Optimize Health During Menopause with These 3 Things: Dr. Monica Medrano

If you are looking to optimize your health as a perimenopausal/menopausal woman, THIS EPISODE IS FOR YOU.

Jeni and Amy sit down with Dr. Monica Medrano of Innovative Vitality in Chicago who is answering the top listener questions about GLP-1s, supplements and what are the top three things women in their 40s/50s/60s should be doing to optimize their health. 

Monica Medrano, M.D. breaks it all down for us:

• Do you need a GLP-1?
  • Who qualifies (BMI 30+, or 27+ with conditions)
  • Side effects & myths
  • Metformin vs GLP‑1s
• Are supplements really necessary or helpful (yes, if you follow Dr. Medrano’s strategy.)

And Dr. Medrano shares her top 3 priorities for women in their 50s:
 1️⃣ Lift heavy things
 2️⃣ Optimize nutrition
 3️⃣ Lower stress & protect your energy

And as always… we’re figuring it out together. This is for education only — always talk to your provider to get the full run down on what is right for you

Write to us at: thedismissedpodcast@gmail.com    

To reach out to Dr. Monica Medrano, click this link:

https://www.innovative-vitality.com/

Transcript

SPEAKER_00 0:03

Hi, I'm Jenny, and I'm Amy, and this is dismissed.

SPEAKER_03 0:10

We are former stay-at-home moms who quit our careers to raise our only children. Now we've been dismissed from our duties as carpoolers, dance moms, and birthday party throwers. And we're trying to figure out our empty nest lives. Each week, we're having unserious but raw conversations about what is going on with our bodies, minds, and lives. Okay. So let's talk about it. Hello everyone. Welcome to Dismissed. I'm Jenny. And I'm Amy. And this is Dr. Madrano. We are going to be talking to her today on this episode. Specifically, we are addressing questions that you guys, our viewers, have asked to be addressed by a doctor. So I need to do a little intro for Dr. Madrano, though. She has been my doctor for just over a year. She works at Innovative Vitality in Chicago. She has taken my optimized my health in one year better than anybody has ever helped me more than anybody's ever helped me before. I just want to give you two quick examples so you understand what she does. One, I came to her a year ago with high blood pressure. Another concierge doctor had put me on blood pressure medicine. Never had talked about anything else that could be causing it. I tried everything health-wise, etc. Went on the blood pressure medicine, came to Dr. Medrano, started seeing her talk through everything, was very upset. I was on blood pressure medicine. We talked, she said, you need to go on hormone replacement therapy. You need to go on the patch. I mean, we talked about a bunch of stuff, but I went on the patch. Two weeks later, I went back to her office to have a bunch of things done, but I got my blood pressure tested. It was normal. I went back two weeks later to have an appointment with her, still normal. She said, bye, blood pressure medicine. I went off the blood pressure medicine, never to revisit it again. Still normal a year later. Preach. Second example, this goes into our first topic that people wanted to know about. I asked her about GLPs several times. Twice. I asked her twice. She said no, both times, and she told me why, which we don't need to get into. And then she said to me, But why don't you try something else called metformin? I take a pill every single day. Um, she can give you more details, but I have lost eight pounds in this year. And it's not, I haven't changed my diet and completely changed, like, it's not about that. It's about how our body processes things at this age. So she is specifically looking at us in this age group, 40s, 50s, 60s, and beyond. How can we optimize our health? She was formerly a chemist, so she also has this brain where she like wants to look at the numbers and wants to figure out what works with what and why it isn't working with Jennifer, but it might work with Amy. She's a genius. I'm clearly in awe, and I'm so, so excited that she agreed to come on here and answer a few questions that you guys have asked. So sorry to build you up so high. Your ego is probably so big right now. But you've changed my life, and I want to share you with everybody.

SPEAKER_02 3:36

That's so kind of you, uh, Jennifer. I I'm humbled. I'm humbled. Um, a little more of my background, I will say I'm a Chicago native, also, which is great because I know all about the resources and everything that we have available to us. Um, you mentioned my chemistry background. It does alter my thinking a little bit, especially when you're like this med and this med. I'm like, I'm telling you what, let's cut this down and like clean this up and so on. Um, some of my other areas of expertise and passion are also aesthetics. One of the things you and I also talked about is looking your best, no matter your age, on the outside as well, right? We focus a lot on internal, but also you want to look in the mirror every day and be like, yep, that's me right there. And so that's a lot of the other stuff that I love talking about. Um, and also, you know, I like to meet my patients uh where they are. If this is your goal, let's do it, you know? And so that can run the gamut. Uh last but certainly not least, I'm all about customization. I want to make sure that your regimen is right for you because it may not be right for Amy. And sometimes we have to start somewhere, but it's always a conversation between the two of us. We're a team and we always will be. And so I never want to blindside someone like the blood pressure medication situation. Like, why is this happening? Do I have to do this? You know, if we ever start something, you're always on board.

SPEAKER_03 4:53

It's true. I could say, as her patient, you you build up to you try to change things and you look at things differently. And like I said, we're gonna address these viewer questions specifically. Let's go. And um, she's gonna talk about supplements coming up, she's gonna talk about GLTs, let's go. She's gonna talk about hair loss, and she's gonna talk about she's gonna leave us with some things we all could be doing in this age group. Okay.

SPEAKER_00 5:21

Yeah, so let's start. I go ahead first. I also love that she said, sorry to interrupt, sorry to interrupt. Um, but I also love that you said that we're a team because I feel like that's a huge issue, especially with women and when it comes to like doctors and stuff like that. I don't, I and just I mean, my experience alone, I haven't felt like, you know, my doctors that I've been going to for years and years and years and years have been a team with me on this like journey, this like you know, perimenopause, menopause journey. So I feel like it's so good to hear that, you know.

SPEAKER_02 5:54

So, Amy, actually, to your point, um, I was listening to your previous podcast about how you were taking like an OCP for a year, and you're like, what is going on here? Luckily, you are your uh you're a very good self-advocate.

