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Calming the Overactive Sympathetic Nervous System with Dr Wayne Todd

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Calming the Overactive Sympathetic Nervous System with Dr Wayne Todd

Our sympathetic nervous system, our fight or flight response, keeps us alive in emergencies. But what happens when we experience chronic stress, resulting in an overactive sympathetic nervous system that will ultimately affect our heath? How do we help our patients who are stuck in sympathetic nervous system dominance?

Dr Wayne Todd, creator of the SD protocol, joins Dr Damian Kristof for an in-depth conversation about extending our understanding of the complexities of sympathetic dominance, and practical ways to identify this in our patients. They discuss the different ways sympathetic dominance shows up in the body, how sympathetic dominance is linked to a variety of conditions including Polycystic Ovary Syndrome and thyroid disease, as well as techniques and tools we can use to help calm an overactive sympathetic nervous system down so we can rest, digest, and restore..

Covered in this episode

[00:09] Welcoming Dr Wayne Todd
[01:06] Defining sympathetic dominance (SD)
[02:46] The development of Wayne’s SD Protocol
[04:51] Balancing sympathetic and parasympathetic activity
[07:55] Clinical symptoms of sympathetic dominance
[13:50] Polycystic ovaries and connection to sympathetic dominance
[19:46] How practitioners from different modalities can help patients with sympathetic dominance
[21:59] Where does the sympathetic drive originate from?
[25:10] Using red lenses and foam rollers to calm the nervous system in the evenings
[31:24] Wayne’s top recommendations for herbs and supplements to combat SD
[33:21] Compliance rates and significant change
[36:12] Additional resources for practitioners
[37:30] Thanking Wayne and closing remarks

Damian: This is FX Medicine bringing you the latest in evidence-based, integrative, functional, and complementary medicine. I'm Dr Damian Kristof, a Melbourne-based chiropractor and naturopath and joining us on the line today is Dr Wayne Todd

Wayne has a passionate enthusiasm for exploring the many methods of practice available within the chiropractic profession. In 2004, he completed a two-year Functional Neurology diplomate program, at the time, making him one of only a handful of Australian chiropractors with this training. 
He lives in beautiful country Victoria, where he's surrounded by fresh air, beautiful singing birds, sunshine all the time, and he's a happy man, and I'm so happy to bring you on to this podcast, Wayne. Thanks for joining us.

Wayne: Thanks, Damian. Thanks for that intro, it's sunny every day except when the clouds are out. So that's really good.

Damian: The sun is always there. The sun is always out.

Wayne: Yeah, it's always there, it's just that sometimes you can't see it. But most of the time, it's all good.

Damian: Wayne, you've done a mountain of work. And one of the big pieces, or the biggest piece, of work that I think that you've done, which has been revolutionary, certainly in my practice, and in chiropractic practices around the world has been the SD Protocol, and SD meaning sympathetic dominance. How did you come to designing a program to help people with sympathetic dominance? And what is sympathetic dominance?

Wayne: Right, sympathetic dominance, I guess is really the crux of what we say when we say dysautonomia, an imbalance that autonomic nervous system where someone's stuck in fight or flight mechanism, where their fight and flight mechanism is switched on and their rest, digest, and repair systems are shut down, being parasympathetic. 

So you can't have both sides of that autonomic seesaw working together at the same time, it's either one or the other, sympathetic or parasympathetic. And increasingly, today, we're seeing more and more people who are stuck in that fight and flight mechanism, where that sympathetic nervous system is just switched on, to keep them safe and protected. Which is good in short bursts but when it stays locked on, it's really compromising all those other good systems in our body, our digestive system, our reproductive system, and our immune system, and our ability to get a good night's sleep and rest. All of those things are inhibited when we're stuck in fight or flight.

And it's really just about addressing how to identify, in clinical practice, that someone is stuck in that fight or flight mechanism. And then what to do about it, and how to try and turn that around, really is what we put together with the SD Protocol or Sympathetic Dominance Protocol. 

Damian: Yeah.

Wayne: And I guess, to answer that question, initially, how did it come about? Working with the...doing the functional neurology work that I was doing, really, down rabbit holes, I guess, looking at really finite imbalances in the nervous system functionally and trying to stimulate one side of the brain compared to the other, and trying stimulate one side of the cerebellum compared to the other to create a better state of balance. 

