0:00

one of the most important things that women can do

0:02

for our own health, which is keep our blood sugar

0:04

steady. And so it's not

0:06

just what we're eating, but making

0:08

sure that we are really getting

0:10

an adequate distribution

0:13

and a good distribution of

0:15

what are called macronutrients, so

0:17

protein fats and carbs. And

0:19

our culture tends to lean into

0:22

either overeating protein, you know, a

0:24

32 ounce porter steak is not

0:26

a healthy dose of protein, any

0:28

more than like only eating carbs

0:30

is, right? And our diet tends

0:32

to lean either inappropriately heavy, really

0:35

pro-inflammatory protein, or really heavy carbs,

0:37

or typically a combination of both,

0:39

rather than kind of a steady

0:41

state of getting enough protein, getting

0:43

good quality protein, getting good quality

0:46

fat. And if you're going to eat

0:48

some carbs, paying attention to how they feel for

0:50

you and when you're eating them. Hello

0:53

and welcome to another episode. Today

0:55

we are chatting about hormones and

0:57

how to understand them better. We're

0:59

talking about the hormone landscape, and

1:02

your cycle and PMS and the foods

1:04

that can support us, and the movements

1:07

that can support us and sleep and

1:09

circadian rhythm and everything in between. Today's

1:12

conversation is going to be really great for

1:14

any woman, any woman, really,

1:16

truly any woman on planet

1:18

earth. Our guest today is

1:21

Aviva Ram, MD. She's a world

1:23

renowned midwife and herbalist who also

1:25

happens to be a Yale trained

1:27

MD and board certified family physician

1:29

with specialties in integrative gynecology, obstetrics,

1:32

and pediatrics. A long time

1:34

home birth pioneer and birth

1:37

activist, Dr. Ram is keenly

1:39

committed to patient empowerment and addressing

1:41

health inequality. You Can find out

1:43

more from her by going to

1:45

her website avivaram.com. On Instagram, she's

1:47

Dr. Aviva Ram, and she also

1:49

has a book called Hormone Intelligence.

1:51

I will include all the links

1:53

in the show notes today so

1:56

you can check her out. Okay,

1:58

let's get to today's interview. Hey,

2:03

my name is Leon Vogel. I'm fascinated

2:05

with helping women navigate how to eat,

2:08

move, and care for their bodies using

2:10

a low carb diet. I'm a small

2:12

town holistic nutritionists turn three time international

2:14

best selling author turned funk soul medicine

2:16

practitioner offering telemedicine services around the globe

2:19

to women looking to better their health

2:21

and stuff second guessing themselves. I'm here

2:23

to teach you how to wade through

2:25

the wellness noise to get to the

2:27

good stuff that will help you achieve

2:30

your goals. Were supporting your low

2:32

carb. Nice. The on. The if it

2:34

fits your macros, conversation, hormones, emotions,

2:36

relationship to your body workouts. letdowns.

2:38

Motivation alone worked detoxing much as

2:40

I'm I'm providing the tools for

2:42

your motivation and accent. Think about

2:44

like quality time with your best

2:46

he makes with a little med

2:48

school for your and powered at

2:50

your next doctor visit. Get ready

2:53

to be talents in encouraged by

2:55

you learn about your body and

2:57

how to care for a better.

2:59

This is a Keto diet podcast.

3:11

Hi of the Va, how's it going

3:13

Hi, it's going really well. I'm excited

3:15

to be here talking with you and

3:17

to support your community. Ah, I love

3:19

the work that you're putting out there

3:21

and today it's no surprise we're going

3:23

to be talking about hormones and I

3:25

would love for you to just tell

3:27

us little bit about how you got

3:29

involved and that's why it lights you

3:31

off and why you just feel really

3:33

called to educate women on this. Well.

3:36

Let's go back forty plus

3:38

years when I started this

3:41

entire journey I'm on in

3:43

women's health and integrate as

3:45

Madison. My first exposure to

3:48

all the things was actually

3:50

about food. And.

3:53

It was about the intersection

3:55

of food and food politics

3:57

and food scarcity and. Environmental

4:00

exposures that we get our

4:02

food and. The. A chemical

4:05

agricultural industry. And so as

4:07

idealistic radical teenager I was

4:09

like oh, I can make

4:11

a difference in my life

4:13

and planetary house by changing

4:15

my diet. So at that

4:18

time I actually work as

4:20

Terry in the plant based.

4:22

And. Primarily V again really couldn't

4:24

get good organic meat good organic dairy

4:27

that that unless you happen to know

4:29

local farmer. And. That

4:32

led to understanding more

4:34

about. Women's. Health, politics,

4:36

the history of women's halls, and

4:38

all these interconnected. Factors:

4:40

And so between fifteen and sixteen

4:43

years old I actually had started

4:45

college, left college, apprentice myself to

4:48

a midwife and an herbalist and

4:50

their began the whole journey that

4:52

led me to here. including four

4:55

kids and practicing as a home

4:57

birth and wife and an herbalist

5:00

and becoming I yell trained M

5:02

D and a family doctor and

5:04

I think what really. Keeps.

5:07

Me Inspired. Now is sadly

5:09

how much things haven't changed

5:12

in sort of this medical

5:14

patriarchy. And cultural patriarchy.

5:17

And how much? The food industry?

5:19

The aggro chemical industry? The pharmaceutical

5:21

industry, not the sun? All conspiratorial.

5:23

Because I'm not. But like literally

5:25

factually, how many of these things

5:27

are still impacting women's health? And

5:30

not just still, but actually impact

5:32

in women's health? More. than ever

5:34

we have more auto immune diseases more

5:36

hormone conditions and more problems that women

5:39

are struggling with and still like the

5:41

answers as a medical community or like

5:43

we don't know or drugs or surgery

5:45

is it will ever to worry about

5:48

that keeps me inspired is the stories

5:50

i hear from women's day after day

5:52

of their struggles but also the women

5:54

who write me i got an email

5:57

last night from a woman in a

5:59

little town in Italy, she's 24, and

6:01

she said, I haven't

6:03

had my period in two years. I

6:06

got your book, Hormone Intelligence, not a plug for

6:08

the book, just telling you the facts. And

6:10

I started taking one of the herbs

6:13

that you talked about in the book

6:15

in Making Changes in My Lifestyle, and

6:17

my period started again, or the story

6:19

of the woman from Turkey, who

6:22

she and her sister-in-law had both

6:24

been struggling with fertility problems for

6:26

several years. Changed their lifestyle,

6:29

changed their diet, started some basic

6:31

supplementation, and both are pregnant. So

6:33

it's that that just really blows

6:35

my hair back, if you will, and keeps me up at

6:37

night on how to make changes in all of this. Yes,

6:41

completely as somebody who had

6:43

hypothalamic amenorrhea for eight years and

6:45

went to multiple doctors who said

6:47

that I would never menstruate, I would

6:49

never ovulate, I would never be able

6:51

to do any of these things. I'm

6:53

really taking matters into my own hands.

6:55

Now I'm six years ovulating, having a

6:57

perfect menstruation, not dealing with

6:59

PMS, and those lifestyle factors and just simple

7:02

things that we can shift really do make

7:04

a difference. And the hopelessness we can have

7:06

when we meet with a doctor, I mean,

7:08

I must have seen seven different specialists who

7:10

all said the exact same thing. And at

7:12

some point you're like, you throw in the

7:14

towel. And so that's why I love

7:17

having this conversation because there has to be

7:19

at least one woman who was as frustrated as

7:21

I was, just feeling like there's this glimmer

7:23

of hope, like is this actually

7:25

my reality? And it's like

7:27

through all of these different arcs of our life

7:29

cycles, right? Like whether it's puberty

7:32

or pregnancy or postpartum or menopause, menopause

7:34

should just start with the P, well

7:37

perimenopause, then it would all fit together, right?

