Let's Be Honest with Kristin Cavallari - Am I Going Through Perimenopause?!

Episode Date: May 6, 2025

I'm joined by board-certified general surgeon Dr. Lee Howard, who walked away from traditional medicine. Why he feels traditional medicine doesn't really help its patients plus we cover what supplements are good for everyone to take, how to navigate allergy season with kids, what the heck the MTHFR gene is, how we should be approaching our kids' health, why were gonna start to hear more and more about creatine, ways we can help the aging process, plus perimenopause and menopause- how to minimize symptoms and recognize when we start to enter that stage. And we cover once and for all what those silly eye twitches are from. Clip 3: Low Testosterone and Alzheimer’s RiskMost people think of testosterone as a hormone that just affects sex drive or muscle mass. But the brain is actually one of its biggest targets. A massive 2023 study from the University of Sydney looked at older men and found something shocking: men with low testosterone had a 26% higher risk of developing Alzheimer’s disease. And we’re not talking about late-stage life—these patterns start decades earlier. Testosterone helps regulate inflammation in the brain, supports memory circuits, and even promotes the growth of new neural connections. When levels drop too low, especially without being noticed, the brain becomes more vulnerable to decline. Here’s the kicker: most men never get their levels checked. And if they do, the 'normal range' is often outdated or way too broad. What’s normal for a 75-year-old is not what you want at 45. I’ve had women come in concerned about their partner’s mood, irritability, even motivation—and it turns out his testosterone was tanked. If you’re in a long-term relationship and your partner is acting like a different person, you’re not imagining it. And getting his hormones evaluated might be the missing link to helping him feel like himself again—and preventing cognitive decline down the line.Study source: University of Sydney & Neuroscience Research Australia (2023)https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.1252Clip 5: Gut Health and MoodThere’s a direct, two-way communication line between your gut and your brain—and researchers now believe that the gut may play just as much of a role in mental health as the brain itself. A major review from 2024 showed that people with poor gut diversity were significantly more likely to suffer from depression and anxiety, even when diet and lifestyle were controlled. Why? Because 90% of your serotonin is actually made in your gut. If your microbiome is inflamed or out of balance, your body literally has fewer raw materials to make feel-good brain chemicals. On top of that, gut inflammation sends stress signals to your brain—keeping you in a low-level “fight or flight” state, even when nothing’s wrong. And if you’ve ever felt brain fog, irritability, or sadness after a weekend of sugar and alcohol… this is why. What’s exciting is how quickly you can make a shift. Just increasing your fiber, adding fermented foods, or taking the right probiotic can make a measurable difference in just a few weeks. This isn’t woo. This is the future of psychiatry. And if you’ve done therapy, made lifestyle changes, but still don’t feel right—check your gut. It might be where your healing needs to start.Study source: Review from the Polish Society of Gastroenterology (2024)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811453Clip 8: Hormone Imbalances and MarriageYou’d be shocked how many couples come into my office thinking they have a communication problem—when what they really have is a hormone problem. He’s irritable, unmotivated, maybe withdrawing. She’s exhausted, anxious, snapping at small things. They think they’ve grown apart. They think the spark is gone. But when we test their hormones—testosterone, cortisol, DHEA, thyroid—what we find is that their biochemistry is off. And once we start restoring balance, everything shifts. The mood improves. The intimacy returns. The little things don’t feel so overwhelming. We now have solid evidence that hormonal health directly impacts emotional regulation, sexual desire, and even empathy. And if both partners are dysregulated, it can feel like the marriage is falling apart—when really, it’s just that their physiology is out of sync. This isn’t a relationship failure. It’s a hormone crisis. And once you name it, you can fix it. I’ve seen couples on the brink of divorce completely turn things around—because we stopped blaming each other and started healing their bodies.Study source: APA + American Journal of Men’s Health (2023–24)https://journals.sagepub.com/doi/10.1177/15579883231166518Clip 11: Whole Milk in Schools Might Actually Be SmarterFor decades, schools have pushed low-fat or skim milk, based on outdated beliefs about fat and weight. But new evidence is flipping that script. A growing body of research now shows that children who drink whole milk are actually less likely to be overweight than those drinking low-fat milk. Why? Because fat makes food more satisfying. It helps with blood sugar regulation and keeps kids fuller longer—so they’re less likely to snack on junk later. In 2025, there’s increasing pushback from pediatricians and nutrition researchers against the one-size-fits-all low-fat approach. Some school districts are already considering bringing whole milk back, and they’re seeing better nutrition outcomes. Whole milk also contains essential nutrients like vitamin D and calcium in more bioavailable forms, especially when paired with fat. It’s time we stop fearing fat—especially when the data shows that cutting it hasn’t actually reduced childhood obesity. In fact, we may have made things worse. So if your kid likes whole milk, don’t feel guilty. It might just be the more nourishing option after all.Study source: Associated Press report (2025)https://apnews.com/article/e4868fdc2dc4e85aeb9375edcd27da49Clip 13: Hormone Fluctuations and Depression in WomenOne of the biggest blind spots in women’s health is how powerful hormone fluctuations are—especially on mood. A 2025 study published in Biomedical Reports found that estrogen and progesterone shifts during puberty, pregnancy, postpartum, and perimenopause play a massive role in rates of depression. This isn’t just anecdotal. These hormonal changes alter brain chemistry, sensitivity to stress, and even how the body processes trauma. In puberty, many girls who were previously confident begin to struggle with mood and self-esteem—but instead of checking hormones, we tell them to tough it out. In postpartum, we’re finally starting to talk about depression more—but the hormonal crash that happens after birth still catches most women off guard. And in perimenopause, where mood swings and anxiety often resurface, women are still too often told it’s “just part of aging.” It’s not. It’s biology. And the good news is, once you understand that hormones are a major player, you can treat the root cause instead of just masking symptoms. Whether it’s bioidentical therapy, lifestyle shifts, or targeted nutrients, women deserve to know that their brains and their hormones are on the same team—and that relief is possible.Study source: Biomedical Reports (2025)https://pubmed.ncbi.nlm.nih.gov/40083602Clip 14: Social Media Changes Teen Brain WiringWe now have MRI data showing that the more often a teen checks social media, the more their brain becomes wired for external validation. In a study from UNC Chapel Hill, researchers found that teens who compulsively checked platforms like Instagram or Snapchat showed measurable changes in the brain's reward centers. These areas lit up more intensely over time, meaning their brains were becoming increasingly sensitive to likes, comments, and digital attention. This isn’t just about being distracted. It’s about a neurological shift in what they find rewarding—and that shift can impact everything from self-worth to emotional regulation. The researchers even found that this pattern predicts increased anxiety and depression, especially in girls. And it makes sense—when your self-esteem is tied to a number on a screen, even a small drop in engagement feels like social rejection. So what can parents do? First, understand that this isn’t just 'teen stuff.' This is brain development. Second, set tech boundaries that prioritize boredom, creativity, and real-life interaction. Even a two-week break can reset the system. Social media isn’t going away—but we have to teach kids how to use it without letting it rewire them.Study source: UNC-Chapel Hill (2023)https://www.unc.edu/posts/2023/01/03/study-shows-habitual-checking-of-social-media-may-impact-young-adolescents-brain-developmenClip 16: Screen Time and Toddlers’ SleepSleep is how toddlers consolidate memory, regulate mood, and grow both physically and neurologically. But more and more research is showing that screen exposure—even if it’s 'educational'—can seriously disrupt toddler sleep. A study published in JAMA Pediatrics found that children ages 2 to 5 who used screens within an hour of bedtime had shorter total sleep and more fragmented rest. Blue light delays melatonin production. Fast-paced content overstimulates the nervous system. And passive consumption before bed blunts their natural wind-down process. We think of it as relaxing—but their brains don’t. What’s worse is that these disruptions don’t just affect nighttime. They carry over into the next day—affecting focus, mood, and even immune function. That’s why experts now recommend at least 60 minutes of screen-free time before lights out—especially for young kids. Replace it with a bath, a book, a calm routine. These rituals help their circadian rhythm sync naturally. Sleep isn’t just a health pillar—it’s a developmental requirement. And screens may be the single biggest obstacle we’re overlooking.Study source: JAMA Pediatrics (2024)https://jamanetwork.com/journals/jamapediatrics/fullarticle/282519Clip 18: Hormone-Disrupting Chemicals = Global Health RiskA sweeping review by the Endocrine Society in 2024 called endocrine-disrupting chemicals a 'global health threat.' These are substances—often found in plastics, pesticides, cosmetics, and even receipts—that can mimic, block, or interfere with your body’s hormones. They’ve been linked to everything from infertility to obesity to neurological conditions and cancer. And they’re everywhere. Prenatal exposure can affect fetal brain development. Chronic exposure is associated with thyroid dysfunction and metabolic syndrome. And it’s not about one product—it’s about cumulative load. What’s scary is how underregulated many of these substances are in the U.S. compared to Europe. But what’s hopeful is that you *can* reduce your exposure. Swap plastic for glass. Say no to fragrance. Wash produce well. Choose organic when you can. Each swap reduces total burden. This isn’t alarmist. This is modern environmental medicine. And it affects every system in your body.Study source: Endocrine Society Global Consensus Statement (2024)https://www.endocrine.org/news-and-advocacy/news-room/2024/latest-science-shows-endocrine-disrupting-chemicals-in-pose-health-threats-globallyClip 19: Gut-Brain Axis and Mental