What I started to see was that overarching sympathetic dominance was really playing a major role in that significant asymmetry that we saw in people. And when I started applying that overarching calming response to try and calm that whole sympathetic nervous system down, we saw some significant improvement in that unilateral imbalance that I saw in the functional nervous system. 

So a lot of that work that I was doing went by the wayside, and looking at that overarching health and well-being perspective. And we also had a functional medicine GP working in our practice for over 10 years at the time. I was doing all the really specific Functional Neurology work. And there was quite a few dawnings that came within interactions and conversations with him and the work he was doing with natural hormone balancing and the work that I was doing with the functional neurology and looking at, "Gee, all of this is connected." And really trying to take a simplistic approach to it and how every practitioner in every sphere, really, this applies to, whether you're working on the psychology side of the triangle, the chemical side of that triangle, working with people's digestive health and digestive system function, or whether you're working on the physical side of that health triangle, looking at physical dysfunction.

Damian: I love that. And I think one of the key things to go back to is that the nervous system controls everything within the body. And yes, we can spend a lot of time in the gut, and we can spend a lot of time on hormones, and so on and so forth, but at the end of the day, without the brain and the nervous system, nothing much is really going to work, right? 

So if we go back and take a step back and we talk about the different parts of the nervous system, we've got the somatic nervous system and we've got the autonomic nervous system. And when we talk about the autonomic nervous system we're talking about the sympathetic component and the parasympathetic component. 

I love that you talk about the fact that there's a seesaw kind of mechanism there, so you've got either sympathetic activity or parasympathetic activity. And surely there's got to be a balance of both, right? There's going to be sympathetic and parasympathetic working at the same time. But are you saying that you can't have one significantly dominant and the other one kind of catching...is that what you're saying?

Wayne: Yeah, you can't have them both really dominant at the same time, one will always take precedence. And when someone is in a stressful state, that sympathetic nervous system will take precedence to keep that individual safe and protected. And when I say stressful state, stress really can only come from three different aspects and that's sort of physical, chemical, or emotional stress. 

And it's being able to identify which might be the primary for that individual, or sometimes there's more than one side of the triangle that's active creating that stress. Whether it's a past history of being molested or witnessing a traumatic event that's keeping that individual constantly in that stress wound-up state, whether it's the physical side of the triangle, someone who's working in a constantly poor ergonomic position, looking down at a laptop all day driving their shoulders forward, their head forward, putting them into that fight-and-flight physical posturing. That whole fight-and-flight physical posturing will then shut down the digestive system, shut down the reproductive system, shut down the immune system.

So it's looking at what is the predominant stress and, where did it start? The chicken or the egg situation and there is that whole sympathetic nervous system is constantly cranked up. Then you've got...if you look at the digestive system, you've got reduced enteric blood flow and also reduced enteric neurological activation when someone's in fight or flight status. So that longstanding suppression of the digestive system will cause poorly functioning digestive system cells. So if you look particularly at that single-cell layer lining of the digestive system tract, that gut membrane when those cells are replacing themselves on an ongoing basis. And if you've got poor nerve function and poor blood flow, then you're not going to get nice robust cells forming. And then you end up with a leaky gut membrane, which creates an inflammatory process within that circulatory system, and partially digested foods, and toxins leaking into the bloodstream, causing an immune response, an IGG response, which then causes the release of inflammatory cytokines. And those inflammatory cytokines will race around the body and attack other tissues, joints, and the nervous system, gut lining itself, again, lungs, whatever tissue you want to describe, that's susceptible to those inflammatory cytokines, will be inflamed. And we think, "Well, where did that whole cycle start?"

Damian: We see a lot of different situations, conditions, diseases, symptoms, in our practices. Regardless of the type of practitioner that you might be, we see all kinds of different things coming into our practice. And it's quite easy just to...you know, look, if you're a plumber, you think that everything's a leaking tap. If you're a builder or a carpenter, you think that everything's a nail and you've got to have a hammer, right? So, as a chiropractor, it's quite easy to think that everything originates in the spine. And if you're a naturopath or a herbalist, you're going to think that the cure is always going to be vitamins or herbs. 

In this sort of situation, I would have thought that it's quite important for us to be able to effectively diagnose sympathetic dominance, and certainly come to a point where we understand what's actually going on. So yes, they'll come with a group of symptoms, but how do we determine that sympathetic dominance actually exists in somebody?

