Ep. 68 3 Things the Medical System Isn’t Telling You About Perimenopause & Cancer—And How to Get the Right Answers (with NP Tiffany Balin)

Hey friend,

If you’ve ever wondered, “Do I really need HRT—or are there other ways to feel like myself again?” this episode is a must-listen. I sat down with nurse practitioner and integrative oncology provider Tiffany Balin, NP to talk about women’s hormones, the HRT “hype,” and a terrain-based, whole-person approach to cancer prevention and healing. Your symptoms aren’t random—they’re signals—and today we decode them together.

🎧 Listen to the full episode: 3 Things the Medical System Isn’t Telling You About Perimenopause & Cancer—And How to Get the Right Answers (with NP Tiffany Balin)   

Inside the episode, we cover:

• HRT with wisdom (not fear or hype): When it truly helps, when it backfires, and why a conservative, individualized approach matters—especially before adding estrogen, progesterone, or testosterone.
• Pellets vs. other forms: Why transdermal options are often preferred and why supraphysiologic dosing can create new problems (think: side effects, metabolism, and can’t-take-it-back timelines).
• The real root causes: How gut health, liver clearance, fiber intake, omega-3 status, sleep, and nervous-system regulation shape hormones more than most women are told.
• Estrogen metabolism & cancer risk: Why serum “low estrogen” doesn’t tell the whole story, the role of tissue storage, and how genetics + detox pathways influence risk and symptoms.
• Genetics without the overwhelm: What nutrition-genomics and DUTCH can (and can’t) tell you—and how Tiffany combines labs with a “10 terrains” assessment to target the right 3 priorities first.
• The emotional terrain: EMDR, breathwork, prayer, sunlight, and daily nervous-system practices as non-negotiables for healing—not nice-to-haves.
• Prevention that’s practical: Muscle as medicine (bone and heart protection), strength training, and metabolic markers that flag issues years before diagnoses.

Quick takeaways

• You’re not “missing” a hormone; you’re missing a map. Start with foundations (cortisol, insulin, gut, liver, sleep) before asking hormones to fix lifestyle problems.  
• If HRT is used, dose and route matter. Go slow, monitor metabolism, and personalize.
• Your nervous system is part of your hormone system. Safety signals (oxytocin moments, breathwork, walks in sunlight) change everything.

Meet our guest: Tiffany Balin, NP

Tiffany is a nurse practitioner with advanced training in anti-aging, regenerative, and functional medicine, and a terrain-based, metabolic approach to cancer. She founded Salus Integrative Medicine in Franklin, TN, where she helps women 35–55 optimize health, prevent disease, and heal by addressing body, mind, and soul. (She also collaborates with trauma-informed therapy and offers practical, data-driven tools like nutrition-genomics + DUTCH to guide care.)

Work with Tracy

If your hormones feel out of control and you’re tired of guessing, The Balanced Hormone Solution gives you a 90-day, root-cause plan—testing (optional but available), food, supplements, and lifestyle strategies that actually move the needle on energy, mood, sleep, libido, and weight. Join today and get a personalized roadmap—so you can stop surviving and start thriving.  

Follow along on Instagram: @perimenopause.nurse (come say hi!)

You don’t have to do this alone. Your body isn’t broken—you just need the right tools.  

— Tracy Erin

Transcript

Speaker: 0:09

Welcome to the Balance Hormone Solution Podcast. If you're a woman 35 plus feeling exhausted, struggling to lose weight, and wondering where your libido went, this is for you. I am Tracy Aaron, a functional medicine practitioner who helps women balance their hormones naturally. Without prescriptions, guesswork, or trending Nonsense.'cause here's the truth, your symptoms aren't random. They're signals. And if you know how to listen, you can fix the root cause and start feeling like yourself again. If you're ready for real solutions, let's get to it.

