Ep. 19: Do This Daily for Your Heart Health: Laugh Your Heart Out! — with Dr. Sam Shay, DC, IFMCP

What if one of the most effective daily prescriptions for your heart is laughter? In this ‘fun Friday’ conversation, Dr. Regina Druz is joined by Dr. Sam Shay — a functional medicine practitioner who is also a professional stand-up comic — to explore the real science of therapeutic humor. They discuss how laughter pulls us out of the chronic fight-or-flight state that fuels high blood pressure, the research linking laughter to better cardiovascular health and arterial function, and how much you actually need (hint: about 10–15 minutes a day). Dr. Shay, who lives with Asperger’s and built his social skills ‘algorithmically,’ reframes humor as a mindset and a vector for truth — then turns to his Neuro-Harmony Model, the surprising placebo power of simply liking your doctor, and why taking both humor and heredity seriously can change your health.

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Episode Chapters

[00:00] Introduction & Meet Dr. Sam Shay
[01:05] Tragedy to Comedy: A Family History of Heart Disease
[03:56] Therapeutic Humor & “NeuroSpicy”
[07:42] Why Laughter Calms the Stress Response
[11:24] The Science: Laughter & Cardiovascular Disease
[17:37] Therapeutic vs. Spontaneous Laughter: How Much?
[22:00] Humor Is a Mindset
[28:28] The Neuro-Harmony Model: Uniting Mind & Body
[31:31] Humor as a Vector for Truth in Practice
[32:30] The Placebo Effect & the Likable Doctor
[38:00] Telling the Patient’s Story — Concisely
[47:30] Take Humor (and Heredity) Seriously + For Clinicians

Transcript

[00:00] Introduction & Meet Dr. Sam Shay

Dr. Regina Druz (00:02): Welcome to Own Your Heart Health. I’m Dr. Regina Druz, your holistic cardiologist. This week we’ll dive into common heart health concerns, uncovering root causes and unpacking scientific discoveries and controversies. The information provided does not constitute medical advice. Please contact your healthcare practitioner before making any changes that may impact your health.

Dr. Regina Druz (00:35): Hi everybody — we have a tremendous treat today. It’s Friday, and Friday is fun day, so my fun-day guest is the extraordinary Dr. Sam Shay. You may not know it, but Sam is a stand-up comic in addition to being a star functional medicine practitioner, and his particular area of interest is how humor can positively impact our heart health and chronic disease in general. Welcome, Sam.

[01:05] Tragedy to Comedy: A Family History of Heart Disease

Dr. Sam Shay (01:05): Thank you — I appreciate being here. I came to stand-up comedy the usual way: through tragedy, which is, tragically, the trope for most comics. Heart disease meaningfully shaped my family for generations. I never knew my grandfather on my father’s side; he was a famous gastroenterologist — founding director of a cancer research center — and he died on the operating table in 1965, because back then they thought his angina and leg pain came from an inflamed gallbladder. They operated on the gallbladder, and the coroner told my father his carotid artery was so clogged you couldn’t fit a pin through it.

Dr. Sam Shay (02:30): My mother, also a physician, nearly died from an aortic aneurysm over a decade ago — she felt the tearing chest pain, called my brother-in-law, a stroke doctor, who told her to get to the hospital immediately. She was in Boston, near arguably the top team for that emergency, and even so the survival rate was about 50%; she was in the lucky half. And my father currently has carotid artery disease. So your podcast topic is of deep, personal interest to me — and the convergence with humor is that laughter really is some of the best medicine.

[03:56] Therapeutic Humor & “NeuroSpicy”

Dr. Sam Shay (03:56): There’s an American Academy of Therapeutic Humor that’s been around about 30 years — Patch Adams spoke there in the ’90s — and I just keynoted there, performing my one-hour comedy show, NeuroSpicy: Love, Life, and Comedy on the Spectrum. It’s about living with Asperger’s: I wasn’t born with ‘social software,’ so what comes to most people intuitively, I had to build algorithmically, one pattern at a time. My theory is that it takes until roughly 40 for someone on the spectrum to reach social parity — but if we keep adding pattern recognition past 40, we can become some of the most socially astute people, because we read everything as data.

