77. Unveiling the Menopause Mystery with Dr. Michelle Harden and Nutritionist Katie Clayton

There is little doubt that midlife and menopause bring along with it a lot of confusion and mystery. Take a listen today as Dr. Harden, Katie Clayton and I navigate through some of the big twists and turns of women's health. 

Dr. Michelle Harden, an OB/GYN and obesity medicine specialist, has worked with nutritionist Katie Clayton for the last number of years in their San Antonio, TX  practice to help women unravel the secrets of menopause and holistic well-being. We talked about the intricacies of hormone therapy and the critical need for personalized care in today's fast-paced medical landscape. Dr. Harden's expertise shines as she advocates for lifestyle as powerful medicine, while Katie's nutritional wisdom offers hope for those seeking a cooperative approach to disease prevention.

A few of the important topics we discuss: 

• The confusion around hormones in women's health (it's not just about estrogen);
• testosterone's multifaceted roles in women's health and how and why to use it;
• the merits of DHEA, insulin, and cortisol, and the profound effects of diet choices on our path to hormonal harmony and balance. 
• the complexities of diet culture and the confusion around what to eat and why;
• the use of weight loss drugs like Ozempic and the future of their use.

If you've ever felt overwhelmed by the maze of menopausal symptoms and hormone replacement therapy options, this episode promises a guiding light toward holistic alternatives and natural interventions. Tune in to empower yourself with the knowledge to make informed decisions, foster peace with your body, and approach midlife with confidence.

Dr. Harden is available for remote visits, you can find her at her website HERE
Dr. Harden on FB HERE
Michelle and Katy's Book 'To Finding Healthy' HERE

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Hang out with Heather on IG @greenpalettekitchen or on FB HERE.

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Whether you are looking for 1-1 nutrition coaching or kitchen coaching let's have a chat. Click HERE to reach out to Heather.

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Transcript

Speaker 1: 0:40

Hi everybody and welcome back. Today I am with Dr Michelle Harden and nutritionist Katie Clayton. So let me start with Michelle. Michelle is a board-certified obstetrician and gynecologist board-certified in obesity medicine, a diplomat and fellow of the American College of Obstetricians and Gynecologists, dr Harden is passionate about the integral approach to preventative health, including evaluating and treating menopause utilizing bioidentical hormones and weight loss management. Michelle has extensive knowledge in training in women's overall healthcare and has an advanced certification in mind body skills and first line therapy. So, hi, michelle and Katie, how are you today? We're doing great. Good morning, heather.

Speaker 2: 1:32

Good morning.

Speaker 1: 1:33

Good Well, I have tons of questions to ask you and it's really nice to have Katie. You are a nutritionist and maybe you know what. Why don't you give me a little bit more about your background and tell me how you two work together?

Speaker 3: 1:48

Yeah, I'm a board-certified clinical nutritionist. My background I have my master's in Ingrative and Functional Nutrition and I've been working with Dr Harden for the last 15 or so years and we run a disease prevention clinic here in San Antonio.

Speaker 1: 2:05

That sounds fantastic. So it's great to have both of you on today because I know first hand the amount of confusion that reigns supreme when it comes to hormones and food and menopause and just simply being a woman in midlife and going through so many changes, and I want to clear up the mystery. That's really the point of my podcast and to just really get women out of this confusing time so they can feel at peace with their bodies and food and what they're putting into their bodies. So I'm assuming that both of you have seen over the years the gamut right of misinformation or just how to feel good in your body. So why don't we just jump in? I have lots of questions.

Speaker 1: 2:55

So, michelle, let me start with you. What do you feel like is wrong with the healthcare system today? What's going on? I mean, because I don't know about you but you just even go on the internet and what are most women I think are doing? And there is so much misinformation and confusion. I mean there's every diet you can imagine. Especially when women are in midlife, I think they're in a crazy vulnerable time. Right, our bodies are changing, they're shifting, we're maybe gaining weight. That wasn't there before. So tell me just more about what you think about the healthcare system, what you think is just going on in the world today, in the world of midlife health.

Speaker 2: 3:45

Well, that's a complicated question, but I think it takes time to really help a woman process this time in her life and most office visits now are very quick. It's a time-intensive problem that can't be solved in a short visit. So now that leaves people open to you and there's so much information out there and it's difficult to know who's really giving that information. What's the background of people giving this information? So I think that knowing where you get the information, establishing a relationship with a physician or a provider that you feel comfortable, that can work through this process People are looking for a quick answer and something that it's not a quick problem to solve and we tend to make it more complicated than it can be.

