Mind Pump: Raw Fitness Truth - 2502: Hormone Therapy for Aesthetics With Dr. Lauren Fitzgerald

Episode Date: January 2, 2025

If you want to pump your body and expand your mind, there's only one place to go. Mind pump with your hosts, Sal DeStefano, Adam Schaefer, and Justin Andrews. You just found the most downloaded fitness, health, and entertainment podcast. This is Mind Pump. Today's episode, we talk about women's hormone health and hormone replacement therapy for aesthetics. What kind of hormone replacement therapy will make you look better? burn body fat build muscle improve sexual and cognitive performance

We have one of the world's best on today's podcast. Dr. Lauren Fitzgerald. We love her. She's blunt. She's honest She's been doing this for a long time. She's a real doctor You're gonna love this episode and this episode is brought to you by one of our sponsors, Element. This is an electrolyte powder you add to your water, no artificial sweeteners, no sugar, but it has the right amount of sodium to fuel you through your workouts and give you good performance. And if you go through our link, drinkelementt.com forward slash mind pump, you'll get a free sample pack with any drink mix purchase.

Also the January special is here. We have four workout program bundles. The new to weight lifting bundle, the body transformation bundle, the new year extreme intensity bundle, and the body transformation bundle 2.0. Every single one of those workout program bundles is $300 off retail.

It's massive sale. If you're interested, go to mapsjanuary.com. All right, here comes the show. Dr. Lauren, welcome to the show. Thank you. It's great having you on. You've said a couple times, we all work together in a forum with a group of people that we're using GLP-1.

We've talked to you a few times, aside from that, and you've said, there's a statement that you've made, and I've heard you say it several times. I'd like to start with that, which is that, why wouldn't you go on hormone therapy once you're past a certain age? It's like everyone should, except for maybe a very small percentage of people,

let's start there, why do you believe that? What does it provide, are there risks? What's the deal with that? So I think, when I opened my functional medicine practice in 2020, I had really highly motivated patients. I don't take health insurance, so they're motivated because they're paying cash, right? And I had so many patients that despite doing all of the right things, we're still struggling

with stuff like weight and energy and sleep and all of the things. And I got to a place where I was like, I think you need hormones. And now after the last year of doing all my BHRT training, I realized this is the missing link for most people. And I think it's because if we were living 100 years ago in 1924, I don't think we would have the same issue. But our bodies are hit by so many different endocrine disrupting agents like our food, the stuff that we put on our skin, what we wash our hair with, the stuff we cook with,

the clothing that we even put on our body. Our body is not supposed to get so many toxic agents and I think that this is why the hormone deficiency is really the key missing element for a lot of people. Well, so what do you notice, what are you looking at when you're taking someone's labs? Because I know just from working with people like you that someone will get their GP, will do their labs,

and be like, well, you're within normal range. Is that just not a range you should look at? Let's talk about that. So normal does not meet octal. Literally, the normal ranges are based on a small group of people that the average. So do any of y'all wanna be average? No.

No, especially not the American average, right? I mean, we're all in our 40s, right? The average American 40 year old is either overweight, obese, has at least diabetes, probably some hypertension, maybe some auto-immunity, already is on two or three different prescription drugs, and it's only going to get worse, right? So I have no desire to be normal.

I want to be optimal. And oftentimes, optimal ranges are too high on lab values. And what do you see when you start to change those? And again, you're working with a group of people who you're getting them to exercise and eat right. It's not like you're just doing that. Absolutely. But when you add the,

when you start to work with the hormones, what are the things that you start to notice? And are most of these people in that age group of like 40 plus? So I think that, I have patients patients in their twenties because they've got hormone deficiencies like for sure, like PCOS females, they need thyroid and progesterone. And so getting that diagnosed early can help them avoid a lot of the infertility, a lot of the weight, a lot of the, you know, stereotypical, um,

phenotypes that you see with PCOS patients, right? But the average patient that's finally is like, hey, I think I need some help with my hormones typically is someone in their 40s and beyond. But now knowing what I know, I really think there's like maybe 1% of people that shouldn't be on BHRT. And when I referred to BHRT, I want to make sure the audience knows I'm talking about bioidentical hormone replacement therapy because... What's the difference? Well, so HRT is the generic umbrella term.

So back in the day before the WHI, the Women's Health Initiative that kind of screwed everything over about 20 years ago, most women that were on HRT were on primorin, which is a synthetic sex hormone from pregnant horse urine. So hence the word prim or in pregnant horse urine, right? And so most of the estrogens that are in that particular hormone don't match the the sex hormones that our body makes. So bio identical just means chemically structured the exact same way of what our sex hormones are made. So I do not do anything that's synthetic that doesn't match what the body makes versus the estrogens in primarin, or that's just one of the examples,

doesn't match what the body makes. And those are the ones that are linked to all the different risks that come along with when you hear the bad stuff. Is that just because they flip the molecule? Like, oh, it's the same breakdown, but the carbons on this side versus this side or whatever? Absolutely, absolutely.

It literally comes down to the chemical structure. Wow, and so it does attach to the estrogen receptor. Absolutely. But some of the other downstream effects aren't the same. For sure, for sure. So, I hate it because when you hear someone say, bioidentical hormone replacement therapy, they assume that it's linked to the risk

of increased clotting. Well, actually, those risks are only linked to non-bioidentical sex hormones, specifically like primaran. Interesting, I didn't know that. Yeah, a lot of doctors actually don't. I mean, I've been an MD since 2005, and it wasn't until the recent past

that I really understood the difference between bioidentical versus non-bioidentical. And I've heard a lot of people, medical doctors, say, oh, that's just a scam word, that's just a way for people to make money. No, it's legit. Like, estradiol is a sex hormone that our ovaries make, and you guys make too, actually. This is, that's another thing. We've got to get away from estradiol as female and

testosterone as male. Like, we all make both. It's just, y'all make more testosterone than us, right? But both sex hormones are very important. But estradiol matches what our body makes, and the estrogens found in like, primarin do not. And those are the ones that are linked to all the bad stuff. Yeah, yeah. And by the way, low testosterone symptoms or low estrogen symptoms, the symptoms are the same in men and women. We just have different references, right? Exactly.

Different amounts. There was a drug that was, it was a long time ago that they were given to pregnant women, and I think it was for nausea, and it was a mirror image of the actual chemical that they were supposed to use. So it was the same chemical, but it was flipped. And it was a mirror image of the actual chemical that they were supposed to use. So it was the same chemical, but it was flipped. And it was teratogenic.

And it caused birth defects. Yes. So they're like, it's the same thing, but instead of it, it was just a mirror image of the chemical, and then children were born with like crab hands or lobster hands, or I think what they called it. So that's a real thing.

Wow. So with bioidentical, that's kind of what's happening. Exactly, it's just adding a little bit, basically changing the chemical structure. The thing is, big pharma cannot patent our hormones that our body naturally makes. So it's money, I mean at the end of the day. Do you understand how much money was made by Primarin?

Tons. Tons, because they can patent that, because it doesn't match what our body makes. I think 88% of the estrogens in primary urine were from the pregnant horse urine, so it didn't match what our body made. Oh, so let's go back again. So you've been an MD since 2000.

I know, I was just gonna say, I want you to, because I don't think that you got here the day you got out of school. No. So catch the audience up on your journey of becoming an MD, what you did right after. Catch us up here. Yeah, yeah.

So I knew I wanted to be a doctor. I actually graduated high school early. So I went to the University of Texas as a young, naive 17-year-old. And I knew that I had a long journey because I knew college was going to take four years and med school was going to take four and then residency would take four or five. So I decided in my third year of med school that I wanted to be an anesthesiologist. So it's a super competitive area to go into it because it makes a lot of money. So I got in, did my residency and I'm a full fledged anesthesiologist by 29. Right. And I was good at what I did. Like I, I, I still am connected with all the OR people that I used to work with. But I found myself, it was about 34 or 35. So I'd only been in anesthesiology for about a year. And I was like, Oh, I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I'm going to go to med school. I still am connected with all the OR people that I used to work with, but I found myself, it was about 34 or 35, so I'd only been an anesthesiologist for five or six years. And I found myself thinking like, okay, it was this one particular day actually that the surgeon that I was with was this old crotchety guy, the OR nurse was

an old crotchety guy. It just happened to be guys, but there's unhappy old women too in the OR for the record. But it happened like all four people that were in the OR that day were just like unhappy, miserable people. And I was like, is this really what I want to do the rest of my life? And that's when I kind of started thinking outside of the box, because the whole reason I went into medicine was because I've been into health and fitness like since early days. I started teaching aerobics at 16.