HealthWe used to think the brain controlled everything. Now we know the gut plays just as big a role—especially in mental health. The gut-brain axis is a communication superhighway that links your microbiome to your nervous system. And studies show that disruptions in gut health are strongly linked to anxiety, depression, and even neurodevelopmental conditions like ADHD. Certain gut bacteria help produce neurotransmitters like serotonin and GABA. Others regulate inflammation, which directly impacts mood. A 2025 review of over 50 studies found that targeted probiotics improved symptoms of depression in many patients—sometimes as effectively as medication. What you eat, how you digest, and what lives in your gut may affect your mind more than your therapist knows. That doesn’t mean meds aren’t useful—but it means we have to zoom out. If your gut is inflamed, your brain is inflamed. And no amount of mindset work can override a body that’s chemically out of balance. Heal the gut. Watch what changes.Study source: PubMed Meta-Review on Gut-Brain Axis (2025)https://pubmed.ncbi.nlm.nih.gov/3963000Perimenopause: Recognizing and Addressing Early SymptomsDid you know that up to 90% of women experience symptoms of perimenopause years before menopause actually begins? Despite that, most women are either dismissed by doctors or told they're too young to be entering that phase. Perimenopause can start as early as your mid-30s, and it’s not just hot flashes—it’s insomnia, anxiety, irritability, brain fog, and cycle irregularities. A study from Stanford’s Center for Lifestyle Medicine in 2025 emphasized that when women are supported with hormone therapy earlier—during perimenopause, not just postmenopause—they report significantly better mental clarity, energy, and quality of life. But here’s the problem: most conventional providers aren’t trained to spot this transition, and women are left thinking it’s just stress, parenting, or age catching up with them. When really, it’s hormones shifting. Estradiol begins to fluctuate, progesterone declines, and the nervous system takes the hit. Women deserve to know what’s happening inside their bodies—and what they can do about it. Simple steps like tracking symptoms, checking hormone levels through saliva or urine testing, and considering targeted bioidentical support can change everything. This isn’t about vanity—it’s about function, clarity, and reclaiming your life before things spiral. If you’ve ever thought, 'I just don’t feel like myself anymore,' and your labs came back 'normal,' this is your sign to dig deeper. You’re not crazy. You’re not weak. You’re likely perimenopausal. And you deserve care that actually sees you.Study source: Stanford Lifestyle Medicine (2025)https://longevity.stanford.edu/lifestyle/2025/03/06/menopause-hormone-therapy-is-making-a-comeback-is-it-safe-and-right-for-you/Menopause and Muscle Mass: The Critical Role of Resistance TrainingMuscle loss during and after menopause is one of the most overlooked drivers of weight gain, fatigue, and metabolic decline in women. In fact, women can lose up to 10% of their muscle mass in the first five years post-menopause. That’s not just a cosmetic issue—it’s a health crisis. Loss of muscle means decreased insulin sensitivity, weaker bones, and lower resting metabolic rate. But the good news? It’s reversible. A landmark 2025 study from the University of Exeter showed that menopausal women who engaged in just 12 weeks of resistance training experienced a 21% improvement in lower body flexibility and significant increases in strength and mobility. What’s even more promising is that these improvements came from just two to three sessions a week using basic strength exercises. Muscle is your metabolic engine. And during menopause, when estrogen drops, protecting that muscle becomes your superpower. This isn’t about getting shredded or spending hours at the gym—it’s about lifting enough weight to send your body the message that it’s still needed. Because when your body doesn’t get that message, it starts letting muscle go. This leads to increased fat gain, inflammation, and risk of chronic disease. If you’re entering menopause or already postmenopausal and you’re not lifting weights, you’re missing one of the most effective, protective tools for your long-term health.Study source: University of Exeter (2025)https://news.exeter.ac.uk/faculty-of-health-and-life-sciences/first-of-its-kind-study-shows-resistance-training-can-improve-physical-function-during-menopause/The Importance of Sexual Activity as We AgeHere’s something most people don’t expect: research shows that sexual satisfaction actually improves with age. A 2025 study published in Social Psychology revealed that older adults reported higher levels of emotional intimacy, comfort, and fulfillment during sex—especially when partnered with someone long-term. It turns out that fewer distractions, better communication, and reduced self-consciousness all contribute to more satisfying experiences in later years. But biology still plays a role. Hormonal shifts—like lower estrogen or testosterone—can affect desire, arousal, and comfort. The good news? These challenges are highly treatable. We now have non-invasive, low-risk treatments like vaginal DHEA, testosterone therapy, or pelvic floor physical therapy that can radically improve function and satisfaction. And here’s the key: sexual health isn’t just about sex. It’s about cardiovascular health, immune health, sleep, and mood. An active sex life improves oxytocin levels, reduces stress, and strengthens the emotional bond between partners. Unfortunately, a lot of providers still don’t ask about it. And many people are too embarrassed to bring it up. But this is a health issue—and you deserve support. So if intimacy has changed, bring it into the conversation. Because aging doesn’t have to mean disconnect—it can actually mean rediscovery.Study source: PsyPost (2025)https://www.psypost.org/sexual-satisfactions-link-to-marital-happiness-grows-stronger-with-age/Preventing Alzheimer’s and Type 2 Diabetes: Blood Sugar and Brain HealthThere’s a reason Alzheimer’s is now being called 'Type 3 Diabetes.' A 2024 study published in JAMA Network Open found that people with Type 2 Diabetes who kept their A1C in the target range significantly lowered their risk of developing Alzheimer’s disease. In fact, risk was reduced by up to 60%. Why? Because insulin resistance doesn’t just affect your pancreas—it affects your brain. High insulin impairs memory centers like the hippocampus, increases inflammation, and accelerates plaque formation. That means your morning bagel and soda aren’t just spiking your blood sugar—they may be spiking your dementia risk. The solution isn’t extreme dieting. It’s metabolic awareness. Simple tools like continuous glucose monitors, strength training, walking after meals, and eliminating ultra-processed carbs can dramatically stabilize blood sugar. Add in sleep and stress management, and you’ve got a recipe for brain protection. Most people wait until symptoms start. But prevention is where the power is. If you have a family history of Alzheimer’s or Type 2 Diabetes, take this seriously. Your future brain is being built right now by the food on your plate.Study source: JAMA Network Open (2024)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821878Testosterone and Aging: It’s Not Just About Sex DriveMost people hear 'testosterone' and immediately think of sex drive. But this hormone does way more than that. Testosterone plays a critical role in muscle maintenance, bone density, energy, focus, and mood. A 2025 review from the HE Clinics found that testosterone levels in men start declining around age 30—and continue to drop about 1% per year. That might sound gradual, but by your late 40s or 50s, it’s enough to cause noticeable issues: brain fog, irritability, fatigue, and loss of motivation. What’s even more concerning is that low testosterone has now been linked to a 26% higher risk of developing Alzheimer’s. The brain literally needs testosterone to function well. The challenge is, many men go undiagnosed because they don’t get tested—or they get told their levels are 'normal for their age.' But 'normal' doesn’t mean optimal. And restoring optimal levels, especially with bioidentical therapies under medical supervision, has been shown to improve mood, clarity, libido, and physical performance. This isn’t about bodybuilder doses or quick fixes—it’s about reversing a gradual decline that’s robbing men of their edge. If you or your partner feels like something is off, it’s worth investigating. Because aging doesn’t have to mean decline. It can mean recalibration.Study source: HE Clinics (2025)https://heclinics.com/testosterone-therapy-in-older-men-recent-findings/Why Functional Medicine Is Gaining Ground Over Conventional CareIf you’ve ever felt dismissed in a 7-minute doctor’s appointment, you’re not alone. Traditional primary care is built for volume—not personalization. That’s where functional medicine comes in. A 2019 study published in JAMA Network Open found that patients receiving care through a functional medicine model saw a 30% greater improvement in health-related quality of life than those in conventional care. Why? Because functional medicine is built around asking better questions, running more comprehensive labs, and looking for root causes—not just masking symptoms. Instead of saying 'your labs are normal,' we ask, 'are you thriving?' We look at hormones, nutrition, sleep, gut health, toxin exposure, and genetics as pieces of a bigger picture. This approach is proactive—not reactive. It focuses on reversing disease, not just managing it. More and more people are turning to this kind of care because they’re tired of feeling unseen. If you’ve been told everything is fine but you still feel off, functional medicine might be the approach you need. You deserve care that listens longer, digs deeper, and treats the whole you.Study source: JAMA Network Open (2019)https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2753520A word from my sponsors:Quince - Get cozy in Quince's high-quality wardrobe essentials. Go to Quince.com/honest for free shipping on your order and 365-day returns. LMNT - Get your free LMNT Sample Pack with any purchase at drinklmnt.com/HONEST. Ritual - Support a balanced gut microbiome with Ritual's Synbiotic+. Get 25% off your first month at Ritual.com/BEHONEST. Happy Squatting.  Primal Kitchen - primalkitchen.com/honest to save 20% off your next order with code HONEST at checkout.Fatty15 - You can get an additional 15% off their 90-day subscription Starter Kit by going to fatty15.com/HONEST and using code HONEST at checkout.Bilt Rewards - Start earning points on rent you're already paying by going to joinbilt.com/HONEST. For more Let's Be Honest, follow along at:@kristincavallari on Instagram@kristincavallari and @dearmedia on TikTokLet's Be Honest with Kristin Cavallari on YouTubeProduced by Dear Media.This episode may contain paid endorsements and advertisements for products and services. Individuals on the show may have a direct, or indirect financial interest in products, or services referred to in this episode.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

