Perimenopause Is the Inflection Point Breaking Women's Health — Dr. Mayoni Gooneratne

What if the most dangerous metabolic inflection point in a woman's entire life is the one we've been taught to simply endure?

In this episode of Health Longevity Secrets, Robert Lufkin MD sits down with Dr. Mayoni Gooneratne — a London-trained former NHS colorectal and pelvic floor surgeon, now the founder of Human Health and vice-chair of the British College of Functional Medicine. Dr. Mayoni walks us through why she walked away from the operating theater and how perimenopause — not menopause — is the real window where metabolic disease, cognitive decline, and cardiovascular risk are either quietly programmed in or actively reversed.

CHAPTERS:
00:00 — Introduction
01:47 — From NHS Surgeon to Functional Medicine Founder
06:53 — Dr. Mayoni's Own Perimenopause Story
07:12 — Her Mother's Menopause-to-Diabetes Cascade
08:43 — The Cortisol Trap: Three Kids Under Three
10:39 — The Surgical Mentor Who Changed Everything
12:27 — What Functional Medicine Actually Is
12:52 — Root Cause vs "Treat and Street" Medicine
18:08 — The Timeline Aha Moment Patients Never Forget
21:09 — The Human Health Roadmap: Gut, Hormones, Mitochondria
24:19 — The Thrive Program for Perimenopause
25:42 — Body Fit: 16-Week Ketogenic Metabolic Reset
29:14 — Why You Shouldn't Stay in Ketosis Long-Term
33:20 — Why Normal Vitamin D Isn't Optimal Vitamin D
35:02 — Where AI Fits in Functional Medicine
36:03 — The Ovarian Age Clock Every Woman Should Know About
37:56 — The NHS-Private Divide in Chronic Disease
40:09 — Eat Better, Move Better, Sleep Better
42:18 — Where to Find Dr. Mayoni

KEY TAKEAWAYS:
• Perimenopause — not menopause — is the real metabolic inflection point for women
• Loss of estrogen can trigger type 2 diabetes and cardiovascular disease within months
• Chronic high-cortisol lives prime the perimenopause crash
• "Normal" vitamin D isn't optimal vitamin D — aim for ~100
• Nutritional ketosis works as a 16-week reset, not a permanent lifestyle
• New ovarian age clocks let women plan for reproductive aging precisely
• Pregnancy glucose tolerance results preview perimenopausal metabolic risk

STUDIES & SOURCES MENTIONED:

• Dr. Mayoni Gooneratne — Human Health clinic
• British College of Functional Medicine
• Institute for Functional Medicine
• Future Patient digital magazine and congress
• Ovarian age clocks / reproductive aging research (Nature)
• North American Menopause Society — hormone therapy position statement

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Transcript

Menopause And Sudden Metabolic Decline

SPEAKER_00 0:00

You know, my mother is uh now a retired doctor as well herself, and she very proudly just white-knuckled her way through the the menopause, and then promptly, literally promptly, within probably a few months of declaring that she was delighted she finished her period, and she actually then developed type 2 diabetes. She needed her first cardiac stents about a year later, and um has gone on to have more stenting, and it she was a generation that really demonstrated the exact immediacy of what happens to women as they traverse that time, that inflection point where we lose the protection of estrogen amongst other hormones.

SPEAKER_02 0:50

Welcome back to the Health Longevity Secrets Show, where we push the limits of human potential and unlock the secrets to our health and longevity with your host, Dr. Robert Lovkin.

SPEAKER_03 1:02

What if the most dangerous metabolic inflection point in a woman's entire life is the one we've been taught to simply endure? Today's guest is Dr. Mayoni Gudaratni, a London-trained former NHS colorectal and pelvic floor surgeon, who is now the founder of Human Health and Vice Chair of the British College of Functional Medicine. Dr. Mayoni walks us through why she walked away from the operating theater and how perimenopause, not menopause, is the real window where metabolic disease, cognitive decline, and cardiovascular risk are either quietly programmed in or actively reversed. You really don't want to miss this one.

SPEAKER_02 1:42

And now, please enjoy this week's episode.