Audio Only - All Participants: 0:51

I am so excited to have my friend Tiffany Bain here today as a local nurse practitioner, and I can't wait for this conversation that we are about to have. So welcome back to the Balanced Hormone Solution Podcast. Tiffany Bain is a nurse practitioner. With advanced training in anti-aging, regenerative and functional medicine that focuses on health optimization and disease prevention by providing in-depth holistic care. She's also trained in the metabolic approach to cancer. I love this approach. I can't wait to hear more about this myself, and she's worked in oncology for many years. With starting her education in exercise sport science, she quickly realized that we were in a sick care system and wanted to provide care that looked at the whole person. And this in particular is what led her to becoming a nurse practitioner and eventually opening Sali Integrative Medicine in Franklin, Tennessee. Her and I completely agree because she states that healing cannot occur without addressing body, mind, and soul. Welcome to the podcast, Tiffany. Ah, thank you Tracy. I'm so excited to be here. I know, I was just reflecting on how we met a couple years ago at a cell core conference in Boise, Idaho, and I think we had a mutual friend and she was like, ah, you've gotta meet Tiffany. She's going through similar stuff. She works in women's health. It was really a pleasure. You know, sometimes in the virtual world, you can feel like a lone ranger. Mm-hmm. You get on Instagram, you get inundated with all these people. You feel like, uh, there's, you know, ev the market is saturated per se, and yet in your own little space in the virtual world, you can kind of feel like, am I doing this alone? So to meet somebody local is really, really special. So I'm glad to meet today. It's funny because most of the people that know me know that I love going to conferences because I love connecting with people and networking. That's the biggest thing for me. I've made so many friends from all over the country just meeting them at a conference, but it just so happened that you lived close to me, which is awesome. Yeah, exactly. I was at, were you at the Microbiome labs too? Yeah, yeah. Wait, we connected there. Of course we did. Yeah. Yeah. Okay. Sorry. Brain fart. Yes, of course. Yes. Duh. I, uh, posted something on my Instagram story about a slide that I, you know, thought was. Uh, fun to share. And another local, another friend who's not local, who lives in Oregon was like, oh, my other friend is there. I should connect you two. So she put us on a text thread together. We ended up having lunch together and as soon as I walked over to her table, I was like, I know you and I had met her years before at a, another health conference. I think it was cell core also. So it is fun to see these faces over and over again and collaborate and learn from each other. And, uh, yeah, the. I love being just the energy of hearing stories too, about what's working, how people are getting results, and, and, just seeing other people grow, it's, yeah, it's always like a, a little energy infusion when you come home. It's nice to like, bounce ideas off of people too. You know, you have that network. I always tell patients too, like, you know, we, we don't always know all of the answers, right? And so sometimes if something challenging is going on, like, I love to have a network of people to be like, Hey, I'm gonna, I'm bounce this idea off you, so it's great. Yeah. Yeah. Well, tell me how you're a nurse practitioner did, and you have a degree in exercise science. Mm-hmm. So tell, tell me your education story and how did you get into this? Well, so I had gone to school with the intent of, I was working as a nurse assistant on an oncology unit and I was in my exercise sports science degree and I was actually gonna go to physician assistant school at the time. That's why I was getting that degree.'cause I loved all the things. Related to that. And, and then I was, as I was working as a nurse assistant, I was like, you know what? I think I really wanna be a nurse. And so I went straight into nursing school from that degree and then straight into NP school once I graduated with my, uh, BSN, my nursing degree. And I ended up in oncology. I love oncology. I was board certified in hospice and palliative, so I did a lot of the palliative care for the oncology patients. And, and then I helped a center here start an integrative oncology program. I was one of their first providers. And just quickly realized that it wasn't true oncology, integrative oncology care. Sure I could talk about nutrition, which is always number one. I tell people like the base of the pyramid and we could talk about movement and stress reduction, but I wasn't able to like really. Dive deep with these people in that setting. Hmm. So one of my mentors there, he's, uh, now retired, but he said, you need to go and spread your wings and, you know, get more into this. And so that's what led me to my A four M fellowship and, you know, more of my metabolic approach to cancer training. And then here we are just, uh, over a year of opening my own practice. Wow. So who would you say the majority of your clients are? Are they in integrative oncology? So actually I would say the majority of my clients are probably in that 35 to 55-year-old range females, although I do see males as well. And more of the perimenopause menopausal women. And then I have a, a little small. Uh, sector of the onco integrative oncology patients right now. Which, that continues to grow also. Okay. Okay. And so, uh, do the clients who are in oncology, are they also seeing a physician in conventional medicine and getting care there and then they're doing. Support with you or what does that look like? Yeah, great question. So a lot of those patients are seeing, like a traditional oncologist, they're looking for answers outside of traditional medicine. Not that they don't do traditional therapy'cause a lot of them choose to. But my role in that is I look at the whole terrain of the