SPEAKER_00 6:06

That's an over-the-counter um Well, I'm sorry. Thank you.

SPEAKER_02 6:09

Thank you for interrupting me.

SPEAKER_00 6:10

No, or let's just see it for I'm so used to the medical jargon.

SPEAKER_02 6:16

Thank you so much for stopping me. Oral contraceptive pill. Contraceptive pill, got it. Or uh COC is another one, combination oral contraceptive, which has estrogen progesterone in it. So thank you, thank you for pausing me on that. Um, and how you were like, I was on this for a year and like nothing came of it, but you're basically like, you're you know, someone was like, here you go, see you next time. And I'm like, it doesn't, it just doesn't work, it can't work that way, and historically it doesn't work that way. And so that's a big part of why I'm like, you know what, we can do things better, we can do things different. Yeah, for sure, for sure.

SPEAKER_03 6:48

Well, thank God for you, and thank God for innovation vitality. I appreciate it. I can't say enough.

SPEAKER_02 6:53

Don't take up too much of our time, anybody who's I mean, we got some questions to answer, and I can tell you we could do individual podcasts on just each of those topics.

SPEAKER_03 7:02

So I agree with you. So I know I I know it's a lot to ask in a short period of time. So let's get started on GLPs. A lot of my friends are asking about these. Okay. Tell us what you know, who can go on them, who can't. Just you lay it out for us.

SPEAKER_02 7:17

Okay, perfect. So um it's you mentioned, for example, I said no no to GLP ones for you. It wasn't like that quite. We had a conversation, decided, okay, maybe not for you, not at this time. So GLP ones, in uh just very short context, are short amino acid proteins, right? They are traditionally and originally diabetes medications. And so what they do and have been found to do is not only to really stabilize the glucose in your blood, which helps with weight management, uh, P not PCOS, now PMOS, if you've if you've heard of that concept, um, and therefore hormone regulation, by proxy, but subsequently found to actually uh decrease appetite and slow gastric emptying, therefore causing pretty significant weight loss over time. One of the questions uh Jennifer and I talked about were who qualifies for that? And so um, by the basic absolute like uh insurance coverage criteria, BMI of 30 or higher, the end, or BMI of 27 plus at least one weight-related comorbidity, meaning something, another medical problem because of weight, and that can be high blood pressure, that can be diabetes, that can be um sleep apnea, for example. And so that's the medical qualifications for it. With that said, they are used off label all the time with low p folks with lower BMIs, um, also other scenarios, insulin resistance, inflammatory states. I've used it in folks who have all kinds of ongoing inflammation, and they're just like, I feel like a million dollars, like it's great. So works on multiple levels because of all of the regulation that happens um inside the body.

SPEAKER_00 9:02

Wow. I didn't know I feel like that's a lot. I feel like that's a lot of background. I didn't know the inflammation part of it. And you know what's funny is when I had gone into my original um G GP, my general practitioner, and I we were talking, and my cholesterol was high, which is very strange for me. I've always had very low cholesterol. This was like pre-going on HRT.

SPEAKER_01 9:27

I was gonna say it was like intermontes.

SPEAKER_00 9:28

Yeah, well, he that's what he in and he was like, You've gained a little bit of weight, you know, you have um, you know, your cholesterol is high. And in my head, I know it's because I need HRT. Like I I know it. And he's like, Well, I know a lot of people have been asking about GLPs. Like, are you gonna ask about them? And I was like, No, I I mean, I I of course I want to educate myself on it, but I wasn't going in there to say, I want I want to be on a GLP. I was going in there to learn about like what was happening in my body and my hormones, and so that it's funny that that took a route too. And I feel like now knowing like everything that you just said, all the things that it it kind of helps, it makes and now I see it. It it there's just such a wide range that you could use it for, I guess, instead of just using losing weight, basically. Right.

SPEAKER_02 10:18

Oh, absolutely. And to your point, Amy, my response to something like that, like if I were your GP, would be like, we have to address your hormones first, right? GLP ones are great tools, wonderful tools. But if stuff's going awry at a baseline, what do you expect it to do for you? Right? Um, in which case it just becomes a crutch. You have to go in a higher and higher dose to get the benefits, in which case you go on, we do hormone regulation first. Once you're at your true baseline, then we visit that and decide is this the right uh next step for you.

SPEAKER_03 10:50

What percentage of your patients? Because I know most of them are, you know, in this aging range, are using GLPs right now.

SPEAKER_02 10:59

I would say easily 75% of my patients. Can I ask what is oh go ahead?

SPEAKER_00 11:05

Oh, and I was gonna say, what is a so did you say sulfur in your area?

SPEAKER_02 11:10

It's just the medication class, it's just what it's called.

SPEAKER_03 11:12

Will you tell us about Matt Foreman now as a because that's what you decided to do for me? Absolutely.

SPEAKER_02 11:18

So the name of the game here is to stabilize your glucose curve. Basically, you know, we expect little spice when we eat things, but if your sugar runs too high all the time, your body is like, well, what do I do with this? Right? Therefore, increases insulin. But all that floating in your blood is actually seen as inflammatory. And guess what happens to glucose that doesn't get processed? If your organs don't use glucose, it goes straight to body fat. Do not PESCO, do not collect $200, go straight to jail. So that is exactly what happens and that's why we gain weight. Wow. Boom. That's why you lost eight pounds on metformin. Because you didn't change anything differently, right? Right? You're metabolically more efficient.

SPEAKER_03 12:06

Wait, will you say that one more time? Yeah. Will you start with and say that's why you lost eight pounds?

SPEAKER_02 12:14

So that's why you lost eight pounds on metformin without doing anything different, is you've become metabolically more efficient. That's what metformin does. It takes the insulin you're already making and says, all right, guys, we actually have to do work. Grab that glucose, let's use it. And suddenly everything is more efficient. That glucose curve chills out, you're no longer living in these crazy spikes. And that glucose that once upon went to body, once upon a time went to body fat is now actually being processed for energy by your organs.

