BREATHE IN HEALTH
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Episode 242:
Show Notes
Episode 242:
Transcript
Dr Mary Barson (0:04) Hello, my lovely friends. I am Dr Mary Barson.
Dr Lucy Burns (0:09) And I'm Dr Lucy Burns. We are doctors and weight management and metabolic health experts.
Both (0:16) And this is the Real Health and Weight Loss podcast!
Dr Lucy Burns (0:17) Good morning, my lovely friend. How are you today? I have a special guest. You know, every now and then, well, quite often actually, we have special guests in and so no Dr Mary, it's just me, Dr Lucy. And I am with another doctor who many of you will know, but for those of you who don't, her name is Dr Avi. So I have known Avi for a long time now and we are both low-carb doctors. And Avi has branched out into another mode of healthcare, which I think is fantastic. So I thought I'd get her onto the podcast to talk all about it. Avi, welcome to The Real Health and Weight Loss Podcast.
Dr Avi Charlton (00:54) Hello, Lucy. Thank you for inviting me to come on your podcast.
Dr Lucy Burns (00:58) You are welcome. You are welcome. Well, you know, I think that the pillars of lifestyle medicine, of functional medicine, of improving health without necessarily needing pharmaceuticals, doesn't mean we're anti-pharmaceuticals, but if we can find other ways to improve our health that can perhaps reduce medications, then that's a win-win for everybody. So you are now a teacher of breathwork. And I thought it would be helpful for people to understand what breathwork is because, you know, like a fish needs water, humans need to breathe, and the art, if you like, of breathing is not as straightforward as we all think it is.
Dr Avi Charlton (01:46) Yeah, absolutely. I'm so enjoying this journey. I've done a couple of courses. First of all, I did Oxygen Advantage. I read the book first, and then I did the course, and I've learned so much about functional breathing. And recently, over the last eight months or so, I did a breathless expedition course, and I've become a breathwork facilitator. I'm hoping to spread the word more on functional breathing, how to breathe better, breathe properly, and incorporating breathwork into mindfulness practices. And I'm loving this journey and I'm hoping to spread the word more. Even in the normal general practice, I would talk about breathing a lot and trying to get people to notice they're breathing, if they're breathing through their nose, breathing through their mouth. And quite often, if they don't breathe properly, they can have lots of consequences. And I'm loving this journey.
Dr Lucy Burns (02:47) Oh, wonderful, wonderful. So when you use the phrase, like, functional breathing, could you just explain a little bit for our listeners what that actually means?
Dr Avi Charlton (02:58) Yeah, yeah. Functional breathing just means breathing properly. And a lot of people wouldn't know that on the other side of functional breathing if you're not doing breathing functionally, it's dysfunctional breathing. So quite a lot of people breathe too fast, too rapidly, and breathing through their mouths, that doesn't serve them well. Sometimes it makes their mental health worse. Sometimes it makes anxiety worse. Breathing too much can also make their oxygen level not as high as they should be and also makes them not sleep well and even exacerbates conditions such as snoring or sleep apnea and your brain doesn't function that well because you might not have slept that well and makes you more stressed. So it all comes down to breathing well.
Dr Lucy Burns (04:03) Well, I mean, I guess we certainly know with sleep apnea, which is breathing while you're sleeping issue, that has disastrous consequences for people's health if it's not managed properly with things like cardiac failure eventually. And in the more present time, people fall asleep when they're driving or all sorts of things. So there's no doubt that having good oxygen levels in our bloodstream is really, really helpful. So when you're saying people aren't breathing, I think you said too shallow. Was it too shallow? If they breathe too much, then that's not helpful. So what is the correct way to breathe?
Dr Avi Charlton (04:53) Yeah, yeah. The correct way to breathe is slowly and less breaths a minute and even quietly, not too noisily. So sometimes people breathe very heavy and they're very noisy and they have rapid breathing. The normal respiratory rate has actually gone up. Many, many years ago, the normal respiratory rate is eight breaths a minute. Now most people would breathe much more than that, like 12 to more than 12 or 16, 18 breaths a minute. So that could be because we're rushing, we're anxious, we're not remembering to breathe through our nose, or it could be that we're not paying attention and we're busy looking at screens or emails. Breathing too much also is associated with other medical conditions such as asthma or even diabetes, heart disease, or cancer. Having a medical condition also makes you breathe more rapidly.
Dr Lucy Burns (06:01) So you've mentioned a number of times about breathing through your nose. Why is it so important to breathe through your nose?