individual. So we're looking at, we're looking at adverse childhood events. We're looking at stress, we're looking at genetic variants that could cause, you know, cells to mutate. We're, we're, we're just really looking at the whole picture and how we can repair their terrain. I tell people like, I'm not here to treat your cancer. I'm here to fix the terrain that allowed it to grow. Yes. And so then that's like where. You know, we, we dive into that and we, we work on repairing that, repairing the mechanisms that maybe were going awry for a long time because cancer really develops long before we catch it. And so my goal is to be watching those metabolic markers, watching those inflammatory markers, and see if patterns are starting to come off after we've done a, a deeper dive into. And then, you know, heading them on that pathway to get whether they've wanted to do traditional therapies, like getting them through that and then getting them beyond it to prevent any type of recurrence. Yeah. And when you say deeper dive, are you talking about functional medicine testing? Yeah, great question. So we're doing like extensive lab panels that we can do through traditional labs like Quest, and then we will do genetic variant testing, like nutrition genomic testing and then we'll look at things like a Dutch panel, just depending on the individual is kind of what, but I will do genetic testing on everyone. And then, and then the Dutch and other testing, like organic acid testing. It'll depend on the individual. Okay. And when you're doing genetic testing, are you doing oral swabs? Mm-hmm. Yeah. Yeah. I tend to use max gen testing. I like their test. And yep. Just an oral cheek swab. Mm-hmm. Yeah. And then you're getting pages and pages of reports back. How do you help make sense of all of those letters and numbers so that it's applicable for the client in front of you to understand what they mean? Yeah, it's a lot. And I always tell people like even if we have, so our genes are our genes, right? So we can have one copy of a gene or we can have two copies and these genes, it's our environment that can trigger these things to be, be turned off and on and, and so like if I look at somebody's genetic variants, I also have every patient do a terrain quiz. So it'll look at the 10 terrains that we focus on in the metabolic approach to cancer. And the top three is where I'll really focus efforts because it's telling me that this based on, on their information of what they've been through and what they've experienced, and then their labs. The comprehensives of lab panel and then the genetic SNPs. I don't look at those alone because I'm like, I look at the labs and think, man, this could be potentially off because of this. And we're connecting and putting the pieces together, and then we're gonna focus in on those three top three things. And, and then, you know, later we could focus on the other things, but we just wanna focus in on those top three things that are really triggering some imbalance in the person. Mm-hmm. Right. For example, it might be like. Dysbiosis in the gut, they might have too much bad bacteria. And that's something that a traditional oncologist is not necessarily looking at. Like you say, if a traditional therapy might be aimed at a tumor alone, but not the reason why that tumor grew in the first place. Right. Right. Yes. The gut, the, the microbiome is always a big part of that too. And that's one of the terrain, that's part of that 10 terrain quiz too. Mm. So then you can really pinpoint what might be off and where to start. Correct. Yeah. So it allows for that informa that with the labs. Yeah. Then we'll kind of pinpoint, oh, okay, maybe this was a hormonal imbalance, maybe this was a genetic thing that went awry. And then we focus in on that and whether we need to add in additional advanced functional testing. Yeah, I have a membership for the ladies who complete my balanced hormone solution. And when they're done with that, they're not ready to leave. There's so much work still to be done, or they're just enjoying the whole process and, and they wanna go deeper now. And so when they join my membership, we utilize a little bit more advanced techniques in. Uh, balancing our body across every single platform. But last night we had our, one of our calls and we were talking about cancer specifically and how emotions play a role in cancer development. And and our. Uh, I don't know, can I say prognosis? It's a very medical term, but in how it ends up playing out in our lives. And we talked about just the energy around fear versus hope and you know, these are some of these parts of the whole person that I feel like are underrated, you know? Yeah. Like, uh, how, how do you, in your practice address, like the emotional side of the cancering process? Yes. So that is so important'cause that is part of the terrain, right? So, I have Shelly here. So Shelly is a therapist, which I like to refer to her a lot. She does EMDR techniques from trauma. And she's a separate entity from me, but she's in the office and I refer to her a lot actually for people, like if they, if I do that 10 terrain qui quiz on them, and it's like socio like emotional top of the list, I'm like, okay, we need to work through this and, and maybe we need to take it slow, but. That is like a key factor of what has caused the system to dysfunction. And, and so some people that scares, uh, understandably so. But you know, if we don't repair that and if we don't. You know, work through that, either with a specialist or also, you know, I tell people day to day little things like breath work 10 minutes, twice a day, or meditation or prayer or whatever that means for that person and, and something that they're going to be consistent with. Because even I tell people, if you could just get outside. Go for a walk in the sunlight like that is just something that is so important. Now of course we have to be careful depending if they're doing certain chemos and stuff like that, but but just be getting that fresh air to reset that mind. We