SPEAKER_03 1:46

Hey

From NHS Surgery To Root Cause

SPEAKER_03 1:47

Mayoni, welcome to the program. Hi, thanks, Ray. Thanks for having me here. I'm so excited today to talk about functional medicine and the amazing work you're doing in the UK and around the world, really, in the in this space. But but before we do that, maybe maybe tell us a little bit about your journey. I I mean, it's amazing. It it spans uh going from a NHS colorectal surgeon to the founder of human health. Like, so like what was a moment, maybe or series of moments that made you realize the traditional medical model wasn't giving people what they what they truly needed?

SPEAKER_00 2:29

I think for me, it was definitely around the time of my research work. Um I did four years of research towards PhD in the middle of my surgical training, and we were looking at something called sacral nerve stimulation, which is now much more widely adopted than it was then, in the treatment of incontinence. Now, it started with treating people who had uh difficulty controlling their bladders and then evolved into helping people with their bowel control. So in my research, we were looking at these groups of women who had struggled for many, many years, and I think that was my first foray into realizing number one, the the sort of how poorly served women were, and women still are, sadly, by the healthcare profession. Um, but it also made me realize that health is so multifactorial, and um, you know, these women had had a period of their life where they had very little uh in the way of symptoms from their pelvic floor disruption following childbirth because their body kept them in balance, and then as they went through their life, lost the effect of their hormones on their pelvic floor, and they started to lose mobility, their symptoms got worse. So you could see this sort of unraveling happening, but I could also see how they were helpless, and actually, the healthcare system was pretty helpless in being able to help them with their symptoms. So that was where I guess my eyes were first opened to the fact that uh there was a lot more than we could achieve with the knife, but also with um, you know, even a prescription pad. Uh, and it went on from there. I then set up my private practice. Uh, that was around the time of COVID, and again, that was very much because I just saw things that I knew were not straightforward, it was not just a viral kind of end result. Why was there a selective kind of picking off almost of people from different ethnic backgrounds, different sexes, different illnesses? And inflammation, of course, we now know was very much the kind of underlying theme. And and of course, we know what causes inflammation, we know about chronic disease. So I started really to look at how we could use other therapies like nutritional therapy to help people. Um, and that was really when I discovered functional medicine, and I just felt like I'd come home to the science, to understanding the biochemistry, the physiology, the anatomy, you know, it was just very familiar language. None of it felt um, you know, like snake oil. Uh, and indeed, I then realized that there was no college here in the UK to help doctors who wanted to practice functional medicine. So that was something I helped set up with my co-founder, um, Dr. Indra. And we set it up almost four years ago now. So we're 70 members strong. These are 70 doctors who are dedicated to offering a root cause approach to their patients' chronic illnesses. So that's been exciting to set up, and of course, then setting up my own clinic um has been very much part of that. It's an evolution, I think, you know, to keep up with the science, if nothing else, and this evolving, incredible space, which is just mind-boggling. I mean, the tech that's happening, the use of lab techniques coupled with uh, you know, all the omic testing that's available, is just phenomenal. Um, and I think for us now, it's the translational um piece that we need to really focus on. How do we take it from bench to bedside or bench to clinic? I think is really key for us. Uh so yeah, it's an exciting time to be here.

SPEAKER_03 6:39

Yeah, I want to I want to dive into the whole functional medicine story with you and also and also about your clinic, but maybe before we do that, a couple more more things. In your

Personal Perimenopause Wake Up Call

SPEAKER_03 6:49

own, you in your own history, you you've spoken about your own perimenopausal experience and shaping your perspective. So, how how did that personal chapter change the way you think about you know health beyond symptoms?