Dr. Sam Shay (05:46): Humor turned out to be one of the most effective vectors for connection — and for truth. As someone on the spectrum I find it bizarre that people lie, and I had to learn the hard way that not everyone wants the truth air-blasted at them in a five-paragraph essay with citations (or a two-minute tangent on dragonflies, however cool they are). But generating laughter has its own honesty and integrity — and it turns out it’s really good for you. That’s what the Academy has worked to legitimize: the science of laughter therapy, rather than being dismissed as ‘not a real doctor, just telling jokes.’

[07:42] Why Laughter Calms the Stress Response

Dr. Regina Druz (07:42): Hi everyone, it’s Dr. Regina here. I know there are contradictory opinions about nutrition for heart health and longevity — the discussion gets heated and confusing. Some push low-fat, low-cholesterol; others are fans of a ketogenic diet; and there are many voices urging vegan or vegetarian eating. To cut through the clutter, my team and I created Holistic Heart University: on-demand courses, nutrition and lifestyle resources, and supplement guidance to make healthy choices for your heart easier to understand. I’m especially proud of our open office hours and the Q&A feature where you can put us in the hot seat. Head to the show notes for the link and use promo code OWNER20 for 20% off our annual subscription. I’ll see you in office hours.

Dr. Regina Druz (08:30): Let me set up why this matters. What I see constantly in cardiac patients — and in myself — is being stuck in perpetual sympathetic activation: heart rate up, blood pressure up, always ‘on.’ There was even a recent article urging clinicians to consider hypercortisolism and rule out Cushing syndrome. But outside of true Cushing’s, this constant sympathetic arousal and anxiety is very much tied to hypertension, tachycardia, and dizziness — and I’ve met many patients whose blood pressure won’t budge until that sympathetic arousal is switched off. What have you found?

[11:24] The Science: Laughter & Cardiovascular Disease

Dr. Sam Shay (11:24): There’s experience and there’s research. One study — ‘Laughter is the Best Medicine,’ a cross-sectional study of cardiovascular disease in older Japanese adults, in the Journal of Epidemiology — found that people who laugh have a lower prevalence of cardiovascular disease, not explained by confounders like depression. So laughter was uniquely the thing. The mechanism is that laughter pulls people out of the sympathetic nervous system and the stress response — you can see it in real time.

Dr. Sam Shay (12:42): Here’s a comedy-writing secret that explains why: never write for funny — write for truth. You find the funny in the truth, never the truth in the funny. You laugh hardest when a comic names something true that’s been unspoken — the thing lingering in the air that everyone’s too embarrassed to say. The moment it’s named, people laugh and the emotional temperature instantly drops; the anxiety of ‘do they see it too?’ dissolves, and the laughter signals social acceptance: we don’t have to hide, we can handle this. That’s how humor dials down personal and social stress.

Dr. Sam Shay (15:06): Is it as good alone as in a group? You’ll still get the benefit watching comedy by yourself — your personal stress response drops — but it’s more effective in a group, especially when the joke is about the very thing the group is stressed about. And it’s not only the Japanese data: the University of Maryland Medical Center has studied comedy films and improved arterial flexibility and blood flow after laughter, UT Austin has compared comedy versus documentary and shown immediate improvements in artery function, and Harvard Health Publishing and Beth Israel Deaconess have gathered more.

[17:37] Therapeutic vs. Spontaneous Laughter: How Much?

Dr. Sam Shay (17:37): So how is therapeutic laughter different from everyday laughter — and is there a dose? The difference is intention: one’s spontaneous, one’s deliberate, like being told to drink more water when you’re chronically dehydrated. Therapeutic laughter is the intentional incorporation of laughter as a daily practice — laughter yoga, a five- or thirty-minute comedy block, whatever the protocol.

Dr. Sam Shay (19:30): As for how much: it depends on the study. One had people watch two-hour comedy sessions twice a week for 12 weeks, with measurable improvements in heart function and lower inflammatory markers; another used a weekly stand-up session for four weeks. The general recommendation that emerges — echoed by sources like the Department of Veterans Affairs on the healing benefits of humor — is about 10 to 15 minutes a day.

