Four nutrition findings with Jill Brook, MA

Mike Brook: [00:00:00] Hello, POTScast listeners and POTS patients, people who care about POTS patients, and everyone else listening out there. This is the POTScast. I am your sometime host, Mike Brook. I'm hosting today because we are talking to your usual host, Jill Brook. Jill, you might recall from other episodes, is a now retired nutritionist.

She was a nutritionist for about 30 years including six of those years as nutrition consultant to Dysautonomia Clinic. She's a POTS patient herself, and today she is going to be sharing with us four findings from the world of nutrition that may be beneficial to POTS patients. Jill, what do you have for us today?

Jill Brook: Yeah. Yeah. So to be clear, these study findings were not done on POTS patients, but they were done on symptoms or things that are relevant to POTS patients. And over the years, I know they've always helped me and [00:01:00] they've helped a lot of people that I've shared them with. So I thought it was worth a try.

They're all cheap, easy, simple, safe things that anybody, almost anybody could try. Obviously some people have allergies or reasons why they can't do certain things, so everybody needs to check with their own medical team. This isn't medical advice, but for the most part, this is some cheap, easy, simple stuff that could be tried to see if it helps make you feel better.

Mike Brook: Okay, great. Yeah, let's, let's dive in. What do you, what's the first one?

Jill Brook: Okay, so the first thing that we'll talk about is blood flow to the brain. We know that in POTS that's a big deal and it can cause a whole lot of the symptoms that we know and don't love, and might be related to brain fog, not being so alert, not having great cognitive function. So you, you probably know what I'm gonna say here 'cause I've been doing it a lot lately.

Mike Brook: Well, I have noticed [00:02:00] you a lot lately doing something that I hadn't seen you do very often. And that is chewing gum. You chew a lot of gum right now, and I have a feeling that this is not ordinary gum. This is not, it doesn't smell like Bubblicious.

I doubt it's Bubblicious, and it also looks like it's quite, let's just say very chewy. Is that what you're gonna talk about?

Jill Brook: Yeah, and it doesn't have to be gum. I'm gonna talk about chewing in general because the finding is that chewing leads to more blood flow to the brain. And this is a really robust, consistent finding. Like it's been well known in the nutrition world for a long time, that elderly people have a much faster cognitive decline if they lose their teeth and have to go on a soft food diet because the act of chewing

brings blood up to the head. So there's a ton of studies on this and they will oftentimes use a PET scan or an MRI or other [00:03:00] fancy technology, and quite often they'll have some subjects just sit there and then do, they'll measure the blood flow to their brain and then they'll hand them some gum, and they'll have them start chewing.

Oftentimes the gum is extra chewy gum, so it might be like mastic gum, not the normal, just really soft gum. And then sometimes they'll even have people do an in-between exercise, which is just lightly tap their teeth. And what they pretty consistently find is that when people are chewing, they get like a 20 to 30% increase in blood flow in some regions of the brain.

Mike Brook: Wow, that's actually a lot more than I was expecting. Can you now, this term mastic gum. That isn't a term I've heard very often. What is that?

Jill Brook: Oh, so there's a kind of gum that's made out of a tree sap in Greece, and some people are into it for some health properties, but it's really, really extra hard to chew. You have [00:04:00] to work at it. So sometimes when I really wanna concentrate or feel like I'm extra sharp, I will not just go for the gum, but I'll go for the mastic gum.

Mike Brook: So are you noticing that it helps.

Jill Brook: Yeah. Yeah. And if I can tell you more about some of the studies, I, I'll say that I noticed it big time, which is why I'm doing it. But for example, some of these studies will say quote, you know, chewing activates widespread regions of the brain. Other studies have found that it improved reaction time.

Some find that it improves memory. Some find that it improves alertness. There's so many studies about this. One said that it reduced stress and people reduced their cortisol levels. Another said that they had found that it had increased cortisol levels, but that it seems to help people avoid having their concentration and energy, mental energy, dip quite as much when they're chewing gum and trying to concentrate on a task.

Mike Brook: That's amazing. It [00:05:00] seems like there are probably some listeners that, for whom they wouldn't wanna do this. I'm thinking of sort of the hypermobility crowd. Is that true?

Jill Brook: Well, certainly if you have jaw issues like TMJ is something that is maybe a little more common in the hypermobility crowd than average, or people who have trigeminal neuralgia. Certainly, if chewing is painful, this is not for you. And sorry, I geeked out. Can I tell you a couple more things that the studies have found?