Speaker 2: 4:52

Also, I think and we undervalue the power of lifestyle as medicine. So lifestyle as medicine is a very powerful tool. Yet we live in a very unhealthy society, which goes back to our healthcare system. So you know we've got chronic disease as one of our number one problems and instead of getting to the root of why those problems occur, we tend to treat the symptoms. So everything becomes very fragmented and you know it's a team approach and that team approach is something that takes time and in our medical system. Nowadays, doctors don't have the time to spend with their patients, so that's where I think you see physicians breaking off and moving off of healthcare plans and moving more into, you know, the concierge business, so that they can be the doctors and the providers that they want to be to take care of their patients.

Speaker 1: 5:54

That sounds like a great, great steps in the right direction. I mean, I also know that there's a lot of medical doctors who are not that familiar with hormones, with women's health, I mean I know. I mean I have my own personal stories about going into perimenopause in my 40s and going to my gynecologist who really was clueless. I mean she never mentioned the words perimenopause to me. My regular, just primary care physician thought I was out of my mind when I did say I was going to go on hormones. She was in that, back in the thinking of those old studies that came out. And you know, I think that's a great question and, yeah, a lot I think needs to be changed right when it comes to women's health, Right, yeah, you know you're right.

Speaker 2: 6:44

What happened in the training for gynecologists? That all stem back from the first women's health initiative. So when I was in training I mean we were trained in hormones, we believed in hormones, we felt like hormone. I mean that was my training, that was my era. We were trained in the first women's health initiative in 2003 came out and basically said whoa, you know, estrogen replacement therapy is going to increase the women's risk for cardiovascular disease and so from that time point they stopped, really stopped emphasizing and training gynecologists in hormone replacement therapy. So, kind of looking at it is not a form of therapy. Yet 10 years and that's really where everything kind of started, from the breakdown in hormones and other people outside of gynecology came in and you know everyone's a hormone expert nowadays, okay. But 10 years later they came out, they re stratified that data and they found out estrogen replacement therapy can be very beneficial, but it's when you start your hormones. So if you start your hormones in the early Perry menopausal period menopausal period 10 years out, in comparison to a woman who is not an estrogen replacement therapy, you actually have a lower risk of cardiovascular disease, a lower risk of osteoporosis, helps with female well being, decreases your risk of colon cancer and helps even with the. You know, so many women complain about brain fog and estrogen replacement therapy at low doses can really or let me say physiologic dose can really help women, even in their own way, to have a comparative thinking, mild depressive symptoms. So what if there's all that good?

Speaker 2: 8:31

What was the big scare? Well, everyone thinks about breast cancer. If you go back to that initial study, women who are on estrogen alone had no increased risk of breast cancer above the time. It was only those women who were on the conjugated estrogen and the medroxy progesterone. And again, they studied synthetic hormones. Most, most gynecologists now are really going to utilize bioidentical hormones. But all the data is from the. You know the synthetic hormones. So again, if you look at that, for every one woman that dies of breast cancer, 10 women are going to die from heart disease, and estrogen replacement therapy is cardio protective.

Speaker 2: 9:15

I really think that we're missing the boat as gynecologists. But what happened to you, heather? No one really talked to you about hormones, and I hear that from women all the time. I said Well now, how come? You know you're, you're 60, why are you not on hormones? Well, no one ever talked to me about it. I don't know. I thought it increased my risk of breast cancer. So I think that paradigm needs to be changed and I think it's slowly you know slowly going in that direction. Unfortunately, you have people now taking it to the opposite extreme and doing the high dose with the, with the pellet therapy, and I don't think from a physiologic standpoint, that that makes good sense. But you know, it's a vulnerable population. Women are looking for answers, they want to quickly. They're being promised that they're going to get all these great things with the high dose hormones and yet there's potential danger or harm long term, in my opinion.

Speaker 1: 10:16

Yeah, I've seen anything right from my my original gynecologist, who was blueless, to then these doctors who are promoting, right, high dose the pellets and charging you a ridiculous amount of money for a lot of testing, right, that you are the unnecessary testing, hormone testing, right, because is that? Is that true that we do not really need to test our hormones?

