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[Intro] Welcome to the Health Fix Podcast, where health junkies get their weekly

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fix of tips, tools, and techniques to have limitless energy, sharp minds, and fit

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physiques for life. JANNINE: Hey health junkies on this episode of The Health Fix Podcast.

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You get me, Dr. Jannine Krause. I'm going to be talking about my experience with

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bioidentical hormones in myself, but also in my patients. I realized I haven't been

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as outspoken as I probably should be since a lot of people are asking

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questions here in this realm. And as the celebrities start to go through

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parametipas and menopas, we're starting to hear all these stories and a lot of

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folks are asking me, well, what do you do, Doc? Because, well, let's face it, I'm a

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naturopathic doctor. So you wouldn't think that I am doing much in the

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hormone space, but I actually am doing a lot. It's one of my favorite things to

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work on. And so today, I want to kind of give you a little insight into my

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background here and how I am helping my clients in hopes that maybe I could give you a little

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inspiration. So back when I was 26 years old, my mom passed and in the 10 years leading up to that,

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I watched her die a very slow death from breast cancer, 10 years, 10 remissions,

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and a whole lot of chemo in between. Now, at 26, you're not really thinking about getting older.

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You know, I would have thought that my age now at 46 was old back then.

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And granted, I was in naturopathic school then.

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And really, you know, I was deep into herbs.

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I was deep into food medicine. I was deep into acupuncture, which are all incredibly useful tools, food at the foundation of everything.

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But I realized that we do need some higher level interventions as we get older.

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And while I had high hopes that just eating certain foods to help certain energetics in the body

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would help my yin and yang right to be able to help me age better, I realized that,

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you know, we have some modern medicine breakthroughs that are incredibly useful. And there are ways to

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microdose them. There are ways to mix and match with herbs and hormones. And I've been kind of

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I'm not figuring that out for the last 17 plus years.

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So at first, I'll be honest, at last year

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we didn't talk a lot about bioidentical hormones.

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We kind of dabbled in it, but it wasn't something that was a full on course.

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You had to go to extra training to learn about it.

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And I definitely did it because I saw that

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people are getting better when they have some bioidentical hormones on board.

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And I'm talking, this was when I was in school. So this is 20 years ago.

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And here we are now just talking about it.

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What? Yeah, I know.

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Things have come a long way though.

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I will give you that. So having my mom die at 26 and my aunt die three months later

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both with estrogen positive cancers,

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both breast cancers, my aunt had a variation

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of a breast cancer comeback as a colon tumor

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and they had figured that out. But both were estrogen positive.

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Of course in my mind I was like, "I'm never doing hormones.

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This terrifies me. This is scary.

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I have actually never taken birth control myself because of that fear.

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But getting into my 40s, I started to realize how much my patients were benefiting and I

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was like, maybe I could look into this.

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Now I also started to prescribe bioidentical hormones based off of my training from the

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likes of Dr. Pamela Worschen-Smith. She's been on the podcast like three times.

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She is my guru. She is my master teacher in that department.

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And you know, I've taken a lot of different courses, but I've also learned a lot from

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my local compounding pharmacy, the gal over there, Kim and Gina, those two are like my

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my muses when it comes to working with hormones because they've had the pharmaceutical side

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of the training. So for those of you who are listening right now and you're like, I don't know a doc that

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can help me. I don't really know what direction to go.

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Find a compounding pharmacy near you that compounds hormones.

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you will find a plethora of information right inside those doors.

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And I really took advantage of that, started to go into some of the conferences for the

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compounding pharmacies. And that's why I learned a majority of my information on how to compound, how to help

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folks with micro doses, not the super physiologic doses of hormones that I'm seeing given to

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women on these corner hormone clinics.

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Men too. Men are not immune from this either.

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It's kind of crazy. I'm the person people see when hormones go south.

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So say you went to a clinic that's prescribing 10 times the amount of hormones that you ever

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had in your body to begin with.

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Let's think about this here.

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When you go into menopause or even perimenopause or men andropause, you don't suddenly need

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10 times the amount of hormones that you had before.

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Your body wants what it had before because that's what it could handle.

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And if you had trouble with your hormones before, now you want to dial stuff in, not

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just throw more hormones at it.