Wayne: Yeah, certainly, that's an interesting conundrum. But I find it quite simple from a neurological perspective to address that. And one of the first things that I do clinically is just look at someone's posture. 
So if we look at a lateral postural view of someone when they're standing, and we dropped a plumb line down, it should pass through the ear, the point of their shoulder, their hip, their knee, and their ankle for someone to be in a nice neutral alignment. And when someone's in a fight or flight posture, we will see their head drop forward or that centre of gravity line.

So for every centimetre that the head moves forward of that standard gravity line, the head doubles in weight from a gravitational perspective, which puts a significant load on that whole upper trap shoulder region, which is why you see people who are constantly stressed have always had tight shoulders. There are those individuals who go and see a massage therapist every week and they say, "Oh, my God. Your shoulders feel like cement," and just they need to be smashed to try and break up those constantly tight muscles.

Damian: You need a jackhammer.

Wayne: Yeah, because they're in that fight or flight posture, which is gravity is trying to drop their head to the ground all the time, and those posterior muscle groups are working hard all the time to hold their head up against gravity. But what that's also doing is it's firing up the upper thoracic cord, which is where our second-order neurons for sympathetic drive originate in the lateral horn of the upper thoracic, or the entire thoracic spinal cord. The IML, or the intermediolateral cell column, and the lateral horns, is where our second order neurons for sympathetic activation reside. So if we're in that rounded shoulder forward head posture position, we will get a secondary ramp-up of that sympathetic drive and shut down on the parasympathetic nervous system. 

So just purely looking at someone's posture will give you a dead set indicator that someone may be in sympathetic overdrive. And so I would ask, when I see someone in that posture, ask them a series of quite simple clinical questions, which the more of these that they would answer yes to, would give you an indication that they may well be in that fight or flight sympathetic dominance status.

Damian: Yeah, nice. So you're starting with a questionnaire and more inquiry around symptoms and almost like a syndrome. So it's more like the sympathetic dominance syndrome is kind of where you're coming at it from?

Wayne: Yeah. Do you want me to read some of those symptoms that someone might have after getting sympathetic dominance?

Damian: Yeah, yeah. Do that.

Wayne: So I would say to the individual, “Do you get shoulder and neck muscle tightness? Are you sensitive to light? Are you sensitive to sound?” And those two things would need to be on high alert when you're in that fight and flight mechanism. You're sensitive to light-sensitive to sound. 

Do you sleep lightly? Do you have vivid dreams? Do you get digestive upsets like bloating, constipation, diarrhoea? Do you have elevated blood pressure? Do you feel tired regularly? Do you feel cold? Do you have difficulty losing weight? All associated with an underactive thyroid, which is associated with that whole sympathetic dominance as well. 

Do you crave sugar and salt? Hormonal imbalances, particularly oestrogen dominance, gall bladder dysfunction, uterine fibroids, irritability, headaches, hair loss, thyroid imbalance, polycystic ovarian syndrome, water retention, anxiety, or depression, how many of those things would you tick? And often when you pick someone who's in a state of sympathetic dominance, by the time you've got through that list, they have tears streaming down their face.

Damian: And they're more sympathetically charged.

Wayne: Yeah, "How do you know all that about me?" Because those are the classic symptoms that you would see when someone is in that fight or flight constant status. 

There are other clinical things that you would look at, for instance, pupil size is a really good indication of acute or chronic sympathetic wind up as well. So we would look at those clinical indicators and knowing what nuclei drive that response. In the early stages of sympathetic dominance, we would see quite dilated pupils. In the chronic, sympathetically dominant individual, we will see pinprick pupils. And that is purely because they're getting their Westphal nucleus, which sits in the mesencephalon mid-brain stem area, which is the powerhouse of sympathetic drive. That kicks in and creates a pupil constriction, which will actually protect that retina from long term damage if the sympathetics are constantly wound up, forcing them to be dilated initially. 

So it's a protective mechanism for the retina that kicks in with long-standing sympathetic wind-up, most of those pinprick pupils. So there's a few clinical tips that I would look for, and then those historical questions in the questionnaire will give you a fairly good confirmation that someone is in that state of sympathetic dominance.

