Evelyne: Do you see that those can be beneficial for other things?

Dr. Pedi Mirdamadi: Yeah, they can be beneficial for other things, because mouth breathing causes dry mouth, and dry mouth is a problem for the oral microbiome. It creates dysbiosis in the mouth. So, that could be a problem because if there’s bacterial imbalance in the mouth, and we’re swallowing that bacteria into the gut, that’s going to cause further dysbiosis in the gut. So, very important to try to minimize mouth breathing for that reason. That’s where the mouth taping can come in.

Evelyne: Interesting. I want to talk a little bit more about that oral health and cardiovascular connection. Tell us more about that. Is that something, again, that you’re evaluating with every patient?

Dr. Pedi Mirdamadi: No, it’s not something I evaluate with every patient, but I definitely keep it in mind, and I educate my patients on that like, “Oral hygiene is important. Seeing a dentist regularly is really important.” Periodontal disease is a problem because if there’s LPS, if we have bleeding gums, and there’s bacterial imbalance in the mouth, this bacteria is going to enter into the bloodstream through the mouth, and can cause systemic inflammation. So, it’s always important to pay attention to oral hygiene, and make sure we’re flossing, brushing, seeing our dentist.

Then tongue scraping is another thing that I really like. So, it’s really important to pay attention to that, because it can contribute to systemic inflammation, which is the root cause of cardiovascular issues long term.

Evelyne: Before we transition away from this topic, just broadly, what are some of your favorite supplements to use when it comes to cardiovascular health?

Dr. Pedi Mirdamadi: I like antioxidants, like vitamin C, glutathione. I think antioxidants are very, very important. I like omega-3s, because they’re very good for the heart, good for triglycerides. I like Vitamin D. I think vitamin D is important for everything. So, those are some of the main ones that I would say.

Evelyne: Okay. I’d love to talk a little bit more about what’s currently exciting you in our field? Tell me more about that.

Dr. Pedi Mirdamadi: What’s really exciting for me is what social media has allowed us to do as naturopathic and functional medicine providers, because it’s given us a voice. That’s really exciting to me because it’s allowing people that are seeking this type of care to find us, connect with us, and learn from us. It’s a vehicle for us to provide such value. I’ve seen that in firsthand given the content that I made on social media, and how people are so appreciative and grateful from that content.

So, that’s really exciting for me. As a naturopathic doctor, just the fact that social media, there are so many platforms now that you could get on, make videos, educate people, and it gives us a voice. So, it’s really allowing us to get out there and spread our message.

Evelyne: Yeah, that’s great. You have a huge following on Instagram. You’re also very consistent with your posting. So I’m curious, what advice would you give to the practitioners who are listening about growing on social media? Can you share a little more about that journey?

Dr. Pedi Mirdamadi: That it’s the most important and best investment you can make for your business-

Evelyne: Wow.

Dr. Pedi Mirdamadi: Because there’s many other ways that you could invest money and promote your business, like SEO, paid ads, but I haven’t paid a dollar to market my business, and we’ve been jam packed for two years now. That’s only because of social media. My web guy, my webmaster told me to get the numbers of hits that we’re getting on our website each month. It would’ve cost me 10 to $15,000 a month just on advertisement ads and his fees in order to get that kind of traffic. This was done 100% organically by me. I haven’t paid a dollar for anyone to help me. I just made a rule to myself that I’m going to make two videos a day for a year.

I pretty much did that, and my social media grew from zero to 1.3 million people now combined in about two, two and a half years. I only started off making two videos a day for eight, six to eight months, and then it reduced, but I’ve been trying to be as consistent as possible. It’s been the bloodline of our business for sure. So I got to say, make that investment in yourself, in your business. You can’t care about people judging you for your videos. Just make the videos. Don’t go for perfection. Just get comfortable talking to the camera.

Watch my videos. Look how I do it, and learn from them, because the data is all there. When you look at the videos and the views, you see what videos are doing well. So, the evidence is all there. You just got to see who’s getting the numbers, and how are they doing it, and come up with your version of doing it. It’s been fun for me, extremely reinforcing. I get messages that, “Oh, doctor, I wanted to tell you, this video that you made about potential signs of low iron led to me having a discussion with my doctor, and I found out my ferritin was two. We’ve been working on that, and my life has changed since I addressed my ferritin and iron levels. Thank you so much.”

