Introduction

Dr. Scott Sherr is a board-certified internal medicine physician who specializes in health optimization medicine and hyperbaric oxygen therapy. He's also the COO of Troscriptions, a company that develops pharmaceutical-grade precision-dosed formulas for energy, focus, sleep, and stress. In this episode, he joins me to talk about something I think every single one of my listeners needs to hear — the sympathetic spiral, why so many of us are stuck in it without even realizing it, and what we can actually do to get out.

Episode Highlights

The Sympathetic Spiral of Doom

Dr. Sherr breaks down what he calls the sympathetic spiral — a self-reinforcing cycle of chronic fight-or-flight activation that most people don't even realize they're in. The key insight here is that you don't have to feel stressed to be stuck in sympathetic dominance.

• Your sympathetic nervous system (fight-or-flight) is supposed to activate in short bursts — not run constantly in the background
• Modern stressors like notifications, traffic, chronic illness, and even doom-scrolling keep the system perpetually "on"
• Common symptoms include wired-but-tired feeling, unstable mood, poor sleep, slower recovery, and increased anxiety or depression
• Many high achievers are running on sympathetic overdrive and mistake it for productivity or motivation
• The goal is to develop the "parasympathetic edge" — a state where you can mount a stress response and then come back down with resilience

Mitochondria and the Energy-Anxiety Loop

Dr. Sherr explains that the sympathetic spiral isn't just about stress — it's deeply tied to cellular energy production. When the mitochondria can't keep up with the body's energy demands, a vicious loop forms between low energy and high anxiety.

• Mitochondria are the parts of your cells that produce ATP (your energy currency) — highest concentrations are in reproductive organs, the brain, heart, and liver
• Chronic sympathetic activation puts enormous demand on mitochondria, eventually depleting their capacity
• Other mitochondrial stressors include insulin resistance, toxins, infections, medications, and hormone changes (especially low estrogen during perimenopause)
• 94% of U.S. adults have some level of mitochondrial dysfunction
• The result is an energy-anxiety loop: low cellular energy triggers more stress signaling, which further depletes energy

Methylene Blue — What It Is and Why It's Having a Moment

Dr. Sherr gives a full breakdown of methylene blue — one of the most talked-about compounds in the biohacking and functional medicine world right now. He explains its history, how it works, and why it's particularly useful as a bridge for people stuck in the spiral.

• Methylene blue is the first fully synthetic drug ever registered with the FDA (1897) — originally developed in the 1870s as a textile dye
• Between 1897 and 1950, it was the leading antimicrobial agent; first antipsychotics were also derived from it
• At low doses (4–25 mg), it supports mitochondrial function by enhancing ATP production and acting as an antioxidant — more like an electric car than a gas-powered one
• It's a monoamine oxidase inhibitor in a dose-dependent way, meaning it can increase serotonin, norepinephrine, and dopamine
• Dr. Sherr describes it as a "bridge" — especially useful for getting people over the energy humps that have made it hard to tolerate other interventions
• It works best when you support cellular energy first, then address the nervous system — this sequencing helps avoid the reactive anxiety that can happen when you "hit the brakes" too fast

Sourcing, Safety, and Contraindications for Methylene Blue

This is the part most people skip, and Dr. Sherr is very clear: not all methylene blue is created equal, and there are real contraindications you need to know about before trying it.

• Methylene blue is synthetic and manufactured in labs — during production, it's commonly contaminated with heavy metals like lead, mercury, cadmium, and arsenic
• Liquid forms are often the worst for purity and potency — many products are about half the labeled dose
• Methylene blue is NOT manufactured in the United States — if a product claims that, it was likely bottled here but made elsewhere
• Always buy from a company that independently retests raw ingredients with a U.S.-based lab, not just relying on the manufacturer's certificate of analysis
• Do not buy supplements (especially methylene blue) from Amazon
• Do not use if you are pregnant or breastfeeding, on dialysis or have kidney failure, on SSRIs or SNRIs without practitioner guidance, or if you have hypertension or are on blood pressure medications (use with caution)
• Serotonin syndrome has not been documented with oral methylene blue, but working with a practitioner is recommended if you're on serotonergic medications
• Some people experience a detox reaction when starting — this is the system recalibrating and usually resolves within a couple of days
• Practical tip: buffered vitamin C removes methylene blue stains from surfaces and clothing

