30 - Dr. Kate Dwyer on Epigenetics, Hormone Health, Perimenopause & Longevity

Episode 30 - Epigenetics, Hormone Health, Perimenopause & Longevity with Dr. Kate Dwyer | Wellness in Asheville Podcast

Introduction to Dr. Kate Dwyer and Kate Dwyer Nutrition

What if the key to feeling like yourself again in perimenopause, optimizing hormones, and slowing biological aging wasn’t just about “eating healthy” or accepting symptoms as inevitable—but about understanding and influencing your epigenetics?

In this episode of the Wellness in Asheville Podcast, host Travis Richardson sits down with Dr. Kate Dwyer, registered dietitian and Doctor of Clinical Nutrition, to dive deep into women’s hormone health, functional nutrition, and the cutting-edge science of epigenetics.

Dr. Kate specializes in helping high-achieving women navigate perimenopause, PCOS, metabolism changes, and hormone-related symptoms through a blend of functional medicine and evidence-based nutrition. She emphasizes foundational lifestyle factors—sleep, stress resilience, diet, and methylation—over excessive testing or long supplement protocols.

Together, Travis and Dr. Kate discuss:

• The basics of epigenetics and how lifestyle can literally turn genes on or off
• Dr. Kara Fitzgerald’s groundbreaking “Younger You” research on reversing the epigenetic clock
• Methylation, liver health, choline, and why these matter for hormone balance and detoxification
• Protein needs, muscle preservation, and sarcopenia prevention in midlife women
• Bioidentical vs. synthetic hormones and local Asheville resources
• The power of whole foods like liver and leafy greens for nutrient density
• Practical strategies for energy, mood, sleep, and feeling empowered in your body

Whether you’re in perimenopause, dealing with hormone shifts, or interested in longevity, this conversation delivers science-backed, actionable insights.

Key Takeaways

• Epigenetics is modifiable—diet, stress, exercise, and sleep can make your DNA methylation patterns “younger”
• Foundations first: Prioritize sleep, stress resilience, and nutrient-dense eating before advanced interventions
• Methylation supports hormone metabolism, detoxification, neurotransmitters, and liver health
• Protein (1.2–1.6 g/kg) + strength training become increasingly important as estrogen and progesterone decline
• Whole food sources (liver, eggs, beets, greens) provide synergistic nutrients that supplements alone cannot
• Women deserve healthcare that listens, educates, and empowers body literacy
• Micro-changes in daily habits can create profound shifts in how you feel

Timestamps

00:00 – Introduction and Dr. Kate Dwyer’s background
01:11 – Personal story, functional medicine journey, and what drives her work
05:52 – Her unique training (biochemistry → RD → functional nutrition → doctorate)
11:58 – What is epigenetics? Why it matters for aging and health
14:54 – Dr. Kara Fitzgerald’s “Younger You” study and program details
20:59 – Protein needs, muscle protein synthesis, and perimenopause changes
22:47 – Methylation explained: symptoms of poor methylation and how to support it
26:15 – Genetic factors (MTHFR and others), testing, and nutrient cofactors
31:55 – APOE gene, Alzheimer’s risk, and why genes are not destiny
36:27 – Bioidentical vs. synthetic hormones and local Asheville resources
40:08 – Eating liver, desiccated options, and Terry Walls protocol
43:34 – What excites and concerns her in the longevity space
46:47 – Future of precision medicine, hormones, and integrative care
49:51 – How to connect with Dr. Kate and special listener offer
51:56 – One piece of advice for women in perimenopause

Episode Links

Dr. Kate Dwyer
https://www.katedwyernutrition.com/

Get in Touch With Dr. Kate Dwyer

Instagram: @katedwyernutrition (or search Kate Dwyer Nutrition)
Website: www.KateDwyerNutrition.com
Free 15-minute discovery calls available
Special Offer for Podcast Listeners: 15% off cash pay packages until July 31st, 2026 with code BWA15

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Transcript

Travis Richardson (00:00)
going introduce you and then just really start off about real ask you just to do a quick intro on yourself. You probably saw the question so you know how it goes. Okay, all right. So we have Dr. Kate Dwyer on the show with us today. I'm really excited. Dr. Kate's actually a part of our Be Well Asheville Wellness Collective. And since I've gotten to know her, I just keep being more and more impressed with the kinds of things that she knows.

Travis Richardson (00:28)
And she's, for lack of a better word, kind of a geek like me in terms of that she likes to get into the nitty gritty nuances of all of the things that I like. And so today we're going to talk about epigenetics. We're going to talk about liver health, hormone health, lifestyle medicine, everything in between. And we're really going to have a focus on epigenetics. So Dr. Kate, welcome to the show. How are you doing today?

Kate Dwyer (00:54)
Thank you, Travis. I'm doing great. It's such a pleasure to be on the show.

Travis Richardson (00:58)
Yeah, so tell us, so in one minute, give us like the one minute version of who you are and what drives your work and why the passionate pursuit of health for you. Where does that come from?

Kate Dwyer (01:11)
Yeah, so I am Dr. Kate Dwyer. I am a registered dietician and doctor of clinical nutrition. I specialize in women's health, helping women understand their hormones and feeling like themselves again. Through my practice, Kate Dwyer Nutrition, I primarily work with women navigating perimenopause, PCOS, metabolism changes, any kind of hormone-related symptoms. I see men as well.

Kate Dwyer (01:37)
But I use a blend of functional medicine and evidence-based nutrition. What really drives my work is seeing how many high achieving women are doing everything they think is right. They're eating relatively healthy, they're exercising, but they're still not kind of optimizing feeling best in their bodies. And they are often told it's stress or just aging or this is just perimenopause.

Kate Dwyer (02:06)
but that's not the full story. Lots of other things come into play when we have changes in hormones. So I'm passionate about helping women understand what's happening physiologically and giving them practical sustainable strategies to get their energy and mood back. And so at the core of this, I just believe that women deserve healthcare that listens, educates and empowers.

Travis Richardson (02:07)
Mm.