I was one of those group fitness people you'll talk about. But I also started lifting weights at 16 for the record. So I've always lifted, but I've also, you know, been into the health and fitness thing. And I just remember like my patients on my OR table thinking like, man, if I could have only gotten to them, you know, 10 years ago, maybe they wouldn't even need the surgery.

And that's the state of our world right now. It's so much is self-induced from lifestyle that is completely reversible. So you were in there and you were just like, I'm not happy, I got here, I'm doing this. By the way, anesthesiologist is very tough. I know I used to train as an anesthesiologist. You guys are very important.

If things go wrong there, it goes real wrong. So you're in there, you're making great money, you're doing great, you did it, and you're like, I'm unhappy. So what do you do, you leave? So I did, and y'all are 100% okay with making fun of me for this because I've heard what prompted you to start your business,

but I did Beachbody coaching. Uh-huh, I know. Wait, wait, wait, wait, you went from anesthesia to Beachbody coaching? I can't make that up. Well, Beachbody was crushing it back then. Multi-billion dollar company. You ain't making no half a million dollars. You're like, you're an anesthesia.

So I always knew that it wasn't going to be a forever thing, but I realized the opportunity. Because I had this YouTube channel, which you can't, if you go and look at Club Fit's fitness I've taken down all the dance fitness videos but it was pretty popular I have like 320,000 subscribers on my YouTube channel like legit like your girl can dance for sure get some b-roll it was so I started it in 2011 when I was living in Japan and I started teaching this dance fitness class just out of necessity because there was nothing there So I started it in 2011 when I was living in Japan and I started teaching this dance

fitness class just out of necessity because there was nothing there when I was living on this military base. I called it hip hop and I co-taught it with a girl. She would do Zumba, I would do hip hop. My class was so sad when we, you know, military, you only live in a place for three years. So I was about to move back and my class was really sad. So I was like, well, military people live all over the world and you can access YouTube all over.

So we just started recording and it went viral. I mean, I would upload a video and in the first 24 hours, a hundred thousand views. No way. Yes, yes. This is 2011? 2011. I was one of the OG YouTubers.

Those type of views back then is huge. Huge and I never paid a lick of advertising or whatever. It was just all organic. I didn't make a single dime though, because it was all music that was copyrighted. Ah. But I just did it because I knew that there were a lot of people that didn't feel comfortable going to a gym.

And if you can find something to just get you moving, and I mean, who doesn't like good music and dancing, right? I mean, I don't know if y'all like dancing, but I think that there's a dancer inside of it. Yeah, totally. We're dancing, sure. Yeah, yeah. Adam does too, but we don't let him,'all like dancing, but I think that there's a dancer inside of it. Yeah, totally. Yeah, yeah, yeah. Yeah, yeah, yeah.

Adam does too, but we don't let him. It's really bad. It's so bad. Probably smart. Probably I believe it's good. Yeah. So you're doing that, you're making these videos, and you're like, but y'all still have to make a living.

So what do you do? Absolutely. So I realized I've got this large YouTube following, and this opportunity with Beachbody that kind of aligns with like, you can't get healthy unless you change your diet you exercise and you know a community that supports and while I mean I've always been very transparent I don't like all of the Beachbody products or all of their programs, but it did offer something that was very Tangible and I'm not gonna lie. I made a lot of money from it

so I literally bought my current business, Larimar Med, and renovated it, $100,000 worth of renovations, all from money that I made from Beachbody. Wow. Legit. So I'm not throwing shade. It's not my favorite workout program, so there's a few that I like, but I'm a mind-pumped girl now.

So you're doing that, you're crushing, and then you decide to get back into medicine? Correct, correct. So there was this one day, it was January 2019. The reason I remember this is because it manifested basically a year later in January of 2020. So I'm at this place that I just left getting red light therapy and cryotherapy,

and I was like, man, if only there'd be a place that offered all of the things that I do, right? The biohacking kind of stuff, but also the aesthetics like Botox, because yes, I'm about to turn 45 and I've been doing Botox since my late 30s. But I had this vision like, why couldn't I just do that?

Like I'm an MD, I kept my medical license and then the whole idea of doing functional medicine, I don't have to go back and do a four year residency. Like I can go do a lot of training to basically be ready to offer functional medicine. So a year later, I can go do a lot of training to basically be ready to offer functional medicine. So a year later, I had an opportunity to buy an established business in this tiny community outside of Chicago called St. Charles, and it was just a day spa. All they did was like facials and massages, and they wanted to sell the business.

And so they already had, you know, basically patients, and I turned it into a med spa. And so now we offer, I mean, I do functional medicine. I have an Ivy lounge, you know, I moved from California where Ivy lounges are everywhere and it was nowhere where I was at. So I was like, okay, this is an opportunity. I have a red light bed, infrared sauna, all of the things. So that was 2020. And so I decided to buy the business January of 2020 and then COVID happened.

Right after. Literally. Right after. Literally. So I'm here against COVID happened. Literally. Right after. Literally. Wow. So I'm here against all odds. Wow. So when you're going through the functional medicine training, is any of it like countering your previous

training and knowledge? Are you having moments of like, oh my gosh. Totally. Totally. There's so many things that you're not taught in med school. And I didn't even realize this, most med schools are mostly funded by pharma. Yeah.

Which, how is that not a conflict of interest? Yeah. So, in med school and residency, all you're learning to do is treat with pharmaceuticals, procedures, and surgeries. It's a great business model, but it's not interested in helping you get healthy. No.

And so, functional medicine was kind of a, give the patient that's motivated, that doesn't want to be on those hypertensive medicines their whole life or or diabetic their whole life like give them an opportunity to reverse that stuff because we all know not Everyone's motivated a lot of people just want to pill that's fine But when you have someone that's motivated but doesn't know what to do Like it's a perfect because I am an MD I can because a lot of people you know are functional medicine that are not MDs, so they can't prescribe or deprescribe prescription drugs. So having that experience in the allopathic world

and then now with functional medicine, it was a perfect marriage, if you will. I feel like it's just, it gives you more of a complete picture because there's a ton of value in traditional Western medicine, but it's not the complete picture. And there's a ton of value in traditional Western medicine, but it's not the complete picture. There's a ton of value in functional medicine, but it's also not the complete picture. So you have the opportunity to go through both worlds and apply both.

Is this serving you well? Are you able to use both with your patients and say, okay, we're doing this, doing that? So let me ask you this. It's probably really easy for me to ask you this, like how you're different from traditional Western medicine doctors, but how are you different from traditional functional medicine doctors in that case? I think it's because I do all of the things

and I practice what I preach. I mean, I definitely, I lift heavy, I require my patients. I let them know at their first appointment that they will be fired if they don't do all of the things. I don't want to have to fire them and I explain my patients, I let them know at the first appointment that they will be fired if they don't do all of the things. I don't wanna have to fire them. And I explained to them, if you don't do it the way I want you to, the healthy way, I don't want your lack of results to, you know,

reflect my, exactly. So I have the fitness background, I have the MD background, and I have the functional medicine background. And I also have my own journey. I mean, I'm about to turn 45 and like I've been very open with my journey. When I turned 42, that was when I really, I'd just gotten back from a really cool trip to Bali

and I was looking at all my pictures flying back and I just like was not happy with what I was seeing. And this happens to a lot of women at midlife that despite doing all of the things, eating right and exercising and doing all the things, I was carrying an extra about 20, 25 pounds. So I used some acrytide and I microdosed it. I started increasing my step count and I showed everyone I lost about 20, 25 pounds and I

maintained that weight loss. Last year this time, I literally realized, okay, I'm 100% perimenopausal. I'd lost about five pounds of muscle on DexaScan, despite, you know, I shouldn't have. I was eating high protein and lifting heavy. And then when I saw my testosterone was like next to nothing, I'm like, all right, you know, I'm perimenopausal. So I've shared my experiences with my audience as well.

