%20(Instagram%20Post%20(Square))%20(25).png)
The Rejuvenating Health Podcast
Join Women's Health Nurse Practitioner, Lindsey VanSchoyck for a weekly dose of Precision Medicine as she addresses the hot-button topics specific to Women's Health, Fitness and Nutrition, interviews expert guests and hosts round table discussions with the team of dedicated functional health care specialists.
The Rejuvenating Health Podcast
165 | Gallbladder Reset
Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.
Right-sided pain after a fatty meal. New nausea you can’t explain. Bloating that shows up the minute you try to “eat healthier.” If you’re in perimenopause or menopause, those symptoms can point to something most women never hear about until it becomes a crisis: the gallbladder.
On today's show, Coach Laken and nurse practitioner Lindsey break down why gallbladder issues and gallstones become more common as hormones shift. We walk through what bile actually does for fat digestion, fat-soluble vitamin absorption, cholesterol clearance, and estrogen detox, then explain how estrogen and progesterone influence the system in totally different ways. Estrogen can push more cholesterol into bile and change bile composition, while progesterone can slow gallbladder motility, creating the “perfect storm” for stagnant bile and stone formation, especially when insulin resistance, fatty liver, or metabolic dysfunction is already in the mix.
We also get practical about hormone replacement therapy. Not all HRT carries the same gallbladder risk, and the route matters: oral estrogen goes through first-pass liver metabolism and can affect bile more than transdermal patches or creams. We cover common red flags to watch for, what changes after gallbladder removal (your liver still makes bile, but storage and timing change), and supportive options people ask about like TUDCA, taurine, glycine, choline, magnesium, and bitter herbs. Finally, we talk about GLP-1 medications and why rapid weight loss can raise gallstone risk, plus how the gut microbiome ties bile acids, inflammation, cholesterol, and hormone balance together.
If this helps you connect dots you’ve been missing, subscribe, share it with a friend, and leave us a review so more women can find the info before symptoms get worse.
If you liked this episode, please consider sharing it out with a loved one and telling us what you think below with a kind review and rating on Apple or Spotify:
To rate and review the show on Apple Podcasts, click here
To rate and review the show on Spotify, click here
Feel free to reach out at www.rejuvenatinghealth.net
And be sure to follow along on the socials:
Instagram
Facebook
Medical Disclaimer And Welcome
SPEAKER_02Any views, thoughts, and opinions expressed on the Rejuvenating Health podcast are solely those of the speakers and are intended as such. Please consult your trusted healthcare practitioner for medical advice. Let's go, girls.
SPEAKER_00Welcome back to the Rejuvenating Health Podcast. I'm Coach Lakin, and as always, I'm joined by nurse practitioner Lindsay. And today we are going to be diving into a topic that honestly it doesn't get very much attention, not enough attention by far in women's health. And that is the gallbladder.
SPEAKER_02I want to say I don't really know that it gets any attention. I don't think anyone thinks about their gallbladder until it's an issue.
SPEAKER_00Or it removed, right, right.
SPEAKER_02Right. But when you're like we deal with perimenopause and menopause women all the time, and gallbladder issues come up a lot as you're entering that stage of life.
SPEAKER_00Yeah. What what sparked today's episode is that you've actually been getting a lot of questions about gallbladder-related symptoms with like HRT and supplements and you know things like that? Where again, I don't think people usually equate it to being related to that. And so this is gonna help to fill in that picture.
SPEAKER_02Yeah, I mean, like people are like, can estrogen cause gallstones? Or why did I start having right-sided pain after starting HRT? Or can I is it safe to take hormones after my gallbladder is removed, or what supplements can help the gallbladder? Why is a GLP1 controversial with gallbladder stuff? So we're gonna kind of answer all those questions today about you know, some things that pop up and maybe some things to do if you start having issues arise.
SPEAKER_00Yeah. So
Why Gallbladder Risk Rises Midlife
SPEAKER_00particularly when it comes to gallbladder problems and perimenopause or menopause, let's start with the basics. Like, why do gallbladder problems become more common as women get older?