Kate Dwyer (02:33)
I really beg on body literacy in my practice and teaching women about their bodies.

Travis Richardson (02:40)
Yeah, you have a really, very holistic understanding of, of, of, health and as it relates, especially to, women in this, in this category and my gosh, I meet women all the time. you know, 90 % of my listeners and people I interact with are women and they're often middle-aged women. And, even my partner is struggling with perimenopause and trying to keep, you know,

Travis Richardson (03:06)
keep things like weight from creeping back on. And even though she's doing all these things, it's sometimes really hard. So what drew you specifically to this area? Is there a personal moment for you? What drove you to get to the point where you're helping this population?

Kate Dwyer (03:10)
Mm-hmm.

Kate Dwyer (03:26)
So I was really drawn to this work through a mix of personal experience and what I just kept on seeing in the medical system as a practitioner. On a personal level, I remember being in doctor's offices and just feeling dismissed or like nutrition was just treated as like a really afterthought or not being mentioned in conversations. I know it's really hard to do in like a 15 minute appointment.

Kate Dwyer (03:53)
But we're not asking the question, why is this happening? What are some the underlying pathologies or things that just aren't optimized biochemical pathways in the body? I did have one experience though that when I was having a lot of GI issues, like bloating, pain, and that.

Kate Dwyer (04:20)
that practitioner was like, hey, you have a food sensitivity. And that really kind of changed the way I was like, oh, like there's this whole thing about like functional medicine and you know, don't have to necessarily have like an anaphylactic reaction to something to have a food sensitivity. And so that got me on a journey into more of the functional medicine realm. And now let's, you know, that kind of mindset is exactly what I bring into my practice.

Travis Richardson (04:24)
Mm-hmm. Mm-hmm.

Kate Dwyer (04:49)
I ask a ton of questions in my intake questionnaire. So I get to know the whole person and that allows me to look at everyone holistically and not just dismiss separate systems or dismiss symptoms. I want to connect all the dots, right? And understand what your body is telling you and then use nutrition as a foundational tool to actually address what's going on.

Travis Richardson (05:17)
Yeah. And before we go on, I was just thinking as you were talking, you have such a depth of experience. have a, you have a doctorate and, you're what's the diet as a dietitian. I don't know the formal name for it, but I'd like you to sort of, say why that training puts you in a sort of a different spot than maybe other.

Travis Richardson (05:42)
clinicians or other practitioners, what that additional training allows you and how it allows you to be different from sort of like other people somebody might come and see.

Kate Dwyer (05:52)
Mm hmm. Yeah. Yeah. So, um, like this has a lot to do with my inner individual path that I took and, becoming a dietitian. So nutrition's actually my pivot career. Um, and my first college experience, I majored in biochemistry. I've worked in academic and clinical lab situations. And so that gave me a really great experience and really strong foundation.

Travis Richardson (06:11)
Ha ha.

Kate Dwyer (06:22)
in science and you know reading scientific studies. But you know within that you know when I started out in that that pathway I quickly realized that I didn't want to pursue a PhD or have a career built on government funding or the pharmaceutical industry. So it took me a few years but I went back and got my registered dietitian credentials so I got a second bachelor's degree did an internship.

Travis Richardson (06:41)
Mm-hmm.

Kate Dwyer (06:51)
And during that training, I realized that I want to do functional medicine. So I found a master's degree in human nutrition and functional medicine. And that really emphasized diet as like a foundational tool in nutrition. You know, as opposed to some other clinicians that I've run into in this industry that have

Kate Dwyer (07:14)
really emphasize testing. I don't necessarily emphasize as much testing in my practice as some other functional medicine providers. I look at deficiencies first, you know, like if we are deficient in zinc and vitamin A, we're not going to have a great functioning gut. You know, so finding out and focusing on that nutrition piece first and then, you know, maybe doing some more in-depth testing. I also am not huge on long supplement protocols or putting people on like 20 different supplements.

Travis Richardson (07:26)
Mm.

Kate Dwyer (07:44)
I prefer to again, correct those nutrition deficiencies, look at the core. You know, are we able to slow down when we're eating? Are we able to focus on our food so that we are digesting things appropriately? You know, a lot of people when they eat or in firefight, not rest and digest. And then they have all these gut symptoms because they're not in that rest and digest. They don't have appropriate vagal nerve tone.

Kate Dwyer (08:14)
So that's part of that. then, you know, towards the end of my master's degree, my program launched.

Travis Richardson (08:19)
Well, but one second, one second, sorry, not to interrupt you here. Because for the listener, I think that's a critical differentiating point. As I was hearing you say that, think the lot of times we don't want to change or a doctor doesn't have time to work with us to change.

Kate Dwyer (08:38)
Mm-hmm.

Travis Richardson (08:41)
or talk to us about our kind of behavioral patterns, the things that we do on a daily basis that can impact our health. so, but what you're saying is that you would like to try to understand like the factors that are going into somebody's condition, whether that is like you just said, pace of eating, like are you eating fight or flight or not? Right. And so I guess if you, if you're doing that, you're fundamentally trying to change the root sometimes of the problem and you

Kate Dwyer (08:44)
Mm-hmm.

Kate Dwyer (09:10)
Mm-hmm.

Travis Richardson (09:10)
I guess some of your patients might find that their symptoms resolve without additional either pharmaceuticals or even nutraceuticals because they're changing, they're shifting their behavioral patterns. They're looking at things outside more holistically than just taking a pill for taking. I see this paradigm of testing pill, whether it's nutritionally or pharmaceutically. It's like testing and then here's the intervention. And it's like,

Kate Dwyer (09:35)
Mm-hmm. Mm-hmm.

Travis Richardson (09:39)
What if we backed up for a second, right? So is that what your, is that kind of your, your philosophy there too? Or how's it.

Kate Dwyer (09:44)
Yeah, yeah, or like if you're not sleeping well, you're gonna be in firefight, right? And that's pretty much a lot of perimenopause women is they're gonna have metabolic changes just from not sleeping well. And then they're gonna have GI issues again from not sleeping well. So sleep, you whenever I talk to clients, I focus foundations are sleep and stress resilience. If those two aren't in line, it's gonna be hard, you know, can't out diet stress.