Mike Brook: Yeah, yeah. Lay it on me.

Jill Brook: Okay, so this is from a review by Chen et al in 2015, and they reported that epidemiological data from an older Swedish population showed that tooth loss was associated with cognitive impairment when adjusted for age, sex, and education. And they attributed that to chewing less. In another study of a rural community, residents aged 70 to 74 without dementia, they found that having poor chewing ability was [00:06:00] associated with worse performance on cognitive tests.

And they found that blood oxygen levels in the prefrontal cortex and hippocampus were higher with chewing. But the chewing findings in mice are even wilder. Not that we're, not that we're mice, but in mice, they found that when they fed them a soft food diet, they had slower neuron growth. But then when they put them to on a hard food diet, then they recovered that and they started growing neurons faster.

They found that in mice chewing during a stressful situation, which for mice means physical restraint. That the chewing reduced the negative effects of the stress on their cognitive function and on their brain cell proliferation. They have found that in mice, when they remove their molars, it reduces neural growth.

They found that chewing during stress reduced the stress hormones and it protected the brain from stress-induced loss of neuroplasticity. [00:07:00] I mean, I could go on and on, but basically they just keep finding that chewing really improves blood flow to the brain and that it protects a lot of the brain function.

So anyway, people probably are doing a fair amount of chewing anyways, so maybe try a little more. Chewing your food thoroughly is healthy anyway, and see if it makes a difference.

Mike Brook: And another, it seems like a lot of these studies, the ones that are more controlled, use something where the, the chewing was quite predictable, like gum, but there's no reason to think that it. It works only with gum. I mean, it sounds like a lot of those other studies that were kind of a little bit more observational were looking at just general chewing capacity, which of course would extend far beyond gum.

Jill Brook: Everyone can try it for themselves, but you know, so I try to do things naturally for the most part. So I try not to do too much gum, 'cause of course any gum is gonna come typically with either some sort of sweetener or whatnot. But even like just eating almonds instead of almond butter [00:08:00] or eating raw carrots instead of cooked carrots.

Eating raw fruit instead of making a smoothie. Would be ways that you could get a lot more chewing in naturally and find out if it helps you.

What I'm hoping is that some listener out there has a Lumia device that measures the blood flow to their head, and I'm wondering if they can do this experiment for us, like maybe an afternoon where they're sipping on a smoothie, see how much blood flow they have to their head, and then on a different afternoon

eat all that raw fruit that would've gone into the smoothie and see if all that chewing makes a difference. And if so, how much?

Mike Brook: Yeah, so that Lumia device was, I don't know, maybe 20 episodes ago or something. We talked with the inventor of the Lumia device, and that was, as I recall, it was some sort of a, I think it measured maybe using light through your skin and measured blood flow to the head. Do I have that right?

Jill Brook: Yep. I think so.

Mike Brook: Great. What's the next one, [00:09:00] Jill?

Jill Brook: Okay, so the next POTS symptom we're talking about is pain.

Mike Brook: Okay, pain. So we're talking about nutritional findings that might help pain. Pain, of course, is one of the more common symptoms in the POTSie- verse. And so what do you have?

Jill Brook: Yeah, and, and I guess one thing about that is that there's all different kinds of pain that POTSies can have. I know I mostly have leg pain. Other people have neuropathic pain or headaches or stomach aches. It can be all kinds, hypersensitivities to all kinds of things, and so that's why I was excited when I found that vitamin C

appears to help reduce a lot of different kinds of pain, so it is found to reduce inflammation. It helps the brain make some natural opioids. It's quite safe. And it has been shown to [00:10:00] reduce pain from cancer, nerve pain during and after shingles, in surgery recovery. It has been found to help prevent chronic regional pain syndrome after trauma to a joint.

It's been found to help musculoskeletal pain to be related to patients using less pain medication in the hospital after surgery. So just looking at like one review that appeared in the Journal of Translational Medicine, it's called The Role of Vitamin C in the Treatment of Pain, New Insights by Carr and McCall.

It just, you know, said basically well quote quoting overall vitamin C appears to be a safe and effective adjunctive therapy for acute and chronic pain relief in specific patient groups. So something people could try.

Mike Brook: Okay, let's talk about foods that would be good sources, or is this just talking [00:11:00] about supplementation?