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It's not like your magic predisposition to heavy periods and painful cramps just magically

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goes away because you're in menopause or it magically goes away because you've had a

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hysterectomy. That's not the case.

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You keep how you metabolize your hormones along with you.

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You want to be thinking about this and a lot of folks aren't.

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I thought about it to an extent to I really started taking trainings by different companies

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that offered the testing like the Dutch test.

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And yes, you can say that their education is biased because the Dutch test does sell

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a dried urine test to metabolize hormones.

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But it makes sense.

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Let's think of it here. I have two relatives, my mom being a first generation relative that died of an estrogen-positive

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breast cancer. Now I didn't have any genetic mutations at all, but we are talking about an estrogen-positive

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cancer. Of course I'm like, "I don't want any estrogen in my body.

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In fact, I spent a lot of my time trying to detox it out because I learned about that

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at an early stage in best year."

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But what I didn't understand is that these Dutch tests, these dry urine tests, are actually

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able to tell us how you break down your hormones through your liver and through your cells.

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How cool is that? incredible information to help prevent cancer, not only from what the Women's Health Initiative

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lied to us about that we get cancer from bioidentical hormones, which is so not true,

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not true. Baby boomers should be pissed. They should be pissed because they were lied to

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about all of these things that could actually help their health and help them age better.

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that sucks. But here we are now. We can go back. We can work on things. But the big thing

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that I want you to take away from this podcast, if you take away nothing else is that you

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can support your hormones in many different ways. And there's no one size fits all situation.

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Yes, pharmaceutical companies give you patches that you know, there are patches that they

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that are available that we can prescribe that have certain dosages. There are progesterone

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capsules and certain dosages. There's testosterone and certain dosages, but you can adjust all

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of that and sync it with what your body is used to, not these super physiologic doses

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so that you get side effects. Now, have I ever seen someone directly correlate having

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taken bioidentical hormones to cancer? No. Have I had patients in my practice get cancer

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well on bioidentical hormones? Yes. What do I conclude in that case? Well, after a lot

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of soul searching when the first one happened to me, let's put it that way, it didn't even

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happen to me. That's such not a good statement. When it happened in my practice, I was terrified.

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I was like, Oh my gosh, I caused this person. I caused this person cancer. Right? I took

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it on myself and thought, Oh my gosh, the bioidentical hormones did it. I, I pray by

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prescribing them or giving her this.

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This is not the case? If we look at what's going on in the history of that patient,

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she was a heavy drinker. She was doing a lot of eating and processed foods.

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Is it her fault? No. It's society.

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That's what we do, right? We convenience foods are a thing, alcohols a thing for coping.

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So there are a lot of factors we want to be thinking about when

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we're using hormones, because can hormones give fuel to the cells

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to get backed up and then have us potentially develop cancer?

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Maybe. But with the women's health initiative set is like the hormone replacement therapy directly caused cancer.

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No. I think there's a lot of factors involved in how cancer truly develops.

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From mindset to toxins in the food and environment, things we can't even control, lots of things.

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So we need to get out ahead of that.

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not deny ourselves the ability of using hormones

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if they are gonna help us feel better.

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Now have I had some people in my practice that we've tried microdoses,

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we've tried different herbs, things in that nature and nothing really seemed to work?

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Yes, that happens in some cases.

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Especially when someone's body is incredibly stressed.

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They've been under a lot of stress

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for multiple reasons in their life.

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Potentially even supplements are seen as a threat

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by their really heightened sense of threat in their nervous system.

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These are the cases in which I see hormones not doing well.

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And we can identify that. And we can work on that and help the nervous system feel safe to be able to tolerate a

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little bit of what could help it get back into balance.

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You see, when someone's nervous system is out of balance, it feels like everything is

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a threat. Food, people, air, water.

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I mean, there are so many people I say in my practice that are like,

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I think everything is against me. And it very well could be if your mind sets that way,

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but also there are a lot of cases in which the nervous system really

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will fight back on things.

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So if that is you or you have heard about that from other people, that is true.

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But you can do something about that.

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You can work to feel safe in your body again before you add in all kinds of

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interventions. That's one of the things that I am doing in my programs with my patients.

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It'll be one of the hallmarks of my concierge program coming out later this summer.