have to be doing something of that nature in order to allow for healing and getting beyond all of this. But I do use my resources too. You know, I refer people I have, there's an online program that I refer people to also, if they don't. Necessarily wanna do in-person visits, they'll work through this online program, which is really just resetting, like the sympathetic nervous system, putting them into that rest phase versus that fight or flight. And just kind of rebalancing that, you know, vagal nerve because it's just, I think so many of us are just living in fight or flight and we've all had traumas of different sorts and, and, and we need to work through those in order to truly. Heal. Mm-hmm. Mm-hmm. Yeah. This is the part of the holistic mind, body, and soul component. Right. Right. Yeah. I'm curious, if you were at a party and you were introducing yourself to somebody, how would you, how would you describe what's you do? That's a good question. You know, people ask me that and I say my goal is always addressing the whole person optimizing health to prevent chronic illness, to prevent things like cancer developing. The sooner we can start looking at those things, then the more we can work on prevention. And so really I tell people my goal is health optimization and, and, and if you're already in it, whether you have had a cancer develop, then our goal is to like get that to repair itself and prevent it from ever coming back. So it's really health optimization and prevention as a whole, but by looking at the whole person and that body minded soul is always a part of it, we have to address the whole system. Yeah. Uh, that, do you feel that people understand what you mean when you're describing that, or do you have to flesh that out a little bit more? I do have to flush it out a little bit more. It's interesting because, you know, I, I, I've always gone back and forth with, oh gosh, how do I explain this? You know, so then here, then I find myself like, okay, we're walking around nutrient depleted. So we have to figure out why are we nutrient depleted? Like what are your, like is it a gut thing that's causing you to be nutrient depleted? Is it your stress that's triggering your ability to digest your nutrients? Is it your food? Like, so it does, it takes a little bit more conversation to, to get people to fully understand what I mean when, mm-hmm. Health optimization, you know, because mm-hmm. Whole body. Yeah. And a lot of the times, a lot of the people that see me are very motivated and they're doing the exercise and they're eating really clean and, and they're still struggling with certain things, whether that's. Hormonal, whether that's stress induced, so so many things, but yes, it usually takes a little bit more of a conversation. Mm-hmm. Yeah. Makes sense. What would you say is the most common question that you get asked when you're just introducing yourself to somebody? They're not a client yet. Yeah. Uh, for the most part, I think it really just starts with. Oh, what do you do? Like, do you just work with menopause people? I feel like people, yeah, they come like, I hear that a lot and I say, well, sure. I work with. Women that are menopausal. But I'm always looking at the whole picture. Yes. So it's, it's, it's not just, Hey, we're gonna put you on hormones, which I will utilize hormones, but we're gonna look at other things as in like, oh, okay, well maybe you're depleted somewhere that's impacting your ability to, you know, efficiently metabolize hormones. What does your gut look like? And, and so, but I do, I think a. A lot of people will say, oh man, I'm, I'm in this perimenopausal phase, and like, I just need to come see you. I think I need hormones. And I'm like, sure. But also like we need to look at everything else too completely. I have a very similar experience if I ever am introducing myself and they say, oh, well what do you do? And I first and foremost say, well, you know, I, I homeschool my kids and then, but I also have a women's health practice and I work with women balancing their hormones and they go, amazing. Can you write my script for me? And I always have to, it's funny how synonymous balancing hormones is with HRT, these days, hormone replacement therapy. It is a train of thought that is, uh, it's very hard to break in the average woman because I think. There is a lot of noise out there that once we reach a certain age, it's time to start adding in, topping off these hormones that are naturally declining as we get older, just by a function of having more birthdays. But you know, the work that I do in my practice, I find that there are so many, there are so many tools that we have at our disposal to balance our hormones without prescriptions. Number one and two, it, it. We have to look deeper. It's not always the best first line of defense. So how do you know in your practice when a woman really is ready for hormone replacement therapy? So here's the thing. This is what I tell people. When somebody comes in and they're not having bowel movements regularly, they're just generally inflamed. They're not sleeping like, and sure hormones can impact that as well. But then, then we add in things like, oh, we're Omega-3 deficient and we have all these other things that are playing a role. We really need to. Work on optimizing that. We need to make sure these women are getting enough fiber in their diet so their body can get rid of excess hormones. We need to make sure that they're using clean products. Like what are we putting in and on our skin? What's in our environment?'cause those things can act like, well we call'em endocrine disrupting chemicals. They can act hormonal in a sense that we don't want them to act that way. So we, we touch on that. We touch on their sleep. Because if we're, you know, I also tell people if we're metabolically dysfunctional, then we're gonna, that's gonna make this perimenopause phase a little bit more challenging. Mm-hmm. And, and so it's, it's. Sometimes I can, I can almost tell if I put somebody on progesterone, uh, I'm