SPEAKER_00 12:48

So do you feel like metformin is something it's metformin, right? That's how you pronounce it. Do you feel like it's something like a lot of like women our age should be taking? Like, and because I feel like you're saying like metabolically more efficient, that's something that we all struggle with as we get older. You know what I'm saying? Like I and I feel like I will say to be quite honest, I I do know I do have a friend that is is on it. Um and on metformin, Amy? Yes, and she's had um, but she has thy thyroid issues, so that's originally why she got put on it. But um, and she's had great success with it as well. But um the but that's what I and and she always says, you know, her doctor says it's one of those drugs that she thinks everybody should be on because it's really great.

SPEAKER_02 13:40

That's a great question, Amy. And um, there's a couple of kind of philosophies and kind of contradictory things that go on there. My general philosophy is that if you don't need it, don't take it, right? Don't take it, right?

SPEAKER_00 13:50

Of course, of course.

SPEAKER_02 13:51

Medications are medications, they come with their own, you know, set of things that come with that. And so side effects, yeah. Side effects, you know, price tags depending on the situation, etc. But you know, one of the benefits I get with seeing uh Jennifer is that I get the labs, I can tell just at baseline, like, okay, you're insulin resistance, there is a role for this. But if you're not insulin resistant, you know, if that's not an issue, then why are we adding something? Cause maybe it'll do something. You know what I mean?

SPEAKER_00 14:18

Do something.

SPEAKER_02 14:18

And so, unless there's an indication, unless I see a role for it, I'm not gonna just add a medication just because someone everyone should be on it. Um, there are, you know, more uh thought processes about its longevity benefits for MATF formin, but once again, still a medication, right? I think the human body is a wonderful place. And if it's already insulin efficient, why mess with it?

SPEAKER_00 14:39

Why mess with it? Yeah, which makes perfect sense. Yeah.

SPEAKER_02 14:42

But but with that said, just like how Jennifer came to me, I think it's a great starting point. And as you can see, we've gotten some success in the last year, and I that's what I said to her. I'm like, we can start here and you can get exactly what you're looking for, and we're done. The end. It's cheap, it's easily available, and it's covered by insurance. GOP1s don't always have that benefit.

SPEAKER_00 15:06

Is that is it something um kind of like in regards to a GLP one too? Is it something like that that you have to consistently be on in order for it to work? And if she would go off of it, then the benefits would not still help, or is it something you're on for a short period of time and then you can get off?

SPEAKER_02 15:25

So that is another great question. Both metformin and GLP1s, as I mentioned, are initially indicated as diabetes meds and they are meant to be long-term. And so can absolutely be on board for a long period of time, no matter what. But I also it also depends on the goals of the patient, right? Like if you're on, if you are insulin resistant and you're like, you know what, I feel great, let's get off metformin, and then all that comes coming back, you need something all the time. Yeah, that's it. Got it. But I have had patients that will go through just kind of like a regulatory phase, let's say, while hormones are getting stabilized or lifestyle comes into place because that doesn't happen overnight. This is meant to be, they're meant to be supports, right? Um, and so yeah, that's a good way to put it. Yeah, exactly. And so sometimes there is um a short-term benefit, and other times it needs to be on board for longer, depending on where that patient is and what their needs are. I love this.

SPEAKER_03 16:19

I love that. I love it too. GLPs are a hundred percent of patients asking for them when they come in or 95%.

SPEAKER_02 16:27

No, yes, but 75% portion. Okay, very large portion are for sure. But no, a lot of people because there's a lot of misconceptions in terms of its role in someone's life, especially long term. There definitely is the concept that once you start on it, you're chained to it for life. Because of the previous year's experience with GLP ones, the shortages, the costs, uh, insurance changes, all that kind of stuff. There is that fear that you're on it, it works, and then suddenly it's pulled out from under you. And then what do you do? And so there is that inherent fear of not having to be dependent on something like a GLP one. So not everyone comes asking for that. Some are very adamant, they're like, I do not want to do this. And that's more of like, well, let's do other things, and then if we need to, we will revisit.

SPEAKER_00 17:14

You can tap into it.

SPEAKER_02 17:16

Exactly.

unknown 17:17

Okay.

SPEAKER_03 17:18

Is there any big fear with a GLP one or side effect that you're seeing with patients, or is it really just individual?

SPEAKER_02 17:28

It really is the individual. Um, side effects I've seen are pretty standard, um, and that's what comes with it. Is GI uh upset, meaning like um uh abdominal pain, nausea is a big one, especially the day of or day after injection. Um, if you don't eat well, meaning like high fat foods, that can run right through you, and you're gonna be visiting the bathroom. And so that's what I'm saying. I'm like, it's definitely not one of the, it's not a crutch by any means, it's a tool, you know? And if you don't know how to use it, it can backfire on you. And so that's what I'm typically seeing. I really haven't seen anything detrimental, um, to be frankly.

SPEAKER_00 18:04

I hear a lot about um constipation.

