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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
E172 | Ask Us Anything Is Back!
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We answer rapid-fire midlife health questions with a simple filter: stop searching for one universal rule and start matching the tool to the person. We walk through hair loss after estradiol, when HRT makes sense, how to use GLP-1s safely, and why carbs and protein still matter when you want strength and energy.
• hair shedding after starting an estradiol patch and why timing can mislead
• hair loss basics including telogen effluvium, stress lag, ferritin and thyroid checks
• EAAs explained, why leucine is not enough, powder vs pill practicality
• deciding when to start HRT based on symptoms, quality of life, risks, route, dose
• GLP-1 medications as a tool alongside lifestyle, not instead of it
• protein, resistance training, adequate intake, and monitoring as non-negotiables on GLP-1s
• sore teeth and oral sensitivity, plus the need to rule out dental causes first
• hormonal IUD vs micronized oral progesterone, local vs systemic effects, tolerability
• peptides like BPC-157, KPV, TB-500 and the gap between animal data and human evidence
• carbs in midlife, glycogen and water weight, gradual reintroduction, higher-quality sources
If you can think of any other questions that these sparked today that you want to add to our next Ask Us Anything episode, please message us. We'd love to hear. And as always, rate and review, send us all those five stars, and we will see you next time.
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Disclaimers And A Quick Reset
SPEAKER_01Any 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_00All right, ladies. Welcome back to the Rejuvenating Health Podcast. Today we are going to do our regular Ask Us Anything episode. So you brought the questions to the table. There are a lot of questions, and we are all over the board as far as uh topics. So HRT, hair loss, GLP ones as always, carbs, peptides, muscle loss, all that stuff. So we are going to address all the things. And then I'm always as always joined by Dr. Lindsay Van Schoy too.
SPEAKER_01Oh yeah, doctor now. Yeah, we have a ton of questions this time. And like I do love these questions because it demonstrates why women can get so stinky confused about midlife. Like they can hear one expert say eat before bed, another says absolutely don't eat before bed. One says you need carbs, the other says carbs make it so you can't lose weight. And you've got hormones and GLPs and peptides and it's confusing. Yes. So I want to add some context before we kind of dive in here. Like, medicine isn't always about deciding whether something is universally good or universally bad. It's asking questions, right? Which is why we probably stick out more than a lot of providers in that we do ask questions and we do take into account like who is the person? What are her symptoms? What are her goals? What meds and supplements is she on? What risk factors does she have? What do her labs show? And then like, what does the medical evidence actually show and support? Because to be honest, you can look at any research article and any research study and make it tweak the way that you want it to be.
SPEAKER_00Yeah, it can be biased based on your opinion. And as always, like just a reminder that this podcast is here for education. It is not individualized medical advice. And we definitely don't want anyone like starting, stopping, or changing any prescription medications based solely on this episode, ladies. So please take it with a grain of salt. This is just for your educational purposes.
SPEAKER_01Yeah. All right, let's dive in.
SPEAKER_00All
Hair Loss After Estradiol Patches
SPEAKER_00right. So, first question Is it normal to have major hair loss happen one to two months after starting estradiol patches? What might that mean? And I get it. This is this can be terrifying when it happens, right? Because hair loss is already a part of perimenopause, is one of those really daunting symptoms. And then someone finally starts estrogen and they're hoping that they're gonna feel better and sudden, suddenly, like they're losing clumps of hair in the shower. So could the estradiol patch actually cause it is the question.
SPEAKER_01I'm gonna, I mean, probably it's probably more of a coincidence, right? Like it is possible to notice hair shedding after any type of hormonal change, but I don't think that estrogen causes it, right? Like a lot of times hair biology has a three-month delay. So hair follicles go through different cycles. Like we have an antigen phase, which is like active growth, a catogen phase, which is this short transition phase, and then a telogen phase, which is like the resetting phase that eventually then causes hair shedding, right? So like one common form of diffuse shedding is telagonifumium. And a lot of times the physiological stress is what happens there and it pushes more hair follicles towards that resting and shedding phase. So a lot of times you're looking at a six-week, three-month delay of what actually caused the hair shedding, right? So if someone tells me, like, I started estrogen six weeks ago and my hair is falling out, is it from the estrogen or did you have COVID? Or is your fair like what like was your stress super high six weeks ago?
SPEAKER_00Yeah, like what did you have going on?
SPEAKER_01Did you have surgery? Did you start a GLP one? Are you in a severe calorie restriction? Is your thyroid dysfunctioning? Like, did you have medication changes? So, I mean, yes, hormones could contribute, but just because the timing kind of lines up, that doesn't mean doesn't cause causation.
