Episode 263: Your Symptoms Are Real—Even When Medicine Doesn’t Have The Answers [featuring Dr. Zachary Spiritos]
What happens when neurodivergent burnout, chronic illness, stress, and medical trauma all start colliding?
Patrick Casale sits down with Dr. Zachary Spiritos for an in-depth conversation about complex chronic illness and why conditions like POTS, dysautonomia, ME/CFS, mast cell activation, hypermobility, and unexplained GI symptoms can be so difficult to navigate.
They explore the potential roles of stress, trauma, environmental exposures, illness, and nervous system dysregulation—and why so many Autistic and ADHD people find themselves struggling with both neurological burnout and worsening physical symptoms at the same time.
Dr. Spiritos also shares a more realistic approach to navigating complex illness: stop expecting everything to be solved in one appointment. Instead, identify what is affecting your life most, understand your triggers, find providers who take your experience seriously, and start accumulating small wins.
3 Key Takeaways:
- Stress and trauma aren't “just in your head.” Dr. Spiritos explains how stress can interact with neurological and immunological processes, and why trauma and medical PTSD can add another layer of complexity when someone is already chronically ill.
- You don't have to solve everything at once. When symptoms include fatigue, pain, brain fog, food intolerances, insomnia, GI problems, and more, trying to tackle everything simultaneously can become overwhelming. Start with what's affecting you most and build from there.
- Being believed matters. A provider doesn't need to have every answer to make a difference. Finding someone who listens, understands complex chronic illness, helps you make sense of your symptoms, and works collaboratively with you can be incredibly valuable.
Disclaimer: This episode discusses medical conditions, symptoms, and approaches to care based on the conversation and should not be treated as individualized medical advice.
More about Zachary:
Dr. Zachary Spiritos, MD, MPH, is a neurogastroenterologist who specializes in treating patients with complex and chronic conditions, including disorders of the brain-gut interaction (DBGI), postural orthostatic tachycardia syndrome (POTS), mast cell activation syndrome (MCAS), Ehlers-Danlos syndrome (EDS), and gastrointestinal dysmotility.
He earned both his medical degree and Master of Public Health (MPH) from the University of North Carolina at Chapel Hill, where he developed a passion for addressing the systemic challenges faced by patients with underrecognized illnesses. He completed his residency in Internal Medicine at Emory University and went on to complete his fellowship in Gastroenterology at Duke University, where he focused on neurogastroenterology and disorders of gut-brain interaction.
Dr. Spiritos is particularly dedicated to supporting patients who have been dismissed, misdiagnosed, or lost in the medical system. He takes a whole-person approach to care, combining the best of conventional medicine with targeted interventions aimed at regulating the nervous system, improving sleep and movement patterns, addressing nutritional imbalances, and managing stress physiology.
He works primarily with patients whose symptoms span multiple systems and don’t fit neatly into one diagnosis—individuals who require time, nuance, and interdisciplinary collaboration. Dr. Spiritos partners closely with his patients to build individualized, sustainable care plans that address both symptoms and root causes—helping them reclaim their health and quality of life.
- Practice website: https://everbettermedicine.health
- Instagram: @drzacspiritos
- TikTok: @dr.zac.spiritos
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Mentioned in this episode:
The Receptionist for iPad
The Receptionist for iPad is a HIPAA-ready digital check-in system that eliminates the need to walk back and forth from your office to the waiting room to see if your next appointment has arrived. Clients or patients can check in for their appointments, and you'll be immediately notified by text, email, or your preferred channel. Break free from interruptions and make the most of your time, because it is valuable. Start a free 14-day trial of the Receptionist for iPad by going to https://thereceptionist.com/privatepractice. Make sure to start your trial with that link to get your first month free if you decide to sign up.
