Building the Best You

Preventing Breast Cancer Through Lifestyle Changes with Dr. Kristi Funk

Jeanne Collins Season 2 Episode 91

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In this powerful and eye-opening conversation, Jeanne Collins sits down with Dr. Kristi Funk—renowned breast cancer surgeon and women’s health expert—to break down what every woman needs to know about prevention, screening, and long-term wellness. 

From the rising rates of breast cancer to the critical role of nutrition, exercise, sleep, and stress, Dr. Funk shares actionable, science-backed strategies that empower women to take control of their health. 

The episode also dives into often misunderstood topics like dense breast tissue, hormone replacement therapy, and GLP-1 medications—offering clarity, balance, and practical guidance for making informed decisions. This is a must-listen for anyone ready to be proactive, informed, and intentional about their health journey.

More about Dr. Kristi Funk Including Discounts Mentioned on the Show:

Kristi Funk, M.D. is a double board-certified breast cancer surgeon, and lifestyle medicine doctor, bestselling author, and international speaker. She graduated from Stanford University in 1991, received her medical degree from UC Davis, completed her surgical residency in Seattle, and a surgical breast fellowship at Cedars-Sinai Medical Center in Los Angeles. She excelled as a Director of the Cedars-Sinai Breast Center until 2009 when Dr. Funk co-founded the Pink Lotus Breast Center in Los Angeles where she currently practices. She has helped thousands of women navigate breast issues, including celebrities like Angelina Jolie and Sheryl Crow. 

She is the go-to breast expert for Good Morning America with repeat appearances on Today, The Doctors, Dr. Oz, Rachael Ray, as well as countless online interviews. Dr. Funk has received dozens of honors and awards and uses her appearances to educate and give back to the community. She resides in Los Angeles, CA, with her husband, Andy Funk, and triplet teenage sons.