Damian: I love it, and it's so simple too. Like, it's not that you've got to go and...I mean, obviously, we've all done university degrees, but you don't have to go looking for anything obscure. And so you're not necessarily relying on pathology results or in-depth pathology, expensive tests to kind of determine whether or not somebody is sick enough to actually go in this sort of direction to manage that.

Wayne: That is correct. And there is a number of labs that you can do to confirm, should you wish to, some of the areas that you know may well be out of balance. And obviously, other further investigations, if someone's got polycystic ovarian syndrome, you might well look at ultrasounds to confirm polycystic ovaries etc. But all of that all, again, is related back to that sympathetic wind-up. 

Damian, I don't know if you would like to...if I can indulge the audience a little bit, and I really love talking about polycystic ovarian syndrome. If we look at the accepted nomenclature which would enable a diagnosis of someone with polycystic ovarian syndrome, the Rotterdam convention, basically you need to have three of the following four symptoms to be diagnosed with polycystic ovarian syndrome. So, multiple cysts on the ovaries - and that's typically confirmed with pelvic ultrasound - infertility, anovulation, and the last one is increased testosterone. And that's either confirmed clinically with increased facial and body hair, or with lab tests. 

So three of those four things to be diagnosed with PCOS. But if we go back to a female gazelle that's out in the jungle that's being chased by a lion, do you think she's thinking about releasing an egg to fall pregnant at that time when she's in stress? No. 

Damian: I hope not.

Wayne: No. So the hypothalamus is the area of the brain that actually controls what the pituitary does. So the hypothalamus would inhibit the pituitary from releasing luteinising hormone and follicle-stimulating hormone to inhibit ovulation when an individual is under stress.

So when ovulation is inhibited, each time an egg is not released from an ovary at that time of the cycle, the ovary forms a cyst. That's why a cyst forms. A cyst forms purely because an egg is not being released. And walls of those cysts generate high amounts of oestrogen and testosterone, two hormones all females can do without excess amounts of. Elevated oestrogen stimulates thickening of the endometrial lining and increased period heaviness, mid-cycle spotting clotting, etc. 

But elevated oestrogen also inhibits thyroid function, because oestrogen and thyroxin blind to exactly the same receptor sites on cells within the body. So if you imagine a cell to have angled car parks around the outside, if you've got high oestrogen, all those car parks are taken up with oestrogen. So then thyroxin and circulation can’t bind and attach to the cell. So you get a relative clinical under-active thyroid. So even though the lab tests are showing that the thyroxin levels are okay and TSH levels are within normal limits, what you classically see with someone who's in that situation, over a period of years, their TSH levels are slowly climbing within that normal range until maybe after having a thorough function test done every couple of years, after 10 years they go, "Oh, now you've got an under-active thyroid," but when you actually look back over the historical lab tests, you're seeing that TSH slowly climbing through the normal range, purely because they've had longstanding oestrogen dominance, inhibiting thyroid function, and then the brain is going, "Come on, come on," in the pituitary, "we need more thyroxine." So TSH is slowly climbing over a period of time. 

But there's a connection with thyroid function and stress response. But that gazelle, when she's being chased, she's not thinking about releasing an egg. But it has that significant flow-on effect and impact within the body physically. Because also high oestrogen levels is another known inhibitor to digestive system function and gastric motility and also increasing biliary stasis as associated with oestrogen dominance as well. So hence gall bladder connection.

So it's common. You know, if I walk into a room, I see a new patient who's got a thyroidectomy scar on the front of their neck and I'll say, "Oh, you've had your gallbladder removed and you had a hysterectomy. Have you?" And they'll say, "How do you know that?" And I'll go, "From the scar on your neck." And they'll go no, that's where I had my thyroid removed, not my uterus and my gallbladder." And I go, "Yeah, I know that. I know that." But that would have been third in the triad. First, you would have had your gall bladder removed, then you ended up with heavy cycles and fibroids and ended up with a hysterectomy, and then your thyroid was the third in the triad to fall over.

So those things are common and I guess that long term in practice, knowing what I know now helping people through those processes over 35 years, I didn't know any of this stuff 15, 20 odd years ago and prior to that. So observing seeing all these things unfolding with people not knowing that they're all connected, and now it's really quite refreshing to go, "Oh, I've seen that before. Oh, yeah, my goodness that was that individual now." 

