Cannabis & the Body: The Hidden System That Could Change Medicine with Mikhail Kogan, MD

[00:00:00] Dr. Mikhai Kogan: Cannabis in small amounts at the right time, whether it is support for a specific symptom or even for a slightly deeper meditative state or some other shift in your awareness, could be a very effective tool. But it has to be taken with a lot of respect

[00:00:21] Dr. Melinda Ring: This is "Next Level Health." I'm your host, Dr. Melinda Ring, Director of the Osher Center for Integrative Health at Northwestern University. On this show, we explore ways to take actionable steps toward optimizing our health with leaders in the integrative, functional, and lifestyle medicine fields who believe in science-backed and time-tested approaches to well-being. Let's take your health to the next level. Medical cannabis is now legal in most states, yet most clinicians have received little to no formal training in how to use it safely, effectively, or thoughtfully. That gap creates uncertainty and often leaves patients navigating a space filled with mixed messages, bold marketing claims and misinformation. Today, I'm honored to welcome one of the few physicians in this country with deep clinical and academic expertise in medical cannabis, Dr. Misha Kogan, chief medical officer of the George Washington University Center for Integrative Medicine, a pioneer in integrative geriatrics and the author of "Medical Marijuana: Dr. Kogan's Evidence-Based Guide to the Health Benefits of Cannabis and CBD." I also recently had the privilege of collaborating with him on a first-of-its-kind publication in "JAMA Network Open" called "Developing Medical Cannabis Competencies: A Consensus Statement," which aims to establish core competencies for educating medical students about cannabis. Today, we are going to explore where the evidence truly stands, where the gaps remain, and how cannabis may or may not fit into patient-centered care that prioritizes safety, nuance, and individualized treatment. Misha, welcome. I'm so glad you're here.

[00:02:10] Dr. Mikhai Kogan: Well, it's such an honor, Mel. It's always a pleasure being with you and so happy we can do this.

[00:02:15] Dr. Melinda Ring: I know. I can't believe I have to get you on a podcast to talk to you these days. You're so busy. Let's jump in because you and I trained at a time when cannabis was illegal everywhere and frankly very stigmatized in medicine, and it is still federally illegal—yet legal in most states in some form.

[00:02:36] Dr. Mikhai Kogan: I know you go over this in your book, but for listeners who may not realize this, cannabis actually has a long history in medicine. Can you walk us a little bit through that arc, from ancient medicinal use to prohibition to where we are now in this regulatory patchwork? Some people arguably say it is the oldest known medicine to humankind. More than 5,000 years ago, it was used in Chinese medicine for very broad indications. There are also reports going even further back—some archeological discoveries where 10,000-plus years ago there were traces of cannabis used for different wounds and even breast cancer. There was a case of "Siberian Princess," I think it is called, where they found the woman who died from breast cancer, and right next to her breast there was a poultice of cannabis, presumably that she had cancer there. And before prohibition, there was like 60,000 tons of cannabis produced every year in this country and used by every doctor. It was prescribed. It was a standard. It was part of the pharmacopoeia. Apothecaries were filled with jars and tinctures of cannabis. I mean, that was that simple. And then in the 1930s when the whole prohibition started, the only organization that vocally stood against the prohibition, aggressively sent a representation to Congress and asked to record the hearing. There is still a recording of that hearing in the Congress library. It was the American Medical Association (AMA). The AMA was the only association that was adamantly against prohibition, and it actually was not the prohibition at first. First, what they did, they taxed cannabis at a crazy rate, which overnight priced out the entire medical field. And of course, then there was this major DEA ruling: a Schedule I controlled substance, which literally means there is no appropriate medical use and a high risk of abuse. Neither is true. The serious abuse risk is around 10%, which is not that far off of a severe caffeine addiction. If you compare that to something like opioids, where chronic use, dependence and addiction is very high—at least 50%, if not more. So we are not looking at anything dangerous or heavily addictive. And despite that, today, there are still arguments over that, which I find crazy that in the era of evidence-based medicine, we are still arguing, is cannabis addictive?

[00:05:11] Dr. Melinda Ring: Schedule I, like you said, is the highest level of restriction that we can have on substances federally. Is this the one that is still in place?

[00:05:23] Dr. Mikhai Kogan: It still

[00:05:24] Dr. Melinda Ring: Have it legal

[00:05:25] Dr. Mikhai Kogan: Right.