Travis Richardson (10:13)
Right.

Kate Dwyer (10:13)
You can't out diet or can't out supplement a really stressful situation. Yeah.

Travis Richardson (10:20)
Right. Totally. Now, where did I interrupt you? Do we remember what we were, what we were, you were saying?

Kate Dwyer (10:26)
Oh, yeah, I was just saying that, you know, at the end of my master's program, my program launched a doctorate of clinical nutrition. And so I hopped on board to that. It felt like the next step in deepening my critical thinking skills in a clinical way. And yeah, finished that program up three years ago now. Yeah.

Travis Richardson (10:53)
Mm.

Kate Dwyer (10:53)
So was yeah in a school for quite a while. Really enjoyed that process of learning.

Travis Richardson (11:00)
Yeah. Well, when we talked initially to, I was kind of vetting you as a candidate for the podcast, we started talking the same. I was like, well, you quickly became a first choice for this series, which is about longevity based off of the kind of things that I was looking for. One of those was an understanding of epigenetics because in the longevity space, if somebody's new to that word,

Travis Richardson (11:28)
I'll let you describe what epigenetics is, why it gets used a lot, and how it sometimes is misunderstood. But to understand that is really the frontier, I think, of understanding how we can slow down our aging, increase our health span, and of course, we might talk about later the co-, or the compression of morbidity. We'll talk about that later. But it all relates to epigenetics. So let's get into that. What is it, and why is it misunderstood, and how does it matter as we age?

Kate Dwyer (11:45)
Mm-hmm.

Kate Dwyer (11:51)
Mm-hmm.

Kate Dwyer (11:58)
Yeah, so epigenetics is relatively new. So if you remember like the early 2000s, we were really focused on DNA and what DNA the whole genome project. And so we have DNA and then we have the epigenetics. So epi means around. And so epigenetics essentially is tags on our DNA that affect expression of DNA.

Kate Dwyer (12:26)
So it's not in our DNA directly, but these are modifiable ways that we can control DNA expression, and that can be good or bad, right? You wanna think about it as, if you're in the grocery store, you want some things to be locked away. We don't want it really accessible to things like tobacco, right? So we want things like our DNA to be locked away when it comes to

Kate Dwyer (12:54)
pro-inflammatory genes or genes that are cancer related, right? We want those not to be turned on. On the other hand, we want things to be easily accessible, like fruits and vegetables, if we're in the grocery store. We don't want those to be locked away behind a counter. We want to easily access genes that are anti-inflammatory that suppress cancer.

Kate Dwyer (13:19)
And that's what epigenetics does is it tags our DNA to either make it more or less accessible.

Travis Richardson (13:27)
And so, so as we as we age, why did kind of relate that to what happens as we age? Why do we need to know how to influence those those genes to turn on or off as we age?

Kate Dwyer (13:42)
Yeah, that's a really good question, Travis. So, you know, depending on how these methylation patterns are on our DNA, that can influence diabetes, cardiovascular disease, mental health. And they've shown over time that we have certain methylation patterns as we age. And there are certain things that we can do

Kate Dwyer (14:11)
to make our DNA methylation patterns younger. And there's a really great book on that by Dr. Kara Fitzgerald called Younger You. She's done studies where she's implemented diet changes, exercise, lifestyle, and for just eight weeks. And they've rolled back that epigenetic clock by over three years. Yeah, yeah.

Travis Richardson (14:34)
Yeah. She, she, she, uh, I came across her work too, in my studies. Actually, I was, actually I was doing a longevity course. Um, of course as a layman, I'm out there trying to do my amateur level research, but I knew enough to see that what she was doing and she actually has her own course, uh, out there about how to eat. And it actually mimics and parallels. One of the things I thought was interesting about her is she, she,

Kate Dwyer (14:42)
Mm-hmm.

Kate Dwyer (14:54)
Mm-hmm.

Travis Richardson (15:01)
her approach mimics Dr. Terry Walls and the Walls protocol a bit and the Walls protocol includes eating things like liver and lots of dark greens. very, it's kind of a paleolithic diet. Dr. Terry Walls is from Iowa. She, she, University of Iowa, where I'm from. So she's like our, she's like my, you know, she's Iowa's claim to fame in terms in the nutrition world. We're all really proud of her, but

Kate Dwyer (15:04)
Mm-hmm.

Travis Richardson (15:29)
Back to Dr. Kara Fitzgerald. I want to say she's really groundbreaking in this regard on methylation and longevity. me. Can you talk more about her work, the nuances and the details a little bit of what she's doing and why it matters? Because I think she's an important figure in longevity.

Kate Dwyer (15:53)
Yeah, yeah. So I also mentioned that study was done on men. I was like to mention those little nuances. And I think I believe that she's working on a study to include women and do a longer and so that that's more her of her intense intervention and she has more of a maintenance stage. It's a little bit more doable because she does exclude certain foods on that. It's very like an anti inflammatory diet that excludes legumes for some people for most people.

Kate Dwyer (16:22)
dairy and gluten. So it's not always sustainable. But her, the foundation of her program is diet. So she really, really emphasizes at least seven cups of vegetables a day. And, you know, to the average person, that might seem like a lot, because most Americans do not eat even close to that. But she really emphasizes the leafy greens.

Travis Richardson (16:43)
Yeah.

Kate Dwyer (16:52)
especially for their folate content. She also emphasizes this color. Color really interacts with our gut microbiome, and that's where two-thirds of our immune system lives. So if we are inflamed, right, we are going to produce more unfavorable epigenetic methylation patterns on our DNA, right? So huge part of this is just the anti-inflammatory

Kate Dwyer (17:20)
cleaner way of eating. She really emphasizes organic foods. You know, she does in the initial part limit meat or protein to 0.66 grams per kilogram, which is as a dietitian, I'm like that's less on the low side, but for eight weeks we could probably do that. But long term that's not sustainable. But yes, she does a lot of different or her program really emphasizes.