Dr Avi Charlton (06:11) Yeah, yeah. The nose is for breathing, the mouth is for eating and talking. So if you breathe through the mouth, quite often you don't get the air properly down into the base of your lung, you don't get diaphragmatic breathing and it's not getting the oxygen wells into the rest of the lung and it only goes to the upper chest. So that's breathing through the mouth. Quite often you're breathing too rapidly, so more breaths than you need, and it makes you more anxious. You also lose water while you're breathing through your mouth because your water is evaporated through the mouth. And if you breathe through your nose, you get the air humidified by your nostrils, your nose. It does all the magic in making the air warm. You don't lose as much water, so you don't get dehydrated. The nose will be filtering the germs and bacteria before the air goes into the airways. And when you breathe through your nose, you make a magic gas called nitric oxide, which also opens up blood vessels, so it's a vasodilator, that makes your blood pressure go down. This nitric oxide also has antibacterial, and antiviral effects that people during COVID have been trying to harness nitric oxide. So there's lots of magic with breathing through the nose. There's a lot more that I can't just ramble on. There are about 30 functions of the nose and quite often breathing through the mouth will make your airway more irritated and even people with a virus, and if they have a cough that lingers on, breathing through the mouth can make their post-viral cough just keep going. And I tell them to breathe through the nose and that gets rid of the post-viral cough, which is, yeah, comes in handy, just normal coughs and colds. And I ask them, you're breathing through the nose or mouth and that gets rid of them.
Dr Lucy Burns (08:28) Well, I certainly know if you wake up in the morning and you've been mouth breathing, you know, dry as the bottom, we used to have this phrase, dry as the bottom of a cocky's cage. Yeah. Yeah, end up with pretty kind of unpleasant taste and very dry mouth and lips.
Dr Avi Charlton (08:48) Yeah, yeah, absolutely.
Dr Lucy Burns (08:052110) So why though, I mean why do we find it hard to breathe through our nose? I think probably lots of people have a preference to mouth breathe. Why do they want to do that?
Dr Avi Charlton (09:05) I think a lot of the times it's we're just not reminded, we're not aware and we haven't paid attention. So we're just breathing through the mouth because nobody's told them they need to breathe through the nose. And then sometimes we're distracted, we're busy, we're not paying attention. And some people just got used to a habit of mouth breathing and the more you don't use the nose, the more congested and blocked you get. And some people say they've got polyps or they've got sinus problems or they've got a deviated septum. Then the more you don't use your nose, the more it doesn't open up because you haven't been using it. Use it or lose it. That's right, yeah. So sometimes when I remind patients to keep breathing through the nose and then if you do some nose unblocking exercises, which is some breath holds with the nose and mouth closed, a few times nose unblocking exercises, and that might just open up the polyps or open up congestion and make the nose breathing a bit easier.
Dr Lucy Burns (10:16) And what about with, say, like exercise? Because I think people probably find it hard to or it feels like it's hard to get a big enough breath when you're exercising through your nose.
Dr Avi Charlton (10:27) Yeah, yeah, absolutely. Yeah, so exercising with nose breathing will be beneficial as well. And, of course, it's a bit harder to breathe through the nose and mouth breathing is much easier. But if you train gradually and you might have to slow down your exercise a bit, so take one step back, you might be able to go four steps forward with your exercise training. So nose breathing during exercise actually harnesses your aerobic capacity a bit more. So you can slow down your heart rate, use more of your aerobic capacity, and you can get more oxygen into your system because you're teaching your body to hold on to more carbon dioxide. The more carbon dioxide you hold on, there's a curve that the body actually gets more oxygen from the hemoglobin. So a little bit of biochemistry with the acid-base balance in the bloodstream.
Dr Lucy Burns (11:40) It's interesting, isn't it, because carbon dioxide levels are our driver for breathing, aren't they?
Dr Avi Charlton (11:51) Yeah, yeah, absolutely. People don't know that we actually breathe because our carbon dioxide goes up, not because of the oxygen level go down. So what happens is if we keep breathing too much, we've taught our body to not hold on to a lot of carbon dioxide. Then our body will breathe with a little bit of carbon dioxide and our body doesn't know how to hold on to more carbon dioxide. That makes us feel breathless. But if we teach our body that we can hold on to more carbon dioxide before we breathe, we actually feel less breathless and we can get more oxygen into our system, into the brain, into the muscle, and we function better.