[00:05:26] Dr. Melinda Ring: Have legalized it, but on a federal basis, it is still considered that level.

[00:05:31] Dr. Mikhai Kogan: Correct. It is still Schedule I, even though they have tried to do some patchwork of simplifying research. So for listeners, what that means is if the substance is Schedule I, doctors cannot legally prescribe it. They can only legally prescribe it within the scope of controlled trials or some kind of research that has been authorized by an IRB and by some entities. And then you have to actually apply for a Schedule I license. If you want research, there is a major headache. Nobody does this. Very few people can do that. So that creates a huge hurdle to the research. And not only from that perspective, it also blocks federal dollars going to the research. If the substance is considered Schedule I, researchers are not allowed to look into the benefits of that substance, so they are only allowed to look at the harms of the substance. So that has been hindering clinical research in cannabis for decades. We have a lot of bench research going on regarding the biochemistry of cannabis and how it operates with our own endocannabinoid system, which we may want to chat a little bit about. So we have done a lot of research on that. But the actual clinical trials have been really hindered because of the Schedule I designation, and that is really the priority to move forward because with the amount of cannabis circulating in the public and the amount of base knowledge we have today, the number one research priority is to start doing dosing trials, right? The biggest problem we have is, for example, there is no argument that cannabis is useful for a variety of different pain syndromes, but what should be the route? How should it be administered? What should be the titration dosing? None of this is evidence-based. It is all trial and error, and that is not good enough, right? For most physicians, for them to be comfortable with this, they need to see controlled trials of cannabis, and there are very few of those.

[00:07:22] Dr. Melinda Ring: So that can bring us to the article that was published in "JAMA Network Open"

[00:07:30] Dr. Mikhai Kogan: Which you were a—

[00:07:31] Dr. Melinda Ring: —Which I was honored to help support. And the rationale for this is, for one, medical professionals are in a place where they are straddling state legality and a federal Schedule I designation, which says you cannot prescribe it. But beyond that, they are not even learning about it in their medical training. But I know as a provider myself in a state where it is legal, I have patients who are asking about it or that I actively might say, "Hey, have you thought about this?" But I cannot, you know, write, "This is the CBD-THC ratio I think you should do" or "This is how much you should do." It really just can only be a recommendation at this point. Has there been any backlash, or has there been more of a "Yes, actually we see the need for this" response? What kind of feedback have you gotten?

[00:08:25] Dr. Mikhai Kogan: You of course know that when we train medical students, one of the ways training occurs, you have to have some kind of a requirement for them to graduate with, right? So we call it competencies. So we said, let's get a set of competencies published in a decent journal. So then we can go to the Association of American Medical Colleges and say, "Look, you have to take this on and put this in a curriculum," and request that every U.S. and Canadian medical school is requiring this. So that was the principal idea. And we published that, and results were very well accepted within our own small community of cannabis experts and also integrative medicine researchers. Unfortunately, I would say, the article did not produce the mass effect I was hoping. It was not picked up by any major media in the country. In fact, we had a negative article come out at the same time on potential harms of cannabis, which was not a good article. It was all about smoking cannabis. More than half of the population does not smoke cannabis anymore, so it is not even applicable to them. So of course, that article was picked up by every major media outlet. So there is a little bit of a political game going on with this topic, I think, in part because it is a very politically charged area. Unfortunately, because of that, I feel like we are missing the core mission here, which is to educate the public in both harms and benefits, because there are both, right? And then clinicians and the public need to make decisions in each individual case: Does the benefit outweigh the harm, your typical benefit-harm analysis? Just like we do it with any approach and any treatment in medicine.

[00:10:12] Dr. Melinda Ring: It reminds me of teaching nutrition this week, which is sort of a similar thing. We did not learn nutrition, and yet now patients ask about it all the time. We need to recommend it. And it is like, "Okay, how do we approach a patient who is asking about a fad diet?" and clinicians need to know enough to be able to counsel people about when there are benefits and when there are harms. And if they are not taught that, then patients get left trying to find this and end up, I think, getting very, sometimes even harmful, recommendations because they may be taking it off an Instagram post. You and I are both in full agreement that whether or not their clinicians are comfortable including it as part of their toolbox of support, they at least need to have enough familiarity with it to be able to counsel patients. And that is what the competencies were all about.

[00:11:13] Dr. Mikhai Kogan: Medical education does not move fast.