[22:00] Humor Is a Mindset

Dr. Sam Shay (22:00): Are certified humor therapists just stand-up comics? No. If I taught their program, I’d have everyone do a five-minute set a year — but the point isn’t to memorize a ‘tight five’ to repeat to every patient. The point is that being funny is a mindset: the ability to see the humor in any situation. There’s even a philosophy you can lean on when your nervous system is overwhelmed — ‘nothing bad has ever happened; it’s just more material.’ I say that tongue-in-cheek, though, because the best humor doesn’t minimize hard things.

Dr. Sam Shay (25:17): After 9/11, much of the nation came to terms with the tragedy through late-night comedy. Jon Stewart’s opening monologue was arguably one of the most important few minutes ever produced about that moment — and that’s coming from a comedian. The best humor maintains the gravitas of a situation while pointing out perspectives that are true and palatable, so people walk away more resilient — better able to spot a bad situation, resolve what’s happening inside them, or mourn through laughter and resolve to move forward. Comics like Daniel Sloss do this with very dark material, like the death of his sister.

[28:28] The Neuro-Harmony Model: Uniting Mind & Body

Dr. Sam Shay (28:28): You’ve brought this sensibility into your practice — tell us about the Neuro-Harmony Model. It’s an updated mind-body model where the connection between mind and body is chemistry. Is a neurotransmitter or amino acid physical or mental? You can’t hold a mitochondrion in your hand, yet it’s there. What’s been missing to truly optimize mind and body is lab testing — that’s the junction point that unites them.

Dr. Sam Shay (29:53): I practice functional medicine: the best of Western diagnostics with the best of natural-medicine lifestyle, diet, and nutrition. We use sophisticated testing for genetics, mitochondria, hormones, hidden gut infections, mold, metals, toxins, fatty acids, vitamins, and minerals — looking from the inside out — then combine it with lifestyle analysis from the outside in. That’s the harmonic model, and it’s what moves people from chronic to normal, and normal to optimal. What it doesn’t do is take someone from crisis to stable — that’s emergency medicine; different tools for a different part of the sandbox.

[31:31] Humor as a Vector for Truth in Practice

Dr. Sam Shay (31:31): How does humor factor into the advice you give patients — do you prescribe laughing five times a day?

Dr. Sam Shay (32:00): With my dry delivery, in the most serious manner possible: you are to laugh five times; one second under and you fail. But really, the laughter isn’t the primary thing — rapport is. I’ll give an example: I analyze genetics, and some people won the ‘crappy gene Olympics’ like me. When someone’s report isn’t good, I won’t lie — I have Asperger’s, lying isn’t my thing — but I’ll say, ‘You’re in good company; I’m a silver medalist. Here, look at mine.’ That keeps them from careening into nihilistic fatalism over a sea of red dots. And in the reverse case — great genetics but poor health — I deliver a sandwich: good news, your genetics are excellent; bad news, your poor health is on you; more good news, you can’t blame your parents, so you have full power to turn it around. They laugh hardest at ‘you can’t blame your parents’ — and they get the message. Genes are probabilistic, not deterministic.

[32:30] The Placebo Effect & the Likable Doctor

Dr. Sam Shay (32:30): I got serious about comedy in 2019 after reading an article on the placebo effect, which at its core is how much you like and trust your doctor. If you’re not likable, you’ll get worse outcomes — because every time a patient thinks about you or your recommendation, they have a small cortisol stress response, and their results hit a cortisol-tinged glass ceiling. I’ve met profoundly mediocre clinicians who get disproportionately wonderful results, and they all share one thing: they’re incredibly likable. The reverse is also true — brilliant clinicians whose protocols glow with genius, who don’t get the results they should because they have the personality of a doorstop. So I decided it was a clinical imperative to become more likable, and that week I signed up for stand-up and improv classes.

Dr. Regina Druz (36:00): Hi everyone, it’s Dr. Regina here. Many of my colleagues and I are seeing patients arrive with self-ordered blood tests. When this trend started, I thought it would help — who doesn’t want more access to their health data? But too often self-ordered labs lead to more confusion and frustration: patients come in with a pile of results and are no better off. That’s why we created HeartWell Toolkits — a curated collection of at-home blood and genetic markers focused on heart and brain health that gives you the data you need to make informed, actionable decisions. You can order them at the shop on holisticheartcenters.com — the link is in the show notes. Use code TESTING10 for 10% off and free shipping.