I was like, “Oh my God, I have never met this person. I made one video a year ago, and look at the impact it had on someone, right?” It led to a discussion with their doctor, which allowed them to unlock the root cause of all the issues or some of the issues that they were having. So, it’s just really positively reinforcing, really exciting, and I think everyone who is in this line of work should put in a certain amount of time to work on that. Plus, it’s the best practice for when you’re in person seeing people. If you can’t articulate this information on your phone in a camera, what are the chances you can articulate it well to people when they’re in front of you?

So, it’s great practice for you to get your lingo, and get your flow and your conversation ironed out. So, I highly recommend it for anyone trying to build their business, whether it’s medicine, coaching, any of these areas.

Evelyne: Excellent point. Congratulations on all the growth. I mean, that’s such a huge investment of time. I know how hard you work. So with the, you said you don’t have a… or you have such a big waiting list. So, I know you’re not specifically targeting people in San Diego, but is it just that enough people in San Diego have seen your videos that they come to you? Do you work with people all throughout the country?

Dr. Pedi Mirdamadi: I see mostly patients in California. I would say that’s most of the bulk of my practice. I would say 50% is from social media. 30% is from referrals.

Evelyne: Wow.

Dr. Pedi Mirdamadi: So, a big bulk of it is from social media. It’s over time just providing value, value, value, and people getting to know you, and familiarizing themselves with your approach. Over time, after months of learning from you, they eventually feel comfortable that they’re like, “Okay, I might just give this guy a call, and see what he can offer.” That’s why I’ve had a lot of providers and practitioners reach out to me, and ask me, “How have you done this? This is incredibly impressive that you’ve got such a huge following,” because what’s beautiful is this. Think about it.

30 years ago, if we wanted to put an ad out… When I was 16, my first business was a car detailing business. At that point, in order to get our ad out, we would go and make flyers, find the mail route, pick a couple of roads in our area, tell the mailman to drop those flyers in those mailboxes, and hope they would call us. It would cost money. It would cost time. Then we would get maybe 80 to 100 homes that would get our flyer, and two or three might’ve called. So, that’s how we would advertise 22 years ago, right?

Evelyne: Right.

Dr. Pedi Mirdamadi: Now, I get on my phone. In two minutes, I make a video, and within one day, over 100,000 people have seen it for free. I could do it again and again and again. Some videos will get two, 3 million people to see it for free. That’s where the value of this comes. I’ve only been doing social media for two and a half years. Imagine what it would be if you do it for five years, and you have a team. You invest some money into it. I’ve done none of that. So, there’s so much value in this, and that’s why…

Because of the demand of how many people have seen the organic growth that we had and how our practices become busy, that I’m making a social media education course for doctors and providers to teach them this blueprint in order for them to get their voice out and to get their clients out, because I’m all about helping people. Then I realized, “Huh, if I could help other providers grow their business, and help more people, that is a beautiful positive ripple effect.” So, that’s what my team and I are working on developing right now, just a little bit of a blueprint to help other providers scale their business using their personal brand and social media.

Evelyne: Very cool. That sounds awesome. So, at the same time that you’ve been building your social media presence, you’ve also started and grown your own business, right? You’re breaking more to practice. I’m curious, what are some of the biggest learnings that you’ve had in building that over this time?

Dr. Pedi Mirdamadi: A lot. It’s been… I have to wear many hats. So before when I worked for Dr. Guarneri, I was just a doctor. I was the naturopathic doctor. But now, I have to make sure operations are good, making sure accounting is good, marketing. So, there’s multiple hats that I wear. At the end of the day, for me, it all comes down to creating a culture, and creating an inspiring place for people to come and want to work. If we’re all on the same vision, which is helping people, making this world a healthier place, it becomes fun and very rewarding.

Of course, there’s going to be stress involved in that, but that’s the nature of the beast. This isn’t an easy industry. It’s not cut out for anyone. Being an entrepreneur is not cut out for everyone. So, some of the main things is surround yourself with people that you can trust. Surround yourself with people that make it fun, make you excited to come to work that have your back. So when you don’t have your best day, they’re picking you up. You feed off each other’s energy. That winning environment really gets me excited to come to work every day, and just try to figure out ways on how we could be better, and create more impact.

Evelyne: That’s great. Is there anything you would’ve done differently? You probably have a list.

Dr. Pedi Mirdamadi: I got to say I’m very grateful for the journey. I don’t know if I would’ve done anything differently.

Evelyne: Okay, good.