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Introducing Dr. Kristi Funk

SPEAKER_00

Welcome to Building the Best You, a destination for you to reimagine what is possible in your life and then create it. Hello, everybody. Welcome to the show. I'm your host, Gene Collins, and today is such a special day. I am so honored. We have Dr. Christy Funk here on the show. And guys, this is like an honor. This woman is like an icon in the breast world. Holy cow. Double board certified breast cancer surgeon. I don't even want to mess this up, so I'm going to read some of it. Lifestyle medicine doctor, best-selling author, and international speaker. Oh my goodness. And yes, she even claims she has clients, not only claims, but has clients willing to say that she's their doctor, like Angelina Jolie. So you are all things women's health. And I am so excited to have you on the show because we are going to talk about so many things breast cancer, GLP1s, HRT, how women can proactively take care of their own health, because I think it is such an important subject. So I thank you so much for taking the time to talk to us. Thanks, Gene, for talking to me. Oh, it's so wonderful. So just really quickly at a high level, because there's so much I want to talk about, but how did you get into the realm and decide that I want to be a breast cancer surgeon? Like where did that come from? Yeah. Okay. So I was in my surgical residency in Seattle. And this is way back when laparoscopy was just starting, where you operate through little incisions and stare at the camera. And, you know, so I get elbowed out of the way by my attendings who were teaching me, but they themselves didn't know how to do it. So I thought, this is the future. I'm going to do a fellowship in laparoscopy because this is where surgery's headed, tiny incisions, TVs. And I came back to LA, where I'm from, to Cedar Sinai Medical Center to do that fellowship. It's called minimally invasive surgery. So I'm doing this MIS fellowship for all of like five days. And the guy who headed it up happened to also be the director of their newly formed breast cancer center, which had literally five men over 50 running it. So they had zippoestrogen going on in this breast center. And so he was like, you know, this was so male. This is so perfect. Male surgeon, I should say. He's like, you know, I never really asked you what your aspirations were after you finish your fellowship. So let me tell you what you're gonna do. You're not gonna do this fellowship. You're gonna do a breast cancer fellowship, and then you're gonna take over the breast center. Okay. And I was like, huh, I am. That seems boring and too easy. Like he's like, don't, I understand it's a big shift. So don't worry about, you know, answering me right away. You can let me know tomorrow. Tomorrow. Take 24 hours. Okay. Exactly. For real, for real. So deep soul searching on like soup hyperspeed and you know, prayer and thinking and envisioning my future. And I was like, you know what? He kind of has a point. I might think breast surgery is easy, but it's anything but easy for a woman going down this road. And it has become the privilege of my life to join women, come alongside them, hold their hand through what they perceive to be and what could actually be the scariest moment in their lives, and provide some guidance and direction and some empowerment for the days after, because cancer is but a moment. We get through it, and then life goes on, and we want that life to be joyful and purposeful. And so that's how I transitioned from general surgery to just hyper focus on breast only. Yeah. Wow. And that was 24 years ago. Yeah. Wow. And now you're the co-founder of this amazing company, Pink Lotus Breast Center, which I think is in Beverly Hills, right? It used to be. So we've now moved everything to Santa Monica because I want to ride my bike to work every day, which is what I do. I like that. I like that. Wow. So how many of the people who come to your center are actually from that area or come from other parts of the country because of your expertise? 90% are local and 10% fly from anywhere in the country or world. All right. Good. All right. So I would love to talk about a bunch of things related to that and sort of try to help people have an understanding of things that they can do, resources that are out there. But first, I am curious. As an outside person, I'm fortunate, thank you. I have not had breast cancer yet. But I feel like the number of women I know who have had it seems to be growing exponentially. And I don't know if that's just because of my age, because I'm 55, or because there just are more cases. So I'm curious from your perspective as a doctor, is it happening more? Is it people are screening more? They're finding it more often. What's your take on what appears to be a rise in it? Right, all of the above, but it's actually factual. So you are in that cohort where we're more likely to get breast cancer. The median age, meaning half at and above and half below, is 63 years old in the United States. So as we approach 63, we're getting to the top of that bell curve where most of the cancers are happening. It's also no longer taboo to talk about it. So you see it in social media and on the news and covered at GMA, et cetera, right? So it's it seems more rampant because people are readily talking about it instead of being like, I don't know what grandma died from. It was very hush-hush, right? But the reality is in the numbers. So the incidence, the number of cases of breast cancer on a yearly basis has skyrocketed. I remember I just said I started 24 years ago. I lectured a lot in the community, and I remember giving the stats on how many breast cancer invasive breast cancers are happening this year. And the number when I started was 210,000. This year, 2026, the predicted number of breast cancer cases is 310,772. Wow. And that's invasive breast cancer. We can layer on that another 56,500 um stage zero in site two cancer. So we're we're talking about like, you know, 370,000 women hearing you have breast cancer. Yeah. The incidence from 2012 to current day has been going up and up and up at 1% per year. However, the clip in those under 50, 1.4% per year. So not only are the numbers overall going up, but the ages are getting younger. Younger. So that is so backwards, right? Like it's 2026. Shouldn't we be like bigger, taller, faster, stronger by now? Like cancer be in the rear view, not more prominent than ever. I will say the death rate, the mortality from breast cancer has been steadily going down since the 80s. And that's due to earlier detection and better treatments. But shouldn't we be smarter about why and stopping it from starting in the first place? Yes, exactly. Wouldn't that be a beautiful thing? Well, and so you answer one of my questions, and I just want to make sure I repeat it, which was I was curious if the level in which people are getting detected for having it and having that identified has lowered. So if it's more, you know, stage one, stage two, and not quite as many as stage three, stage four, which would indicate to me that people are going for screenings and catching it sooner. And based on what you said, that does at least appear to be the positive part of that trend, is that it is being caught sooner. Right, right. More stages zero, one, and two than decades ago. But it's still, you know, quite disappointing. We're gonna see 42,000 women die from breast cancer this year. And, you know, behind skin, it's the number one cancer that women get. And in fact, in 2020, breasts surpassed lung to become the number one malignant tumor on planet Earth. More than prostate, more than colon, more than lung. Like we win. Not the prize that we want. No, no, right. No, that is not. You that's not the plaque you want at the front of the office. No, right. Oh my goodness. All right, so let's talk about screening then, because I feel like that is, you know, so important. What do you recommend to people that they should follow as a screening protocol? Right. Okay, so here's what I recommend. And I also recommend, you know, just exhale. Just think about the stuff I'm saying. And, you know, it's your life, your breast, your choice. No one should really get all up in your business if you're like, no, I don't want to do mammograms, right? But data is data. So I will say that when you look at data, mammography repeatedly shows a 30% drop in mortality and dying from breast cancer in women who at least get a mammogram every other year. Okay. My recommendation for normal risk women, and we can talk about who would be at elevated risk, but if you're just average risk, you want to begin mammograms at age 40. Don't stop and don't skip years. Get them annually every year until you think it's reasonable that I will die in the next 10 years. Admittedly hard to predict, but not so hard if you're like oxygen bound and in a wheelchair, right? Like we can stop your mammograms. Why? Because even if you made a breast cancer, it would be insignificant. It wouldn't grow to the size where it broke skin and caused pain, it wouldn't metastasize and kill you before other said issue in your life, medical issue. So that's the schedule. But part two, if you have dense breasts, this is a huge increase, not only in breast cancer risk, but in missing a cancer when present if you're screening with mammograms alone. So how do you know if you're dense breasted? You really don't, except thankfully, last year became ubiquitous across the US in every single state that all imaging centers by law must send you a letter in the mail that says, hey, your mammogram was negative. That's awesome. But by the way, you're dense. So we're not so good at seeing cancers when they're dense. Good luck with that. So it's useful information, but literally zero direction. Like, yeah, they don't tell you what to do about that. No. No. They honestly do not. They put the onus back on your doctor, whether it's your Obi-Gon or primary doctor, maybe you see someone like me, but they do not tell you what to do. I'm going to suggest to you what you might want to do. So if you find out you're dense-breasted, absolutely hold breast screening ultrasound. Knee-jerk reaction, no questions asked. Why? It's so harmless, right? Like there's no radiation, there's no heavy metal injections. It's just a sound wave. Now, there's always drawbacks to any imaging study, specifically in the what we call false positives. Oh, we think we see something. It might be cancer, it