7:39

Like we can alliterate women's life cycles. There

7:42

are so many women struggling and

7:44

still like a survey was done

7:46

looking at endometriosis. 70%

7:48

of doctors interviewed said they didn't know enough

7:50

about it to diagnose it. And If they

7:52

really, even if they knew, they wouldn't know

7:55

how to treat it. We Look at the

7:57

overlooking of thyroid problems, the dismissal of women

7:59

with PC. The I was and. The.

8:01

List goes on and on and

8:03

on and on. And. There's so

8:05

much that we can do when we just take

8:07

our health know on hands. And I'm not saying that

8:10

I don't ever. Recommend. Surgical

8:12

procedures or pharmaceuticals. But it's

8:14

really. That. Is the exception.

8:16

Compared. To the rule and I just

8:19

see so many things as possible and so

8:21

many changes when we really do make simple

8:23

lifestyle changes. Unfortunately for women, it's not always

8:26

disliked. it's easier said than done right. Like

8:28

you've got little kids, you've got parents are

8:30

taken care of, and now we're talking about

8:32

like, how do I prepare meals, race off.

8:35

and there's like economics involved and all the

8:37

things so. I do like to make it

8:39

simple but I don't wanna just make it sound like

8:41

it's oh is so simple. Completely

8:44

and so is that, where the

8:46

whole ecosystem healing kind of concept

8:48

comes from. Of seeing the body,

8:51

not just as when you go to your

8:53

doctor and they say like this part is

8:55

broken and we're going to fix this part

8:57

while not looking at the whole picture. Is

8:59

that kind of what you're getting out when

9:01

it comes the whole ecosystem. Yeah. Totally

9:03

it Like there are these kind

9:05

of to intercepting ecosystem set aren't

9:07

really separate but it's helpful the

9:09

think of them as like a

9:12

Venn diagrams. there's one circle, another

9:14

circle, they overlap bright And the

9:16

ecosystems are all the things that

9:18

are happening in our physical sales

9:20

and our emotional beings. So whether

9:22

it's the health of our gut

9:25

microbiome or the stress point of

9:27

our our stress response based on

9:29

may be like trauma we've had

9:31

our a living situation. All these

9:33

things that lake save our personal

9:36

world. And. Then or diet all

9:38

the things how well we assimilate or

9:40

nutrients. And then there's the

9:42

external world. which is like the

9:44

environmental chemicals were exposed to the

9:46

food, marketing and advertising, Were exposed

9:49

to the food, were exposed to

9:51

the stress, Were exposed to racism,

9:53

Sexism. all the things that affect

9:55

people depending on ages I'm gender

9:58

is and like depending on. what

10:00

your sort of wheelhouse is, and

10:02

then those things intersect into the

10:05

ecosystem that sort of shapes

10:07

you and that you're living in. Mm.

10:10

So when you're saying taking

10:12

our health into our own

10:14

hands, I would assume that that

10:16

whole ecosystem healing has to contain

10:19

the addressing of the diet, stress,

10:21

trauma, other things you mentioned, like

10:23

living situation, like everything combined

10:25

into one big holistic piece

10:28

that we're addressing. Totally.

10:31

And also there's another element, which is,

10:33

and I know it's sort of an

10:35

overused word, empowerment, but

10:37

when we talk about taking our

10:40

health in our own hands, there's

10:42

actually data that shows that women

10:44

who actually become more empowered about

10:47

their health actually have better

10:49

outcomes. One, they're more

10:51

likely to advocate for themselves at the

10:54

doctor's office, but also that difference between

10:56

being in a fighting spirit

10:58

for your health versus this

11:00

sort of hopeless, helpless victimization,

11:02

which the medical model reinforces

11:05

us to be hopeless and helpless. And

11:07

yes, we can feel hopeless and helpless

11:09

because feeling unwell can feel so overwhelming

11:11

and our choices can feel overwhelming to

11:13

pick from, or we might not even

11:16

have access to all the choices we

11:18

might want. But there

11:20

was a study done in Australia

11:22

looking at women with endometriosis who

11:25

felt victimized by having

11:27

endometriosis, like what's wrong with me? What

11:30

am I doing wrong? I'm broken. I'm

11:33

never going to get answers versus women who

11:35

are a little bit like, okay, I've got

11:37

this issue and I am going to do

11:39

everything I can to get to the bottom

11:41

of it and find the right doctor. And

11:43

interestingly, those women were more likely to

11:46

not surprisingly find the resources they needed

11:48

to feel better. But just getting activated

11:50

like that in a way made them

11:52

feel better too. So

11:54

when we're thinking about chatting about

11:57

hormones, I'd love to kind of

11:59

define Like, who would need

12:01

to listen to this episode? And I think a really

12:03

good way maybe to do this, and you might have

12:05

other ideas, is to kind of go through the common

12:08

symptoms that are hormonal symptoms

12:11

that we just assume are totally normal, to

12:13

kind of give us an idea of whether

12:15

or not a conversation about hormones is where

12:17

we need to spend our time today. Yeah,

12:20

totally. So I think every woman should listen

12:22

to this episode, one because you're obviously a

12:24

good interviewer. Thanks. But

12:26

I think we're so – you're welcome.

12:29

We're so under-educated about our bodies.

12:31

Most women can't identify most of

12:33

their intimate body parts. Most women

12:35

can't define their hormones. Most

12:38

women go into perimenopause and menopause having no idea

12:40

what that is. So I think

12:42

it's important for all of us. My

12:45

sort of bottom line

12:48

with our hormone symptoms and knowing

12:50

what – so I separate what

12:52

I call signs and

12:55

symptoms. So for example, let's

12:57

say you are three days premenstrual

13:00

and your boobs feel a little

13:02

bigger, maybe tiny bit fuller.

13:06

And maybe you're kind of feeling like, yeah,

13:08

I just assume not go to that office

13:11

party on Friday because I'm just going to

13:13

be bleeding or it's like tomorrow and I

13:15

just really want to be home watching my favorite

13:17

Netflix show and you're wanting

13:19

a little chocolate. Those are signs.

13:22

There's nothing wrong with any of that. It's

13:24

like there are just signs that you're going

13:27

through some hormonal shifting and maybe you feel

13:29

a little more internal, have

13:31

a little bit of a craving because your

13:33

hormones are dropping, your blood sugars may be

13:35

a little different and you're just sort of

13:37

like, yeah, not feeling the same perky thing.

13:39

I might feel what I'm ovulating. But

13:42

there's nothing wrong with that. There's nothing wrong.

13:45

Now let's put that on steroids.

13:48

Okay. I can't

13:50

get out of bed to go

13:52

to work today, let alone

13:54

that party tomorrow night because

13:57

I feel like hell. I

13:59

feel so depressed. depressed. I feel

14:01

so anxious. I am so filled with rage.

14:03

And it's like, you're not just having a craving

14:05

for chocolate, but you feel like you're

14:08

completely empty and you just want to eat the

14:10

whole bag of chips, then the whole container of

14:12

Ben and Jerry's, then eat the chocolate and then

14:14

maybe go for some fries or the

14:16

pizza. And your boobs aren't just aching

14:19

a little bit, but they're like, you

14:21

can't put your bra, your normal bra

14:23

on or your shirt and you're thinking

14:25

I've got to take some ibuprofen, right?

14:27

So we've got kind of

14:29

like normal little body signals

14:31

or signs that you're getting

14:34

to your cycle versus like discomfort

14:37

and a level of

14:39

incapacitation and inability to

14:41

do like your normal social or career

14:44

things. And there's a spectrum in

14:46

there, right? But I would say that like

14:48

signs that our body or signals that our

14:50

body is going through some changes, that's normal.

