Good Life Project - How One Doc “Biohacked” Her Hormones and Reclaimed Her Life

Episode Date: July 9, 2014

What if you weren't just a statistic?What if you were a single human being, with unique genes, biology, chemistry and needs? And what if the "generic" approach to "fixing" what ailed you didn't work?Over the last 10 years, there has been a groundswell around an idea known as biohacking. It's about rejecting the notion that your best possible state is exactly the same as everyone else's, owning the fact that you are one person with highly unique needs and optimizing everything from your health to your performance around what works best for you. Regardless of whether anyone else responds to something different.Generic, broad-based, minimally-effective solutions are out. Running individual experiments that yield individual solutions and extraordinary outcomes is in.Enter this week's guest, physician-biohacker and author of The Hormone Cure, Sara Gottfried. Watching her health, mindset, sex-drive and relationships spiral downhill, she sought the advice of other doctors, but became incredibly frustrated by the generic and ineffective "solutions" being proposed. So she decided to take things into her own hands. To start treating herself as an "n of 1" and hack her own system, with a deep focus on non-pharmaceutical ways to normalize and optimize her hormones.That led not only to a profound change in Sara's health, weight, ability and life, but a dramatic shift in the way she practiced medicine and sought to serve others.We go deep into this journey and explore the intersection between medicine, biohacking, hormones and life in this week's conversation.Watch this week’s episode here, subscribe for our weekly updates below and be sure to listen and subscribe on iTunes so you never miss an episode and you get to take each juicy conversation on the go. Hosted on Acast. See acast.com/privacy for more information.

Welcome to Good Life Project, where we take you behind the scenes for in-depth, candid conversations with artists, entrepreneurs, makers, and world shakers. Here's your host, Jonathan Fields. Hi, I'm Jonathan Fields, and this is Good Life Project. So my guest today is Sarah Gottfried, who's the author of a really fascinating book called The Hormone Cure. She's also a physician and a biohacker. Is that kind of how you would still describe yourself to a certain extent? I would, although I'd say biohacker feels so masculine to me.

It really does. There's a lot of machismo in that word there is so i'm looking for a more sacred feminine have you figured anything out i haven't okay can you come up with something well i'll think about it okay good but it is interesting though because um let's kind of deconstruct what this thing called biohacker is or biohacking is also because at least in the world that I live in and apparently the world you live in, it's kind of, it's popping up all over the place right now. And it almost feels like it represents a movement to reclaim a certain sense of control over your health, your life, your performance, all this different stuff. Take me a little bit about into what it is for you and

how you bring it to the world. Sure biohacker i think of biohackers as being mostly citizen scientists and i know you have a fondness for citizen science so i i think of it as leveraging whatever means possible you know medical information the internet brings that so easily within our reach genetics um laboratory, laboratory testing, there's so much direct-to-consumer laboratory testing we can do now. And figuring out, okay, what's the best path for me? I'm not going to buy into this broken medical system that tells me I should take an antidepressant when I feel like crap. So what are the alternatives? How can I figure out my dashboard of the needle movers? Yeah. And I think it's so interesting too that

there does seem to be, I don't know what it's being driven by. I don't know whether it's frustration with a system that doesn't seem to be serving certain fairly chronic things all that well, or maybe it's that combined with what you just said. There now seems to be just so much more access, ready access to being able to go direct to get our own metrics. I mean, it's kind of frustrating. Actually, I live in New York State and we can't actually get direct blood information. Yeah. What's up with that?

I don't understand. I don't know. I mean, I want to change it. Great services. Like you have to go to New Jersey or Connecticut, I think, where it's okay. I can go and get all my own blood work done and then look at the metrics. But in New York, we still can't do that. But, but I think in a lot of places, it's really changing in a pretty profound way. And it's sort of like, you know, if you look at yourself as an

N of one, you know, like rather than this is the average information for the average person, well, it may or may not be relevant to me. And now I can get the data myself and now it's a game changer for a lot of people. It's a total game changer. And I love that you said N of one, because you just hit upon what I would call evidential hierarchy. What's that? Which is so cool, right? Because when you look at, why don't we take antidepressants as an example? When you look at an intervention like taking antidepressants, which I think are way oversubscribed, one in four American women is taking an antidepressants, which I think are way oversubscribed. You know, one in four American women is taking an antidepressant over the age of 40, one in seven men. And these are people who are getting treated for exactly the wrong reasons. Like it works with severe depression, but most

people have mild to moderate symptoms and there's a way better way of getting into root cause analysis. But there's this idea when you look at science and whether taking a drug is a good idea or even taking a supplement or changing your hormone levels, testosterone, estrogen, for instance, you want to have good evidence behind it so that you're not causing harm. And so the evidence generally, you know, the best standard is a randomized trial that has the least bias. But even better than a randomized trial is an N of one experiment where, for instance, you try rhodiola to manage

your stress hormone cortisol and you try it for six weeks and you compare it to six weeks without it. That's the ideal experiment. It's not population based, which is what we've been doing in medicine for so long. Yeah. And I think, I mean, it's so fascinating to me that there just hasn't been more of it sooner. But I think also, I think now it's like what we said, now we have so much more access to information. We have so much more access to getting our own data for our own, to getting our own data for our own, to run our own experiments. And I think, again, it's bundled with this pervasive high level frustration with a lot of chronic symptomology. You're a physician, right? So

I'm not going to knock, and I'm sure you're not going to knock traditional medicine. It's great for a lot of things. Oh, I'll knock it. So at the same time, there are a lot of chronic things that it just doesn't seem to be working for. And so here's a curiosity of mine, okay, because you live in a community that I don't have access to the inner sanctum. I wonder very often from within the community of doctors. Now you're the voice of the community of doctors. The mainstream doctors. Do you feel that there's any kind of growing sense that we see that people are going and seeking outside intervention, not the stuff that they've come to us for because what we're doing isn't working as effectively as possible?