might not, but now you need to come back and we're going to look again and we may biopsy and it, you know, so there's this whole avalanche of anxiety and downstream things that can happen all for nothing if it's benign, but that's a thing, an experience we're willing to tolerate in order to find the cancers. Yeah. So I can briefly give you like the stats on that. I would, because I don't, I don't think a lot of women actually do that. Of the women I know, I don't know a lot of women who do that extra step. They really should. And this is half of women. So 50% of women for menopause have dense breasts, and 50 don't. Then between 50 and 60, you start to lose some density, particularly if you do not go on hormone replacement therapy. So your natural estrogen declines, which was keeping your breasts more dense. And so we see instead of it being 50% of women, it's 40% are dense. And then after H60, 30% are dense. So you do lose density with aging, but density is a problem. Now, on a mammogram, we grade it A through D. A's and B's are not dense, and C's and D's are. Sure. This is also important because they don't distinguish whether you are a C or a D. And this is actually pretty meaningful in terms of how bad we are at finding that cancer. So 40% of all women are going to be C and 10% are going to be D. That's the 50% who are dense, right? Yes. Right. Yes. So most of us who are dense breasted are in the C category, which means we look, we look at a mammogram and visually about 50 to 75% of what we're looking at is a white splotchy snowstorm. Problem because cancer's white on a mammogram. So now we're looking for a snowball in a snowstorm and we miss cancer in C level density 25% of the time. D, we miss it 40% of the time. Add in there an implant just for augmentation, yeah, and we're gonna miss another 20%. So in all dense-breasted women, we want to add whole breast screening ultrasound because the dense breast still looks white, but cancer looks black, so it pops out. Ah, okay. I like spacing if people can keep their um schedule. I like spacing their screening mammo six months from their screening ultrasounds, like January, July, or February, August. So that's yeah, there's something called an interval cancer. In other words, anyone who's had breast cancer, their first thought is like, why didn't they see it last year on my mammogram? Right, if they have been keeping up regularly. And that's because it wasn't visible last year and now it's of a size where it popped out and revealed itself. However, if you had gotten a mammogram at the six-month mark, would it have seen this cancer? Would we have had a six-month heads up on its presence? Probably. But that's too much radiation. We don't do mammograms that frequently. But that's the point of staggering the ultrasound away from the mammogram so that you have the opportunity to catch an interval cancer rather than letting a whole 12 months go by. Fascinating. Now, layer on top of average risk a little bit of higher risk. So maybe mom or sister or your own daughter had breast cancer. So first degree relatives, or a whole lot of cancer going on, and two aunts and grandma, or you yourself have had a breast biopsy with what we call a marker lesion. So atypical cells, radial scar. There's there's words that we would look for in a path report that elevate your future. It's basically whispering. Your breast is talking to you, saying, like, I'm busy in one of these days. I'm gonna try to make something out of myself. Right. So these proliferative breasts are a little higher risk. So what we like to add on top of MAMO and ultrasound is maybe a breast MRI, or one of my favorites, which is not available widely throughout the US, but it's contrast-enhanced MAMMO. Both of those MRI and contrast mammo do require injection of either iodine for the mammogram or gadolinium, which is another heavy metal if you're getting an MRI. So again, pros and cons to all this stuff, but as a general example of how helpful these tools are, let me give you the results of the braid study that came out May 2025. So quite recent. Just happened. They looked at 9,300 women in the UK who all had density D. So here are super duper dense women in whom we miss 40% of breast cancers. All of their mammograms were normal, and they were divided into three groups. You guys get a whole breast screening ultrasound, you guys get a breast MRI, and you guys get the contrast mammo. So nobody had a normal mammal fine cancer. The ultrasound found four, the MRI found 17, and the contrast mammo found 19. Ooh, okay. Yeah. So we definitely up the anti by adding imaging beyond mammograms alone. Right. Four to nineteen is a substantial increase in the world of science and statistics. Like that's a lot. So everybody density D, which is not the majority, remember, 10% of all women. I definitely throw an MRI or contrast mammo into the mixed. Not every year. Depends on their extra risk factor. So it's just that they're D, but no family history, no inherited gene mutation like BRCA check 2, Pal B2, and the like. Then I'll go every three years with the extra imaging that involves contrast. And then if the risk elevates from there, maybe every other year, and for the highest of risk, like a BRCA carrier every year. Yeah. Wow. That is crazy. Okay. I have a couple quick questions. One, the first one is probably really dumb, but if I have it, I'm sure other people do too. Is there any correlation between breast size and density? There is not, actually. So yeah. So like you can have small breasts, you could be a B size cup and still have dense breasts in terms of how we're talking about your breast density. Yeah. The truth is your A and B cup women are probably going to have more density than fat. It's usually the converse mistake. People are like, oh, I'm, you know, double D, so I'm gonna have a higher risk of breast cancer. The larger the breast, the more there's a fat percentage underneath that breast skin. So they're not even necessarily dense breasted just because they're large breasted. So the stuff that makes cancer is under that skin, that's the problem. And fat's never the problem. Well, fat has its own category of being a problem, but fat doesn't make breast cancer. Yeah. Okay. All right. That's super helpful. All right. Second question. You mentioned starting mammograms at 40. Will insurance pay for that? Or does that require the doctor providing some sort of justification as to why that should happen at that age? All insurances cover mammograms at 40. There's no controversy there. Yeah. I wasn't sure. I've been having them for years. So I wasn't sure, but I don't want to be a case study of one person. So also interesting. So I'm also really curious do breast implants increase someone's risk of cancer or not really? That's just sort of a myth. Or is there any validation to that? Okay. So it's a total myth. It doesn't matter if they're saline or silicone, breast implants do not increase breast cancer risk. However, they, as I already mentioned, impede breast cancer detection through mammogram alone. Ultrasound, MRI, they don't care, they don't care at all about your implants. So that's another reason to implement a little extra imaging. And here's the interesting truth women with implants tend to have less breast cancer than those without. Has nothing to do, yeah. It has nothing to do with the implants. It has everything to do with the type of person who generally chooses to have breast augmentation, which is generally someone thinner and athletic and very body conscious and so health-minded. So they're more likely to eat better. They are more likely to have all of these attributes in their diet and lifestyle that are known to categorically reduce breast cancer risk. Right. That's a broad generalization, but in studies it pans out to equal less breast cancer. Wow. That's fascinating. Okay. So, but that transitions so well to my next question, which is what, if anything, can women do to try to proactively reduce their risk of breast cancer? Understanding that I don't know that you can, but maybe you can really. Maybe you really can. This is my favorite question on Playboy. Like I'm I'm bursting with excitement. And I wrote an entire book about it. Yay. All right. All right. I know I hate it when my favorite question comes with we did really quickly, we only have 60 seconds left, but in the math. No, because I'm so curious because so many other types of cancers like, okay, lung cancer. All right, don't smoke, but you still could get lung cancer, but don't smoke. Like that's kind of a no-brainer. Breast cancer, when I think about it, I don't really, I, as a woman, I don't know if there's anything I can do. So I am so curious for the answer. Oh, I'm so excited to talk. Okay, so there's so much you can do. This is so empowering. Whether you've already been diagnosed with breast cancer or you just never want to be, there are so many dietary and lifestyle tweaks that you can make to your life that will alter the cell microenvironment. These little, like the bathtub water that your own cells soak in is always screaming out pro-cancer or anti-cancer based on what you eat or don't eat, do or don't do, move or don't think or don't think, touch or don't forgive or love. Like it goes deep. There's so much you can do. But let's back up one second and ask this question What percentage of women with breast cancer have an inherited gene mutation from mom or dad, like the BRCA genes or Czech two or these gene mutations? They're mutations in genes whose sole job it is inside of you to is to identify cancerous changes and to either fix them or throw those cells out before they can form a cancerous wad and become a threat. Okay. So all of us have BRCA. We have BRCA genes and they work. So when you have a mutated BRACA, all of a sudden your risk skyrockets to as high as 87% chance of breast cancer. All right. So what percentage of the women who get breast cancer can attribute it to a gene? I would think a lot. If I had to guess, I'm just gonna take a stab here. I would think 60% more than half. Oh, wow. Okay, I'm totally wrong. I'm on the other spectrum. Okay. Five to ten percent data various. Okay, so only five to ten percent of all breast cancer comes. Because largely because of these inherited mutations. This is a second stat that kind of falls in line. If we buy the first one, what percentage of women with breast cancer have a first degree relative with breast cancer? That I would think is high. I'm going back with my 60% again. 13.