Speaker 2: 10:43

Well, I mean, that's a that's a complicated question again, because I think that you know, initially testing to confirm that a woman is in menopause is helpful. But I think where the harm comes is a woman can go in and this is what I see a lot and her primary care draws her hormones and she says oh my goodness, your testosterone level is undetectable. You need to, you need testosterone. The patient's fine, she's not complaining about anything, she feels good, but now all of a sudden she's told that her blood is low and pellet therapy is recommended and it takes that woman down a road that is not necessarily the best way to go.

Speaker 2: 11:22

You know, 95% of the time I can help someone get started on a. You know and let me just backtrack to lifestyle is probably the most important thing. So it's lifestyle that's going to have the most impact and then the bio identical hormones can kind of tap in and decrease risk of disease and help that woman to live that lifestyle right. So I think testing can be important if a woman gets stuck and is not doing well on your initial regimen and there's something called the Dutch test which can be helpful and very complicated patients. But I think that you know the testing is really being done when they're giving high dose hormones and you want to make sure that the levels not too elevated or find the trend. So when you use testosterone it is really important to check levels because that can have adverse effects on the clotting system and you know the hair loss of the levels get too high.

Speaker 1: 12:27

Yeah, let's just go back for a second and talk about pellet therapy, because I don't know if, if a lot of women might be familiar with that. So what exactly is? I mean, I know what it is, but you tell. You know, why don't you tell the audience what? What pellet therapy is exactly? So?

Speaker 2: 12:43

so pellet therapy is the modality of giving estrogen and testosterone long term. So they put higher doses in a little pellet that is, which is like a little capsule that's inserted into the buttock area most of the time. Sometimes people put it into the abdomen and then it'll stay in there and be slowly released estrogen and testosterone for three to six months. So what's going to happen is you're going to get initial significant elevation and then again at two to four weeks and then it'll slowly decline depending upon and every woman has a different metabolism. So you know, people tend to feel really good at about two to four weeks because their testosterone level.

Speaker 2: 13:30

You know you're giving an artificial substance. Now, right, you're taking a bio denical hormone that's meant to work at a physiologic dose and now a woman may have a level of two to 400, and a normal level in a female is between three and you know, 75, 55 to 75 depending upon the laboratory that you utilize. So people are getting a basically a high, they feel good energy, but it's all artificial and it overrides your own internal system because the body smart, right, the body seeing these high dose hormones. So now it's shut. The body kind of shuts down its production and if you're on that long term, you may require you know long term hormones in order to feel good at a higher position.

Speaker 1: 14:23

So then my next question is because we're talking about testosterone right now. So I think, for many women, they are under the assumption that it's estrogen, right, it's what we need. Hormone replacement equals estrogen, but there is also some testosterone, right? Our bodies as women do make testosterone and that drops, and there's also progesterone, right? So there's these three hormones. What's the role of testosterone, then? Because I think, for most women, they would think of it as a male hormone.

Speaker 2: 14:53

Right. So our bodies do produce testosterone naturally. It's the ovaries, our fat cells, the adrenals. Once a woman goes into menopause, the source from the ovaries is going to decrease, but again, testosterone is produced naturally in the body. With exercise I mean ways that you can stimulate your own production of testosterone is with exercise, lowering your stress level, certain types lowering your cortisol. So ashwagandha is an adrenal adaptogen that can be beneficial in that form. But testosterone helps with lean muscle, it helps with mood, it can have an effect on the immune system. So a lot of women think of testosterone and libido right. But they actually study testosterone to see if it would have an impact on a libido and it did not, and that is the reason that testosterone is not FDA-approved in women. From that study, however, they did find that testosterone did improve mood and it has an effect on the bone and just some women overall well-being.

Speaker 1: 16:06

Yeah, I definitely know that some women do take testosterone for sex drive and have good results of it or say that they help them Right.

Speaker 2: 16:17

Because I think, right, libido it's a multifactorial problem, right, even if you're feeling better about yourself, you're going to have more of a desire to have sex, and if you are less stressed I mean, there's so many things that are involved in it that is just not the level of the testosterone, unless you go to a superficial logic, high right, like with the pellet therapy, if a woman is running around with a testosterone of two to 400, she's going to have the sex drive of a male, and men and women are. You know, they're kind of wired a little bit differently. If there's a male and a female and both are exhausted, most of the time, a female would want to sleep, right, rather than sex. A male would take sex and then sleep. So we're just wired differently.