[00:11:17] Dr. Melinda Ring: No.

[00:11:17] Dr. Mikhai Kogan: But I do see an interesting trend, though. I do see the public generally slowly getting more and more educated. I remember five, even five years ago, I would have people come in, and they were completely clueless, right? They did not know the difference between different cannabinoids. A lot of people still do not know we make our own cannabis, right? So there is still this belief that cannabis is like a substance out there, completely not in any kind of relationship with us.

[00:11:45] Dr. Melinda Ring: Right.

[00:11:45] Dr. Mikhai Kogan: But our body makes more cannabis than people think. We call this the endocannabinoid system. So our own body produces molecules that are very similar to THC in the cannabis, and it operates a lot of things in our body: appetite, how we sleep, how we respond to pain, and how we respond to stressful stimuli or trauma. All those things are regulated by the endocannabinoid system. And so figuring this out—how external cannabinoids can potentiate or optimize some of these internal workings—seems like a no-brainer.

[00:12:18] Dr. Melinda Ring: It has been decades since my medical training. I have no recollection of being taught the endocannabinoid system in my pharmacology class or my physiology class. Is there anything else about this endocannabinoid system that will help demystify it for listeners, whether they are health professionals or lay public?

[00:12:40] Dr. Mikhai Kogan: Well, I think the biggest thing is that people do not realize. People think that endorphins are the primary pain regulatory structure. They are wrong. It is actually secondary. The primary is the endocannabinoid system; the endocannabinoid system regulates the endorphin system. So if you have a misworking endocannabinoid system, opioids will never help you because they are not going to treat what is going on. You are going to try to patch up, and your band-aids are going to be put on the wrong side of the wound, literally. By the way, one of the core reasons why I think the whole opioid crisis exists is because we misread the pathophysiology of the pain. We misunderstood it. We presumed that the primary dysregulation has to do with endorphins. That is wrong. [Speaker interjects: (They are)] stupid. They are a secondary response.

[00:13:30] Dr. Melinda Ring: That is going to be the title of this podcast: "Endorphins are Stupid."

[00:13:35] Dr. Mikhai Kogan: Well, yeah. So, you know, the endocannabinoid system is extremely ancient. It is actually one of the oldest regulatory structures, right? It exists throughout the entire animal kingdom. Endorphins only exist in mammals and a couple of other animals. You look into the back of evolution—cockroaches have the endocannabinoid system; they do not have endorphins. So it is a complex interplay. It is shocking that we know more about how some of the exogenous cannabinoids, let's say THC or CBD, impact us. We know more about that than about the details of our own endocannabinoid system. This has to do with the fact that prohibition created a field where researching this topic was not financially sustainable for a lot of researchers, so they could not really go there. This has to change because the moment I think we are going to deeply research the endocannabinoid system, we are going to pick up way more pearls and we are probably going to discover all kinds of interconnectedness between other systems—the thyroid and the cortisol system and everything. There have to be bridges in so many ways that can be tapped into for therapeutic potential. But we do not really have enough data.

[00:14:53] Dr. Melinda Ring: So let us talk about, let us clarify what a lot of people find confusing: the difference between THC and CBD. And of course, CBD is incredibly popular because it is not intoxicating. It is widely available, but it is derived from the same family. So what do people need to know about this whole variety of compounds?