unknown

Oh my God.

Nutrition and the Power of a Plant-Based Diet

Exercise, Weight, and Metabolic Health

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Clearly, I don't know my research on breast cancer, but that's why we're doing this. Most people are doing it. Most people don't. Right. Most people don't. Until you have it, you don't know. So yeah. Until you have it, you don't usually want to know. And that's what I've spent a lot of my career doing is trying to make breast cancer risk reduction fun and approachable and understandable because you don't want to do the crash course in my office one-on-one. You have breast cancer. Here's everything you need to know to treat and cure it. Right. Like, yes. Now, so here we go again to summarize only five to 10% of breast cancer patients have gene mutations. Only 13% of them have mom, dad, probably not dad, but could be dad, by the way. Men get breast cancer. A first degree relative, parent, sibling, child with breast cancer. And only 20% have a single relative anywhere, second, third degree. Wow. Wow. So that gives us five to 10% gene mutation. I'm going to say five to 10% weird stuff, inexplicable. It's actually getting worse post-COVID. And I have theories about that with the, you know, 20-something with no family history who hasn't even lived long enough, badly enough, to explain what is going on in that breast of hers, right? That just seems unfair. And it is, but the point is it's a little less knowable and understandable, at least scientifically, right now. It leaves us with a huge fat middle of a solid 80% of cancers where we can get in to tinkering with stuff. Back to that bathtub water. What are we fueling it with? So here are the big heavy weights. There are nine of them. Okay. That according to my research, this isn't like an article. I'm in. Yeah, yeah, yeah. No, I'm excited. Heavily research-driven. Nine things that you can focus on that can dramatically impact your risk of getting breast cancer or of having an existing cancer recur. Okay. So the biggest that have the most support in the scientific literature, I'm going to have you think of as boulders on your scale, tipping you toward or away from breast cancer, depending on if you have the boulder or not. And then the other five are pebbles, heavy enough to tip a scale, but if you've already got a boulder on there, like, honey, let's stop worrying about microplastics when you got a boulder. Okay. Okay. But the microplastics are on my list. Okay. So here are my four boulders: nutrition. Okay. The science is extraordinarily clear that a whole food plant-based diet is your most cancer prevention strategy type of diet. So animal protein and animal fat are going to elevate estrogen levels inside of you, abnormally higher, so that estrogen has a chance to feed and fuel a cancer. 80% of all breast cancers have receptors for estrogen on them. So they're fueled by estrogen. They're fueled by estrogen. Eating animal protein will elevate estrogen. It elevates a hormone called IgF1, insulin-like growth factor. This is the big daddy growth promoter inside of our bodies. Like it screens at every cell to grow, which is super useful if you're a child growing up. And it's useful to us adults because we turn over a shocking 50 billion cells a day. So thanks to IgF1, we turn over a new layer of cells. But your brain is super smart, tells your liver how much IgF1 to make. When you eat animal protein, you now elevate your IGF 1 beyond what your body needed for the daily tasks. So now IgF1 is just screaming at things to grow, grow plaque, grow fat, grow cancer, grow metastases into the lung, into the liver. Like, so you want to shiet the IGF one levels down. There are uh people in, they're in Ecuador, they could clearly leave, but they haven't all be there. They have uh something called Laren syndrome, and they cannot process IGF one. So they all have medical dwarfism because they don't grow. And no one in the history of the world with larynx syndrome has ever had breast cancer. No one in the history of the world with larynx syndrome has ever had type 2 diabetes. Why? Because you need IgF1 to make breast cancer and type 2 diabetes. So we do not need an excess of IGF 1. Right. Eating ammo protein does oh so many other things, but I wanted to highlight one more thing that it does that's um bad. And that is angiogenesis, angio blood vessel genesis birth, the birth of new blood flow. So for any cancer, not just breast, aspiring to be larger than the tip of a ballpoint pen, two millimeters. Once it reaches that size, it has to get its own blood supply. Diffusion doesn't work anymore. So it has to send out some angiogenic factors. The biggest of all is called veg F, but meat will increase veg F, which then gets sprinkled out into the nearby bathtub water so that blood flow comes to this cancer so it can get the nutrients that it needs. And when it gets big and strong enough, boom, exit strategy straight through those same blood vessels to the liver to the lung, right? Right. So in the same way that eating animal protein has these detrimental effects, it's not just that, oh, I guess I'll have like lentils, beans, peas, soy, seitan, which is weak gluten, the high source of protein, instead, like I gotta get my protein from somewhere. So I'll do that. Oh well, move on. It is incredible when you realize that plants, on average, have 64 times the antioxidant content of any animal product. 64 times, 6,300% more. So the food you're eating instead of the animal protein for protein does all the opposite of what I just said. It lowers excess estrogen, it lowers IgF1, it creates anti-angiogenic compounds that literally take unplug the blood vessels that may be already inside of a cancer. In other, we in other words, we can reverse a pro-cancer process to make it anti-cancer. Ooh, okay. Pretty fascinating. That's fascinating. Okay. So that's number one is food. I had ab I had absolutely no idea. Like absolutely I don't eat meat. I do eat fish, but I definitely don't eat meat and I do eat fish. But I've been vegetarian and vegan before. I've done both of those too. So fish is, I wish, I mean, it's not as innocent um as we like to think, and it's still filled with cholesterol and saturated fat, despite the you know, billing of oh, high omega-3 fatty acids. But we also in those fish in modern times have dioxins, PCBs, microplastics. And then whenever you cook meat, so unless you're having sashimi, you're cooking meat, and it doesn't matter if it's fish or beef or anything else, the high heat combined with the creatine in meat creates heterocyclic amines and polycyclic aromatic hydrocarbons, which is a mouthful for two of the most potent carcinogens that you could possibly chew and swallow down and put right into the bathtub water. Wow. Okay, so this is fascinating. Because I was actually thinking of making a vegetarian dish for dinner, and now I definitely am going to. Yeah, double down on the tofu. I am definitely doing that for dinner because that just feels right. So before we move on to the other eight, because I want to make sure we get to them, just really quickly. So if people come in and they have been diagnosed with breast cancer, is that the first thing you tell them to start doing is to really think about nutrition? I do, and I am power then because I have a smoothie. You can use just Google Christy Punk smoothie. It's like viral. Yes. Because it's packed with 13 of the 18 anti-breast cancer superfoods that I want my patients to be getting into their bodies every single day. So a smoothie is a very convenient, easy way to do that. I understand that it's not always easy in this transition, especially for like the meat and potato lover who grew up, you know, Midwest, like this is just so ingrained. It's like tied to family gatherings and the meaning of love and life for them sometimes, you know. So we're not trying to dismantle the life entirely in a day, but I encourage them to like, let's just look at a meal. Like breakfast is pretty easy to veganize, you know, instead of having eggs and bacon, let's think about getting some oatmeal. We can put flaxseed and cinnamon, some berries, some walnuts, soy milk, amazing meal, right? So yes. I just encourage them, and I have a bajillion resources. So it's not just, I told you to do this, now go figure it out. And open the fridge at home and you're like, forget it. Make me a turkey sandwich. I can't figure it out. Right. I guess you do. You have recipes and stuff on your website. You have a blog, you have a book, you've got all kinds of stuff. So oh, look at you doing your research. We'll put all of that in the show notes. So you definitely have lots of resources. Okay, I want to make sure we get to the other eight that make up the nine because I want to make sure we have time to talk about. I want to talk about HRT and GLP ones too, and how some they play with that too. All right. The other eight. I'm obsessed. Um, okay, so the other eight. So boulders. We were doing four boulders. Diet was boulder one. Yeah. Exercise is boulder two. Yeah. Oh my goodness. The the data that just is pouring out year after year in recent years about the benefits of exercise is unbelievably like overwhelming to me. You know that exercise is is beneficial, like in a general way, because you just feel better and you have more energy, but it's actually working in such like potent cellular ways to stoke your immune system, to improve insulin sensitivity, which is a term, but you really have to understand what that means. Like your muscle and your liver liver cells have these receptors for insulin, right? You eat a meal, particularly one with carbohydrates, um, and you get more glucose flying around in your blood, that stimulates insulin release to come out and manage the glucose, manage the sugar, right?

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Yeah.