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So the need to prime your body to tolerate hormones is something that I find incredibly

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important in being overlooked, especially in the clinics, the hormone clinics on the

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corner that are giving out the high dosages of hormones.

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We need to know first how you metabolize hormones before we start giving you them.

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We need to make sure that you are a lymphatic system.

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You are liver. Your kidneys.

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Your cells are working well.

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Because if we throw stuff into a system that's not optimized, things can break.

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Now I totally understand that a lot of people come to me and they're desperate.

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They have wicked hot flashes at night where they're not sleeping all night.

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They're incredibly fatigued. their brain fog is so strong that they can't seem to think one thought to the next and

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people are looking at them and they're like, what is wrong with you?

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And they're relying on their brain for their work.

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I mean, we are at one of the first generations where women are full time in the workplace

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at high positions and they're going through menopause and perimenopause.

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Of course they need these things to be able to keep going.

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I've heard so many women have quit their jobs because of the perimenopause and menopause

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symptoms that interfere with their health. That's not cool. We want women to stay in the workplace.

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If they want to, we want women to do whatever they want, we want women to achieve their dreams.

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And so this is important. The woman entrepreneur can benefit from hormones. This is something that

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we need to be thinking about now. No, am I saying that every single person blanket statement,

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everyone needs hormones? No, some people can keep making their own as they get older. They don't

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even need support. This is another reason to test hormones too. And this is another reason to use

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microdosing and cycling it. So priming your body for hormones should be step one before the hormones

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go on board. Now do I prime and put a little hormones in? Yes, sometimes, especially if symptoms

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are very intense. What I'm hoping for in the future of medicine for women and men is that we

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we are priming the body to get older

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and we are priming the body for the hormones

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and replacing as we get older.

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Versus like, oh crap, I can't sleep through the night.

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My brain is like shot, I can't remember anything.

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And I've got half lashes all day all night, right?

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Like let's not get to that point. Unfortunately, we are getting that point

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and that's where women are deciding like, okay, I'm gonna try these,

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these what we've considered poison hormones

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because I am at my wit's end.

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That sucks, I don't want people to get to that position.

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And I'll be honest, like up until probably 10 years ago,

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I was a little afraid of hormones too.

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I really didn't know what to think.

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We hadn't been taught accurately, and we also always had that women's health initiative study

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in the back of our mind. Always.

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It was like hammered in, even in naturopathic medicine school.

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It's crazy. Now, of course, in naturopathic medicine school,

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We talked about herbs. We talked about helping women with herbs and supporting.

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Herbs are wonderful for helping to counter a lot of the symptoms that come with perimenopause

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and menopause. But sometimes there comes a point at which the herbs are not strong enough.

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And this is where I will blend protocols.

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For many women, I'm seeing as I've been in the practice longer, symptoms of perimenopause

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are getting a lot worse.

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Are we getting sicker as a society? Yes.

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Are we having more imbalances? Yes, but I also think the overarching theme here is stress.

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Women in perimenopause are now needing hormones to help counter some of their symptoms because

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stress is so high up here and we're depleting our hormones rapidly.

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So yes, I use bioidentical hormones on a cycling basis in women that still get their

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period. For many doctors right now, that is going to be a cringe and oh my gosh, she is endangering

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people. I know that, that that's gonna be scary for a lot of people.

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I'm not endangering anyone.

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We are doing all the testing, all the checks and balances,

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and we're also working on diet.

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Every single person that works with me, with hormones knows what we're getting into, right?

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We know what we're up to. We're working to optimize things.

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Because when the hormones get into the system

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at the right dose for you and you feel good,

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you feel amazing. And this is why I don't want to keep my mouth shut anymore

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about what I'm doing because so many people can get their

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lives back, their energy back, their sleep back, their

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vitality. And if we catch it early enough, we can also work

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on fine lines and wrinkles using estral cream. The same

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cream that's on the face can go down below for the vaginal

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tissue. It's all the same skin. If your skin's wrinkling on

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the face, you better believe it's wrinkling down below. So there

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are so many things out there that can be a benefit and we

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You're not talking about it as extensively as we can

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when it comes to customizing.

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Now we're talking like, yes, there's patches out there.

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Yes, there are pellets for replacing hormone therapy.