And my patients, I think, trust me more because- Because you've done it. Yep. I'm my own guinea pig. So what does that feel like? Because I've had people tell, and this is looking into my past as an early trainer, I cringe at how I didn't believe people sometimes and I feel really bad for it. Because I would have clients, oftentimes women in their early 40s, sometimes late 30s, but usually early 40s, and they would say things like, I haven't changed anything, Sal.

I don't know what's going on. I never stored body fat in my midsection. I suddenly have a belly. Early trainer, Sal, stupid version of me was like, you're just not tracking properly. You're just not doing it right, whatever. What does it feel like when things, does it feel like that? It's just out of nowhere and what's happening? Oh yeah, absolutely.

It's not fair. It's not fair at all. But it happens to men too. I mean, I think it's a little bit more apparent with females, but I mean, I was the same way. Because I've been a group fitness instructor for so long, I mean, I would hear the women say, and I would literally in my head think

they're lying to themselves. They're really just eating too much and not really moving. And the reality is, no, hormones do play a role. They really do. Yeah, and a lot of, hormones do play a role. They really do. Yeah, and a lot of- They play a massive role. I mean, I don't know what it's like to be a woman and go through that, but I know what it's like to be a man

and have your testosterone on the floor and you're still doing all the things. Dieting, working on sleep, strain training, and not see progress. That's what's so, it's like unbelievably frustrating to feel like you're checking all the major boxes and to wake up and be like, why am I not seeing any positive results?

Well, my own personal experience with it was really crazy because years ago, we get approached by people all the time, companies that want to work with us, and we had gotten approached by a company that did hormone replacement therapy, particularly for men, and they said, hey, you guys, we'd love to work with you, and we're like, nah, whatever, and they said, we'll give you free blood tests.

And so Adam's like, I'm gonna go get it done. This is when Adam had stopped bodybuilding. And he's like, I probably need to get on testosterone. I've been trying to get mine up for the last year. I feel like garbage. And he's like, do you want to come with me? So I'm like, sure. Now at the time, now I've been consistent

with workouts since I was 16. Very consistent with diet, very consistent with supplements. The crazy thing for me was my libido was okay. And so because my libido was okay, I didn't think my testosterone had any issues. But there were lots of other symptoms. But I went with them just for fun, got my results, and I was like, I was destroyed, I was crushed.

Probably due to anabolic use in my early 20s, probably had that effect on me. But I'm looking at it as my testosterone was low, and I remember I was like in disbelief. Then I went on replacement therapy, and it was like a light switch got turned back on. I was like in disbelief. Then I went on replacement therapy and it was like a light switch got turned back on. I was like, oh my god, it was deficient.

It's like being deficient in anything. Deficient in a nutrient. You're gonna have these crazy symptoms. So let's go back to when you do the smaglutide. You're doing everything right, you've been consistent. You're body fat, so you start microdosing smaglutide? Correct, correct. And this is kinda how I do it with my patients. Not everyone responds start microdosing some agglutide? Correct, correct. And this is kind of how I do it with my patients.

Not everyone responds to microdosing, and everyone's gonna ask, what's officially microdosing? It's different for everyone, honestly. But truly, tiny doses of some agglutide, Orchard's Epidide, really only work in someone that's already metabolically healthier than the average person. So I know a lot of people are interested in microdosing, but the average American needs actual real dosing but oftentimes

they don't need as high dosing as the standard increasing. Like a lot of these weight loss mills they don't even look at the patient. I make sure that you're losing about one pound of weight per week and I don't increase the dose unless you're doing all of the things and you have hit a plateau right because I don't want them to lose weight too fast and I don't want them to lose muscle. Did you get appetite suppression from the micro dose? Big time.

I mean, listening to you guys talk about it, like it was, it's 100%, you can't really explain it until you actually are there. But I mean, the food noise that I'd heard people talk about, I didn't even think I had food noise, but I definitely had food noise. Did you notice any effects on muscle with that dose? So I've always been good about getting DEXA scans,

and when I did it, I wanted to make sure and show my audience that follows me online, you can do this and not lose muscle. So I was getting DEXA scans, and I actually gained muscle while I was on it. Okay, so let's talk about that for a second, Dr. Warner, because there's this, and I want to be clear, I don't think GLP-1s are for everybody.

I think they can be abused. There's a right way to do them, wrong way to do them. But nonetheless, there's this myth out there that they cause muscle loss. The fact is, the data actually shows a muscle preservation effect, and there's even some data suggesting it's pro muscle or pro muscle function.

Let's talk about that for a second. Correct, it really irritates me when these people with large social media followings continue that narrative that's a false narrative. If it is done properly, you can actually spare muscle. But the problem is the average person is not doing it right. And so this is why they get that reputation, right? And so that's why, you know, I always tell people,

look, you're gonna pay a little bit more to do it with me, but you're gonna do it the right way. Because a lot of these places, I mean they just keep upping the dose, and of course you're gonna lose muscle. Good job for losing 30 pounds in 30 days, but 15 of that is muscle, and it's really hard to gain that back.

Which will happen with any severe calorie restriction, no strength training, not hitting your protein. That's the body pairs it down. Totally. Whether you're on somaglutite or not. Exactly. You notice a difference in you or your patients between somaglutide and terzepatide? So, yes.

I mean, it's iPhone 14 versus iPhone 15. Of course, this is great, but this is even better, right? Right. The way that I sell it is, look, semaglutide, I've seen it work for 95% of my patients and it's cheaper, but if you have a money tree in the backyard and you don't care, then cool, go with your Zapatide because it is better. Because it has two mechanisms of action instead of one. Okay, I heard, now this is anecdotal everybody,

but I've heard people say that semaglutide, because you hear this anecdote, and there's some studies going on right now talking about how GLP-1s also affect other hedonistic behaviors like, people are like, I'm not smoking as much, I'm not drinking as much. Are you noticing that with patients? 100%, there is one woman who did my weight loss program

and had this nicotine gum addiction. She didn't even smoke, she just started taking nicotine gum because she heard someone talk about it on podcast and she, yeah, no, and she was literally addicted. The amount of money she was spending on nicotine gum is crazy. It broke her, it completely broke her habit. She was like, if anything, this was totally worth it

for me because I've tried so many times to stop this habit and I couldn't, yeah. Are you noticing a difference between some agglutite and trisipatite in that respect? No. Not really. What about retachotide? Am I saying retachotide?

That's a hard one to say. You're so close. I was gonna bring that up, but I didn't even wanna try. Have saying Retachortype? I can't hear you. I'm like, you're so close. I was gonna bring that up, but I didn't even wanna try. Have you worked with that one yet? I have not. Is it officially out yet? I don't know if it's out or if it's gray market. I've seen some studies on it.

I think it's gray market. And it's like, holy cow, what has happened here? Yeah, I haven't used it because it can't be compounded and I only use a high quality compounding pharmacy. Right, right. So now let's go back to hormones. What are the most common ones that you start with people? Is it thyroid and testosterone, progesterone?

Absolutely. So for my females that are midlife and beyond, most of them need progesterone, thyroid, DHEA, and testosterone. My men typically need all of those except for progesterone. So a lot of times when people think TRT, like yes, testosterone replacement therapy is important,

but your other hormones are important as well. So I make sure that all of their hormones get optimized. But those are typically where we start with the midlife patients. And which ones provide the most aesthetic benefit? Is it testosterone and thyroid? Oh, 100%. So insulin resistant is at the root

of most people's problems, right? Most people are not getting DEXA scans, so they can't see how much visceral fat they have, but literally if everyone could get a DEXA scan and see their visceral fat and aim to decrease that, that would decrease all of their metabolic markers, they would be a lot healthier, and testosterone and thyroid are the key ingredients to helping especially

motivated patients like people that follow you guys that are actually working out and doing all of the things. Yeah, you tend to see insulin sensitivity improve with testosterone because of the muscle building aspect of it. Absolutely, for sure. And then progesterone, what does that provide to women? Oh man, so my first symptom of perimenopause that I was completely in denial about was terrible sleep because I was telling you guys a couple years ago, our business was financially

struggling and so I just assumed that my bad sleep was the stress of all of the things that were going on at work and whatnot. But really insomnia is one of the first symptoms that a lot of women experience in perimenopause and it's because the hormone inhibin and the hormone progesterone are two of the first hormones that start to decrease in that stage of life from the ovaries. And isn't it also enzyolitic?