Kate Dwyer (17:48)
diet as a foundation, but also meditation. So working on that stress piece, stress as a huge driver of inflammation in our bodies. think a lot of people don't necessarily realize that, but if you have unresolved trauma or your stress resilience from whatever patterns you modeled growing up is not sufficient to handle your current stress levels, that's huge.

Travis Richardson (17:58)
Mm.

Kate Dwyer (18:18)
like you're going to be inflamed and there's nothing diet wise that we can do. There's very little diet wise that we can do to overcome that. So you're working on that stress modification, meditation is huge as well. And then like exercise, not too much. You can't do too much. People who ever exercise actually have poor methylation patterns. Yeah.

Travis Richardson (18:38)
Yeah.

Travis Richardson (18:43)
Yeah, that's interesting. We, I, we see too that, there's a cutoff, in terms of exercise. We, they like the latest research shows that, too much vigorous activity. it's like, there's a sweet spot where you do want vigorous activity. And there's, there's some research that shows like Dr. Rhonda Fitzpatrick talks about, you know, she said just the other day, I was watching her she says one minute of vigorous activity is equivalent in terms of age reduction.

Kate Dwyer (19:00)
Mm-hmm. Right.

Travis Richardson (19:13)
or biological age reduction by like 120 minutes potentially of low intensity movement, like just walking. Like crazy, crazy numbers. But then if you get to too much, you start to run into what you just talked about, inflammation, where you may be damaging vessels and then your body may be trying to repair those by putting...

Travis Richardson (19:37)
you know, the inflammatory markers say, well, this is, this has now been damaged. Let's lay down some plaque or something like that to kind of like repair the, the spot on the, on the vessel that's been damaged. So we think about like longer term, like marathon runners and things like that. I always wondered about that. was like, why do these sometimes just, they just drop, they just kind of drop dead sometimes like during the run. I'm like,

Kate Dwyer (19:56)
now.

Travis Richardson (20:02)
Well, it kind of starts to make sense. Like a really overtaxing the body. And I don't know that the body, while it can do those things, has made for it. okay. So another couple, a couple of things I also wrote down that you said, and this goes back to, when we look at studies like, Dr. Fitzgerald's is that this was a study done in time on a population for a specific reason. And yes, it showed.

Travis Richardson (20:31)
that a holistic lifestyle reduced the pace of aging. But like you were saying with the protein, if you went by that diet or that program strictly, you might say, well, and you can talk to this too for women who are, know, perimenopausal, menopausal, postmenopausal, don't protein requirements go up as we age potentially? Like, we want certain amounts of protein and it's different, right? That's why you got to go.

Kate Dwyer (20:56)
Mm-hmm.

Kate Dwyer (20:59)
Now, yeah.

Travis Richardson (21:01)
you can't just take one reference point.

Kate Dwyer (21:04)
right or follow a restricted diet for a long period of time. That's huge too. But yes, you know, for women in my practice, I was aiming for 1.2 to 1.6 grams per kilogram protein, you know, and as we age, estrogen, progesterone, I just saw a study on this. was actually progesterone and testosterone really stimulate muscle protein synthesis, NPS.

Travis Richardson (21:09)
Yeah.

Travis Richardson (21:34)
Mm. Mm.

Kate Dwyer (21:34)
Which I thought was really interesting because you know and women progesterone is one of the first hormones to decline Yeah, so You know if we don't have these hormones on board We're gonna rely on other things to get that muscle that muscle protein synthesis part of that is protein part of that is exercise like weightlifting So that we can simulate muscle growth and just maintain that muscle mass

Travis Richardson (21:41)
Yeah.

Kate Dwyer (22:01)
Because that's a huge predictor too of metabolic changes in women too is the decline of muscle mass.

Travis Richardson (22:07)
Yeah, have like sarcopenia and those kinds of things. Like, you my mom is dealing with that and we know that like, exercise is exercise plus protein, as far as I understand, are the two strongest interventions that you can do to shift that. Well, let's talk about methylation a little more.

Kate Dwyer (22:25)
Mm-hmm.

Travis Richardson (22:28)
If you haven't defined it, and I'm sorry if you already have, but let's define methylation a little more and what it looks like when it's suboptimal. Like how would a person know, hey, you know, my methylation doesn't seem optimal today. I should go see Dr. Kate and see what's going on. Like, let's talk about that.

Kate Dwyer (22:47)
So in plain language, methylation is a chemical process. It adds a carbon and three hydrogens to different molecules, to cells, to your DNA. That's part of the epigenetics is the methylation. And so it's putting control marks on DNA, protein, and other molecules. Your body knows what to switch on, what to switch off, and how to keep things balanced.

Kate Dwyer (23:15)
It's also a huge part of liver health as well. So methylation regulates gene activity. We know that poor methylation below full-ate intake during pregnancy is linked to neural tube defects, right? And that's part of that whole regulating of gene activity. It supports detoxification pathways. So this could be toxicants that you ingest, or it can be

Kate Dwyer (23:42)
estrogen. Estrogen is metabolized in the body through methylation. So if you're someone who has higher estrogen levels, like if you're in that flux and perimenopause, you need to be methylated properly. It's assist in neurotransmitter production, you know, and that's also huge in women during that perimenopause phase, menopause phase is, you know, with the fluctuating levels of neuro of hormones.

Kate Dwyer (24:11)
that affects neurotransmitter production. And that's gonna be even more aggravated if we don't have the necessary nutrients on board to help with that. It also plays a role in immune system function, hormone function. It handles things like metabolism too, and part of normal cell communication as well.

Travis Richardson (24:19)
Mm.

Travis Richardson (24:35)
So if somebody is coming to you and they have like they've got low energy, they've got, you know, maybe their mood is off, cognitively they're not there, all those things are related. And they might come in and and they might say, I think my thyroid is the problem or something like that.

Kate Dwyer (24:48)
Yeah, all of things.

Kate Dwyer (24:51)
Mm-hmm.

Kate Dwyer (24:58)
Right.