The following podcast is a Dear Media production. This is Let's Be Honest with Kristin Cavallari, a podcast all about getting real and open on everything from sex, relationships, reality TV, wellness, family, and so much more. And just a fair warning, there will probably be some oversharing. Welcome in to Let's Be Honest. I hope everybody is doing amazing. I have a very special guest today. I have Dr. Howard.

Hi. Hi, Kristin. Thank you for having me. Thank you for being here. This is actually a great day to have a doctor in my house because I have one of my boys homesick. He has had crazy allergies and he had pink eye a couple of weeks ago. So anyways, I went, I had to pick him up from school this morning and I was like, perfect. Dr. Howard's

coming over to see us. I'm going to have him look at you. Yeah. Well, we had a curbside visit here, right? We were able to kind of do a little doctor and up before we got started. It was perfect. Well, I wasn't actually going to ask you about this on the podcast, but I do think it's interesting because it is allergy season and you essentially said allergies sort of are what they are, but you did give me a couple pointers that I can do with CAM. So would you want to say them here too? Yeah, absolutely.

I think allergies at the core are an immune response. And so if we think about where the immune response and the immune system can be centrally located, I would say a lot of it's in the gut. So as we talked about, let's prioritize some gut health. If there are concerns about SIBO or other growth and you think a probiotic would be a good option, that's always something to consider. But I mentioned specifically, let's get rid of gluten.

Because gluten is, I believe that gluten is a major trigger of gut imbalance just because of the effect that gluten and some of the other proteins in wheat has directly on the lining of our intestines. And so if you think about what could weaken that barrier and then allow these pollens and allergens into our system, I believe it plays a pivotal role, right? So restoring gut health would be kind of removing that stimulus, getting rid of gluten, kind of going paleo really, right? And prioritizing things like that. If somebody had really poor gut health, we may even go to the

point of supplementing with bone broth a couple times a day with the probiotics to rebuild their gut health. But gut health becomes important. I also want to kind of help with immune boosting, which would be in the form of vitamin D. So ideally, the vitamin D would allow for more of our natural immunity rather than this reactive immunity kind of thing that's going on with the reacting to the things in our environment. And then I think, especially when we're dealing with little ones that are kind of in Tennessee here, it's definitely probably the worst time to have allergies. And if we're dealing with little ones, knowing that this can affect their sleep, if they're

adenoids and their sinuses are constantly swollen, it's going to affect their hearing. So it can affect their performance in school and their development even, right? Because we know that hearing and cognition are linked together. So if we are dealing with a youngster that's got this, what we want to do is make sure that they can ideally be as dependent on as few medications or as few therapies as possible. But we also don't want to not allow them to develop normally and have normal hearing, normal speech and those kinds of things. So, so you have to balance out will allergy shots be a good option for this client given that

the disruption of the allergies may be so substantial that it could affect them long term. Wow. Okay. Yeah. I know I just, I feel so bad. Well, and that's the thing. It is affecting school because he's home today.

Yeah. Exactly. It just kills me even just seeing him. Okay. But let's back up. I want to catch my listeners up to speed on who you are. So you are a board certified general surgeon, but you walked away from traditional medicine. So tell us why. Yeah. I got board certified on November the 14th, I think of 2010. It was just a few months after I completed my residency. And I'd always thought that in that moment, I would find a significant degree of happiness and elation at accomplishing that goal. And

instead, after practicing for three months, I just felt like I was not only not doing anything for myself professionally, but I wasn't really, really helping my clients or helping my patients at that time, because we just reflexively went to surgery kind of for whatever it was. And I, at the same time, started to have some changes in my body. I was 34, bordering on 35. We know that men and women start to change pretty fast at that point. And I was no exception to that rule. So once I started to have some questions about my health and I thought, okay, well, if I go to my regular doctor, what are they going to tell me? And I knew what that was gonna be. I'm not a depressed guy.