Alcohol, Stress, and Environmental Factors

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It needs to be done efficiently and quickly. Otherwise, the sugar hangs out too long. And that is cancer food. Like literally people hear sugar fuels cancer. It's true. Yeah. I want candy. Like that is the battle cry. That is the favorite song of cancer. And we can like we I could, I could keep, I could deep dive into any one of these avenues, and they're also fascinating to me. But just believe me that sugar fuels cancer. But even more deleterious than sugar is insulin. So now, if you don't have that insulin, come out after the sugar, do its quarterback job, telling everybody where to go, and then retreating away because its job is done until your next meal. Right. If it's hanging out, insulin, it has direct receptors on breast cancer to make it grow. Insulin goes off to the fat where you can convert precursor steroids into more estrogen. Insulin spikes that veg F I was talking about to make angiobet more blood flow happen to a tumor. It really goes on and on, and the bad effects of too much insulin. So, what makes you insulin resistant? Everybody who thinks about diabetes just thinks sugar, like that's why you shouldn't have fruit if you're diabetic. That is not the problem. Even doctors don't understand. The problem is that the receptor on the, say the muscle cell, sugar comes out, insulin says, sugar, go into the muscle so it can be stored as glycogen. Insulin will go into the insulin receptor on the muscle. And when it does, the sugar gate opens and the glucose comes in. Okay. Saturated fat clogs the receptors. Okay. So too much saturated and trans fat in a diet doesn't like we don't know where to stuff it now. We've like you put it under the chin, we put it in around the organs. And now your body's like, just go into the receptor, just sit there. And so now you eat the meal, the insulin comes out, and the receptor's like, can't hear you. I'm stuck with fat, right? So this sugar's running around, the insulin has nowhere to go. And your body sees this feedback loop and it's like, what the why isn't it listening? Let me just throw out more insulin so that maybe we can get rid of the sugar. Right. And that's the bottom line problem. So exercise slowly but surely, in conjunction with eating. Well, it's going to melt the fat out of the receptor, lets insulin back in to do its thing. So you have insulin sensitivity now. Okay. All right. So we've got that. Exercise improves body composition, meaning less fat, more muscle. It decreases estrogen at a standalone mechanism of decreasing estrogen. It decreases inflammation. And this is such a buzzword these days, but it is a good one to have because it really is the bottom line in all of our illness, whether we're talking autoimmune diseases, depression, and anxiety, like inflammation is the background requirement for all badness in our bodies. It means that oxidative stress has tipped the scales and now mayhem ensues. So exercise dials that back. You have less inflammation. All right. So once I wax on about the benefits like of exercise, most people are like, okay, well, Doc, how much is the very minimum amount of exercise I have to do? Oh my goodness. And I will tell you that I'll take whatever you'll give me. And if you're, you know, couch potato by nature and have been for decades and walking five minutes is a stretch, then give me four and a half, and next week maybe we get five. And I mean it. Like just start because the data shows yeah, there was this really great study of post-menopausal women, and even just walking briskly for 11 minutes a day dropped breast cancer incidence by 18%. Wow, that's huge. Pretty cool. That's huge. Yes. If you want to get an A, which I always did as a student. So, you know, obnoxious, right? Right. Get all the answers right and the extra credit. That golden answer is five hours a week. Five hours a week if you can carry on a conversation with whatever you're doing. Two and a half hours, you get to cut it in half if it's super sweaty, vigorous exercise where you're huffing and puffing and cannot be singing a song while you do it. Right. The interesting thing about the curve for more exercise, more benefit, is that there is no end, but it starts to look like it's gonna plateau at 150 minutes at so two and a half hours a week of cardio exercise. But then you actually extend life and have more benefit, pushing it to double that to five hours. And then the line again looks pretty much flat, but it technically isn't. And the irony there is that the extra number of hours you would exercise beyond five hours a week is about the number of hours that you extend your life by. So you do live longer, but you spend all that time exercising. Oh, okay. Well, but that's okay. You're still living longer. All right. You are living good. It's still all good. Yeah. Yeah. Well, and weight training is also, I'm sure, part of your recommendation in there for people who do currently exercise, especially for women who get into the perimenopause stage, having to build up your muscles and do some weight training and strength training. I know is super important too. 30 minutes three times a week. We try to hit all the muscle groups, depending on how you like to do it. But for sure, we can talk about that with the DOP1 use in particular. It's like critical. Critical. Okay, I'm gonna make sure we bring that back up because I've heard that that's critical. Okay. What's the other two? We have two more boulders, right? Two more boulders, yes. Two more boulders. Yes, what are they? This one's a buzzkill. Alcohol. Everyone knows it's bad for them. I know. Well, surprisingly, in polls, most people, most women are not aware that alcohol is a direct connection to breast cancer risk. So if you pick your poison, uh, five ounces of wine equals 1.5 ounces of hard liquor equals a 12-ounce beer. A drink a day increases breast cancer by 10% over a non-drinker. Two drinks a day, 25% increase, three drinks a day, 30 to 40% increase, and onwards and upwards from there. Yep. Alcohol is just a pure carcinogen, not to mention that it's a neurotoxin. It shrinks your brain, it messes with your sleep, it causes weight gain. It, you know, I wish there was some redemptive quality, but the truth is, even claims of like, oh, but there's risk veritrol, and that's an antioxidant. And we were just claiming inflammation's the big problem, right? Yeah. Do you know a gram of risk veritrol, which you know you can pop in a pill, and you get from the skin of the red grape. You don't actually have to make it into wine and then drink red wine. To get a gram of risk veritrol, you need 500 liters of wine. Oh, wow. Okay. Yeah. All right. There goes that theory. There goes that theory. Okay. Yeah. Wait. Being overweight or obese. At a paucity, fat is so inflammatory. It goes well beyond what we used to think. This is pretty new data. I mean, in the last decade, that we've understood fat and breast cancer as more than this simple connection. Fat has an enzyme called aromatase. Aromatase converts adrenal gland steroids into estrogen. And we've been talking about how estrogen is one source of fuel for breast cancers. So we were theorizing that overweight women are just converting more estrogen and therefore are having higher rates of breast cancer. And while that's one mechanism of action, it goes way deeper, and the bigger triggers are more likely that fat is an endocrine organ. It's metabolically very active and it is the main source of leptin in our bodies. And there are literally leptin receptors on breast cells that then create cancerous uh proliferation. So leptin is a cancer promoter in that way. Fat spews out all of these like cytokines and these mediators of inflammation that tip that oxidative stress balance and other things. But this is the beautiful take-home message. Lose the fat, lose the risk. Yeah. So it's not like damage is done. The damage is totally reversible through weight loss. Weight loss. Okay. Now we have five pebbles. We have five pebbles that we'll just touch on as putting them out there. I mean, again, I could do, you know, long lectures on each one of