[00:15:19] Dr. Mikhai Kogan: So THC is the molecule that is closest to our own endocannabinoid molecules I am thinking about. That is what you actually used the word intoxicating, and that is the way we call it. It is inappropriate to call THC just psychoactive—I mean, it is appropriate, but all of the cannabinoids are psychoactive. CBG is psychoactive, just not psychotoxic. So getting high will happen from THC and some other THC sub-variants, like Delta-8, which is a kind of synthetic form. There is Delta-10; there are some others. So that is one. THC is what we typically think of when we go after a whole slew of symptoms: pain, nausea and vomiting, and appetite, so sleep induction. Sometimes we think of THC mostly. Cannabis has upwards of 200 different exogenous cannabinoids. CBD is probably the number two. CBD does not directly affect the receptors the way I was discussing, but it modulates how THC does and how our own molecules affect the receptor. So CBD plays within the endocannabinoid system, not by attaching to receptors, but by changing how other molecules attach to receptors. That is why CBD is often thought of as a universal molecule that we include in most preparations. It tends to increase side effects of THC while potentiating its benefits. So, on its own, it has applicability, right? High doses of CBD can be very good for sleep, can be very good for seizures. In fact, we have the only FDA-approved plant-based cannabinoid in this country, in the U.S.: Epidiolex, which is nothing but purified CBD product sold for $3,000 a month, where it should be sold for $30 a month. But that is a whole separate conversation we do not have to have today. But it tells you something. It actually does tell you a lot, right? Because there is a reason why cannabis is called weed—because that is how it grows. It literally grows like a weed, and you can make a lot of it at very low cost. And, in fact, federal legalization probably will drive the cost even lower, and it probably will democratize it to the point where people will be able to grow their own at basically no cost. In fact, there is quite a strong indication that if we allow prices of cannabinoids to go down, it may be one of the most, one of the cheapest and widely available medications down the road. Of course, you have to discuss the details of potential abuse and all those other things. But putting that aside, so going back to the cannabinoids, you think of CBD as an additive benefit to any formula. That is why most of us will always put some CBD in patients' formulas. On its own, it has very little effect. I almost never use it in isolation except when patients are very anxious, very overstimulated, and have this kind of internal central nervous system hyperexcitability. For those patients, sometimes I put them on pure CBD with nothing else, but the doses are very high—sometimes 200, 300, or 400 milligrams a day. The problem that drives the cost up a bit: that would cost $100-plus a month, which is not a small amount of money for a lot of my patients. So that is one. There are a couple of really cool new cannabinoids. CBG is the one that probably has a lot more effects in isolation than CBD. It is a very good adjunct to chronic neuropathic pain and a very good adjunct to an overstimulated nervous system. For some people, it is a very effective sleep aid, again, in conjunction with other things. So we use it increasingly a lot. CBG also tends to have some really interesting benefits for patients with very dysregulated nervous systems. In cases of neurodegenerative disorders, Alzheimer's and Parkinson's seem to be quieting the hyperactivity. It is kind of good for the symptoms like agitation. Exactly.

[00:19:34] Dr. Melinda Ring: I feel like CBN is the other one that I hear about.

[00:19:37] Dr. Mikhai Kogan: CBN is more for sleep. CBN is overhyped. I think it has minimal benefit at most. There is nothing wrong with adding it to the formulas on its own. I have never seen it being effective for anything. So I think there is probably a little bit of overhype with CBN.

[00:19:55] Dr. Melinda Ring: When we pull these things out and put them in specific ratios or dabble in them, it is making them like pharmaceuticals, but sometimes that in itself can be associated with some of the harm that we see from it versus the native plant.

[00:20:13] Dr. Mikhai Kogan: We have a good term for that. It is called an "entourage effect." When we mix different cannabinoids with terpenes (the smell molecules) with flavonoids (the taste and color molecules), the interaction between all those molecules when you do a full extract versus an isolate—that is where I think a lot of magic happens, even though we probably do not understand all the nitty-gritty of how things are happening in there. But we need a lot lower doses of those whole extracts compared to the clinical trials of isolates. And of course, we do have a number of clinical trials on isolates, particularly because there are several cannabinoid drugs like the Epidiolex I mentioned. There is also Sativex in Europe, which is a one-to-one THC-to-CBD purified isolate. We do not have it here. It is an alcohol-based drop, in essence. And, you know, there are effective to certain types of pain, but when those trials are compared to, let us say, a pure, purified full extract, the dosing is substantially lower. We can get away with much lower doses of THC, which also means you are going to have less potential toxicity and fewer side effects. That is a very important principle. Full extracts with that entourage effect produce a much more powerful benefit than the isolated active ingredient alone. I think that actually applies not just to cannabis.

[00:21:43] Dr. Melinda Ring: You know, patients need a physician recommendation if they are getting it medically. But they obtain their products from these dispensaries, and physicians literally cannot write a prescription for a specific cannabis product or dose. Different dispensaries have different strains and products. What are the pros and cons of this arrangement? Do you think that is going to change anytime in the near future? How should health professionals and patients evaluate? What is a good dispensary? How do they know what product to take when they go there? Because I think they rely on—you know, I have patients who are like, "Well, what should I ask for?" I am like, "You have to talk to the dispensary to see what they have." So what are your tips on that? Yeah, let us start with the pros, because there are fewer of those. Okay.