So they're going, they're trying other things. They're running their own experiments. They're trying supplements. They're doing different things. They're changing their nutrition and viewing that as food. And then they're having really profound results and coming back to us. But physicians are bound by certain guidelines that they don't have control over, and they literally can't do those things because it wouldn't be within the ethical bounds of what they can do.

And I wonder whether there's a growing frustration within the medical community around that dynamic. Yeah, great question. And we could go in so many different directions. And I would say, let's go back to Hippocrates, who said, let food be thy medicine, let medicine be thy food. And I think that we have gotten so far away from that basic precept. We all took the Hippocratic oath when we became physicians. And yet, I went to Harvard Medical School. I had 30 minutes of nutrition education. Andy Weil went to Harvard Medical School a little bit before me. He just turned 70 or 71 and he had 30 minutes of nutrition. So yes, it's outside of the purview of mainstream medicine, but I think that's wrong. And there's this long

tradition, I think in medicine of patriarchy. And I would say that biohacking this citizen scientist takeover is really about reclaiming our power and saying, okay, I want to work collaboratively with the physician, but I don't want to turn my power over to them and say, okay, I'm stressed out. I'm bitchy. What you got for me?, the first option is to take a selective serotonin reuptake inhibitor. Like we should be going back to, okay, what's really going on? Like, let's have a longer conversation. Now the average appointment with a physician in the U S is about seven minutes. It's very hard to do a root cause analysis, which is why I think it's so exciting that we're at this tipping point where we've got, you know got the growing discontent with mainstream medicine together with the access that you're describing

with the internet. And I kind of imagine a lot of doctors are really frustrated. I can't imagine that the average visit being seven minutes is a function of physicians wanting the average visit to be seven minutes. Oh, right. It's totally the economics. If you're trying to survive, pay off your student loans, you have to pack your schedule. And some people have control over how much time they have with their patients. But when I finished residency, I decided to work at a health maintenance organization. I had this illusion that it would be better for my quality of life, that I wouldn't give up nights and weekends compared to the academic job that was offered at UCSF. And ultimately I was, I was in a factory. Like I was

seeing 30 to 40 patients a day. I was so burned out at the end of the day. I would, you know, like barely slog home. I was a working mom in my thirties and I just was stressed out of my mind. So you're a doctor. Stressed out of your mind. Yeah. How is that good? Which seems like there's, I mean, there seems like there's a lot of that in the industry is because I guess there's so, there's so many constraints and so much pressure and so many limitations that are coming from so many directions now. And you bundle that with,

you know, with a growing question about the efficacy of certain treatment modalities. It's got to be a tough profession to be in now. It's a tough profession. I mean, I remember being told when I was first wanting to become a doctor that I could become a plumber and make more money. Like, it's not about the money.

It's really about being of service. But I think that there are a lot of constraints. And I don't mean to only defend physicians, but there's a very high burnout rate. I mean, I think if you look at any service profession, teachers, nurses, doctors, super high burnout rate and physicians have some of the highest. Yeah. But then if you flip, well, I guess it's interesting because in New York the phenomenon is a little different in that it's increasingly difficult to find physicians who are actually taking. Yes. Except, and so, you know, I know a number of physicians over the last couple of years who are friends who have, like they didn't want to walk away from sort of like the payment system,

but it felt like to actually treat on the level that made them feel like they were doing what they were here to do. It felt like they had to. And their fees went up dramatically. But also now, so they don't love the fact that they can no longer treat a certain group of people that they really wanted to treat. And some of them will continue to volunteer a certain chunk of time or go to clinics, stuff like that.

But, you know, all of a sudden now you've got 45 minutes to sit down and just have a conversation and move beyond sort of like the seven minutes and done. But I think also, you know, as we're all patients at some point, we've got our own responsibility for that to a certain extent also. You know, it's not just on the docs or on the system. Well, that's right. I mean, that's the disruption to patriarchy, that I think when patients really step into their power

and see this as a partnership and a collaboration, that's when you get grace. Like that's when health starts to happen and you receive it. And you don't have to be an official biohacker. I feel like I've got Tim Ferriss, like on one shoulder here, you know, sort of one of the original biohackers, maybe Dave Asprey on the other shoulder, but you know, the, I think when, when you're not turning over your power to a clinician, when you really own it for yourself and you really own your true, um, body awareness and you bring that to the conversation, that's when it changes health.

Like that's when you see dramatic transformation. And I, you know, my plug is don't wait for the cancer diagnosis. Like don't wait until you hit a wall. I want to really, I want to change that conversation so that people buy into prevention. They buy into the way that they eat, move, think, and supplement, and they change it so that they're really in integrity. And they're not saying first thing in the morning, okay, I'm not going to drink a bottle of wine with my husband tonight, or I'm not going to have, you know, the three chocolate chip cookies that are in the freezer. And then they do it. They're in integrity that day with how they most want to eat and move and feel and think and supplement.