I don't need to think about taking some sort of mood stabilizing medication. It was more organic, I thought. And I knew that if I was gonna go there and get that answer and I didn't want that answer, there were probably a lot of other people that didn't want that answer also. So then the journey began to be,

well, okay, well, what would Lee Howard do knowing what he knows as a doctor to start to fix these problems? Initially, it really was diet. I started really hardcore diving into paleo, reading some of the early research on paleo dieting philosophy and why that made the most sense. Started applying that in my clinic, in my surgical clinic. And instead of doing more endoscopies for people who had GERD and reflux, I was instead taking them off of medications. I found a huge link, at least in my population, and

you know, I didn't do a scientific study on this, but my, the link between reflux and food was meat to me gluten and processed foods, right? And so once I was able to get them to remove processed foods, their bowel movements, their reflux, all those kinds of things that were off before started to correct themselves. Weight loss happened, right? So I even tell the story in the office about a guy who was a cyber security expert. He was an ex-military guy, was still in the reserve, very large, physically big man. And, and I, you know, we were having kind of a discussion about what was going on with him and he thought he needed an EGD and a colonoscopy because he had a bad reflux. His blood pressure was up.

He was having some bloody stools and his bowel movements weren't normal other than that. And it was to him, it was a very clear sign that he needed to get these tests because he was looking for the answer from that. And as I told him, I said, I'm not going to find the answer on doing this. I've done 10,000 colonoscopies, 5,000 EGDs. I'm not going to find anything. The answer is you have to stop treating your body like a garbage dump. And when you do that and this guy physically got angry with me for saying that.

And I said, this is not personal. I'm trying to help you. And the reality is, is that you were thinking that there's something actually wrong with you and I'm here to tell you if that's not the case. He did not want to take my approach, but I broke her to deal with the guy. I said, I tell you what, give me four weeks, right? Like, what do you have to lose by trying my plan for four weeks? And if it's not any better, okay, then we'll figure out something else.

So four weeks goes by, he rolls into the suite where we're going to do his EGD and colonoscopy. And I said, Hey man, how's things going? And he hangs his head and he said, you were right. He says, I'm off my medicines. My bowel movements are normal. I've lost 12 pounds. I feel great. I'm sleeping through the night. Like literally it was all food. Wow. And just in four weeks. Just in four weeks. I saw that over and over again. So it doesn't take but a few episodes of that for you to realize like, okay, I'm probably on a better track doing this than what I was doing.

That's amazing. So with your practice, when people come and see you, I know everyone's different, but is that what you tell everybody to do is get on a paleo diet? I think the paleo becomes the cornerstone. Yeah. I think the paleo diet is sort of that foundational principle. And then once you get a little more specific about what you like, and let's take females, for example, there's a sizable percentage of women who don't do well with fasting. They require a little bit more carbohydrate intake.

They don't do well with periods of going without food. And so for those females, intermittent fasting is not typically going to work for them and they're going to find themselves hangry, you know, and more likely to make a bad dietary choice than if they would have just ate something good in the morning, right? So taking that philosophy of Paleo, you can take Paleo and then Paleo with intermittent fasting, you can do a high protein sort of version of that with low carbs. And that's kind of where I guide most of my clients is a low carbohydrate, high protein version of a paleo diet. And then, and then working in some things for them, like, like for a lot of guys, white rice can make sense. It's typically excluded on a paleo diet, but if

you're exercising and you, and you can justify the carb intake by eating a little bit of white rice. We're not talking about a whole big bowl, but we're talking about small strategic quantities. And white rice is one of those things that we fudge on and bring that in. And I think dairy is another one of those categories that while typically excluded in the traditional paleo sense, it makes sense to do it in the real world. Dairy becomes strategic. It's not the old food pyramid where dairy was its own food group. It's a condiment and we treat it like a condiment. You know, we put small amounts of high quality cheese on broccoli or small amounts of brie cheese that you use with other types of foods, but it's just not relied on

as a main ingredient. What do you think about raw milk? I think it's great. In fact, we were talking about some articles that I brought. There's some research to support that raw milk in schools might actually help our students. I'll leave that citation with you and you can put it on the show notes.

But yeah, I mean, anecdotally, if you look around and you say, well, what are the kids who drink raw milk look like? They're typically pretty healthy kids. You know what I mean? So yeah, it's hard to argue with that outcome, especially when generations of people existed on raw milk before us with really no problem.

I know. Well, I think we're lucky being in Tennessee because I just get raw milk from a little farm over here. I mean, my whole family does farm. Yeah, we definitely don't face the restrictions like places like Pennsylvania and some other states do. I know in California too, you can buy it in the grocery store, which I'm really jealous about.

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No questions asked. They have a very low return rate and high reorder rate. DrinkElement.com. Again, Element is spelled LMNT. Let's talk about ritual. Seems like everything is connected to your gut microbiome. Well, the fact is we are learning so much about how the gut microbiome is key to our mental health,

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Plus, I just feel so great. That's just my own personal opinion. And another thing I love so much is that it's delivered right to my door. Me and a lot of people are probably doing that. I know I say that all the time, but for me to just be able to have one less thing to worry about is the best. Rituals' Synbiotic Plus is designed with a delayed release capsule to help reach the colon, not the stomach, obviously an ideal place for probiotics to survive and grow. One daily pop of mint scented for bloat, gut, and regularity support. Vegan-friendly

and formulated without GMOs, major allergens, animal products, shady fillers, or artificial colors which you guys know I love. So get your gut going. Support a balanced gut microbiome with Ritual's Symbiotic Plus. Get 25% off your first month at ritual.com slash be honest. That's ritual.com slash be honest for 25% off your first month. Okay what else when clients come to you or patients I guess I should say, what labs do you run on everybody no matter what? Yeah, so that's a great question. And by the way, this is evolving for me, right?

Like I think the more I learn and the more I see and practice and learn kind of what my clients are looking for and what's really working for them, I've changed my approach. But largely speaking, I'm gonna get a CBC and a CMP, which is basic lab stuff where we're looking at hemoglobin, cellular blood counts, just basic stuff. And then a CMP is more kidney function,

liver function, electrolytes. Is this all blood tests? These are all blood tests, just basic stuff. And then a CMP is more kidney function, liver function, electrolytes. Is this all blood tests? These are all blood tests, that's correct, yeah. And we do use urine hormone testing, like a Dutch test, for example, but I tend to be strategic about doing that, not just, it's not my go-to reflex sort of test. Okay, why not?

I use it in situations where traditional hormone therapy hasn't worked. So let's just say I had a 48 year old female who we tried what we would believe to be a typical approach to help her during that transition. And we got a confusing picture. The results were mixed. We weren't seeing her symptoms resolve. Maybe maybe we noted some other things popped up like anxiety, for example, and you start

to think, okay, what would be going on underneath all of this that a urine test, which can give you some metabolites and some breakdown things that a typical serum panel won't be able to give you. And so you start to think, well, if that would that information be helpful, and would it change our approach? And sometimes it is sometimes it's not. But that's when I tend to go to a more of a urine panel where I'm trying to compare it to serum testing. that's when I tend to go to a more of a urine panel where I'm trying to compare it to serum testing and also when things haven't quite gone the way that we thought they would. Okay.