[00:22:35] Dr. Mikhai Kogan: So the pros are like this: In every state, there is a regulatory structure now, right? So if you go into a dispensary that is legalized and approved by the state, you are going to get real products. They are going to have what is on the label. You will get a certified product that you can trust. The problem is, as you said, that your doctor is not going to tell you what to get. So you are going to walk in and you are going to be at the mercy of the dispensary staff, whether they are educated enough to fit your medical needs with the products they have. And that is a big if. Now, sometimes it works amazing. Some states, like you in Illinois, are better off than many other states. There are some states where it is really top-notch, like Connecticut, where every dispensary must have pharmacists on staff. Of course, the pharmacists would be the ideal person to learn about this since their expertise is in understanding this. However, those states are in a major minority. Most states have a patchwork, and it is a zoo. So unfortunately, what I cannot do is tell all of your listeners who could be in any state what your state is doing and how good your products are. We know that what we are really looking for in clinical care is almost exclusively topical and edibles, and occasionally inhaled products. Because you do sometimes need faster-acting medicine, but really the inhaled products are the least predictive of everything, right? They can be very predictive for certain symptoms, but when you are looking for long-term management of particular illnesses, like for example, you are looking for anti-inflammatory impacts of cannabinoids, which are very profound, you are not going to get them with smokable products. You are actually going to potentially create more inflammation. The bigger issue is the next step. The problem is not just, "Okay, you cannot find a good dispensary to give you advice." You usually can. You can talk to your neighbors. You can try to figure out which dispensaries are a bit more medical. There is also a lot of online resources like Leafly. There are organizations out there that will tell you which dispensaries carry what products, how those products have been evaluated in the past, et cetera. So you can figure that out. You can also find coaches at a fraction of the price of physicians. If the physicians who are experts in cannabis are not taking your insurance, your next best bet price-wise would be to find a good cannabis coach. And there are a good number of those now.

[00:24:57] Dr. Melinda Ring: Is there an organization that vets them or trains them?

[00:25:01] Dr. Mikhai Kogan: Yes, there are several organizations. "Cannabis Clinicians" is one, and that is one I associate with as well. As a patient, when you are looking, you do not have to look for a doctor, right? Sometimes the better person is simply a lay person who has decided to take this on. They went through a deep dive on the topic; they understand it. And then you want to make sure that this cannabis coach will work with your medical team because it is important. Cannabis coaches may be very well trained in cannabis, but they may not be very well trained in your medical problems.

[00:25:34] Dr. Melinda Ring: Do they have to pass a certification? Like now there is a National Health Coach certification?

[00:25:38] Dr. Mikhai Kogan: No, there is not. There is not. There is not. There are some standards they are required to meet—you know, every program has some kind of an exam after the training. Again, the problem is it is impossible to ask those folks to get the level of medical training you and I have.

[00:25:54] Dr. Melinda Ring: Yeah.

[00:25:55] Dr. Mikhai Kogan: And so they are not going to understand the intricacy of diagnosis and certain interface-related issues with the rest of medical care. Good news: there are very few truly concerning interactions between medications and cannabinoids or between different conditions and exogenous cannabinoids. So, in essence, there are very few situations where you need to truly be worried. The biggest practical concern with dispensaries and the current structures is because, A, the products are sold for the for-profit industry exclusively. So you are running the risk. Let us say you have gotten to use a particular tincture for insomnia, and it finally works great for you, with no side effects. You titrated it to the right dose, and then three months later, the maker says, "Okay, we are not making enough money on this. Goodbye." Tincture is gone permanently. This happens all the time. And this creates a havoc because then the patient starts experiencing withdrawal. They are trying to go get something similar. It is not going to work right away. You just mess a person up majorly. This requires a lot more complex system in place. This requires someone to really understand the intricacy of going from one product to another. But more importantly, it requires a very stable industry that is not related to, "I am going to sell high to someone so that they can call me back for more." We need to have a returning market for the medications. And that is, I think, at risk because as more and more states become recreational, we are potentially going to lose part of the medical market. We are already seeing this because it just does not make the money.

[00:27:36] Dr. Melinda Ring: On the one hand, you have said, "Oh, it is safe, it is safer than all these drugs." And yet you are also saying that somebody can have withdrawal, they can have symptoms if they stop it abruptly. What is the reality about some of these interactions? Can you be addicted? Can you withdraw from it if you are using it regularly and stop? What are some of the potential harms to using.

[00:28:00] Dr. Mikhai Kogan: I said safe? I think I said safer.

