The Ultimate Human: Perimenopause, Burnout, and Nervous System Reset with Dr. Remina Panjwani

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So Gary Brekka just did an incredible episode with Dr. Remina Panjwani on The Ultimate Human, and it completely changed how I think about stress and burnout. I caught that one too. What stood out to you most? Her opening warning really hit me. She said cortisol spikes are totally normal, but staying in fight or flight after the stressor is gone? That's where the damage happens. And most people miss the early signs because society literally rewards overdrive. Right, that whole "sleep when I die" mentality. But she had this great line about how you cannot outperform a dysregulated nervous system. Her message was so simple: regulate first, then stimulate. Exactly. And she gave really practical tools too. Like not reaching for your phone in the first five to ten minutes after waking. Instead, use that time for deep breathing, meditation, journaling, or getting early morning light. These aren't expensive interventions, they're free practices that support the vagus nerve. I loved that part. Give yourself permission to pause now, or be forced into a crash later.

But what really grabbed my attention was the conversation about female health and perimenopause. That felt overdue.

Absolutely.

Dr. Panjwani pointed out this huge blind spot in the wellness world. Women start having symptoms in their late 30s, brain fog, exhaustion, irritability, frozen shoulder, sleep disruption, body composition changes. And those symptoms get dismissed or treated with antidepressants when the real issue might be shifting hormones. And she said standard labs often miss the full picture, right? She mentioned the DUTCH test for seeing how hormones are actually metabolized, not just a snapshot from conventional bloodwork. Yes, plus fasting insulin, glucose, and GI-MAP testing to understand metabolic health and gut dysfunction.

Her point was that chronic stress drives inflammation, affects the gut-brain axis, and contributes to weight gain, sleep problems, even thyroid issues. What about her personal story?

That gave the episode so much depth. It really did. She moved from classical internal medicine to functional medicine after seeing the system's limits, especially during COVID.

Her work is shaped by her own experience with panic attacks, breathwork, and a refusal to dismiss patients. That authenticity comes through. She said true health is multifactorial, and being an "ultimate human" means being present, functional, creative, and vital. Not just optimizing one metric. Exactly. The episode traced such a clear line from chronic stress to hormone disruption to losing your health without realizing it. But it also showed the path back through nervous system regulation, proper testing, and daily habits that actually support your biology.