Mind Pump: Raw Fitness Truth - 2752: The Menopause Solution with Dr. Lauren Fitzgerald

Episode Date: December 18, 2025

The Menopause Solution with Dr. Lauren Fitzgerald What was the black box warning? Why was it there? Why is it now gone? (2:09) An interesting symptom of perimenopause. (8:12) Progesterone will change your life! (9:52) The importance of monitoring your thyroid levels and the 10 most common low-thyroid symptoms. (14:20) Testosterone for women. (22:57) Her main issue with primary care doctors. (27:14) The role of peptides in her practice. (30:01) The buy-in. (30:47) Ranking the various applications of testosterone. (33:39) The BIG myths surrounding HRT. (36:03) It's not a business, it's a mission. (40:26) GLP-1s: Incredible tools when used appropriately. (41:40) Normal isn't OPTIMAL. (45:27) The missing element for MOST people. (55:51) Related Links/Products Mentioned Visit Pre-Alcohol by ZBiotics for an exclusive offer for Mind Pump listeners! ** Promo code MINDPUMP25 for 15% off first-time purchasers on either one-time purchases (3, 6, 12-packs) or subscriptions (6, 12-pack) ** MAPS 15 FORTY PLUS 50% half from Dec. 14-20th. Code DECEMBER50 at checkout. Mind Pump Store FDA to Remove 'Black Box' Warnings From Menopause Hormone Therapy. Here's Why. The WHI Study: How Misinterpretation of Hormone Therapy Data Hurt Women's Health Welcome to the 'menodivorce'. Why women aren't sweating marriage in a sea of hot flashes Estrogen Matters: Why Taking Hormones in Menopause Can Improve and Lengthen Women's Lives -- Without Raising the Risk of Breast Cancer Mind Pump #2502: Hormone Therapy for Aesthetics With Dr. Lauren Fitzgerald Mind Pump #2597: Before You Take Ozempic, Wegovy, or Mounjaro Listen to This! Muscle Mommy Movement Mind Pump Podcast – YouTube Mind Pump Free Resources Featured Guest/People Mentioned LAUREN FITZ, M.D. (@drlaurenfitz) Instagram Website Dr. William Seeds (@williamseedsmd) Instagram Peter Attia, M.D. (@peterattiamd) Instagram

If you want to pump your body and expand your mind, there's only one place to go. Mind Pump. 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, The Menopause Solution with Dr. Lauren Fitzgerald. She's actually one of the nation's leading doctors when it comes to helping women through menopause.

She's phenomenal with both men and women, but this is my favorite topic to talk with her about. So we had her on the show, and she gave some solutions. By the way, you can find her on Instagram at Dr. Lauren Fitz. So that's D-R-L-A-U-R-E-N-F-I-T-Z. You can also find her website at laura-M-M-R-M-E-D.com.

That's L-A-R-I-M-A-R-M-M-D.com. Now, this episode is brought to you by a sponsor, Z-Biotics. This is a pre-alcohol drink. So you have it before you have your drinks. It makes a big difference in how you feel. There's no product like this, by the way, out there. This is a probiotic that's been genetically modified to break down acetaldehyde. Nothing else does this.

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December 50 for the discount. All right, real quick, if you love us like we love you, why not show it by rocking one of our. shirts, hats, mugs, or training gear over at mindpumpstor.com. I'm talking right now. Hit pause. Head on over to mindpumpstor.com. That's it. Enjoy the rest of the show.

Welcome back to the show, Dr. Fitz. Thank you. It's good to be back. You are a favorite of our fans. Oh, thank you. I want to bring something up. I told you a little bit about this off air. Obviously, you know about this.

But I just read that they finally removed the black box warning on hormone replacement therapy medications for women. They did. So let's talk about this for a second. What was the black box warning? Why was it there? Why is it gone? So the big C word, cancer.

Everyone's scared of cancer, right? So the women's health initiative that came out in 2002, it was, first of all, it was misinterpreted. And by the time they realized that it had been misinterpreted, it had already gotten out. So we have a generation of women that basically missed out on hormone replacement therapy because this misinterpretation of this data from the women's health initiative, basically saying that hormones are linked to cancer. And so estrogen got basically the label of black box.

It's going to lead to cancer. So now every woman is scared to death of cancer. And for 20, almost five years, no one has been on hormone replacement therapy, even though there's so many benefits and decreasing risk of all of the bad stuff. So the FDA finally was like, all right, well, we were wrong because there's so much data that shows that it's actually protective. And they finally took it away. Now, am I excited about that?

No, because I don't trust the FDA myself. I mean, truly. Like, I haven't trusted them in a while. So could this be moving in the right direction for us? Yes, but we're going to have to fight all of these 20 plus years of belief that estrogen leads to cancer. What was the misinterpretation? What did the data say that they... That there is an increased risk of breast cancer if you take it.

HRT. So what they didn't realize or they didn't decipher was the difference because actually in the Women's Health Initiative, they used estrogen, which it's not, let's define bioidentical versus non-biotidinical, right? So bio-addenical is what our body makes. Non-biodeetical, also known as synthetic, doesn't match what the body makes, right? So all of these women were on synthetics, estrogen or non-biotentical, but they were also on progestins. And they didn't realize that the actual progestins are the thing that increase your risk of breast cancer. So even though I'm not a huge fan of synthetic non-biodeinical estrogens, this is not what increases your risk of cancer. It's the progestins. And the progestions are in like birth control pills and I mean, a lot. I was just going to

ask you, it's so crazy that we've, we've pushed birth control pills for so long and never said, it, never say anything, but then freak out if a woman takes a little bit of testosterone or estrogen or something. Correct. Correct. I mean, a true informed consent is not given to probably 99 percent of women that are started on birth control. I was not sexually active when I was started on birth control pills. No one told me that, well, if you start taking this, it will increase your risk of cancer, breast cancer specifically, but other types of cancer, increase your risk of clot, increase your risk of autoimmunity, increase your risk of all sorts of bad stuff. They just say, this is, it's going to help your cramps and that's it. It's a band-aid. Now, progestin, this isn't

taking progesterone. These are essentially, they're taking progesterone in 12. weaking it in a way to create a new chemical that prevents pregnancy. So, so let me, the way I like to teach it is you think of the word estrogen as an umbrella term, but under the umbrella, there's non-bi-identical and bio-identical. So in the progestogen world, progestogen is the umbrella term. You've got bio-identical, which is progesterone, and non-bio-identical, which are progestin. So I think they intentionally try and confuse us because big pharma can't make money off of the not the bioidentical. So they basically take a molecule like progesterone, tweak it just a bit,

create a progestin, and now they can make a whole bunch of money, and then they start confusing the people and medical people as well. Like, I mean, I've been a doctor now for 20 years. I graduated 05, MD since 05. And I literally just in the last maybe three or four years truly understood the difference between bioidentical and non-biotentical. So they start trying to confuse you from day one. And if you use, so they can't make money off of bi-odendical because of the way that the, I guess the classification works with how you patent things. Correct. If it's naturally occurring, I can't patent it. Correct.