SPEAKER_00 7:04

Okay, thank you for asking that, Rob. And actually, I would probably go one generation before me to my mother. You know, my mother is uh now a retired doctor as well herself, and she very proudly just white-knuckled her way through the menopause. And then promptly, literally promptly, within probably a few months of declaring that she was delighted she'd finished her period, and she actually then developed type 2 diabetes. She needed her first cardiac stents about a year later, and um has gone on to have more stenting and is possibly one of the worst people that I know to manage in terms of her diabetes. Uh, that's not least because she's my mum, but also I think because she's a doctor. But she was a generation that really demonstrated the exact immediacy of what happens to women as they traverse that time, that inflection point where we lose the protection of estrogen amongst other hormones. And so, really, for me to witness that, I remember thinking, wow, what is going on here? You know, how has this happened? But it was almost just assumed that this would happen. It's it's an interesting kind of conversation when you speak to my mum and she's like, Well, I've just got older, that's just what it is. But when I talk to her and explain about the metabolic piece, I think it lands. And I think uh for me then, when I started, I had my children a little bit later. Um, and of course, on the backdrop of my cortisol story as a surgeon, you know, long days, long nights, constancy, I think the constant uh kind of being on it was a really important thing for me. Um, so that cortisol switch was very much um active. I then had my children in my mid to late 30s pretty much sequentially. I had three children under three at one point, okay. So, along with the physiological stress that put on me, I know that obviously the um of carrying three children, I think that the the nights or the no sleep would have had an impact on me. And certainly, with my first um pregnancy with my son, I was borderline failing my glucose tolerance test, and I was exhausted, you know. And now, of course, knowing what I know, and it's one of my first questions to any woman if she's had a pregnancy, is how was that pregnancy? Because we know we can get so much data from that. So for me, I kind of had my eyes open quite early, and I feel very grateful for that because for me, my metabolic health is absolutely kind of not the cornerstone, it is the foundations of my my daily life because it has to be, because I'm I wear so many hats like many of the women I look after, and and they're all important roles, and I want to show up for those roles in the best possible place and state I can be.

SPEAKER_03 10:11

Well,

What To Unlearn From Protocol Care

SPEAKER_03 10:12

and and thinking about your your past experience from surgery and NHS practice, which lessons uh from those stuck with you and which had to be unlearned when you created this holistic health model?

SPEAKER_00 10:29

Well, I think one of the most important things was actually one of the sort of um pieces of advice that my surgical mentor gave me, Mr. Snooks. He said, and he was one of the fantastic kind of maverick surgeons of his time, really, and he just said, My only, I can teach you to operate like I can teach anyone to operate, really. Uh, you know, which wasn't a great compliment, but he said, the most important thing I can teach you is that uh is you know, choosing the patient, making sure you're operating on the right person with the right operation at the right time. And I think that applies to all of medicine, it's not just an operation, is it? It's we have to look after our patients and even the kind of not doing anything, the active not doing anything has to be done at the right time. You know, when are we choosing to not intervene with a medical intervention, but holding space for them, listening to them? That in itself is therapeutic. So that was a really beautiful kind of thing that has always stuck with me. Um, and certainly the things that I I wouldn't want to take through to would be the kind of following a protocol, not switching on my brain, you know, doing something because that's what everyone does, and that's what we should be doing, and that's what the kind of the guidelines, the financial guidelines dictate. Um, you know, the loss of that human connection, uh, working to deadlines because the hospital's going to get a fine if we don't achieve those, hit those targets, right? You know, where where is the human connection? Where is the patient and all of that? And I think that was definitely for me one of the points at which I just woke up and just went, I can't do this, this kind of medicine anymore, because it it's not really medicine to me.

What Functional Medicine Really Means

SPEAKER_03 12:26

Well, let's let's talk about functional medicine a little bit. And for for some of our listeners who may not be familiar with that that term, uh, what what exactly is functional medicine and how does it differ from, let's say, mainstream medicine or integrative medicine? I mean, we've all heard the term, but maybe dive in on what the what the nuances are there.