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I said that's so weird.

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Or when replacement therapy pellets, bio-t.

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Now there's also injections, there's drops,

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there's sub-linguals, there's trophies, there's films,

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there's creams, there are so many different things

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in terms of options for delivery of the hormones to the body.

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There's a lot of argument in terms of what is the most stable form

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of the bioidentical hormones.

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In my mind, it's the one that someone's going to use,

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but it's also the one that someone has really primed themselves

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to be able to use.

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A lot of people ask me, why do you not insert pellets?

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One, I haven't done training yet, and I will.

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But two, it's because it's harder to get the right dosage

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leading up to pellets.

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So the idea is once you know what your dosage is

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that your body tolerates, then pellets are a good idea,

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at least in my opinion. I know a lot of people are gonna argue that.

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Some people's lives have been changed by having the pellets right off the bat.

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Other people, the pellets, you know, don't go so well.

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And here's the thing with the pellets, they're inserted, right? So if the dosage is too high, you don't feel good on them,

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you have to kind of wait for them to ride out. I had a little trauma back in the day with

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different patients using Depo-Provera and different things like that where it took months

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to wear off. And it's something that, let's put it this way. It's something that you don't

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want to take lightly, but I do think pellets can be incredibly helpful. Now other hormones

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that like forms that are stable would be capsules of progesterone. I've seen that to

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be more stable for helping with the uterine lining compared to progesterone cream. We used

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to think progesterone cream was the standard for helping to prevent overgrowth of the uterine

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lining because you want to, if you have a uterus and you're going to use hormones, you

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have to have progesterone and estrogen. You have to have them for protection because the

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progesterone protects from the uterine lining from getting too thick. And the capsules did

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a lot better than the cream in terms of the data that I've seen now because there's been

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a long enough time frame to use it. Now, are we going to find over time that there's different

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tweaks and different things that are better than others? Absolutely. Absolutely. But this is why

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being open to trying different formats can be incredibly helpful. I have some patients,

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you know, years ago we were told that any oral estrogen was, even if it was biolidiacal,

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would be harmful and more of a risk for cancer.

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Now, we're finding that bio-identical astrodials

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on a film, kind of like something you suck on,

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like those mints that you used to get with the little strips you put in your mouth

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and it just dissolves, using things like that can be more of a stable dosing amount for folks.

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And it does seem scary to me to use oral estrogens

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after all these years of being told that it was not the optimal way to go.

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Here's the thing. One day at a time with this stuff

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and monitoring, we have to monitor.

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And underlying everything is watching someone's habits.

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Right? How much alcohol are you drinking?

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What are you doing with your diet? Because these things do impact what happens

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with your hormones. How's your gut microbiome?

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We can reabsorb estrogens through our gut lining

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using something called beta glucuronidase. we want to know those levels.

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So these are all incredible pieces to the puzzle

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that you want to have known

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before you jump into the hormones.

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Because I'll be honest, I'm not gonna just willy-nilly work with folks.

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I want to know your background.

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And so this is something to be thinking about

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when you're looking at adding in bioidentical hormones.

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Now with this, it's not a one-size-fits-all situation.

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It's incredibly not a one size fits all situation.

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I will often be known to take patches and cut them in half

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or cut them in a third to help women

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versus using full dose patches.

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I will also compound capsule amounts of progesterone

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to have a specific amount that works for them

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'cause too much progesterone can cause you to feel puffy

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and have acne and not feel so great.

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So you wanna be thinking about how all of these things

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or are able to be customized.

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You can blend, as I mentioned before,

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say you don't want any bioidentical estrogen.

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You can use a little red clover and pair that with a bioidentical progesterone capsule.

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There's lots of different ways to do this.

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Now, some people don't tolerate progesterone for one reason or other when it comes to detoxing it.

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So we use evening primrose oil, and then we can use red clover,

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or we can use black cohosh, or we can use Siberian rhubarb,

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whatever it may be to help balance these hormones.

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Now, one of the things I think that

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is really important to mention right now, because a lot of people I still find

20:59

getting confused as to what is natural hormone replacement

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therapy versus bioidentical versus synthetic.

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Synthetic is going to be coming from your regular pharmacy.