Interesting. But going, you know, typical blood tests are vitamin D, hemoglobin A1C, a basic lipid panel, free T3 and TSH. And I know people get a full thyroid panel and all this stuff and reverse T3. And we do those things, but I'm more selective about when I do them. I'm just not my reflex. In females, we do FSH and LH levels progesterone, estradiol, free and total testosterone with sex hormone binding globulin and a vitamin D level. And that's kind of our basic starting lipid panel.

For guys, it's very similar, but it includes a PSA because of the prostate. And then we don't get an FSH level. We just get LH or I'm sorry, we don't get LH. We get FSH. And then from there you write up a whole protocol for that's right. We meet back and let's kind of see what this beginning step tells us, right? With us is sort of just initially open the hood up and take a look underneath. And with that we can start to put together what is our clients experience our client experiencing. And then what do these tests tell us? What do we know based off of where this data can send us?

Do we need more data? Are we pretty conclusive about what we're dealing with and what can we move forward with and if that's more testing or treatment or a combination of the two? What if you can't do some of these tests? Are there certain supplements that you give everybody? Like are most people deficient in vitamin D or magnesium? Like what are the universal supplements that everyone could take? That's a great question. And you know, so many times people ask me, you know, do I need

to, for example, MTHFR has gotten a lot of buzz recently, right? In the methylation cascade. And for good purposes, data says up to 70 percent of us or so can have a Breakdown in that gene family, which means explain what that is because I I know I feel like in the health world It's taking off but mainstream. I don't think you don't think people got it. Okay. Well, that's that's good I mean because this is a great opportunity for a lot of people to I think take a small Intervention that they can make that will make a big outcome in their health So mthfr stands for the long word methyl tetrahydrofolene reductase. But it's an enzyme that really participates in the breakdown and labeling of toxins in our body

that then allows our body to process those toxins and move them through a pathway of excretion. And there's several steps to this, but the gene family, that MTHFR gene family, which has, I think about two dozen different genes in it. And the ones that we commonly check are what's called a C677T mutation and an A1298 mutation. Those are the two most common mutations that we can attribute clinical outcomes to or clinical disease states to. And the C six, seven, seven T mutation is probably, it's definitely most impactful specifically from the element of detox. So it's believed that if you have a single gene mutation in that pair, then your detox capacity is impaired by about 30 to 40%.

If you have both genes are bad, then you're probably reduced up to about 70%. And that can be catastrophic. I mean, we're talking about alcohol, you're talking about caffeine, drugs, sedatives that we get people in the operating room, you know, for a long time, I didn't, I didn't know this, right? Like I would have people that I was getting ready to do surgery on. They say, you know, doc, I'm really sensitive to anesthesia. And in the medical world, you're like, oh boy, this is one of those problem patients, right? Like everything's a problem. Like, you know, I'm always nauseated or whatever.

You know what I mean? And so, and we falsely, I falsely attributed what they were truthfully telling me to something that was not based in real science. And it is. Oh my gosh. And now what, you know, 15 years later, I see the pattern. I'm like, okay, these people are also sensitive caffeine. They're sensitive to alcohol. They're sensitive to every like hormone replacement therapy. As a general rule, it's going to be a lower dose. I mean,

it spans across a spectrum, right? And so, yeah, anyway, that's kind of the MTHFR would be take a methylation supplement, right? I think that's a great one because most, a lot of people have breakdowns in that cascade. So taking something with methylfolate or methyl B12 would be advisable. I think vitamin D is huge, especially for the females who are listening to us. There are studies out there that show that vitamin D, and I like to keep that in the upper 20% of that range, which is typically around 80 to 100, that that level of vitamin D can reduce a woman's risk of breast cancer by more than 80%. I remember you telling me that when I first saw you. Huge, right?

I don't know of a single other therapy in the world that can reduce a woman's risk of breast cancer by that much. I mean, even if it was half of that, it's still a huge number. And just by taking vitamin D. So I try to push vitamin D levels up a little bit and I'm not like some of the other docs out there. If it's 120, I'm pretty cool with that. I don't really get so worried if I'm above 100, even 130 on the vitamin D levels

because I've never just seen toxicity. And then I think the third thing would be is what you kind of hit on, which was especially as we get older sleep just becomes not only harder to get, it becomes more important to prioritize. And so getting something like magnesium or taking some sort of sleep cocktail before bed, strategic sleep planning becomes necessary as we age. Oh, okay. And yeah, magnesium is good for sleep.

Absolutely. But there's so many different kinds of magnesium, right? That's right. The magnesium chelates are the ones that are typically so they are the ones that end in say like mag glycinate or magnesium threonate. Those tend to be very good systemic absorption of magnesium glycinate and threonate are probably the best for sleep. Okay, if you're dealing with some bowel issues and you want to promote like relief of constipation, mag citrate and mag oxide tend to

work the best. Okay, great. That's I love that information. Okay, let's talk about kids. We're both parents. Should we be looking at kids' health the same way that we look at ours? And what I mean by that is, I'll just give you an example. Obviously when my kids were little, I could control everything that was going in their bodies. And now that they're in middle school and they're off in the real world, I can only control what I can control. And they eat like shit a lot of the time. And so I guess my question is if they're eating like shit 30% of the time, is that okay? Because, you know, I think about like when I was a kid and I did eat like crap a lot of the time. Food is different

today. So I guess how bad is it if they're eating crap 30% of the time? I think a lot of times it depends on the kid and because I do believe that genetics and environment can make a difference, right? There's always an argument of nature over nurture and which one kind of plays the biggest role. But if you're feeding your child healthy foods 70% of the time and they are in your watch getting the right amounts of protein, some healthy fats, and overall not consuming too many calories, especially from sugar, then that 30 to 40% disruption is probably not going to be so significant for most children that are active and otherwise healthy.

But if you took a child who had asthma, for example, and maybe struggling with maybe obesity because they're not as active, and then they had that 30 to 40%, that could be catastrophic for that kid. But thankfully, I think there's a greater awareness. And as you said, like we ate bad, it was the rise of fast food.

And you've probably done the same thing. I take my kids to the grocery store, I'm like, I don't remember, there was not half of this stuff wasn't even around when I was a kid We didn't have that and and I'm glad we didn't because I probably would have been a different kid But but the point is is that we ate bad we did those things and and as you said though It's not the same stuff just like the flu vaccine now ain't the flu vaccine from the 80s and neither is The MMR vaccine like it's just those things we can't

assume that just because our parents ate that way that we should do the same thing even though it looks on the surface to be the same. It's a lot of times it's not. Right. Even GMOs. When were GMOs introduced into the food system? As we started doing Roundup Ready soybeans, I think. Yeah. Right. We started kind of getting things that could tolerate roundup spraying and that led to the whole, you know, breeding and cross breeding of fruits and foods and stuff. Yeah. What about supplements for kids? Are there supplements? Same thing that you would just recommend for every kid? There are. Yes. I think I'm still a big proponent of vitamin D because I think that, you know, they're the most susceptible to the viral illnesses that are out there in school. And older research indicates that having your

vitamin D level up not only helps prevent cancer like breast cancer, but it also helps prevent some of these seasonal flus and things that we get colds and stuff. So it will help keep them from getting sick. I think that if they are starting to exercise, like little boys and little girls getting like 13, 14 years old, giving them a couple grams of creatine is probably not a bad idea.

I think that's probably a good thing for creatine is probably not a bad idea. Oh, cool. Okay. I think that's probably a good thing for the little ones as their brains are developing. If you are talking about smaller children, like maybe around the two-year-old age group, using a good fatty acid profile. Now, whether or not that's some moms now are more advanced, right? They're giving their children eggs and kind of cooking with beef tallow and doing some really unique things. So I believe that that's a great approach to get those healthy fats and high protein, good quality proteins in the younger kids.