SPEAKER_00 12:49

Absolutely. So functional medicine is commonly referred to as root cause medicine, which means that we take a broader view on an individual. So if they come to me talking about, say, brain fog, I won't just sort of exclude a couple of obvious things and prescribe some antidepressants, for example. For me, I would want to know the whole of their health history, including the story that they're kind of born into this world with, so the genetics, understand their childhood events, which we often describe as adverse childhood events, ACEs, right through to how various interactions and potentially trauma may inform their young adulthood and their adulthood, right through to their um experiences of their environment, and this could be relationships with various toxins, uh, right through to current events that may be happening in their life. For example, perimenopause, for example, um, you know, having recently lost their job. We know that all of these activities and these exposures are going to prime their genetic coding to mean that they're going to experience their health in a different way to say, even their twin. Okay. And so that's a sort of scientific description. When I talk to patients, the way that I explain it is that, you know, hey, your car, you know, if you're likened to a car, you take your car in to have it fixed because it's not working properly. And instead of just kind of tinkering with something and giving you the bill, I'm going to literally lift up the car bonnet and have a really good look around. I want to know everything that's happening, I want to be checking all of the levels, all the pressures, and understanding the whole of you so that it may not be quick, you may not get your car back anytime soon, but you're going to have a really deep understanding of what's going on under that bonnet, so that we know that you're going to be running a lot more efficiently moving forward. So that for me is a really exciting um possibility. And I think when you explain this to people, they get that it's not going to be a quick fix, they get it's not going to be an answer at the end of a prescription pad, they get that it's going to be work on their side too. You know, I'm not carrying them. And I think again, to go back to your question about what would I leave behind, I think that concept of this big kind of patriarchal system that's going to save the individual, that's going to stop them thinking and asking questions, that's not where we sit now. You know, we have got a responsibility to be keeping up to date with our skills and understanding recent testing and changes in testing so that we can decode that data for them. Because they come to us with the story of their health, but they also uh we need to check, you know, what are the oil levels? So we may need to do some functional testing. We need to, as clinicians now read those tests and understand it in the light of that individual sitting in front of us. It is no longer acceptable, I don't think, to sit there and just look at some reference ranges and say, yeah, normal, normal, fine, you know, people need answers. And I think functional medicine gives us the lens to answer some of those more chronic conditions, which let's face it make make up the vast majority of the disease burden in the world, um, and give people viable solutions, which may not be quick fixes, but we are there to walk with people. We're there, you know, as clinicians, we are coaches, we we do hold a space for them that allows them to experience their health, and sometimes they're kind of you know, they fall over and we help and we wait with them till they get up again and start walking, right? That's our job. We're we're we're there to kind of hold that space. So for me, functional medicine is a really exciting place to sit. Um, having you know walked in the standard of care model, I think there are lots of differences, we've covered a lot of them already, but not having this didactic listen to me, this is what I'm saying, you know, don't ask questions till it's broken, you know, that is not that's not uh what I would want people to do anymore. Um, and of course, the kind of the role of farm the pharmaceutical world cannot be uh underestimated or ignored. Medicine has evolved in the last hundred years uh really under the influence of that, so that it's it's not necessarily where medicine started. Um and integrative health is really the space where we're combining lots of different models. So we may be using a little bit of that holistic approach with some of the prescribing approach. And I think there's a beautiful place for that as well within the evolution of healthcare for the world.

The Timeline And Symptom Clusters

SPEAKER_03 18:05

So what maybe what's the most powerful aha moment you see in people once they stop thinking of health as the isolated parts and start thinking in this functional, integrated, systematic approach?

SPEAKER_00 18:21

So, and that's a great question because I literally see people go, oh, is when I show them the timeline, right? When they so they've before they see me, they will have plotted and they will have answered, you know, over a hundred questions, really, which is you know, it requires time and it requires focus. And for me, if they can't complete those, it's almost a red flag that they've not been able to kind of have the bandwidth to do that. But um, when they have done that and they I show them the timeline, they start to realize, and actually, for some people it's very emotional because they suddenly realize what their body has taken them through. And I'm like, isn't this an incredible opportunity to say thank you? You know, I know you're here annoyed about these symptoms that you've got and they're frustrating for you, but actually look how far your body has got you to this point, in spite of everything you have experienced. Um, and so that is often a big aha moment. Um, and also when you create a matrix, you've then got this opportunity to create clusters of symptoms, which makes sense. So suddenly they're not seeing all these very disparate symptoms that are happening in different organs, they're seeing them as a whole because they are whole, and these our systems talk to each other, they don't sit in silos, you know. As much as we in in kind of standard of care model would like them to be separate, they're not. It's awkward, it's it's annoying, but we have to somehow actually, as clinicians, put the whole story together. So, yeah.

Telemedicine And Global Patient Care

SPEAKER_03 20:04

And and so your your practice uh patients can come from anywhere within the UK, is that right? In order and and to uh for their payments, or do you take international patients also through telemedicine or anything like that?