not sure how this is gonna go, you know? Mm-hmm. Mm-hmm. We really need to like, repair the gut and we need to fix these other things. I also notice. A vast amount of people are being overdosed on hormones. And, and there's no reason I tell like, yes, I will use bioidentical hormones, but there's no reason a woman needs to be over over-prescribed hormones. That's where we get into those side effects. That's where we get into, you know, things going, becoming dysfunctional and. I tell, I also tell women like if sure if you shoot somebody's testosterone up to 300, which is like a male level, they might want to have sex with their husband all the time and have this libido. But then what else is going on? But at what cost? Correct. So that's where I am all about balance. I'm all about like more of a conservative approach. Mm-hmm. While we're repairing all of the other things. Yeah. Yeah. I love that. I mean, just because it's available to us does not mean that we need to take full advantage of everything at all times. I have a question for you that's something that's mulling around in the back of my head which is. Hormone replacement therapy. I mean, it's relatively new in the grand scheme of things. Yes, there's been some poor studies out there and there's a big push for it right now, especially in the social media online space. The idea behind my question is sort of like my grandmother didn't have it accessible to her. Moved through the transition. What's the big push now? Why do you, what do you think is behind, uh, every time you open social media or you go to a doctor's office, there's a flyer being handed to you? What's the, what are the reasons behind the big push for HRT for every woman starting earlier and earlier, and furthermore, all the hormones, progesterone, estrogen, and testosterone, rather than a more individualized approach. Yeah. So I think the big thing that why we're seeing it all over the place now is, well, people are becoming more aware, but it's when we lose those hormones in women, the number one killer of women is cardiovascular disease, right? And so when we start to lose those hormones, we see es es, especially estrogen, we start to see heart disease increase. Now, that's why I tell people. Sure the hormones play a role there, but what else in the environment is playing a role there as well? And, and so we, that's why we wanna look at everything. And so there's the cardiovascular benefits, there's the bone protection but not without weight training, you know? Mm-hmm. So we need to be doing the weight training as well. And, and so I think what we're seeing is, is, oh, we, you know. We had that bad study and hormones got taken away from women and, but we have to ask ourself too, like. Yes, hormones have these protective benefits, bone protection, cardiovascular protection but it's not without lifestyle as well. Yeah. So that's the biggest thing. But I, and, and, and I think they're talking about that too. You know, I think we hear a lot of that, you know, everybody's, everybody's got a weighted vest nowadays. Mm-hmm. We're talking about the activity component and lifting heavy weights. I just, you know, I can't exactly put my finger on it. I just think we have social media and we have bigger names talking about it and, and you know, we're talking about the cardiovascular benefits, we're talking about the bone protection, we're talking about the other, the mood benefits. But I don't know that we're talking about the whole picture yet, I hope, right. That over time we're gonna see, you know, hey, we gotta see how this person's metabolizing their hormones. We gotta make sure they don't have two copies of this genetic variant that could potentially cause them to metabolize them the wrong way. Mm-hmm. And we gotta make sure that their gut is efficient in removing excess hormones. So I hope that over time we'll start to see that shift. But in. Traditional medicine, usually we're just saying, Hey, you know, here's some estrogen, here's some progesterone. We're really not even on that testosterone train fully yet. Mm-hmm. Women and we're not addressing the whole picture. Yeah, yeah. Call me skeptical. I don't know. Part of me wonders do we utilize it as an easy button? Uh, yeah. Much marketing is behind it. That is really. Have sending the message out that something that is meant for symptom relief can solve more problems than it can actually solve. Yeah. And I think there's a huge marketing push behind these things. Mm-hmm. Have like all these celebrities like Halle Berry and these people that are pushing it. And I, and I'm just like, this isn't a new thing. This doesn't just. Occur, you know, but I think back to, like, my mother had a hysterectomy very early after she had us. So she was in her thirties and she was placed on hormone therapy at that time. This was a long time ago. Now, does she remember what kind it was? No. Was it a synthetic right. Probably. I don't know, you know, but I, I, maybe it was. Bioidentical. But so, you know, we have utilized it in the past. It's just we're seeing such like a it's like a celebrity mm-hmm. Topic right now. Just like I like to say, you know, a buzzword. It's a buzzword. And I like to say things like M-T-H-F-R is the celebrity gene that people love to talk about. And I'm like, what? 70 to 80% of people have some variant of M-T-H-F-R and, and it doesn't mean that it's triggering issues for us right now, but there's other things we can look at to see. Mm-hmm. So yeah, I definitely think there is a big media push. Now. Yeah, it's, it's a money thing. Certainly. It's completely, it's completely, the question to me is, are we as women being served or as are we being sold to, you know, when we were younger, the idea was the pill would solve all of our problems. And part of me can't help but think that we are in the new era of the pill. It's interesting. I was telling my husband the other day how women's health issues sell. You will always make money off of women's health. Men are not so inclined to prioritize their health or to