14:53

But when any symptoms you have

14:56

are making you have to take

14:58

a medication regularly or

15:00

miss work or miss school or

15:03

bail out on social events, not because you just don't

15:05

feel like going, but because you just really can't get

15:07

it together to go and you don't really want to

15:09

be around other humans, you know, or

15:12

they're either causing you physical

15:14

or emotional or psychological or

15:16

cognitive discomfort. That's very

15:18

different. And that's where I would say help

15:21

is needed, support is needed. And then kind of

15:23

like you have to decide where on the spectrum

15:25

you are. Now to your question about what we've

15:27

been taught to expect is just normal, heavy

15:30

bleeding, skipping periods,

15:32

irregular cycles, painful

15:34

periods, PMS that does make

15:37

us feel like crap, even if it's

15:39

not completely incapacitating, premenstrual headaches, feeling like

15:41

you do need to eat to the

15:43

bottom of the bag of chips and

15:45

then the fries and then the ice

15:47

cream, you know, that is we've just

15:49

been taught to expect all of this

15:51

is just how it's meant

15:53

to be any pain. No, we're

15:56

not supposed to be in pain. I mean, Maybe

15:58

when you're in labor, you know? Labour is

16:00

pretty intense, but for. The most part, there's

16:02

no other time that you should normally be in

16:04

pain. Painful. Sex. I would say

16:07

low libido is more complicated because low

16:09

libido can be a sign that your

16:11

hormones or off or something is going

16:13

on below. Libido could also just be

16:15

like different people have different levels of

16:17

sexual desire that can be related to.

16:20

Your. Partner. Relationship: Others more

16:22

complicated having little kids and you

16:24

to still touched out, but yeah,

16:26

anything that sort of seeking you.

16:28

Or. Are. Getting more attention than

16:31

it should because you're uncomfortable. None of

16:33

the as normal. I love

16:35

that definition and almost sounds like. Sauce.

16:38

Experiences of little magic versus being

16:40

pushed off a cliff. you know,

16:42

like pretty epic. Yeah, like

16:44

I mean I had some hot flashes

16:46

when I went into menopause and I

16:48

didn't think oh, this is abnormal, had

16:51

to take hormone replacement therapy but if

16:53

hot flushes were making the embarrassed to

16:55

show up on podcast because I'm sweating

16:58

or keeping the up like three, four

17:00

six, eight times in a and now

17:02

I'm getting sleep deprivation like that would

17:05

be the difference. To me. We.

17:11

Know that we lose muscle as

17:13

we age and that this loss

17:15

massively affects our ability to function.

17:17

Like I'm talking basic tasks. Here,

17:20

muscle is important for protecting her

17:22

joints and also keeping our metabolism

17:24

revving. Basically, you want muscle, and

17:26

unfortunately, a lot of us just

17:28

don't prioritize muscle maintenance or see

17:30

it as an important. and you

17:33

may also be cringing at the

17:35

idea of going to the gym

17:37

and be able to maintain that

17:39

muscle consistently. Yes, Active

17:41

Moving is super good and there's

17:44

really nothing like it when it

17:46

comes to the mood boost of

17:48

pumping iron. So.

17:50

when i share about your life and

17:52

a i am not saying just sit

17:54

do this and you can maintain your

17:56

muscle with out movement well like i

17:59

am saying now because

18:01

Urolithin A does do that,

18:03

but I think pairing Urolithin

18:06

A with exercise is likely

18:08

the best path forward. So

18:10

I started taking a product

18:12

called Mitopure to boost my

18:14

performance and improve muscular strength

18:17

and Mitopure has 500 milligrams

18:20

per serving of Urolithin A.

18:22

A postbiotic shown to have

18:25

major benefits to significantly increasing

18:27

muscle strength and endurance with

18:30

no other change in lifestyle.

18:32

Yes, you heard that

18:34

right. I just said that

18:37

it has major benefits to

18:39

significantly increase muscle strength and

18:41

endurance with no other change

18:43

to lifestyle. It gives

18:45

your body the energy it needs

18:47

to optimize its cellular power grid

18:49

through boosted mitochondrial health without changes

18:52

to lifestyle or diet. Now imagine

18:54

what it could do with your

18:56

low-carb diet and a walking goal

18:58

or a lifting goal a couple

19:00

of times per week. It took

19:02

me a long time like a couple

19:04

of months to introduce Mitopure to my

19:06

day because it's so strong.

19:08

Every time I took it

19:10

I almost had too much

19:12

energy so I really had

19:14

to side straight up. Mitopure is

19:17

the first product to offer

19:19

a precise dose of Urolithin

19:21

A to upgrade mitochondrial function,

19:23

increase cellular energy and improve

19:25

muscle strength and endurance. They've created

19:27

three ways to get your

19:29

daily dose of 500 milligrams

19:31

of Urolithin A in their

19:33

product Mitopure. They've got a

19:35

delicious vanilla protein powder that combines

19:37

muscle building protein with the cellular

19:39

energy of Mitopure. Now this product

19:41

does contain whey protein and then

19:44

they have a berry powder that

19:46

easily mixes into smoothies or just

19:48

about any drink. This is dairy-free

19:50

and Finally, the soft gels

19:52

which is what I prefer because it's

19:54

just easier. This is also dairy-free. I

19:57

Love the starter pack idea though if

19:59

you can. Handle the dairy that

20:01

three forms of might appear to

20:03

play around, with, which one is

20:06

your favorite? Top notch. The Timeline:

20:08

the creators of Mito Pure is

20:11

putting the other a sweet little

20:13

offer for you. Ten percent off

20:15

your first order to the go

20:18

to time line at nutrition.com/kdp and

20:20

use the code Kdp you'll get

20:22

ten percent off your order again

20:25

that time line nutrition.com Flask A

20:27

D P I recommend trying their.

20:30

Starter pack with all

20:32

three format and picking

20:34

out your best for

20:36

us Again, that's time

20:38

nutrition.com/kdp. Okay so when

20:40

we're talking about these individual pieces I know since

20:42

we're talking about this they're going to be many

20:44

women that if I don't ask this question they're

20:46

going to be upset with me. So should we

20:48

go into of the other real anywhere you know.

20:51

I know there's that woman being my come on

20:54

the an ask question. Can. We go

20:56

into some reasons why these.

20:58

You. Mentioned a couple things like a

21:01

regular cycles and wanting to eat all

21:03

the things hot flashes. What are some

21:05

of the root causes under these common

21:08

issues that are a lot more symptomatic

21:10

than they are the signs. So.

21:12

At the surface level. There.

21:15

Are the cycles that we go

21:17

through with our a certain are

21:19

Progesterone testosterone throughout the month and

21:21

throughout different phases of our lives.

21:23

And along with those changes, you

21:25

know we think of that as

21:27

you mentioned, like in Silos, right?

21:29

Like there's the cardiologist and the

21:31

neurologist and the obstetrician. But. In

21:33

reality your hormones and your neurotransmitters

21:35

the so that dopamine and serotonin

21:38

the things that make us feel

21:40

good. Those are all interconnected. So

21:42

when. For. Example: Estrogen and

21:45

progesterone normally drop a four

21:47

year period soda serotonin. It

21:49

goes down with estrogen. so.

21:51

Some. Of these. Cichlids. Changes are

21:53

what give us these normal little nudges.

21:55

As you said, But. when

21:58

things are falling off the cliff

22:00

usually there are some underlying or

22:02

root causes. And that

22:04

can be a whole kind of

22:06

panoply of things that interact like

22:09

these multifactorial causes as I say,

22:11

or it can be an individual

22:13

thing. So for example, you could

22:15

have low calcium and

22:17

low magnesium and that causes

22:19

you to have more spasy

22:21

muscles and that causes more

22:24

menstrual pain. And

22:26

lower mood, you could have low vitamin D

22:28

and low magnesium. That can cause lower mood.