SPEAKER_00Yeah. So what would you evaluate in that case if someone's coming to you with that concern?
SPEAKER_01If you're having hair loss, like the number one thing you should be getting checked is your ferritin and your thyroid, right? Like you should be getting a CVC, iron studies, a thyroid evaluation. What's your weight doing? Ask yourself, like, did I have a dramatic weight loss and my nutrient deficiency? Like, is it winter time and I'm low in B and D and zinc and folate? Did I go on a GLP one and I'm losing weight too dramatically, right? Like, but ferritin is a really huge one. You also want to look like the pattern. Is it all over your scalp? Is it a widening part? Is it like recession? Um, are there discrete bald patches? Is your scalp itchy, flamed, painful? Like there are so many different reasons that could cause hair loss. So you have to look at the pattern of the hair loss, things that happened six to six weeks to three months ago, but then also like what are your labs and your weight doing and stress as well?
SPEAKER_00Yeah. Okay. So basically, this is one of those situations where my estrogen causa is too simple of a point the finger. It's like it's probably a lot of contributing factors, and it's not necessarily something that's happening right now in real time.
SPEAKER_01If it if we're talking about testosterone, though, the thing's story.
SPEAKER_00Yeah. There. Okay.
EAAs Powder Versus Pills
SPEAKER_00All right. Question number two. How do EAAs in powder form compare to those in pill form? So this client was specifically asking about perfect aminos, essentially. So essential amino acids. And then first let's break that down. What are EAAs for?
SPEAKER_01Yeah. So EAAs are essential amino acids. So proteins are made of amino acids, and nine amino acids are considered essential because our bodies can't make enough of these as their own. So you have to like take them in orally, right? And we need to obtain those from our diet, and we need to obtain those from muscle protein synthesis, right? So one amino acid you hear a lot about is leucine, and that's where we say you need to eat 30 to 40 grams of protein to hit your leucine threshold because that's what signals the muscle protein synthesis and MT MTOR signaling. But like leucine alone isn't enough to build an entire protein. Like leucine's like ringing the doorbell, it's time to build, but then you still need the other eight essential amino acids to build the materials, right? Okay. So if we're looking at powder versus pill, what do we want? Like I d the delivery format is pretty less important than the actual product, right? Like you want to look more at the composition of the amino acids. So like what's the total dose? What's the quality? Are you taking it consistently? Like amino acids are like icing on top of a cake too, though. Like if you're not doing the other things, like do you really need to be taking amino acids? I do think a powder is probably easier to get. Like I drink it when I'm working out in the morning. Like I drink an amino acid powder. Um, but tablets are easier for travel. Um, but just be like, I don't think there's a difference between the two.
SPEAKER_00Yeah. So it's like whatever works for you, but either way, they are not a replacement for eating whole food protein. That's what I think that's the most important thing. They are supplemental, ladies.
SPEAKER_01Yeah. They're definitely supplement. Like, and if you are getting adequate dietary protein throughout the day, like you probably don't need EAAs. Like, I probably don't need EAAs, like, right? The only reason that I take them is because like I don't eat a bunch before I work out in the morning. So it's fine to like take them.
SPEAKER_00It's more like preventative for muscle breakdown during your workout.
SPEAKER_01Exactly. Exactly. But always supplements should fill the gap.
SPEAKER_00Yeah.
unknownYeah.
SPEAKER_00Yeah. All right. Next
Knowing When To Start HRT
SPEAKER_00one. How will I really know when to start HRT? And I think women expect there to be one lab result where a doctor says, like, okay, like today's the day we're gonna start HRT. So I'll let's get let's get some clarity around that.
SPEAKER_01There is no magic day or time, or it's just not how it works. Like, because perimenopause is not one day, it like it's a transition and the hormones fluctuate so substantially during it. So you can like and I can test your estrogen on Tuesday and then test it on Saturday and it looks completely different. Like, and that's a lot of times like testing is great, but in perimenopause, you you honestly don't need hormone testing for estrogen because it's all over the place, right? So if you're treating perimenopause based on a hormone panel, like it's probably very misleading. So the conversation should be more around like, what are your symptoms? What's your menstrual history? What's your age, your medical history, your risk factors, your goals, right? Like, are you having things like hot flashes, night sweats, sleep disruption, vaginal dryness, mood changes, trouble sleeping, joint pain, brain fog, like labs aren't gonna tell you the picture. It's more of the symptoms.