Dr Lucy Burns (12:41) Amazing. I think lots of things when it's uncomfortable at first, we're a bit reluctant to push on through. That's right. It's really like training anything, isn't it?
Dr Avi Charlton (15:54) Yeah, yeah, absolutely, yeah. So I teach my patients to breathe less. So rather than big amplitudes, smaller amplitudes are helpful. That's lighter breathing. So let's say you put your finger under your nose and you imagine not being able to feel the air going in and out and very light breathing. That's actually really good and training your body to breathe light and smaller breaths. So that's the light breathing. And slower breathing is also good. Rather than taking 12 breaths a minute, eight breaths a minute is fantastic. So that's much better with less breaths a minute. And deep breathing. Deep breathing is going into the diaphragm a bit more. So you can have both hands on the ribcage, on the base of your ribcage and feel the diaphragm going out as you breathe in and feel the ribcage going in as you breathe out. So that's going way deep into the diaphragm. So that's the mnemonic. LSD is light, slow and deep. So you can take some LSD and improve your breathing that way.
Dr Lucy Burns (14:17) So are you doing light and deep at the same time or are they three different things?
Dr Avi Charlton (14:24) You can train yourself separately but you can incorporate all together.
Dr Lucy Burns (14:32) Right, okay. Right, okay. Well, that sounds amazing. It's interesting because I know, and you've probably seen this when sometimes you ask people to take a deep breath, they kind of take this huge breath and they suck their stomach in and they kind of go. And that's actually the opposite really, isn't it?
Dr Avi Charlton (14:00) Yeah, it is. Absolutely, yeah. So ideally we want the diaphragm to go down and the ribcage to go out. So a big breath means you take a big breath into the diaphragm rather than sucking your belly. And you can actually lie down and have a book on your belly and you can see your belly going, see the book going up, then that's proper breathing into the belly rather than the book going down that's sucking in the belly. That's no good.
Dr Lucy Burns (15:28) Yep. And breathwork's an old practice, isn't it? I mean I know, you know, you're talking about you've just done a few courses and introduced it into your clinical work recently. But it's an ancient practice, isn't it?
Dr Avi Charlton (15:39) Yeah, absolutely. You can see all religions, a lot of the religions actually have this breathing practice. The Buddhas would do humming and they would do slowing down and breath holds. And the Indians have shamanic breathing. And it's a very ancient practice. Lots of religions would have breathing. Even the Christians and the Catholics, if they do prayers, that's also like a slow breathing practice as well.
Dr Lucy Burns (16:14) Yeah, yeah, yeah, yeah. Yeah, I'd never thought of it like that. Yeah, so I know. It's amazing, isn't it, that sometimes some of these ancient practices are now, you know, making a resurgence. You know, even things like, and I know you're a fan of intermittent fasting from time to time and that can be part of various religious and cultural beliefs. So there's a lot of, I guess, things that we are now bringing into modern medicine that were practised without probably the understanding of physiology but that people realised deemed benefits.
Dr Avi Charlton (16:53) Absolutely, yeah. So I have started doing breath work most mornings, at least five to ten minutes, and on the weekends sometimes 30 minutes of sometimes slow, sometimes fast breathing. And I feel much better. I feel like my cortisol has come down. It sets me up for the day and maybe the parasympathetic nervous system has activated a bit more than the sympathetic nervous system. I just want to spread the word to the patients and the public that breathwork is such magic and you can harness it without any cost, just need a few minutes in a day.
Dr Lucy Burns (17:38) Yeah, absolutely. So are there any people for whom perhaps shouldn't do breath work or would need perhaps specific supervision?
Dr Avi Charlton (17:49) Yeah, there are some people who have severe mental health disorders, like if they have uncontrolled anxiety or if they've had some trauma, and it might be triggering for their mental health. Sometimes in some epileptics or if they have severe respiratory disorders or asthma, it might be triggering as well. So just have to be careful. They might have to train very slowly and go very gently at their own pace.
Dr Lucy Burns (18:24) Yes. I guess if you've got, like, advanced COPD or something, that might be hard as well. Yeah.
Dr Avi Charlton (18:30) Yeah, absolutely.
Dr Lucy Burns (18:32) And so you're training people these days in your clinics and doing group work as well? Yeah.