I know some women will take progesterone and find their anxiety. Absolutely, I've always been a very chill person, never experienced anxiety and last year when I was 43, I never experienced panic attacks, but almost. So I was dealing with anxiety as well. So the mood up and down is very real and that's from progesterone. Now what were your labs saying when you were first getting in? Did your labs look quote unquote normal and then you still went in and did stuff?

Or were there things that were off the chart right out the gates? That's a great question. So labs are not near as important as symptoms. And up until the 1970s, actually, testosterone and thyroid were completely treated by your symptoms. Like there were no lab values. Oh, interesting. Yeah. And it's crazy, because I have lots of patients that have endocrinologists that literally

will tell them, I don't care if you felt better on a higher dose of natural desiccated thyroid, I'm going to treat your numbers. So we've gotten back ass words, no ass backwards, that's the word, as far as how we treat people, right? So labs, they are important, but not near as important as a lot of people think. For me, my testosterone was super low,

and that was the biggest thing that I could tell, like this explains my weight or my muscle loss in the last year. But they actually tell us to not even measure progesterone and estradiol in a perimenopausal woman because it's all over the place in perimenopause. And perimenopause can last 10 years. So like my labs, I'll show this on my Instagram stories.

My labs from last November, they actually showed zero estradiol, but I'm still menstruating. I'm irregularly menstruating. But if I would have done my labs even two or three days later, it could have shown estradiol of 100 or even 500. So the actual values of the estradiol and progesterone in a perimenopausal woman don't really matter.

It's really symptoms. Now, why are they going off of labs and not symptoms? It's interesting to me. Are they afraid of? 100%. A lot of primary care doctors and gynecologists will not treat with testosterone just because it's a controlled substance.

And I think you just don't know what you don't know. But the safety profile of testosterone, especially, I mean, we have decades of data that show the safety profile specifically because there's a huge population of biological females that think that they're men, that have taken high, high, high dose testosterone, and we know the safety profile.

It's very safe. So. It's actually one of the safest hormones you can. That's why it's so weird that a GP won't do that. I know. We've known this for a long time. If you get 10 times of your normal dose of any hormone, you could kill yourself or cause problems.

Testosterone won't. You'll get some symptoms. Yeah, absolutely. But you ain't gonna kill yourself with it. It's just very interesting. No, the safety profile is so, I mean there are no risks of high dose testosterone. Wow.

Yeah, us females can have some of the unwanted side effects. Yeah, you're gonna grow a beard. Right. Cursatism, some acne, and some hair shedding, but that's not necessarily in all females, it's in like 20 to 30% of females. Well, what's interesting to me too about this is we know that there are, it's in like 20 to 30% of females. What's interesting to me too about this is we know that there are differences between individuals

and let's say androgen receptor density or estrogen receptor density. So a certain amount of testosterone on one person is gonna feel great because they have more receptors versus another person. And there's no way to measure how many receptors they have. So this is literally where you have to talk to the patient and know like their symptoms. So most men feel best when their free testosterone is somewhere between 30 and 50, right? You might feel amazing at 30, but you might feel

great at 60, right? So I'm not going to treat the number. I'm going to, I know what you're supposed to feel like when all of your hormones are optimized. So I'm not scared of going higher on these hormones because I understand the safety profile of them. Now you recommend to women when they take testosterone, because there's different methods of administration. There's creams, there's pellets, there's injections. You recommend creams to women applied intra-vaginally. Correct.

Now why is that? So at the first initial appointment I always tell patients, look I'm going to go over your labs and ultimately the end goal of your labs are going to be looking like what they looked like when you were hormonally optimized, which is when you're like 19 or 20 years old, right? And so oftentimes the end results are going to be labeled too high, right? So testosterone ebbs and flows in a 19 year old peaks and troughs every 24 hours. It's a nice side wave, right? And so this is why pellets are my lease. I offer pellets and I think pellets are great for a certain patient population.

So maybe someone that's in a nursing home that's not going to do a intramuscular injection or applying their cream to their balls or their vagina. But to the average person who can take vitamin D every day, you can put cream on your balls or can take vitamin D every day, you can put, you know, cream on your balls or cream in your vagina. Right. Right. So it most closely mimics what your body was

doing when you were hormonally optimized at 19 or 20. And so you do, you like creams for men too. I do. I do. You can get great levels. I can you really? Oh, 100%.

If, if you are applying it to an area of the balls that doesn't have hair and I always tell my patients, you gotta, if you have hairy balls you're gonna have to shave it because that's the way that you get the best and then you do it twice a day so literally if you can brush your teeth twice a day you can put ball cream on twice a day. Just don't go hugging anybody naked. Correct. No, wasn't there some reports of like parents, they don't wash their hands, they're playing with their kids, or petting the dog. Oh yeah, oh yeah.

Well that's always part of my, when I'm talking to them, because I give them options. For my telemedicine patients, I can't do a pellet, but for my, you know, everyone, I always offer intramuscular injection, subcutaneous injection, or cream.

I let them know, which is my favorite, and then let them choose. So I do have some patients that are like, I'd rather just do a shot. That's fine. Wait a minute, how do you do sub-Q with testosterone? Isn't it in an oil? You dose it a little bit more frequently,

but yeah, a lot of people are doing sub-Q. In an oil? Yes. Wow, does that leave a little hole not in your? I mean, I don't know because I did an intramuscular for the first five months and I definitely, it worked, but I feel so much better on daily cream. You can just dose it.

What's the difference for you? You don't feel the too high, too low type of deal? Yeah, no, I feel the best and I feel a lot of the sexual benefits from it. A lot of people don't get the sexual benefits from the intramuscular injection. Oh, libido, huh? Yeah.

Interesting. But what you said earlier, I do want to address, I think a lot of men assume, well, I've got a strong libido, I've got great testosterone. No, that's not always true. You can have a good libido and have terrible testosterone. Testosterone is important for so many other things. Low libido is one of the first symptoms of low testosterone, but for some men, yeah, because it can also be driven by,

like libido is driven by dopamine, can be driven by lots of different things. And so I thought my testosterone, these guys, I mean, Adam's like, oh, your testosterone would be fine, because these guys are like driven by, libido's driven by dopamine, can be driven by lots of different things. And so I thought my testosterone, these guys, I mean, Adam's like, oh, your testosterone would be fine because these guys know me. And it was in the floor and I couldn't believe it. Now that's not to say it didn't get better

when it went on testosterone. Although that first three, four month period, my wife wanted to shoot me. I can imagine. It was too much. I can imagine. But it did start to kind of balance out a little bit. Do you have a preferences when it comes to thyroid prescription? Cause I know like my wife was actually going through that and they're

recommending her like the ones that thrive from pig. Absolutely. Absolutely. So we have been replacing people's thyroid with that kind of natural desiccated thyroid since 1890s. Like literally it literally it's been forever and again we weren't even testing our thyroid labs until 1970s. So yes this is a hundred percent I so many of my functional medicine patients came to me and runs basically synthroid so it's levothyroxine, it's synthetic T4 and yet they they were told they were normal based on their labs that they had all of the symptoms of a subpar thyroid.

I would take them off of Synthroid, put them on natural desiccated thyroid, which has T1, T2, T3, and T4, and all of the sudden they're starting to feel amazing. I literally, one of my weight loss patients, she is a type one diabetic and she has hypothyroidism, and so I told her, I'm like, look, your endocrinologist is managing these two things.

Ask if you can switch from Levo to natural desiccated. So I was surprised, she let her, definitely started feeling better. And then I told her, I'm like, off the record, if you wanna double up the dose and see how you feel, do that. And she was like, oh my gosh, I feel amazing. She literally told her endocrinologist that,

but the endocrinologist would only treat the labs instead of listening to the patient saying, but I doubled up on the dose and I felt amazing. Yeah, it's so frustrating because you have to have that insider knowledge to even ask for that, right? Exactly, and here's the thing. We know that thyroid cancer patients,

we suppress their TSH, which stands for thyroid stimulating hormone. It's the hormone that our pituitary gland is supposed to send to our thyroid gland to say, hey, thyroid, make more thyroid. But if we're taking enough exogenous thyroid in natural desiccated thyroid, our brain is gonna be like, yo, we're good, we don't need any more thyroid.