[38:00] Telling the Patient’s Story — Concisely

Dr. Sam Shay (38:00): In functional medicine, a foundational skill is telling a patient’s story back to them — the same story, now seen through the lens of antecedents, triggers, and mediators. How does comedy help? Stand-up is about 30% writing, 30% performance, and 30% listening — reading the room. Sometimes humor is exactly right; other times someone is so distraught that lightness would trivialize them, so you don’t. But the deeper gift comedy gives is concision: good writing is saying things as concisely as possible. If you can re-articulate someone’s history and problem more succinctly than they can, that’s when rapport is built, the sympathetic system relaxes, and their ears and mind open.

Dr. Regina Druz (40:30): When I wrote my 60-minute special, I generated hundreds of minutes of material and pared it down to the essential. That same discipline — paring down, paring down — is what lets you reflect a patient’s story back with what I’d call serious whimsy: the outside-in lifestyle analysis and the inside-out lab analysis, delivered with warmth and a light touch.

[47:30] Take Humor (and Heredity) Seriously + For Clinicians

Dr. Sam Shay (47:30): Any closing pearls? First: take humor seriously — it’s one of the few unambiguous positives in life, so intentionally build it into your day, especially if you’re concerned about your heart. Second: if you’re worried about cardiovascular health, work under a qualified practitioner who can prioritize your lifestyle, labs, or ideally both. And third: if you’re starting with one investment, consider a really good genetics test — the data doesn’t decay, so amortized over decades it’s effectively nothing. For the heart, the top genes to look at aren’t the blood-pressure genes; they’re the pro-inflammatory genes, the vitamin D receptor, and — as you’d add — endothelial-function genes, which are highly prevalent.

Dr. Regina Druz (50:14): Beautifully put. We do medical-grade genetics on essentially every patient at Holistic Heart Centers, and it’s been an eye-opener — because not all genetic tests are created equal, and direct-to-consumer kits often aren’t built to give the insights people are looking for. So take humor seriously, and take heredity seriously, and work with qualified people — that should get us to a good place. Sam, this was awesome. Where can people find your comedy?

Dr. Sam Shay (51:52): Just put my name — Dr. Sam Shay — into any podcast player, and you’ll find me. The links will be in the show notes so you can get your daily dose of humor for your heart.

Dr. Regina Druz (52:09): To the professionals listening: if you’re thinking of launching a cardiometabolic or integrative cardiology program in your practice, we can help. Holistic Heart Centers helps physicians expand into hybrid or concierge services — head to the show notes and click the application link; your intro call is entirely free. Ready to schedule a practice review? Use code DOC10 for 10% off our Practice Power Hour, a 60-minute coaching session. Thank you for tuning in to Own Your Heart Health with Dr. Regina Druz. This podcast is powered by Holistic Heart Centers. If you enjoyed the show, please rate and review us on your favorite platform, and visit holisticheartcenters.com and subscribe to our YouTube channel. See you next week.

Frequently Asked Questions

Can laughter really improve heart health?

There’s a real and growing evidence base, according to Dr. Shay. He cites a cross-sectional study of older Japanese adults (Journal of Epidemiology) showing that people who laugh more had a lower prevalence of cardiovascular disease, an association not explained by confounders like depression. He also points to work from the University of Maryland Medical Center on improved arterial flexibility and blood flow after laughter, comparisons at UT Austin of comedy versus documentary showing immediate gains in artery function, and resources from Harvard Health Publishing and Beth Israel Deaconess. The proposed mechanism is that laughter pulls you out of the sympathetic ‘fight-or-flight’ state that drives high blood pressure and inflammation. Dr. Druz adds that many patients’ blood pressure won’t improve until that chronic sympathetic arousal is calmed. This is educational information, not a substitute for medical care — laughter complements, but doesn’t replace, treatment for heart disease.

How much laughter do you need to get a benefit?

It varies by study, but the general recommendation Dr. Shay lands on is about 10 to 15 minutes of intentional laughter per day. He notes research using larger ‘doses’ — for example, two-hour comedy sessions twice a week for 12 weeks, which produced measurable improvements in heart function and lower inflammatory markers, and weekly stand-up sessions over four weeks. Even laughing alone (say, watching comedy) lowers your personal stress response, though he believes it’s more effective in a group — especially when the humor is about the very thing the group is stressed about. The key distinction is intention: therapeutic laughter is a deliberate daily practice, much like being prescribed to drink more water when you’re chronically dehydrated. As always, build new habits in the context of your overall care plan with a qualified clinician.