22:30

So it could be simply like a nutritional

22:32

factor. But let's say

22:34

you have irregular periods, you skip a period

22:37

for three months, then you get one, then

22:39

you skip it for six months, then you

22:41

get two. That could

22:43

be, let's say, PCOS or polycystic

22:45

ovary syndrome. That could

22:47

be due to insulin resistance. That

22:50

can happen as a result of not even

22:53

just a standard American diet, but just a

22:55

diet that is not heavy

22:57

enough in protein and

22:59

not getting enough exercise and

23:01

that causes insulin resistance. But

23:04

inflammation can cause that. And inflammation

23:06

can come from diet, it can

23:08

come from stress, it can

23:11

come from endocrine disrupting chemicals in the

23:13

environment that we don't even know we're

23:15

being exposed to. It could

23:17

come from four rounds of antibiotics you

23:19

had because you had UTIs

23:21

in pregnancy or you got UTIs

23:23

in another. There's a

23:26

whole wide range of things. We

23:28

look at something like endometriosis, which

23:30

can cause debilitating menstrual pain, pain

23:32

with sex, urinary problems, bowel

23:35

problems, depression, anxiety.

23:38

And that can be a

23:40

result of chronic exposure to

23:42

endocrine disruptors before we were

23:44

even born that have changed

23:46

our immune system and caused

23:48

inflammation. And even these endocrine

23:51

disruptors that I'm talking about,

23:53

those can mimic estrogen, progesterone,

23:56

thyroid hormone, and block our

23:58

own body's hormones. or mimic

24:01

us having extra hormones and that

24:03

can set off a whole wide

24:05

range of these impacts. So it's

24:07

really quite complex on one level

24:09

because there are multiple different factors,

24:12

but what's kind of interesting is the

24:14

solutions in one way

24:17

are relatively contained. I'm

24:19

not going to say simple

24:21

or easy because making changes

24:24

is complicated and then there's

24:26

a level at which we have no control.

24:28

We have no control over what

24:31

chemicals are in certain foods or

24:33

our water or our soil or our

24:35

air, but we do have

24:37

control over what cosmetics we use, what

24:40

shampoo and soap we use, what household cleaners

24:42

we use so that we can

24:44

reduce our endocrine disruptors that way.

24:46

We have control over what

24:48

we're eating and while certain

24:51

things like going 100% organic may

24:54

be cost prohibitive for most people, there's

24:56

a lot we can do to reduce

24:59

those environmental exposures. We can support our

25:01

gut health by eating a wide variety

25:03

of foods in our diet and getting

25:06

some fermented foods. We can

25:08

do our best to get better sleep

25:10

and reduce our stress and all those

25:12

things. So there's like a set sort

25:14

of container of changes that

25:16

we can make that actually impact

25:19

pretty much all

25:21

of those imbalances and

25:23

disruptions and symptoms and conditions pretty

25:26

straightforwardly. Yeah, so earlier

25:28

when you spoke about hot flashes you

25:30

mentioned it sort of being a sign

25:32

as an experience or menopause, but if

25:34

you were sitting on this interview

25:37

and you were sweating like crazy then

25:39

it becomes more of a symptom. So

25:41

what are your thoughts when a woman

25:43

goes to her maybe functional doctor or

25:45

doctor and they instantly say hormone replacement

25:48

therapy, what are your

25:50

thoughts on that ecosystem situation? It's

25:53

actually driving me a little bit crazy

25:55

and feeling a little bit throwbacky to

25:57

like the forever young.

26:00

kind of thing. And it's

26:02

interesting because a lot of the sort

26:04

of wellness people, some of

26:06

whom are doctors, some of whom aren't, who

26:09

are really promoting hormone therapy right

26:11

now are some of the same

26:13

people that would be critical of the overuse of

26:16

birth control in teenagers. And yet

26:18

I feel like we're kind of

26:21

the pendulum swung from, oh, we

26:24

shouldn't use hormones with the women's health initiative

26:26

study in the early 2000s

26:28

to now, like you've got

26:31

all these wellness influencers who

26:33

are menopausal age who are

26:35

like hormones for everything. And

26:38

the data is a little bit

26:40

more gray area

26:42

than that. First of all, I think there are a lot

26:44

of ways that we can support

26:46

our perimenopausal and menopausal health

26:49

without using hormones. I

26:51

also think that nobody should suffer and be

26:53

miserable. So if you're already

26:55

at the point of misery and

26:57

you have symptoms for which hormone

27:00

therapy is appropriate, and that's a

27:02

big important statement right there, then

27:04

absolutely, you can use

27:06

hormone therapy if it's not contraindicated

27:09

or unsafe for you, but

27:11

you want to make sure that you're

27:13

using it for an indication that is

27:15

appropriate. So for example, we do know

27:17

that hormone replacement therapy or now called

27:19

menopausal replacement therapy can be very effective

27:21

for hot flashes. It can be very

27:23

effective for vaginal dryness and it may

27:25

even help with sleep. There are

27:27

a lot of people touting

27:29

how important hormone therapy is

27:32

for preventing dementia. And

27:34

basically, women should all just go

27:36

on it for a few years to prevent dementia.

27:39

But that evidence is not definitive. And

27:41

there are lots of other ways to

27:43

prevent dementia than going on hormone therapy.