these. Oh, of course. We could do this every day for the next three weeks, I'm sure. Exactly. Definitely. Because I have enough questions about every single one of them. But we're gonna we're gonna make sure everybody gets them all. All right. Okay. Yes. So our boulders were eating too much animal protein. So you lift the boulder off by eating more whole food plant-based, a lack of exercise. So start exercising, drinking alcohol, so stop or cut way back, being overweight, reach your ideal body weight and stay there forever. The pebbles, environmental toxicities. So this is so ubiquitous. You cannot live in a bubble. But I do encourage you to just examine your home, work, car environments. And especially when the higher-ticketed items like a new couch or a new frying pan come into play. Let's look for a non-toxic option, right? Right. In terms of your cooking utensils and furniture. Bigger picture there, though, that can start right away. Look at your laundry soap, detergent makeup. Like, are there phthalates? Are there microplastics? Are there parabens? Like, look for these words. They hide and they're in there. You're like, what? I've been using this, this face moisturizer my whole life. I had no idea the word paraben is right there, right? So be more mindful and just it's such an easy swap. And so just get rid of that stuff. Think about if you have a little extra expendable income, put a HEPA filter in so your air is getting filtered. Think about a point of entry filter for your whole house. So the water that you're drinking and showering in is purified. The whole idea of like, you know, don't touch receipts because there's BPA in the receipt. It's going to be, again, maybe a grain of sand in our analogy with the pebbles. It's a small amount. Do you could say I don't need the receipt? If you don't need the receipt, then don't touch it, right? But these are not causing breast cancer. It's just one more thing tipping us torter away. But let's really look at the environment and try to clean that up. I'm and and microplastics is a big part of that. There should be no, you know, those black. I'm shocked that people don't know that you that you don't heat food in plastic, first of all. And second of all, the black, I know. But thereafter, I just saw someone the other day. She took her black plastic food container that came from a food delivery service, which is, you know, based on being healthy because you're trying to have excellent organic food delivered to you, and they put it in these plastic things. Then heat it up crazy. Okay. Anyway, those are super toxic. I've actually read that it would be better for all of us to throw them in the trash to go into the landfill rather than recycling the black plastic to just come back and live another day as a fork. So, okay. Bleaked glass. Ceramic, silicone, like the spatulas, the you know, uh Tupperware that you're using. Get rid of all the plastic. Of all the plastics. Yes. Straws too. Metal straws. You have to use metal straws, everybody. And your water bottles, they need to be metal. No plastic. No plastic. It's the easy swap. It is an easy swap. Okay. Here's another biggie that I love emotional stress. And this includes paying attention to your relationships, right? Okay. So having strong positive social connection in a planned way, right? Like don't just expect it to happen. You want to schedule time with your partner, time with your BFFs, right? Like, yep. Because stress is ubiquitous again, just like environmental toxicities, but you can try to harness and manage it very intentionally, right? Sounds like a little hocus pocus, but mindfulness and meditation really matter. They really do change your internal biochemistry. Most doctors have no idea. I didn't have an, you know, and to I just think about breasts all day and all night. So I happen to like uncover these little fun facts. So fun fact breast cancer has beta adrenergic receptors on it. Estrogen driven, like 30 to 40% of the cancers are driven by cortisol and epinephrine, like your stress hormones. There's receptors on them. When the stress hormone hits it, it makes it divide. Triple negatives, 60 to 80% of them have these receptors. So that's just a very direct connection between stress and breast cancer because it can fuel it. The more indirect one is that mind-body connection is real, right? You're watching a scary movie and all of a sudden your heart's pounding, your palms are sweaty. Like, yeah, you know, the knife isn't, the guy's not coming after you with the knife, but your body is literally your mind is making, yeah. So, and we just ask any guy who's ever had an erection if there's a mind-body connection, right? So when you don't harness that connection to be positive, you are elevating all of these biochemical pathways that land us in that world of oxidative stress and inflammation. Yeah. So that's another controllable risk factor. Okay. Fasting, the judicious use of fasting, both intermittent on a daily basis and a more prolonged fast of at least five days, does wonders for rejuvenating your immune system. Okay. Obsessed with prolon, if you've ever heard of that. It's a five-day fast because you get to eat while you're fasting. Yeah. I have heard of that. And actually, I think we're going to put a link in the show notes because I have a link that takes people to that. And so that I have seen that. So talk to me about that really quickly. Okay. I'm uh obsessed. So so here's the thing about eating. It's a really arduous task for your body to deal with a meal. So most people, you know, they have breakfast, you may fast till, you know, do intermittent and fast until like 10, 11 a.m., but eventually you're eating. And then out comes the process that I was talking about with insulin and glucose, and it's it's busy. And your immune system really just doesn't have time through all of your daily life, your movement, your thinking, and all of that. So you need to quiet it down inside of you in a way that allows cell rejuvenation and repair to happen, and this cool process called autophagy to happen. Auto self-phage eat. So autophagy is when you eat yourself in a very strategic way. In other words, your cells start to get broken down in order of age. So these senescent buzzing around, old, dead, damaged, dying, deranged cells get broken apart into components and recycled into brand new, like strong, healthy, recruited cells. Yes. When you fast. Okay. The overnight fast, it's a laughable, like it scratches the surface of autophagy in a meaningless way. You need to have not eaten for 72 hours to get into autophagy. And then you get into all the cell rejuvenation and renewal. And so a lot of the prolon diet is a box. You order it and it comes with five boxes of food that you get to eat. It puts you into a vegan ketosis. The food is specifically formulated so that your body never gets the memo that you just had soup or a seed and nut bar. It never elevates insulin. Yeah. So here's what's happening now. Your cells get a little announcement that says she's not eating. And I don't know why, but you need to slow down and just conserve energy. And when she eats, we'll let you know. Right. So the cool thing about that is you are eating, so you're not so hangry. It's not great. It's like 880 calories a day, and two days is 650. Those are like the worst days, days three and five. But even I do it. I have my cancer patients do it for specific reasons there, but even I do it every three to four months. I've been doing it for a decade because the science is so strong. So you're gonna eat this food so that you can handle it, not be too hungry. Yeah. You're gonna get into autophagy days three, four, five. And here's the cool thing on day six, when you eat again, all the scientific studies in humans with blood draws show you get an eightfold increase in stem cell production for having gone through the fight. Stem cells can zip out and become, yeah, whatever you need them to be. Like a new liver cell because of your alcohol or your Adiban or your all the detoxing, right? Or what most of us need, especially my cancer patients, brand new natural killer cells, like the big leader of the immune system.