Okay. So in other words, if I make progesterone as a pharma company and it's naturally occurring or it's identical to naturally occurring, another company could just sell the same thing. But if I tweak it, then I can patent it and now I am protected against competition. Exactly. Is that the deal? Exactly. Okay. And now some of the tweaks that they put to them can be for like what longer half life, more of this, more of that.

This is what they're trying to create when they make these birth control. So like let's take progestins, for example. So progestin's, they connect to the progesterone receptor. They actually have a much higher affinity for those receptors. And so they will suppress your body's natural ovulation, but they won't give you all of the benefits. Like let me use a perimenopausal woman, right? So a pari menopausal woman comes in and she's complaining a lot of the, standard perimenopausal symptoms.

I can't sleep. I want a throat punch my husband for no reason. Like, that's a common one. You laugh, but that is a common one. But you went to it for number two. 100%.

The struggle is real. So all of these symptoms that can be described as perimenopause come from an initial drop in progesterone. But if you have a woman that's on birth control pills, those progestins, which don't match what the body makes, are connected to these receptors. And you won't get.

any of the relief. So this is a common, like you come in, you get a birth control pill for your perimenopausal symptoms and they don't feel any better. It makes no sense. But these progestins are linked to increased risk of breast cancer, increased risk of clots, increased risk of all sorts of bad stuff. Right, because they don't have the natural checks and balances at the natural hormone test. Exactly. You brought up an interesting symptom of paramedopause, which I did not know. Let's talk about this. I mean, this is real. This is very interesting because if you look at the data on divorce rates, there is a spike right about when women start to go through paramenopause and menopause. Totally. And it's not often talked about. And this is this big hormonal

change when suddenly you are what? You start to just be more irritable. You hate your angry, whatever. I got to think that's also exacerbated by, that's also the timing when your kids are probably getting out of the house and you're now having to reconnect to the men you married. Well, typically it's in the mid to late 30s, right? most women hit perimenopause in their 40s. It can start as early as mid-30s, but I've talked to plenty of hormone doctors that have been doing this way longer than I have that all swear marriages could be saved if both are hormonally optimized.

And women, you know, we're more menopause, but y'all go through hormonal changes too. We'd like to call antropause. It's not quite as definitive as our menopause. But typically divorces happen in their 40s and 50s. And if both could just get hormonal. optimise, I think a lot of... Yeah, just imagine you have...

I mean, how many times do you see this? We know this, watching friends that have gone through this, maybe even experienced it when you start having kids, you tend to divide and conquer, you lose that connection to your wife. That's okay, but we're building this family. Then the kids often go, and it's like, now we have to focus on us. And oh, my God, didn't realize how much we didn't like each other. Hormonal issues are going on.

And it's just like... And don't know it. Yeah. Yeah. And then exactly. And then it's just like, I would imagine that has a lot to do with that statistic. I wanted to go through the different hormones that tend to be involved with hormone replacement therapy and what a woman, okay, so I want to be clear, it's typically a combination of things, right? We don't typically look at hormone replacement therapy is like one.

Correct. Okay. But when you add one of these, what are the things that people typically experience? Let's start with progesterone. If a woman is now using progesterone, what is that going to, what could that do for her in terms of how she feels? Changes your life. I mean, truly. So unfortunately, women that have had a partial hysterectomy. So that means their uterus has been taken out, but their ovaries are left. Those women have traditionally not been offered progesterone because when you start estrogen, if you have unopposed estrogen, you can have endometrial cancer. Well, you just took out the uterus, so I don't have to worry about endometrial cancer. So now you have a woman just given estrogen and told, well, you don't need progesterone. Well, what about do I not want to protect my breasts and my ovaries and my bones and my brain? And I I mean, progesterone has protective benefits of so many things.

And the insomnia that hits us at midlife is very real. Progesterone is the solution for most women that have insomnia. There's this. So you take your progesterone. It goes through your GI track. It gets absorbed through the blood. It goes through the liver. First past metabolite goes to the brain and gives you all of the benefits of helping you sleep and with your mood.

Interesting. 100%. Okay. So it's relaxing. So people that I know, that will take progesterone, they'll take it an hour before bed. And then it's like bedtime. They're like ready to get some good sleep. So in my paramedopausal women, I'll let them know the dose of progesterone that is right for you is the one that helps you sleep well, takes away the moodiness.

You don't want to randomly throat punch your husband for no reason. It takes away the anxiety makes your PMS minimal to nothing. And it makes your period minimal to nothing. So everyone's different. I was just going to ask that. How do you know the right dose? Everyone is different. And does it take time to adjust? Absolutely. So in my program, I make patients commit to a full year because I know that it's going to take about a full year to find the doses that make you optimized. Is that because when you first start taking it, you're more sensitive? And so you're like, I got to wait a little bit or just configuring it out.

No, not necessarily. I mean, hormones are just slow. And also, I always say hormones are bullets. They're not magic bullets. So if you have a patient that just gets on hormones but is not doing the diet, lifestyle, sleep, exercise, all the things, then there's you're not going to feel optimized. So it has to be an entire approach. On average, I don't know if it's okay for you to say this,

but on average, what does a typical progesterone dose look like? And again, it varies everybody. So what you're about to say could be very different from person and person. So when patients come to us already on some sort of hormone replacement therapy, it's kind of like a cookie cutter. Everyone is just started on 100 milligrams of progesterone and estradiol patch. And they're still feeling terrible.

So personally, use estradile and a woman in perimenopause because that's the last hormone for the ovaries to stop making. And so when you give estradial to a woman that is still making estradial from her ovaries, she can get the five Bs. So the five Bs of too much estradile are bleeding, bloating, breast tenderness, blemishes, and bichiness. And literally when I list all of those and they're like, oh my gosh, yes.

I'm like, so we're going to take you. Yeah, we're going to take. Yeah. Exactly. Exactly. Exactly. So I take my perimenopausal women off of that estradiol patch that they're almost always given. And then I minimum start them at 200 milligrams. But I also, I like to go through, are they PCOS or not? So if they are perimenopausal and PCOS, often they need way more progesterone than a woman without PCOS. Okay. And then typically where does the dose of progesterone fall after a year for some women? I mean, I have someone that needs as much as 1,200 milligrams. Now, that's not average. The average paramedopausal woman, and need somewhere between 2 and 400. Okay, so that's on average.

Yeah. Okay, so progesterone, it calms you down, less anxiety, get good sleep, rest. Are there any aesthetic changes from progesterone? Or is it more of a feeling hormone? So there are some that can have a little bit of water retention in the initial three to six months. But we know that progesterone, not progesterone, but progestin actually can cause weight gain. So it's not just water weight. It actually can cause fat gain as well.

Progesterone can't. You can't have a little bit of water retention with progesterone. Yeah. How much does thyroid play a role in all this? That's a good question. So let's start with the next hormone. Yes. Let's go with thyroid.

What does thyroid do? What do people feel from that? What do they expect from? It's my favorite. So it's funny because this past weekend I taught at a hormone course. And Saturday morning, I taught on progesterone. Saturday afternoon I taught on thyroid. And I'm one that I talk fast.