27:45

And most women are not going to

27:47

get dementia. So putting every

27:49

woman on hormone therapy to prevent something

27:51

that hasn't been proven for it to

27:53

prevent, which there are other ways to

27:55

prevent that don't involve things that can

27:57

have risky side effects and which may never

28:00

to you seems like overkill to

28:02

me. So I'm more conservative. I

28:04

do prescribe hormone replacement therapy for

28:06

menopausal women in my practice who

28:09

just really are struggling and symptoms are

28:12

debilitating and either for whatever reason

28:14

they didn't get quick enough or effective enough

28:16

results from more natural therapies like you

28:19

know herbs or supplements or they're just

28:21

freaking over it and they're like I

28:23

am not getting any sleep. I can't wait four

28:25

weeks for these other things to kick

28:27

in please help me now and

28:30

we might do hormone therapy as a stopgap

28:32

while we're you know onboarding some of these

28:35

other things or it may just be like

28:37

exactly exactly the best thing for them in

28:40

which case I'm going to use the lowest

28:42

possible dose for the shortest amount of time

28:44

and be really mindful of safety guidelines. So

28:46

yeah I'm a little I feel

28:48

like an outlier not an unusual thing for

28:50

me but to feel like an outlier in

28:53

the wellness world when it comes

28:55

to women like there are a lot of women doctors

28:57

and there are a lot of companies sprouting up for

29:00

menopause. It's a cash cow. It's like a

29:03

multi-billion dollar industry. So I'm a

29:05

little bit leery. It sounds like

29:07

you are too. I got I

29:09

got a little sense of like

29:11

yeah the amount of ladies that

29:13

I onboard in my one-on-one coaching

29:15

that are on a significant

29:19

amount of hormone replacement therapy while also

29:21

having massive infections like Lyme living in

29:23

mold heavy metal toxicity and I'm like

29:25

you can throw hormones this all day

29:27

long. It's going to do nothing. It

29:29

is a drop in the bucket if

29:32

you're dealing with these issues and it's

29:34

it costs a lot of money like

29:36

those testosterone pellets are not cheap and

29:38

the programs and the subscriptions and yeah

29:41

well and the data on testosterone palates

29:43

is not convincing in my opinion. I'm

29:45

not saying testosterone never has value but

29:47

I would never I never use

29:49

testosterone palates. The other thing

29:51

that's really important for listeners to know

29:53

is that bio identical hormones even

29:56

if they're from natural sources aren't

29:58

necessarily safer. than other forms. And

30:01

a lot of people are like, oh, it's bioidentical. So

30:03

it's natural and it's safe, but we have to treat

30:06

all the hormone therapies with the same

30:08

level of respect as any conventional. And

30:11

I have had patients who

30:13

started seeing me after they

30:15

were put on bioidenticals

30:17

by an integrator or functional MD

30:19

or nurse practitioner or what have you who

30:22

have had endometrial hyperplasia as

30:24

a result of overgrowth of

30:26

their uterine lining from too

30:28

much estrogen, including two

30:31

women who were getting biopsies and

30:33

being told they might need a

30:35

hysterectomy for cancer, who when

30:37

I took them off of their hormone therapy, their

30:39

symptoms resolved. And sadly, one woman who

30:41

did not become my patient, but I met her

30:43

through a friend, I was meeting a friend for

30:46

tea and she's like, can I bring a friend

30:48

who would love to meet you? And it turned out to be like a

30:51

curbside consult, but she

30:53

was actually put on hormone therapy

30:55

about a year and a half

30:57

prior and did develop endometrial cancer

30:59

and was having a hysterectomy. By the time I

31:02

met her, it was like so far gone. She had

31:04

to have the hysterectomy. But yeah, so

31:06

I think we're going to see another

31:09

swing back in another five or 10

31:11

years, maybe sooner. I'm totally taking

31:13

the curbside consult. That is a

31:15

fabulous. Yeah, I'm always ready

31:18

for the curbside consult. Like I

31:21

used to do them, but now it's

31:24

like, we're having tea and this is

31:26

not the best way to give you

31:28

information. Yeah. Yeah, I feel

31:30

you. Okay, so kind of moving

31:33

into other hormone replacement type

31:35

therapies, can we touch a little bit

31:37

on the pill with PMS? Because oftentimes

31:39

a woman would go into her doctor's

31:41

office and say, I'm dealing with all

31:43

these symptoms and they go, how about

31:46

the pill? Does what you were talking about

31:48

with hormone replacement therapy kind of merge

31:50

into that? Yeah, it's kind of the

31:53

same thing. It can be really effective

31:55

to go on the pill for some

31:57

women. It can be a great mood

31:59

stabilizer. through stabilizing hormones. I mean,

32:01

I've worked with women with polycystic ovary

32:03

syndrome and horrible cystic acne, and they

32:05

go on a low progestin dose that

32:08

doesn't convert to testosterone and

32:10

they get such relief. And it's like

32:12

they get their life back because women

32:14

with cystic acne don't show up for

32:16

job interviews or graduate school interviews or

32:18

that date or that social event because

32:20

they're so stigmatizing to have acne in

32:22

our culture. So it can be like

32:25

night and day. But I would say

32:27

a few things. One, there are so

32:29

many other things that we could

32:31

try first. It's a band-aid. It's

32:33

not a solution to the root

32:35

causes. So if somebody

32:38

has polycystic ovary syndrome and we

32:40

treat their acne and their cyclic

32:42

irregularity with a pill, but we

32:44

don't address the underlying factor of

32:46

insulin resistance, they can still develop

32:48

diabetes later. And I've worked with

32:50

so many women who come to

32:52

me at 32, 34, 36 who

32:57

have been on the pill since they were 15, 16, 17

32:59

for hormonal problems who come off of

33:01

it and their symptoms have been suppressed all

33:04

this time. And now they're like, I want

33:06

to get pregnant and they go off it

33:09

and wham, they're right back

33:11

to the symptoms. And

33:13

now they're 36, 36,

33:16

37 facing that fertility

33:18

deadline that is

33:20

so often imposed on women. And

33:22

then the other thing is much

33:24

like hormone replacement therapy for menopause.

33:27

Women are just not given adequate

33:29

informed consent. We're not told about

33:31

the actual real risks. Most

33:34

doctors don't even screen for

33:36

things like migraine with aura,

33:38

immediate family history of cancers.

33:40

We don't tell women that

33:42

you have a 26% increase

33:44

in likelihood of meeting an

33:46

antidepressant even if you've never

33:48

felt depression before or teens,

33:50

like 80% increase in depression. And so women go

33:52

on these things and they're just kind of left

33:54

on, you know, it's like take two aspirin and

33:56

call me in the morning. It's like, take your

33:59

birth control pill and call me never. Call me

34:01

when you're 35 and having a baby or call

34:03

me when you're 55 and in

34:05

menopause. So yes, these therapies can

34:08

have tremendous palliative effects

34:10

on symptoms and

34:13

we still aren't addressing the underlying issues

34:15

that come back to bite us in

34:17

the butt or still are acting as

34:20

underlying factors. Like if you're having cycle

34:22

trouble because you have excess estrogen, that

34:24

doesn't go away if you go on

34:27

progesterone. It's now just all those risks

34:29

are still there and accumulating. So we're

34:32

just not doing a good job at looking

34:34

at root causes and we're

34:36

not doing a good job about educating

34:38

about the alternatives, the risks, the

34:40

pros and cons and we're not doing a

34:43

good job and when I say we,

34:45

I'm talking about physicians, medical providers of

34:47

follow up, right? Should she come off the pill

34:50

that she went on at 13, at 18, at

34:53

22? See if she still got the symptoms,

34:55

does she still need it or did we just sort of

34:57

like stay stay on it indefinitely because you want birth control

34:59

anyway? Yes, I feel like

35:01

we're so aligned in how we view things. I

35:03

agree with you 100%. I think too

35:06

because you've mentioned root causes quite a few

35:09

times, I know it can be frustrating for

35:11

the woman who's listening being like, one, I

35:13

don't know my root cause and two, my

35:15

PMS is just so bad. My period is

35:17

terrible. Like what do I do right now?

35:19

Do you have any advice

35:22

for that individual? Yeah, definitely. So first

35:24

of all, I want to just emphasize

35:26

that the term root cause, there are

35:28

people out there who are really anti

35:31

integrative medicine who will say, oh, if

35:33

somebody says root cause run. Well, first

35:35

of all, that's scientifically unsound. There is

35:37

an entire body of medicine called exposome

35:40

medicine. There is a department of exposome

35:42

medicine at Columbia University Medical School and

35:45

this is exactly what we were

35:47

talking about earlier, looking at the

35:50

various factors that contribute to why

35:52

we're having this increased rate

35:54

of so many of these problems in women's

35:57

health. And so at a core

35:59

level, Even if you're still going

36:01

to go on the pill or even if

36:03

you're going to take doxycycline for your acne

36:05

or you're going to take a medication for

36:07

your endometriosis or metformin for your PCOS, even

36:09

if you do those things, all

36:12

the things that address healthier

36:14

diet, better sleep,

36:16

stress reduction, reducing

36:18

environmental exposures, improving gut

36:20

health, those are sort

36:22

of core foundational things

36:25

no matter what. It's

36:27

like no matter what kind of car you're going

36:30

to drive, whether you're going to get on a

36:32

plane, you just put your seatbelt on. Think of

36:34

those things as putting your seatbelt on essentially. Those

36:36

are the core healthy lifestyle things, getting good exercise,

36:39

being around people that make us laugh and make

36:41

us feel connected. If you're really

36:43

just not functioning and

36:46

miserable right now, that

36:48

could be a time to say, all right,

36:50

I am going to go on the pill.