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Yeah.

Hormone Replacement Therapy Explained

GLP-1 Medications and Weight Loss Insights

Dr. Funk’s Resources and Closing Thoughts

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So fasting, really important. Okay. Another one that is so overlooked and poorly understood by just the everyday woman. Sleep. We think of sleep. Yeah. It's a third of your life kind of a thing, but you think, oh, I'm just gonna sleep so I can wake up and have energy to go into the grind again, right? Sleep is fascinating. Like there's two things I want you to know about sleep. Number one, that is when your immune system comes out to play and to kill cancer when you're sleeping. I just was talking about fasting. It's too busy all day. Right. It is not only when you sleep, it's the first three hours of sleep. And it's not just that, it's your deep sleep. So like I have this garment. I encourage people to have some sort of wearable so that you can understand your sleep. I will tell you. Oh, yeah, your aura ring. Yeah. I have my aura ring. It's amazing. So life changing. And it it's life informing too. Like, for example, I'm not a teetotaler. So I will tell you my sleep score overall will be 92 to 98 every night. I'll have one glass of wine and I sleep was 55. Yes. I had no idea though. I didn't realize it because I still closed my eyes and woke up the next day. Like I'm a pretty great sleeper. I don't have to pee in the middle of the night and stuff. So I had no idea. Like my REM sleep is gone when I look at like that bad number. So you really have to, if you're wanting to get into the weeds with optimizing your health, have some sort of thing that tells you about your sleep. But you want to sleep because number one, immune system function beyond the obvious, because you want to sleep well so that you're can have focus and energy and stamina the next day. Number two, this is super new. We only discovered it in 2012. It's called the glymphatic system. So just like your lymph system and your nodes gets rid of debris and damaged cells and viruses and bacteria infection, et cetera. We have a similar system, but it's only for the brain. It's called the glymphatic because it takes the trash out of your glial cells, your neurons. Yeah. And it's only active when you're asleep. Oh, okay. Yep. So it's critical. It's critical that you sleep and sleep well to get the get all the junk out of your brain. Yeah. Including starting to get rid of some of the beta amyloid plaques and tau proteins, which are those two things that elevate Alzheimer's risk. Yeah. Right. Well, and a lot of times people don't get enough sleep because they're also so highly stressed, too. So they it's circular, right? You don't exercise. Yeah, they drink too much. They don't exercise. It's like all of it all really ties so beautifully together. And if you can make changes in these things, then all of a sudden, I would think it compounds and has a compound effect of goodness as well. It really does. And it makes it easier because it's not like, oh my gosh, I have to exercise to fix this one thing, and I have to sleep to fix that one. No, you kind of just it all, as you said, compounds are more synergies style. It's a lifestyle. Okay. All right. I don't want us to run out of time. GLP ones. Oh, wait, talking about the nine things. And you're gonna love it because it's what we have to talk about anyway. Yeah. So here's my like, you're gonna be like, what? What is she talking about? How is this? How is this a pebble or a grain of sand? And yet then I'm promoting it. And that is hormone replacement therapy. Yes. Okay. Yes. Okay. So that is our ninth possible contributor to that bathtub water that can be a little pro-cancer, but is it really? And this is where it gets nuanced and very patient specific. Okay. So talk to us about that. Let's talk about HRT then. We'll end with GLP ones. So hormones. That was not what I expected you to say. So I feel like I heard you say a couple times for some of the other things, it like increased estrogen, which was gonna be a bad thing. But then I'm thinking to myself, well, but it we take HRT to increase estrogen. So, or maybe I'm misunderstanding, but I feel like a couple times you said a couple things there were bad because they increased estrogen production, but you're gonna tell me. You heard me, Gene. That's exactly right. So this is where it gets, you have to really let me think it through with people because everybody wants the one-second sound bite, and then you take it in isolation and you're like, she said estrogen causes breast cancer, full stop. Great. Okay, right. You just don't all it can't always be in one sentence. Okay, great. So yes, estrogen can cause, but I would argue you can't bake a cake with flour. Okay. Alone, right? Yeah. We need flour and milk and butter and eggs, and of course, I want it all vegan. But the point is estrogen can be one ingredient in your cancer cake. It's not even necessarily a necessary ingredient to make a cake, but it's just something that's there in the pantry that can contribute. And mechanistically, it's proven again and again and again in from petri dishes to animal studies to full-on human studies. We know that estrogen can be carcinogenic. It can contribute to creating a disruption of how a cell normally floats happily throughout its life and then replicates itself and it can disrupt that whole situation and allow mutations and mistakes to happen, and then it proliferates that mutated cell until finally it's a cancer cell. Here's the key. Here's the big B U T. But yes, estrogen does so very infrequently. Okay. And when people on hormone replacement happen to get breast cancer, they are 40 to 50% less likely to die from that cancer than someone not on HRT. Okay. Because the cancers that are that go along with people on HRT are generally less aggressive, more curable, and people do well. Now the incidence in large studies is just to cut to the bottom line, is somewhere around for say 15 years use of HRT, 1.2% increase. 1.2% increase. Okay. I just said a drink a day increases breast cancer by 10%. It didn't give you stats, but being overweight or obese, which is a nice segment to GLPs, right, literature varies somewhere between 20% all the way up to a 200% increase in breast cancer. Okay, so let's not scream about 1.2% when it has oh so many benefits. So I'll just break down my bottom line with HRT for people wondering because I'm hyper focused on the breast cancer aspect. So how do I square this? Yeah, right. Exactly. So I think of menopause as three things. One is what you notice and complain about half lashes, night sweats, vaginal dryness, moots, swings, increased wrinkles, itchy skin, decreased libido, right? All this stuff that's bothering. Yep. That guess what? Estrogen totally fixes all of it. So that's a big bonus. Yeah. Part two is what you didn't know was because of the perimenopause and menopause transition and lack of hormones. But once it's said out loud to you, you're like, oh, I have that. And I had no idea. I had no idea that my new heart palpitations, that my frozen shoulder, yeah, that my adult acne, that the new hairs on my chin, that my newfound anxiety or depression is menopause. Okay. Then we have category three that I care about the most. I care about quality of life for sure, but this is actually can be life and death stuff. And it's behind the scenes, and you don't even know what's happening until it happened. And that is an acceleration of cardiovascular disease, messing up with your health, what used to be a healthy lipid profile. So in other words, your total cholesterol goes up, LDL up, HDL down, triglycerides up, right? So you get all that badness happening that leads to cardiovascular disease, which is heart attacks and strokes. Yep. Osteoporosis. Your bones are getting thinner, and you don't know until all you did was step off the curb and cracked your ankle, right? You're like, well, I just I was, I was only thinking and I broke a bone. So estrogen is super protective and bone building. So a lack of estrogen uh quickly over the decades, you know, between menopause and your fracture has been allowing your bone resorption to occur, whereas hormone stops. And along with that goes sarcopenia, which is muscle wasting or you know, thinning of your muscles. Right. Yes. Which leads to imbalance and postural, like just gait and posture and balance. So when you're imbalanced and then you fall, then you get the fracture. An unfund fact one out of every two women in menopause gets a totally preventable osteoporotic fracture. Wow. Shocking data. It's huge. There was a study in the New England Journal, I want to say it was 2024, and it looked at women over 65 who got a femur fracture, 30% death rate in the next 12 months from the fracture. Wow. So fractures can equal death, not just disability. Right. No, yeah. And you hear about that when people get much older. You hear about that all the time. They fell, and that was the beginning of the end. And you know, so everything we can do when we're younger to not have that happen is beneficial for sure. And again, you've got to do your part too, right? So we can do the patch and the pill or you know, creams and all the pellets and the different ways of getting HRT, but you've got to do your part. We have to do the exercise. We have to eat well, we have to strength train, we have to maintain all the other aspects of a healthy body because not one thing like taking a GLP or putting on an estrogen patch is the panacea for all ailments. Correct. The other thing that's behind the scenes that I worry significantly about is GSM, which is the genito-urinary syndrome of menopause. So both your genitals and your urinary tract are love estrogen. And the withdrawal of it will lead to in the vagina, people notice often, usually, especially if they're sexually active, that it's sex is painful, everything's drier down there, you can get bleeding. Uh, the vagina actually shortens and narrows, and the acidity changes. But the thing women don't know is that you can start getting UTI, it's urinary tract infections with no intercourse. It's not like the the kind of fun UTI you may have gotten in your 20s from having anti sex. Like you're like, oh, I'll just I'll take that. That was just the that was the price you paid back then. That was the price you paid. Now you're just like, you know, 80 and getting these, you know, not that 80-year-olds don't have sex. Sorry, I didn't mean to imply that. No, but it's not as common. Yes. Not as common. They have less. And they still get the UTIs with none of the fun. So the catch there is that when you're older, especially because the symptoms are not necessarily obvious, it can progress really fast to uursepsis with the bacterial infection, it gets into your bloodstream, and then you're hospitalized. This happened to my own mother. Wow. She was 87 and she was loony as like completely loony. I walked into the hospital where she was hospitalized for the eurosceptis, and she looked at me and she's like, Good. She took off her covers. Get out, let's get out of here. There's a guy with a gun. Like she had lost it in her eurosceps. And I wasn't sure we were gonna get her back. And women die from euros sepsis. So the one thing I didn't mention on purpose, and I'll mention now to because I didn't forget, and it's dementia. The data's mixed and unclear. It's evolving. And I think we will figure it out very soon. But it there's protective effects and deleterious effects with when it comes to estrogen in the brain. We have more receptors for estrogen in our brains than on any other organ in the body. And so it's very protective in that way, but it's specific. Okay, so there used to be like the Women's Health Initiative, which I can dissect