Yeah. And I, it sounds like, okay, that sounds great. Like, why aren't we all doing it? You know, the reality is also, I think a lot of, I think a lot of the reasons why, you know, like prescriptions are written is because people just want that. They want the quick fix. Just give me the pill. So if you tell somebody, and I'm so curious how these conversations unfold with you and patients. Somebody comes in, right?

I guess if they're coming to you in the first place, they're already kind of in a different place. So many people live in a world now where they wake up and from the time they open their eyes, the time they close their eyes at But, you know, so many people live in a world now where they wake up and from the time they open their eyes, the time they close their eyes at night, number one, it's a crazy long day. They're massively scheduled, overscheduled, up against deadlines. They're trying to manage family and life and work. And then they come and you're like, okay,

you can have a pill, which is going to kind of mask the symptoms and make you feel better to a certain extent. Or you can change the way you're eating. You can build mindfulness. You can meditate. You can exercise. You can invest a substantial amount of time into profound lifestyle change to go past the symptom, a lot of people probably just don't want to do that. Totally. Totally. I mean, I think the purpose of life is to awaken and this is part of awakening and this is the compliance part of awakening, right? Where I

think it is a hard sell, but I also think that, you know, that crazy busy person that you're describing is suffering. I agree. Totally. And they're learning from, you know, some pain may be the way that they learn. But I'd much rather that they learn from joy. And I think you have a choice. So if, you know, and I have so much compassion for that person who feels stress out of their minds, didn't sleep well last night, get up in the morning,

first thing you think about is a cup of coffee, and then you're off to the races. Cortisol is running the show. Cortisol is the main stress hormone. But I would also say I've lived it. I felt that way in my mid-30s, and I had to really architect my life in a different way. So that was a big, you know, surrender point for me. But so let's kind of dive into, um,

the compliance word that you used. Yeah. Yeah. It was interesting. One of the first conversations that we ever filmed was with Dan Ariely, who like his professional life is messing with people to see how they behave. Like, he just comes up with all sorts of crazy experiments to see how people respond, how they behave. And one of the conversations that we got on was the idea of compliance and health compliance in particular and how brutally hard it is over the long term. And one of the things that he brought up was he was saying how if there is not some sort of visual or visceral reminder that's there and present every day to say, you've got to keep behaving a certain way, it becomes really hard.

And it's one of the hardest things for anybody to sort of crack is how do you actually inspire somebody to create long-term sustained behavior change. And I'm sure you know this stat better than change. I guess this one, and I'm sure you know this stat better than me. I'm curious if it's true. I've always heard that the average person who has a heart attack, has surgery, comes back, they'll go through cardiac rehab, but then, and they, massive change in behavior and lifestyle. And six months to a year later, they're back to the same behavior as before, even though they've been through this incredibly painful, traumatic, almost life-ending event. Six months to a year out, it's like the pain is gone and they're back to all the same behavior that led to it. Well, this is the human condition, right?

I mean, it's what we're up against. And, you know, when I have someone who comes to me, I'll give you a quick example. I have a 52-year-old woman who came to see me recently and she just said, I feel flat. I feel fat and I don't want to have sex with my husband. And I heard that I could just take testosterone. So why don't you give me some testosterone? I know you're a yoga teacher. I'm not going to do yoga.

Just give me the testosterone prescription. I'll be on my way. And I, you know, I have to break it to her gently, probably not in that initial appointment, but over time that it's so much richer to mind this, you know, to take this symptom like low libido or feeling flat or fat and to decode it. Like, what does that mean for you? And there's a biohacker quality to it of, you know, how do we address nutrient gaps? How do we, you know, how do we address nutrient gaps? How do we, you know, get the right supplements that are really going to move the

needle for you. But there's also a way that we shut down and don't connect to inner divinity. And that's what I think really changes physiology for the worst. So deconstruct that a little bit. Well, you know, you have deep experience in yoga and meditation and I feel like my, what I've learned, you know, over the years, I'm 47 years young now, I think you're around the same age, right? And so I, you know, I've really found that there's a grace that occurs that you receive when you're connected to your inner divinity and when you see it in others. And it's the game changer. It creates this harmony with your hormones.

It creates harmony with your neurotransmitters, your happy brain chemicals, dopamine and serotonin. Dopamine and serotonin went into a bar. I think it's really important to be thoughtful about this. You know, I, I like to think of it as this dashboard that you want to create and the organizational structure is inner divinity. And it doesn't come from working harder, you know, doing more. It really comes from surrender and this deep listening. How do you break that to somebody?

Well, not in the first appointment. Right, exactly. It's like, give me testosterone, let's talk interdivinity. That's not going to go well. Yeah. I totally agree with you. I mean, like I said, I agree that there's a place for all sorts of other more direct and specific, you know, like this is what goes into you, interventions.

But there is that. And when you meet people who are sort of in that place, you kind of want to be around them. You want to know what it is. What are you taking? Yeah, exactly. What are you doing? What pill are you on? Right. What are you actually doing?

Because I don't want to be like, hey, man, it's funny. A lot of people have come to me, a lot of entrepreneurs, a lot of personal brand-oriented entrepreneurs have come to me also, and they're kind of like, what do I do? How do I build this? How do I do that? What's the marketing? Where's the funnel for all that stuff? And I'm always kind of like, first, okay, take a big step back fundamentally.