spend money, great amounts of money on their health, whereas women will and why is will for their husbands. But men are out there as readily as women are, you know, looking for all of these solutions. And so is this a matter of capitalizing on things? Just some questions to ask. Not, I don't know that we'll ever get to the bottom of everything, but I think it's good that women stay informed and that we really consider all the risks when we're going to be putting something in our body that can impact, does impact our physiology. But something I'm really curious about, because I love that you work in the, in the cancer realm is the natural process of perimenopause is progesterone begins. Its initial descent and estrogen stays high, higher in rel, in in relativity to progesterone. Eventually, once we cross over into post-menopausal years, we have low levels that do sustain biological processes, I must say, but low levels of both estrogen and progesterone. Why do you think. The median age for diagnosis of breast cancer then is when estrogen is at its lowest and the majority of breast cancers are estrogen receptor positive. Is it possible that what we're finding is that we have tissue storage? Of estrogen hormone that can't possibly be measured in something like a blood level. So when we say estrogen is low and we add more estrogen to it, are we considering the impact of the tissue storage of these hormones, which we know to be proliferative? So here's the thing. So we know that estrogen can actually store in our tissues and hang around much longer than we, you know, if we are looking at a serum at one point that gives us like a glimpse into that, that point when we took that blood draw, right? Now we know that it does decline as our ovaries, you know, stop. Making it right. But it does, we do still have tissue storage of it. And the, the point with the cancer too is, like I had said earlier, cancer starts to develop years before we catch it. Right? And that's why we discuss this like metabolic approach, right? Because we're, we will see dysfunction. Years before, but nobody's looking at it really. Mm-hmm. And nobody's looking at the genetic SNPs, or is your body metabolizing estrogen before you even hit menopause? Like, is your, has your body just been for years metabolizing down this unhealthy pathway which has caught, which has triggered that DNA damage? And yes, you're correct. We do have storage of estrogen. Further beyond, we see a low level in a serum. And so that's why it's so important that, and I'll use an example here too. You know, I, I have a patient who was getting pellets and, and that estrogen and testosterone, and then was diagnosed with. Breast cancer, right? We don't know how long that cancer had been there. And so likely years before we found it. But we also don't know. How she was metabolizing hormones prior to getting them placed. And that pellet we can't take out. It shoots the levels very high. It's there. And then we get this estrogen receptor positive breast cancer. And here we are, we're kind of stuck with that pellet in place and there's nothing we can do Now, we, now we can support, trying to support that pathway of that healthy estrogen metabolism. Looking at the gut, calcium to glucarate, things like that. And looking at a Dutch test. And what do we need to do to rebalance the system, right? But we, we didn't know what was going awry before that was causing that cancering process. Mm-hmm. And then we just kind of, you know, at times we don't look at the whole picture and that's where we get into trouble. Things start to dysfunction. And pellets are swapped out about every three months, so, right. Yeah. Like every three to four months. I don't do them. But that's, that's my understanding is it's every three to four months. And, and not to mention, you know, I don't love that we're like having to put this like incision into people every three to four months. So we're, it's mini surgery. Yeah, we're doing a little, you know, we're doing tissue damage. I just am not a proponent for them. You know, I, I don't get me wrong, I have patients that get them and, and that's their, that's their right also. But I am definitely not a proponent of them. Yeah. So if you're working with estrogen, with women, what forms do you like to use? Yeah, so typically I, you know, I prefer a transdermal, like a, through the skin. That would be, that's where I. Start with everyone. You know, the, the oral of course, I, I tell everybody these are the options that we have. Do I do all of them? No. These are the options that are out there though, and there's, you know, oral lozenges, there's tablets that you swallow, which are processing, you know, those. Again, are available, but they process through the liver, they increase blood clotting risk a little bit just like birth control. That's what birth control did. And, and so we have to pay attention to that. Like, is our liver overloaded? What's going on there? So we can just support health. Again, it goes back to healthy metabolism of hormones. Right. But I focus more on the transdermal, uh, formulations. If somebody, if somebody wants like a like a oral troche or lozenge because of absorption, or they're worried about other reasons of like the cream, they don't like the things like that. So I give the options. I just don't do pellets. Mm-hmm. Yeah. Do you find that there are women in your practice who want to come off of HRT. There's, yeah, so that's a really good question. So HRT is not for everyone. Mm-hmm. So the other thing too, so. I know there's so much buzz around it. And so we're on this like, oh man, I need it. And of course like there's those benefits too, but there are those people that no matter what you do, they do not react well to it. And that is just the body sending a signal, right? It's like, and these people have done everything. I mean, they've done the gut stuff, they've done the gut work, they've done all the, and their body still isn't responding well to it. And so it's, I, for those people I say like. This just might