Travis Richardson (24:59)
How do you differentiate and figure out, what is going on? Like, what would you look for? What would you do? Is there testing that you can do? Like, how would you? Because this seems, the methylation thing seems to be, I know there's tests for it. Are they genetic? Like, what do they look

Kate Dwyer (25:16)
Yeah, so I think you hit some of the symptoms on there, the fatigue, the mood changes, poor stress resilience, trouble clearing certain compounds like even estrogen and histamine. I see folks with maybe a little bit higher histamine type symptoms, maybe rashes, maybe they're waking up in the middle of the night too. And we can do differentiation. One is a blood test.

Kate Dwyer (25:45)
Checking for thyroid, we always want to a thyroid panel. If you're also thinking about fatigue and mood changes, iron panel hands down, especially impairment of positive women. Even a man, I had a client yesterday who was male and he had a ferritin of 22, that's pretty low. The American Gastroenterological Association, she likes that to be above 45 for ferritin. And then we can also do genetic tests.

Travis Richardson (26:10)
Mm.

Kate Dwyer (26:15)
to see if we have any, what are called single nucleotide polymorphisms. So these are single base pair changes in our DNA that affect how methylation-related enzymes function. So they can function either more optimally or more efficiently or less efficiently. And so one of the more popular ones that we hear about is MTHFR, but that's not the only one. We have MTRR.

Kate Dwyer (26:44)
MTHFD1, PMT, BHMT. We can also look at hormone methylation markers like CMT, which is related to dopamine and estrogen metabolism as well. So there's a bunch of different things we can look at genetically.

Travis Richardson (27:07)
Yeah, those are, those are, those are new to me. haven't heard of all of those, the, the MTHFR. Yes. But not, the other one. So yeah, I think that's where you got to come in and see. And I think that's that, that as I remember it, if you're not methylated properly, the idea is that you potentially could need, if you're going to supplement, for instance, and we can talk about actually that's maybe a good next segue is, is that, okay, well how, if, that

Kate Dwyer (27:11)
Mm-hmm.

Travis Richardson (27:35)
As I recall, somebody had to, who was deficient, had to supplement with like some multitude, exponentially number higher B12 or something like that, then, then in order than another person, because they, the amount that they needed was just incredibly high, but there was a number, but it was just a lot. So how does that work? B12 shots? Like what is the method for, supplementing or figuring that out?

Kate Dwyer (27:45)
Mm-hmm.

Kate Dwyer (27:58)
Yeah

Kate Dwyer (28:01)
Yeah, so for me, in my practice, I start off with a simple methylated multivitamin. So something that has methylfolate and methylcobalamin, which is B12. And then we also focus on diet because a lot of people think they might dynamically go to folate or B12, but really it's a lot bigger than that. And there are a lot of other supportive nutrients in there like

Kate Dwyer (28:31)
vitamin B6, riboflavin. Riboflavin is what's called a cofactor, so it helps the function of an enzyme. can actually overcome some of the deficiencies of that MTHFR, and that gets not enough press. We need niacin. We need amino acids like methionine, glycine. Glycine is found in collagen. Glycine is actually a methyl donor and a methyl receptor. So it can...

Kate Dwyer (28:59)
either be broken down into a methyl group or it can accept three methyl groups and become trimethylglycine or betanine. We need vitamin C. We need choline. 90 to 95 % of Americans are deficient in choline. It's predominantly found in liver, eggs, and soy, not tofu, but soybeans. And choline, when we are low in choline, it increases our folate demand.

Travis Richardson (29:29)
Hmm interesting didn't know that either

Kate Dwyer (29:31)
Right? Yeah. And actually, yeah. So if, and if we're deficient in choline, that can cause fatty liver and folks. So then we're getting into liver issues. Yeah. Yeah. That's one of the things that we're saying. So, you know, a quarter of all Americans have fatty liver disease, but it's not something routinely tested because it doesn't show up on lab work. It usually shows up on imaging. We're not doing imaging of abdominal cavity cavities on the regular.

Travis Richardson (29:43)
Wow.

Kate Dwyer (30:02)
But yes, Colleen is huge, huge, huge. I could go on and on about Colleen.

Travis Richardson (30:05)
So doesn't also Dr. Fitzgerald, I remember, so some of the food sources, think, if I recall, one is beets, beets supply. Is it TMG or?

Kate Dwyer (30:18)
Yeah.

Kate Dwyer (30:23)
Yeah, TMD, so that's the badening, the trimethylglycine.

Travis Richardson (30:27)
Yeah. So like for me, I happen to actually like beets. So to me, it's no big deal. Like a lot of people don't maybe like beets, but I guess I feel like there's a lot of, if you could structure proper eating, you might be able to get a lot of these things through diet, which I think is if you look at, and this is other thing I would have to stress too. Maybe you agree with this is that, you know, we, when we're talking about these individual components, you just reference the co-factor and

Kate Dwyer (30:31)
Mm-hmm.

Kate Dwyer (30:40)
Right.

Kate Dwyer (30:49)
Mm-hmm. Mm-hmm.

Travis Richardson (30:53)
I, the way I see things is there are in any given food, you know, countless, maybe hundreds, I don't know, thousands of constituent compounds in here, all working together, all have evolved over countless eons of time to come up with this thing, right? And then you eat it and you don't, don't know like what's going on with like what actual thing creates this synergy that makes the

Kate Dwyer (31:07)
Mm-hmm.

Kate Dwyer (31:10)
Right.

Travis Richardson (31:18)
the thing healthy. You take one thing away. A classic example, I guess, is if you take too much zinc, you deplete yourself of copper, I think. Is that correct? Yeah. So it's like, got to know better to get your zinc and copper from something that has it in as a whole food, right? So that you don't have to worry because these things have figured out naturally over the course of time how to put enough of

Kate Dwyer (31:21)
Mm-hmm.

Kate Dwyer (31:33)
Mm-hmm.

Kate Dwyer (31:42)
Mm-hmm.

Travis Richardson (31:48)
in there all of the ratios that you need.