But they need those fats for brain development, right? Our brain and nervous system is largely made up of fat. And so having a good amount of healthy fats is important for the kids. And so if that means you need to supplement with like an EPA, DHA, fish oil formula, fine, but I would try to get good meats, good fats, good butter, olive oil, you know, use those types of opportunities

to get those extra good calories in, especially when it can come from healthy fat. So butter does count as a good fat? I do, especially if it's grass-fed butter, yeah. I would definitely say that. It kind of goes back to the whole, the milk, the raw milk thing, right? Sort of the same type of fat and protein that is all found.

Oh, okay, so the raw milk is considered a good fat. Well, that's right. That's the cream and stuff that's in there, right? It's gonna have that same fatty acid profile that would be found. It's just the butter's just devoid of the milk solids. That's the only difference. Right, we power through butter in my house.

It's insane how much butter we go through. That's right. So you said a minute ago, as we age, sleep becomes really the most important thing. What about for kids though? How important is sleep for kids? Well, probably more important than it is for us because they require more of it. And so it's just that as we get older as adults, we don't require as much sleep, but it's harder to come by, you know, because we're just pulled in more directions. And the little ones, you know, thank God, largely, if you just get out of the room and close the door, you know, until they're 12 years old and then they get a phone last night at 11. I said, go to bed. Yeah. A parent's worst nightmare, right? The screen. And, and so, yeah, I've also

got a couple of articles that I can leave with you about how screen time does affect things like insomnia and depression rates in kids and so I have started to and you know and look I'm not some Gestapo parent that's like every night marching up there to seize my children's phones but I have tried to because they're getting big now my boys are 14 and 16 right and it's time for me to encourage them to make the right choice and show them what that right choice looks like. So what I've tried to do is like after eight o'clock, we need to be limiting screen time. Like phones need to be put down, ringers and notifications are turned off and it's time to start winding down and get your body ready for bed. And so yes, those hours before bed, whatever hour

one or one or two hours before bed become critical in getting good sleep. That sleep hygiene is really important. So, you know, I used to read to them. They don't really want that anymore, of course. So that's not, that's out, but, but still a similar thing of even, I feel like even turning the, getting the phone away and just going to the TV is probably better because at least it's a few feet away, right? You know, and I can kind of like, TV is probably better. Because at least it's a few feet away, right? You know, and I can kind of like, the distance makes me feel better. Same. Same with me. I am kind of a freak about this, but like I have all these little red lights that I put in everyone's bedrooms. I turn those on at night. Camden actually

showed me you can make your whole phone screen red by it's a program you have to do. I actually talked about on my podcast like a week ago, but you can just click your little button three times and it turns it red. So, because that helps with the natural melatonin, right? That's right. That's right. You get rid of the blue light, you'll stimulate your normal melatonin. There's a couple other ways to do that, right? Like getting out in the morning, first thing in the morning, early morning, sunlight, grounding, getting that sort of first sunlight of the morning, because it sort of sets you up for like a melatonin release 16 or so hours later. So you're priming your clock to think, okay, it's morning time.

And that means in about 16 hours from now, I got to start to wind down, right? That'd be our natural sort of rhythm. So getting that early morning sunlight is important, right? I didn't realize that's what it was doing. Yeah, it's kind of program. Yeah, it's like, hey, it's time to get up and then it's going to be time to turn down later on.

That's very cool. I love that. Okay, great. Yeah, sleep is very important. Let's talk about young moms. And you know, if you are a young mom, I've been a young mom, it's very busy. You know, there is no time for anything, but you're little kids, but a young mom's health is still very important. What are ways that young moms can be prioritizing their health? It becomes more of a, I think you bringing awareness to it and having other moms be aware of

it is the biggest factor because when you, whether you're 48 or 28 and you're dealing with a 16 year old or a 16 day old, the time demands and the way that you're going to sort of like sacrifice your own health for your children is maybe a little bit different, but overall still the same thing. So I tell women sometimes I'm like, look, if you're at home all day and you don't feel like you're gonna get outside and go do an hour workout, every time you walk in the laundry room,

do 10 air squats. So find something that you do routinely that you can almost mindlessly work in some kind of workout. So what if we said every time you walk by this table, you're gonna do 10 mountain climbers on this table. Just lean over, pull your knees up 10 times. And what research is showing, and recently is like just a couple of weeks ago,

there was a study that came out of Japan where they would do like three minutes of fast walking, three minutes of slow walking. And I think they did that pattern like six times or five times, and it was almost as much cardiac benefit as running for like 30 minutes. So what we are seeing is that short bursts of moderate exercise are really good at stabilizing blood sugar, which, and probably I would say going to go for maintaining muscle mass too, right?

And then not pushing you into a cortisol response. So, so many young women like to do high intensity cardiac activity, right? Because they equate input, like I'm gonna work my butt off, which means I'm gonna burn a bunch of calories and I'm gonna be skinny. And that is, as you get older, that equation starts to not work anymore. And that can even change rapidly after childbirth.

So, intensity of exercise doesn't necessarily guarantee results, consistency will. Okay. So even doing small amounts consistently will pay dividends. And the thing, I think the biggest mistake that Kelly and I made when it comes to exercise is believing that, and there's a couple of ways we can say this, believing that it had to be perfect,

or believing that taking our kids with us was dangerous, or taking our kids with us was boring to them, or it was going to, you know, not stimulate them. And it's the exact opposite. Them watching us do that and us bringing them that environment would have been more powerful than what we, you know, than what we attributed to it. So I think I would have brought them with me, even if it was a walk, walk up the hill, you know, do air squats, roll a yoga mat out there on the thing, on the porch and just do some basic ground work,

but leave them there with you on the ground. Get them involved, that's the main thing. I agree. I've always, for the most part, worked out at home. And when my kids were little, yeah, I mean, they would be with me, you know, goofing off, putting ankle weights on and like doing silly stuff. And now they're actually, well,

Sailor's a little young, but the boys are into working out. And especially once they start playing sports and stuff, Kevin's like, I want to hit the weights. I'm like, this is great. I love it. That's right. That's right. And so you will set the tone for your children to determine where their health and fitness level is going to be. Exactly. If we had to prioritize three things for young moms to do, what would you say are the most important things? Eat plenty of protein. Supplement with creatine. I would put those in the same category. Do some type of movement exercise daily and sleep as much as you can.

Sleep as much as you can. Yeah. Sleep with your babies. Yeah. You know, when they take a nap, you take a nap. That would be it. Yeah. Eat good, take some creatine, move daily and sleep as much as you can. Okay. And so remind us again, creatine, I think I've been saying it wrong. Creatine, creatine. Okay.

Say whatever. I started taking it maybe six months ago. I've noticed a huge difference. It's amazing. And I think the benefits, long-term we're going to see that the benefits for women are greater than for men. Right? Really?