not, this might not be the option for you. Like this might not be what your body needs. And we need to focus on all the other things all the lifestyle stuff, all the, and because I don't believe everybody is a good candidate for HRT and I think a lot of what we hear is that everybody should be on it. And that's why I just have to. Pay attention to all the other things like the genetic variants and the metabolism and things like that, and just people's response, you know, because if you're not responding very well and we're having a lot of issues trying to like rebalance, and then, then we have the conversation of maybe this just isn't the right option and we need to focus on all the other stuff. Yeah. Yeah. Like you mentioned about progesterone. You know, progesterone is meant to be calming, anti-anxiety helps with sleep, and yet there's a certain subset of women who it does the complete opposite in them. Mm-hmm. That's very true, and that's what I tell people too. We have to look upstream. So, so we have to look at other things like trytophan and gaba.'cause progesterone, if you're taking it orally, stimulates GABA production, which is supposed to be very calming in a sense. But then when we're having those opposite effects where we're like, okay, we, a second, are we having issues with triptan conversion? Like what do we, we need to. Stop the progesterone. We need to look a little bit further up at the cellular level and see if we need to repair that mechanism. Because I have had people have an opposite where, where they were anxious and they couldn't tolerate it and they were more like, and so we really have to dig a little bit deeper, especially in those cases. But we're not seeing much of that. Being done. And again, that goes back to, Hey, maybe you're not the right candidate. We, I think we need to fix things more at a cellular level here. And then work on your body, just optimizing all the other things. And let's talk about, and men and women's hormones, as I understand it, are a little bit different here. So women specifically, once you start HRT, do you have to stay on it or is there a point at which you can safely come off? How does that, what does that look like? Yeah, so well now we're seeing all sorts of new things coming out about this and like, so, you know, technically you, the guidelines before would say, oh, you only wanna be on it for 10 years, and then you have to come off. And and now we're seeing people on HRT till they're 80, 90 years old. Mm-hmm. Life and, and you know, more people are. Staying on it more? Well, this is, I guess I don't have a study on this, but it's more for those, you know, cardiovascular benefits and the bone protection. And, but can you come off of it? Sure. You know, it's, it's not that you can't. Stop it. I tell, I tell that to everyone. You know, if you start something, it doesn't mean that you can't come off of it, especially, well, especially if you're not tolerating it. But there are things that you, you know, start with anything that you. Can come off of the goal is, you know, I told you the goal is, is you know, to fix how your body is functioning at a cellular level so you don't have to be on a bunch of stuff. Because we don't want to have to have people on a bunch of stuff. We have to look at metabolic markers and all these things, and but. Yeah, people can come off of them, but we're gonna, I think we're gonna see over the next 10, 20 years that people are staying on their HRT just because of the big buzz we've been seeing over the last couple years. They're gonna be staying on it much longer than they had been. Yeah, yeah, of course. And in the next 10, 20, 30 years, we'll know a lot more about the impacts of that. Yeah. Yeah, definitely. Uh, yeah, I think there's gonna be a lot more research around it moving forward. Yeah. Yeah. Well, uh, I'm really intrigued by the integrative oncology part of what you do. How, how do you find, how open are women in particular to exploring some of these other aspects of the metabolic approach to cancer? Some of the emotional pieces that we mentioned before terrain pieces. Do you find women are really open to finding root cause of why this started to begin with? What kind of outcomes do you see when they take this approach? Yeah, that's a good question. So I think when people come to me, they tend to be a little more motivated in general, in, in integrative modalities, right? So, I think they're all in, like they're, they're like, okay, I, I've got this cancer diagnosis now. Like, what do I need to do? To fix and repair and go beyond it. And so, like I had said before, sometimes people are a little hesitant if they're, if I'm saying like, Hey, we really need to work through this trauma component. Sometimes that's scary for people to try to like, you know, rehash those things that they had been through. But for the most part, I think that these. Women are very open to it. I mean, they come in here and they're like, oh gosh, what coffee should I be drinking, if any? Or like, what, what cream? What lotion should I be using? Like they're very motivated in switching those things out. And, and just doing whatever it is they can to support their body through it. I use my, my, my best friend as an example, she just is not a breast cancer, but she's got a stage four colon cancer and she's 42 years old. She's young and, and she got diagnosed and, you know, went to traditional medicine and they said. Hey, you're gonna be on chemo the rest of your life and you know this is gonna be maybe five years and that's terrifying to hear for anyone. And she. Was in this like state of panic, right? And she went to integrative, she went to a metabolic approach to cancer specialist, and then also she did start traditional chemotherapy. It was a terrifying time. And, but she's been doing all the things, the hyperbaric oxygen, you know, no longer eating sugar. She does her lymphatic stuff. I mean, just so many things like, and everybody's so individualized. But we've had multiple clear scans. She stopped chemo. She's