SPEAKER_02Well, there's lots of reasons. So, first off, women just have a higher risk of gallstones than women. And men. Yeah, than men. They're actually like two to three times more likely to develop gallbladder issues or gallstones throughout their lifetime. Then you add in the hormonal changes, like drop in estrogen, insulin resistant, weight gain, metabolic dysfunction, dieting, changes in bile production, then your risk gets even higher. So, gosh, just being a woman kind of sucks. We're more at risk for gallstones and Hashimoto's and autoimmune condition, like all of those things because our hormones do fluctuate. And most people don't know that estrogen and progesterone both really influence influence gallbladder function, but in really different ways.
SPEAKER_00So basically, our hormones are directly affecting our gallbladder.
SPEAKER_02Yes. Yes. Because yeah, because hormones affect the liver. Your liver produces bile. The gallbladder stores and concentrates that bile that the liver produces. And when you eat fat, like a fatty food, the gallbladder contracts and releases that bile into the digestive tract to help break down the fats and absorb those fat soluble nutrients. So hormones, they can't affect the liver and multiple different things, kind of influence every step of that process. So as your hormones start to fluctuate during perimenopause, that bile composition changes a little bit and your gallbladder and motility changes a lot. And so those two things together can increase that risk of gallstones quite significantly.
SPEAKER_00For those
Bile, Gallstones, And What Goes Wrong
SPEAKER_00that are not familiar, what is a gallstone?
SPEAKER_02So I think let me explain what bile is and then I'll help you know what a gallstone is. Okay. So bile is a digestion fluid, and it's one of actually the body's like major detox pathway, and it's produced continuously in the liver. And it's made from cholesterol, phospholytid, bile acids, bilirubin, electrolytes. And it's like super fascinating in that cholesterol is actually the raw material for bile acid production, which is why you need cholesterol, which is why you shouldn't plummet your cholesterol down to zero. But like one of the major ways of removing excess cholesterol is by converting it into bile acids. So your liver produces roughly 600 to 1000 mls of bile. And that got that bile is concentrated and stored in the gallbladder until we eat. And then when fat enters your small intestine, there's a hormone that's released that signals the gallbladder to contract and release that concentrated bile into your stomach. Without adequate bile, you're not gonna be able to digest fats, you're not gonna be able to absorb those fat-soluble vitamins, you're not gonna be able to clear estrogen from your liver. Your cholesterol might not be able to get cleared. So it's a lot more than a digestion or organ. But what happens is that concentration changes and that bile can turn into gallstones, essentially.
SPEAKER_00Okay.
SPEAKER_02And it can get like plugged. And if your bile gets plugged and you can't contract that bile out, then you're gonna get pain and and issues.
SPEAKER_00Okay. So it's essentially it's like really disrupting your your detox system, like the way your body detoxes itself.
SPEAKER_02And breaks down fats and absorbs fat-soluble vitamins and all that type of stuff.
SPEAKER_00Okay, all right.
Estrogen’s Direct Link To Gallstones
SPEAKER_00And one thing that is really interesting is that women are dramatically more likely to develop gallstones than men. You mentioned that. Why is that? Why are we so why are we so blessed?
SPEAKER_02It's completely due to estrogen. Because estrogen receptors live directly in the liver and gallbladder. And think about it, this it makes sense if you know anything about estrogen and perimenopause. One of the first things we see in perimenopause is a drop in estrogen and a spike in cholesterol. And cholesterol and the gallbladder and the bile function are all related. So estrogen increases cholesterol secretion into bile and it kind of alters that bile acid base. So it creates more, more of a cholesterol supersaturated environment that favors that crystal formation to where gallstones occur.
SPEAKER_00Okay.
SPEAKER_02Pre-science-y. But like think of bile like salt water. If you add too much salt, crystals form, i.e., gallstones. The same thing happens in the bile. When cholesterol becomes too concentrated, because our estrogen drops and we get a bump in cholesterol, then those crystals form. So essentially it's the drop in estrogen raises the cholesterol, the cholesterol becomes too concentrated, crystals come together and forms stones. Yes. So this is why, even in this is why in pregnancy, too, you're more likely to get gallstones. And sometimes when you introduce hormone therapy, you can get gallstones. Or sometimes when you have perimenopause and your estrogen surges. So a lot of periods of fluctuating hormones increase that likelihood of that bile becoming lithogenic or stone forming, essentially.
SPEAKER_00So let's keep down this rabbit hole of estrogen. Most women hear that estrogen is protective. You know, we've talked about that before in previous episodes. So why can it increase gallstone risk? Like if it's supposed to be something that's protecting us, and then, you know, obviously we're going to talk about how that comes into play with HRT.