How so? Well, I think cognition really. Oh, wow. So there's, I don't, I'm not going to have the resource here, but a couple of weeks ago, there was an article that I read and it was not really like a scientific articles, more of an assessment of the literature, if you will. They were just talking about how the literature seems to point to the fact that females age in terms of their cellular aging, they lose creatinine levels faster. So would there then be a bigger role for supplementation in females when it comes to,

you know, helping cellular anti-aging and creatine? And the outcomes seem to point to that, that there's something about creatine in women, like even now, a lot of people are recommending 10 grams rather than five grams, which seems like a whopping dose. But I don't really know that there's a top level of absorption or benefit. And at the end of the day,

if it just turns into urine, what you don't need, what would be the harm? Oh, well I'm gonna up my creatine. I think it does. And I don't know that I would up it in one dose. I would probably split dose it, right? I do five grams in two different doses. But I think that we're gonna see some emerging literature

that's gonna be highly supportive of specifically females using creatin, maybe even in higher doses as they age. Cool. I'm excited. Good stuff. A brand that I absolutely love and always get excited to talk to you guys about is Primal Kitchen. Let's talk about real food for a hot minute. We all know we should be eating more real whole foods, but guys, who has time to make homemade sauces and dressings from scratch all the time? I wish, but it's just not realistic for my life.

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And there are just things that come with aging, you know? Sometimes poor sleep, lack of energy, stiff joints, you know what I'm saying? It is important for me to stay youthful. You know, I wanna feel and obviously look good as much as possible. And let's talk about how much time, money, and energy that we spend on health and wellness products and supplements to look and feel younger.

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Start paying rent through BILT and take advantage of your neighborhood benefits by going to joinbilt.com slash honest. That's J-O-I-N-B-I-L-T dot com slash honest. Make sure to use my URL so they know that I sent you again. That is joinbilt.com slash honest to sign up for Built Today. Okay, well, speaking of aging, let's talk about aging. Because as you get older, you know, I'm 38 now, it's always at the forefront of my mind. It's the topic of conversation with all my friends.

It just sort of is what it is. And not just for appearance, but also just how we feel as well. So I want to talk about some preventable challenges that we face with aging. Yeah. I would say the first one is going to be that most women, it really gets her attention is when perimenopause shows up. Right? So kind of mid thirties, maybe even late thirties, early forties, depending on some factors, maybe even late thirties, early forties, depending on some factors, you know, like there's, I've noticed in some women that if they have a child late, let's say at 38 or 39, they'll tend to kind of start to have some pretty significant hormone shifts after that. Not, not every time, but that if I have

a 38 year old woman who has a baby and she comes in six months later and she knows her body's off, it's not surprising that they felt great before the delivery. And then afterwards things really change. Right? So, so, but, but this, this perimenopause part shows up and you know, up to 90% of women and another study that we have that I'll leave with you is that the 90% of women have symptoms of perimenopause. And the fact is, is that we as doctors are not trained to identify the symptoms, to sort of put. And the fact is, is that we as doctors are not trained to identify the symptoms to sort of put together what the client is telling us and what the labs look like, and then make a plan to help that person. Because there's really not a, there's not a treatment

plan, if you will, for perimenopause, right? And so it disturbs the mood, it causes anxiety, weight gain, sleep disturbances, and all of those things start to show up. And if you go to your regular doctor, unfortunately, we're just not equipped to kind of help you. And so you end up getting a label, maybe it's an antidepressant type drug. Yeah. How many women do you know at like 38 years old end up on an antidepressant? And when you see them when they're 58, they're still on the antidepressant, you know?

I actually, I can think of a few friends in my life right now that just told me they're on anxiety medication. And now I'm like, wait, maybe it's- This is a lot of it, right? This is so much. And in real life, this is how it plays out, right? The husband and the wife come in, the wife sits here, the husband sits here and she, he looks at me and goes, yeah, I can't. And she goes, oh my gosh, I'm so sorry. I don't know why I'm yelling at everybody. I feel so bad. I don't know what's wrong with me. Like this is not normal. I don't want to feel like this Yeah, he's going doc you got to help us and that's so common. That's so common to see that probably like literally twice a month

That's what's gonna play out in my office. And so that is the first time where women are really like smacked with it It's also about that same time that their husbands start to lose testosterone, right? Like I was telling you I was, my body started to get off. Initially I approached that with diet, but by five years into that, I was already thinking and seeking out testosterone replacement. So I was 39 when I got on TRT. And so, so men and women's bodies both start to pivot at this point. And of course now to get this picture, you got a husband and wife who are both 40 years old. They got, let's say four, three kids in the house, two, six and eight. Right now they're both having problems.

So now they start, you see what I mean? This just starts to go south fast. Right? So anyway, that, that, but perimenopause is what really starts to get young moms. And that perimenopause can be accelerated in certain circumstances, particularly if there's a late last pregnancy. And, and usually what will happen is it will be mood disturbances, weight gain, low libido, poor sleep, feeling sad, feeling blue, especially in the week or so leading up to your period.

Like that's a pretty clear, like I feel off in that 10 days or so before my cycle. That's a pretty clear indicator that things are starting to change. And consistently like for a few months, right? Cause I mean, I feel like, I mean, I'm sitting here thinking like, I've had moments like that, but it's not consistent. Yeah, that's right. It usually you're going to see a consistent pattern. You're going to notice that, okay, this was the week before my site.

And it's usually, honestly, you're not going to be surprised by this, but the husband will tell the wife. Like he'll be like, I don't know. You seem a little bit irritated. Like I don't know why. Like I did something last week and you didn't yell at me. And this week I did the same thing. And you're like, you know, really dropped the hammer on me.

And so it does. There are your loved ones will typically pick up on that or the people in your house. You know, I know, I know when it happened to us, here's the thing. I wasn't even as smart to know what was going on then. You know what I mean? So Kelly had Parker at 38. Oh. And boom, like the hammer dropped. Interesting.

And I felt powerless, Kristen. I mean, it was so, yeah, to watch her be like this and be like this with us. Yeah. And then to know that there's not anything I can do about it. Like I'm not, I don't know what to do, you know, because I hadn't figured it out then. So are there things that you can do to minimize the symptoms? Absolutely. Absolutely. Yeah. You know, the most common female pattern is estrogen dominant progesterone deficient, right? So, and when that refers to a relative imbalance

of how those two hormones should work together. And estrogen is kind of like your fun, let's go out adventurous hormone and progesterone is like your let's stay home clean house and prioritize things for hormone, right? They're sort of like, you know, good devil, bad devil in a way, right? But you got to have a balance of those two things when that shift in perimenopause starts to occur. And I guess I would like to, my ask of all your female listeners would be, don't think about these as singular events. Think about this as if you're going across the Appalachian Trail and these are just mile markers along your journey.

It's not like the journey just you open one door and, you know, and close another kind of thing. It's, it's a chapter that sort of just never really has a beginning and an end. Right? So it's all of these are steps along a woman's journey and they're gonna come at different points for different people. And it's just that perimenopause is the beginning

of your body winding down from being reproductive. So we may, if you have a woman who says, well, I had to have progesterone so I could carry my last child, then I would have you consider that they had already started getting into perimenopause, right? Like their progesterone levels were low, so low that they couldn't, their body would not develop a placenta.

And so if we didn't give them progesterone, that process would have never occurred. So what we're seeing really is this shift between being reproductive to now not being reproductive. And we're not, and that takes like 15 years, right? The average age of menopause in the U.S. is 51. So if a woman starts perimenopause at 35, and they don't go through formal menopause till 50,

that's a 15 year journey. I had no idea that it could last that long. And you know, we don't tell our clients, as doctors, it's not like we sit down and draw this out and say, okay, here's what's gonna happen, sweetie. You know, this is what this is gonna look like. We don't do that. Oh my gosh.