And when I listen to lectures, I listen to them at 2X. And so literally the person that was the instructor or the person that's over us kept saying like slow down. And when I got to thyroid, I'm like, I'm hormonally optimized with thyroid. And I think that that's why I talk fast. So it's my favorite hormone. And it's the one that it's almost never utilized by hormone replacement doctors that they will, they will, you know, prescribe the 100 milligrams of progesterone, the esterile patch and then send you on your way. Right. So thyroid is my favorite because it, I've yet.

to meet a woman at midlife that doesn't have thyroid symptoms, right? And what will happen is they'll listen to a doctor like me online and they'll go to their primary care doctor or their OBGYN and be like, hey, yeah. You're fine. Too much. Well, yeah, no, exactly. He'll be like, I have a lot of these symptoms. Can you check my thyroid? And what they do is they just test T-SH, right? So T-SH stands for thyroid stimulating hormone. So it's a hormone that are pituitary makes. The way I like to explain it, it's like a text message that goes from your brain to your thyroid gland that says, hey, make more thyroid hormone. Okay. So the TSAH has been traditionally the only lab that primary care doctors or G.O.I.Ns or endocrinologists will use to tell you if you have thyroid issues or not. That is so

interesting that just that that part where the brain's telling you, because if you're not upregulating it or you're not absorbing it or your body's not like there could be a whole host of things I would imagine that would change that. To their defense, right, it can be a pretty strong correlate. In other words, if it's low or high, it can give us some information. It can give us some information on true hypothyroidism, but there are tons of studies that show that the level of symptoms that a patient has does not correlate with TSA. What else, Sal, what else would we measure like that where the signal from the brain is what we're going to determine if you're at optimal rates?

Wouldn't we normally, what else? Exactly. Everything else we would measure by alcohol hormone. But see, this is a fun fact. And I don't think most medical doctors even know this, much less the lay person. So every kind of doctor. So I used to be an anesthesiologist. So I was a member of the ASA, the American Society of Anesthesiologists.

Right. So each specialty has their own society. And these societies come out with these guidelines every about seven to 10 years. Okay. So these guidelines you would think would be based on the most recent literature and the highest quality of research. Right. So like a randomized control trial. That's like grade A versus grade D, which is just someone's opinion or just a retrospective look at the literature.

So it's not. what it is, it's a group of physicians that are, you know, elected, you know, high ups in that society that sit around and decide, well, these are our guidelines. Now, are these people influenced by big pharma? Absolutely. So it is not the most recent data and the best quality data, right? Wow. So when I found that out, I was like, how is this even legal? Right. Right. But so the thyroid society and endocrinology society, they have always said, said the guidelines are to only measure TSA, even though there's tons of high quality research that show that TSA really doesn't correlate to how well the patient feels. It's the free T3, and that's what's happening inside of the cell. But they say free T3 is not a good test to use, even though it's 100% in my client. I was just saying it would be better. Absolutely. Absolutely. So when I look at labs, I'll let patients know, like, look, if you go to your primary care doctor, they're only going to look at TSA, maybe free T4, but they will not look at.

at free T3. And this is actually the number that I care about the most because the lower it is, the more likelihood that you're going to say yes to a lot of these low thyroid symptoms. And so I will list them. There's 10 of them. And I'll be like, I want to know how many of these do you relate with. And they'll be like, oh my gosh, you know, at least half. Or sometimes it's like all of them, even though they've just been told your thyroid is normal. And what are those symptoms? So weight gain or difficulty losing weight. Cold intolerance, which is pretty much only in females. I've yet to meet a man. I mean, it's rare that men will be like, oh, I'm cold, the time, but it's typically a woman thing.

Brain fog, difficulty recalling, names, words, or numbers, low energy, dry skin, brittle nails, constipation, depressed mood, overall lethargy. Oh, and hair loss. So somebody goes on thyroid. You put them on thyroid. I'm assuming you're using, like, armor, which is what, T3, T4? So that's a brand name of natural desiccated thyroid, right? So armor is a brand name.

M.P. Thyroid is a brand name. I like to just use a high-quality common. compounded natural desicated thyroid. This is actually what the FDA is trying to take away from us right now. So we have a year to fight that because if they take that away, then we will not have a good natural desiccated thyroid hormone to prescribe. What we have to use. Synthetic T3 and synthetic T4. And you'll have to figure out whatever the ratio is.

Exactly. Exactly. Now, is thyroid also like is it the way people respond to it individually similar to like with testosterone? Like for example, for a male, you know, 400 to 1100 is just huge range. Some men feel totally fine at 600. Other men feel not good at all, and they need to be closer to 1,100. Exactly. And so thyroid is.

That's the whole point in optimized health is I'm going to find the dose that makes all of those symptoms go away. So typically, and I'll let them understand, like at the beginning of each new patient console, I'll be like, look, we're going to look at your labs and we're going to talk about how your normal labs are not optimal labs. And if you let me take over the management of your hormones, you'll find that this time next year, all of them will be labeled abnormal. And that's typically where people feel their best.

So like when we're talking about thyroid, I'll let them know, look, your free T3 will probably be labeled too high between about five and seven. Now, here's the thing. Your primary care, they don't check the free T3. But what they will check is your TSA. And your TSA. And your TSA will be suppressed to zero. And I explained, so if you're going to take exogenous, meaning outside of the body, thyroid hormone, it's going to go through the GI tract, get absorbed through the blood, go to that center of the brain, the hypothalamus and the pituitary. And they're going to be like, hey, we have enough thyroid hormone. So we don't need to send that text message to the thyroid gland, T-S-H, to say, make more thyroid. So, of course, it's going to be zero. Same way with a woman who's on birth control pills, their LH and FSAH are going to be zero because it's being suppressed.

We don't care about that. And then actually, people that have a history of thyroid cancer, we intentionally suppress the TSA to zero forever. So we know it's safe. And in fact, one of my most recent patients, she's 38, a history of thyroid cancer, she's been working with the endocrinologist forever, just at her, three-month appointment, I was able to suppress her TSA to zero. And she was like, I've never felt this great. And the endocrinologist couldn't even do this. So they take thyroid and you get them in these ranges.

Yep. They don't feel the lethargy. They feel sharper. They feel amazing. And I've heard thyroid is being referred to as one of the aesthetic hormones. What else so happens with them when they take it? Oh, your body composition totally changed. Absolutely.

So the underlying root cause of so many problems is insulin resistance, right? So if you, when you think insulin resistance, you need to think about visceral fat, right? I wish that we could require everyone to get a dexas scan so that you can see exactly where you're at with this real fat. Exactly. Because the more visceral fat you have, the more likelihood that you have insulin resistance and all of the hormonal issues that come along with insulin resistance, right? So if you have a lot of visceral fat and you're metabolically busted, thyroid hormone is going to be key in helping reverse that. Yeah, so people go on thyroid, they get more energy and they get leaner. Absolutely.

I notice, so I take thyroid. I take a little bit of thyroid. I noticed, yeah, I do. In the morning, I take all. I know. He feels cold. Yeah. No, I, taking the, I noticed with thyroid, it made my other hormone replacement therapy work better.