SPEAKER_00 20:19

Yes, we do. There are regulatory pieces, of course, um, for us to navigate, but um, in essence, we are able to take patients from you know globally, which is exciting. And that's one of the beauties, you know. I think one of the small COVID gifts would be uh the fact that the concept of speaking with someone online is far more acceptable. Uh I remember I tried to bring it in before COVID and they were like, no, we're just gonna come and see you, you know. And now, of course, people are more than happy, it's very convenient. Um, different connections happen online. It doesn't mean you can't connect, it's it's just different. Um, but I I I do try to encourage people to come and see me at some point, yeah, in person.

SPEAKER_03 21:05

Yeah, well

The Human Health Roadmap Pillars

SPEAKER_03 21:06

let's talk about your your program. Maybe the let's start with the human health roadmap. So, what are the key physiologic pillars that you look at first when someone walks into the clinic or or comes uh remotely over uh uh telemedicine link?

SPEAKER_00 21:23

Yep, so for me, the first part of that is really uh ensuring that we can help. So there's always a clarity call. So I always want to know that I can help that individual before they embark on a program. So that's um usually just a 20-minute check-in. And then uh, if all is good, then they will be sent this extensive list of intake questions, uh, which we will then go through. I won't go through the questions to like individually. I'm looking at the patterns before I see them because I want to hear from them what their symptoms are in real time, and because you know, a question. Don't give you that emphasis and those nuances, and of course, then in that time with me, we it's a deep dive. I really want to know everything about them. I want to know their inside leg measurement, the name of their dog, their neighbors, you know, their relationship. Like, because these are critical, right? For for how they function. I want to have a mental image of their whole day, and um from that, we then put together this a journey, a plan. Um, so for me, the first piece of that is really understanding what their gut health looks like, these are the foundational pieces, and how they are detoxifying potentially their hormones and everything else. So that's the first critical piece. The second part of the process is then looking at hormones and metabolism, and then I will take them through a process of kind of understanding their nervous system and helping them to reset that, and finally, really hopefully by then, we will have got to a state when their mitochondria were actually being optimized. So that's the kind of framework, it's a loose framework. I've evolved it over time because I feel we needed something, you know, to hang our hat on and a pathway. Otherwise, it's a bit of a kind of a leap of faith. Um, but it's open for change, it's open for them to feel, you know, to challenge. For example, I saw a lady literally yesterday who was talking to me about her um inability to function for two weeks of the month, and it has been getting worse, and she's 41, you know. So she's probably perimenopausal. She's more than likely, you know, and she can very clearly pinpoint it to the two weeks before her menses, and it's now almost disabling. Now she is so frustrated and angry she cannot function, and she's even so angry she finds it difficult to sleep. Okay, so for me, talking to her intentionally about her hormones and possibly supporting her with some hormones would be quite important so that she can function through the program itself. So there is room for maneuver in that structure.

SPEAKER_03 24:14

Yeah, you

Thrive For Perimenopausal Women

SPEAKER_03 24:15

and then you mentioned uh the you have the Thrive program also, which is one of your flagships, I think. Um so what what specific physiology or lifestyle patterns does this target first? And who who is that for?

SPEAKER_00 24:31

So Thrive is very much aimed at women who are in the permenopause for exactly the reason that the name, you know, it's exactly to help them thrive. Because I think um certainly again, going back to my personal experience, there was a period of my time when I was just surviving, you're just in survival mode, and suddenly you come out of it and you're like, wow, that was exhausting. What is going on? And you realize that your hormones are changing, your career's changing, your children are challenging, you know, all these pieces are happening, and you kind of think, is this it? Is this it forever? Um, and so I thought, well, my piece in that that I could contribute is helping women to have some element of understanding and awareness of their hormone health. So, really, Thrive is designed to help women to come to terms and understand their hormones better so that they can thrive, so that they can continue to smash those glass ceilings and really move through their hormonal health in a more kind of mindful way rather than just blindly kind of navigating it so they had some handle on what was happening for them. So, yes.