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Those are gonna be your estuary screams,

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things of that nature. estradiol patches, like the Vivel dot, things of that nature, those are bioidentical, but

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they are still synthetic. Bioidentical means it looks like your hormones in your body, but they are still made synthetically

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in a lab. At the compounding pharmacy, you're also getting bioidentical synthetics.

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They work better because they look like the hormones in your body.

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They also are useful because compounding pharmacies can make things in different variations and

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customize it for you, which is what I love about compounding pharmacies.

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Now, the other side of this is natural hormones.

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These are wild yam derived creams and things of that nature.

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If you've heard of the naturopath, Barbara O'Neill, this is what she's talking about wild yam creams.

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They can be incredibly helpful as well.

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What the harder part with some of the natural ones is that we don't have an

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official, like, let's say it's harder to dial them in exactly even though there are certain

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amounts of that wild yam in the cream.

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It's just not a standardized dosage in some of them.

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Now, and I misspoke a little bit because there are some products endorsed by Vibronio that

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are standardized in terms of amounts, but if you have something that just says wild yam

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cream, but it doesn't give you a milligram dosage, you are getting something that is

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a natural hormone cream, but there is not a standardized doses.

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You don't know how much you're actually getting in that. So let me make that be very clear as to what's going on there.

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Now I use certain ones of the natural wild damn creams that are standardized and it's

22:54

great. A lot of people benefit from that.

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A lot of people benefit from creams of herbs that are women, like basically geared towards

23:04

women's health, but basically geared. What am I trying to say here?

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Gear towards the hormone support, herbally,

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but it's in the form of a cream. And there are some that are amazing that can work there.

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There's a lot of different options out there,

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and you've probably seen this if you've been looking in the space

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and you might be feeling like, oh my gosh, where do I start, where do I go?

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This is where I help people figuring out

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which direction is gonna be best for you because there's a couple of things to think about.

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Severity of your symptoms, what you've tried before,

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what your diet and lifestyle's like, and being really honest with yourself.

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If you're too busy to cook all the time, okay, you're gonna have some exposures

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more than someone that's cooking their own food and growing their own food at their home.

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We just gotta think about exposure level. And we gotta think about like,

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what is your body dealing with on a 24/7 basis?

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Because stress, that will interfere

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with how you metabolize your hormones too. Methylation defects, so how you detox

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just in general through your cells, big deal.

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What's going on in your sulfur pathways in your liver?

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these are incredibly important too.

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Knowing all this information will set you up

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to really have an understanding of what's best to start with.

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And when I work with folks, I'm always gonna start at the minimal dose possible

24:17

to get effect. I'm not starting at high and then trying to come down.

24:21

That is side effect city.

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Because a lot of times with hormones,

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sometimes you could start hormones and have worsening of symptoms if the dose is too high.

24:30

That's not good. or your symptoms just stay the same, right?

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So this is a big deal.

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Now, one of the other big things I want to dispel

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in terms of the myths that a lot of people

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are putting out on social media. You can get on your estrogen

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and your weight just drops off. I wish that was really the case.

24:50

And I would love to meet these people that are talking about it

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because the truth is it takes time. It doesn't just fall off.

24:55

When you get things balanced, things can stabilize

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and weight can come off, especially if you're kind of like that five or 10 pound weight gain around perimenopause

25:04

and menopause kind of person. But if you're looking at 30, 50, 100 pounds of weight does not the case with hormones,

25:09

it's not going to drop off like that.

25:12

Ultimately the more weight that you have on your body, the more fat that you have on your

25:15

body, the more that you have hormones that need addressing before trying to start a super

25:23

physiologic dose of bioidentical hormones.

25:27

So there's a lot to think about here, but I really wanted to talk about the fact that

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all of this can be optimized and that it does work.

25:37

It really does work and not everybody that's used by identical hormones has ended up with

25:43

cancer. So this is another really big thing to think about.

25:47

And on top of all of it, the most important thing is to think about priming yourself for

25:52

you're using hormones versus just jumping right in.

25:55

And this is why the younger generation, folks who are in

25:58

perimenopause, it's a great time for all of you to be

26:01

working on getting your health dialed in.

26:04

So that as your hormones start to decline, if they do,

26:08

because like I said before, some people's hormones don't,

26:10

you can definitely keep your hormones going a long time.