Are you living a really strongly aligned life? And when you dial in that, using using your language was divine grace divinity divinity you know when you dial that in when it really starts you start to glow you become a beacon there's an energy that radiates from you and people sense yes and there's no greater marketing marketing thing that you can do than to become a beacon for your message by just living it. And people don't want to hear that either. No, no, no. What do I do? Can't I just buy it or outsource it? I need a copywriter. I need a website. Where's the funnel? It's like, okay, that stuff is all

useful, just like nutrients. But there's something deeper. That's the, okay, that stuff is all useful, just like, you know, like nutrients. And, and, but there's something deeper. That's the core that even if you bolt on all the other stuff, you're still going to hit a ceiling because there's something else at work here. Oh yeah. I totally agree. I mean, I think marketing is a sacred activity and when you do it from the place that you just described of attracting magnet magnetizing, that it just, it changes everything. It changes your, your actual physiology. It changes your subtle energetic physiology. You know, it's just a completely different way of doing it. And we have this tradition with capitalism of what I would call, you know, sort of too much of the immature masculine. And the more that we have

this balance, I'm going to totally sound like I'm from Berkeley here of, you know, like a higher feminine imbalance from Berkeley. Yeah. So I, I really agree with that. And I think the, I think people have a detector for bullshit. They have a detector for the folks who are not in alignment. They can see it. And so I think the people that grow like crazy in terms of, you know, their online platform are the ones who really walk the talk. You know, Danielle Laporte is a beautiful example. And she's one of the ways that I first heard about you many, many, many years ago. And, you know, you, you listen to her talk, you read her blog and you lean in because it's so voraciously truthful. It's so honest. It's so authentic. No, I completely agree. And I mean, what's so empowering about someone like her is that she lives it, but then she also,

she takes the extra step, which terrifies people, including me, which is that she lives it, but then she also, she takes the extra step, which terrifies people, including me, which is that, you know, like that, which is her soul. She fully expresses to the world. Yes. That's really hard. It's, it's vulnerable. Yeah. Um, and because now you're like, okay, now if they reject what I write or what I speak or what I say, it's me. It's personal. It's deeply personal, and I'm terrified of that. And I think so many of us are wrapped up in that, me included. I have a filter.

I censor for various reasons. Part of it, I have an almost teenager-old kid, and her and some of her friends follow me on social media. This is a family show. But no, it's still, but, but fundamentally it's just because, you know, like there's, there's that moment where I'm like, I wonder how it's going to land. And it bothers me that I still have that in me. And then I look at someone like Danielle and it's just, you know, she's fully expressed. And I think that's

part of the magic of it. A lot of people will live fairly aligned, but then for people who actually part of what you do is communicate that to the world, there will still remain that gap in that you're not fully communicating, you're not being fully expressed, like you're not sharing the true essence of who you are. And it's interesting. I think that can sometimes start back and create this disconnect, this cognitive dissonance that people sense and that also you just sense about yourself, which leads to internal stress. I think that's true. And I like that you refer to this extra piece of vulnerability, you know, kind of the soul-bearing quality of Danielle's work. And I do think it's such a differentiator for her. And I feel like she's so connected to that inner divinity, and she shares it. She doesn't overshare. She's really careful about that.

You and I both have kids, and she has a son. But she talks about her son, but she talks about it in a very respectful, loving way. She doesn't overshare. So how do you connect to that sense? Well, so I'm a bit dopamine-driven. That's how I think about this, right? So you're a junkie. I'm a dopamine junkie.

I'm also a recovering cortisol junkie, truth be told. So I know where this conversation is going. So with dopamine, I like the shiny new thing it's sort of my my kryptonite it's my blessing and my curse so my way of connecting to inner divinity changes all the time now there's some rituals that I have

I'm a big ritual believer, it's something that really helps me I also have attention deficit because I'm so hooked on that dopamine. So it means that rituals really create structure and organization for my mind and for my day. So I always have a morning ritual. You know, I get up in the morning and I make some green tea and I sit for 30 minutes and 30 minutes, you know, I've tried less. I've tried more. 30 minutes is like the magic place for me with where I am in my life as a householder with two kids and a husband. It's interesting. For me, it's 25.

25, okay. Yeah, so something really special about 30 minutes, it allows me to hear the voice, you know, whatever you want to call it, true self, God, source, higher power. It allows me to clean out my channel self, God source, higher power. It allows, it allows me to clean out my channel, like run the pipe cleaner through. And sometimes it's yin yoga, you know, do some sacral releases. It seems like my low back, you know, sitting makes you dumb and fat. And so I like a good sacral now know. And gives you diabetes, yeah. Right. So, you know, sometimes it's just sitting crisscross applesauce. And sometimes it's using, I love the work of HeartMath.

So I use the Interbalance app. I like that accountability. It's really fun for me to have, you know, my iPhone turned into a biofeedback machine. So those are some of the things that I do. And then I have to come back to it. Like every time I put in my passcode on my iPhone, I take a deep lower belly breath so that I'm not panting like a rabbit like I am right now. It's interesting you mention that because I meditate every morning also,

25 minutes like clockwork no matter where I am or what I'm doing. But I use a timer app. Uh-huh. Yeah, yeah. So every morning there's like sort of like there's a micro battle. Oh, yeah. Because I've got to like, you know, turn on my phone and then there's the timer app and then there's my email. Right.