Jill Brook: So in the studies they tend to use supplements 'cause that's easy to control and they can give people a placebo, but you can get very high doses of vitamin C through your diet if you want. The doses that they used in the studies tended to be between 500 milligrams and two grams. And so, geez Mike, how many oranges did you eat today?

I'm pretty sure you went way over that.

Mike Brook: A lot. Yeah. It's orange season here in California, so I eat a lot of oranges. I'm sure I exceeded that, so, but I don't have any pain right now either. So, you know, maybe those are connected.

Jill Brook: Yeah, so other places you could get it would be things like bell peppers, kiwi, potatoes, berries, leafy greens. There's a lot of places you can get it.

So in three studies of herpetic neuralgia, that's the nerve pain from shingles that I've, I've not experienced it, but it's supposedly [00:12:00] pretty bad as nerve pain can be. They gave patients vitamin C infusions between two and a half grams to 15 grams every two days, and it brought the pain ratings down from, this was three studies, so the first, the first ratings were 73%, 80%, and a hundred percent reporting pain. And it was 0% after, in all three.

Mike Brook: And what, what again? This, this was, did you say this was shingles?

Jill Brook: Yes. So in just a nerve pain. Yeah. In cancer, it reported that cancer related pain saw about a 50% reduction from similar vitamin C infusions. Now granted, you know, not everybody can get an infusion, but you can, you can take oral vitamin C and get your blood levels quite a bit higher. And then there was a controlled retrospective study of terminal cancer patients where [00:13:00] 79% required narcotics in the control group, but only 17% required narcotics in the group that was given five to 30 grams of oral vitamin C daily.

Mike Brook: So that's incredible to me. I mean that, that is amazing, 'cause it seems like of, of all the bad things that happen with cancer, the treatment and then having to take pain meds and all this just seems to pile on and there's just so many side effects of the pain meds and everything like that. And if it's that easy to lower that, that dependency, that's incredible to me.

Jill Brook: Yeah. And then in two other studies of surgery patients, they administered IV vitamin C right after giving the anesthesia, and that reduced patient's need for pain medication two hours post-surgery. And, and like I could go on and on, there's so many findings like this and, and I, I might have been biased against the ones that had more impressive findings, but, but a lot of the studies also just gave people like 500 milligrams [00:14:00] vitamin C or a thousand milligrams vitamin C, which are

you know, the, the amount of vitamin C that a lot of patients might already be taking. But the thing is, it, it washes out of your system quite quickly. So if you're like me and your pain tends to come at night, but you were taking your vitamin C in the morning, one thing you could do is, you know, retime it or you know, talk to your doctor about how much you can take.

You know, there are some reasons why you wouldn't wanna go crazy on the vitamin C. You know, too much can cause diarrhea, it might contribute to kidney stones or whatnot. But for some people, their physicians do kind of give them clearance to go pretty high on the oral vitamin C.

Mike Brook: So let me ask you a question. One of, in the last year, I would say one of your go-to MCAS meds has been vitamin C. And you, you take it at times when maybe you [00:15:00] would've taken an antihistamine. So like if you're, if it's nighttime and you're starting to itch, that's, that's a common thing that happens to you and taking a swig of this liquid vitamin C, which I think is liposomal,

I think there's a couple different kinds of, or maybe you do both. I'm not sure. Maybe you can tell us about that. But, so that's an MCAS thing. Could that be related here?

Jill Brook: I don't know. That's a, that's a great question. I don't know how much. I mean, I know that MCAS is related to pain. I don't know if it's related to pain in, you know, all these other populations where it was studied, but for sure vitamin C can help you process histamines a little bit faster, get rid of 'em.

It's it's a really common go-to supplement for MCAS. And again, the problem is it only lasts a few hours. So sometimes I have to get up a few times during the night and take a few swigs on nights when I'm itchy. And my understanding is that, so there's liposomal vitamin C and there's, there's non liposomal, like, like [00:16:00] ascorbic acid, and I do sometimes take both of those at the same time because my understanding is that they're absorbed via different pathways and you can get your blood levels up a little bit higher if you take both.

But it is true that this one, liquid vitamin C, the one made by Pure Encapsulations. Their liquid liposomal vitamin C, that one works better than every other one I've ever tried, and it does take away my itching in minutes, whereas the other ones don't do that. And so I don't, I don't know why, but that one is almost like Benadryl for me when I'm

itching.