26:14

That is a real deal thing.

26:17

Some people do it. Is it the common?

26:20

No, it's not. but I do have some folks that are keeping their hormones going naturally really nicely.

26:26

So it's something to think about, takes a lot of discipline there, and especially if you're an

26:32

entrepreneur, you're a high level, you know, executive things of that nature, or you're just

26:38

mom-ing really hard and grandma-ing really hard, you know, the amount of stress in your life really

26:43

does matter in terms of how well you're going to be able to continue to make hormones as you get

26:48

older. And so having a little support can be incredible, especially for helping the concentration,

26:54

the focus, the energy, and just feeling more stable with moods. I mean, yes, hot fush as it

27:01

helps with that sleep. Incredible too. Those are kind of the big, biggies there to think about in

27:06

this department. And I can say it's quite helpful. So what am I up to in this department? I am working

27:16

with women one-on-one with their hormones. I'm not doing group programs. I'm more of a concierge type

27:22

of doc, meaning we work together, we troubleshoot your hormones, we figure out what you need to

27:28

be ready to start hormones, or what we need to help you tolerate the hormones that you are

27:35

already taking. So maybe you come to me with hormones, maybe you have tried multiple different

27:39

things and you're not adjusting well. We're going to go back to the basics. We're going to see what

27:43

What is going on with how you break down your hormones?

27:47

What is going on with all your lymphatic pathways, your kidney, your liver, your colon, your

27:52

microbiome, everything, head to toe?

27:55

Now you might be thinking, gosh, this sounds expensive.

27:57

There's going to be a lot of testing. No, that's not the case.

27:59

Really what we're looking at here is assessing what's going on.

28:04

The more someone can track their cycles, if they have periods, and the more you can just

28:08

track throughout the month. If you don't have a period, just to see what shows up for you and how it shows up possibly

28:13

cyclically because us women, we will cycle even after our period is done. So information to keep

28:22

on hand and there's great stuff to bring into me. I'm going to look at that anyway. And so looking

28:27

at all those things, looking at your fitness, you know, I don't want people to think that they

28:31

have to be like athletes to work with me. It's more just making sure that you've got some form of

28:36

movement going. Now is that a prerequisite to coming to me? No, we can work on that. But the idea is

28:41

there's going to be some talk about that. There's going to be talk about mindset. There's going to

28:44

be talk about brain function. Lots of cognitive stuff plays in here when it comes to hormones

28:51

and getting older. And so I aim for a total body approach to hormones, not just give you the

28:59

hormones and hope things work. We're looking at all of your body pathways to make sure we're

29:04

priming you for replacement therapy and priming you for optimization, whether it be for the

29:13

mind, whether it be for sexual health, whether it be for energy, whatever it may be, that's

29:19

what we're going for in that department.

29:22

So that's kind of a little rundown of how I work with folks on a one-on-one basis.

29:28

And if you have more information or you want more information, by all means, head over

29:32

to my website at doctorjkrausend.com. Click on a chat with me. I do charge for my calls, but

29:40

that can be rolled into a program with me. Should you choose to work with me? Those calls are

29:46

very useful for the folks that jump on them because you're going to get some answers. You're

29:50

going to get some direction and I'll give you it straight in terms of what I think and what I would

29:56

do if I were working with you and next steps. So either way, if we don't choose to work together,

30:01

you're still going to leave that call with clarity and ideas as to next steps for you

30:06

to help in your journey of aging well. So, that is my scoop on how I'm using

30:14

bioidentical hormones and hormone optimization in my practice and in my one-on-one concierge

30:20

groups, or not groups, concierge programs. And so nevertheless, if you're interested,

30:26

hit me up at doctorjkrausend.com. You can even send me a message and we'll chat. And if you'd like to

30:32

talk further, I also have those chats available. All right, you have survived another episode of

30:37

The Health Fix Podcast. I hope you have a great day whatever you're doing and stay tuned for more

30:42

these Wednesdays where I weigh in on the podcast that we've had for the week or the topic of the

30:48

week. All right, take care. [Outro] Hey, health junkies, thank you so much for listening to another episode of

30:54

the health fix podcast to help support my mission to bring you tips, tricks and tools

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