Right. So in a way, it's like this split second of training every single morning. It's like, don't go there. Go here. Even if you're like, I'll just check for a second first. No, no, no. Just don't do it. So it's like this daily conditioning of like, no, first start this way.

And at times I thought about removing, just saying, well, remove the temptation. But in an odd way, I actually think it's good training. It is. It's integrity training. And to choose, to deliberately choose not to go there and to start your day in a very particular way. Other people, like people who talk about habit formation and ritual formation, tell you, no, don't do that. You know, just make doing the habit as foolproof as humanly possible. Take away every possible barrier or distraction so you just wake up and do it.

There's something in that like forcing me to make a very quick but deliberate choice to do this every single day. I don't know. In some way, it feels powerful to me. And it's very much a habit, a ritual for me at this point. Well, I think there's maybe two types of people here. And of course, there may be you know, at one extreme is people who like to tempt themselves like you do with the email versus the timer and others who need every obstacle removed. I'm more in your camp. I feel like the obstacles are the path. So we know that if you wake up in the morning and you start checking your emails, like your productivity goes down or something. And, and it's also, I have a mentor, Brendan Bouchard, who says your email inbox is a convenient organizing system for other people's agendas. So I think when you really sent,

set that intentionality for your day and you go with the timer instead of checking your emails and you have your 25 minutes, it creates this cascade of grace that you carry into your day. And that's so powerful. It's so powerful. And I think, you know, the, it's a compliance issue because I think a lot of people wake up and they just

are like, Oh, I got to check my emails. I got to do that. And it really affects your day. And it's, uh, I,

I have a, uh, one of my yoga teachers talks about architecting your day the way that you would architect a yoga class. And I know you have years of teaching yoga. So just like you said, an intention at the beginning when you wake up in the morning. You know, Wayne Dyer puts his feet on the floor. I don't know if you saw that movie, The Shift.

He puts his feet on the floor when he gets up from bed and he says, thank you. Thank you. Thank you. And I love that. But that's not me. Like, I don't wake up in the morning. Oh, man. Yeah, I'm like green tea, green tea.

Right. I'm awake, but I'm not human until after I'm done meditating. Yeah. So, you know, you set this intention. Then you figure out your apex pose. You know, you know, you set this intention, then you figure out your apex pose. You know, for me meeting with you today is my apex pose. You crescendo and then you decrescendo and you prepare your body for sleep. Yeah. That's an interesting way of looking at the day. Um, I have to think on that a little bit, but I like it. Is it, I mean, it's on a

forest by the way. I should give her credit. Yeah. Who I love. So powerful. So fierce. Her book, Fierce Medicine. Right. So fierce. It's interesting, too, because when I think about when I taught, I taught the hardest way that you could ever teach, which is I didn't ever go into a class with a particular class in mind. I improvised the entire class,

90 minutes, 40, 50 people in a room. I don't find this surprising in the least. And I would often have an intention and I might have a little bit of a sequence or just a peak pose, you know, an apex energetic moment. But other than that, um, I would freestyle. I'm not in the beginning. It took me a couple of years to get to a place where, but I just really felt like if I went in with an agenda, and I start forcing my agenda, which I would do a lot in the beginning, and then you get 30 minutes into a 90-minute class, and you can make the analogy to your day, right?

You can go with a particular agenda. Then the people in my class, if you're really aware, if you're tuned in, if you're present, you'll start to realize very often what they need is not what I was preparing to offer them at this moment in time. And I think you probably feel that in your day. If you take that same lens also, it's really interesting overlay. You're making me think about where it's like, you'll get a third into your day. You're like what I had planned out doing. That's not what this day needs. You know? So I, I learned pretty quickly.

I was like, you know, I can stick to my plan and take people from 90 minutes and give them a decent experience or I can abandon it. And I can just pay deep attention to what people need, uh, on any given moment and then freestyle and do my best to give it to them. And that became the way to teach. And it's not an easy way to teach. If you stopped me at any given moment during a 90-minute window and said, what's next, I couldn't tell you. It was almost like it would channel through me because that's what I felt the room needed at any given moment in time.

And it would change in the blink of an eye based on the feedback that I was getting. This is so yummy. It's so yummy because that again, I would call grace that there's, you know, when I first started teaching yoga, I would like plan out the whole thing. Yeah. And like every, like I would like, I had cheat sheets. I would keep a book on my mat with a little piece of paper hanging out on the side. And I had a code. Oh, yeah. Where I could see like every single pose.

And actually when I first, first started, I memorized the routines of like all the top teachers. Right. And I would just rotate like who I was on any given day. Yeah. Today's Tiber Ray. Right. Exactly. Right.