Kate Dwyer (31:49)
Right. Our bodies could better regulate that intake when it's in a whole food form. Yeah.

Travis Richardson (31:55)
Yeah. So let's talk about, so you talked about mental health. talked about liver health as it relates to methylation. I talked about some testing. I suppose one thing we didn't hit yet so far is the, moving on, guess on is the APOE gene. And I thought that was interesting because you and I talked a little bit about APOE. We maybe some of the listeners know about APOE being

Travis Richardson (32:24)
the cholesterol, familiar cholesterol gene or molecule lipid, guess. I think I'm probably out of my league with terming these things, naming these things. Let's talk about APOE. I'm going to edit that, by the way, because that would just make me sound ridiculous. Let me back up.

Travis Richardson (32:47)
So by the way, if you ever need to pause like this, that's totally fine. Let me gather myself what I want to say here.

Travis Richardson (32:59)
Okay. So moving on a bit from methylation, but still in that same realm, let's talk about APO-E. Some of the listeners may have heard of APO-B. I know I have, when I do my advanced lipid testing and my advanced cholesterol testing, one of the things that doctors for me are concerned about is my APO-B. Let's talk about B and then actually the E and then the variants and how epigenetics sort of plays into all of that.

Kate Dwyer (33:29)
That's a big question, So apolipoprotein B is part of that advanced lipid testing. So you have to specifically ask your doctor for that. And that is a measure of atherogenic. So things that cause atherosclerosis, kind of the bad kind of plaque that...

Travis Richardson (33:31)
Yeah, I know there's a lot there wasn't there

Kate Dwyer (33:56)
the cholesterol that we don't necessarily wet in our body that can predispose us to developing, you know, heart disease. And that is a good proxy measure for you know, how many of actual particles in our body that are atherogenic. Not to be confused with APOE, which is more associated with

Kate Dwyer (34:24)
Alzheimer's risk. And so whenever we talk about risk, we're talking about predispositions. And so these are not destiny, right? I really want to emphasize that that's not destiny. Everyone who has a certain APOE variant for is the one of particular concern does not get Alzheimer's. It's about what we do to kind of modify that expression.

Kate Dwyer (34:50)
that really counts. And so there are people who don't have that, that develop Alzheimer's, right? And so your genes matter, but they're not the whole story. And that's where Epigenetics comes in, because they can explain why two people with the same risky gene have very different outcomes, depending on how they live their lifestyle and what they're exposed to.

Travis Richardson (35:15)
Yeah. Yeah. I think, you know, when I, had my genetics tested and I mentioned this in a prior podcast up recording, is that it came back with like countless things that were like really bad. It's like, it's like, like, well, shoot. If, if, if I believed this, I shouldn't be here. You know? So I guess what I learned is that why?

Kate Dwyer (35:30)
Right? Yeah. Yeah.

Kate Dwyer (35:33)
Right?

Kate Dwyer (35:37)
Right? Mm-hmm. Yeah. we know what we're doing, right? Mm-hmm. And some of those genes don't even come into play if we're eating healthy, right? They're of, you know, overwhelmed. But if we're eating that standard American diet, then that's what can really bring up some of those genetic predispositions.

Travis Richardson (35:47)
Right.

Travis Richardson (35:58)
Hmm. Totally true. Um, let's talk a little bit about hormones. I'm doing a, actually a hormone, uh, guide here soon, and I'm going to be looking for, uh, practitioners who specialize in hormone replacement therapy. Um, so yeah, so maybe you'd be a good candidate for that. Um, well, let's talk about bio identical hormones versus conventional hormone therapy. What's the differences there? Uh, I think people are confused and I've heard a lot of, um,

Kate Dwyer (36:12)
Awesome.

Travis Richardson (36:27)
negative things. There's a, there's a, I don't know if it's just a common, I feel like it's a bit of a myth that hormone therapy is like blanket statement bad, but I feel like that lots of people I run into like, I would never do that. I would never do that. And I'm like, why? I don't see why.

Kate Dwyer (36:44)
Yeah, yeah, yeah. So first off, was going to clarify I'm not a prescribing provider, but I am working on my Minneapolis practitioner certification through the Minneapolis Society. And so I really like to educate myself about, you know, what my clients may be on and, you know, how can we bring nutrition in to help support that. So

Kate Dwyer (37:12)
Biochemical hormones are hormones that our body makes. And these are also prescriptions that you can get at CVS. They don't necessarily have to come from a compounding pharmacy, though for whatever reason that can be an option for some people. They can come in different forms. They can come in patches, pills, creams.

Kate Dwyer (37:41)
And you know not to be confused with more synthetic hormones and synthetic hormones can have their place just depending on on the person and their goals and What's working for them because what works for someone else is not necessary and work for the next person Hormone therapy for most women especially is very personalized You know, I've had clients going like I

Kate Dwyer (38:09)
I can't even tolerate progesterone and that's not uncommon or I can't tolerate estrogen. That's also not uncommon. But then I also have clients that are like, oh, I I've changed my life, right? And so, you know, going back to synthetic hormones, synthetic hormones are things like birth control. So think about, you know, things that have been more created in the lab. And like progestins, that's a really common form of progesterone.

Kate Dwyer (38:38)
artificial form progesterone that you find in birth control pills, IUDs, etc.

Travis Richardson (38:48)
Sorry. Okay, so yeah. And so if I'm somebody who's looking at getting bioidentical hormones, I guess maybe, do you have a recommended path or a person or way to access those? What would be a way to, do you refer out for that kind of thing or how does that work?

Kate Dwyer (39:14)
Yeah, yeah. there are two or several clinics in town that can help people help folks. One is Live Well and WNC. They are a gynecology practice in North Asheville. And then the Fosnite Center. At least Fosnite is a urology trained PA and she has a staff that provides great

Kate Dwyer (39:43)
care for hormone placement therapy. And then Mayheck also has a menopause clinic too, where they have trained practitioners on prescribing hormones and getting you on that right journey.

Travis Richardson (39:57)
Okay, thanks for that. That's good information. We can put that in the show notes just to support the listeners. So, do you eat liver? I have to ask, do you eat liver?