36:52

I am going to take an antidepressant because

36:54

I've been unable to get my life going

36:56

for three weeks, three months, three years and

36:59

I'm just so down. I

37:01

need to do that. Or similarly, if PMS

37:03

is taking you out of your life, three,

37:05

five, seven days a month, migraines are taking

37:07

you out. There's no good

37:09

or bad in this. You have to

37:11

do what helps you live

37:13

your best life. Sometimes

37:15

if you're so exhausted, so

37:18

depressed, so uncomfortable, it's

37:20

impossible. If you're fatigued and depressed

37:22

and in pain, what are the

37:24

chances you're going to batch cook

37:27

yourself four chicken breasts on Friday

37:29

or Sunday and make a big

37:31

salad and make a big pot

37:34

of great squash soup? It's

37:36

like zero, right? Because you're going to

37:38

want to watch Netflix and sleep and

37:41

not do any of those things. Sometimes

37:43

those things can be a catalyst to

37:45

give yourself permission to use, but you

37:47

have to know your risks. It doesn't

37:50

exclude doing all the other things we talked

37:52

about. Then ideally, you're

37:54

finding someone you can work with,

37:56

an integrative nurse practitioner, an integrative

37:58

nutritionist, an integrative MD. or

38:00

functional, who knows how to support you

38:03

using supplements, botanicals, targeted nutritional

38:05

and dietary therapies that are

38:08

right for you while you're

38:10

on those pharmaceuticals and maybe had

38:13

a bridge off of them. Then it

38:15

becomes kind of working with the right

38:17

person, people, or team, or having the

38:19

right resources if you don't have access

38:22

to those for whatever reason, your location,

38:25

your finances. That's where podcasts like

38:27

yours are a book like Hormone Intelligence

38:29

which is meant to be a

38:32

comprehensive program that you can use

38:34

that I would give to my

38:36

patient. But you're living in Wisconsin

38:38

and don't have access to someone

38:40

who can provide that for you directly. So,

38:43

I would say, yeah, and then

38:45

figuring out, you know, going deeper, there

38:47

are so many subtle things that could

38:50

be leaky gut. It could

38:52

be SIBO. It could

38:54

be histamine intolerance. It can be

38:56

a whole host of more granular

38:58

subtle things that then, you

39:00

know, you've tried the more general things.

39:03

You've gotten a book like mine or

39:05

you've done a program that should be

39:07

trustworthy and you've done all the things

39:10

and maybe you've had some improvement or maybe

39:12

not. And there's still things

39:14

going on and that's where the one-on-one

39:16

can really be so important.

39:19

So, what I'm hearing you say is step

39:21

one, get yourself to a place that you

39:23

can at least make the chicken breast, walk,

39:26

and if you're so very uncomfortable, you may

39:28

need to use some form of medication for

39:30

a time while you work on the root

39:32

causes that are causing that uncomfort and get

39:34

yourself to a comfy place and start working

39:37

under the hood so you can build yourself

39:39

up so that ideally you can get off

39:41

those things and be in a better place

39:43

than when you started. Absolutely. And

39:46

look, some people might be like,

39:48

yeah, my symptoms are uncomfortable but

39:50

I can still make the chicken breast. I don't need the medication.

39:53

But then certain conditions like hypothyroid, if

39:55

it's significant enough, you will need the

39:57

medication and you may just need to

39:59

also... to stay on it. And I

40:01

think that brings us to another piece of

40:03

this whole conversation. And I think like if

40:05

there's any takeaway that I would want women

40:08

to have from what I'm saying is that

40:10

you're not broken and none of what's happening

40:12

is your fault or you're doing.

40:14

There are 80,000 environmental

40:17

chemicals that are circulating in

40:19

our environment. Maybe 200 of

40:22

them have been tested and not

40:24

even necessarily found safe for women's

40:26

reproductive and hormonal health. We're

40:28

being exposed to all of those. Not

40:30

only that, we don't know how those interact

40:32

in our bodies. Our mothers

40:34

may have taken antibiotics when they were

40:36

pregnant with us or we may have

40:39

had the average American has 18 rounds

40:41

of antibiotics by the time she's 20 years old.

40:44

Think about what that does to your gut health.

40:46

So none of this is your fault. And

40:48

some of it is unpacking

40:51

what we can heal

40:54

and improve and resolve. And

40:56

some of it is doing

40:59

the best we can. So I might have

41:01

a patient who comes in to me and

41:03

I say on a scale of 1 to

41:05

10, how significant is your pain? And

41:08

she's had, you know, she's 38.

41:10

She's had endometriosis symptoms since she

41:12

was 14. She has adhesions in

41:14

her bowel and her abdomen that

41:16

are causing urinary problems and bowel problems.

41:18

And I'm not going to say to

41:21

her, look, we can get rid of

41:23

all those. Those can all go away.

41:25

Maybe with a really good surgeon and

41:27

really good anti-inflammatory diet and all these things

41:30

we can improve dramatically. And she'll say I'm an

41:32

8 on a scale of 1 to 10 with

41:34

discomfort. And I'll say, okay, if we could get

41:36

you to a 4, she'll be

41:38

like, amazing. And then maybe we can

41:40

get her to a 2. But I'm

41:42

going to be honest and say the

41:44

chances of getting to a 0 could

41:46

happen. I'm not going to kibosh that.

41:48

Let's also set realistic goals because this

41:50

happened long before you even

41:53

knew it was happening or had a chance to

41:55

do anything about it. And so I

41:57

think that's really important that we not blame.

42:00

ourselves. We're the canary in the coal mine

42:02

and we have to really give

42:04

ourselves grace. And I think

42:06

that's also important too because I see women

42:08

go crazy, like

42:11

trying every dietary approach, every

42:13

supplement and exhausting

42:15

themselves and exhausting their

42:18

bank accounts. And so

42:20

finding like guidance, knowing

42:22

what doesn't doesn't work, being careful like we

42:24

were talking about with hormone therapy, like just

42:26

jumping on things because they're du jour or

42:28

like the trend is really

42:31

important. And always getting back

42:33

to the basics like low inflammatory

42:35

diet, good sleep, stress

42:38

reduction, healthy gut, you

42:41

know, avoiding pharmaceuticals that we can

42:43

avoid whenever possible. And those are

42:45

all such getting out in nature,

42:47

connecting with people that make you

42:50

happier because just connecting with other

42:52

women increases progesterone. It improves oxytocin.

42:54

These are all things that are

42:56

really important. So so much

42:58

we can do, but we again, have to give

43:00

ourselves grace and compassion. Yes, completely.

43:07

Today's podcast is sponsored by

43:10

Nutrisense. What your blood

43:12

sugar is doing can significantly

43:14

impact how your body feels

43:16

and functions moment to moment.

43:18

Nutrisense lets you analyze in

43:20

real time how your glucose

43:22

levels respond to food, exercise,

43:24

stress, sleep. So let me

43:26

tell you a little bit about how it

43:29

works. If you're not familiar with the continuous

43:31

glucose monitor technology, basically, it's a small device

43:33

that you wear on the back of your

43:35

arm, I swear it doesn't hurt to insert

43:37

it, I promise you it does not hurt.

43:39

And it allows you to track your glucose

43:41

level in real time. Application

43:43

is super easy, I promise it's

43:45

painless, and each device lasts 14

43:48

days. Then you use the Nutrisense

43:50

app to help you interpret the data. So

43:52

if you wear a CGM alone, all you're

43:54

going to get is a number, but it's

43:56

going to be hard to interpret that number

43:59

based on food. and adjustments

44:01

and movement and the Nutrisense app

44:03

does all of this for you.

44:05

So if you're unsure what the

44:07

app is showing you, though it

44:09

is super straightforward, each subscription plan

44:11

comes complete with one month of

44:13

free nutritionist support. So your nutritionist

44:16

will actually help you to interpret

44:18

the data and provide suggestions based

44:20

on your goals. Now seeing this

44:22

data in real time makes it

44:24

super easy to identify what you're

44:26

doing and where you need room

44:28

for improvement. So if you're

44:30

feeling a little bit off, where's your

44:32

glucose level at? If it's super tanked

44:35

or really high, you can adjust your

44:37

activities in the moment based on what

44:39

you're seeing. If you wake up in

44:41

the middle of the night, was your

44:43

glucose to blame? If you totally had

44:45

the best workout of your life, where

44:48

was your glucose at? Perhaps you feel really

44:50

really well for this workout and you need

44:52

to repeat it. By tracking and

44:54

learning from and then acting on

44:56

the data from your Nutrisense app,

44:59

you can expect to lose weight,

45:01

provide stable energy throughout the day,

45:03

better sleep, understanding which foods are

45:05

good for you, control cravings, and

45:08

my personal favorite, make lasting change.