SPEAKER_02Yeah. So I mean, we've talked about this before. Estrogen, I love it. It's great for bones, it's great for brain protection, it's great for cardiovascular support, it's great for insulin sensitivity. But when you take estrogen, one effect is that it increases cholesterol secretion into bile. So the more of that cholesterol that's secreted into the bile, the more likely it's to become saturated. And then the more likely those crystals are going to form. So it's kind of a like too much estrogen.
SPEAKER_00Yeah, it's like we've talked about this before with, you know, like when we talk about ferritin or like, well, honestly, any any hormone or anything that the body is naturally producing on its own that we're aiding in any way? Estrogen in this way is changing the composition of bile, but it can also be it's it's necessary. We can't have our estrogen too low. So it's about finding the right balance and the right level specific to your body.
SPEAKER_02Well, and here's the thing. How many times have we talked about putting estrogen in a dumpster fire body?
SPEAKER_00Yeah.
unknownOkay.
SPEAKER_02So here's here's here's the issue. If you're putting it, most people don't develop gallstones on estrogen, but if you're putting estrogen into someone that has insulin resistance and obesity and fatty liver and poor family history of cholesterol, poor bile flow, then you're increasing that risk of gallstones. So this is why we say you really like you gotta be a little bit metabolically healthy to add that.
SPEAKER_00Lifestyle first. Yeah. Like so the estrogen isn't just indirectly affecting the gallbladder. Like this is not an isolated situation. It's not again, the system is all-encompassing and that everything has to be taken into consideration, all the variables.
SPEAKER_02Yeah, because there is actual like direct cellular effects. And when estrogen binds to those estrogen receptors in your liver, it can increase the activity of those cholesterol transport pathways, and more cholesterol gets dumped into bile essentially, and that bile doesn't get synthesized appropriately, and then you just get that really thick, crystallized solution. So, from a functional standpoint, like a functional medicine standpoint, this is why two women can have the exact same estrogen levels, but have completely different outcomes. One woman is metabolically healthy and has a healthy bile flow, another woman is insulin resistant, has fatty liver inflammation, and the sluggish bile movement. So, who's gonna get the gallstones? Yeah, yeah. This is why you also cannot compare your hormone therapy regimen to your friend. Like I had someone tell me, my friend does this, and like your friend's not on birth control, like you are. Quit comparing your dosages to your friends.
SPEAKER_00Yeah. Well, and again, we're also only comparing it to the people that we view as like it's working, you know what I mean? Just because they externally have a result that we want, which may have nothing to do with the HRT potentially. Yeah. All
HRT Choices And Oral Estrogen Risk
SPEAKER_00right, so in that, let's talk about HRT because this I think is where women get really confused.
SPEAKER_02Yeah, so not all estrogen therapies have identical risks. There's a difference between oral, transdermal, injectable, cream, whatever. The route of administration matters tremendously. So, especially oral. So if you're doing oral estrogen, it undergoes what's called first hepatic metabolism. So it means every dose that you take passes through your liver before entering circulation. What that means is it has a much stronger effect on the hepatic cholesterol metabolism and bile composition. So if you take it orally, you're gonna be more at risk to get gallstones because it bypasses that liver.
SPEAKER_00Just having to go through the, yeah, through your through your gut.
SPEAKER_02Where if you're doing transdormal, like a cream, a patch, it largely bypasses that first liver metabolism. And so you're gonna have it's you're gonna be less likely to get gallstones. So, like one of the largest studies ever conducted on this topic followed like over one million postmenopausal women, and they found that oral hormone therapy was associated with a much, much, much higher risk of gallbladder disease than transdermal, right? Like the relative risk was approximately 1.74 with oral and 1.17 with transdermal. And that's like a massive difference in research.
SPEAKER_00Is there a reason why you would because I feel like most women that I'm aware of that are doing HRT is usually not oral estrogen. Is there a reason why you would opt for oral estrogen?
SPEAKER_02There's mere there's reasons. Well, some people's skin doesn't absorb the transdermal very well. Like I did transdermal and I like burn through it like a mad woman. And I'm active, I sweat, I sauna, like I couldn't get it to stick very well. I'm not doing oral estrogen because I have a down the road risk of blood clotting. So I do injectable, which is controversial in itself. But you will have some people that the patch just doesn't work or they're allergic to adhesive or something like that. But the patch is always my go-to first.
