Cardiologist Dr. Alexis Cutchins joins Dr. Dean Mitchell to break down POTS, postural orthostatic tachycardia syndrome, a condition defined by a heart rate increase of more than 30 beats per minute when moving from lying down to standing, without a drop in blood pressure. Dr. Cutchins explains that POTS is not a single diagnosis but one symptom within a larger picture that frequently overlaps with mast cell activation syndrome, hypermobility, and Ehlers-Danlos syndrome.

The conversation covers what may be driving the condition, including an autoimmune component, small fiber neuropathy, and vascular compression syndromes such as jugular vein compression and pelvic venous congestion. Dr. Cutchins shares findings from her own published research showing that 83% of her POTS patients had iliac vein compression on imaging, and that stenting the iliac vein helped 70% of patients with orthostatic intolerance. She and Dr. Mitchell also discuss why COVID-19 and long COVID have driven a sharp rise in cases, alongside other triggers like viral infections, Lyme disease, bariatric surgery, and major life stressors.

Dr. Cutchins walks through how she evaluates patients, including holter monitoring, echocardiograms, and a 10 minute stand test rather than the tilt table test, which she says can worsen symptoms. She outlines her treatment approach, starting with antihistamines, salt, fluids, and compression, then medications like nadolol, propranolol, ivabradine, calcium channel blockers, fludrocortisone, desmopressin, midodrine, and droxidopa depending on the patient. She also covers which forms of exercise, like swimming, recumbent biking, and strength training, tend to be best tolerated.

Guest Contact

Social Media:
LinkedIn
X (Twitter)
Instagram

Website:
Cutchins Cardiovascular Medicine

Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD

Psychiatrist and neuroscientist Dr. Dave Rabin returns to the podcast to discuss his new book, A Simple Guide to Being Alive, and why he believes healing from chronic stress and illness is simpler than most people are taught. Dr. Rabin explains that the autonomic nervous system, specifically the balance between the fight or flight sympathetic response and the rest and digest vagus nerve system, sits at the core of how the body handles stress, illness, and recovery, and that most patients are never taught the basics of how these systems work.

Dr. Rabin and Dr. Mitchell talk through why techniques like deep breathing, meditation, and mindfulness work, tracing the idea back to teachings from Jon Kabat-Zinn. Dr. Rabin describes how breathing at five to seven breaths per minute helps the body access a calm, present state, and how his company Apollo Neuroscience developed a wearable device that uses touch based vibration, rather than sound, to raise heart rate variability and vagal tone within two to three minutes, based on research conducted at the University of Pittsburgh Medical Center.

The conversation turns to why Gen Z is showing declines on standardized cognitive testing, and how chronic nervous system stress, screen time, and a lack of in person mentorship may be contributing factors. Dr. Rabin also shares his approach to helping children work through tantrums and difficult emotions, why parents model stress responses for their kids whether they realize it or not, and why physical touch and safe human connection remain central to healing, even as modern medicine has grown more cautious about it.

Guest Contact

Facebook
Twitter/X
Instagram
LinkedIn

Websites:
Book: asimpleguidetobeingalive.com
Personal/Clinic: drdave.io
Apollo Neuroscience: apolloneuro.com
The Board of Medicine: boardofmedicine.org

Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD

Simple daily breathwork can meaningfully calm your stress response, Dr. Dean Mitchell explains in this week's tip. A few minutes of slow, deep abdominal breathing tops the list, since most of us breathe shallowly under stress in ways that quietly affect the heart, lungs, and oxygen levels. One striking example: just five minutes a day of basic breathing exercises, easily learned from free videos online, can have a profound effect on overall health. The key is making it a daily habit rather than a one-off fix, then noticing how much steadier you feel handling everyday stress. You can't stop the waves, but you can learn to surf.

For the full conversation, listen to Ep. 238 with Dr. Dave Rabin on The Smartest Doctor in the Room.

Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD

Nuclear medicine treatments use very small, carefully controlled amounts of radioactive material that decay to nontoxic levels within minutes to days, making them far less taxing on the body than standard chemotherapy. Cathy Cutler, PhD, FSNMMI, of Brookhaven National Laboratory joins Dr. Mitchell to address the fear many patients feel at the word "nuclear," explaining how these treatments target cancer cells directly while leaving healthy tissue largely untouched. She discusses new alpha-emitting isotopes now helping patients who have run out of other options, the workforce and supply challenges facing the field, and why patients on these therapies often report a far better quality of life than those on traditional chemotherapy.