Kate Dwyer (40:03)
Mm-hmm.

Kate Dwyer (40:08)
I do.

Kate Dwyer (40:11)
Yeah, I don't eat it as a singular like, I'm eating like, you know, liver and onions. I eat liver in the form when it's ground up with other meats, like muscle meat. if you were in Asheville, you can go to like Earth for Whole Foods and you can pick up two different brands. One is Herinet Gap has a vital organ blend that includes liver.

Travis Richardson (40:17)
You

Kate Dwyer (40:41)
And then there's another brand called a national brand called Force of Nature. They're also regeneratively focused and they have liver blends for different animals outside of cows, including cows too. But they have a chicken blend that's very mild. Actually, I made it the other day and my husband was like, this is really good. And I was like, yeah. Like he couldn't even tell that it was liver. the chicken, if you're looking for something like a

Kate Dwyer (41:11)
starter into liver, chicken liver especially chicken liver blends where they have other muscle meats in there can be really helpful.

Travis Richardson (41:20)
Yeah. And the reason it's funny, cause I just, I've tried to get on, tried to deliver and I just cannot make it a part of my normal lifestyle. really, it's something I have to think through and like be diligent about actually trying to do. but I keep thinking about Dr. Terry walls too. And how if we're just the listener too, she went from wheelchair and

Kate Dwyer (41:28)
Mm-hmm.

Kate Dwyer (41:31)
Mm-hmm.

Kate Dwyer (41:38)
Mm-hmm.

Travis Richardson (41:46)
She went from a wheelchair to being able to walk and I can't, and nobody can say precisely what the formula is for that. She's developed the protocol, of course. She would say that that didn't hurt at all to do her protocol, but a main component of that is liver. And so, I always thought, gosh, I should really just be eating liver. And what is it once a week or something like that is the recommendation.

Kate Dwyer (42:03)
Mm-hmm.

Kate Dwyer (42:10)
Yeah, he like, I believe the younger you is like two to three times a week, three ounces. You can also buy desiccated liver capsules too for the people who just, you know, absolutely can't stomach eating liver as well. But yes, you know, Terry Walls has multiple sclerosis, I think, and she was able to

Travis Richardson (42:17)
Okay.

Travis Richardson (42:33)
Yeah, MS.

Kate Dwyer (42:36)
reverse that progression through diet and lifestyle.

Travis Richardson (42:40)
Yeah, pretty amazing. Super inspirational and her being a doctor herself, usually doctors run into clients or patients that, that do some of these things, but they themselves are not often the, the person that does it. So it's really cool when you, when you see that, because then she can talk to it from a very different perspective. well, there's lots of things in longevity science right now that are just exploding. We've got, you know, biologics, epigenetic

Kate Dwyer (42:54)
Mm-hmm.

Kate Dwyer (42:56)
Mm-hmm.

Kate Dwyer (43:06)
Mm-hmm.

Travis Richardson (43:10)
that measure your biological age. We talked about epigenetics a lot on this episode. Peptides, you name it. guess what's the most, what are you most excited about? I know you're, this is a topic that's of interest to you. What are you most excited about and what most concerns you?

Kate Dwyer (43:11)
Yeah.

Kate Dwyer (43:34)
I'm most excited about, know, all this research, you know, like the younger you is just pointing back to diet and just the importance of having a good diet. And I think this can get overlooked in a lot of biohacking protocols. Like I'll have clients coming to me and they're like, you know, what do you think about NAD? I'm like, but you aren't hitting your fiber goal or you know, you're still way, way, you know, like, I don't know how much this is going to benefit you if we aren't.

Kate Dwyer (44:02)
know, leveraging basics. And so I'm most excited about, you know, how this kind of supports, especially epigenetics, eating a good lifestyle. And, you know, I'm coming that same note, what concerns me the most is that a lot of these protocols are not accessible for the average person, right? You have to have the funds because they can be really expensive.

Kate Dwyer (44:32)
There's also, you know, they may or may not be as established by the science and backed. So you have to take that with, you know, kind of into consideration too. But yes, I would love to see, you know, some of these a little bit more accessible to people, may be covered by insurance.

Kate Dwyer (44:55)
and so forth.

Travis Richardson (44:56)
Yeah, I know. think, I think for me too, the, what I've always seen is that I owned a gym for eight years at a few different locations back in Iowa actually. And what it was a body transformation program. So it was a five day a week. did nutrition, fitness, um, strength training. Um, uh, we taught them how to eat, how to eat and, and gave them a basic way of eating. And I always thought that at least 50%, if not more.

Kate Dwyer (45:05)
Mm-hmm.

Kate Dwyer (45:10)
Mm-hmm. Mm-hmm.

Kate Dwyer (45:14)
Mm-hmm.

Travis Richardson (45:25)
of what I should have been doing is doing habit training sometimes some kind of way to do, to, to, to do habits, right? Because I mean, even doing one thing different from your normal routine is hard adding one thing in, let's say drinking more water. That's hard. It's hard to just drink more water during the day. And so I see sometimes these, influencers on YouTube and they're, they're like, all right, here's what you got to do. And it's like this.

Kate Dwyer (45:33)
Mm-hmm.

Kate Dwyer (45:37)
Mm-hmm. Mm-hmm.

Kate Dwyer (45:43)
Mm-hmm. Mm-hmm.

Kate Dwyer (45:54)
Mm-hmm.

Travis Richardson (45:55)
super kind of like, my gosh, nobody and nobody is even if you do do that, I promise you your likelihood of doing it one year after you start is really low. I've seen it. Like I've seen people try it. It always goes really badly. And I think, of course, maybe that's where we get health coaching and some of the more supportive kind of things or being able to spend more time, you know, with, with, folks like yourself to, walk them through what are their lifestyle patterns.

Kate Dwyer (46:00)
Mm-hmm.

Kate Dwyer (46:05)
Mm-hmm.

Kate Dwyer (46:09)
Mm-hmm.

Kate Dwyer (46:16)
Mm-hmm. Mm-hmm.