SPEAKER_00Yeah. So it's worth discussing essentially when your symptoms get bad enough that it's interrupting your day-to-day lifestyle.
SPEAKER_01Yeah. If if your symptoms are affecting your quality of life, like you should probably be talking to your clinician about like there isn't a prize for suffering until your symptoms become unbearable. Right. But uh but but at the same time, like HRT is also not appropriate for every woman, right? Like you need to take into account your menstrual history, cardiovascular risk, also your metabolic health. Because sometimes if you put estrogen into a metabolically unhealthy body, you are gonna get some crazy bad side effects.
SPEAKER_00Yeah.
SPEAKER_01Bad side effects. And the type and route and the dose matter so much. Like transdermal estrogen is a lot different than oral estrogen, right? And if you're have a uterus, you need to then talk about progesterone to make sure that you're protecting your uterine lining. So it is a very caveated thing that you definitely need to like take, talk to someone that knows what they're doing and talk about a lot of different things while you're talking about it.
SPEAKER_00Yeah, that's why we reference it as an art, right? It's not necessarily like, okay, what my hormone number tells me at this time. It's like, are my symptoms affecting my life? Am I an appropriate candidate after an individualized risk-benefit discussion? And am I in am I aligned with my provider?
SPEAKER_01Yeah, exactly.
SPEAKER_00All right. Next
GLP-1s Plus Lifestyle Done Right
SPEAKER_00question. When is it time to consider GLP ones versus continuing with lifestyle? This one comes up all the time.
SPEAKER_01So I don't like framing it GLP one versus lifestyle because it's not, it's not an and or, it is a both, no, like no matter what, right? When these medications are appropriately prescribed, if your clinician is not prescribing lifestyle with them, then you shouldn't, you should not be taking the drug, right? Like GLP1 medications, they affect your appetite, your satiety, your gastric emptying, your glucose metabolism. And depending on certain medication, like additional pathways may be involved as well, right? So they're really powerful medications, but like they don't resistance train for you. They don't choose nutrient-dense food for you, they don't preserve muscle, they don't create healthy sleep. Like, and and to be honest, like they don't help you maintain your long-term health behavior goals.
SPEAKER_00Yeah. So it's like, how do you know when I think I think the better way to phrase this is like maybe not versus lifestyle, but in addition to lifestyle alone, right? So how do we know when lifestyle habits aren't enough on their own anymore?
SPEAKER_01I mean, I would ask whether we've actually implemented adequate lifestyle interventions, right? Like, because I've tried everything sometimes mean like means like, oh, I've been eating 800 calories a day. Right. I've been doing tons of cardio, I've been sleeping for five hours, I'm not eating any protein, like I'm constantly dieting Friday through or Monday through Friday and then eating pizza on the weekend, or I'm doing I'm changing my diet strategy every two weeks, right? Like there's different from a structured, sustained intervention, right? But you also have to know that like obesity is a chronic disease. And so we shouldn't moralize medication. You shouldn't shame anyone for being on a GLP because it is it is a chronic disease, right? And if someone meets evidence-based indications for anti-obesity drugs and lifestyle interventions alone haven't produced like adequate improvement, it can be a legitimate tool. But also, I've seen them not work for a lot, a lot of people as well.
SPEAKER_00Yes. Yeah. And so if someone starts one, what you know, like we've talked about what they can expect, but there's it's not just, oh, this is the answer to your problem.
SPEAKER_01No, I mean, if you're gonna be on a GLP one, you have to eat 120 grams of protein. You have to resistance train three to five times a week, you have to get your micronutrients, your fiber, right? Like you have to eat enough food. You can't eat 800 calories. You still have to eat enough food for your body, right? And you have to have clinical monitoring. I refuse to prescribe these for someone that doesn't work with a health coach, at least in the beginning.
SPEAKER_00Yeah. Yeah, because a lot of times people won't know what negative symptoms to look out for or, you know, what's off because they weren't necessarily feeling completely healthy before either. So they don't have a good context to compare to. Yeah. All right. Next
Sore Teeth And Perimenopause
SPEAKER_00question. This one was an interesting one. Are sore teeth a symptom of perimenopause? And this, I'm glad that this came up because it's not necessarily a classic perimenopausal or menopausal symptom on the checklist, but some people apparently do deal with this.