And it's not as authentic, right? I mean, there's a lot to be learned as you learn these different lineages and styles, but there's like this forcing quality to it of, okay, this is my plan. We're going to do it. It's going to be like bootcamp. It's again, that immature masculine quality where if you trust and instead receive the energy of the students that you have in the room and you intuit from their energy, okay, this is what I'm guided to teach. That is, that's so good. It's, it's, it's so much better than, um, forcing your agenda. I mean, it's, it's true in relationships. It's true in the yoga class. Yeah. That's why I'm making the analogy

when you say like, if you looked at your day that way, I'm like, yeah, really? It's sort of like, it is the microcosm of how you want to experience, you know, almost everything. It's a different ecosystem. And it's also, you know, it makes me think a bit of the gut microbiome. I think the next 10 years of medicine is going to be all about, you know, these bacteria. It's so fascinating. It's so fascinating. So fascinating. And I feel like there's this way that we've been forcing the worst food possible

on our poor microbiome, you know, just like coming into a yoga class and you have your agenda of exactly what the 90 minutes is going to be. We've been forcing, you know, fake food, processed food, pizza, pasta, all of these things on our gut. And now we're so surprised that we're in so much trouble. And so we want to get back to, you know, this alignment and the sense of, oh, you know, these are the foods that really serve me. These are the foods that nourish me and really fill me with the kind of energy that I want to have. And these are the foods that don't, and I need to stay away from them. Like that's, you know, even you asked about compliance a few

moments ago. And to me, the greatest compliance comes from really tuning into that feedback loop so that you have a sense of, you know, how to, how to feed yourself, both literally and metaphorically. Yeah, and I think part of the challenge with that also is that we've taught ourselves to tune out. Yes. It's like you ask people what they want in life on almost every level. What do you love to do? People are like, what are you passionate about? I don't know.

I never buy that answer. But then you can take it deeper also, like the internal awareness, what are you passionate about? I don't know. I never buy that answer. But then you can take it deeper also, like the internal awareness, what's happening in your body. I make most decisions based on a visceral response. I'll look at data, but then fundamentally I'm like, okay, what's going on when I think about this? But I think we're so trained to tune out an awareness of what our body is telling us, because most of the time it's telling us there's something sucky happening and we don't want to feel that. So instead of responding to it, we just stop listening. Yeah, absolutely. And you know, there's a whole physiology to this where I would say it's not some moral failing that leads to people tuning out. It's often a response to a traumatic childhood.

It's a response to being steeped in cortisol for so long because you're, you know, you're not maybe, uh, managing stress skillfully. It's, um, you know, I think there's a lot of physiologic reasons for tuning out and for either, you know, thinking about the past or thinking about the future and not being in the present moment. But the, you know, the cool thing you were talking about, like these visual and visceral ties to keep people in compliance and in these behaviors that create, you know, these upward, uh, virtuous cycles as opposed to vicious cycles. And I think that you can have these little baby steps that add up to major transformation when it comes to the visceral and the visual cues that help you to stay on the path. So what would some of those baby steps look like?

Yeah, I knew I was teaming that up for you. Well, maybe we could riff here. We could do like a Mars and Venus baby steps of what helps you stay on the path as well. So, well, definitely my morning rituals really make a big difference. I think just the idea of ritual is, you know, like whatever, maybe like taking something to the point that it becomes rituals. Huge. At least for me. It definitely is.

And, you know, another one for me that i find super helpful and i do this whether i'm insane you know i've got a book deadline or i'm flying back east or whatever it is i i make every effort to really connect with my daughters and with my husband first thing in the morning and i can't remember who to attribute this to. I learned it through Oprah. I don't know if it was like a conversation with Gail or Toni Morrison or someone like that. But there was this idea that when you greet your child in the morning, you don't want to be like, you know, whipping the eggs and half distracted.

You want to be like, good morning, sunshine. How are you? I'm so happy to be with you. Like this shine, the love lights shine, the love lights. And it's so, what if you have a teenager? Oh yeah. Don't kiss me. Yeah, totally. I got a 14 year old. You have a 13 year old daughter. Yeah. The nine-year-old still totally goes for it. And the husband, this is like the husband totally loves it as well. That's awesome. It's funny. Cause I I've had, um, when I write, you know, we were both authors too. So when I write very often, I've noticed that one of my, like I'm good sometimes really late at night. Um, so if I was going to drop into that natural window, it would also probably mean that I was waking up a lot later in the morning. And, um, and so one of the reasons I

don't do it is just, it's literally because I want to be there for the family. Yeah. So I, I know that it messes with my productivity. I know that, you know, I've got to rearrange things and I'm not as functional or productive as I can professionally, but to have that small window where, you know, like I can see my daughter, even if it's just short in the morning, maybe every once in a while I'll even walk her a few blocks to school. Yes. You know, that's magic.

And especially at this age, it's funny. I've always wondered about whether we sort of get our time allocation wrong as parents. You know, the average parent works like crazy, barely sees their kids until the kid's out of college. They pay for the debt, and then they peel back, and then they're available for the kids when the kids don't really need them anymore. Right, right.

And I'm like, I'm not going to fault anybody. Like, we live the way we live, and we've been trained that this is the way that you do it. And we're freaked out that if we don't make the money now to cover it, then we're never going to be able to retire, which is also based on the assumption that retirement is good because work is bad, which I have major issues with because I love what I do. But what if you reverse that and said,

okay, I'm going to work for as long as I can work because I love what I do and I'm fully capable of making whatever money I need to make to be okay in the world. But first and foremost, I want to be here while my kid needs me. Even if it's short windows of time. And then when they're out of the house, if I need to work harder, if I need to double down, do what I do, I need to work five years more, I'm actually okay with that. And I would also say this is a better retirement account than working like a dog, burning yourself out to make your IRA as much as possible.

There's a way that it creates more. Love is such a game changer. Love, being grateful for these people that are in your life, having a connection with them where you have clear and direct communication and you're not fighting because you're not able to do the self-care that you most need because you're working so hard to be able to retire. So I think that that's, it again creates this cascade of events that is so good for your health, so good for your heart. It raises oxytocin.