SPEAKER_02 18:07

That's a big one that I hear because it slows gastroempting, as I mentioned, right? So because it hangs out for a longer period of time, in which case there are ways, more natural ways to remedy that. Prune juice is one of my favorites. Um, but it could also be an indicator that maybe the dose isn't right for that patient or that specific GLP one may not quite fit. My philosophy also for medications is that they should pretty they should fit pretty seamlessly into your life, right? It should be more benefit than than downsides. Um, if that's a problem, it sounds like maybe it's time for a switch. Let's do a quick breakdown of the GLP ones, okay? So these are also depending on their FDA indication. Ozempic and Wagovi are both semi-glutide, exactly the same. Ozempic indicated for diabetes, wagovi for weight loss. Wagovi has seven, seven, I don't know, it has a bunch of other indications, which helps with um insurance coverage, but to simplify it, that's how that works. What yourzepitide is the um Manjaro that is indicated for diabetes, and then Zeppound is indicated for weight. As of recently, and I mean the last three months, um, there are now oral versions. So um Wagovi came out with an oral pill version, which has been great because there are people who have needle phobias, and then there is another medication that's similar in that category called Foundateo, uh, that also came out recently. Um coming down the pipeline is going to be CAGRI SEMA, which is a GLP1 plus amylen. It's another diabetes ingredient, if you want to think of it that way. And then one of the big ones that's supposed to be coming down um for FDA approval at the end of 2026 is retitrutide. So the way you think about it this way is semaglutide is a GLP1, uh, trzepatide is a GLP1 and a GIP, and then retitrutide is GLP1, GIP, and then I apologize, there's one more ingredient that's escaping me right now. Um, but it's a triple agonist, so it's going to blow everything out of the water. Data has its own weight loss comparable to bariatric surgery with this going.

SPEAKER_00 20:18

What? Oh my gosh. That's medicine is amazing. That's amazing.

SPEAKER_02 20:22

It's insurance that's not as fun. But yes, it's so funny. It's great. And so the other thing that a lot of people don't realize is um in the US, patents um expire after 10 years. You can get an extension for pediatric stuff for six months. So what's gonna happen is all of these are gonna be available in generic in about six or seven years.

SPEAKER_00 20:43

Six or seven years. Yep. Wow.

SPEAKER_03 20:46

Okay, that's fascinating. And looking into the future, totally have like some side info. Yeah. Way to go. Yeah, yeah. It's good to be. Let me ask you about a side effect. Go for it. Which is um, since I talked to you about the podcast, I've been approached by so many women who are having hair loss at around my age. And I know I've heard about it being a side effect of a GLP, but there these are people who aren't on GLPs necessarily.

SPEAKER_00 21:10

This is like a menopause. You're saying like a menopause or perimenopause. I don't, I guess I'm gonna ask the doctor.

SPEAKER_02 21:16

Yeah, no, so yeah, so I hear I ask, get asked that all the time. Is this a side effect? The answer is no, actually. Um, at least not according to the data. What will happen to lead to hair loss is malnutrition because you're eating less and therefore not really giving yourself the nutrients that you usually have. But in this era, it's really the decrease in the estrogen.

SPEAKER_00 21:38

Really? Oh, that makes sense.

SPEAKER_02 21:40

Hair comes out at the end. If so, anyone who has been pregnant remembers how awesome hair was during pregnancy, that's because estrogen is totally high during pregnancy and then drops.

SPEAKER_00 21:53

It really does affect every single part of our body. Like you're now you're saying our hair follicles, and I never. Even thought about that.

SPEAKER_02 22:01

Correct. So yeah, it's not a direct side effect of GLP1s because there are plenty of people on it that have no issues. So it's usually malnutrition andor hormone dysregulation.

SPEAKER_00 22:13

Well, which makes sense too, because I don't know after I had my daughter, like probably like two or three months after I lost a lot of hair.

SPEAKER_02 22:19

Right. Your estrogen went.

SPEAKER_03 22:22

Yes. You see Amy's hair though? She still looked like she had nine million pounds of hair oncles. No problem.

SPEAKER_02 22:36

Right?

SPEAKER_00 22:36

And so I feel like it's different. Yeah.

SPEAKER_02 22:39

And I go by, I would go by what Amy's perspective is. What I think about her hair is irrelevant. What she thinks about her hair is what matters because she's within it.

SPEAKER_00 22:47

So true.

SPEAKER_03 22:48

That is such no, but that like goes to the point of how you look at things, Dr. McGrath. Seriously, that is you're exactly right.

SPEAKER_00 22:56

You're listening to your patients rather than saying this is what usually happens during this time. We're gonna treat X, Y, Z, or everything looks fine. That's that's like all your hair looks fine.

SPEAKER_02 23:09

Like that's that's my opinion's irrelevant.

SPEAKER_03 23:12

Let's just take one second to acknowledge that. Like, I know you're pushing back when I said that, like, ha ha ha, I'm making a joke, but there's such a deep moment there in terms of doctor actually listening to what you're coming in with. And you know, she says that's true. That's what Amy's saying, and so therefore, like that's right. You're validating your patient.

SPEAKER_00 23:35

Yeah, validation.

SPEAKER_02 23:36

Okay, I tell you, all I can do is try, and then um, yeah. I mean, my job as a doctor is you know, not just writing scripts and things like that, is it's to guide and advise. But how do you know how to do that if you don't shut the fuck up sometimes? Yes, right. So drill. Yeah, so true. That's something they need to start, you know. I I'm glad I learned that. But sometimes you just need to shut up and listen. And then suddenly things unroll the way they're supposed to.

SPEAKER_00 24:05

By the way, I I just texted my my girlfriend that's on MetFormin, and I was like, hey, I was like, just so you know, I was like, I'm talking about it on the podcast, I don't mention your name. And she just texted back, no way, Metformin is the GOAT. That's what she texted. It is the OG.

SPEAKER_02 24:21

I will say it is the OG, that's for sure. The OG in regulation, the OG for sure.

SPEAKER_03 24:27

Amazing.

SPEAKER_02 24:28

Yeah, it's amazing.

SPEAKER_03 24:29

I love this. I love it. I'm so glad we addressed. Okay, so we addressed GLPs, we addressed Metformin. Can we talk about supplements next? Yes, actually, we're talking about malnutrition, right? Yes, so that's a perfect segue. The question people have about supplements. Do I really need them? If so, how do I know which ones? Do they really need and how do you know? What else were you gonna say, Amy? And are they worth it? Great question.