SPEAKER_03 25:40

And and

Ketogenic Weight Loss And Maintenance

SPEAKER_03 25:41

what about the the body fit and core membership programs? How do those two differ and and who would benefit from each of those?

SPEAKER_00 25:50

So, body fit is my um essentially it's a weight loss program, but we are using the metabolic piece and the cortisol resetting as the core piece to that, so that people, women primarily, but we do help help men as well. I'd like to kind of highlight that. Um, the men that come to us come through the women, um, and really that is about resetting uh metabolic health because one of the fallouts from that obviously is the weight loss, and that's fantastic. So that is a 16-week program where we use essentially a nutritional ketogenesis, so we help people to become ketogenic under medical guidance. Um, so obviously, there is a selection program and eligibility criteria for that. Um, but once people hit ketosis, they are in a fantastic place. So we help them do that and then bring them to a maintenance in that program. Um, and core is a membership space, so that is really access to lots of recorded content and um meal plans and ideas around health. Uh, lots of interviews that I've had with incredible people um around the world. Rob, you'll have to be part of the next one. Um, and uh it's it's really a resource because what I was finding was that people were coming to me having done a good old Doctor Google search and still had no answers, right? We're in the middle of an infobesity epidemic as much as an obesity epidemic. People just have access to so much information, but they just don't know where to start. So they're almost worse off than ever before, I think, sometimes.

SPEAKER_03 27:35

In your in your keto, your ketosis programs, do you um what what is the the strategy for getting them into ketosis? Is it through um nutrition, exogenous ketones, fasting, or all of the above, or what works best?

SPEAKER_00 27:52

Yeah, good question. So it is through um uh using uh nutrition, so they will be removing carbohydrates and any fats for uh six weeks in that program, um and eating lots of fantastic food, but you know, and so it's very structured um and nutritional therapy-led. Uh, and then we move them into reintroducing fats and complex carbohydrates, complex naturally occurring carbs. But by that point, of course, their palate has switched, their kind of mental um relationships with food has improved, and they are really ready to stay in that really healthy kind of place metabolically. So I find it's often something they probably need to do once or twice a year, uh, if that, and they often become very self-motivated because they know the kinds of weight loss that they can achieve alongside that um program. So, yeah, that's powerful. And I think CGMs are also, you know, for for maintenance, CGMs are exciting tools uh to use as well in these programs.

SPEAKER_03 29:06

For people in the ketogenic programs, do any of them ever request or do you do you recommend if they do to continue on in ketosis, or or is it usually just a self-limited um program?

SPEAKER_00 29:20

It is a self-limited program because I think the evidence is mixed about sustained ketosis. Um I think we have to be careful, particularly in women, sustaining ketosis, that they're not beginning to lose muscle for too long. Um, which of course that's sarcopenia, which is likely to happen anyway. Um, we want to minimize that, and if anything, we want to build it. So I think, and also I think people lose the kind of momentum when they are denied any food group for any any length of time, right? So we have to be realistic, and I think going in kind of hard and fast and then getting out again is is a powerful tool. Um, you know, you know that from doing the three-day water fasts, etc. Well, as I think as human beings, we it's it's very difficult to sustain any kind of particular way of eating when it's restrictive for too long. Um, and I want I want them to be able to kind of not be as you know, be afraid of it if they're going to use it again as a tool again that year.

SPEAKER_03 30:31

Now,

Evidence Based Testing Without Guesswork

SPEAKER_03 30:32

um functional medicine sometimes gets criticized or accused of being, you know, too alternative. So how do you anchor your work in evidence and science and how does that translate for patients?