Speaker 1: 17:04

Right, okay, all right, well, we'll come back to that. So I have one other thing I wanted to just. You've mentioned lifestyle a couple of times and, katie, maybe you can talk about this too. You know, just as far as food and what we're nourishing ourselves with, I know, I mean, I know as a nutritionist also that how important our food is and what is. There's a lot of people that I know at least, who are scared to take hormones. I mean, they still have that fear from those old, outdated studies. Plus, they think it's medicine and they don't. You know it doesn't feel pure or you know, whatever their reasons are, but they'd rather try other, alternative ways to deal with their menopause. So what do you think? Are there foods that we can?

Speaker 3: 18:00

I think we put a lot of emphasis on treatment and not enough energy goes into prevention and I think that it takes that takes a lot of time.

Speaker 3: 18:10

And our patients come in and they're like you know, sometimes they're just convinced that it has to be their hormones that are making them tired and making them exhausted.

Speaker 3: 18:20

And Dr Hardin always says to them the two most important hormones that are going to have an effect on how you feel are your insulin and your cortisol, which goes back to how you eat. What foods are you feeling your body with? I think we tend to just think about food in terms of calories, but food is information and we're constantly breaking down ourselves and rebuilding. We're constantly breaking down muscle and bone and rebuilding these out of the foods in our diet. And, interestingly enough, in the United States we spend $50 million a year on the sales the sale of DHEA, and studies have shown that if you can eat a plant-based diet and lower your protein intake, you can increase DHEA production by 20% in just a week. So food has a great impact on the hormone regulation in your body and how you feel and your energy needs and your energy production. So I think it's underutilized. You really just kind of overlook food in that regard.

Speaker 1: 19:27

So $50 million a year on DHEA supplements? Yes, so can you explain what DHEA is just to my listeners, just because that might be a new one for them too.

Speaker 2: 19:41

Yeah, so DHEA is dehydroepi-endosterone and it's a precursor to testosterone. So and it is actually, in my opinion, a preferred way if you're gonna use a hormone to use a DHEA low dose. A lot of times providers put women on high dose 50 to 100 milligrams I'm talking about five to 10 milligrams and that really is converted in the body to testosterone. So the benefit of that is you don't have to draw levels, the body is gonna knows how to utilize it. Dhea, again, has the same effects Immune system, mood, lean muscle mass and interesting they did a study of men and women in an intensive care unit who were septic and they found that those people who had higher DHEA levels actually made it out of the ICU. So it's the effect on the immune system that it has on the body. But, as Katie was saying, what you put in your body can naturally raise your levels also.

Speaker 2: 20:52

But again, our lifestyles in this country it's the antithesis of what the blue zone people live. So our social medias, our phone and Facebook, that's our community, whereas in the blue zone they don't have any of that. They live a very mindful life. We're very mindless on the go. All the time Everyone says, well, I'm so busy, I don't have time to exercise, I don't have time to cook, but yet that's gonna have an impact on our health. So lifestyle, like Katie said, is very much underutilized and there isn't. I have found that the higher your insulin levels, the more hot flashes a woman has. So like you, Heather, I have women in my practice that don't wanna take estrogen replacement therapy for the reasons that you state they feel. Even though I say, well, it's not a medication, they go. Well, I just wanna do everything, quote naturally Well, they can live a very good life eating low glycemic. So the lower you keep your blood sugar, the less hot flashes, the less night sweats a woman may have. So that's just the impact of how estrogen, insulin, you know, are intertwined.

Speaker 1: 22:12

So what you're saying is that night sweats, hot flashes the typical menopause symptoms can really be helped by low glycemic food. So tell me so what would be an example of some low glycemic foods again? I mean, I know this, I've just, you know, just for the my audience, just to, so they're educated on what this is.

Speaker 3: 22:36

Well, I think, for example, if you ask the average person coming into our clinic what they eat first thing in the morning, well, they'll say well, I have a cup of coffee. So if you look at how we wake up in the morning, we've gone, you know, sometimes eight hours or longer without food. That fasting affects your cortisol, which affects your insulin, which affects your ability to burn fat and build muscle. So we wake up fasting, we're dehydrated most of the time, we're not hydrating through the night, which can also affect your cortisol, which affects your insulin. And then we're stressed out cause we're, you know, thinking about our day and what's gonna happen, which affects our cortisol. So we've got this really opportunistic time to fuel our body with something really nourishing.