So when you see someone who's gone through that, you know why that happened. But more importantly, when you see someone younger you know what you can do to help prevent those potential cycles from occurring. It's a really quite powerful stuff.

Damian: Yeah, totally. And I love that you could consider that you're looking for these sorts of signs and symptoms in somebody younger. Obviously, not everyone who's had a thyroidectomy has also had their gallbladder taken out and a hysterectomy. But that is...

Wayne: No. Not particularly.

Damian: ...definitely something that you might actually go, "Oh, I could look into that." Because people who are presenting with these sorts of symptoms and diseases could also have these concomitant disease processes also going on. And it's worth considering, of course.

And so, we are seeing a lot of people being diagnosed with thyroid disease these days. Now, I'm dubious and I'm doubtful as to whether or not the epidemic of thyroid disease is as big as what it appears to be. And I wonder whether or not that's just, you know, maybe we're barking at shadows, potentially, we could be looking at sympathetic dominance. But maybe we're looking for sympathetic dominance because we're chiropractors. 

But obviously, the SD Protocol or sympathetic dominance can be managed through multiple channels. And of course, chiropractic is part of that. How else would another practitioner come into the sympathetic dominance space? So how does a naturopath come into this sympathetic dominance space? How does a psychologist or an exercise phyiso come into this space?

Wayne: An exercise physiologist, there is particular exercises that will be really important for someone who's in a state of sympathetic dominance. For instance, we would not want them to be working on their anterior muscle groups above two, six or the upper half of their body. We really want them to be focusing on stretching those muscles in the anterior half and toning the muscles in the posterior half. And vice versa for the lower half of the body. Because we don't want to be driving that whole fight and flight posture. We want to be working on building up the extensors on the upper body and taking away from that whole fight and flight drive posture. So an exercise physiologist would have a huge part to play on the physical toning and conditioning of muscles that would take someone into that status.

From a naturopathic perspective, certainly, if we look at someone with long-standing sympathetic drive that's inhibiting that digestive system function, we've really got to try and turn that digestive system function around. Get that leaky gut membrane healed. Take the appropriate supplements and nutrients and bone broths and probiotics. Remove inflammatory foods from the diet. Help people with a diet plan to change and get rid of those inflammatory cytokines out of their diet.

Damian: Wayne, I know, having done the SD Protocol and using it in my practice, how important it is and how successful it is for my patients. And obviously, I've got a naturopath hat on as well as a chiropractic hat on, having done both of those courses in my life. But I also use the skills of integrative GP to assist me in accessing different functional tests and also to be across other disease processes that could be involved in what's actually going on. And I really, I love the whole idea of a collaborative approach to the management of these sorts of conditions. And so, where it gets too complicated for me, I will always refer out to a naturopath, and where I need further support or then I'll refer through to the integrated GPs.

And for psychological support where it's required, it's far more way outside my scope of practice, I'll refer to a psychologist or a counsellor. That's kind of where I go. And I think it's really nice for people to be mindful that we can't be all to everyone. I think it's important to understand what your skillset is, and understand where your strengths actually are. 

With regards to chiropractic, I consider that to be one of my strengths and clearly it's one of your strengths. How did you come up with, I suppose, the idea that we needed to research and look into the effect of an adjustment on this? And what area? How did you decide on that?

Wayne: Yeah, look, I guess that knowing where that sympathetic drive originates from. The sympathetic powerhouse, if you like, in the nervous system, is in the brainstem, and in the mesencephalon, particularly at the top part of the brainstem. And the primary motor neurons that reside in that mesencephalon, I call them “embryological homologues.” And so they're brothers and sisters that all formed at the same time in utero in that same location in the brainstem for one sole purpose, and that is to keep us safe and keep us protected. 

So, those embryological homologues, when one sibling gets fired up, the other gets fired up. So we have sight and sound, primary order receptor nuclei sitting there. We have red nucleus, which is a large muscle group firing to help enable us to run and fight. We have mesencephalon reticular formation, which is the bunch of neurons that fire down to our adrenal medulla and have that adrenal response. So they're all there.
So knowing that they're all housed in that one area, what do we do to help calm each one of those individuals down? It's like having that family four-wheel drive, where you've got the back of the car full of five kids, those five primary order neurons. When one gets fired up, they all get fired up. And If you can calm one down, the back of the car is a bit quieter. So we might calm down that superior colliculus, for instance, with some red lenses to help dampen that light input.