SPEAKER_00 30:46

Yeah, no, that's a great question because I think when I discovered it, it just I just thought, where has this been my whole life? Because this is the stuff I learnt at medical school, right? Like none of it is witchcraft or voodoo or snake oil, it is the very foundations of the work that we learnt about for three years at medical school, and then we were promptly put onto the wards, and um I think you guys call it uh street uh treat and street, um, so that we literally you know get people in and out of hospital, and that's again not medicine. You know, the the best histories were the ones the medical students do, right? Where they take a full history. So I think the biggest tool I have is time to listen to my patients and really understand what and and listen, really kind of sit and kind of slot it into all the experience that I've accumulated over my clinical years. Uh, and I know I have nowhere near as many Airmars as you do, Rob, but it's you know, you start to hear patterns in stories, um, and you then begin to get better at asking the right questions, like, oh really? So can I ask about your childhood? You know, was there any trauma? Was there any, you know, like there are some things that are happening as adults, you go, Wow, okay, so what like let's talk about food when you were seven, you know, what did that look like? So there are connections and patterns. Um, and I think, of course, the testing that we do is really exciting. Again, it's about algorithms and looking at say homocysteine with B12 and folate, for example, how does that fit? Why is it one goes up and one goes down? Um, we also look in the bloods, we look at different sorts of reference ranges, don't we? We we want to know about um where does that value sit for the individual in the reference range? It's not just yeah, that's normal. I want to know, is it optimal? Like how good is your vitamin D? I don't want it to be 50 because it just creeps into the normal range. I want it to be about 100, you know, especially if you're someone who has got a VDR SNP receptor abnormality on your neutrogenomic testing, because I know that your vitamin D receptors have got an issue with the way the vitamin D molecule activates that receptor on your uh cells. So we I want your levels of vitamin D to be higher actually than someone else. So there are there's lots of space for personalization, and that comes from understanding that individual story and understanding their lab tests. And listen, you know, there's always a lot of data that comes out of any functional medicine kind of consultation. I think one of the things, going back to my mentor's sort of um recommendation to me, is making sure it's palatable and understandable for that individual so that they can action it. There is no point me giving them 20 lab results if none of that lands with them, if they're not able to exercise, if sleep is an issue, you know, it's kind of like we need to give people tools that allow them to unlock the data as well. Otherwise, it's just a load of numbers, right?

SPEAKER_03 34:18

Yeah, there's so much going on, as you say, with the personalization, the nutrition, the hormone balancing, the metabolic testing. Where

AI And Biological Age Clocks

SPEAKER_03 34:27

do you see this all going and where would you like to see it five years from now? Uh, what does the future hold for this space?

SPEAKER_00 34:35

Well, I think AI is undoubtedly already is holding kind of uh a really powerful place. It certainly does in my practice. I think what it allows me to do is to really humanize the human interactions so that I'm totally focused, you know, I'm totally understanding what that individual is saying to me and using AI to potentially decode some of that data so that it's more available in the consultation for that individual. Uh, I think certainly, you know, I'd like to hope that we don't lose the clinician in all of this because I do truly believe no matter what happens, people still want a human being who is medically trained to be the individual that delivers that information. Um, I think the nuances of knowing someone's story really deeply is a very human quality. Um, and of course, compassion. You know, we we can't we can't delegate that to a robot or to AI. Um, but there is so much to be gained by having that sort of tech available for us. Um, testing, I think we're looking at um biological um clocks that are going to look at organ-related aging. So, for example, um I know that Timeless biotech has just brought out a ovarian age clock, which is phenomenal. I mean, you know, for a woman to know, although it can be terrifying, I think for a woman who is approaching her perimenopause and menopause to know exactly when she's going to stop ovulating forever, how powerful is that? Because we know that whole prelim period is a time for metabolic change, and if she can use it to then optimize her metabolic health, why would she not want to know that? So there are so many powerful, you know, if there is useful, there's useful things that she can actually do. I mean, there's no point knowing if you can't act on it. So I think not only is the tech going to absolutely kind of explode in this environment, I think the the tools that are available will become more powerful for people and the messaging will become more powerful too.

Bridging NHS Care And Prevention

SPEAKER_03 37:08

You're also active in clinical education, and I I had the pleasure of attending a great conference you just had recently there in London. What's the and maybe share what you've got coming up and also what's the biggest shift you want to see in how health professionals practice medicine over the next decade?