45:10

I've been using continuous glucose monitors

45:12

now for about three years. I'm

45:15

in love. I use them every couple

45:17

of months to just help me kind

45:19

of mitigate some adjustments I've made with

45:21

my diet and movement and really tone

45:23

things in a little bit

45:25

and then I'm off to

45:27

the races again. You can

45:30

visit nutrisense.io/KDP and use my

45:32

code KDP for $30 off

45:34

plus one month

45:37

of free nutritionist support. Be sure to let them

45:39

know that you're a listener of the Keto Diet

45:41

podcast when they ask you how you heard about

45:44

Nutrisense. Again that's

45:47

nutrisense.io/KDP with the

45:49

code KDP. You've

45:52

talked a little bit about the improving of diet.

45:54

Can we focus on that just a little bit

45:56

and kind of what that means because you also

45:58

touched on doing a lot of different diets

46:00

and getting really busy with that and

46:02

how do we know kind of the

46:04

restriction versus not restriction and all

46:07

the diet stuff. Yeah. So

46:10

for me, a healthy diet at

46:12

the most basic level is

46:14

whole foods as close

46:16

to natural, as few ingredients as

46:18

possible. So like if I were to walk you through

46:21

my kitchen right now, you know,

46:23

and you went into my pantry, you'd see bottles of

46:25

grains, bottles of beans, bottles of nuts, bottles of seeds.

46:28

Those are single ingredients. If you

46:30

went into my refrigerator, you'd see

46:32

kale, collards, chicken breast, tofu, salmon,

46:35

eggs, single ingredient things that

46:37

are as much as

46:39

possible organic and 100% unprocessed.

46:43

I mean, tofu is processed, but when I say like unprocessed,

46:45

I'm talking about like zero ultra

46:47

processed foods, minimal

46:50

processed foods at all. That's sort

46:52

of the foundation and

46:54

a wide variety of

46:57

vegetables and staple type of

46:59

foods like that. And

47:02

then the next level, that's sort of for

47:04

everyone, right? But

47:06

it may be that you are... I have a patient

47:08

right now, she just started in my practice the other

47:11

day and she's having hives

47:13

all over her body and

47:16

she's in her early 30s, has no idea

47:18

why this is happening. And as

47:20

I'm looking through her medical history, I see that

47:22

her two sisters and her mother all

47:25

have autoimmune thyroid disease. One

47:27

has graves, two have Hashimoto's. Her

47:30

sisters and her mother have

47:32

either joint pain or joint problems

47:34

and rheumatoid arthritis. So I started

47:37

talking with her about diet. Now

47:39

I am 100% zero restriction. I

47:42

don't believe in restricting anything. I

47:45

think we either choose not to eat

47:47

certain things because they're not helpful foods.

47:49

I mean, not drinking Coca-Cola is not

47:51

restricting. It's not drinking

47:53

something that's not a food. I mean, like sure,

47:55

if you have one, it's a hot summer day

47:57

and you decide to have that rum and coke.

47:59

at the beach, and it's a one-off. Sure, that's

48:02

one thing, but Coca-Cola is part of it. That's

48:04

not a food. So to me, not having it

48:06

is not restricting it. If

48:08

you are celiac, as

48:10

it turns out, this

48:12

patient's mother is. So the patient's mother is

48:15

celiac, two sisters with

48:17

autoimmune disease and joint

48:19

problems. And now this woman is starting to

48:21

have this weird immune reaction.

48:25

Everybody's ever explored whether these

48:27

three women, daughters, have

48:30

celiac. So to me, having her

48:32

take gluten out of her diet, that's not restricting.

48:36

If something is toxic to you and

48:38

actually making you sick, it may feel

48:40

sad to not be able to eat

48:42

it because you might really enjoy bread.

48:44

But it's not technically restricting. That's making

48:46

a therapeutic lifestyle choice. So

48:48

past that sort of big picture

48:51

of the whole healthy foods, I

48:54

want to look at things like are there specific foods

48:56

that are triggers for you? I

48:58

also gloss over or skipped over

49:00

some, to me, probably one of the most

49:02

important things that women can do for our

49:04

own health, which is keep our blood sugar

49:07

steady. And so it's not just what we're

49:09

eating, but making sure that we are

49:11

really getting an adequate

49:14

distribution and a good

49:16

distribution of what are called macronutrients,

49:18

so protein fats and carbs. But

49:21

our culture tends to lean into

49:23

either overeating protein, a 32 ounce

49:25

porter steak is

49:27

not a healthy protein, any more

49:29

than like only eating carbs is.

49:31

And our diet tends to lean

49:33

either inappropriately heavy, really pro-inflammatory

49:35

protein, or really heavy carbs,

49:37

or typically a combination of

49:39

both, rather than kind of a

49:42

steady state of getting enough protein,

49:44

getting good quality protein, getting good

49:47

quality fat. If you're going

49:49

to eat some carbs, paying attention to how

49:51

they feel for you and when you're

49:53

eating them. So I'm generally like, I

49:55

encourage my patients not to have carbs

49:58

at breakfast, but to stick with really a

50:00

good quality protein, good quality fat, and

50:02

some veggies ideally. I mean, I'm

50:04

not opposed to the occasional soaked

50:07

overnight oats, but it's got to have some

50:09

almond butter or nut butter or nuts and

50:11

seeds or some nut milk in it to

50:14

make a steady blood sugar food. But typically

50:16

more like savory breakfast. And then

50:18

if you're going to have a carb, there's

50:20

some evidence that having a small amount of

50:22

carb at dinner, for example, may actually help

50:24

with serotonin, mood, and sleep.

50:27

So thinking about it then.

50:29

So those are some of the big

50:31

picture things. But then again, if somebody

50:33

has specific symptoms, then

50:35

I'm going to start looking at are

50:37

there specific dietary modifications that we might

50:39

need to make. So somebody comes in

50:41

with a really high cholesterol and they're

50:43

eating a paleo diet with like four

50:46

eggs a day, or they

50:49

are a vegan or vegetarian and they're

50:51

tired all the time and they're not getting

50:53

protein, or they come

50:55

from a family with someone with celiac

50:58

and autoimmune disease and they're getting hives,

51:00

I'll look at those very specific

51:02

dietary approaches and create something

51:05

that feels nourishing and

51:07

delicious and abundant and

51:10

proactively healthful rather

51:12

than thinking of that as restrictive. Yeah.

51:15

So when it comes to, I guess the next

51:17

kind of pillar that people will think about is

51:20

exercise and movement. You talked about being

51:22

outside and what are some pieces that

51:24

we can think about to support our

51:26

hormone health versus things that we

51:29

can do with our movement that doesn't support it. Yeah.

51:32

So being sedentary doesn't support it. And that's

51:34

just the bottom line. The whole 10,000

51:36

steps or 8,000 steps a day has been

51:39

disproven. I mean, yes, it's helpful, but getting

51:41

a minimum of 4,000 steps a day

51:43

is good. Now, that's hard if

51:45

you're sitting in front of a computer all day.

51:47

So how can we do that?

51:49

Standing desk, making sure that we're

51:52

getting a good walk in before work

51:54

or after work, like two miles is

51:56

going to be about 4,000 steps-ish. Whatever

52:00

it is that you love to do, I

52:02

think is the most important though. Like I

52:04

quite honestly, I love, love

52:07

walking and hiking. I

52:09

am not a person who's like, Oh,

52:12

let me exercise. My oldest daughter, she

52:14

lives for exercise. She's like one of

52:16

those people who like it totally transforms

52:18

her stress to exercise for me. And

52:21

she like does it. She's religious about it. For me,

52:24

I love movement. I love fun movement.