SPEAKER_00Like it's worth trying that first, right?
SPEAKER_02And and and all estrogen isn't delivered the same way, like the oral does create a lot longer effect on the liver function, which is why I don't love it as much. That's why I like transdermal decreases your risk of blood clots and gallstones and triglyceride elevations compared to oral. So this is why most menopause providers are pushing you more towards the creams and the patches to try first. Okay.
SPEAKER_00Yeah, so like patches, creams, gels, all that stuff.
SPEAKER_02Yeah.
SPEAKER_00I would assume the patch is the easiest.
SPEAKER_02And also, you just change it twice a week. But some people forget to put it and change it, and you know, yeah, yeah.
SPEAKER_00But it it is the safest in terms of it. I'm saying in comparison to like a cream.
SPEAKER_02Oh, yeah, the creams are a little bit of a pain. You have to rub them and you have to make sure you're not doing skin-to-skin contact. Like the creams can be a little bit of a pain.
SPEAKER_01Okay.
Progesterone Slows Gallbladder Emptying
SPEAKER_02Then you can't talk estrogen without progesterone.
SPEAKER_00So So how does how does progesterone play into this effect and how does that affect the gallbladder? So it's completely different. You're right. We never you never do just estrogen without progesterone as far as HRT goes.
SPEAKER_02Yeah. It has a completely different mechanism. So progesterone, and instead of changing the bile composition, it affects your gallbladder movement. So this is why some people, when they take progesterone, have loose stools. It's this it's essentially a smooth muscle relaxant. So it relaxes that smooth muscle tissue. So that's this is this is also why pregnant women get more gallbladder issues, because that increase in progesterone to keep the pregnancy causes slower digestion, constipation, reflux. The gallbladder is an or is a muscular organ. So if the progesterone causes sorry, I said diarrhea and I meant constipation. If the progesterone causes the gallbladder to contract less, that bile is gonna sit longer. And when that bile becomes stagnant, then stones are gonna form. So it it the estrogen kind of changes the composition of it, where the progesterone changes the movement of it. Gotcha. Yeah. So that kind of makes it more easy to understand, essentially.
SPEAKER_00So let's go deeper into progesterone because I don't think most women realize that it it can influence gallbladder function overall, like the with motility.
SPEAKER_02Yeah, I mean, you just have to think of progesterone as a smooth muscle relaxant, right? Like it literally exists in your GI tract, your blood vessels, the gallbladder, and it just if you have really high levels of it, it it can pick compare that contraction. So if you just now imagine that you have an increase in estrogen, which is causing an increase in cholesterol, and then you have the progesterone, which is causing slow slowing, emptying, you just have the perfect storm for gallbladder.
SPEAKER_00Yeah. Symptoms.
Symptoms Of Poor Bile Flow
SPEAKER_00And then what symptoms would would women be looking out for if they were worried about poor bile flow?
SPEAKER_02So you're gonna have like right upper gall, right upper abdominal pain. That's where your gallbladder sits, right? It's gonna be you're gonna have pain under your shoulder bone because it kind of radiates back there. This is also symptoms of heart attacks in women.
SPEAKER_00I was gonna say this sounds like not related to gallbladder.
SPEAKER_02But the issue with gallbladder is is it normally happens after fatty meals, right? So you're gonna get some nausea after fatty meals. You're gonna get some bloating, some burping, some indigestion. Your stools can become loose and sometimes like clay colored, right? Pale. They can they float a lot. Like you can see like fat in it, and you're not able to really eat fat. So, like a lot of times what I hear women say is I feel really terrible after eating healthy fats. Like that can often be a clue that you have those motility issues.
SPEAKER_00Okay.
Life After Gallbladder Removal
SPEAKER_00And what happens if you, you know, have to get your gallbladder removed or if you've already had your gallbladder removed? You know, I'm sure a lot of listeners are probably in that boat and they may think, oh, like this doesn't apply to me.
SPEAKER_02Yeah, if you turn the episode off because you're like, I don't have a gallbladder, then you should turn it back on or you should share it back with your friend, right? Because removing the gallbladder doesn't stop bile production, the liver still produces that bile. The difference is, is now that bile drips continuously into your digest digestive tract rather than being stored and released strategically. Okay. So this can create issues. This is why people with a gallbladder struggle a lot sometimes because that's not being stored. Now it's just being freely flowed out.