So of course TSH is gonna be zero. Yeah, absolutely. It's not dangerous. We know that these thyroid cancer patients live at TSH of zero their whole lives. So we know it's not dangerous. But yeah, but here's the thing. The endocrine

Society recommendations are very highly influenced by Big Pharma. I mean, do you realize how many of the recommendations, like if everyone just started to get their hormone deficiencies and their micronutrient deficiencies replaced, like people would feel so much better and they wouldn't need all of the pharmaceuticals that are making these companies. Now what hap, cause I know that context matters when you're looking at like context of the, the health of the human body. For example, if you stimulate mTOR in the context of cancer,

you're going to make the cancer grow, right? But otherwise it builds muscle, improves recovery, improves athletic performance. What happens if you take someone who's inflamed, unhealthy, obese, and then you put them on hormone replacement therapy? Is it not a good idea or is it different? You have to be careful? You don't have to be careful.

For a lot of them, it's their starting point because they've tried to do it, you know, changed the lifestyle, but now all of a sudden you're starting to give them a little bit more pep. I mean, thyroid and- So it actually helps motivate them. That makes sense.

A lot, a lot. But are you going to get optimized if you just take hormones and sit on your ass? No. I mean, and we're all about like, let's get people fully optimized. So it has to be combined with diet, lifestyle, sleep management, all of the kind of things. This is why you said you'd fire your clients if they're not lifting weights. 100%. Right, you have to do all the things.

Absolutely. Now, okay, so improves quality of life. What about longevity? What does the data show on longevity? So let me tell you, my parents are super healthy. I'm really, thank you Jesus, they're really healthy. They've always set the example of what diet and lifestyle looks like. So my mom is 69 and my dad is 70,

and I literally started them on BHRT. And I'm pissed because if I would have known, I would have started them 20 years ago. So it's never too late, but literally when I was talking about they were my first two patients to start hormones on. And my dad was like, but Lauren, we're really healthy. I'm like, I realize that you all are healthier than 99% of people your age,

but you're not fully optimized. And here we are, they've been on it for six months. And my dad is like, I'm starting to build muscle again. Cause he still lifts weights three four times a day a week So yeah, and he's like I can start to see muscle again So from a longevity standpoint though does the data because someone might be like well these hormone changes are natural And if we just force the body to have all these extra hormones, it's not gonna make you live longer Yeah, you're gonna feel better and younger on stuff. But what is the data showing longevity? I hate hate that argument. It's so dumb. Well, it's natural to not brush your teeth. Are

you going to not brush your teeth? I mean, come on. Yeah, absolutely. I mean, we used to not live past our fifties, so we're living into our seventies, eighties, nineties. No, it's not natural, but I don't want to be natural because I know what the average person that looks in their seventies and eighties looks like. I'm not about that. I want to be natural because I know what the average person that looks in their seventies and eighties looks like. I'm not about that. I want to be optimized. I want to be like my great grandmother. She was a full-blooded German woman. She was literally mowing her own lawn at 98.

Oh, that's great. That's awesome. Absolutely. That's awesome. That's what I strive to be like. Now you did say that there is a very small percentage of people you would not do hormone replacement therapy. Are these people who had like previous hormone sensitive cancers or who are we talking about?

So this is where if they were my loved ones, I would still start them, but we live in such a legal society that yeah, and we're trained. Like you have to understand, like if you are gonna take on that patient, you have to basically have a solid consent form because you are taking on the risk. But there is not a single patient that I think wouldn't benefit from hormones,

even with a history of hormone-sensitive cancers. If they are actively fighting cancer, that would be the only time that I wouldn't take them on. Yeah, that's different, right? Like you have breast cancer, well, we can't give you estrogen or anything like that. Or you have your testicular prostate cancer. Right, not at this moment.

But in the future, they're 100% candidate. Speaking of which, for a while, for a long time there, there was this conversation about testosterone that it could cause prostate cancer because the prostate is sensitive to testosterone. Well, lo and behold, the data comes back and shows that low testosterone is a risk for prostate cancer, not high testosterone.

Correct, and low estradiol. So all these people that are taking AIs, blocking the estradiol, I will not prescribe AIs to my male patients. That's an astrozole. Yeah, that's correct. Okay, so those are the ones, so I've heard people say that.

Don't touch those, they're not great. Do not. What if, okay, so if somebody's on synthetic testosterone at the higher range, they feel better at the higher range, they're gonna have higher than normal range of. And it gives you the same protective benefits that it gives us. Like, it gives you cardiovascular protective benefits,

decreases your likelihood of developing osteoporosis, dementia, like there's so many benefits of the downstream metabolites, the DHT and the estradiol. So I would never prescribe AI for my male patients. And that's a common theme that I'm seeing from a lot of these testosterone mills. They typically give it to them with their replacement. Absolutely, absolutely.

So when would you, or do you have, what if they have estrogenic side effects? Never. The, literally, talking to my colleagues that have been doing VHRT way longer than I have, I literally, Keith Nichols, he's very well known. He's got a good following and does a lot of teaching. He said in his 20 plus years, he's

seen two men with gynecomastia. And it's because they already had a predisposition. He's like, it's such a feared thing. He's like, I almost never see it. And so in WorldLink Medical, that's where I did all my BHRT training. We are taught, stay away from AIs. The risks that come along with it are not worth it.

Make you feel like garbage to some people. And it's a pharmaceutical, you know? I mean, literally, if we can just get back to replacing people's hormones and their micronutrients that they're deficient in, they're going to feel so much better. What about, like, finasteride, dutasteride, the DHT, to reduce those for things like... DHT has so many good side effects and benefits.

Let's talk about that. So the sexual benefits. It's more androgenic than testosterone. So you need it for those effects. You want the downstream metabolites of DHT and estradiol and that's why when people are blocking them, I'm like, you don't understand. You're blocking yourself from so many great benefits.

The brain fog, there's some anti-cancer benefits, there's sexual benefits. I mean, there's, look, testosterone, if you happen to have some of the bad side effects of some hair loss, I believe that it's worth all of the benefits to not block the DHT and estradiol and have all of the benefits of all the hormones, the testosterone, DHT, and estradiol. There's also peptides now that people use on their scalp and for that kind of stuff to kind of prevent that kind of stuff. Blocking THD always sounded so extreme to me to block that.

So you're also like, no. Absolutely. I mean, God created us perfectly and he put those enzymes and those metabolites there for a reason. Now, what about the cost of doing something like this? Okay, I want to go on hormone replacement. Is it expensive or because they're generic, they could be not so bad?

So, I always explain to people, your health insurance is like your home insurance. If you get hit by a hurricane, you're really glad you have home insurance, right? Your health insurance is not there to optimize you. So, your home insurance is not going to pay for your new floors and your re-decor. You are optimizing yourself and that's an investment.

And ultimately, the sooner that you can invest in yourself, the better, well, the cheaper your healthcare is gonna be when you're older as well. So it's an investment for sure. And there's, I mean, I've spent a lot of money on my training, so you're paying for the expertise and so typically health insurance does not cover it.

The ROI though on every other aspect of your life is so high. I try to explain that to be like the healthy fit stronger optimized version of you is a better partner, is a better business person, is better at work, is just like all that stuff. It's hard to measure that and put a dollar amount to that, but if you've experienced it and you know what it's like, it's beyond worth it, it's crazy. Marriages that are saved once both are being hormonally optimized.

I mean, I've heard so many, so many stories from my colleagues that have been doing it a lot longer. I mean, think about the woman at Midlife who is just all of the sudden like, you know, you never know which side you're going to get of her. Like, if you could get her mood leveled out and if you could get the man, I mean, it's not just libido. I mean, it's energy, it's motivation, it's confidence.