Speaker 3: 23:22

And then you know they might say well, I was in a rush, I grabbed a banana, and a banana is high glycemic, it's got more natural sugars, yes, but still affects our blood sugar.

Speaker 3: 23:33

So we're putting caffeine, we're grabbing quick sugars and maybe even a toast sometimes, which studies have shown that the bread that we buy in the store, that whole wheat bread, can affect your blood sugar as much as white bread because it's so processed. So, thinking about higher protein-based foods, adding more fiber. Thinking about plant-based, we utilize a protein. It's not really a protein shake, but it is higher protein. It's a medical food. It's full of vitamins and minerals and you can get about 70% of your target nutrients in a day with the first thing you put into your body, whereas when you look at the average population coming into our clinic at about seven o'clock at night, the average person has only had 60% of their target nutrients for an entire day. So just learning how to fuel your body with the right foods at the right time, you can affect your energy levels throughout the day and have a regulation on your hormone production.

Speaker 2: 24:35

And when you think about low glycemic, if you just keep it simple, say well, if it's not packaged or boxed and if it comes out of the earth. So you think about your vegetables, you think about your low glycemic. Low glycemic fruits. I mean things like Katie said, they're not gonna raise your blood sugar. So your berries and your apples are gonna be a better example than your pineapple and your watermelon. But your plants and that's why a plant-based diet is something that's underutilized and I'm not saying that meat is bad in any way, but if you wanna look at ways to get your nutrients and ways to stabilize blood sugar, the fiber from your vegetables and your plants are gonna be very beneficial.

Speaker 1: 25:20

Well, I think just back to Katie's point of women also starting their morning with coffee. I see a lot of people who just say I'm just not hungry in the morning and I say to them you're missing an opportunity to nourish yourself, to start off your day right, Because then it can kind of snowball into snacking and grabbing things that are packaged and processed.

Speaker 3: 25:45

And if you wait until you're starving right Anybody, when you're ravenous, your willpower is just depleted, you're gonna grab that. You crave that quick energy and a lot of times that's that processed carbohydrate that is just readily available. That's gonna fill you up quickly but not nourish you.

Speaker 1: 26:03

Exactly right. You're sometimes not even thinking straight. We've all been there right, we're so starving. And you're like just give me a candy bar if I have to have that. But what about protein? I know in this country I mean protein is. People are obsessed, I think, with just making sure they have enough protein. What are your thoughts on that? Far as midlife women, and maybe even with symptom management, is there something to be said?

Speaker 3: 26:33

about that. I think when you hear the word protein, we automatically picture a steak. There was a stigma that you can't build muscle, you can't be strong without protein, without meat and steak. We've really proved that wrong. There are a lot of plant-based sources of protein buckwheat, for example, quinoa, soybeans. I just think we tend to think that it's just that we think black or white. We think that meat is bad or meat is good. I need meat or I don't need meat.

Speaker 2: 27:09

There's a very happy Flexitarian Flexitarian, yes, right, if you want meat, utilize it, but it's not going to be the main source on your plate. It's going to be surrounded by those beautiful colored plants. But I do think protein is important as you age and as you age you don't require as much caloric intake, so it's even more important to get real food in your body to maintain that lean muscle mass, to maintain your hair, skin and nails. I think protein is important. We look at what getting at least four lean proteins a day. There's actually a formula that someone can figure out, but it works out to about four sources of lean protein a day from different sources animal or plants.

Speaker 2: 28:02

The majority of people do not get that Because, again, most people are going to go for that quick energy, like you and Katie were talking about. It's the carbohydrates, it's the quick things, it's the sandwiches and it's the muffins and the toast and the tacos and the San Antonio Okay, the wraps, right, I think that, again, protein is really important. But all the emphasis on the keto, which protein and fat, and there are certain instances where, from a medical standpoint, that may be helpful, but studies over and over for disease prevention and overall well-being really have proven that a modified Mediterranean lifestyle is going to be the most beneficial in disease prevention and really from how people feel.

Speaker 3: 28:53

Protein does go beyond just we just think about muscle. But it's involved in the production of hormones, right, it is involved in immunity and creating antibodies. It's for collagen in the skin, so it goes beyond just muscle.