SPEAKER_01I've literally never had anyone ask me this. So it's it is good, right? Like I had to do a little bit of research, right? Yeah. Because it's it's not normally a classic standalone symptom, right? But estrogen receptors exist everywhere, right? And they do exist in your oral tissues. And so sometimes hormonal changes can affect your oral environment, right? So you could experience dry mouth, burning mouth, oral sensitivity, right? And like I think this is important. Tooth pain should not be blamed on your hormones. You should definitely get it evaluated. Like, go rule out a dental, like go rule out a cavity, a cracked tooth, gum disease, an infection, TMJ. But so like, yeah.
SPEAKER_00Yeah, so rule the thing. So don't go to your dentist and be like, it's fine. Lindsay said it's just the estrogen.
SPEAKER_01No, like if your teeth hurt, get it evaluated. But if everything comes back clear, hormonal changes may be a part, a part of it, right?
SPEAKER_00Yeah, and it makes sense. So it's just like it's an it's another microbiome in your body that is craving balance, right?
SPEAKER_01Yeah, exactly. Yeah.
SPEAKER_00All right.
Hormonal IUD With Oral Progesterone
SPEAKER_00Uh no, next one. My friend has a hormonal IUD, and her primary is hesitant to give her oral progesterone. Can she take both?
SPEAKER_01And when might someone not be able to have so yeah, this is a really good example of why terminology matters, right? So a hormonal IUD contains progester, synthetic progesterone, such as lemon estrogel, right? Micronized oral progesterone is progesterone, it's bioidentical. These two things are not identical at all. Not identical at all, right? It also depends on when the IUD was placed because the estro like an IUD that was placed over six years ago probably isn't going to give you enough endometrial protection. Like it probably needs to be six months or before. But that progesterone in the IUD, progested in the IUD doesn't really get systemic. So if you're looking for uterine, if you're looking for endometrial protection, then yes, an IUD alone may be fine if it's been put in in the last like five to six years, right? If you are having night sweats and trouble sleeping and anxiety, that IUD is not going to fix that. That's where oral progesterone comes in. And you can 1000% take oral progesterone on top of an IUD. And if someone's having a lot of bleeding on HRT, then an IUD might be great to stop the bleeding.
SPEAKER_00Okay. Yeah. So basically what we're saying is an IUD that they can be used for different things, but an IUD is not going to be systemic, meaning it's not spreading anything that's giving off throughout your entire body, any of the hormone of that progestering. Yeah. And so an oral is going to be able to allow you to have the systemic benefits of receiving that in your entire body.
SPEAKER_01And there's like, there's a lot of people that don't tolerate progesterone, right? Like it has metabolites in it that affect your GABA receptor pathways. So like you can have like really sedating effects. It can increase depression. If you have a peanut allergy, it can cause issues with that. It can cause sedation, dizziness, mood effects, stuff like that. So you always need to ask like, what is the goal? What are the symptoms? What are the side effects? Why are we adding it? What problem are we treating? Like, are do we already have endometrial protection? What dose of estrogen is being used? Are my hormones balanced? Like, again, super complex question.
SPEAKER_00Yes. Yeah. So it and it needs to be specifically individualized based on you and what's going on with you and your conversation with your provider. Exactly.
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Peptides For Gut Healing Claims
unknownright.
SPEAKER_00Next one's all about peptides. So July just happened. And so we had some new peptides come on the scene. And the question is: are BPC 157, KPB, and TB500 peptides legit for gut healing and decreasing inflammation? This one is going to be all over social media as well. Yeah.
SPEAKER_01Um, okay, so this is an area where we need to distinguish like biological plausibility from like proven clinical treatment, right? So you have like an interesting mechanism here, and like there's tons of promising animal data, right? And like there is a lot of research on this, but none of those automatically equal like high quality evidence showing that this is safe and effective in humans, right? Like BPC is commonly promoted for like tissue and GI healing, and there is some research that generates that hypothesis, but we don't have the kind of like robust human clinical evidence that that you do on like medications, right? Right. TB500 is also promoted for like healing, but again, these things are not studied like regular meds are.
SPEAKER_00They're new.
SPEAKER_01They're new, right? Yeah. And here's the thing like I like my friend took it, it helped, great, but testimonials aren't controlled trials, right? You can get a little bit of placebo effect. Like I've used BPC for injuries and it worked. Yeah. Did it work because like, right?
SPEAKER_00Did it work because I believed it worked? Maybe.
SPEAKER_01I don't know, right? But I've used it. The issue is right now is that there is no product that you can legally get. So you have to worry about its puridity, its sterility, how it's being dosed, its sourcing. Like they're these are outside of regulated pharmaceutical pathways. Like I've seen people end up in the ER with massive, crazy issues because they got a research peptide. So you also have to think at like what gut healing isn't really a diagnostic.