Absolutely. It seemed to have a synergistic effect with the testosterone. So, which is quite interesting. Yeah. When I have male patients, I'll let them know. Like, look, typically men are one of two stereotypes. You're either just wanting me to help you with your testosterone. or you're going to let me get all of your hormones optimized.

And when I say that, I think it gives them a sense of like, okay, I have some control, right? And they'll be like, well, yeah, let's do all of the hormones. So typically, if I have a man that's like, let's do all of them, it's thyroid, testosterone, and DHA. Yeah. Oh, interesting. Awesome. Okay. Okay.

So we talked about progesterone. We talked about thyroid. Let's talk about testosterone for women. What does that look like for women when they start taking testosterone? And is there a wide variance with that as well? It changes everything. Okay. So first of all, can I address the word overdose?

Yeah. Okay? Because being a former anesthesiologist, when I hear overdose, I- Oh, that's death for anesthesia. 100%. Absolutely. If you overdosed a pain, you put anesthesia. Legit.

Like, I remember my very first day in residency. Dr. Gakowski was teaching me. We had an insulin patient or a type 1 diabetic, and it was a long case, and so we had to give them insulin. And I remember she scared the poo out of me because she's like, you can kill a patient if you do this wrong. Because if you give too much insulin, you can literally kill them, right?

So that's an overdose, right? Or fentanyl. You know, we use fentanyl as anesthesiologist all the time. If you give them too much narcotic and you're not controlling their airway, that overdose can kill them, right? With our sex hormones, you can't kill someone. So if I overshoot your testosterone,

I'm not going to kill you. And in fact, testosterone and women is one of the most well-studied hormones. We have 30 years plus of one, women that want to be men on really high dose of testosterone and we know how safe it is. Like insane levels of testosterone. Absolutely. So I know that roughly the range of where all of the women will feel their best, it's totally going to be labeled too high. And if they go to their primary care doctor and get it measured, their primary care doctor is going to scare them, telling them all

of the misinformation that, oh, you're going to get a clot, you're going to get cancer and all of the dumb stuff that I hear associated with just hormone replacement therapy and especially testosterone and women. But it literally changed your life as a woman. I mean, what do they notice? Sexual benefits are literally like, again, it changes everything in the bedroom. So when I talk about testosterone, when it is fully optimized in a female, you have sexual and non-sexual benefits, right? So it will increase your libido.

It will help easier orgasms and better quality orgasms. It helps improve vaginal lubrication, which obviously helps everything in the bedroom, but also prevents UTIs because dry vaginas lead to UTIs that lead to sepsis that lead to death, right? And then the non-sexual benefits, I mean, your performance and the gym. in the gym. Yeah, absolutely. I mean, literally, I've been on testosterone now for two years, and people comment about my arms. This is like new for me. It's literally the muscle mass is crazy. Your performance in the gym, it will help decrease both subcutaneous and visceral fat. So if muscle mass is going up, fat mass is going down, percent body fat goes down. So composition changes, right? We have testosterone receptors in the brain,

so it'll give you better mood, better energy, more motivation, more vigor. I mean, you feel like Superwoman. your testosterone is optimized. I like to think of testosterone as like a dopamine type hormone. It's like a drive, motivate, you know, I can do this thing. Yes. Type of deal. And people typically feel really good on it. Absolutely.

In combination with thyroid, that's your aesthetic combo. Absolutely. For visual changes. Correct. Those two make the biggest ones. Correct. But with women, it's men, I can literally, and all of my patients, I require them to lift weights anyway. But men, if they just got on hormones and didn't lift weights, they could still see body

comp changes, we women have to put the work in. If we really want to change our body, it has to be in combination. Yeah, you mentioned DHA. Now, that's over the counter. So why use that, why would anybody use DHA in this hormone therapy? Yeah, DHA has some great benefits too. It's a great anti-inflammatory. So we're all in our 40s. And this is the decade where people start to complain about the aches and pains of getting older, right? That typically, when you get that in optimal range, it will typically take that away because it's such a strong anti-inflammatory. And in fact, there's a lot of autoimmune patients that will aim for even higher levels of DHEA because it helps suppress the inflammation that comes along with it. I think, you know, when I think hormone replacement therapy, the word, the important word on this is therapy because you're looking at a combination of hormones.

You're looking at how the person's symptoms resolve, how they feel. And then you're looking at the hormones in relation to each other. Correct. Because, you know, I noticed for myself, because of my testosterone replacement therapy, taking a little DHAA makes me. feel better, and I don't think it's because I was low in DHA, but rather it's relationship to my current levels of testosterone. And so you're looking at all these things when you're working with a patient. Absolutely.

Are women generally harder to treat? Oh, yes. I mean, there are some days I'm like, I wish I could just treat men. Y'all are so much easier. Just come on testosterone. Exactly. Two levers really, yeah. Well, how often do you have to, so we've obviously, we've all personally, I think, personally,

have sent a lot of family, friends, your way, and that you've helped out. If any of them ever come back to me, like, questioning or concern, it's always because they're still speaking to their other practitioners. And they're always like, you know, Dr. Lawrence's telling me this. But then I'm my doctor saying, this is crazy and this is this. And I'm just like, oh, my God. I'm like, stop it. Like, go, I sent you to her to listen to her.

Yes. Like, you got to ignore that because this is why you're with her. It's like, it hasn't worked for years seeing your regular physician. how often are you having that conversation? I've become more intentional at that initial appointment to let them know. If you're going to let me take over the management of your hormones, these are going to be the areas that your primary care doctor is going to put you in an awkward position. And when all due respect, your primary care doctor is a specialty,

he specializes in primary care and not in hormones. If he did, you wouldn't be in front of me, right? So let me manage your hormones. Let them manage your primary care needs. And so like specifically thyroid, that's probably the one, Number one. It's so annoying. So I will let them know your TSA will be 0.0.

That is almost 100% of patients. That's where they feel their best. It's completely safe, but this will freak out your primary care doctor. They'll tell you that you have hyperthyroidism. And then you'll be like, no, I'm taking thyroid. Oh, well, then you're being overdosed. No, you're not. You're being optimized.

And but they, unfortunately, they're not, they're not trained in hormones. Like, that's not their specialty. So they're, they're associating the bad side effect. of graves, which is an autoimmune hyperthyroid state with being given the high dose of thyroid. Because in graves, that's when you see TSA at zero. Right. But that's a symptom of this autoimmune issue. Exactly.

So when you take a person's thyroid out that has Graves disease, you still get the bad side effects of thyroid that can lead to cardiac issues and all of the bad things. So they assume that because I'm giving them levels that will suppress their TSA, to the same as if it were grades, that it's the same outcome. And there's not a single study that shows that. Do you work with growth hormone? What about growth hormone therapy? Yeah, growth hormone.

So it's a great hormone. It typically is done in our brain by the time we're 50s. So replacing growth hormone is typically something that I only do with patients that are in their 50s and beyond. If I'm working with someone in their 30s or 40s and I want to induce their own natural growth hormone production, I'll use some peptides like Tessemeralin or something like that. Yeah. How much have peptides now been played a role in your practice? It's definitely becoming more of a role. I mean, the way I like to explain it, hormones are bullets, peptides or BBs.