Speaker 1: 29:08

I think the type of protein, the quality of protein, is important, because there's those high protein granola bars or high protein energy bars or just poor sources of protein like that. That's not what we're talking about. I mean, we want good, high-quality protein. I think another thing that you said is that as we get older, our calorie needs start to go down. I think when women start to gain weight, it's not necessarily because we're just in menopause. It's not like you can't blame menopause, but there's a lot of other things going on. Our calorie needs are reducing, our metabolism is lowering a little bit. So we have to be really mindful of what goes on our plate and then fill it up with plants and those lower calorie but high nutrient dense foods and then, of course, make sure we have some good protein on there. So it's all about balance good fats.

Speaker 3: 30:11

I think as we age too, we do tend to become more sedentary. We do move less as we age. A lot of our older population. One of the things they complain to me about is I don't feel hungry and they don't have an appetite. So when you don't have an appetite if you've ever been sick you don't feel like eating a well-balanced meal, you feel like snacking on things, sweet things or smoothies. You hear people say I got sick so I had some ice cream and I drank some Gatorade and I ate some saltines. I mean, it's never a well-balanced thing when you don't have an appetite. And so if we can get people to move and become more active, their appetite is better and they crave better, more well-rounded meals. And there's this YouTube video of this man. He's how old is he? He's 102. He's 102. And he is a sprinter. He's a runner, and one of the things he said when he got into running and competitively, his appetite increased, and so that was a huge benefit for him, and now he's able to eat healthier, more balanced meals.

Speaker 1: 31:22

Wow, that's great. I can't imagine being 102 and sprinting. That's something we can aspire to for sure. So I think the takeaway is I mean, eating. I don't think that food is very complicated at this time in midlife, but there are people out there in the wellness industry who want to like pray on women, our age, because we're vulnerable right now. Right, we're gaining some weight. Maybe you know and we don't know what to do about it. And so here come the like the menopause diet. Food is not that complicated. It can be really pretty simple. It doesn't have to suddenly when you turn you get into your 40s. You don't have to like adopt some brand new diet, right.

Speaker 2: 32:06

Right, and it's not just a problem for people in menopause either. It's a societal problem. So you know it's not really. I always tell people it's not really your fault, because if we look at our society and what's being promoted, it goes all the way back from the Cheerio box, right, heart healthy. So it's a societal problem that comes down to an individual and it requires us to really kind of get back to our basics and really kind of use our minds and, you know, make sense of things. I mean Cheetos, doritos is that going to really give us what we need, right Versus apples? And, you know, fresh strawberries?

Speaker 2: 32:46

I always tell people food scientists are out there and they're creating food to make it addictive. It's true, you probably can't eat one Dorito, but you know you don't eat 10 apples. You just don't do it because your body knows that you. You know you've got some nutrition when you've eaten that apple. So I think you're right where you were making it too complicated as a society. We just need to get back to some of the basics and not use the word diet because, as studies show, diets just don't last. So I think even the talk that comes out of our mouth has to really be well. This is how I've chosen to live my life. I've chosen to live a lifestyle that's conducive to well-being and decreasing my risk of chronic disease. I see so many patients who are taking care of their appearance and they're you know. It's just problem after problem after problem, all stemming from chronic disease, and we really need to start in our 20s in living I mean even really as children, right? Because right now, one out of three children have adult onset diabetes.

Speaker 2: 33:53

So, you know, the hormone problem is starting right there, and hormones are not just, like Katie was talking about, estrogen, progesterone, testosterone, dhea, it's our insulin, it's our cortisol, our norepinephrine, I mean it just. The list goes on and on. And so, like you said, we need to create that balance in a society that's very unbalanced.

Speaker 3: 34:16

And we also need to look at food as more than just something that regulates our weight. I mean, if you look at your genes, epigenetics, you know, if you look at a piano being the set of genes that you've been given, how that piano is expressed is based on our choices. How do we do we move or not? What type of food do we eat? Do we eat more veggies or more processed and packaged foods? Do we smoke or not? Do we live a high stress life or not? So our choices have a great expression on the law of genes that we've been given and food plays a giant impact on that.

Speaker 1: 34:55

Yeah, no, that's very, very true. But you know, I think this could be a whole other conversation just talking about, you know, food and genes. I think that with all the like, hijacked flavors from, like packaged food and everything it's, it is sometimes difficult to get people to get off of like processed and take out foods and like all that stuff and say just eat an apple and eat some grapes because that sounds boring, you know. And then if you don't know how to make your food taste good with spices and herbs and you know it's that's a process too, right.