SPEAKER_00 37:30

Yeah, thank you for mentioning Future Patient, which was a wonderful congress in February, and there is also a quarterly free digital magazine. So please do go ahead and download it and read it and feedback to us. Um we've got, I mean, I think to answer maybe your last question first, we have got certainly in the UK a very sizable divide between clinicians practicing medicine in the NHS, in our national health system, versus clinicians who are practicing it in the private healthcare space. And I would say both groups are trying to navigate that divide, but it's really tough because the NHS is set up on structures that are based on population medicine, you know, and rightly so. It is there to serve the sick community. But how about that whole run-up when people are experiencing chronic illness and we know that there is a huge period of time that we can actually implement education changes, not just screening, I'm not just talking about early cancer detection, I'm talking about true cellular health change where we can change the needle and move people back into an area where actually, when their symptoms are appearing, we're not saying to them, don't ask for help, like you know, where keep your head down and keep going. We're gonna encourage people to come to us earlier and earlier with symptoms, or they can start to act on those early symptoms themselves and start to move themselves back into health because we know that moving the needle back is a lot easier when it's not come too far off north, right? So there's a lot less work for us to do as a profession, but also within the population, there will be a lot more autonomy, a lot more sovereignty over people's own health and responsibility, you know, and that isn't just on the individual and on society, that is also a responsibility to be laid down at the feet of policy makers of the food industry and of course the pharmaceutical industry. So there's a lot of work to do. Um, I think change comes from the public, it comes from the individual asking, knowing better. So, all I can do as a clinician is to keep signposting, to keep elevating the level of education, and you know, hopefully move people back into some really fundamental tools like just letting their body do what it was designed to do, so eat better, move better, sleep better. Some of these really kind of you know, it's that beautiful mundane, right? The the things that we find slightly boring, you know, unfortunately, that is that um those habits that we create are the things that inform our health later on.

SPEAKER_03 40:47

Well, as

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SPEAKER_03 40:48

we get near the end of our time together here, is there any question I haven't asked you that you wish I'd asked you, or any any closing comments you you want to make for everyone here today?

SPEAKER_00 41:00

Well, no, I think I really want to thank you for this opportunity. And I'm you know, I'm so uh honored to be on this um podcast, and particularly I think for you and the likes of your kind of uh generation of specialists that did this work so early on is just paved the way for us, right? Because otherwise, yeah, I know you find it funny, but it's like seriously, it gives you a lot of things.

SPEAKER_03 41:26

No, no, thank you.

SPEAKER_00 41:27

That's very kind, it's very kind of thing. We would we're only ever able to stand on the shoulders of giants, right? And we each generation of clinician is able to change things based on what's gone on before. So thank you. I'd like to really uh you know applaud you for all the work you have done and continue to do, because this is like this is an incredible space to have these honest conversations and um and hopefully keep inspiring the next generation of clinicians that are coming through too.

SPEAKER_03 42:00

Thank you. Thank

How To Work With Dr. Gudaratni

SPEAKER_03 42:01

you, Miani. Uh if if if listeners want to start their journey with you, what's the best way for them to get in touch with you and find out more? We'll put it in the show notes as well, but maybe you could just tell them for people who are listening only, also.

SPEAKER_00 42:15

Well, please do um drop me a message on Instagram. I'm on dr.maion i. So that's dr my on Instagram. Uh, and also there are, I'm sure the email handles they're they're really long, so they they can go into the show notes. But you can contact me um and email my team, and we would happily see you.

SPEAKER_03 42:36

Well, thanks. Thanks so much, Mayoni. This was a great, great conversation, and thanks so much for all the great work you're doing. It's it's it's wonderful. Thank you so much. Thank you for your time.

Subscribe Review And Medical Disclaimer

SPEAKER_03 42:50

If you are enjoying this program, please hit that subscribe button or even better, leave a review. Your support makes it possible for us to create the quality programming that we're continually striving for.

SPEAKER_01 43:03

Can I start this?

SPEAKER_03 43:05

It's already recorded.

SPEAKER_01 43:06

Summary. This is for general information and educational purposes only. And it's not intended to constitute or substitute for medical advice or health money. The practice of medicine or the creation of health care diagnostics or treatment or the creation of a specific patient or clinical relationship. So use the information that it's great. If you find this to be on the value, please hit that like button to subscribe to support the work that we do on this channel. And we take the your suggestions and advice very seriously. So please let us know what you'd like to see on the screen. Thanks for watching, and we hope to see you next time.

SPEAKER_03 44:01

I think that was good. Yes. Alright.

SPEAKER_01 44:03

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