SPEAKER_02 24:56

Because it's money and time. Great question. So the question is, do you need them? We're gonna go back to the malnutrition point for a second. In that scenario, yes, absolutely, because getting what you need is very hard in a traditional format, right? You're like, how are you gonna eat more if you're like, I can't, or it's gonna make me throw up or whatever, you know? The other part to that is you have to look at what we have in our country as a diet, right? It's very, it's still very difficult to get true actual nutrients from things that we have easily available to us, okay? So I would say, you know, if you're looking to just live status quo, no, they're not necessary. If you're looking to live your best life and live optimally, then yeah, absolutely. How do you know which? One, yeah, I'm gonna say lab work. I can't, I can't see through somebody and determine, oh, you need this, you need that. It's just not a thing. Um, and then which ones? That's where my chemistry brain comes into place. There is something called bioavailability, meaning the percentage of what you take that you actually get, right? Because there's a lot of stuff that keeps it in capsule formats or you know, whatever filler, that kind of thing. And so there are varieties of, let's say, zinc, for example. Not all of them get absorbed the same way. And so you go by what the data shows as like the highly absorbable one, and then you go give that a shot. Also, I will tell you, and Jennifer knows this about me, I am my first guinea pig. I try all the things before I recommend patients. I'm never gonna be like, oh, I don't know what this does. Here you go. And so, you know, that's that's I mean, there's some exceptions, of course. I can't try everything, but um, you know, I've tried metformin and I did all the other stuff. So um that's the other part to that. And then we keep up on it. Once again, with the labs, is this really working? Right? If it's not, scrap it, let's try something else or a different formulation. Zinc, once again, it's my example because I have found very recently that a lot of my patients are just not getting their zinc increasing, despite being very exactly, I'm in the same boat. And so I'm actually trying out a different formulation in gummy format because of the whole bioavailability thing. I'm gonna check my own levels um at the end of the month, and then I'll be able to report back and say, you know what? This works. Let's do this instead. Because if you're taking it, the juice needs to be worth the squeeze.

SPEAKER_03 27:20

Yes. There's that phrase she always says. I love it.

SPEAKER_00 27:24

The juice needs to be worth the squeeze.

SPEAKER_03 27:26

Juice needs to be worth the squeeze. So I was very resistant when I went in. I was like, I'm not taking freaking supplements. I think it's stupid. I think vitamins.

SPEAKER_00 27:33

First of all, my this is my favorite thing about Jenny is she goes into a situation and already she says, nope, not going to do that. No, I'm not, nope, not going to do it. And I love it when somebody changes their mind. It's my favorite. Do you know how I do that, by the way?

SPEAKER_02 27:47

I go, tell me, tell me why. Just tell me, tell me, tell me what's up. Tell me the thought process. I want to know where that comes from because you know she thought about it, made that decision before even coming, right? And so I'm like, okay, this is obviously taking some time and thought. I want to know, like, take me on that journey with you. Yes. And then, and only then can I say, I see and hear where you're coming from. Let's talk about it. And then she's still like, nope, not for me. I'm like, I hear you. If you ever want to revisit, I'm there for it. Otherwise, I'm not gonna pester you about it. The end.

SPEAKER_03 28:17

Yeah. And so when she took my lab, saw that I was deficient in all these vitamins. All I took a bunch of, I don't remember how many, I'm gonna say eight to ten a day. I did it until she checked my blood again. Six months later, I committed. The blood work was so much better, it was scary. Wow, the cup, not scary, so much better, it was better. Impressive. Impressive. And so she and then what she did was she didn't stop there though. She was like, Okay, we need to maximize your iron. So I got an iron infusion instead of taking a pill. Yes, I remember when you did. In 14 years, I'm not taking a pill every day for iron. We're about to check my blood work uh next Monday, I think. Actually, I'll let you know what happens. She combined or she took away a couple of pills, uh, the zinc that wasn't working. We're gonna I'm gonna look into if this other one works for her. And then she moved me to a vitamin D once a week. So that was a bunch of pills I didn't have to take anymore. Pill, oh shoot, remind me, pill exhaustion, pill fatigue, pill fatigue. And I was having it. So exactly it's like a con constantly revisiting, too, which is you know, right? And that's where the word need really comes into play. Do you need to be? Like what do you need? Do you need yeah, right, and right, and I didn't need to take all of them because some one wasn't working, right? The others you weren't. The other ones transform, yeah.

SPEAKER_00 29:45

Exactly. This is amazing, so amazing.

SPEAKER_02 29:48

So, yeah, and I think one of the other things you brought up, uh, Jennifer, was pills versus infusion, right? I think that's something that you kind of brought up to me. I will tell you, I love going straight into the bloodstream if at all possible. Not always a possibility, also not always accessible to folks and cost effective, right? Listen, you got the option, go for it. That's like no bioavailable, that's not an issue. You don't have what's called first past metabolism where your body has to process it through the intestines and so on and so forth. Right. You go straight to the source. So I love that. Uh, but once again, if that's not available to you, then you go with the oral versions. Now, it's you said pills versus infusion. There's liquid also. Um, there are also, once again, gummies that, and I don't endorse gummies across the board because there's added sugars there. But for me, for example, zinc, I can't tolerate that orally, it gives me upset stomach. I switched to a gummy, and I was like, let's check this out. And the key, as you know, is consistency. So if you're gonna be able to stick to it, if you hate taking eight a day, you're not gonna stick to it. There's no point.

SPEAKER_03 30:52

And I don't know if I would have continued to stick to it, but now I don't have to. I have a whole nother plan. It's like phase two, right?

SPEAKER_02 30:58

But and that's because you vocalize, these are a lot. You're like, I don't like, do we have to do this? I'm like, no, we can we can shave off some stuff here and there, and then we revisit. But you are your own best advocate and said, you know what, these are a lot, these are a lot, and I don't know if I'm gonna stick to it. So absolutely.

SPEAKER_03 31:14

This is how it should work. This is how it should have been working our whole life, Amy.