52:26

I love dance. I love walking. I

52:29

love hiking. I have a little hoop

52:31

and my jump rope, but I have

52:33

to get myself to like get on

52:35

a stationary bike or do things

52:37

that are specifically exercise. So

52:40

I love how I feel when I do it. So

52:42

if you're one of the people who like loves exercise,

52:44

then the main thing is just to be careful not

52:46

to over exercise because that

52:48

can have an impact on our

52:50

inflammation, on our hormones. And as

52:52

you mentioned earlier, hypothalamic amenorrhea, one

52:54

of the causes of not getting

52:56

our period is over exercising

52:59

and or under eating. But find what

53:01

you love. You know, if it's putting

53:03

on music in the morning and just

53:06

dancing it out, I have a hula

53:08

hoop, a weighted hula hoop. It's a

53:10

two pound weighted hula hoop. I love

53:13

that. If it's, you

53:15

know, swimming, yoga, whatever it

53:17

is, and then find a variety

53:19

of things so that you're using

53:21

different muscle groups and have some

53:24

aspect of it be a little

53:26

bit promoting cardio metabolic health. So

53:28

like, you know, getting your heart rate up

53:30

a few times a week is really important. And then

53:33

for women, and particularly as we

53:35

get into perimenopause and menopause, bone

53:37

strengthening is really important. So weight

53:40

bearing, exercise, walking, jumping rope,

53:42

jumping, you can jump rope five minutes a

53:44

day and get benefits from that from weight

53:46

bearing. And then actually lifting some using some

53:48

free weights can be really good. Anything that

53:50

builds your strength, anything that builds your core

53:52

and anything that builds your balance, particularly as

53:54

we get into 40s and 50s and beyond.

53:58

And ideally, you're doing it. your 30s

54:00

and early 40s not waiting to catch up later.

54:02

It's always harder to catch up, but you can

54:04

do it. Yes, completely. And

54:07

so I guess the other piece that you

54:09

touched on a little bit that I just

54:11

wanted to clarify was sleep and its effect

54:13

on hormones because we're go, go, go. We

54:15

have the to-do list and the thing that

54:18

gets cut often is either food prep or

54:20

sleep time. So can we talk a little

54:22

bit about the impacts of that? Definitely. Well,

54:24

and the thing with sleep, it's like in

54:26

Italy, they say if mama ain't happy, ain't

54:29

nobody happy. I actually had somebody, a young

54:31

man in his 30s say that about his

54:33

mother when I was in Italy one time

54:35

in Rivello. And I always

54:37

think if sleep ain't happy, ain't nothing

54:40

happy, right? If you're not sleeping well,

54:42

that automatically increases your cortisol. That

54:44

increases weight around our waist, which is

54:47

inflammatory. But it also makes us tired,

54:49

which makes us want the coffee and the

54:51

sugar and the carbs, right? Like that's our

54:53

quick go-to energy. It increases

54:55

inflammation and inflammation, as

54:57

I mentioned, even with the belly weight,

55:00

but it can be more systemic inflammation.

55:02

That can affect our moods, our

55:05

physical comfort, and disrupt

55:07

our hormones. When cortisol is

55:09

jacked up, it affects our

55:11

thyroid hormone, our estrogen, and our progesterone.

55:13

So we can have irregular cycles, all

55:15

kinds of things. It affects our

55:18

mood. So it affects our motivation. And

55:21

if our motivation goes offline, there

55:23

goes exercise. There goes the food

55:25

prep. So to me, getting good

55:27

sleep, and good sleep is seven to nine

55:29

hours a night. I need seven hours. Some

55:31

people really do need the nine hours. Sleeping

55:34

under that or sleeping over that can

55:36

both actually be disruptive of hormones.

55:38

They can also be symptoms of

55:40

hormone disruption. So if your cortisol

55:43

is already dysregulated, that may

55:45

affect your sleep may already be off.

55:47

Parimenopause and menopause may no sleep problems

55:50

start. And so doing everything you

55:52

can to sort of, and you mentioned like

55:54

we're go, go, go all day. Like you

55:56

can't just go, go, go all day. Stay

55:58

on your screens until 11 o'clock

56:01

at night and then necessarily expect to get

56:03

a great night's sleep. So think about winding down

56:05

in the couple of hours before sleep, getting

56:07

off of electronics in the hour before sleep,

56:09

a Kindle might be fine. But I find

56:11

that I don't have a Kindle, but I

56:13

sometimes have read on my iPad at night

56:15

and I feel like I'm still on my

56:17

computer. It's like I'm still on a device.

56:19

So getting off of devices, ideally,

56:22

if you're not getting off of them

56:24

because you're reading on one, use

56:26

blue blocking glasses or use the

56:28

dimming feature or both. And then doing

56:31

everything you can to create your

56:33

bedroom space, your sleeping space to

56:35

be conducive to sleep. So

56:37

cooler temperatures, ideally like 65 to

56:39

67 degrees would be

56:41

great. And then covers as you

56:44

need them or layers as you

56:46

need them, making sure it's dark

56:48

and soundproof as possible, keeping

56:50

your phone notifications off and

56:52

your phone not near your bed, all

56:55

the things that you can do to

56:57

promote sleep, not having caffeine. And

56:59

honestly, probably the number one thing,

57:01

particularly for perimenopausal and menopausal women

57:04

is stay away

57:06

from alcohol. Like alcohol is just

57:08

a circadian rhythm disruptor, mood

57:10

disruptor, sleep disruptor, hormone disruptor. So 86 alcohol

57:13

completely. Yes.

57:16

I feel like we could go through

57:18

PCOS and endometriosis more and menopause more,

57:21

but we got to cut it off. So

57:24

thank you so much. Well, and all

57:26

those root causes like or the root

57:28

health things, we like there's the root

57:30

cause but there's the root health things.

57:32

Those all support you in healing

57:34

all those things as the baseline

57:37

plan anyway. And then you

57:39

add on the things that you need to support

57:41

that whether it's herbs or supplements or specific

57:43

dietary tweaks or a pharmaceutical if

57:45

needed. So it's still the core, it's the

57:47

foundation. Yes. Where can people find more from

57:49

you? Where can they grab your books, connect

57:51

with you? How do we get in touch?

57:55

My website is avivaram.com. There's tons

57:57

of free articles over there. Instagram,

58:00

Dr. Viva is great because I

58:03

actually am the one in there

58:05

doing posts and checking comments. And

58:09

yeah, you can find out about my practice, my

58:11

books, all the things on my website. And then

58:13

of course, there's the old

58:15

Amazon for hormone intelligence,

58:17

which is for all

58:19

things hormones and adrenal

58:21

thyroid revolution, which is

58:23

specifically for adrenal thyroid,

58:25

autoimmune, general state of overwhelm.

58:28

Those are great books for those.

58:30

Well, thanks again for coming on the show

58:32

and I'll include all of those links in the

58:34

show notes if people are looking for them. Thank

58:36

you. Thank you for having me. I

58:39

hope you enjoyed our time with

58:41

Dr. Aviva. You can find out

58:44

more from her by going to

58:46

Instagram, Dr. That's Dr. Aviva Ram,

58:48

A-V-I-V-A-R-O-N-N her

58:53

website avivaram.com and her book, Hormone

58:55

Intelligence. I hope to see you

58:57

here next week for another episode.

58:59

Have a good one. Bye.

59:06

Thanks for listening. Join us next

59:08

Tuesday for another episode of the

59:10

Keto Diet Podcast. Looking for more

59:12

resources? Go to helpfulpursuit.com for keto

59:15

meal plans, weight loss programs, low

59:17

carb recipes, and oodles of free

59:19

resources to get you going. The

59:22

Keto Diet Podcast including show notes

59:24

and links provides information and respect

59:26

to healthy living, recipes, nutrition, and

59:28

diet and is intended for informational

59:30

purposes only. The information

59:32

provided is not a substitute for medical

59:34

advice, diagnosis, or treatment nor is it

59:36

to be construed as such. We cannot

59:39

guarantee that the information provided on the

59:41

Keto Diet Podcast reflects the most up-to-date

59:43

medical research. Information

59:45

is provided without any representation or

59:48

warranties of any kind. Please

59:50

consult a qualified health provider with any

59:52

questions you may have regarding your health

59:54

and nutrition program. www.mooji.org