And oxytocin is the best antidote to stress. So, hard-trained physician, and we're talking about all this stuff. curiosity is um do you how do you operate in a world where the vast majority of your colleagues still um don't look at the practice the way that you do? Well, I, I turned the corner at a particular point in my career. And of course, many of my friends that I trained with in mainstream medicine have also turned the corner or they're still in mainstream medicine, but they understand, you know, they knew me for so long that they understand the reasons why I do what I do. And they respect it.

You know, I made a difficult choice to leave mainstream medicine, but I had to. I mean, I think the other choice was to become a bitter old woman, you know, just really unhappy, probably on an antidepressant. And so I needed to leave and sort of create my own system. But fortunately, you know, we live at a time where there's a revolution happening in medicine. You know, there's the functional medicine arm, Mark Hyman, Jeff Bland, folks who, you know, really believe that we need to get away from the disease-based model. And we need to focus more on systems biology, the set of systems that kind of organizes the matrix

and doing root cause analysis and filling in the nutrient gaps and addressing mind, body, and spirit and not just the physical. So I'm really encouraged by this movement, the functional medicine movement. There's also integrative medicine, Andy Weil and his group at the University of Arizona. So I feel like I've got brethren. I have a community. And the part that is frustrating for me is the patients that I see who suffer, who maybe have adrenal burnout and their cute little adrenals in their mid-back are just, you know, like doing their best to pump out the cortisol at the expense of all their other hormones. And they go to their doctor and explain what they're feeling and they get

treated with exactly the wrong thing. Because mainstream medicine doesn't really believe in adrenal fatigue. They believe that your adrenals are either completely fried, which is Addison's disease. You know, there's no cortisol at all at the party, or you're secreting too much Cushing's disease. There's no middle ground. It's black or white, either or. And there's so many people, you know, I would say like 90% who live in that gray in between. So I'm sad that those people often don't get the care that they need. And that's the conversation that I want to change because cortisol, you know, cortisol, there's a hierarchy in the body and this main hormone that's made when you're stressed out of your mind controls everything.

Like all paths lead back to cortisol. That woman with the low testosterone, like part of that conversation, getting to the inner divinity is to say, let's look at your cortisol levels because I suspect cortisol is out of whack. It is in 91% of my patients. And you want to unlock the cortisol first because it's probably lowering your testosterone. Right. So you have to trace it back to the real root. You want to trace it back to the root. And you also want to amplify the innate intelligence of the body, you know, kind of like the concept of positive psychology. It's much easier to amplify the positive than to come in and fix the negative. So you start with the cortisol very often, and then that reverses back up to how you're living

your life to a large extent. Well, the thing about cortisol that's kind of cool is that you can measure someone's cortisol. Like if you, when I was in my mid thirties and I was at this surrender point, you know, I was just like, okay, a glass of Zinfandel or Cabernet isn't working. Was there like an incident by the way? Like, was it, was it a gradual awakening? Or was there like a moment where you're just like, oh hell no. Like this, something has to change. Was there something that happened or was there some moment? There was an, Oh hell no. So the, Oh hell no was feeling this way for many years. So working mom, mid thirties, fat, frumpy, frazzled. And I went and saw my primary care provider. And I can still remember, you know,

I had one of those pathetic paper gowns on and I'm like shivering, waiting forever, you know, for like 30, 40 minutes. And my primary care provider came in and I was explaining my symptoms, you know, I'm, I'm PMSing, I'm in couples therapy. I don't want to have sex with my husband. And I'm angry all the time. And I just feel so stressed. And he suggested three things. He said, well, Sarah, it's simple math. First of all, with the weight loss, he wrote on this little whiteboard that he had in the office. I can still see it. He wrote exercise more plus eat less equals weight loss. You know, this it's simple math, Sarah, which was humiliating and totally wrong. And then he said, why don't you go on this antidepressant at the time it was Prozac. And then he wrote another prescription for birth

control pill. It's like, you know, maybe it's hormonal. Why don't you just go on this birth control pill? And first I was so frustrated that, you know, it felt like it missed the mark, that it wasn't addressing what I most needed. And then I got angry because I felt like millions of American women are being told exactly the same thing across the U.S., and it is totally the wrong message. And I had a hunch. I was able to use that medical training. You know, I left there with my prescriptions, never filled them.

But I had a hunch that my problem was that I was so stressed out. And so I decided to look at my hormones. I looked at my cortisol, and it was three times what it should have been first thing in the morning. And it was slowing down my thyroid, so I was gaining weight. It impacted this tango between estrogen and progesterone, so that, again, it caused difficulty with weight loss and gave me PMS. So it took me about a month to change my cortisol. But that changed everything.

And once I realized that, I just felt like, we've got to change the conversation that we're having about cortisol. And when you can measure it. My point was when you can show somebody, okay, darling, your cortisol is through the roof. We got to do something about it. That's a much easier way to say, let's work on this inner divinity along with these other strategies, these other baby steps so that we can get your hormones back into balance. So for you, you said it took you about a month to get your cortisol back in balance.