Damian: Can we stop on that for a second? Because I think this is a really important thing. And I think it's something that, as practitioners, we can intervene with immediately in our practice. It's easy to recognise that someone's been overdriven, their sympathetic nervous system has been hyper-driven because of all the screen time and just these penetrating blue light that's being thrown into our faces from the screens we're around all the time, particularly with children. How is this affecting our brain and our nervous system? What's the blue light doing to our brain and nervous system, Wayne?

Wayne: If we take ourselves really back to caveman days, I love the analogy, when we really need to be out in the normal daylight during the day. And then when that sun goes down, we should not be having any blue light impacting our system, our neurological system. So when that sun goes down in the caveman days, we would be sitting around the campfire, that red glow, and it calms the brain down, enables our pineal gland to start producing melatonin. When that sun goes down, when we've got blue light, stimulating our retina, our melanopsin receptors in our retinas are inhibiting the pineal gland from producing melatonin. 
But when the sun goes down, we're bombarded with blue light coming out of televisions, telephones, computers, laptops, LED lights, halogen lights, blue light, all around us. And then we wonder why people can't sleep because they haven't had that melatonin production occurring because we've had all this artificial blue light bombarding our nervous system.

So if we wear some red lenses, for instance, red in the evening time will...it's like putting a red filter in front of us, it makes all light coming back into that brain stem, have a red wavelength. And red is the longest, slowest, calmest wavelengths that we can have to calm that input down to our brain. So it's really blocking out that blue light in a much stronger way than blue light blockers. Blue light blockers work very, very effectively in blocking out blue light, but we still let the other 255 colours of that 256-colour spectrum into our brain stem. We put a red filter on it blocks the other wavelengths out and just allows that red, long, slow, calm wavelength. So that's one of the things that we do with the SD Protocol, is get people to wear some red lenses in the evening when they're in their lower-lit environments.

Damian: I love that.

Wayne: It's simple too.

Damian: Yeah, I love that. Wayne, just also on that. There's two things that come up for me when we talk about this. I know of some people that wear their red lenses all day. And that freaks me out that people are wearing red lenses all day. And the other thing that I find that people tend to do is put a band-aid on this whole situation, they'll screen time, screen time, screen time, screen time, and then take melatonin as the answer. That, to me, sounds like you're bringing our band-aid to a chainsaw fight. So I was just wondering if you can speak to those two little things, please.

Wayne: Yeah, absolutely. So I don't encourage red lenses during the day. During the day, if we take ourselves back to cavemen, back to basics, which is how we should interact with most things in our society and the things that impact our health, back to basics. 

So we don't want to be blocking out that blue light during the day. It's necessary to be inhibiting melatonin production during the day because we want that hit at night when the sun goes down. So the red lenses during the day, I discourage people from doing that and just get out and be active and be normal with regard to daylight during the day. And what was the other thing, Damian, you wanted me to address there? I just lost my train of thought.

Damian: Just taking melatonin as the band-aid. I think, clearly...

Wayne: Yeah, absolutely. It is. And then, certainly, you're better to take on that caveman approach. Rather than someone who's constantly stressed all the time or they're in that stressful environment at work or at home taking heaps of magnesium and taking heaps of Withania, wearing red lenses, all of those things will help, but they're not addressing the underlying cause. You need to stop juggling that chainsaw, or playing with a razor blade. They're all band-aids, they're all going to work and they're going to help change that pattern. But we also need to address the underlying primary drivers of that fight and flight response. Is it physical, chemical, or emotional?

Damian: So we'll talk about the people the kids sitting in the back of the car in that regard, just to manage whether using the red light or the red lenses, which I'd love. It's such a simple little intervention. 
There’s other parts as well that you focus on, and part of that is to lie on your back on a foam roller. And it's a principle and a practice that I've really embraced and I love it. Both Amber and I, have our foam rollers where our SD Protocol, a half foam roller, and we lie on that and stretch out our chest muscles. And we love it, like it's a really great way to kind of wind down at the end of the day. 

How does that work? Is that just by switching off those second-order neurons? Is that what we're doing there?