Both can do a lot of great, but let's get your hormones optimized first before we play around with peptides. That's a cool way to give that. I've always trying to explain that because people are always asking me like what I think about peptides. Because obviously it's popular shit right now. Everybody's seen it on the internet and everybody knows that I have access to it. So they're like sitting, what do I need to do? Listen, let's first get the diet and working out first. And let's go get your blood work.

Let's see where your hormones are. And then I can tell you what peptides take. They are awesome, but it's like it's not the big rocks. No, no. Do the other stuff first. And then it makes a big deal. Absolutely. Yeah.

Absolutely. Is it an issue if somebody has, let's say, unhealthy lifestyle. They don't eat great. They're not exercising, so they're sedentary, overweight. and they want to get on hormone replacement therapy. Is that not a good idea to push hormones up to a level when the person is inflamed and unhealthy? Or is that just suboptimal? It's just suboptimal.

I mean, oftentimes getting them started in hormones will push them to be motivated. Absolutely. Because they feel better. Absolutely. Yeah. And that's a big part of your practice, too, is encouraging. Let me ask you this as a doctor. Yes.

I'm going to guess. But I can imagine getting someone to take their hormones is probably a lot easier than getting someone to consistently exercise and eat right? All day, every day. Y'all know that. Yes. But I also, I mean, we don't take health insurance. So it's a cash pay. Oh, you get a little bit of a bias of people.

100%. And I make them pay for the full year because I know specifically women, just being in the health and fitness world for so long, I know that they're not going to feel amazing by three months in and maybe not even six months in. so I need them to buy in for the full year because nothing happens fast with hormones, right? It's so good you do that because that's the other conversation that I've had is that like, yeah, I've been doing everything she's saying. It's like, it's been three months. Like, keep going. Yes, exactly. It takes time to reverse a lot of this.

I literally have only had one patient at the nine month appointment because I see them every three months, right? I only had one patient at the nine month appointment that was not feeling amazing. And I think other things are going on with her, but that's, you know. So I'm so, so this is so great because you're speaking. speaking coach talk now because as a trainer, what's really important when you work with someone that you forecast accurately and let them know, here's what to expect, because when they have different expectations, then it's hard to kind of back. So you're telling them, like, look, it's going to take us a year to figure this out. I mean, these were back from my beachbody coaching

days. I mean, all jokes aside, though, literally, I mean, I did, you know, health coach for quite a while. And so my experience with that, I just know how we want instant gratification and we're so easy to quit if we don't see changes in the first three months. So I'm like, nope, you're bought in for the full year. And they also know that I will fire them. So, I mean, I'm very clear about that from day one. Like, if you don't do what I ask you to do, I will fire you because I don't want your bad outcome to make me look bad. Any initial side effects from hormone replacement therapy that you communicate like, hey, when you start on progesterone, you might feel lethargic. at first or when you start testosterone.

Oh, yeah. Oh, yeah. And some people feel worse before they feel better too. That's part of that three months. I don't feel better. I feel like I'm worse than I was. I'm like, yeah, that's, you're changing. You're transitioning right now from what's going on right now.

Stay the course. This is where women are more challenging than you men. Now let's talk about the way that you, because you are a huge proponent of how you advocate for testosterone to be applied. So let's talk about that because the traditional way of using testosterone is a once a week. intramuscular injection. You like to use creams. Yes.

Intravasional or vaginal? Absolutely. Why is that? So it most closely mimics what our body was doing when we were hormonally optimized. So when you're 19 or 20 years old, your testosterone peaks and troughs every 24 hours. So that's why I like. And it's easier for, I mean, I can get really high levels with that cream. So I give patients the options, right?

There's multiple ways that I can give you testosterone. Pellets are my least favorite because. Because of the slow. Exactly. You feel great in that first month, and then month two, three, month four, you're feeling not so great. So I want you to feel great every day, right? And when I first started testosterone, I was doing the once a week I am injections.

So I can speak from my own personal experience, but then also now seeing so many patients taking them from the injections to daily cream. And I let them know, like, if you are not feeling great by, you know, three, six months in, we can always go back to injections. And that never happens. Is, are there, this is probably speculative, but are there, the receptors on the vagina that would make it so that when you use it vaginally that there's more sexual benefits?

It happens all the time. So it increases sensitivity now to the areas that you're applying. Oh, interesting. Yes. I mean, women that are looking for a help in libido that I've been on testosterone, my libido's crap, like, just wait. I got you, girl. Put it on here.

The reason why I'm saying that is because I actually saw some places promoting like libido-enhanes. cleansing creams that had some testosterone in them, but also had tadalafil, I think, which is, I believe, a PD5 inhibitor. And it was vaginal. I'm like, wait, testosterone. I'm like, I wonder if there's an increased improvement in sensitivity because you're applying it to that area. Absolutely.

Absolutely. I will tell my women that are still menstruating, literally put it on your finger and literally stick it up your hoo-ha like a tampon. If you're bleeding, then put it on your labia. But literally, I mean, it's life changing in the bedroom for a while. The Tadafel or whatever, isn't that like Viagra? Yep. Yeah, that is.

Okay, so basically they're putting testosterone and Viagra on. Which just the mechanism of action is just, exactly, increases blood flow. That makes sense. So blood flow down there is effective for both men and women. Yeah. What are some of the, so what are some of the big myths you still have to overcome or conversations? I feel like people are so much more aware now. True.

Around hormone replacement therapy. True. Where it's not so taboo. But, you know, what are the big myth? out there that when you go do these conferences and you're talking about this, what are the things that people want to want you to speak about? The breast cancer thing always comes up. I mean, because you hear hormones and you automatically think breast cancer because we've been brainwashed over the last 20, 25 years that hormones cause breast cancer. So I always have to break that down

and the literature is very clear that bioidentical hormones not only do not cause breast cancer, but they're protective against breast cancer. Absolutely. Think about it. The women in their menstruating years don't get breast cancer for the most. part. It's typically women that are postmenopausal, right? If the natural hormones that our body was making would increase your risk of breast cancer, we would see it way more in menstruating women. So it's similar. Wouldn't you say it's similar with men and testosterone? That's still the stigma around men taking testosterone. It's increased cancer risk. And it's just like, no, if you're an unhealthy, low testosterone male, you're at a higher risk than someone who's at optimized hormones.

Well, I also think there's, it may come from here as well where, if you had breast cancer or you're treating best cancer, they block estrogen at the receptor because in that situation, hormones can drive cancer once you have cancer. Yeah, but won't anything drive that? Yeah, but I mean grow it once it's like at that point so you can make that case? So here's the thing. I will not take a patient who's in the middle of breast cancer. But after she's over that, she 100% is safe to do. hormones. The book that I always recommend, it's called Estrogen Matters, it is written by an oncologist,

and his wife is a breast cancer survivor. And so he dispels all of these myths that, oh, you have a history of breast cancer, you can't do HRT. That's just a lie. And he goes through it. It's a great book. And it's written for someone that's not medical. So I always send patients to that because that's the biggest fear. I mean, even one of my own staff, she has a history of breast cancer. And I cannot, for the life of me, convince her that these hormones are not going to increase. Because it's scary. Yeah. Well, some, when you have cancer, some of them are hormone sensitive. This is while you have the tumor.