SPEAKER_00 31:18

100%. That's I love it. She's like, Breach. Um, I have a quick question too. Like, so so do you visit Dr. Medrano like she is your general practitioner? Or do you see a general practitioner? I love that. I also I didn't know if she was like in addition.

SPEAKER_03 31:37

No, she's it. I she did my pap smear in five years. She does it all. Oh, you're a one-step shopper. Yes, you're a one-step shopper.

SPEAKER_02 31:48

On that, Amy, I will tell you that I am um family practice. I am what's called full spectrum trained. So I have delivered babies, I have done women's health, prenatal, postnatal, geriatric, you name it, I've done it all. And so my preference with any patient is that I'm their hub. I'm their hub. I love that. We can bring in the specialist, we can bring all that stuff, but it's so much easier for people to really stick with their care if they have one person they deal with.

SPEAKER_00 32:14

It's so true. It's so true. It's so true.

SPEAKER_02 32:16

And so I'm like, you know what? Unless you need surgery, which obviously I can't do, um, I got it. You need a PAP, let's go. You need an IUD, I can do that too. Let's do it. And I will be there for as long as you want me to be. Wow. And this is where the happens.

SPEAKER_03 32:32

That's and I and that's what we need. We do. And I mean, the bottom, but the top line is that she's actually listening. She's listening, Amy, when you say what you need. She's listening when I say what I need, and they're different things. Exactly. Right. Right what?

SPEAKER_00 32:51

I think that's what that like, and so here, I this right, that's what I mean. Like, I'm thinking back to my when I saw my GP in the fall, and I'm literally like, like, not one person listened to me. Not one. It's such a not one, like, nor did my my gynecologist, like, nothing. And literally, so it's just so great to know that like that you're there and that you listen and you get it, and that even though we're we're telling you everything that we're thinking and we're feeling, you're really listening to that. You're not telling us what we should do, have to do. You're like, okay, let's figure this out together.

SPEAKER_02 33:28

That you summarized it. That's literally the name of the game.

SPEAKER_03 33:32

So lastly, I really want to leave women, specifically in their 50s, with a few things. If you said you only do three things, because it's a lot, a lot of these You can't do 20 things. What are the three things every woman should focus on right now in their 50s? All right.

SPEAKER_02 33:52

In order of importance, one, lift heavy things. Weight training is everything. And um Jennifer and I talked about this very briefly. I, for example, you know, used to do underserved medicine, and so I know not everyone can have a gym membership, an at-home gym, what a personal trainer, what have you. It doesn't matter. Lift heavy things, pack a backpack with bricks and do your laundry. Go for a walk with a weighted vest. It doesn't matter. Weight training not only helps with your muscle, makes you feel good, makes you look good, it helps with bone health and the endorphins that come and light everything up. Lift heavy things. That's your number one gospel truth. Absolutely. I love that. Absolutely. It doesn't matter what age you are, it doesn't matter what your physical condition is, there are ways to modify it. You can make it work into your life in whatever capacity that looks like. I, for example, a lot of my patients are moms, right? And they're like, Well, how do I do that? I'm like, you don't have to make a fiasco of it. It doesn't have to be an event, right? Um, I purposely have my laundry is on my bottom floor. I purposely make myself go up and down stairs to do laundry, go back and forth, and you'll put out like weights on or a vest. You'll see in our vitality office. We just throw on a weighted vest and just go do our stuff. And all those things matter, they actually make an impact. And so, whatever it looks like to you, lift heavy things. That's amazing. That's number one. You guys number two, Dr.

SPEAKER_03 35:30

Madrano.

SPEAKER_02 35:31

Number two is to optimize your nutrition. Okay. You put crap in your body, you gotta expect crap to come out of it, literally and figuratively. Okay. Okay. So it's a matter of, you know, your lean proteins, uh, limiting processed foods, the sugars, the alcohol. I'm not saying don't have a good time. Don't, you know, enjoy your food, enjoy what you're eating, but also be mindful of its nutritional value, right? If, like I said, if you're not putting good things into your body, how do you expect it to perform the way you want it to? That's a good thing. And I'm not saying it has to be an overhaul. I'm saying look, look at your pantry. What's in it? Do you really need that? Is there something better?

SPEAKER_03 36:11

That sort of thing. Do you have any recommendations for when you do want something? You know how you have a craving for, I don't know, whether you're salty or sweet. Like you're saying just do that when you want to do that, but yeah, overall.

SPEAKER_02 36:26

Um, I don't know like moderation. Moderation is always the key to all those things for sure. Absolutely. Um, and so the the caveat to that is um I don't have any specific recommendations, but we inherently have an idea as to what's healthy and what's not healthy, right? You want something salty, let's say. Why not do a cucumber with salt rather than chips? You're still gonna get the crunch, it's a green vegetable, and you're gonna get the salt that you're looking for, and you can season it with whatever you want. And so that's just one idea I'll throw out, for example. But the here's the caveat to that. I have chips, okay? Yeah. And sometimes you just want some other trucking chips. Eat your chips. Yeah. Eat your chips. You do feel be like, I'm just happy with that, and you move on with your life, and make sure that is not a daily habit, right? Right, right. Enjoy your life, moderation, you know, make sure you know what you're signing up for. Don't be surprised later that you're like, you know, you had like a bar of chocolate and you suddenly have like a sugar drop and you kind of feel like you need a nap in the middle of the day. Like, don't be surprised, right? Know that you're like, right, this is the chocolate. I want this, I'm gonna, I'm gonna enjoy it, and then I'm gonna go on with my day and go back to what all the healthy things I was doing.

SPEAKER_03 37:34

All right, now what is number three?