SPEAKER_01Right.
SPEAKER_02And then you can create have issues with fat digestion. This is where nutrient absorption can really become an issue, especially for those fat-soluble vitamins. Your gut health can really be affected. You can have bloating and diarrhea. And I'll be honest, like many women never get proper guidance after getting their gallbladder. Like they're just, it's kind of like the appendix. They're just told it's this useless, unnecessary organ, but you can have like a lot of digestion changes after removal.
SPEAKER_00I love how they're like, oh, it's no big deal. You don't need it. It's like it's there for a reason. Yeah.
TUDCA And Key Support Nutrients
SPEAKER_00We do need it. One of the other things that that is like a common question that I know you get when these symptoms are coming up or when you're discussing this with women, is around TU DCA. What is T U D C A?
SPEAKER_02So it's TUDCA essentially. I'm not even gonna try to pronounce the real word for it because it's like tarosolytic acid. I'm just slaughtered that, I'm sure. But it's a common supplement, okay? And it it occurs naturally in the body. It's a it's a bile acid naturally produced in small amounts in the body. And it's been really studied extensively for liver support and bile flow and cholestasis and gallbladder function and cellular protection and all that stuff. So think of it as helping improve that movement and quality of bile. So it can really help prevent that bile production from just being stagnant and help support those pathways.
SPEAKER_00So it's kind of helping both of the things that an offbalance of estrogen and progesterone could be causing.
SPEAKER_02Yeah, and you can still take it even if you don't have a gallbladder because it can still help with that fat digestion and bloating and stool quality and upper abdominal discomfort. And because again, you still produce bile even if you don't have a gallbladder.
SPEAKER_00But it's not replacing your gallbladder.
SPEAKER_02Correct. Correct.
SPEAKER_00Yeah, yeah. It's just supporting like the overall system because like after your system doesn't have the gallbladder anymore, it could use additional support. Correct. So what are what are some nutrients that are gonna support the gallbladder health or support that bile flow?
SPEAKER_02Tarine taurine isn't a great one. It's required for bile acid conjugation. It helps make bile flow more effective. Glycine is great, it supports detox and bile production. Choline, which we talked a lot about a few episodes ago.
SPEAKER_00Choline's good for everything. You should be getting a lot of choline.
SPEAKER_02Yeah, it's critical for liver health and fat transport. And like we talked about a few weeks ago, many women are super deficient. Phospholycholine helps support healthy bile composition.
SPEAKER_00Magnesium, which we talked about, every woman should be taking magnesium.
SPEAKER_02Yep, supports that smooth muscle function overall digestion. And then those like bitter herbs, like dandelion, artichoke, they can also help stimulate digestion, secretions, and bile flow, right?
SPEAKER_00Okay.
Diet Mistakes And Smarter Fat Intake
SPEAKER_00What about like dietary approaches? How do how do food interventions or like nutrition, how does that affect gallbladder health?
SPEAKER_02So I think one of the biggest misconceptions is that women receive is that they should avoid all fat when they don't have a gallbladder. And that can actually be like super counterproductive, right? Like your gallbladder needs stimulation and healthy fats trigger those gallbladder contractions. The key is healthy fats. Right. Not McDonald's french fries. It's avocados and olive oils and nuts and seeds and fatty fish, right? So at the same time, we're eating those healthy fats. We want to make sure that we're increasing our fiber, eating vegetables, drinking enough water, eating enough protein. And again, like we talk about all the time, reducing those ultra-processed foods, refined sugars, excess alcohol, right?
SPEAKER_00So, you know, the regular stuff, the same stuff that we should be doing anyway to promote overall health of our body. Yeah.
unknownYeah.
SPEAKER_00Exactly. Okay,
GLP-1s, Rapid Weight Loss, Gallstones
SPEAKER_00let's talk about rapid weight loss with gallstones and like gallstones and how that's related, right? Because this is especially relevant with GLP1 medications. And I know everybody's gonna ask about it, so let's go there.