Mike Brook: Yeah, that, that's been a real, that was kind of a breakthrough therapy that you found about a year ago, and I believe it was from a guest on the POTScast. Can you remind us of the name of the person that we had that talked about that?

Jill Brook: Yes, we had a, a wonderful woman that I love Megan Barnett of Bio Lounge, PDX. She's a [00:17:00] functional nutrition, a functional medicine nutritionist, and she taught me about that among many other things. And that has been a real, real life saver for my sleep at night, 'cause I don't like to take drugs to not itch.

When I take antihistamines, I don't sleep. So being able to take vitamin C instead has been huge for me.

Mike Brook: Yeah. And the little bottles of liposomal vitamin C, the one that you're talking about needs to be kept cold, right? So what, what you, what I've caught you doing, is filling a bowl with snow, we live in a snowy place, and sticking that in there and putting that on your nightstand,

to take a swig out of it. So it's like you have a little a, you have a little mini fridge next to your bed, but it works for you and, and you know, when, when you find something that works, you gotta lean into it. And so it's, this one definitely has been a good one.

All right. [00:18:00] So what's next, Jill? What's the third one?

Jill Brook: Okay. The next one is just about boosting mood, which I figure we can all use more of.

Mike Brook: Boosting mood. Okay. Is this the one where you wanted to quote the abstract of the, of the paper? This is, there's, this is one where there's a bit of a lengthy quote, so everybody just buckle in. We're gonna get a quote from an abstract now.

Jill Brook: It's amazing. It's an amazing quote and it, it's worth it, I promise. Okay, so this is from a study by Brookie et al 2018. I'm not gonna tell you the name of it yet 'cause that'll give away what we're talking about. But, it's talking about a nutrition habit that they're calling FVI and to maintain suspense

I'll tell you what that is afterwards. But here's the quote. There is now good evidence that higher FVI is related to better mental [00:19:00] health. Research has established that people who eat more fruits and vegetables have a lower incidence of mental disorders, including lower rates of depression, perceived stress and negative mood.

This is all cited in here. It's got tons and tons of so sources cited. People who eat more fruits and vegetables also have a higher likelihood of optimal mental states, such as greater happiness, positive mood, life satisfaction and socioemotional flourishing, which captures feelings of meaning, purpose, and fulfillment in life.

Importantly, these associations between FVI. Okay, I guess you figured out by now FVI is fruit and vegetable intake. Importantly, these associations between FVI and various mental health indicators appear to be, one, dose dependent, where higher intakes of fruit and vegetables are associated with increasingly higher mental health scores.

Two, they're robust when controlling for demographic, [00:20:00] economic, social, and health covariates such as gender, income, education, BMI, smoking, exercise. And three, they're bolstered by longitudinal and interventional research that has shown causal relationships between higher fruit and vegetable intake and mental health.

By the way, I've passed over like 50 sources that are cited here. It goes on to say, for example, using longitudinal data from 12,389 people in the household income and labor dynamics in Australia survey. Mujcic and Oswald found that a shift from low to high intake of fruits and vegetables across a period of two years resulted in a significant improvement in life satisfaction, showing an average gain comparable to moving from unemployment to employment. Interventions have also shown that increasing fruit and or vegetable [00:21:00] consumption improves depressive symptoms among clinically depressed adults, improves feelings of vigor in young men with low baseline levels of vitamin C and a higher baseline mood disturbance. And it increases flourishing in young adults with a low baseline consumption of fruits and vegetables.

Some research has indicated that positive mood states can also shift people towards healthier food choices and negative mood states, such as stress can shift people toward unhealthier, food choices and overeating. However, the longitudinal and experimental research designs outlined above provide convincing evidence that fruit and vegetable intake can also have a direct and causal impact on subsequent psychological wellbeing. Okay, I'm done.

Mike Brook: Okay, so fruit and vegetable intake. So the part that I think you find most interesting, which I do as well, is that part about how it compares going from low to high fruit and [00:22:00] vegetable intake over two years, and that gives the same benefit in this socio-emotional flourishing way as going from unemployed to employed. So that's probably pretty big. I think probably most people, I mean, I'm old enough to where I would, I would increase my socio- emotional flourishing from going from employed to unemployed.

But for most people, that would be great.

Before we move on, do you remember what they said low was and what high was in this case?

Jill Brook: I believe it was two servings to six servings a day.