like, it's like even yesterday I got a text from her saying her, her oncologist was like, we, I have no idea how this is happening. You know? And so, yeah, it's amazing. So it's just like, that's like with any type of cancer, it's just like there's, there's other things that we need to look at and it's just, ugh. I think the people that come to me though in, in response to your question, are just very motivated in that regard. And I also tell people too, like, if you're not willing to change your nutrition or your diet, then I might not be the right fit, because that's part of what's needed to get that right. You know? Right. Yeah. What's one new thing that you've brought into your practice, the way you help your patients over the last year? You know, I think a big, I'm trying to, you know, kind of get the whole picture here. So I am looking at an InBody scan because I do wanna see people's muscle mass to visceral, uh, uh, mine does the visceral fat mass and they're, they're lean mass. I wanna look at that because if we're losing that, we need to repair that. So that's something that I have every single patient do. I, I am actually shifting a little bit into. Wanting to do nutrition genomic testing. That genetic swab on every patient that comes in because it never changes and we use it as a reference. Mm-hmm. If things are going awry, I tell people. And then, you know, something else that we're gonna be adding in here soon is more like clean skincare, regenerative stuff. Versus like, I think we're seeing a shift in the aesthetics world where people don't want. The toxins and the fillers, and we're looking for more regenerative stuff, so we're gonna be adding some of that stuff in over the next couple months also. That sounds amazing. Are these things like red light therapies or what other kind of regenerative, it's, it's you talking about, it's so like red light therapy, so like exosomes you know, the PRP that's coming from your body, stuff like that. And then just like clean skincare that we can put all over our body because of course, you know, our skin is our biggest organ, so we just wanna make sure that we're, these products are things you could use. During a cancer journey, making sure that you're not putting extra topicals for my breastfeeding moms. Like these are safe for all the patients across the board. Amazing. Yeah. Well, how can people find you if they want to work with you? So Salus Integrative Medicine you can find me on Instagram at Tiffany Balen np, or you can find the business at Salus Integrative, tn, and it's S-A-L-U-S. People ask me, what is Salus? I said, you know, it is the Roman Goddess of wellbeing and aw. So that's how we came, that's how we came to that. And, and then also it's the website is www dot salus Integrative health. So any of those modalities would be the easiest. And we're in Franklin, Tennessee. Do you see people virtually as well? I do there's some laws around, you know, seeing people out of state and stuff. I'm licensed in Colorado and Montana and Michigan, so I'm licensed in other states, but it just depends what state they're in. And then there's some laws of having to see people once a year in person if we're doing telemed. Oh, okay. Okay. Sounds totally workable. Well, here's a question that I like to ask everyone that I interview on this podcast, and that is what is one thing that you do for your own personal health on a daily basis? Yeah. So, uh, gosh, I would say the one thing that I consistently do is I wake up at 5:00 AM and I like to go downstairs and I, it's kind of like my natural alarm clock. But I like to go downstairs and try to have a few minutes. By myself prior to diving into work and all the other things. Now my little guy, he tends to be a ninja and he can hear me the second I'm moving, I don't know how. And so now my mornings have become, I wake up and I might get a couple minutes by myself, but then he comes down and he snuggles me for the next 30 minutes or so. So. Aw, but that is that oxytocin, that, that love. And so that's what every single morning starts with for me. Aw, I love that. How old is he? He is four. Aw. Yeah. He's so sweet. It's just sweet. Even the other day he said, mommy, you didn't snuggle me this morning before.'cause I had to, I ended up going to Pilates and I was like, oh man. So then it's like, it, it's his routine too. I know. It's his routine also. It's so, it's so important for both of us, but I love it. Oh, I love it too. I just, my oldest is 20 and I, he's at UT Chattanooga just drove down there yesterday to take him to lunch and spend the day with him. And it wasn't too long ago that he was four years old and in my arms on my lap. So enjoy every single day. It's precious. Oh, I know. It goes by too fast that, what do they say? The days are long, but the years are short. Exactly. 100%. Yeah. Well, it's been a pleasure having this conversation with you. I am so glad to have you here locally as an amazing resource. And, uh, thank you for everything that you shared. I love the work that you're doing with women, and I love to hear your passion behind it and, uh, the, the difference that you're making, that you're providing. Real answers to real problems and changing women's lives. So thank you for being here today. Oh, thank you so much, Tracy. I really appreciate you bringing me on and more of just spreading the world to help as many people the word so we can help as many people as possible. Amen to that. Alright, thank you and I will see you next time on the next episode of the Balanced Hormone Solution Podcast.

Speaker 3: 46:51

That's it for today's episode of the Balanced Hormone Solution Podcast. If this resonated, don't just listen. Do something about it. Make sure to subscribe so you don't miss what's coming next. And if you know another woman who's tired of feeling like a stranger in her own body. Send her this way for more support. Check out the show notes. I've got resources to help you get started. Just remember, your body isn't broken, you just need the right tools. See you next time.