I mean, a man that doesn't have enough testosterone, you're deficient in so much more than just libido, right? So imagine if you are the best version of you and your spouse becomes the best version, you're only going to better your marriage. I watched it happen with Katrina and I. I felt so bad for her. Not just like you said, libido, but I'm more motivated to help her around the house. Help her with our son, do things like that.

Those types of things are also affected. Absolutely. A lot of people don't realize either that because testosterone is known as this aggression hormone, which by the way, the aggression that you get from normal high levels of testosterone is a motivated aggression. It's not aggression like the back. Low testosterone causes irritability.

A lot of people don't know that. So they think like the asshole who's just super irritable might be low testosterone. 100%. Because they tend to feel better when they're on it. But what happens to them, here's your prescription for an SSRI, and then that decreases their testosterone even more.

Do they really? Oh, 100%. Statins do too. Do you understand how many people are on an SSRI and a statin? I mean, it's a vicious circle. By the way, the margins on those drugs are so much higher because they're patented.

Testosterone is not patented. No. So the margins are, it's not a huge one. They make it for. Exactly, exactly. That's why these big pharmaceutical companies are worried about people basically getting healthy. That's interesting.

We don't want us to get healthy. Now for, are you seeing a huge uptick? Because this is kind of more commonly known in the news, right, where you see that testosterone levels have been dropping in men now for decades. We're starting to see that. But is it becoming more well-known that women don't have to deal with or have solutions to, you know, they kind of suffered in silence before going through perimenopause. Are you seeing a higher interest in women saying, okay, I can do something about this? There's definitely a movement without a doubt for sure. There was this guy who is a big YouTuber and he posted my little blurb on testosterone

because I always say the same thing when I'm talking to a female patient. I'm like, I saved testosterone for the last because it's my favorite hormone. I always let them know, look, when your testosterone is optimized, you've got a strong libido, you're able to easily orgasm, you're able to have multiple orgasms, you've got good vaginal lubrication, you can increase muscle mass, you can decrease strong libido, you're able to easily orgasm, you're able to have multiple orgasms, you've got good vaginal lubrication, you can increase muscle mass, you can decrease visceral fat, you can improve your present body fat, you have better mood, better energy, more vigor.

Why would you not want all of that, right? And so he, yeah, no, for sure. Everyone's like, you should have started there, I'm sold. But he took that clip and then there was a man in the comments that was like, none of these are necessary for a female. And I mean, can you imagine? I was just like.

What? What is wrong with that? I know, I know. Single dude. Yeah, 100% must be. Must be. But no, I think that there's definitely a movement of like, no, this is, you don't just have to put your big girl panties

on and suck it up buttercup. Like there are options. So I have, I want you to't just have to put your big girl panties on and you know, suck it up buttercup Like there are options so I have I have I want to ask I want you to kind of like step us through here because You came to mind the other day when I was talking to my my niece and my sister-in-law Both over eight overweight the younger ones mid-30s right now. My sister-in-law is late or mid-50s My sister-in-law is late or mid 50s. And the norm that they like the average, they fall in the category, the average female that wants to get in shape,

that's got a couple extra pounds. They go right away to cut calories, cut out the junk food, goes right to the salads, and then sign up to the bootcamp classes, and they start, or get on the treadmill, so I can't stress how important it is that they balance out their hormones first, they get healthy, then they strength train. So walk through someone like that who's about to make a shift. Like, okay, they're

motivated. The order of operation for you, like getting blood work done, like what does it look like? What should they make sure that it looks like? And what are the most likely things they're probably going to have to do? And then what is that step that person through? That's a great question. So they all always need to start with labs for sure so that you understand the baseline. And I use labs as a teaching tool, but also let them know that this is just going to guide. But ultimately, I'm going to treat their symptoms and side effects.

I did learn when I first started all my BHRT training, if you have a woman that's midlife and 30s is still partially midlife because a lot of women can start going through period menopause at 35. So you can start seeing those midlife symptoms as early as mid 30s. I think it's like a quarter, right? Quarter women by 37 are already going through some of that. It's crazy. So if you have a woman at midlife that is struggling with her weight and you can only do BHRT or GLP1s,

get her hormones right. And then. First. Absolutely. But we do know they're synergistic. There was a study that looked at a group that only did BHRT, a group that only did GLP1s, and then a group that was together,

and that group had a 30% better outcome. So as far as weight loss goes. Well, GLP1 is a hormone. It's a peptide. Technical, okay. Yeah, yeah, it's a peptide that our GI tract makes. Okay, okay. Right, so it's just a matter of how many amino acids. That makes it a hormone or a peptide.

Correct, correct. But almost, yeah. So you'll start them there first. If they can only do one or the other, I will get their hormones right. There's this one pharmacist that works for WorldLink. She literally lost over 100 pounds just getting her hormones right.

So it can be done. And especially when you have a patient that's like, all right. And oftentimes the motivation that comes from getting a little bit more thyroid and a little bit more testosterone on board leads them to... Exactly. Exactly. So hormones would be if they could only do one or the other, but if they could do both, absolutely.

Well, what are some things too, like when they get their labs, because this is the other thing, I wish I remember what levels you were talking about, but you were talking about your own blood work and that what the GP would tell you is in the normal level and what you've found in your practice is like, I operate so much better at these higher levels. Thyroid, thyroid. So I always use my labs from last year versus the end of the summer. So my TSH, which is typically the only thing your primary care doctor is going to measure when you say, hey doc, I think I have a thyroid issue, you know, I'm having low energy struggling with my

weight, maybe some brain fog, maybe cold all the time, we call it cold intolerance, some dry skin, brittle nails, constipation, that's all the ways that, you know, low thyroid can manifest. So the doc goes oh yeah I'll check it they only check TSH and they say oh your thyroid's normal. So I used my labs from last year to show that my TSH was completely normal but my free T3 was 2.6. Now your free T3 is really all I care about because that's what's available at the cellular level. So absolutely. So I can guarantee if I see someone's free T3 is on the low side I know that they're gonna say yes to almost all of those symptoms and they need to ask for that separately Don't yes, but here's the thing though if they ask for it the doctor's not gonna know what to do with it That's the problem because the endocrine society suggests their recommendations to only use TSH

So this is why so many people are being failed. I mean thyroid is amazing I know what I felt like when my free T3 was 2.6, and now mine's on the high side. I am around about eight. You know, people know that thyroid affects your cognitive function, your IQ. You'll see IQ go up or down based off of your thyroid. So it's not just I'm getting fatter,

it's literally you're dumber, because your thyroid isn't being up. Imagine how tough this is when you hear, oh, I should go get my blood work, I listened to that podcast, Mind Pump, you go to your GP, gives you your blood work, they come back, yeah, they don't even look at it, and then the level they are looking at

is in the normal range. Meanwhile, this is very common for you to see that someone could be in that normal range, yet would feel so much better if it was a little better. Absolutely. I always tell my new patients, and I use my before and after, I'm like, I will not fight with your primary care

or your gynecologist over this. Because what's going to happen is if they measure your TSH, when your thyroid is optimized, it's probably going to be zero or close to zero. And it's going to freak them out, and they're going to say, you have hyperthyroidism, you have Graves' disease. No, you don't.

You have optimized thyroid. And I'm not going to fight with them. I'm not going to send them literature that backs up what I do. So you basically, if you wanna follow them, keep doing that. So let's pause there, Dr. Lund. So it's called a negative feedback loop with hormones, right?

So if I take testosterone, my body will see the testosterone and will stop producing its own, right? If you're taking thyroid to optimize your thyroid, your body's like, oh, you have plenty of thyroid, we can stop producing TSH, because TSH signals thyroid production. So it is going to be zero because you're taking thyroid. So that's what's supposed to happen.