Right. So for men, I'll just use a man example for men. If the man has prostate cancer taking testosterone may speed up its growth. Only if their total testosterone is less than 250. Got it. Okay. Okay. So would I take on someone as a patient in the middle of cancer?

If it was my dad, I would 100% start him on testosterone. Oh, wow. Interesting. But if it's someone that can sue me, and this is, unfortunately, this is the life that we live in. Yeah. They'll teach us. If it's you and your own, you can do this. But if it's, if it's just a, you know, a patient that's not connected to you that can come back and sue you, then don't do it. Back up for me there. So if you had to start a testicular cancer and you were lower than 250, it was your dad, we're saying. So you're not getting in trouble here. You would still take. Oh, absolutely. Wow. Wow. Okay. Interesting. What do you see with hormone replacement therapy and other measurements like blood lipid levels, you know, signs of insulin resistance, stuff like that? Do you see any changes? Yeah, absolutely. We check lipid panel once a year. The two numbers that I care most about are your good cholesterol, your HDL and your triglycerides.

The triglycerides are almost always decreased in that first year. We see a pattern of in the first year, typically a drop in HDL and then it bounces back in year two. but overall LDL is almost always decreased. And more importantly, the LP little A, which they say it's just genetic and there's nothing you can do. There was a drug that I think just went through phase three trials in the recent past. I'm sure it's super expensive that can apparently lower LP LLA. But guess what? Testosterone can just lower LPLA.

So one of my patients dropped her LPLA in just one year from 300 to 200. Wow. Yeah. Wow. And what about insulin sensitivity? Oh, thyroid and testosterone, baby. I mean, yes. And you see a big change there.

Absolutely. Absolutely. Their home I.R. and their fasting insulin almost always decrease in the first year. That's great. Tell me a little bit about your practice because people, we get, you know, people go to you who've listened to the show and they just come back and they just love you. And I think they love you.

You do a good job. Thank you. But I think they love you because you guys, they seem to feel like they're really cared about. So tell us a little bit about your practice and what do you do that's different. Like what's going on? I mean, I don't, I don't know what we do. do that's different. We just really care. I mean, I really, like, I'm in my purpose, and I've got amazing staff that really care. We all understand that it's not just a business, it's a mission,

and we have the tools to help people literally change their lives. And so, I mean, you know, I, when you come in, whether it's to be hormone patient or maybe a weight loss patient, or maybe just do functional medicine, there's always this initial evaluation. We'll look at labs. We'll talk about your options. But just like with my weight loss program, we see you once a month. I don't, I don't want you to become that, you know, Ozympic face, Ozympic butt person that loses 30 pounds in 30 days and you've lost 15 pounds of muscle. Like I'm not going to do that. So would it, would I make more money if I didn't see them once a month? Absolutely. And just recently one of my staff members were like, can we, do we have to see them once a month? Yes, we do. Talk to me a little bit about,

because obviously GLP ones are huge now. Give me some ideas, like how many patients are you seeing on it? What are you noticing? What are the challenges? I think they are incredible tools when used appropriately. And I have a lot of my patients that have reached their ideal body weight and they come off of it. And they're like, can I just get back on a small dose for the inflammatory benefits? So I will literally have patients that cycle on and off a very small dose of GLP-1s, six months on, three months off, six months off.

Do you like, do you have a preference over some agglutide? versus Trezepotide? I mean, you know, iPhone 14 versus iPhone 15. Yeah. Right? I mean, they're both great, but iPhone 15 does it better than 14, you know, and then Reda Trutide, which has the three mechanisms of action is even better. Are we using that already or is that still?

Ish. Okay. Ish. Okay. Yeah. Soon to be. Yes. That's the one.

That is crazy. That one just the, that's the one that the body. I can't wrap my brain around the science on how it's possible to gain muscle and lose body fat. It is happening with red or true diet. That's the one that's taking the bodybuilding world by storm. Exactly. Has anybody reported like any changes in addictive behavior?

Oh, 100%. I mean, it is, it's going to be used off label in so many different patients. I mean, I think last time I was here, I might have told you all about my patient that had the addiction to the nicotine gum. And she literally, she wasn't a smoker. She just started it because she heard nicotine gum was good on a podcast and literally had this like crazy addiction. And she was losing like a lot of money every month because she was so addicted to it. And Samaglite broke. And she was like, I don't care if I don't lose weight.

This was 100% worth every single penny that I paid for it. So, wow. Yeah, I know. Those areas in the brain. Now, talk about the challenges, though, because we, I mean, this, we obviously take a lot of live callers. We have written a program for GLP1. So we ran a group that you've talked to. The thing that I see probably the most common is someone like who's been on a GLP.

LP1 for like a year. And let's say they had like a 100 pound plus goal. And they did really good and they get like to 50 by just crushing the appetite. Yep. And then they get to a point where they're like 1,100 calories or something like that. And they've been at this hard plateau forever. And they're walking. They're doing all the things.

Are you seeing that a lot? And do you typically lower the dose reverse diet? What are kind of your strategies? I was not saying. I will send them to people like y'all to help them reverse diet. But also just splitting the dose has helped a lot too. So some of our patients are twice a week. Some of them are even three times a week.

And just taking the dose but dividing it. Oh, interesting. Yeah. And that's started to move the needle. So instead of taking a once a week, it's more frequent half dose. And what is that producing? Just less. It's starting to move the needle.

Yeah. Less of a crushing appetite and just more subtle. I didn't even think about that. Yeah. So it's funny about that, by the way, I don't know if you're already doing this. You're so busy. So I don't think so. But if you ever read.

Bodybuilding forums. Yeah. These are the cosmonauts. I definitely don't do that for the record. Let me just establish that. But if you ever want to, like, just like, when you say that, I do that every. If you ever want to, like, go into, and observe a group of people who are willing to experiment on themselves. It's the bodybuilding world.

I do know that. And they're the ones that have done all this stuff. Oh, yeah. And they're, that's how they use Reda 2 Tribe. Oh, yeah. They use, they don't use one dose. They use, like, three or four small, and that's that, that's what they're saying. What we call?

Fermanauts. Yeah, no, cosmonaut. Yeah, former, form of cosmonauts. Oh, yeah. Oh, yeah. So that's what they typically do. Hey, we're pushing the science forward, dude. Yeah. So let me ask you.

I am grateful for that. A few deaths here and there. No big deal. Let's see what happens. That's great. So tell us about, I love that you're doing these speaking. By the way, you're a great speaker. Thank you.

Yeah. You and I both spoke at the peptide Congress. Right. And when I was done. And I have to thank you guys because Dr. Seeds would have never known who I am. if it weren't for you guys putting me on your podcast. Well, I got to tell you, so I had this ego boost,

and then I was like, what? So I come off stage and people like, you were the best speaker. So I'm like, wow, that's so awesome. And then the next day, people were coming up to me, Dr. Fitz was the best. I was like, oh, wow. All right, that's great.