Dr. Pedi Mirdamadi: Sometimes I’m like, “Oh, maybe I got into medicine too late.” Like, “Shouldn’t have done my master’s or gone to nutrition school and whatnot.” But I feel like when I was in medical school, I went in at age of 29. I was really ready. I was really ready. I’m like, “This is where I want to be. This is exactly what I want to do,” whereas I felt like some of my younger colleagues were a little bit more nonchalant about it, so actually worked in my favor. So, I’m just grateful for the journey and how it’s been very organic guided by the divine. So, I’m just riding this wave, trying to be in a flow state, and just enjoying the ride.

Evelyne: I love that. Well, to wrap up, I ask all of our guests just three rapid fire questions. So, first one is, what are your three favorite supplements that you take?

Dr. Pedi Mirdamadi: One of the most important supplements I take is magnesium, specifically magnesium glycinate at night. I feel like that is a miracle worker for me. I went three or four days without it, and I was feeling a little bit more stressed. So, that really helps me de-stress, get some good sleep, and I like a good multivitamin or something that has good B vitamins to give me energy throughout the day. Last but not least, I got to say enzymes. I think keeping my gut feeling good. So, sometimes because being stressed out or eating quickly, you’re not taking full advantage of the digestive process. So, I would say enzymes are up there too.

Evelyne: Great. What are your favorite health practices that keep you healthy and balanced and resilient?

Dr. Pedi Mirdamadi: Oh, number one must be going to the gym, getting a good workout in. For me, it’s weights. That’s why breaking my hand was very challenging, because I couldn’t work out anymore. I realized the impact that weight training has on my mental health. So, that is a huge non-conditional for me that I must continue to do. The next thing is just trying to de-stress at night. So one hour before bed, I’m taking it easy, taking a shower, hanging out with my dog.

Then last but not least is getting IVs once in a while. Every three, four weeks, I give myself a nutrient IV to keep my immune system strong, support my adrenals and my nutrient levels to keep me dialed in and sharp.

Evelyne: Great. Then what is something that you’ve changed your mind about through your years in practice?

Dr. Pedi Mirdamadi: That in order to heal, you need to feel. By that, I mean you need to address the mental emotional aspect. It’s healing is truly body, mind, and spirit, and the emotional aspect is huge. So for me, I started doing a lot of healing, and working on the physical body, and I felt like I had plateaued a little bit until I started diving more deeply into the emotional spiritual body. That really allowed me to unlock my full potential and my health potential, because I realized some of the things that I went through potentially as a kid had been maybe holding me back from reaching my full potential.

So unlocking that, working through that, feeling some of that instead of just suppressing it down and ignoring it, really allowed it to move through my body, and was an instrumental piece in my healing journey, specifically my gut health.

Evelyne: That’s beautiful. Thank you for sharing. I feel like with almost any issue, it’s one of the key factors, right, or it’s that missing piece. I feel like you as a doctor, having gone through that, it probably makes it easier for you to share that with your patients, and to encourage them to go on that journey themselves, right?

Dr. Pedi Mirdamadi: I just send them to the person that I work with now.

Evelyne: Great. I love that. Pedi, where can practitioners learn more about you?

Dr. Pedi Mirdamadi: Instagram, Dr. Pedi Natural Health. TikTok, YouTube, Facebook, Dr. Pedi Natural Health. You look it up. I pop up. Then on my website, drpedinaturalhealth.com, I talk about the social media program for providers and practitioners that developing. If anyone’s interested in that, that would be available there, but my social media handles and then my clinic is in San Diego, Oasis Health and Medicine. If you’re in the local San Diego area, want to say hi, meet, come on by and say hello. Would love to see you all.

Evelyne: I love that. Well, Pedi, thank you so much. This has been wonderful. It’s just a blessing knowing you, and I’m so grateful for everything that you do both in our San Diego community and in the world. So, thank you.

Dr. Pedi Mirdamadi: Thank you so much for those kind words. Thank you for always supporting us, and keeping us excited about things to come. I’m grateful to be here, and hope this was exciting and valuable to the viewers.

Evelyne: Absolutely. Thank you. Thank you for tuning in to Conversations for Health. Check out the show notes for resources from today’s conversation. Please share this podcast with your colleagues. Follow, rate, or leave a review wherever you listen. Thank you for designing a well world with us.

Voiceover: This is Conversations for Health with Evelyne Lambrecht, dedicated to engaging discussions with industry experts, exploring evidence-based, cutting-edge research and practical tips.