What did you actually do? I did a few things. I was running at the time. And so my doctor was like, run more. And this is part of being a cortisol junkie. I think probably during my residency training, I just, I had the set point of like a really high level of cortisol and anything less than that, I would be a little bored. And so I was a runner. The answer wasn't to run more because

running raises your cortisol. I needed to run less and I needed more adaptive exercise. So that's when I started practicing yoga more seriously. I actually learned it from my great grandmother, but I didn't really practice it every day. And, uh, and I started doing Pilates. I, I started to, um, you could call it meditation. You know, I, I believe in really a kind of a broad net when it comes to meditation. I think calling a girlfriend is meditation. Taking a hot bath with Epsom salt is meditation. I want everyone to have an a la carte menu of how they just turn off the monkey mind and kind of bump it up from the amygdala where you sense fear and danger to the prefrontal cortex where you're more resourceful. So I developed a practice and I also took phosphatidylserine, which is an extract of plant membranes shown to lower cortisol levels.

And that's what did it for me. So there is this, there's the woo-woo side of you. Oh, yeah. But there's also the fierce biochemical, endocrine-oriented side of you. That's the name of your book, The Hormone Cure. So it's interesting um you know i guess it's really like using the lens back and there's a whole systems approach where you're like okay let's talk about um the divinity side the meditation side of the yoga um but at the same time you're not averse to saying we also need to change your

chemistry and there are some things that you can do and consume. Yes. Oh, definitely. To do that. side or to consume differ from a pharmaceutical intervention or a drug that would have, say, a similar effect on the symptomology? Well, I have a protocol that I use, which is based on functional medicine. And the protocol has three steps. So the first step, if you're talking about something like high cortisol, which is my main issue, my Achilles heel, I like to first fill in nutritional gaps and make the lifestyle changes that really make a difference with that particular hormone imbalance. So for me, like the shift from running to more adaptive exercise helped me with my cortisol levels and the phosphatidylserine, omega-3s

help to lower cortisol levels. So I like to start first with the nutrient gaps and targeted lifestyle changes, ideally that are proven in randomized trials. And then the second step, if that doesn't solve the symptoms, would be to take a botanical. And you asked about the difference between what I'm suggesting biochemically versus a pharmaceutical. And I believe that those are foundational. So step one, where you're filling in nutritional gaps and you're making targeted lifestyle changes. I feel like even if you ultimately end up on a pharmaceutical, you'll need a lower dose and you'll need it for a shorter duration if you do this groundwork. And I think it's more compelling when you can say, Jonathan, I've got these five randomized trials that show that if you take that omega-3 that's in your refrigerator that you're not taking, and it lowers your cortisol levels in these

randomized trials, I feel like that's more compelling than just saying, yeah, you should take an omega-3, maybe a high-potency multivitamin, and stop running so much. Step three is to take bioidentical hormones, but at the lowest dose and for the shortest duration. And many of those are prescription. But I find that most people can actually balance their hormones with step one and step two. The other thing about botanicals and one of the ways that they're different than taking a pharmaceutical is that a pharmaceutical usually is a synthetic, you know, is devised in a lab. Some of them, I think are lifesaving, but many of them, you know, I think of, I'm going to go woo woo here for a moment. I think when you, when you meet the energy of a plant of a botanical in the middle,

so why don't we use rhodiola or maca as an example. Maca helps to improve libido in women who are perimenopausal and menopausal. When you take that herb and you meet it in the middle and you really need it, that's when it has the most profound effect. And I think it's harder to meet a pharmaceutical in the middle. You know, it's for people with depression, for instance, I don't think of it as a Prozac deficiency or a Lexapro deficiency. I think of it as, okay, you're probably low in vitamin B6, probably B12, because most of us don't absorb it or extract it from our food very well. How's your sleep? What's going on with serotonin and melatonin? What's happening with your

circadian rhythm? You know, do you have this kind of sacred rhythm that you are careful about every day in how you architect your day? So those are the pieces that I think are really effective. And it's also, you know, if you do a head-to-head comparison of a pharmaceutical like Lexapro versus rhodiola in someone that has high cortisol, it's not like I'm saying, take the rhodiola and don't do anything else. Because there's this integration that happens around taking the rhodiola, like the targeted lifestyle tweaks, the other filling in the nutrient gaps, that I think is what makes it stick.

Yeah, it makes a lot of sense, actually. So the name of this project is A Good Life Project. It's an exploration. And we've been talking a lot about health and seeing if we can fix things that are chemically off with all sorts of different approaches to it. When I offer up the term just on a broader scale to you, to live a good life, what comes up? What does it mean to you? Well, I think I go first to the inner divinity because for me, living a good life is, is really being connected to it and to feel my own, you know, sometimes today it and to feel my own.

You know, sometimes today it feels more like my best self, you know, my true self, and to see it in others and to stay kind of in the now, seeing it in others. So for me, that's when I know that I'm on target, when I feel that, when I can see it in my husband at the end of the day, when I can see it in my kids when they're cranky, when I pick them up from school and they don't want to do their homework, when I can see it in my friends and the people that I serve. So one piece that comes up is this inner divinity. And then another piece that comes up kind of related to it is service, which I think is quite paradoxical. You know, I seem to specialize in women who do too much,

you know, women who over-provide, overwork, and I used to be one of them. And there's this paradox that when you're really tired and depleted, that service really makes a difference, like true service from that place of connection to source. You know, you get pulled forward by it. It's not pushy and it's what I think really makes a difference in the world. Beautiful. Thank you. My pleasure. So, um, I've enjoyed the conversation.

Me too. Uh, so I'm Jonathan Fields. My guest today has been a physician best-selling author of the hormone cure sarah godfrey signing off for good life project Thank you.