So tell me about these speaking engagement. Why are they inviting you on? This must be just the, the interest must be just exploding right now around this. Well, I think she's, I mean, every time you've been with us, you've communicated, you communicate it really, really well. And I think there's a lot of women that are being told by their general practitioners, you know, but yet they know in their heart that they don't feel right. And they're trying all the things. Totally. And they're getting told, you're fine or you're good.

And it just doesn't make sense. And I think you do a really good job of communicating that. And I just don't think there's a lot of resources for people like that. When I was preparing to come on your show this time last year, I've been listening to you guys for a long time. So I knew all of the great people that y'all had on board, but you'd never really addressed this thing. And so I was like, I know that you have so many people that listen that need to hear this message.

Because normal isn't optimal. And your normal labs, you're feeling like crap, fire that doctor and find someone that will listen to you. This might be controversial, but do you think most women should be on hormone replacement therapy once they get into? 100%. menopause. What about the whole like, you know, I'm sure you hear this argument. Like, well, it's natural. You're supposed to go into menopause. I mean, that's fine. Like, you can do that, but I choose, I know what my quality of life is when I'm hormonally optimized. So that's the beautiful thing about hormones is that if you get on it and you're like, this is not worth it for

me, you can stop them at any given time, whether it's a year from now, five years from now, 10 years from now. I'm 45 and I will be on this until the last day on earth. because I understand it protects me from all of the things and I feel amazing. I don't remember the doctor who my mother-in-law was very close friends to, but she's been advocated. This is the 30 years. She's been advocating for this. And I always thought it was interesting when I first met Katrina that her mom was so adamant

about when you were in your 20s and early 30s to get your blood work done, see where you're soon going to be on hormones and you're going to be able to look back and be like, this is what my optimal is. and she helps coach life coach people. And almost every single first thing she does with every woman she life coaches is send them to go get their hormones. So that's how I explain it. Because I have a lot of cousins. We're around the same age.

There's like nine of us that grew up together. So includes my brother. And so it's a bunch of dudes that grew up. And I'm the guy on all the hormone replacement therapy. Yep. And so they're asking me like, you look younger than all that. Oh, seriously. I also have four kids and I was divorced.

So I got that work. But we'll talk and it's like, you know, I'm like, look, you still get older. So it's not like I'm like, you know, I'm a 20 year old. I can still tell that I'm 46. But it's definitely very different. Well, anyway, finally, one of my cousins, who's my age, went on some testosterone. And he's like, dude, he goes, I didn't know how bad I was feeling. Yep.

You know, because, you know, he's a black belt and jihitsu. He trains. And we're talking all the time. And he's always like, well, natural's better. like, listen, dude, you're not doing crazy stuff. This is optimizing you. I said, you work out. You try to watch your diet.

Do you like doing your jihitsu? Do you like working out? And I'm like, you'll enjoy it more. And so he gets back on. He's like, dude, I didn't realize how low my tolerance for exercise stress was. He's like, I would go to jihitsu and I'd roll and I'd try to go easy, but I'd just feel beat up. Yeah. You know, I was just feeling beat up from everything.

He's like, man, I feel like I can train again and I feel good. And he's on like a low, he's like super conservative because he's like scared to go on hire. He's not like me. Where I'm like, what's the most like I think? But he's coming back and he's like, dude, this feels so different. So now everybody else is starting to kind of get convinced like. And I'm a big believer. Like, you know, I get older.

But you also have to remember, it's not natural for us to eat processed food. It's not natural for us to breathe, you know, the chemtrails that were, you know, were exposed to. Did you watch that documentary, by the way? No, I love it. Got to. I don't know I'd like to let you more. I'm a full-fledged conspiracy theorist. Thank you very much.

But I mean, it's not natural all of the things that we're exposed to. So if you want to go through it just, you know, naturally just to say you did it, here's your, you know, gold star. But I ain't doing that. I know it's quality. I'm so hard. I'm trying to convince my best friend is like, I can't get him to. I'm literally about to like finance it just so I'm like, I'm going to finance it.

for like a year. What's stopping him though? I mean, it's, it cost a little bit because he's like, I know, I know, even just, but just the steps of go get my blood work. Just the step. And him feeling like, I'm okay. And I know, I'm like, no, you're not. I'm on the outside going like, no, no, you're not. I know. I know. I'm saying. I grew up with you, you know. And again, you just, you get so adapted. The body is so resilient that you start to fool yourself of like, yeah, I'm fine. I'm normal. And then you get on that nice little dose and it's like, oh. Well, it's the same thing when I was talking. So my parents were on my very. first two patients and got on FaceTime with him. And my mom has always just done blindly what I tell her to. My dad, he has to hear it from Peter Atia before he believes it, right? Let's just be real. So my mom is, you know, yes, let's do it. Whatever you say. And my dad's like, tell me why I need this. I'm pretty, you know, I feel like I'm pretty good. I'm like you are, but you're not optimized. I don't know. Dad, give me six months. And if you don't feel any difference in six months,

you can go off of it. Okay. And sure enough, he was like, well, I'm starting to see muscle again. Yeah. You don't know how much better you're going to feel until you try it. And what's to hurt? Like worst case scenario, you invest and you do it for a year and you're like, no, it didn't do anything. Okay, cool. Like the next time dad says that, you tell him, you say, hey, I've been on mine pup twice. Peter T. I've never been on there. Totally. The way I look at it, there's a couple things. First off, we know that men's testosterone levels have been dropping for something like 50 years. It's well documented.

Very well documented. So this is a, this is not like, this is not, you know, controversial in any way. No. It's for sure going down. Fertility in general is going down. Women are more hormonally imbalanced, natural women than ever. Why? There's a lot of reasons possibly why, probably a combination of things.

Nonetheless, hormone optimization is becoming less of a like, like that's cool and more of it might be more necessary for a lot of people because of the things that are happening to us through our, unnatural environment. Absolutely. It's exposure to things like xenoestrogens and microbiome being thrown off and our lifestyles and all that stuff. So, yeah. Well,

how rare is our business partner? I mean, Doug is like the only dude I know that's. You know what his natural testosterone levels are at? I heard y'all. His totals are like 1100. Yeah. Yeah.

That's not normal. Yeah. Those are old numbers. Yeah. Oh, they're higher now. Yeah. All right. Easy guy.

Easy guy. Easy guy. But when he was in his teenage years and 20s, he wasn't exposed to a lot of the Integrity and Disrupting agents. He's also, I would say, you know, the three of us are obviously the gurus, but he's the better student. Right. He's, he's better than all of us.

I think he is better at working on his sleep. He's better consistent with whole foods. I think he's one of the best. I think he at that. But she makes a great point, you know, he wasn't exposed. The amount of chemicals now that you grow up with. Totally. Just from the things you touch and the clothes you wear and the stuff you put on your skin is just insane compared to what it was.