SPEAKER_02 37:37

Yes. This one is one of my favorites, all right. And it's essentially in a very vague way, but I'll elaborate on it, is lowering your stress. Okay. A big part of that, and this looks like it's gonna look very different for many people. I'm not saying go quit your job unless you're a trust fund kid or anything like that. But for example, rid yourself of things that no longer serve you, right? You have that. I literally put a blazer like into a plot and like I literally have never worn this thing, and I actually don't really like the way it looks on me, why it's in my closet. So, first things, stuff like that. Um, also setting and enforcing boundaries, personal, professional, all that. You like you make your rules, but you gotta stick to them, right? Um, ever since I I have an infant at home, I've changed my hours, and I'm like, I'm not staying in the office past this time. I'm just I'm not doing it. I'm just not. Will I revisit later? Of course. Like, you know, we gotta be real. But now at this point, at this point in my life, this is what makes sense to me. In addition to that, say no. Don't explain yourself. Just say no. I'm not just no. Can you do this? No, walk away. You do not need to justify, you do not need to explain, you have the right and absolute privilege to say no. Period.

SPEAKER_00 38:50

You have the right and the privilege to say no. That's amazing. Full stop.

SPEAKER_02 38:56

Last but not least, as my under that umbrella, is distancing yourself from toxic people. It goes under kind of like ridding yourself of things that no longer serve you. You don't need that in your life. You know, those people who are like your friends, but not really. It's like, why do I have you in my life if there's just not there's you just bring negativity or toxicity or so on and so forth. Now, granted, sometimes that's people we have no choice but to have in our lives, but that's why I say distance. You you're like, you know what? I'm good. Goodbye. Like, we're gonna keep things minimal and call it a day. And I will tell you that the exhaustion, the neurological dysregulation I see in many women as they're going into 40s and 50s and 60s because they have been at the service of everybody but themselves is real. And then they come to me and they're like, Well, must be hormones. I was like, We're gonna start with the hormones, but who's this individual, who's this like, you know, slacker boyfriend you have living with you that's not contributing to your life? Real story. That's a real story, by the way. Um, you know, you know, all this kind of stuff. And it's just like you actually don't need to put up with that. Who to thumb? And for what it's worth, we also have to support each other in enforcing those things. Like, I have a lot of um female uh colleagues and you know staff that I work with, and they're like, oh, I'm taking PTO because of this. I'm like, you don't have to tell me why. That's your right. Enjoy why. Whether it's a doctor or you just want to lay in bed all day, that is your absolute prerogative. You do not have to justify that to me. And that is the other part to that. We have to say that to each other as well.

SPEAKER_03 40:39

Okay, just want to acknowledge that, first of all, at your age, that you know all that. That's not just documents. I know. I wish I would have had that insight because Amy and I, I know, both work on this one that you're talking about cleaning things, people, setting boundaries, boundaries, a daily chore. Absolutely. And I want to bring it back to dismiss the podcast for a second, Amy. Amy has taught me when we started this, Amy has taught me by example how to be in a work environment that is supportive and sets boundaries. And um yes, I bring the I bring my own fun and my own boundaries, but Amy does it better. And Amy, yeah, she says that's very nice, but it's true. She says, Oh, I can't. Oh, I can't. Oh, I do. I do. And no, and and I say, okay. And I don't I didn't know how to work. I was a workaholic when I was working in public relations and in film and television. This experience working in this podcast is driven by producer Josh and driven by Amy validating these choices. You just nailed it, Dr. Madrano. I know that was not what, but my life, my health, how I look, my day-to-day life is better because of what you just said and the support from Amy and producer looking at life differently, setting boundaries.

SPEAKER_02 42:20

I I just it just really getting that reinforced, right? You're the people around you are like, yes, good for you. We we love and support this. Yeah, it's right. It's right.

SPEAKER_00 42:30

And I and I feel like it's nothing, I think the other thing too, it's something that like you and I both, Jenny, we've had to learn how to do this.

SPEAKER_01 42:38

Yes.

SPEAKER_00 42:38

Because we're both very much yes people, and we will drown ourselves in the yesing of our lives. And and I have in the past, and I feel like it's now we're at the point where we're like, no, I can't do it anymore. I can't, I've got to have time for us, I've got to have time for me, my family. I've got, you know, I work another job. So I have to be able to, you know, balance that too. So I feel like we, you and I uh just by habit, we'll just go jump into it like feet first and be like, yes, let's go. That's I'm yesing it all uh all up. And then finally we look back and we're like, oh God, why did I do that? I'm stuck. And you know, so you don't want to do it that way anymore. It's like it's like literally changing the generational the things that we learn generationally.

SPEAKER_02 43:23

Yes, yes, the generational mindset because here in hindsight, I was taught to do that, and luckily I had a very rebellious, I was taught to be like, yes, you know, you're like all like take on more, take on more, do more, do more. I was I was taught that. And luckily, I have uh had a re very rebellious mother who was just like, or not, and I'm like, oh okay. I mean, listen, but the other part to that is we also get chastised for doing those things, right? Like, or Christian that's like, oh, like I can't. Well, why? Well, how about none of your fucking business? You know what I mean? But we're not able to say. That without being disrespectful, or you know, etc. etc. It's like, or how am I just standing up for myself? You know, we are misconstrued as problematic when we stand up for ourselves, and that is definitely a societal and generational thing that I think we are slowly but surely getting better about, you know, honestly, giving less fucks about. Yes, right? It's like what was something I remember hearing once it was your opinion of me is none of my business. Like I not one I couldn't care less. And so, but you're comfortable with that discomfort before you're able to really reinforce it. And so, like you said, Amy, it's learned. This is not something that we are being taught, unfortunately. This is something where we have to break these preconceived notions that we legit are raised with and learn to be like, no, we're gonna do something else.

SPEAKER_03 44:56

Yeah, and us supporting each other in those decisions is going to your your son, Dr. Madrana, will be raised understanding to say no.

unknown 45:07

Yeah.

SPEAKER_03 45:08

Being able to say no and supporting other because we're talking about women who say no.

SPEAKER_02 45:13

Absolutely, absolutely, and like, yeah, no, I couldn't agree more. Couldn't agree more, and I'm very, very lucky to have that privilege to bring a male into society with a different mindset than you know our counterparts, for example, may have been raised with. So, you know, I consider myself very lucky to be the mother of a boy.