[00:28:03] Dr. Melinda Ring: Safer. Safer. Yes. Safer. Yes. I agree.

[00:28:05] Dr. Mikhai Kogan: On a gradation of things, it is definitely safer. It is not necessarily safe, so the side effects are very common. If you are using cannabinoids that have a good amount of THC, particularly if you are inhaling it, you are close to guaranteed to have some dry mouth, increased frequency of urination, a slightly fast heart rate for an hour or two, or maybe some anxiety for an hour or two. So, very common side effects. Good news: none of those side effects are really severe and long-term lasting. So they will be gone in a few hours. Even if you took a crazy amount and you got really intoxicated, maybe 10 hours later you will be completely back to baseline. So there are no serious consequences. That does not mean no side effects. Side effects are extremely common. Good news for patients who are older: we do occasionally see pretty strong paranoia from overdoses, but we are not seeing a lot more falls and we are not seeing a lot more fractures, thank God. So yes, a person can be somewhat altered, but they are altered in a different way than how alcohol alters you, right? So you actually become more aware of your body and at lower risk of certain bodily harms, versus in alcohol, you are actually going to go and potentially harm yourself more. So that is a kind of a small plus there. That is one thing. The other really serious concern is what we call withdrawal. They are not withdrawal from a physiologic perspective in the way we think of opioids, where you have been taking something for pain, you stopped, and now you have horrible cramps and muscle pains and all. No, you will not get that, but you will get psychological withdrawal. Your sleep will potentially be very disruptive for a while. You may have relied on using cannabis for anxiety, and now you are hyper-anxious, so you are definitely going to have some symptoms that are going to be there for a little bit. They are mild, but they are still there. More importantly, the symptom that was managed successfully often comes back. Sometimes neuropathic pain gets lighter with long-term use, but it is rare that it will go away, meaning you stop taking it, then the pain will come back.

[00:30:16] Dr. Melinda Ring: So, Misha, I know there are so many other things we could talk about. You approach this and every topic with humility, with your deep care for your patients, with curiosity and openness. But I do like to close with one question: what is one piece of personal wisdom from your many years that you would share with listeners to help them think more clearly, not just about cannabis, but about health decisions in general, that will help bring them to their "Next Level Health?"

[00:30:52] Dr. Mikhai Kogan: Do not look for patches for the symptoms. Look for the tools that continuously help you to optimize your health in the long run, so that health improvement becomes a lifelong journey. Even if you think you are not improving health, but you are working toward better health, it will produce a long-term benefit. Cannabis in small amounts at the right time, whether it is support for a specific symptom or even if it is support for a slightly deeper meditative state or some other shift in your awareness, could be a very effective tool. But it has to be taken with a lot of respect. Abuse is real, and you do not want to go there. You need to be forming a relationship with this plant that is very healthy. And I am particularly worried in the future about kids and teenagers; we see an uptick there. And so what I would tell the parents is: normalize this topic. Ensure that kids do not think of it as a prohibited jewel. That is where the problems occur—when they go and explore without any limitations or safeguards. Teach them, if they are going to have a relationship with this plant, to have a healthy relationship. And I believe that it can be established on a national level if we do this right—just one of many tools that can be used for a variety of symptoms and also for a variety of life situations. I mean, yes, cannabis can have a profound global impact, anywhere from improvement in sex and mood to the management of multiple symptoms. There is nothing wrong with that if it is done right. So teach kids early how to do this and do not shy away, because if you do, they are going to go and explore on their own. If you think that they are not going to do it, they will.

[00:32:42] Dr. Melinda Ring: All right. Words of wisdom from a physician and a father. This conversation reminds us both that our medicinal options have a deep history entwined with culture and what nature provides, and also that medicine evolves sometimes faster than our medical training. Our responsibility is not to avoid complex topics, but to engage them with science, nuance, and centered care. We will link to Dr. Kogan's book and our "JAMA Network Open" publication in the show notes. Thanks for listening. Please like, comment, and subscribe on your favorite platform, and I will see you next time on "Next Level Health." Thank you for joining me on this episode of "Next Level Health." I hope you found some inspiration and practical insights to enhance your wellness journey. Do not forget to leave a comment on YouTube or a review on Apple Podcasts. I would love to hear your thoughts and suggestions for future topics or speakers. Be sure to follow "Next Level Health" with me, Dr. Melinda Ring, as we continue exploring the path to healthier, happier lives together.