So why do some women go through menopause really early and some really late? I think genetics has a lot to do with it. Like you're most likely gonna go through menopause closer or near when your mom went through, right? So if you kind of know what your mom did, then, and I can tell you that this is very close. Like I see some young women who go into menopause in their early forties, because their mom did, then, and I can tell you that this is very close. Like I see some young women

who go into menopause in their early forties because their mom was, you know, through menopause and done by 45. So I saw it last week. I saw a 29 year old girl, 28, 29, who's already in menopause. Right. So she had trouble conceiving her second child who's now six months old. So she had to be on progesterone before that. So this is exactly the pattern I'm telling you, right? So now you've got a young girl who was on progesterone. She was probably already starting to wind down her reproductive clock anyway. She got on progesterone was able to conceive and carry a second pregnancy to term. But after that, she's got no hormones, nothing like she hasn't got her period back.

She hasn't done anything. So, and she had classic symptoms of menopause, hot flashes, dryness, all the stuff that we would think of. Right. And then of course we replaced those hormones and her symptoms improved. So, and that's a 29 year old young woman, right? Yeah. That's, I've never heard of anyone that young going through menopause. Does menopause accelerate the aging process? By far. Yeah. And there'll be another citation that I'll leave with you about this. You've got about five years, right?

The data shows that once menopause starts, and menopause, as I'm going to define it, would be when the estrogen starts to leave the body. Perimenopause hormonally is characterized by a deficiency or a loss of progesterone and typically testosterone. So that's why we see menstrual cycles change. They typically get heavier. They may become a little erratic. Like my cycle was always 28 days. Now it's 21 and then it was 32 and then it was 26.

And am I going through perimenopause? It starts to sound familiar, right? Like, yeah, right. Why was this? Why was it not on time? Like it always is. So we start to see these patterns and then, and then it all adds up when you start to look at it. Right. So, so anyway, perimenopause is progesterone and testosterone. And then once we get to estrogen starting to

leave the body, that's when we know like menopause is infinitely close, right? Like it's really starting to be upon us. And so within that last loss of estrogen, you've got about five years to replace the hormones to counteract and really, I guess, mitigate any long-term damage. A lot of women lose a substantial amount of muscle mass in the first five years after menopause. And the data shows that if you act soon enough, hormone replacement therapy, exercise creatin being the big cornerstones of that and high protein diet. So it's not complicated, right?

But if you act, you can stop that loss of muscle mass. So HRT and those four little things that I just mentioned, you know, eating protein, taking creatin, exercising, eating high protein diet, and those things will stop that process from happening. So it's not as complicated or as farfetched as people would have thought in the past. Yeah. What I know that you are a fan of NAD and NAD is great for anti-aging. Is that something that you can do as well?

It is. But, you know, and I would, I would say that that's not even, you know, how do you put it? Time has nothing to do with, yeah, we could all benefit from it. Yeah. Right. Like whether you're not going to change when, yeah. We could all benefit from it. Yeah. Right. Like whether you're not going to change when you go through menopause. That's exactly right.

Yeah. So I got to, and depending on the day, it may not even make you feel better. You know what I mean? Like, so how, depending on what's going on, but, but yeah, NAD, I'm a real big proponent of NAD and a great anti-aging measure, probably not necessarily going to affect the timing of your menopause. Okay. I really do feel like maybe I am going through hairyimenopause and I never, it was not even

on my radar really until we just had this conversation. The signs are subtle and they don't always cause problems, right? So and the healthier an individual is, the less likely they are to get that disturbance, right? Wow. Okay. This is blowing my mind, but I'm glad we had this conversation. Okay.

And then I have a really silly question for you. You know, eye twitching when your eye twitches. Okay. So mine has been twitching for months and I thought it was stress for my podcast tour, but that's been over for a month and a half now and it's still twitching. Not as much, but it's still twitching. So can you just answer once and for all, what causes eye twitching? Do I need to eat a banana? Like what? I would say that this is a, um, and by the way, I don't have a lot of qualifications in studying eye twitching. Okay, so let me qualify my statements

from like my perspective. But I think of eye twitching probably like I would like a diaphragm or a hiccup. It's a nervous system kind of glitch. And our nervous system can glitch for a lot of reasons. It can be from stress, it could be from lack of sleep, could be from an electrolyte disturbance, perimenopause.

Oh my God. Yeah. Like think about it. Like why else would a woman feel anxious? That's a central nervous system thing. I'm going through perimenopause. You may be, you know, I'll let you take the inventory once we're done today and you can go in and like right on the whiteboard and start checking off some boxes and say, well, here's where I am, doc.

But yeah, I would say that eye twitching is like a little nervous system malfunction. Is it usually from an underlying electrolyte imbalance? Probably not. You know, it's probably not a deficiency of sodium, potassium or magnesium or something like that. It's probably more, and I agree with what your initial assessment was, is this is probably my nervous system, like a little bit on overdrive, you know? And then, and then there's the sort of things that, you know, we've always watched like our dogs and stuff when they lay down and they get calm and they twitch a little bit. Well, what if it's the same thing as that? What if it's not necessarily a sympathetic response, one of stress, but what if it was a

relaxation? What if it was your body saying like, because if you noticed it at night, like what if you guys were hanging out here on the couch and you're kind of like relaxing lights are down, you know, you got your little red lights on, everybody's sort of chilled out and your eyes start twitching. Well, maybe that's Kristen's body winding down, right? So, I believe it could probably go both ways. It could be a system on overdrive or a system coming down off of overdrive. Interesting. Okay. Now I'm going to have to really start paying even closer. Just see what you find out. Yeah. And see if taking magnesium makes a difference, right? Because that's a central nervous system relaxant. Got it. Okay. I'm convinced I'm going through perimonopause.

Yeah, that's going to be the topic for the next few days. It is what it is. Okay. Well, this has been amazing. Is there any other advice that you would want to give my listeners, primarily women, obviously? Yeah, I do. I think there's so much of what we have been taught about aging, specifically around don't eat a lot of protein, don't weight train, don't take hormones. I think that those three pieces, if you can as a female, as you age, start to think about how can I work on exercise to maintain my muscle mass because just as dollars in your retirement account fund your retirement, muscle mass on your bones funds your aging. It is key to maintaining your blood sugar, to preventing Alzheimer's, to preventing a fall.

So you've got to maintain your muscle mass and the earlier you start, the better. So resistance training, creatine, and protein become very, very big. And then that's one big thing. I would always prioritize sleep. Sleep, even if you don't think you need it, sleep more, manage stress.

And then the last thing would be get your hormones checked. Find someone, and when you start thinking like, gosh, this is not me, right? Like I'm not the guy, or the girl rather, who yells at her husband just because he left his plate right there. You know what I mean?

And when you start noticing those things, you say, well, that's not me. I think something's going on. You're probably right. Trust your gut. And if the labs are normal, that's an even more sign that you're probably onto something. Right. And then you don't need to believe the, the practitioner who just says, Hey, Kristin, your labs are normal. I think, you know, there's nothing going on here. I think I would always ask a deeper question. So yeah, get your hormones checked. There's a lot of data out there.

There was a big paper that came out in the journal of menopause last year on May 1st, 2024, that showed tremendous benefits in women past the age of 65 taking hormone replacement therapy. So, so basically what we can see is that, you know, between like 35 and 75 or 85, there are tremendous benefits for pretty much every woman in taking hormone replacement therapy. So those would be my three recommendations. Great. Those are great.

I love that. Thank you so much for being here. Thank you. It was great to be here. And then tell everyone where they can find you. Yeah. So we have our website is compasshp.com, Compass Human Performance. And then I'm on Facebook, TikTok, Instagram,

YouTube at Dr. Lee Howard. Amazing. And if you guys are in Tennessee, you can go see him. Thank you so much. Thank you for having us. Great to be here again. Yeah. Yes.

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