Dr Avi Charlton (18:39) I have invited a few patients to come and do breath work in my clinic. So I coached them to breathe better over a four-week period, first of all being breath aware and paying attention to their breaths and I've incorporated some breath work exercises and just giving them some coaching. And I did some breath flows while they were in the clinic and they feel much better, just 15, 20 minutes. And this weekend I'm starting to do a breathwork workshop in my own neighbourhood, which is only one kilometre from my house. I hide a council room, a hall, a small hall, and I've got eight people coming in to do breath work in a bush setting. So we're going to do breath work, talk about the importance of functional breathing, how to breathe better, and we're going to do a breath flow for about half an hour and try to incorporate it into the mindfulness practice and get them to relax and teach them how they can incorporate breath work into their lives and do some bush walk and maybe kangaroo spotting in my neighbourhood. So, yeah, I'm very looking forward to that. Next year in 2025 I'm hoping to run these breath workshops every four weeks for three hours at a time in the bush setting doing breath work.
Dr Lucy Burns (20:13) Oh, wonderful.
Dr Avi Charlton (20:14) Yeah, that's my hope.
Dr Lucy Burns (20:16) Wonderful. Well, I'll tell you what's funny. Lots of the listeners know that I like to swim and I swim either backstroke or I do it's called life safety backstroke. So it's almost like the opposite of breaststroke because you're on your back doing it. And so when I'm doing it I'm reminded of you and I think, rightio, okay, I can do my breath work while I'm backstroking, and it's kind of easier because it's rhythmic. But when I go to do the life safety backstroke, for whatever reason, I don't know what it is, it's harder. Like I find it quite hard to remember to get my flow. I'm breathing and I seem to be sinking and I just think, oh, so clearly I need a little bit of practice for that one.
Dr Avi Charlton (21:02) I think you just have to keep practising and everyone's got a little bit of room of improvement. And if you're swimming then you can do breath holds at the same time and then you'll get your body used to holding onto more carbon dioxide and that'll be beneficial for you.
Dr Lucy Burns (21:19) Yeah, absolutely. And I think that's the thing, you know, as you mentioned, physiologically we breathe when our carbon dioxide levels start to rise and we can train our body to tolerate higher levels of that over time. And it's like lots of things that we teach our bodies to do. It's that increasing your distress tolerance. But the key is always with everything, I think. It really is. The key is just slowly, slowly, gently, gently.
Dr Avi Charlton (21:49) Yes, that's right. I think just practise self-compassion and I wouldn't go too overboard. I wouldn't be doing severe long breath holds. But just go at your own pace, practise self-compassion, and improve a little bit at a time and everyone will reap the benefits.
Dr Lucy Burns (22:09) Absolutely, absolutely. So, Avi, if people want to find out more about your breath work classes or follow you or learn about functional breathing, where do they find you?
Dr Avi Charlton (22:21) Yeah, I'm very active on social media as Dr Childs and Lifestyle GP. I've started a new website called Breathe In Health. So this is my new website called breatheinhealth.com.au and they can still go to my usual website called Melbourne Low Carb Clinic, mlcclinic.com.au, and I've put the breathing information there as well. So they can find me on social media and on either of the websites.
Dr Lucy Burns (22:56) Excellent. And we'll have all the links for those in the show notes. So if you're driving and you're thinking, I can't remember all of that, you can just at the end of your drive have a look at the show notes at the end and they'll have all of Avi's links. Well, Amy, I think like lots of things in health, there is no magic bullet for anything. It is finding all the little bits of the puzzle and I'm very happy that breath work is one of those pieces and very glad that you're teaching it to people. So thank you very much for all your work. And my lovely listeners, if you want to learn more about it and, again, you kind of think, really, it shouldn't be that hard, we should just be able to breathe. Yes, that's true. But in the way we live our modern lives these days, that seems even something as simple as breathing. We seem to have buggered that up a bit. So it's time to reclaim that aspect and you can do it. And once you learn, it's free. It's always with you. It's portable. It's got no side effects. It doesn't interact with any medications and it will help you immensely.
Dr Avi Charlton (24:02) Absolutely. I totally agree with you, Lucy.
Dr Lucy Burns (24:05) Good. All right, lovely ones, that's it for this week. I will be back next week with another episode of the Real Health and Weight Loss Podcast. Bye for now.
Dr Lucy Burns (24:14) The information shared on the Real Health and Weight Loss Podcast, including show notes and links, provides general information only. It is not a substitute, nor is it intended to provide individualised medical advice, diagnosis or treatment, nor can it be construed as such. Please consult your doctor for any medical concerns.