Speaker 3: 35:29

And so there is a period where food doesn't taste good because you've been eating so much of chemically altered food, right, your taste buds change. And when somebody switches from like jiff peanut butter to a natural peanut butter, I hear my patients, they're literally gagging right. But then when they switch back to to the jiff stuff, they're like ew, it's so artificial, it's so gross. I could just taste the oils in there, you know. So you have to give your body time to to adjust.

Speaker 1: 35:53

That's yes, absolutely. You know you have to know why you're doing it right For your health and, and you know, have really good reasons behind it, which then, I think, leads me into my next question about weight loss medications like OZMPIC. I have been seeing, at least here in the Northeast, is exploding women who only need to lose, or do they even really need to lose weight, but you know they want to lose 20 pounds. I know many people on it right now and so and it's just alarming to me in a way, because it's so easy, it's just kind of goes along with our society, because it's just like a we don't have to deal with all the trying to transition out of eating unhealthy food to healthy food, and this is is a quick solution. So what? What are your thoughts about that?

Speaker 2: 36:46

Well, I would agree with your summary. It's so true. It's it is a quick fix. Now, on the other hand, there are certain populations that this drug can be life changing. There are significant you know, potential, small but real, significant risk with the semi-acryptides. But it's the population that wants a quick fix and physicians and providers are utilizing it in the wrong way. Someone who has a BMI under 30 or under 28, without any comb or Vinny's remaining, no other disease processes. It's really not an indication for this population, but it's been exploited throughout the internet. You can get it anywhere, you can get it compounded and it can't really become pounded. It's not the drug. That's not the drug that's being compounded.

Speaker 2: 37:40

So, and it's going to have, you know, we don't know, let me put it this way we don't know the long-term effects. We don't know what's going to, what the body's going to do 10 years from now. Again, it's overriding our leptin and our relin, which are hormones that tell us we're satisfied or we're hungry. So when people get off of these hormones, if they haven't made a lifestyle change, meaning they haven't connected the dots oh, my goodness, I don't have to eat so much food and they've been eating the healthy foods that are going to nourish their body. Those tend to be the and they're moving during, while they're doing it, they're exercising. Those tend to be the 20% that lose and can maintain their weight. So it was a tool that utilized they utilized to overcome the you know, basically the imbalance of their hormones that led them to the, you know, to the weight that they were having to lose.

Speaker 2: 38:38

But I think that the in the other way it's just, it's not right. It has potential long-term effects and we're even seeing a couple of. There's been a couple of suits brought against the big pharmaceutical companies regarding gastroparesis, because what it does is it slows down the emptying of your stomach, right, so that you stay full longer. And so for some people again, everybody's different, everyone has different genes, so that medication may not react very well on a certain population. And now gastroparesis, if you're off the medication and you cannot move that food through, that causes a long, a whole sequelae of medical problems from that.

Speaker 1: 39:26

Well, it'll be interesting. I mean, I did another podcast earlier. It'll just be interesting to see how this all unfolds, because it's not ozepax not going away, no it's not going away and I think there's going to be more and more drugs available.

Speaker 2: 39:41

But I think it's the long-term effects and I think that people have to realize. For some people it is definitely indicated. I mean, you know, if I'm in a obesity medicine standpoint, this is really a breakthrough for people who really need it. But it has to be utilized with lifestyle under good supervision, including the psychology of food. Okay, that is very, very important to be successful long-term. And the story will unfold. Time will tell. We don't know. We can't make a comment really one way or the other.

Speaker 1: 40:15

Yeah, I agree with you. I think that's so critical. I mean that it could be a lifesaver for someone who has obesity and other you know, other significant health issues. But you have to learn how to eat. Well, I mean you have to because you might not be on this medication forever and there's evidence right when you go off of it and you can just simply just gain all the weight back, which would be about 80%.

Speaker 2: 40:39

Eight out of 10 people will gain their weight back within a year.

Speaker 1: 40:45

Yeah, I mean that's. That's really disheartening. That would be.

Speaker 2: 40:49

Yeah, I think that's why you have to go to the root of the problem. It's just like anything in medicine you can't just treat the symptom, which would be the weight, right, you have to go to the root of the problem to figure out. Okay, you have to look at someone's life story, okay, because their food isn't. It's an. It's an, it's an illness. It is definitely a disease. So you don't just like with any disease from a functional standpoint, you want to go to the root of the problem. I think if you take the time to go to the root of the problem in the right patient, you're gonna really help them to live a healthier, healthier life with the with the greater quality of life, if you do it the right way and I want to add and say that it also really goes back to your daily habits.