SPEAKER_02I don't think we can talk about the gallbader without talking about GLP1s, right? So one of the biggest risk factors for gallstones is rapid weight loss. And because when you lose weight quickly, your cholesterol is mobilized, that bile composition changes, and your gallbater emptying is gonna decrease, right? So this is you should always probably be like your provider should always be talking to you about gallbater support if you're taking a GLP one.
SPEAKER_00Not because I guarantee that's not happening.
SPEAKER_02That's not, right? And it's not because the medication is bad, but it's because that rapid weight loss dramatically increases your risk of gallstone.
SPEAKER_00Yeah, it's a it's a stress on the system. And like this is especially important right now because so many women are taking GLP1 medications, but it it it there are, I mean, among other risks that are associated, which we've talked about in previous episodes, but this is something worth paying attention to that's not necessarily going to be talked about by your provider. So it's worth bringing up to them.
SPEAKER_02Yeah, and then GLP one does not cause gallstones. Like that's not that it's the the issue is the rapid weight loss. Okay. The that rapid weight loss is just becoming that bile to become really cholesterol rich and becoming it to just for it to not empty out. And when that calorie deficit, just when that calorie intake drops so dramatically, you're just increasing your risk of gallstones. So if you're someone that's losing 40, 50, 60 pounds, you shouldn't really be thinking about your bile flow support. Like not after symptoms develop.
SPEAKER_00Yeah, like proactively.
SPEAKER_02Yeah.
Microbiome, Root Causes, Key Takeaways
SPEAKER_00So one thing that hasn't come up yet that I think is worth talking about is the microbiome. Obviously, our gut is related to our bile production. So how does gut health affect bio?
SPEAKER_02Yeah, I don't think you can talk about liver, gallbladder, anything in the abdomen region without talking about gut health. And there's a lot of like cool research coming out about how gut microbiome actively transforms bio acids. So certain bacteria can help recycle bile acids, they can help regulate signaling pathways involved in the metabolism, inflammation, blood sugar control, cholesterol. So when you have gut dysbiosis, then you're gonna have bio acid metabolism changes. And that can cause that estrogen recirculation, that cholesterol dysregulation, that gallation. So your gallbladder isn't just a gallbladder issue, it's a liver issue, it's a hormone issue, it's a gut health issue, it's a metabolic issue.
SPEAKER_00Yeah. So just like any other time we bring up the gut microbiome, it is Or anytime we bring up anything, it's tied to everything multi-system. Right.
SPEAKER_02Like one thing does not affect one thing. It's all multi-system.
SPEAKER_00Yeah, which is why the the functional medicine approach is gonna be the preferred approach. So, how do you approach gallbladder concerns from a functional medicine perspective? And how's it different?
SPEAKER_02Yeah. So why is the bile stagnant? Why are stones forming? Why is your digestion impaired? Is it due to your hormones? Is it due to insulin resistance? Is it due to liver function? Is it due to your metabolic health? Is it due to your gut health? Is it due to weight deficiencies? Is it due to rapid weight loss? Like, what the heck is causing it? Like any that's what functional medicine does, ask questions. Root cause, root cause medicine.
SPEAKER_00Yeah, instead of like just treating the symptoms.
SPEAKER_02Exactly.
SPEAKER_00Exactly. Okay. So what would you say is the biggest takeaway from today's episode? We covered a lot.
SPEAKER_02That your gallbladder is not a useless organ. It's actually quite complex and it's far more connected to hormones than most women realize. Estrogen affects the composition, progesterone affects the movement, menopause changes both. So if you're someone that's experiencing digestive symptoms, the bloating, the nausea after fats, the right-sided discomfort, don't ignore that. And if you're someone considering HRT, make sure you're metabolically healthy and make sure you work with someone that understands how that can affect all of your systems.
SPEAKER_00Yeah. Yeah. And whether you're navigating, you know, menopause, perimenopause, considering HRT, or if you've had your gallbladder removed, or you're just simply trying to like improve your digestion overall health, there are a lot of evidence-based strategies that can help, some of which we mentioned today, as far as nutrition lifestyle interventions. Exactly.
SPEAKER_02So hopefully you learned something today. I learned a lot researching this. And if it was helpful, be sure to subscribe, leave a review, share it with a friend who's kind of navigating these challenges.
SPEAKER_00Yeah, especially if you know somebody that's that you know is being impacted by something like this or that has some of these symptoms. Share it with them. It might be really insightful. Yeah. See you next time. See you next time.