Wayne: Yeah, absolutely. You're putting your body into that neutral postural alignment and reducing that whole fight and flight wind up, and particularly reducing the upper back tension. It's a really excellent way of passively trying to realign that fight and flight posture back to a neutral posture. 

Doing 15 minutes twice a day is optimal, lying on a posture pole or a half foam roller. But it's also really important, throughout the day, to have your ergonomic setup as correct as it can be and then put into place mindfulness with regard to your postural pattern, bring your chest up, shoulders back, tucking your chin in. And then also, if you're doing any gym work, you want to be minimising pec decks, bench presses, push-ups, minimising all of those things that are driving your body into that whole fight and flight posture.

So the posture pole or the half foam roller is an excellent tool or strategy that can be put into place to reduce that whole physical sympathetic drive. And also I get people to do some meditation while they're on the posture pole, kill two birds with one stone, just to switch that busyness for the brain off as well.

Damian: I love that. What a great idea. Multitasking, I'm not really good at that, but that sounds like two simple things that you could easily do. So I love that. 

Now from a nutritional perspective too, Wayne, there's important things to consider. Obviously, you mentioned earlier on about an inflammatory diet, winding that back, trying to find ways in which we can manage a leaky gut sort of profile that somebody might actually have. 

But then also, some nutritionals that we might be looking to use. And in my practice, yes, we look to use nutrition where appropriate. My preference is diet first and then supplements later when we get to the supplements piece. What are the sorts of supplements? Magnesium is clearly one of those things, but what else might you consider?

Wayne: Definitely magnesium and certainly Withania. It's certainly very, very beneficial for helping to calm and normalise the adrenals. It's an adrenal adaptogen. So it works extremely well. 

But magnesium, definitely when we're under stress, we burn magnesium like it's going out of fashion, and you can't store it, either. So magnesium is certainly, certainly vital. 

For those women who have significant hormonal imbalances associated with that sympathetic drive and oestrogen dominance there are a number of other natural supplements that they can take to help reduce their relative estrogen levels. As a younger individual, chaste tree, or Vitux Angus-castus, is certainly important in helping increase that luteal phase of the cycle. For those women who are perimenopausal, seeing your functional medicine doc and getting a script with some bioidentical progesterone cream, certainly, that will help with a lot of the symptomatic outflow that occurs at the different times in those hormonal lifespans, I guess.

And taking what's appropriate for those individuals, given their age, to help create a fairly rapid symptomatic change whilst also looking at that underlying primary premise of reducing stress physically, chemically, and emotionally.

Damian: Yeah, I love that. And now, Wayne, as a naturopath, I practised for a number of years as a naturopath, over a decade actually, just solely as a naturopath, and then have gone on to then practice as a chiropractor. I used to...and, I love naturopathy, and I found myself often being challenged by compliance. I found myself concerned that I wanted people to get healthier than what they wanted to get. And so, I would make these recommendations for people and people would often find it difficult because it was...sometimes it was slow to see change. 

In managing sympathetic dominance, because people's symptom picture is so profound, when they make these changes, it appears that the results, the symptom reduction is quite significant and quite rapid. What's the process and what's the timeline for somebody following this process? How long does it actually take for someone to notice that something's actually going on and changing?

Wayne: Yeah, good question. I guess that's always an individual outcome. But I would have to say, for those that embrace and understand the whole concept, and I've found that those individuals are the ones that have read my book that I've written and they understand it, and they want to do the protocol, rather than me telling them, "You need to take this supplement. Do this exercise. Do that." The compliance rate when you tell us on what to do is relatively low compared to someone who's eagerly trying to change things themselves once they understand that concept.

So I've had situations where I've been looking after people for sometimes a month, on a regular basis, and I walk in the room and I put my hand out and say, "Hi, I don't think we've met before." And I've seen them several times over the preceding month.

Damian: That's embarrassing, Wayne.

Wayne: And the first time that happened I thought I was definitely losing the plot, and I was definitely developing Alzheimer's. And I said to the individuals, and this has happened multiple times they’ve said, "No, no, don't worry, my friends walk past me in the street, they don't recognise me anymore. And I don't recognise me in the mirror anymore because I look totally different." Their whole aura changes, they look well.

Damian: Isn't that exciting?

Wayne: It's pretty cool stuff.