Connect with Cathy Cutler:

Social Media:
LinkedIn
Websites:
isotopes.gov
Resources/Publications:
Radiopharmaceutical Therapy: Rapid Growth, Rising Challenges, and the Critical Need for
Expertise — J Nucl Med
PET Drugs — 2023 Workshop Proceedings — J Nucl Med



Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD

If a tooth gets knocked out, place it between the cheek and gum immediately, since the chance of successfully saving it drops by roughly 10% every ten minutes if it isn't found. In this episode, Dr. Joseph Alton (Dr. Bones) and Nurse Amy Alton join Dr. Mitchell to break down what it actually takes to be medically prepared when help isn't immediately available. They cover why a $30 to $35 military-grade tourniquet belongs in every car and go-bag, how the stretchy SWAT tourniquet is designed to fit children who can't be treated with standard sizes, and why hemostatic dressings should be paired with any tourniquet for serious bleeding. They also explain how raw, unprocessed honey is used in hospitals to treat burns and staph-resistant wounds, how two drops of clove oil mixed with zinc oxide can form a temporary dental filling in a pinch, and why staying calm with an injured person can be just as important as the medical supplies themselves. Dr. Alton and Nurse Amy also share the real story of a nurse whose emergency kit helped her save two lives in a car accident years after she first bought it.

Guest Contact:

Social Media
YouTube
Instagram
Facebook Group: Survival Medicine DrBones

Websites
doomandbloom.net
altonfirstaid.com

Resources/Book Links
The Survival Medical Handbook: The Essential Guide For When Help is NOT On The Way

Live Q&A with Dr. Mitchell, August 19: How Stress Turns Into Disease, and What Actually Works to Lower It

Nobody just gets colitis. Stress goes looking for your weak spot, and thirty years of practice says it usually finds it. Dr. Dean Mitchell is live on Wednesday, August 19 at 6:00 PM Eastern for a free hour: the Holmes-Rahe scale, what HRV shows, which relaxation methods have evidence behind them, and where medication belongs. Register here

Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD

Being ready for a medical emergency doesn't require expecting a disaster, Dr. Dean Mitchell explains in this week's tip. Every household benefits from a basic medical kit stocked with bandages, antiseptics, gauze, adhesive tape, tweezers, and scissors, along with core over-the-counter medications like acetaminophen, ibuprofen, an antihistamine, and an antidiarrheal. When traveling, keeping a list of your medications, allergies, and medical conditions on hand (a printed copy or a note on your phone) can be critical if someone else needs to speak to first responders on your behalf. A portable, battery-powered phone charger and bottled water round out the essentials, and telemedicine now puts medical guidance within reach right from your smartphone the moment an emergency starts. A few minutes of preparation today can make all the difference when every minute counts.

For the full conversation, listen to Ep. 236 with Dr. Joseph Alton & Nurse Amy Alton on The Smartest Doctor in the Room.

Live Q&A with Dr. Mitchell, August 19: How Stress Turns Into Disease, and What Actually Works to Lower It

Nobody just gets colitis. Stress goes looking for your weak spot, and thirty years of practice says it usually finds it. Dr. Dean Mitchell is live on Wednesday, August 19 at 6:00 PM Eastern for a free hour: the Holmes-Rahe scale, what HRV shows, which relaxation methods have evidence behind them, and where medication belongs. Register here

Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD

Tick bites can transmit far more than Lyme disease. In this episode, Saravanan Thangamani, PhD, SUNY Empire Innovation Professor in the Department of Microbiology and Immunology at SUNY Upstate Medical University and Director of the SUNY Center for Vector-Borne Diseases, explains why coinfections are common, with roughly one in three ticks carrying the Lyme disease agent and five to ten percent of those also carrying additional pathogens like anaplasma, babesia, or Powassan virus. He breaks down how the deer and mouse life cycle spreads ticks, why pets are "tick magnets," why the old 24-to-48-hour transmission window is outdated advice, and how tick testing can give clinicians critical extra information. He also covers the expanding range of the lone star tick, alpha-gal syndrome, and where Lyme vaccine development currently stands.