Yeah, it's not dangerous at all. I will tell you, I am not going back to my free T3 of 2.6. I feel amazing with my free T3 around eight. And my TSH is zero, and I will live like that forever. Yeah. Now, form of exercise with your patients which form, I know the answer but I want you to say it. What form of exercise produces the best the best kind of results across the board? Lifting heavy shit. I literally at the gym, so I'm a 5 a.m. worker out there and there were these two young girls and they're like young 20s and I went up to them I'm like keep doing what you're doing

I'm 40 almost 45 and if you keep doing you will you will definitely not regret but I mean it's it's You know so many I know it's amazing right see a 20 year old lifted. Yes, I never saw Cuz they were all cardio bunnies. Yeah, I was I've always lifted weights in addition to cardio But I've definitely I do less cardio now. I walk a whole lot. I mean, I'd say that was what the good, smart girl was doing 20 years ago was she was doing both,

where now you actually see girls that are like heavily- Like lifting. Yeah, lifting weights, which is so good to see. I know, well, and especially in your 20s and 30s, like when you have hormones that help you build muscle, like man, that is, you know, Gabrielle Lyons says it right. It is the organ of longevity and you want to build as much of that as you can because what your life looks like when you're elderly will completely depend on how much muscle

muscle you have. And it's like I tell, I'm screaming this the rooftop. It's like investing too. The sooner you start and the more you do it. I courted you on that the other day. Hey, the easier it is. I think there's such this myth around- Muscle memory is real, man.

People talk about, oh, it's so hard to build muscle. It's so hard when you get older. Only things that are hard to get in shape when you get older. It's like, not if you've been investing since you were 20. If you've been investing and lifting heavy shit since you were 20, even if it wasn't every single day of your life and you had bouts where you were off for six months, if you just kept doing that for decades,

holy shit is it easier and better when you get older? I heard you say that on a podcast a few weeks ago and I literally quoted you exactly because that is such a great analogy. It is. And it's a myth that people continue to spread that it's so difficult when you get older. It's like, no, I'm having an easier time maintaining a healthy, fit, strong physique than I ever had in my life. In my 20s, I was doing 10 times the amount of volume and intensity and I looked half as good. It's like it gets better you guys. If you just start now and be consistent with it, it'll pay you back.

But it's also never too late to start. My mom literally, my dad and I have been trying to get her to lift weights literally for the last three or four decades and she finally started lifting weights at 67. So she's been lifting weights now for the last three or four decades. And she finally started lifting weights at 67. So she's been lifting weights now for two years. My mom looks amazing. And she's like, I wish I would have listened to you earlier. So it's never too late. There was a study I just quoted on a recent podcast where they were looking at people in their 70s and 80s.

Their ability to build muscle is not hampered. Now the potential is less because you're in your 70s. But the rate of muscle growth and the strength that they were gaining was, there was actually, there was no difference between them and the 50 year olds. That was the comparison. So yeah, your body will adapt and respond.

The potential, it starts to change as you get older, but like you can always build muscle and get stronger. Let's explain to the audience, especially for the female, what is happening hormonally when they do decide they're gonna lift weights. Explain to the audience, especially for the female, what is happening hormonally when they do decide they're going to lift weights? Why is the body just seemed to organize the hormones in this optimal way or a better way than what it would be doing with them?

What is the difference between the same girl who is trying to get healthier but is not lifting weights versus the one that is lifting weights? I mean, I think it just goes back to like, we're supporting the way God created us to live. Like, God didn't create us to sit all day and not move and not lift heavy stuff. And like, we've just become so sedentary. And so, getting back to going to bed when it's dark outside and, you know, not eating crap food that's, you know, highly processed and like, just, you don't have to complicate it. So I think that getting back to the way that our ancestors lived just helped support our hormones

in the way we were designed to work. Well, the insulin sensitivity that comes from extra muscle is huge. So that's gonna make a big difference. I mean, you mentioned earlier PCOS, there's a strong connection or correlation between that insulin insensitivity and resistance. They need to rename it, honestly.

I mean, they teach us literally assume a woman is PCOS until proven otherwise. So if you look at, and now this is only true for a woman in her menstruating years and perimenopause. So once she's, she's become postmenopausal, her LH and FSH ratio don't matter. But if you look at their FSH and LH, no matter where they're at in their cycle, if the LH is equal to or greater than their FSH, their PCOS. And what that means is that they have a luteal phase defect.

So follow me on this, I'm not gonna get too geeky. So in a female cycle, you've got four phases. You've got the menstrual phase, from day one you bleed to the last day, right? Then it's followed by your follicular phase, which is mostly your estrogens, right? Then you ovulate, so you have your ovulatory stage. And then the luteal stage is progesterone, right?

And so if you have a luteal phase defect, you don't have enough progesterone. So this is why the PCOS female has terrible periods or terrible PMS, oftentimes can't get pregnant, oftentimes has history of miscarriages. Don't they sometimes say estrogen dominance? Wouldn't that be the term? No, we don't use that anymore.

I know that, but that's what they would say, right? Correct, correct. But they're just not making enough progesterone. That's right. Yeah. So my PCOS patients oftentimes need a lot of progesterone and literally like it will change their life. Does progesterone help with insulin sensitivity or is it the insulin sensitivity that helps progesterone or is it both? No, it's mainly thyroid and testosterone that help with your insulin sensitivity.

And then build that muscle and that'll get that- For sure. Yeah, that makes a big difference. I wish we could require everyone to get Dexa scans so they could stay on top of their muscle mass, their visceral fat. Are you looking at bone density for your female patients as well? For sure, for sure. And literally one of my staff members who's 25 already has osteopenia.

Isn't that crazy? Crazy, but it's reversible with hormones. Super reversible. Literally. Especially with strength training combinations. Is that just because of how sedentary we've become and how convenient everything is? If you have weak muscles, you'll have weak bones.

I think it's a combination of that and then just the fake food that we eat. I mean the Franken food that's highly processed. Like the analogy that I use, if you brought your car, your car dude, if it's supposed to have diesel and you put regular gas in it, what happens? Right?

It's all bad. Was our body designed to be fueled on all of this fake crap? No. Yeah. But. So talk about diet. What are the, one of the first things that you recommend

for diet? Is it high protein? Is it whole natural foods? Protein, yeah. Absolutely. So you're not afraid of protein. This was something that the medical community was kind of weird about for a little while.

I know, isn't that crazy? I mean, our ancestors literally ate meat, eggs, and dairy all the time, and yet everyone's scared, especially here in California. Yeah, yeah, no. Talk about how grossly under-eating protein most people are. Man, I will literally, I make my patients track it

for a week because I cannot tell you, I would say 95% of them, when they tell me, yeah, I eat a lot of protein, I'm like, track it for a week and come back to me. And all of them are like, I have no idea. 40 grams, 50 grams a day. Yeah. What's wild about that statement to me is they had the same experience too, just as all the years of training people is that these are the people that say they eat high, right?

Totally. I mean, they, I can't tell you how many times I had someone, oh yeah, I eat lots of protein. Really? Let's track. Let's see. And it's like, I had cheese with my salad. Yeah, exactly. That's literally what clients tell me that. Oh, I have cheese with my salad. Well, and I think, you know, that's where it comes from. Like if you're someone who's just like, oh yeah, every day I eat meat or every, every, even every meal you you could say I eat a protein. It's still not enough for most people. Your four ounces of meat three times a day

is not enough for even the tiniest woman protein wise. And so huge, huge complaint. How long does it take when you're working with someone typically, I know it's different from person to person, but when you first start with hormone replacement, there's a process of figuring out what the right levels are, right? So you gotta kinda start with hormone replacement, there's a process of figuring out what the right levels are, right?

So you gotta kinda start here, and then how long does that typically take? Do you give someone a number, like, okay, within six months we'll start to figure this out. So I actually, my hormone management program, it's a year, because I tell them, it's gonna take a year to get your hormones optimized. It's kinda like the hostess at a restaurant

that tells you the wait time is an hour, but they know in their head it might only be 45 minutes. So it doesn't take a year for everyone, but I like to make sure that they understand nothing happens fast with hormones. And I have some people, so I have a hormone phone, so all my BHRT patients, a hormone phone. I carry two phones now. So my hormone phone, I love it because I will get text messages from patients like, like

one had sex with her husband for the first time in like three years. Oh my god. Yeah. Literally, I mean, like life changing. And then some, so everyone's different. Everyone is their own unique snowflake when it comes to hormones and how long it's going to take.

But this is why you can't go with just one of these kind of, you know, these hormone programs that are just kind of cut and dry. Standard, yeah. Exactly, exactly. Like you want to work with a professional that these kind of, you know, these hormone programs that are just kind of cut and dry. Exactly, exactly. Like you want to work with a professional that is talking to you. Which one?