Speaker 3: 41:36

If you can't establish these small daily routines that accumulate over time, we, we talked to her and I wrote a book together called to finding healthy, and in that book we talked about the power of consistency. We talked about consistency really being the secret sauce and our, our society, really overlooks the power of a little. We think that if I, if I don't get a lot of exercise and I just get a little exercise, well it's not good enough, right? But we show images in our book. We, there's this one monk who would stand in the same spot Every morning to say his prayers and his feet were ingrained in the wood. We show that a Latch on a swing set at a child's playground. Over time, just that constant swinging Wears that down.

Speaker 3: 42:24

So if you can just establish some really good habits that you do every day Over time, that that adds up to create a large change in your life. So if you can walk for 15 minutes a day, you may think that that's nothing. But over a lifetime, 15 minutes a day, you could walk around the earth a couple of times. So we have to, we have to really establish good habits. We can't, there's not going to be one thing that we can do In any regard that's going to make such a large impact. That's going to change our life. We can't take a pill, it's common sense. Lose a lot of weight, change our life, gain our energy, extend our lifespan. It's gonna go back to our daily habits.

Speaker 1: 43:08

Well, I think that's a great way to maybe blows out our interview, but I, because I think you know just the consistency and and just small habits, right, right, fortunately some women think it's like, really like all or nothing. I mean, I think that's what diets are, and but I, you know, just to Really focus on lifestyle first. Right and just I just start.

Speaker 1: 43:33

Just take one step after the other. I think is really important, and know that we're just doing our best, absolutely yeah, yeah. So any last words of wisdom? I mean anything about hormones, anything that you would like to leave my listeners before we sign off.

Speaker 2: 43:54

You know, I think, yeah, I think that you know it's a good idea to really have a conversation With your gynecologist on hormone replacement therapy when that time comes. I think it's important to understand that the benefit and I tell women, the only way you're really going to know if you're going to feel better is to give it a short trial. I mean, if you try it for six months and your quality of life is better, then that's going to answer. If you feel like you really did not and you have that underlying fear of breast cancer, you know, because you don't want to have any regrets in life, you don't want to say, well, I took this hormone, then I was diagnosed with breast cancer. I wish I never would have listened to my doctor on taking those hormones. So you have to realize that.

Speaker 2: 44:39

You know one in seven women are going to be diagnosed across their lifetime with breast cancer, so that if you do get breast cancer, you have to kind of look at it, the fact, because estrogen doesn't cause breast cancer, but once someone's diagnosed with breast cancer it may not be the right way, you know, to proceed and then to have grace and compassion with yourself as you're aging.

Speaker 2: 44:58

You know, when we were 20, we never thought we would be 60, right, every 20 year old is going to be 60. So to go through life, you know, treating your body and thinking about, as Katie said, your health every day, because your health, as someone said I don't know who said it, I did not say this, but I believe this health is your greatest Well and yet we put it lowest on our list, especially as women, because we take care of everybody else. So I would say have compassion, have grace, have a conversation with your doctor, try to be consistent in healthy lifestyles, realizing that food is information, food is medicine and movement, movement is what's going to help you to keep going through life and Create that lifespan and health span that hopefully Will equalize.

Speaker 1: 45:48

Right, well, great words of wisdom to, I think, end our our conversation. And, michelle, where can people find you and can people work with you online?

Speaker 2: 46:00

Yes, we have a. Both Katie and I have a virtual Practice and we can leave you that information. We have a website and on our website it's wwwstone oak women's center, calm, and then is it wwwfit-fearscom yeah, it's just fit-fearsthinkificcom.

Speaker 3: 46:19

And then you can find our book to finding healthy on Amazon.

Speaker 1: 46:23

Okay, great. Well, I will definitely link those in the show notes that people then can easily get to you from there.

Speaker 3: 46:30

So thank you, and we appreciate what you're doing for women, educating them and making this knowledge available to them, because it's not it's not easy to find good quality information.

Speaker 2: 46:40

Well, thank you so much do everything, heather, keep it up.

Speaker 1: 46:44

Thank you, and thank you both so much too. This has been a great conversation. I know people are gonna get a lot out of it and have a great day.

Speaker 3: 46:53

Thank you, heather, bye, bye, bye.

Speaker 1: 46:55

You.