About the Guest:
Saravanan Thangamani, PhDSUNY Empire Innovation Professor, Department of Microbiology and Immunology, SUNY Upstate Medical UniversityDirector, SUNY Center for Vector-Borne Diseases and Vector Biocontainment Laboratories
Website
Instagram: @upstate_tick_lab
X: @NY_Ticks
Facebook: UpstateTickLab

Resources Mentioned:
Upstate Tick Lab — Research, Education & Public Health
TickMAP — Interactive Tick & Tick-Borne Disease Surveillance
Upstate Tick Testing Laboratory — National Tick Testing & Surveillance Program
Thangamani Laboratory — Powassan Virus & Vector-Borne Disease Research

Live Q&A with Dr. Mitchell, August 19: How Stress Turns Into Disease, and What Actually Works to Lower It

Nobody just gets colitis. Stress goes looking for your weak spot, and thirty years of practice says it usually finds it. Dr. Dean Mitchell is live on Wednesday, August 19 at 6:00 PM Eastern for a free hour: the Holmes-Rahe scale, what HRV shows, which relaxation methods have evidence behind them, and where medication belongs. Register here


Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD

Dr. Dean Mitchell's Health Tip of the Week: outsmart ticks before they make you sick. From his conversation with Dr. Saravanan Thangamani, the top prevention move is a simple habit — a full-body self-check every time you come in from outside. Another easy win: spraying clothing with permethrin, which kills ticks on contact. And if you find one, don't just toss it — bag it and send it to a lab (like Dr. Thangamani at SUNY Upstate) since the tick itself often holds the clearest clues about infection. Watch for a non-itchy rash, fever, swollen lymph nodes, or a severe headache — early treatment makes all the difference.

For the full conversation, listen to Ep. 235 with Dr. Saravanan Thangamani on The Smartest Doctor in the Room.

Live Q&A with Dr. Mitchell, August 19: How Stress Turns Into Disease, and What Actually Works to Lower It

Nobody just gets colitis. Stress goes looking for your weak spot, and thirty years of practice says it usually finds it. Dr. Dean Mitchell is live on Wednesday, August 19 at 6:00 PM Eastern for a free hour: the Holmes-Rahe scale, what HRV shows, which relaxation methods have evidence behind them, and where medication belongs. Register here


Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD

The evidence increasingly points to a laboratory origin for COVID-19, not a natural spillover from the Wuhan wet market. In this episode, returning guest Steven Quay, MD, PhD, FCAP, Chairman, President, & CEO of Atossa Therapeutics, walks through the case built in his book, The Code as Witness. He explains why none of the animals or market workers tested showed signs of infection, how a 2012 mining accident produced a coronavirus strain closely related to SARS-CoV-2, and what the furin cleavage site reveals about possible genetic engineering. The conversation also covers gain-of-function research, biosafety failures at the Wuhan Institute of Virology, and concrete steps that could help prevent the next pandemic.

About the Guest:
Steven Quay, MD, PhD, FCAP
Chairman, President, & CEO of Atossa Therapeutics
Website
LinkedIn
X: @quay_dr

Order your copy of Dr. Steven Quay's book, The Code as Witness, here.

Live Q&A with Dr. Mitchell, August 19: How Stress Turns Into Disease, and What Actually Works to Lower It

Nobody just gets colitis. Stress goes looking for your weak spot, and thirty years of practice says it usually finds it. Dr. Dean Mitchell is live on Wednesday, August 19 at 6:00 PM Eastern for a free hour: the Holmes-Rahe scale, what HRV shows, which relaxation methods have evidence behind them, and where medication belongs. Register here


Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD

Simple habits do more to protect you from viruses than any supplement, Dr. Dean Mitchell explains in this week's tip. Frequent handwashing, avoiding touching your face, and paying attention to indoor ventilation top the list, alongside adequate sleep, regular exercise, and a healthy diet. One striking example: during the COVID pandemic, 75% of passengers on a bus in China caught the virus, but the 25% who didn't were seated by an open window. Add a well-fitting mask in crowded, high-risk settings and staying current on your flu vaccination, and you've got a simple, evidence-based defense against the season's respiratory viruses. No single measure is perfect, but together, they make a real difference.

For the full conversation, listen to Ep. 234 with Dr. Steven Quay on The Smartest Doctor in the Room.

Live Q&A with Dr. Mitchell, August 19: How Stress Turns Into Disease, and What Actually Works to Lower It

Nobody just gets colitis. Stress goes looking for your weak spot, and thirty years of practice says it usually finds it. Dr. Dean Mitchell is live on Wednesday, August 19 at 6:00 PM Eastern for a free hour: the Holmes-Rahe scale, what HRV shows, which relaxation methods have evidence behind them, and where medication belongs. Register here


Contact Dr. Mitchell:

Email: [email protected]
Website
Instagram
YouTube
Facebook
LinkedIn


Book: Conquering Candida
ImmunoLytics - code SmartestDoc, 5% off
Apollo Neuro - code SMARTMD