I would imagine though, most people start to see at least positive changes pretty quick. If you take any, if they're deficient in anything and you start to, even if it's not the perfect optimal mal, they're already heading in a better direction than what they were heading. Totally, I have seen zero patients that haven't told me that they're improved in some way

at the first three month follow up. Yeah, so yeah I bet. Zero, so everyone has some sort of progress just three months in. Are you a start low, go slow, or how do you typically approach it? Like let's start in the lower dose and start bumping up, or does it depend on the hormone?

Well with thyroid, so I have a little spiel that I talk because thyroid is like nature's caffeine, right? And I want them to experience how you feel when you have a triple espresso, but I can't start at that dose because they might be a little jittery, you know? So I'll start them at my single espresso dose for a few weeks, then I'll bump them up to my double espresso dose. And then in the second month, they're at my triple espresso dose. And that tends to work for a large majority of people. And I will get their labs done at the three month mark to see where they're at. And then in the second month, they're at my triple espresso dose. And that tends to work for a large majority of people. And I will get their labs done at the three month mark to see where they're at. And then their numbers might correlate with optimization or they might say optimal numbers, but they still maybe have some afternoon fatigue or whatever.

You know, so, so the numbers help, but ultimately I'm treating the symptoms. You had said, by the way, and this needs to be talked about, I think, that when you take thyroid medication in the morning, take it with distilled water. Correct. Don't take it with electrolytes. Correct. Now why is that?

So that is the one hormone that if you take it with anything else, it will actually bind to it and you won't absorb the whole dose. So I always tell my patients, have a cup of distilled water or reverse osmosis water. I think I've ever heard anyone say that. Yeah, yeah, yeah. Yeah, electrolytes will bind to it. You don't want minerals or electrolytes in it.

So basically you have your cup of distilled water and take it first thing in the morning and then look at your clock and don't have anything for at least 30 minutes. So you take it with another hormone? No, it has to be taken solo. It also, I didn't know that. Yes.

So it can also bind with DHEA or something like that? Correct, correct. So I have my patients take DHEA in the same time at basically vitamin D3. And everyone should be on vitamin D3 K2. Are you all on D3? Yeah, yeah. Why do you have the K2?

Well, so D3 needs adequate K2 and magnesium in the system to work. I actually don't put K2 in mine because I eat plenty of K2 rich foods. But a lot of people don't. So that's why you oftentimes see it together. So D3 K2 or D3 by itself, it needs to be taken with a food that has fat

because both of those are fat soluble vitamins. So we saw a whole lot of people start taking vitamin D once COVID happened and literally their levels were zero. And I'm like, you're taking on empty stomach, aren't you? And they're like, how'd you know that? It's fat soluble. Because you didn't read the back of the bottle. It says take with food.

So you have to take it with food that has fat. And I like my patients for their vitamin D levels to be 100 or higher. Really? Wow. That's way high for what they would say you would need. What do they recommend, like 40? Again, normal is not optimal.

Normal is not optimal. Vitamin, it's a hormone. It supports your immune system. Wait, say that again. A lot of people don't know that. Vitamin D3 is a hormone. It's a hormone, absolutely It supports your- Wait, say that again. A lot of people don't know that. Vitamin D3 is a hormone. It's a hormone, absolutely, absolutely.

And I don't care where they live in the United States. I have plenty of patients that are in sunny states that still have terrible vitamin D levels. So my dad, who's outside constantly working, constantly working, always outside, he was getting all these weird pain symptoms. His back was hurting, he was feeling stiff, couldn't figure out what the hell was going on.

He's like, I'm just getting old, I have arthritis. His vitamin D levels were low. Oh yeah. So and the reason why they never, my dad never tested it is because he's literally outside all the time. Right. Now we're dark skinned but he's always outside. Right but we lose our ability to convert vitamin D as we get older so that's why I just carte blanche told all my patients you need to take vitamin D. Bottom line. Oh, awesome. Most people need about 10,000 IUs a day. Some people need 15,000 IUs.

10,000? Yeah, absolutely. I'm that way. I mean, I remember when we first did the test, I was taking 5,000 a day consistently and I tested still super low. I take 20,000 a day. Wow. Wow.

Yeah. See, I didn't know I could bump it that way. I haven't been sick in a long time. Well, I've been at 10,000. Maybe I'll bump a little because I was low at 5,000 long time. Well, I've been at 10,000, maybe I'll bump a little, because I was low at 5,000 still. Yeah, you were taking it regularly, and your levels came back to you.

There was this really smart doctor at this MEN conference that I went to a few weeks ago, and he was actually talking about how he basically has his patients get to 150 or higher. Wow, I thought it was dangerous to have too high. If you go way high, sure. If you go way high and you have high calcium, that's the only time, and it's very rare that you see that. Oh, wow. If you go way high and you have high calcium, that's the only time.

And it's very rare that you see that. Oh, wow. Yeah, so I will tell you, a lot of people are told by their doctor, oh, that's dangerous, and they don't know what they're talking about. Like, I always tell patients, ask your doctor to basically show you data to back that up,

and they'll realize like, they don't. I don't have any. Right. Like, there's this really well well known menopause doctor online and she was literally, she's got a huge following and was telling terrible advice basically that it's wrong. And I'm not that person that's controversial that's in the comments like you're wrong.

But I will always tell patients like ask for proof. Like show me the data that says that because I followed this one chick online that says the opposite. And oftentimes they won't be able, opposite and oftentimes they won't be, not oftentimes, they won't be able to back that up. Wow, wow. What is your primary business?

Is it still seeing private practice patients? Do you do anything else or is it just primarily that? It's primarily that, yeah. Laura Marmed, I have patients that are local and telemedicine, I've got a staff of 17, so I've got estheticians, massage therapist. So it's all wellness and allmedicine. I've got a staff of 17, so I've got estheticians, massage therapist, and I've got some- So it's all wellness and all the whole thing.

Absolutely, absolutely. We've got the aesthetic side, so I've got some nurse practitioners that do the injectables, which, you know, I've still gotta keep that around. But it's mostly health and wellness. Now, are you personally still taking this? I thought the last time I talked to you, you were like overwhelmed.

Are you actually taking patients? I am, I am time I talked to you, you were like overwhelmed. Are you actually taking patience? I am, I am. I'm booked out until March. Praise Jesus. Yeah, yeah. So say you've been booked for a while. Well, we love you. We love working with you.

Thank you. Yeah, I appreciate you coming to the show. Can we address my shirt though? Yeah, yeah, yeah. I literally made this shirt for y'all. Make them break up hard again. Oh, don't worry. It'll be in the comments.

It'll make the comments already. So what's that all about? So we are doing a men's event in St. Charles, Illinois at the end of January. And I got this idea from my friend Amy Stuttle who owns Victory Men's Health out of St. Louis. She had these little koozies at that men's conference that said, make America hard again. And of course, like I've always been about to make America healthy again before it was actually a thing. Like that's, you know, that's what we all strive for, right? And when I saw that, I was like, that's amazing.

So we're doing this conference at the end of January in St. Charles and I was like, we should do that. And now St. Charles, Illinois, it's like, it's conservative. So it's gonna be rocking the boat. But I thought, you know, the Rosie the Riveter. So do you realize that's my face on her, like, oh no, I didn't even know that. Oh, look at that.

Yes. Wow, that's great. I know, I know. I have a friend that's an artist, Madeline, who I was like, hey, this is the idea that I have. You know, I want something catchy. And of course, you know, make America hard again. It's not just about making the penis hard again.

It's about making muscles hard again because we are soft and mentally. I mean, like, we need to become harder, like in the good way harder. So, but yeah, literally my best friend who, she's a designer, she had this idea literally two days ago, she was like, we should get a t-shirt made for the interview.

I'm like, so that's what I did on Sunday, two days ago. First thing that Adam said when he came in is that you gotta see her shirt. I literally made it just for you all. I appreciate it. You're on brand day. Yes, for sure. You brought one for Adam, right?

Yeah. I will send them to you. I'll rock that for sure. You're the best, Dr. Lauren. We appreciate you. Thanks for coming on the show. I appreciate you all having me. Thank you.

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