Damian: That's so cool. And I just know that as people are listening to this and the thousands of practitioners that listen to this particular podcast right now, they're probably going, "Oh, I want that for my patients too." And every time you listen to...or every time I listen to you, Wayne, speak I think about, "Ah, there's Mrs. such and such, or there's Mr. such and such, or there's the kid of such and such." I'm thinking about the people that would benefit from this sort of intervention and I love it. So having these sorts of chats, Wayne, I love it, I really welcome it. I'm so grateful that we've had the opportunity to talk again about this. 

When people want to learn more about the SD Protocol with you, I'll send them to sdprotocol.com. But in the past, pre-COVID, we used to do classes, and lessons, and seminars, with you, how are you managing that these days?

Wayne: Even better. So we have online modules for practitioners to do the online practitioner SD training. And so they could leave it at that during the online training, which is equivalent of four days of individual work-shopping.

Damian: Wow. And so would that be all CPD for practitioners?

Wayne: Yes. Yes, CPD for all of that as well. And there's a series of...there's about 85 videos throughout that training, there's quizzes, etc. So at the end of it, you should be fairly comfortable with the theory of sympathetic dominance. 

And then we have a one-day virtual workshop, so that can be done from your own home as well for any practitioner. And that is really going through the nitty-gritty of how to implement it into practice, how to answer those difficult questions, and how to look at it from many different sides of the triangle, no matter what style of practice you're running and what type of practitioner you are. So we have that one-day virtual workshop to finish off the online theory training.

Damian: Wayne, I want to thank you again. I know you're up in Darwin in the Northern Territory. And I'm very jealous of where you are right now, given that I'm in Victoria and still in lockdown. But you're doing great things around the world. And I want to thank you for all the great work that you continue to do and the message that you're spreading. I know that the people that listen to this podcast will have got a lot from it. And thanks so much for joining us today.

Wayne: Thank you, Damian. You're more than welcome. And also thank you and appreciate the work that you're doing and helping change people's lives, and it's what we can take to our graves with us that we, hopefully, will have helped at least one person. And see their aha-moment and turn them around.

Damian: Yeah, absolutely. Thanks so much, Wayne, catch you soon.

Wayne: Appreciate it, Damian. Bye-bye.

Damian: Thanks, everyone, for listening today. Don't forget that you can find all the show notes, transcripts, and other resources on the FX Medicine website. I'm Dr Damian Kristof, and thanks for joining us.

Resources discussed in this episode

The SD Protocol website
Free first chapter of the book SD Protocol
Posture Pole
Red Lenses






If Dr Todd's work resonates with you and you’d like to extend your knowledge about the SD Protocol, he has offered an excellent discount to his online practitioner training for FX Medicine listeners (normally $995 to $795).  Use the discount code FX MEDICINE DISCOUNT.

About Dr Wayne Todd


Dr. Wayne Todd graduated from RMIT University in 1988 with the prize for clinical excellence in his final year. Since then he has completed numerous postgraduate courses, including the two-year Carrick Functional Neurology Program, and has mentored clinical placement students for more than thirty years. In 2004, he became a Diplomate of the American Chiropractic Neurology Board.

Dr. Wayne Todd is currently the clinical director of twenty-one Practices, having amassed more than thirty years of busy clinical practice. Over this time, he has observed a disturbing trend: demanding or stressful lifestyles can activate the survival mechanism in the brain and keep it activated for extended periods of time. He has discovered similarities with the symptoms of people who stay in that wound-up zone and has developed a highly effective protocol to reduce these symptoms.

Dr. Wayne works on the physical, chemical and emotional sides of the health triangle, enlisting techniques that target specific areas of stressful wind-up in order to calm the whole system down and return it to a state of rest and repair. This is called the Sympathetic Dominance Protocol and is the topic of his Best Selling book The SD Protocol. The SD Protocol simplifies the complex interactions between the survival mechanisms of the brain and the physiological, chemical and emotional wellbeing of the patient. It presents linkages between seemingly random symptoms, giving simple tools to recovery.

Dr. Wayne has lectured on the SD protocol for various groups, including professionals and lay-people and also Fortune 500 companies around the world.


The information provided on FX Medicine is for educational and informational purposes only. The information provided on this site is not, nor is it intended to be, a substitute for professional advice or care. Please seek the advice of a qualified health care professional in the event something you have read here raises questions or concerns regarding your health.

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