Supporting the GABA System to Calm Anxiety Without Sedation

Once you've supported cellular energy, the next step is giving the nervous system the tools to actually downshift. Dr. Sherr explains how the GABA system works and what he uses to support it without the downsides of alcohol, benzodiazepines, or sleep medications.

• Glutamate (excitatory) and GABA (inhibitory) make up about 80% of the brain's neurotransmission — they need to be in balance
• Glutamate converts to GABA with the help of magnesium and vitamin B6 — deficiencies in either make anxiety and sleep problems worse
• GABA deficiency is extremely common and linked to anxiety, depression, insomnia, tremors, and other mental health issues
• GABA as a supplement is too large a molecule to cross the blood-brain barrier on its own — if it works for you, that may indicate a leaky brain barrier (which is often tied to leaky gut)
• B3-GABA (niacin-bound GABA) crosses into the brain more easily and is more effective
• Troscriptions' Trocalm formula combines B3-GABA, kava, CBD, and CBG to provide anxiety relief without depleting energy — giving people the actual experience of the parasympathetic state

Sleep as a Full-Day Practice

When asked for the one lifestyle step every listener should be focused on, Dr. Sherr's answer was sleep — but not in the way most people think about it. Sleep isn't just what happens at night; it's a process that starts the moment you wake up.

• "Your day doesn't start when you wake up — your day starts when you go to bed" — reframing sleep as the first thing you do rather than the last changes how seriously you take it
• Sleep quality is shaped throughout the day by light exposure, stress load, nutrition, and timing — not just your bedtime routine
• Dr. Sherr targets five different systems for sleep support: GABA, melatonin, serotonin, endocannabinoid, and adenosine
• His sleep formula includes compounds like magnolia bark (Honokiol), agarin from Amanita muscaria mushroom (non-psychoactive at low doses), and trozy to address all five systems
• When someone is deep in the sympathetic spiral, Dr. Sherr sometimes starts with sleep support before anything else — because without sleep, nothing else works as well

Immune Support, Cordycepin, and the Short/Medium/Long-Term Plan

Dr. Sherr wraps the clinical picture together by addressing immune resilience and giving a framework for how to layer these interventions over time — not just as a one-size-fits-all approach, but in a sequenced, sustainable way.

• Chronic sympathetic dominance hammers the immune system — if you're catching every bug that goes around, your stress load is likely a contributing factor
• Cordycepin (from cordyceps mushroom) is about 100x more potent as an antiviral, antimicrobial, and anti-inflammatory than standard cordyceps extract — it also supports deep sleep
• Methylene blue can also be used in detox protocols because it supports the cellular energy needed to sustain a detox process without crashing
• Short-term: give the body bridges (like methylene blue) to get over the biggest energy and anxiety bottlenecks fast
• Medium-term: support the GABA system and immune resilience
• Long-term: optimize sleep, gut health, and overall lifestyle — these are what sustain the parasympathetic edge over time

Notable Quotes from this Episode

You need energy to have less anxiety. That's what I've solidified on this podcast.
Dr. Scott Sherr

Your day doesn't start when you wake up — your day starts when you go to bed.
Dr. Scott Sherr

When you're more rested and more parasympathetic more of the time, you're going to show up and do better than you think you are. People think that you need to be in sympathetic dominance to get everything done. But the highest performers in the world — they're not in sympathetic when they're doing their highest performance. They're in flow. And flow is parasympathetic.
Dr. Scott Sherr

We have so many people who have just become used to their baseline — that's just how it is. So you don't have to be aware of feeling stressed to be in this state.
Julie Howton