What’s the difference between therapeutic and spontaneous laughter?

Spontaneous laughter happens on its own; therapeutic laughter is the intentional, structured incorporation of humor into daily life — through laughter yoga, scheduled comedy, or similar protocols. But Dr. Shay’s deeper point is that humor is a mindset, not a memorized set of jokes: the ability to find the truth (and then the funny) in any situation. The best therapeutic humor doesn’t trivialize hard experiences — it faces difficult, even tragic topics head-on while offering true, palatable perspectives, helping people feel more resilient or mourn through laughter. He illustrates with Jon Stewart’s post-9/11 monologue and comedians who address very dark material. So therapeutic laughter is less about forcing a chuckle and more about cultivating a durable, truth-seeking, lighter relationship with life’s stressors — which in turn calms the nervous system.

Why does it matter whether you like your doctor?

Because of the placebo effect, which Dr. Shay describes as, at its core, how much you like and trust your clinician. If a patient doesn’t like their doctor, every time they think about that doctor or a recommendation, they may have a small cortisol stress response — and their results can hit what he calls a ‘cortisol-tinged glass ceiling.’ He’s observed that some merely average clinicians get outsized positive results largely because they’re highly likable, while some brilliant ones underperform because of poor rapport. That’s why he took up stand-up comedy in the first place — to become more likable and a better communicator — and why he emphasizes rapport and concisely reflecting a patient’s story back to them. The takeaway for patients is to seek clinicians they genuinely connect with, and for clinicians, that warmth and communication are part of effective care. This is general insight, not medical advice.

Show Notes & Resources

Guest: Dr. Sam Shay, DC, IFMCP

Dr. Sam Shay is a functional medicine practitioner with more than two decades of experience specializing in genetics-based, personalized health — and a professional stand-up comic. He is the founder of the DNA Decoded genetics program and the Neuro-Harmony Model, which unites mind and body through functional lab testing and genetic analysis. Living with Asperger’s, he advocates for neurodiversity through his one-hour comedy special, ‘NeuroSpicy: Love, Life, & Comedy on the Spectrum,’ and was the 2025 keynote speaker at the American Academy of Therapeutic Humor.

Dr. Sam Shay: drsamshay.com
Free genetics eBook: drsamshay.com/genetics

Resources Mentioned in This Episode

Dr. Sam Shay — functional medicine, the DNA Decoded genetics program, and the Neuro-Harmony Model (drsamshay.com); search ‘Dr. Sam Shay’ on any podcast player for his comedy and interviews
NeuroSpicy: Love, Life, & Comedy on the Spectrum — Dr. Shay’s one-hour comedy special
Free genetics eBook — drsamshay.com/genetics
American Academy of Therapeutic Humor (AATH) — the organization working to legitimize laughter therapy (Dr. Shay was its 2025 keynote)
‘Laughter is the Best Medicine’ — cross-sectional study of laughter and cardiovascular disease in older Japanese adults (Journal of Epidemiology)
University of Maryland Medical Center & UT Austin — studies on comedy, arterial flexibility, blood flow, and artery function
Harvard Health Publishing / Beth Israel Deaconess Medical Center — resources on laughter and health
Comedians referenced — Jon Stewart’s post-9/11 monologue; Daniel Sloss
Holistic Heart University — on-demand courses and resources (use code OWNER20 for 20% off annual)
HeartWell Toolkits — at-home heart and brain health lab panels (use code TESTING10 for 10% off and free shipping)
For clinicians: Practice Power Hour coaching with Holistic Heart Centers (use code DOC10 for 10% off)

Holistic Heart Centers

holisticheartcenters.com
HeartWell.ai — AI-powered cardiovascular risk assessment
Address: 55 Bryant Avenue, Suite #6, Roslyn, NY 11576
Phone: 877-511-5166
YouTube: @reginadruzmd
Instagram: @dr.reginadruz
Podcast: Own Your Heart Health — available on Apple Podcasts, Spotify, and all major platforms

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