Yeah. And maybe that's not surprising given what we know about the gut microbiome having to having a lot to do with mood and brain or maybe just inflammation. But, but yeah, I think, yeah, you, you nailed it. That the point is that it's a huge effect size, a huge effect size.

Mike Brook: Yeah. And this has been [00:23:00] replicated, right? I mean, it wasn't just this one study in Australia. These, this is the type of thing that's been found over. I mean, I think that you, as I recall, back when you were in grad school, this was one of the things that you kept finding over and over kept looking at, over and over study after study was finding this kind of improvement in wellbeing from this sort of one dietary twist.

Jill Brook: I mean, this was like a big reason that I went into nutrition in the first place. And why then I felt like I sort of became a cheerleader for fruits and vegetables, because, yeah. And then, so incidentally, the, the name of this study is Intake of Raw Fruits and Vegetables is Associated with Better Mental Health than Intake of Processed Fruits and Vegetables.

And so that's probably not too surprising, but yeah, so, so I know that there's reasons why a lot of people cannot tolerate a lot of fruits and vegetables. If you have SIBO or reasons why you can't handle a lot of fiber, that this might not be realistic, but one thing it might make you [00:24:00] do is just try to find ways that you do tolerate more, maybe by cooking them really well or you know, I know I went through a period where I couldn't really tolerate much fiber, so I juiced vegetables and,

anyway you know, I, I've encountered a lot of people over the years who are very quick to give up on fruits and vegetables saying, oh, they don't taste that great anyway. I don't think my digestion likes them, but I guess I would, I would argue don't give up on them too easily. Work with a doctor, see if you can do something to be able to tolerate some amount of them, 'cause I think they, they do have some big big benefits.

Mike Brook: Yeah. And I don't wanna out you too much, but I just had a flashback to your, the first website we ever built for you to promote your nutrition services was eat your veggies.com. But we we're so old that we were able to get that website way back in the day. It's offline now, unfortunately. Should we move on to the fourth one?

Jill Brook: Okay. Fourth and [00:25:00] last one. Yes. This has to do with exercise tolerance.

Mike Brook: Okay. So, nutritional findings that presumably could help with exercise, improve exercise tolerance, decrease intolerance.

Jill Brook: Yeah. Yeah. And I just wanna be clear that I'm not talking about solving ME/CFS or post exertional malaise. I, I don't think that this is necessarily helping that. This is taking people who can already do some amounts of physical activity and helping them do more.

Mike Brook: Yeah, key caveat there.

Jill Brook: Yeah. So we're gonna talk about dietary nitrates that are found naturally in foods.

Now, there's also some, some dietary nitrates that are basically chemicals added to processed meats to keep them from going bad. We're not talking about that kind. We're we're talking about the kind that occur naturally, [00:26:00] usually in vegetables.

Mike Brook: Okay, so this is not. This is not salami promotion here. This is, what are you talking about? What are the foods?

Jill Brook: So the foods that are naturally high in dietary nitrates are like beets, arugula, lettuce, spinach, any, any kind of leafy green, broccoli. There's a whole bunch. Yeah.

Mike Brook: Okay? But the point is, and you have some studies to show this, they help with exercise tolerance.

Jill Brook: Yeah, there's a lot of studies that show some pretty cool stuff and these are again, are really robust findings, and so I'm gonna talk about a series of studies that have been replicated a whole bunch of times and they pretty much always do the same thing. And so the subjects are given some nitrate rich vegetable juice or a placebo,

or a vegetable juice where they have somehow figured out how to remove all the, the dietary nitrates. And they have [00:27:00] the subjects drink about two cups a day for five or six days. And then on day seven, they come in for an exercise test. Now this has been done on healthy people cycling at high and low intensities.

It's been done on hypoxic COPD patients who could not walk very far. It's been done on patients with peripheral artery disease. It's been just done on recreational athletes. It's been done on all kinds of different populations doing various different exercise tests. But the idea is that whoever it is, they, they do this exercise twice, about one month apart.

And one time when they do the exercise, they have spent the last week drinking this nitrate rich juice every day. And then on the other time, they had been drinking a placebo every day. And then they can compare the exercise performance on the nitrate versus on the placebo.

Mike Brook: So similar kind of study design in all cases, sort of one of these crossover [00:28:00] deals, and but different, slightly different populations, probably different exercises, sometimes looking at intensity, sometimes duration. What kind of findings do they get?