SPEAKER_00Is the potential reward that hasn't been vetted by large-scale clinical trials worth the potential negative downside of using something that hasn't been vetted?
SPEAKER_01Yeah. And like when these are legal, like when these come to legit compounding pharmacies, try it. Do it. When you can go to like strive or empower and order this stuff, go try it. Like go try it. But you also need to remember like gut healing is pretty complex. Like, what is actually wrong with your gut? Is it celiac disease? Because BPC is not going to help that. You need to take out gluten, right?
SPEAKER_00Like if you have not removed inflammatory foods for a period of time, it's probably not a good idea to introduce peptides.
SPEAKER_01Is it like BPC is not going to help your SIBO, right? Like you can spend thousands of dollars trying to heal your gut, but like you probably need to figure out the diagnosis that you're healing. Like if you have like leaky gut or IBD, yeah, it's probably gonna help you a ton. But yeah.
SPEAKER_00I think it's just another one of those cases where it's like, yes, we have very studied, very um viable options that are a slower go, right? That are proven to work, but this is the new sexy, flashy thing that's like feels like the easy button. So it's like, yes, it could work for you, but there's not enough trials and tests out there to say that it's going to work when there are other things that will work, but they may take longer and be more laborious. And that's a choice.
SPEAKER_01Yep, exactly.
SPEAKER_00All right.
Carbs In Midlife Without Panic
SPEAKER_00Why are carbs so important in midlife? And what's a realistic amount for someone who's always been low carb or is afraid of carb? I love the phrase afraid of carbs because that is something that we deal with all the time. Like because there was an entire generation of women that were marketed to to be afraid of carbs.
SPEAKER_01Yeah, it absolutely is. Like carbohydrates, okay, carbohydrates aren't an essential nutrient in exactly the same biochemical sense as like essential amino acids or essential fatty acids, because you can make glucose through gluconaginous, right? Which is why people can do keto and stuff like that. Like your body can make glucose. But that fact also a lot of times get transformed into, okay, well, I don't necessarily need carbs, so carbs are bad or they're unnecessary. And those are not the same thing. Like, if you're an active woman, you need carbs, right? Like they support glycogen stores and higher intensity exercise programs. They can make your resistance training feel better. Like, but you have to eat the right kind of carbs, right? Like whole food carbs that are full of fiber and vitamins and nutrients and phytonutrients, right? Like fruit isn't equal to a donut.
SPEAKER_00Right. Yeah, not all carbs are created equal. And what happens with the women woman who says, like, oh, I've been eating 40 grams of carbs forever and I'm terrified that if I eat over 150, like I'm gonna gain five pounds overnight.
SPEAKER_01You probably are. Right? At first. Yeah. Because your glycogen is expanding and it's not fat, it's water.
SPEAKER_00Right.
SPEAKER_01So this is where education prevents that panic, right? When you store more glycogen, you also retain water. This is why bodybuilders like don't eat any carbs before a competition and then they do, right? So if you've been chronically low carb, you probably should increase it very slowly rather than going from like 40 grams to 150 overnight because you're gonna, you're gonna the scale's gonna go up and you're gonna feel puffy.
SPEAKER_00Now it will even out over time, but I know a lot of women have a really bad reaction to that. So it's like if that's gonna throw you for a loop, then go ahead and do it gradual.
SPEAKER_01So if you're gonna start introducing carbs, my thing is okay, well, introduce fiber, like high quality carbohydrate sources and build it up, right? Like fruit, sweet potatoes, beans, lentils, oats, rice. Like, don't, oh, I'm gonna get carbs, so I'm gonna eat a donut today.
SPEAKER_00Right. And pair them, like pair them with protein or fat source.
SPEAKER_01You, yeah, you always want to pair your carbs with protein, right? And healthy fats. It's gonna help with satiety, but like, yeah. But if you're training at all, you should probably be eating carbs.
SPEAKER_00You 100% should be eating carbs. Yes. Yes. All
Wrap Up And Listener Questions
SPEAKER_00right, ladies, that is all we have time for for today, but we are going to pick up the rest of our questions in our next Ask Us Anything episode. So hopefully some of these were really helpful today and gave you some insight. I'm sure some of you have asked these questions yourself at home. So if you can think of any other questions that these sparked today that you want to add to our next Ask Us Anything episode, please message us and let us know. And as always, rate and review, send us all those five stars, and we will see you next time.
SPEAKER_01Bye guys.