SPEAKER_03 45:33

Okay, I'm glad you are too.

SPEAKER_02 45:35

Thank you.

SPEAKER_03 45:37

I am we have a we have a few more minutes, so I just want to ask a couple more questions if that's okay. Go for it. I'm here for it. All right.

SPEAKER_00 45:43

So we do this thing on our podcast. It's called our PMO moment. It's a piss me off. Yeah, it means piss me off moment. Um, and we have so many of them. I love it. Our um, could you name like a PMO moment or a piss me off moment that you experience, like practicing like, you know, medicine or in your practice or something like that? What's your PMO, Dr.

SPEAKER_02 46:09

In medicine specifically? So I will say that it is my initial reaction is the PMO, but then you know, I take, I take, I'm like, okay, no, it's fine. We're we'll we're fine. It is the whole I read this on insert social media, whatever here. Oh, it's basically heard it on TikTok. That was it, yeah, TikTok, Facebook, Reddit. Oh, Reddit's a good one. That's a good one. Oh, yeah. Um, any of those things. Of course, um my you know, I've been trained very well to not eye roll every time that happens. Thank you, COVID, because it's all you had for a while, right? Um and I'm like, you know what? I'd rather welcome any information people get so that they don't feel sheepish about it and would rather just talk to me. Just come and talk to me. Yeah, I will tell you why I think that's a valid point or why I disagree, and we'll make it a conversation. And so I still encourage that, but my initial reaction is seriously, calm, calm up. Really? I will say there's I have had one, just one instance where I look actually my medical advice was overruled by Reddit. And which what else can I do for you today? I was like, this is not going anywhere. Obviously, this is not going anywhere. So let's end the conversation. And if you want to revisit, I'm here. But there's no point in being like, but, but, but, but I'm like, okay, I gave you my piece. You decided not to not to follow what my I'm advising, but rather what the folks on Reddit are doing. Okay. And I moved on. Okay.

SPEAKER_03 47:43

If you've ever spent some time on Reddit, that's a crazy place.

SPEAKER_00 47:47

That's what I was just gonna say. I'm not a Reddit person, but like I have come across a couple Reddit threads, like, especially about some reality TV situations. Well, that is good. And I that one's like I just I just don't feel like it was like it's a world I never knew existed, really. And I feel like it's a lot.

SPEAKER_02 48:08

Yeah, it is. Well, let me tell you, if you're like a people watcher, it's like the virtual version of people watching. Yes, yes, we're just like yes, okay.

SPEAKER_00 48:18

Yes, yes you can say entertained all night. It's amazing.

SPEAKER_02 48:21

Absolutely, absolutely. My husband's a huge Reddit person, and sometimes I'll just like look over, I'm like, dude, what are you what are you what kind of images are what is that? He's like, Oh, it's Reddit. And I'm like, what? It's just like the rainbow. I'm like, what is okay?

SPEAKER_00 48:35

It's like going down the um, Jenny, it's like going down the Facebook, um, the college Facebook sites that you have. Like when your child gets accepted in a college and you go into their specific, it's for parents of children that go to certain universities, you log on, and it that's what it's like. It's like a constant Reddit thread of like all of this amazing stuff. And I remember when my daughter first went was going away to college. My husband would be like, What are you reading? And I'd be the Facebook page of the college she's going to, it's amazing. Like you, you can't, like, you can't, it's it's wild. There's a lot, it's a lot, it's a lot.

SPEAKER_03 49:14

But you told me not to do that, so I only visited for information and then because I went down the drain. Because you went crazy. I did not yeah, you went before me so I could be normal. Right. Exactly. Past changes, any anything. And Dr. Madrano, you'll find this with the uh like Northside Parents Network or some of these kids' blog websites. So excited. So excited.

SPEAKER_00 49:39

You'll go down the drain. Don't go down the drain, use it as entertainment.

SPEAKER_02 49:44

That's use it as entertainment.

SPEAKER_03 49:45

That's where it's at. I love that. Dr. Madrano is gonna raising herself too from a younger age than we are, to have all these things lined up for her. It's it's beautiful.

SPEAKER_02 49:56

And sharing it with all of my colleagues and counterparts so that very frankly, we don't have the same experience.

SPEAKER_03 50:04

This is amazing. I have to say, I'm so grateful I found you. And sweet of you. Glad. I don't know. I'm just so glad you came into my life, and I'm mostly glad that I shared her.

SPEAKER_02 50:16

I'm like a little nervous, but it will suddenly be really, really popular.

SPEAKER_03 50:21

I want to keep it to myself.

SPEAKER_02 50:23

Listen, Jennifer, you know I'm always there for you. But at the same time, part of the purpose is to pass the word on, right? We can do a better thing.

SPEAKER_03 50:32

Yes, exactly. This is why we started this podcast is exactly this. Don't gatekeep this stuff. Put it out there, let the people make their own choices with the right information. Absolutely. So appreciate this. And we are now gonna close out this amazing episode with Dr. Madrano from Invet Vital Innovative Vitality. And we'll have a link in our podcast if you want to reach out to them. And um we like to wrap up the show with a little a little catchphrase, and we're gonna all three do it today. So you're dismissed. You are dismissed.

SPEAKER_00 51:14

You're dismissed.

SPEAKER_03 51:16

Now you go, doctor.

SPEAKER_00 51:17

Now again.

SPEAKER_02 51:19

You are dismissed. Bye. Take care.

SPEAKER_03 51:24

Bye. The best part of building this community is connecting and engaging with you, the listeners and viewers. We want this to be a conversation, so we want to hear from you. You can reach us on all the socials at the dismiss podcast. That's Instagram, Facebook, TikTok, and YouTube. And if you want to email us, send it to the dismisspodcast at gmail.com. We hope to hear from you. You're dismissed.