I have three families that I'm taking care of where I'm taking care of the mom and dad that are in their 40s or 50s and then they're adult children. And the dad's testosterone is always higher than the son's testosterone who's in his 20s. That's so crazy. Yeah. Because he's been exposed to all of these endocrine disrupting agents for his entire childhood and adolescents. The way I try to look at... How much is this playing a role in all these weak-ass men

that was... Oh, yeah. Can we... Yeah. We will go there if y'all want to. I mean, I know what it's like to have very low testosterone and you feel,

you don't feel like the man you are on optimized testosterone. Imagine me being a single 45-year-old female trying to find a man that, yeah. See? Uh-huh. The struggle is real.

You know, I mean, there's a couple ways, too, to look at this. There's definitely, and I'm just going to call it out, this is what I struggle with. There's definitely, you can go on hormone replacement therapy to really push the limits and you might be a little too focused on aesthetics and that kind of stuff. That happens to me. But then there's this other side, which is, you know, it will improve the quality of your life so you can do the important things more often and better. So more energy to play with my kids, more energy to perform at work, better sleep so I feel better, things that can, you know, I can, you know, I can,

enjoy the sports and activities that I used to enjoy, which bring me joy and allow me to connect with people. And I really, I think that's the main benefit. Yeah, it's how you show up to the world. Yeah. So if you are a better version of you, then everyone in your world appreciates that. We really appreciate when you come and speak to our groups. They love hearing you talk. How do you enjoy doing that? These are all like just coaching clubs. Yeah, no, I love doing that. Yeah, what do you think of the Musa Womami group? It's awesome. Yeah, yeah. I will have to say, I'm not as good about getting on school versus the Facebook group last summer. Yeah.

I need to be better about that, but I've been juggling a lot. Well, you know, for your like own self, business wise, I tell you what, I'm blown away by school. Yeah. So that's my, that was my first introduction to it. And the UI is incredible and the things that you can do. So I don't know how much you've dove around. I need to talk off air about all the business stuff you can do with it. Very, very cool.

Have you thought about, because you're, you know, very smart, especially with, and even in business, have you thought about combining what you do with like trainers and coaches and gyms? Absolutely. Absolutely. I just don't, I could see the synergy just so much where, I mean, we've talked about having our trainers and coaches work with doctors and stuff. Have you thought of that? Absolutely. Absolutely. I mean, I've thought about, you know, the three of you guys, you know, doing something with me because, I mean, what y'all bring to the table versus what I bring to the table is what most people need, you know? I've also talked about it with one

of my best friends who has been in the fitness world forever. You know, she's the health coach nutrition, whatever. And yeah, it's, I think it's the missing element for a lot of people. So do I, because I even have a friend who's a psychiatrist. And we've talked about this. And she's actually learning about hormone replacement therapy for her practice. Oh, yeah. Because of all of the people that she sees.

And she's like, you know, a lot of some of these issues. That's what I'm telling you. What I'm telling you about my mother-in-law, who's the life coach, that's like, They come to her and, oh, the husband, this, that. And she's just like, go get your hormones, take care of first. And then we'll work on all the other shit because you're just battling uphill. I can teach you all the tools on how to communicate with your husband and this and that. But if you're hormonally out of whack, you're just, you're fighting an uphill battle.

Do you understand how many people don't need to be on SSRIs? They just need hormones optimized. Right. I mean, when I give the patient even hope that maybe they don't need to be on that SSRI the rest of their life, they're like, are you kidding me? I've been on this for 20 years. So I know personally, I know people personally who've done this. And here you have, so the symptoms were anxiety, worry, you know, mood was kind of up and down. Doctor puts you on an SSRI, which comes with the side effects, by the way.

Nobody talks about this. Erectile dysfunction. Well, it was a woman. It was sexual dysfunction. Oh, yeah. And so these are people, these are friends of ours. And it's like you feel numb or numb down there. So issues with orgasm, sexual.

Weight gain. Yep. Those are the side effects of this, you know, kind of numbing agent, which kind of, okay, so the anxiety got a little better, moods got a little better, but also sexual dysfunction, also weight gain. On the hormones, mood is better, no anxiety, sleeping better, except I'm leaner, not gaining body fat. And my sexual, you know, how I respond and how I feel sexually has improved.

So it's like the best, the best versus, you know, you get all these crazy. effects. Correct. I think there's a lot of women, because again, you look at the data on women prescribed SSRIs and enzeolytics, it's right around the time when paramedopause and menopause is. Oh, that's the standard. If they go to their primary care doctor, they'll be put on birth control pills and an SSRI. They're doing terrible hormone replacement. Terrible. Terrible. Yeah. No, it's, I, I think that if psychiatrists really understood that their patients don't need all of these, you know, terrible drugs that are, you know, pharmaceutical drugs that these patients think they need to be on for life, they really just

need hormones. It would take a huge portion of pharma out of business. At the very least, because I think there's a role in some of the stuff, but at the very least, you could lower doses to optimize hormones. But put it differently, a hormonally optimized person probably needs less of everything else, even if they did need something else. Yeah. I think the amount of the percent of people that are on some sort of a psychiatric drug, whether it's an SSR or whatnot, would be, significantly decreased to like 10% if maybe even less than 10% if we just addressed hormones diet and lifestyle. Does that happen with you? We get these clients and then they go on hormones and then they start coming off stuff. All the time. All the time. I will let them know. I don't want to even talk about it

until the six month appointment. And then at the six month appointment, we can talk about you doing this with whoever is prescribing that because technically since I didn't prescribe it, I'm not supposed to deprescribe it. Right, right. So you work with them. Yep. Well, Dr. Fitz, you're always so awesome. Thank you. We love you being on the show. You're always such a great, such a gift to our community. Thank you. And I'm sure your books are totally slammed and you can't, I mean, are you just so. I'm booked out till March. Are you trying to grow? Yeah. How do you do that? I go back and forth if I want to open a location in a warmer place because Chicago is really cold in the winter. But I've, I have two other medical providers and I'm about to

hire a third. And then if I want to open a second location, I go back and forth. But we take over one of the spaces right next door. I mean, maybe so. I mean, the weather here is much better. I will say that. It's snowing in Chicago today. And I sent a picture to one of my friends. I'm like, don't hate me because I'm not wearing a jacket. Well, awesome. Well, thank you so much for coming on. I want to thank you guys, though, because the amount of patients that have come to me, because y'all put me on your podcast last year, I will never be able to say thank you enough. I truly am grateful for that. It's an honor because you are servicing people that we care about. So the fact that they're going to somebody who knows what they're doing is good, cares about them,

that for us is the best. Thank you. I appreciate you guys. Thank you. Thank you for listening to Mind Pump. If your goal is to build and shape your body, dramatically improve your health and energy, and maximize your overall performance, check out our discounted RGB Superbundle at Mind Pumpmedia.com. The RGB Superbundle includes Maps Anabolic, Maps Performance, and Maps aesthetic. Nine months of phased expert exercise programming designed by Sal Adam and Justin to systematically transform the way your body looks, feels, and performs. With detailed workout blueprints and over 200 videos, the RGB Superbundle is like having Sal Adam and Justin as your own personal trainers, but at a fraction of the price. The RGB Superbundle has a full 30-day

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