with you if you want, but this big study that said that being on hormones increased cardiovascular events by like 26%. Well, if you do the dissection work, which eventually we all did, you we found out that if you have existing cardiovascular disease, if you already have plaque buildup and then you become menopausal and decide to take hormones, you're going to accelerate that plaque buildup and increase your risk of a heart attack. So that woman needs to dial back the HRT use and fix the heart first or something, right? Yep. I think we're going to figure out the exact same thing with the brain. For example, it may come down to uh genetics of Apo E3 and E4. Right. These are these genes that the Alzheimer's gene. But you can have a heterogeneity, meaning you have a one good one, one bad one. And then if you layer HRT on top of that, maybe it accelerates dementia. But if you have a 3-3, which means you don't have any of this Alzheimer's predisposition, then it's full on protective dementia. And that's helpful. Yeah. Yeah. Lisa Moscone is an amazing researcher, worth following that space if you're interested in um neurodegenerative disorders and estrogen specifically. That's her entire world. Okay, that's good to know. Because I do know a lot of people are interested in that. I feel like dementia is taking on a another realm, and I see that more and more often. But what's interesting about what you said is I also think there's a very individualistic approach to all of this. And it's, I don't want to say it's like pick your poison, but in some ways maybe it is a little bit, you know, it's like, would you rather maybe have a slight increased risk of one thing in exchange for some benefits of some of the other things? And HRT can help a lot of women who are in perimenopause and in menopause with lots of things that make everyday life incredibly difficult. And so in my opinion, it's like, would you rather have a better everyday life? And maybe, maybe you have a greater risk of potentially having dementia down the road. Maybe, but right now your current quality of life can be improved so dramatically by making some of these changes to your life and reduce your risk of breast cancer, also, which is another huge one for women given how many of us get it. Yeah, yeah. The data is that estrogen alone doesn't actually seem to it increases risk, maybe a tiny, a tiny bit in bigger studies, but other studies have shown that it actually decreases risk by as much as 23%. So it's the progesterone component of hormone replacement that seems to be a little bit more sinister, which is interesting and multi-layered, but I do think it's what you're saying. It's an individualized conversation and a balance, but for the vast majority, benefit exceeds risk. And the risks that you're talking about are probably manageable even if they show up, like the breast cancer. Yeah. Right. Exactly. Okay, before we run out of time, GLP ones, because being overweight was one of your massive. Yeah, exactly. Let's talk about GLP ones. How do you help people with GLP ones and what's your stance as a doctor on GLP ones? So I've been watching this space really carefully for the last three years. Of course, things like True Licidity, the GLP ones have been around for 20 years in type 2 diabetics, right? But now it's exploded. We've got uh you know different options of which medications and the other indication of obesity has been accepted by the FDA. But for non FDA approved, like microdosing, or if you are overweight and need to lose weight, maybe full dose, the benefits. I I keep I maybe I shouldn't say this, but I was watching all the science and I kept waiting. Like wanting harm for anyone, but I was just waiting for you to be like, aha, I knew it. I knew it would like cause blindness or like like a year ago, I saw Zempic and cancer, and I was like, aha. And I clicked on it, decreases colorectal, decreases breast, decreases pancreatic cancer. And it wasn't like I was like, no, I just, I don't know. Part of me is like, you know what? I've been skipping dessert since I was born. Like it's I can't be just a shot. Um, but it, you know what, it isn't just a shot. And like it has become a theme of our time together today. It is leading a balanced life, and that means paying attention to the diet, to the exercise, to the sleep, to the, you know, details that surround the one intervention that's going to be a big help. So, yes, the GLP1s have a massive role in my breast cancer patients now that I'm a true believer in the benefits and have seen the science. And of course, you can have some nausea vomiting, diarrhea, constipation. There are bigger complications like gallstones and pancreatitis and bowel obstruction, but it's all so manageable if you're getting watched by a physician who's mindful of your dosing and checking labs and you know you don't want to go rogue with it. Um, and you won't die even if some of these unwanted things happen. Right. Okay, so here's the thing the GOPs have blown my mind on so many in so many respects, on so many metabolic and health-related levels. So we already talked about the damaging effects of adipose and this endocrine-like effect that fat cells have throughout our body. So obviously the weight loss has a tremendous benefit there. And the metabolic benefits of increasing that insulin sensitivity, of having your sugar come and go more briskly, of having it released into the bloodstream more slowly. Why? GLP1's slow stomach emptying of a meal. So the meal sits there, creating that feeling of satiety and goes to your brain, telling you that you're full. So you've got a double whammy. The stretch receptors in the stomach are like, hey, lady, stop eating now. And your brain is like, I'm actually satisfied and full. So the slower emptying of food into the intestines means that it the carbs are, there's less glucose at any moment getting absorbed into the bloodstream. Therefore, there are no spikes. There's no glucose spike, there's no insulin spike. So metabolically, everything is quieter. Cardiovascular-wise, GLPs make your this endothelial cells of the cells that line your blood vessels more relaxed. So blood pressure goes down, and we see decreased heart attacks and decreased strokes in people on GLP1s. And that whole lipid profile of bad cholesterol starts to reverse and normalize. Psychologically, I talked about the satiety thoughts, but also the the people call it food noise, that obsession about like, what am I gonna eat lunch? What am I gonna eat? Like what like and is there enough of it? And maybe I have chips tonight and you're fighting with this, like all like you just got an ice cream calling me. From the freezer, your addictions go down, and it won't only be for food. It could be for cigarettes or alcohol or other addictions, and mood improves in people. Uh I mean, incredible like downstream effects that we weren't expecting. Liver. So a lot of people have non-alcoholic, the fatty livers. So non-alcoholic fatty liver disease, it's called, but basically there's fat shoved into your liver the way it was stuffed into the insulin receptors. And that makes your major detox organ and has all those enzymes that are converting things into their active form in the liver. It can't do its job well when it's stuffed with fat. So you lose the fat right out of the liver. And we see this evidenced by liver enzyme markers, ALT, that we look at to assess liver function and health, and that all improves. One major benefit that's unfolding more recently is protection. We were talking about Alzheimer's and estrogen and such. Uh, there's less neuroinflammation in people on GLPs. So all of a sudden, all of those like neurofibrillary tangles inside the brain that lead to things like Alzheimer's dementia, Parkinson's, et cetera, those are getting squelched. And so we're thinking this is uh, you know, a direct connection to less neurodegenerative problems down the road because the inflammation is systemic. All the drop in inflammation is going to help every organ just everything work better. And in the cancer realm specifically, and this needs to be proven, but it's already started with data rolling in, and there are big trials going on in places like I know uh MD Anderson, Dana Farber, there's a bunch of places that are putting breast cancer patients on GLP ones and following them for decreased recurrence and mortality for breast cancer because of the GLP one. Yeah, usually the people that are enrolling are overweight or obese. So it, and of course, if you lose weight, we've talked now about so many beneficial mechanisms. But it's gonna go beyond that. And it just has to do with when you get rid of the systemic inflammation, when you get rid of, you're gonna when you get rid of the insulin, one thing I mentioned in passing, I think, was one other thing that's bad that insulin does is it elevates IgF1, which was the bad bad promoter of all growth. So if you in in the cancer realm of how we're thinking GLPs work as an anti-cancer agent, it would be to decrease IgF one and decrease inflammation, thereby allowing your immune system, the innate protectors and killers of cancer, to do their thing. And when do they do it? When you're sleeping. When you're sleeping. I do closer to that. Reproductively, we've known for a solid decade that people on GLP1s and PCOS, polycystic ovary syndrome, they definitely improve their metabolic profile and their PCOS just disappears. Disappears. Yeah, I've heard that too. So many benefits and synergistic benefits with HRT. Yeah. New studies are showing that. Yeah. Yeah. Yeah. Well, I think what we should be so excited about as women is it all feels very empowering. It feels like all of these steps, all these things that you can do, whether it be what you're doing with exercise, what you're doing with the food you put in your mouth, what you're doing with microplastics, what you're doing with your weight, if you're trying GLP ones, if you're not, if you're trying hormone replacement therapy, there are choices. There are options. There are things out there that you can proactively do to take control of your own health, to try to prevent breast cancer and many of the other things that this lifestyle can benefit for you as a woman and as a man too. But let's, we're talking women because we're talking breasts mostly. So I think it's super empowering. And I think women should feel very excited about that what's happening in medicine and what's happening with the technology. Yeah, absolutely. You have so much more control over this disease and over your health destiny than you probably ever thought or imagined. So it's very exciting. You're a good student. You just rattled off a great summary, by the way. Dr. Funk, you have been just a wealth of knowledge. I am so excited to share this with everyone because really, this is what people need. They need knowledge, they need information, they need actionable things that they can proactively do and look into. I'm gonna have everything in the show notes about how people can find you, they can get your resources, intermittent fasting, GLP1s, HRT. We're gonna put all that in the in the show notes so that everybody can feel like they have access to the resources in addition to being able to get to see you. So I thank you so much for your time, for bringing your sunshine, your knowledge, and your passion to something that I think is so important, which is women's health. So thank you. Well, thank you for helping me spread my message. I love it. Have a beautiful day. Thank you for joining us for this week's episode of Building the Best You. If you are ready to take a deeper dive into transforming your life, check out my Empowerment Fundamentals course on my website, houseofgermar.com. Thank you, and I will see you next week with another inspiring guest.