Kate Dwyer (46:22)
Mm-hmm.

Travis Richardson (46:22)
So, um, well, guess for you yourself, where do you see, um, where do you see your practice? And I guess in this bigger context of, um, longevity, and we talked about epigenetic medicine, like, where do you want to see 10 years? We have AI coming on board. I'm like, gosh, what, what does 10 years look like out from here? What are we going to have?

Kate Dwyer (46:44)
Yeah. Yeah.

Kate Dwyer (46:47)
I think that's really interesting too because part of that depends on the medical system as a whole and we know that the medical system moves slowly. It takes a while for things to be integrated, for doctors and other medical professionals to be educated and also for the big payers, the insurance companies to reimburse for certain things, right?

Kate Dwyer (47:16)
So I think integrative and hormonal, especially for women, hormone placement therapy is going to become more mainstream. And I think that's going to be amazing for women, but probably not fully mainstream. We're still seeing lags in access reimbursement in that implementation. But I think going forward as these

Kate Dwyer (47:43)
things become more accessible, you they'll become more talking points, you know, even like, you know, we go through fads and health and science too, you know, 10, 15 years ago, was the gluten-free fad and pipe paleo, you know, and some of these health things. but I think, you know, as we get more advanced diagnostics and that cost goes down, you know, more biomarker tracking more

Travis Richardson (47:58)
Yeah.

Kate Dwyer (48:13)
metabolomics. you know, like if I was to my clients like I really wish we had a test where I could just take a drop of your blood, see what's missing, or like what's going on and then and go from there. So I think, you know, we're being closer and closer to getting some of that science and making it validated. But at the same time, you know, whatever that is, like

Kate Dwyer (48:38)
the data that comes out of that, it's still gonna keep on reinforcing those basics, sleep, nutrition, stress, keeping a healthy body weight.

Kate Dwyer (48:48)
So I think the future is more about, you know, precision medicine and individualization than is maybe some of these more generalized recommendations.

Travis Richardson (48:59)
Yeah, I think so. I think also a movement toward having more in-home testing, a bit of outsourcing the need to go into a doctor's office as much as possible just to cut on costs, but also because we now have advanced wearables that are also going to come down in price. We have continuous glucose monitors. So being able to do telemedicine a bit, think, yeah, is going to help. I think would

Kate Dwyer (49:05)
Mm-hmm.

Kate Dwyer (49:11)
All

Kate Dwyer (49:16)
Mm-hmm.

Travis Richardson (49:25)
I think it's a good thing, although I still think the human connection and in-person part is important. But we are going to have massive amounts of data that we're going to be analyzing and sifting. And so we're going to learn a lot about what works and doesn't work. So AI is a whole other topic. AI is going to be like,

Kate Dwyer (49:31)
Mm-hmm.

Kate Dwyer (49:37)
Mm-hmm, right. Yeah, and the AI will come in handy for that. Yeah.

Travis Richardson (49:47)
Your blood sugar is low. You need to have a, you have three oranges in the refrigerator. Go have half of one. Something like that. Yeah. Yeah. Don't have the word. That was a, yeah. Not advice to anybody. Go have a protein shake, please. Cool. Well, I guess how can people find you connect with your work? What did they do to get into your world?

Kate Dwyer (49:51)
And pair it with a protein.

Kate Dwyer (50:11)
Yeah, so people connect through me, through my website. I have a blog on there. I think my latest post as we record this is about sleep and what to do about sleep and perimenopause because it's so, so foundational. I also have an Instagram that I keep active. If you want to work with me, one of the ways I'm trying to make care more accessible is accepting insurance. So I accept Blue Cross Blue Shield.

Kate Dwyer (50:39)
Aetna, Medcos, UnitedHealthcare. And the great thing about that is that most insurance plans view nutrition counseling as a preventative benefit, meaning zero dollar co-pay. So for example, Low Cross-Broadcast Shield is amazing for North Carolina plans. They have about 30 visits per year with that zero dollar co-pay. So you can use the booking link on my website to schedule your appointment. So that's www.

Kate Dwyer (51:10)
www.KateDwyerNutrition.com. I also offer free 15 minute discovery calls. So if you're wondering for a good fit, that's another way to connect. And then for listeners of this podcast, I am offering 15 % off cash pay packages until July 31st, 2026 with code BWA15. That's all capital letters BWA15.

Travis Richardson (51:38)
Okay. Awesome. I wrote that down too. And we'll put that in the show notes as well. And let's see, last, last question for you today. one piece of advice for a woman entering or who is in perimenopause currently and who feels like their body is becoming a stranger.

Kate Dwyer (51:56)
That's a good one. Part of that is just accepting that different stage of life and giving yourself permission to treat this as a real transition and not a personal failure. This is not something that you did to yourself. It's about relearning your body and relearning what your body needs. So one of the most helpful things to ask is what can you do to support yourself right now?

Kate Dwyer (52:24)
Right, I mean, it's putting up boundaries. So you know, things, women are more susceptible to stress during this time. you know, saying, no, I'm just not gonna do that. And then grounding through basics. You know, we regular meals with enough protein and fiber. Consistent sleep, you know, I can't emphasize sleep enough for this population. Talking to your doctor.

Kate Dwyer (52:53)
Progesterone for a lot of women can be really helpful for sleep because it affects that GABA receptor and GABA is what calms us down. But if you have consistent insomnia, that's also something to get evaluated. Daily movement, right? Never underestimate just daily movement, getting out in the sunshine. You know, watch that over commitment and as...

Travis Richardson (53:21)
Yes. Say no to things. I love that. Well, thank you for being on the show today, Dr. Kate. It was really, I really appreciated it. And your perspective is amazing. I think we should do more talks like this and share more information like this. Because I think you have lots more you could help people with. So thank you for your time today.

Kate Dwyer (53:22)
Say no to things. Yeah.

Kate Dwyer (53:40)
Yeah.

Kate Dwyer (53:45)
Mm-hmm. Thank you, Travis. It's my pleasure.

Travis Richardson (53:50)
All right, so.