Jill Brook: Yeah, so for example, in eight patients with COPD, they found a 15% increase in the distance that they were able to walk. In eight patients with peripheral artery disease, they were able to walk 18% further. When they had eight healthy men do a specified rate of cycling, they found that after the nitrate juice, they used 19% less oxygen to do the same amount of work.

And then when they were made to do a very, very fast pace and their time to exhaustion was measured on the nitrate rich juice, they lasted on average 16% longer. Then another study looked at knee [00:29:00] extensions, like that works your quadriceps, and they had middle aged, recreationally active males doing that to exhaustion after five days of either the nitrate juice or the placebo.

And they saw more than a 30% improvement in that. Importantly only eight of the 12 people were better after the nitrate rich juice. So for four people it did not help. But among the eight, it must have helped a lot because the mean improvement was 30%.

Mike Brook: That's a lot. I mean, the, the other thing that, that I like about that is like fitness and exercise begets more fitness. And so, you know, I imagine two, three months down the road when everyone's able to exercise 20% more, all of a sudden their fitness level is now 40% higher. You know, something like that.

I mean, does that surprise you a little bit how big that effect is? In [00:30:00] five, six days of drinking some juice.

Jill Brook: It does surprise me. That that's, and the cool thing is, you know, they've done this study many, many times and most of the time when they have the athletes doing this or, or the, the exercisers doing this, they don't realize that they're working harder. Right. So it's, it's basically being able to do more without even feeling like you're doing more.

And I have to say, I personally notice this a lot, and so you might have noticed that I try to eat a lot of arugula right before we start our cross country ski season because I'm always super intimidated to keep up with you and I notice it big time.

Mike Brook: Oh, okay. I mean, I have noticed you eating quite a bit of arugula, but I didn't realize the timing, so that's like a prep. You're prepping for those first few days on cross-country skis when you're not ready for it, and it's very, very hard. It's very tempting to just quit, you know? It's very, very hard.

Jill Brook: [00:31:00] Yes.

Can I tell you what, what the dietary nitrates are doing?

It increases oxygen delivery to tissues. It decreases the oxygen cost of exercise. And so more ATP, the energy units, more ATP is made per unit of oxygen. And so that improves endurance and reduces fatigue. So literally every oxygen molecule makes more energy. It improves muscle contractility efficiency via calcium ion metabolism.

Jill Brook: And I don't even know what that means. I just took that out of the study. But it's improving your muscle's ability to contract. And then here's a bonus. It even improved cognitive performance at rest and during exercise via oxygen delivery in hypoxic areas of the brain. Now, that was in a, a population [00:32:00] of, of normal people, not POTSies who might have way more hypoxia going on in areas of the brain. But you know, it might be worth it to you know, throw some arugula into your eggs in the morning.

It melts down almost into nothing, and you could see if it helps.

So I would just mention that one thing about dietary nitrates is that they can reduce your blood pressure. And so for anybody who already has blood pressure that is too low or is a fainter, you know, talk to your doctor first. Maybe go low and slow. I personally do have low blood pressure and a history of fainting, but I did not have that problem from this.

I, I managed to get benefits only. So, but that is something to theoretically keep your eye out for.

Mike Brook: That's a good one. So, I don't know Jill, maybe we ought to just quickly recap these four.

Jill Brook: Sure. Sure. So I just wanna reiterate that none of these studies were done on POTS [00:33:00] patients. None of them mentioned POTS. This is purely just me saying that as a POTS patient, these, these findings caught my eye as

things to possibly try if you know, if they can be safely done for, for each person's situation.

So the first one we talked about was how chewing is found to increase blood circulation to the brain and to improve cognitive function.

The second one was how vitamin C is found to help all different kinds of pain.

The third one is that increased intake of fruits and vegetables improves mood and mental health.

And the last one was dietary nitrates from vegetables helping exercise tolerance.

Mike Brook: So I think this is great, Jill. Anything else you want to add?

Jill Brook: No, that's all. Thank you for hosting.

Mike Brook: Well, it was my pleasure to host and I feel like my socio-emotional flourishing is at an all time high right now. So [00:34:00] I hope everyone out there is feeling it. And thank you for listening. That's all for today, everybody. And we'll be back again with another episode of the POTScast next week. But until then, thank you very much for joining us and for listening, and remember you're not alone, and please join us again soon.