Pursuit of Wellness - Ozempic 101: Microdosing, PCOS, Fertility & Building Metabolic Health w/ Dr. Tyna Moore

Episode Date: December 9, 2024

Ep. 157 On today’s episode of Pursuit of Wellness, Dr. Tyna Moore, a naturopathic and chiropractic physician with expertise in regenerative medicine, joins us to provide clarity on GLP-1 medications.... With a background in metabolic health and chronic pain management, Dr. Tyna explains how GLP-1s can benefit individuals with weight loss goals, PCOS, and insulin resistance. She shares valuable advice on individualizing doses, understanding how these medications interact with insulin and muscle mass, and how to approach conversations with doctors about your dosage. We also cover the risks associated with Ozempic, especially in those dealing with metabolic dysfunction, and discuss how these drugs impact areas like fertility and chronic pain. Leave Me a Message - click here! For Mari’s Instagram click here! For Pursuit of Wellness Podcast’s Instagram click here! For Mari’s Newsletter click here! For Dr. Tyna’s Instagram click here! For Dr. Tyna’s Website click here! Sponsored By:  The holidays are closer than ever, so make sure you order by December 16th to get their gift (or yours) underneath the tree in time! Visit Carawayhome.com/POW to take advantage of this limited-time offer for up to 20% off your next purchase. Again that’s Carawayhome.com/POW to get new kitchenware before the holidays. Caraway. Non-Toxic cookware made modern. Visit BetterHelp.com/POW today to get 10% off your first month. That’s betterhelp.com/POW. Head to Manukora.com/POW to get $25 off the Starter Kit, which comes with an MGO 850+ Manuka Honey jar, 5 honey travel sticks, a wooden spoon, and a guidebook! Visit clearstemskincare.com and use code POW at checkout for 20% off your first purchase. Again, that’s code POW for 20% off your first purchase on clearstemskincare.com. The Fits Everybody collection is available in sizes XXS to 4X. You can shop now at SKIMS.com. After you place your order, be sure to let them know I sent you! Select "podcast" in the survey and be sure to select my show in the dropdown menu that follows. And if you’re looking for the perfect gifts for the whole family - SKIMS just launched their biggest Holiday Shop ever - also available at SKIMS.com.  Show Links: Ozempic Uncovered University   Dr. Tyna’s GLP1s Done Right Dr Tyna GLP1 Episodes  Finding A Doctor  Topics Discussed 00:00:00 - Introduction  00:03:54 - Dr. Tyna’s journey 00:06:44 - Initial success stories 00:07:54 - Fertility  00:09:20 - GLP-1’s and cystic acne 00:16:22 - PCOS diagnosis 00:21:09 - Low dose GLP-1 benefits 00:29:18 - Who metabolic health applies to 00:31:53 - Pick up the weights! 00:34:41 - GLP-1’s and the microbiome 00:37:20 - Ozempic mistakes 00:41:49 - How Ozempic affects the body 00:45:24 - Individualized dosing 00:48:01 - How to talk to your doctor about low dosing 00:52:56 - Cycling do’s and don’ts 00:54:05 - Clarity around the different drugs 01:00:01 - GLP-1’s and addiction 01:02:46 - Dr. Tyna’s Ozempic Done Right University 01:05:45 - Wellness to Dr. Tyna

Transcript
Discussion (0)
Starting point is 00:00:00 The reason I came up with this concept of utilizing these GLP ones outside of weight loss and diabetes was because we had all this data showing that they had these impacts on different organ systems of the body. Why not? This is the Pursuit of Wellness podcast, and I'm your host, Mari Llewellyn. What is up, guys? On today's episode of the Pursuit of Wellness, we have Dr. Tina Moore. She is a naturopathic and chiropractic physician with expertise in regenerative medicine. She is joining us today to provide clarity on GLP-1 medications, aka Ozempic and variations of Ozempic. I have touched on this in a few episodes with other experts,
Starting point is 00:00:45 but finally we have an expert who really is honing in and focusing on GLP-1 and giving us the information that we wanna know. She has a background in metabolic health and chronic pain management. She explains how GLP-1 can benefit individuals with weight loss goals, PCOS, and insulin resistance. She shares valuable advice on individualizing doses, understanding how these medications
Starting point is 00:01:11 interact with insulin and muscle mass, how to approach conversations with your doctors about dosage. We also cover the risks associated with ozempic, especially in those dealing with metabolic dysfunction, and discuss how these drugs impact areas like fertility, chronic pain, and even addiction. What I found really interesting about this conversation with Dr. Tina Moore is she's one of the first people to discuss the positive effects of GLP-1 outside of weight loss.
Starting point is 00:01:39 It's pretty incredible, the studies that are coming out about this drug. And she also talks about the importance of dosing. It really seems like a lot of people are taking too much of this medication. I think we've all seen, you know, some of the influencers in LA who lose a ton of weight all of a sudden, or, you know, people taking it who maybe shouldn't be
Starting point is 00:01:58 or taking too much of it. She discusses the benefit of microdosing or cycling. And she talks about that today. And I think a lot of people have questions about this drug. And she really, really got into detail. She also talked about things like addiction, which I think is just mind blowing. She made a comment about the homeless population and how potentially GLP-1 could be a helpful solution for people who really cannot break their addictive habits. And I population and how potentially GLP-1 could be a helpful solution for people who really cannot break their addictive habits. And I just think that that's a really crazy concept and honestly I've been thinking about it ever since she said it.
Starting point is 00:02:35 So today's episode is really, really interesting and I would just urge you guys to go into it with an open mind. I'm someone who I've heard a lot of different opinions on GLP-1. I've had people come on the show who say it's awful, some people say it's beneficial. I think it's important to have an open mind, listen, check out the studies, see for yourself. But this episode really sort of shifted my opinion on things a little bit and opened my eyes to people who could be benefiting from this in other ways. So before I get rambling, let's hop into this episode with Dr. Tina Moore. Just a reminder to subscribe or follow if you enjoy the episode, leave a review, let me know what you think and let's hop right in.
Starting point is 00:03:16 Dr. Tina, welcome to the show. Thank you for having me. I'm excited to be here. We've already been chatting behind the scenes and I'm just so excited to have a new fresh perspective on this topic. You've become known for being an advocate for microdosing semaglutide for benefits beyond just weight loss. So really excited to dig in there. You have an amazing resume. You're an expert in holistic regenerative medicine, resilient metabolic health. You're a licensed nat holistic regenerative medicine, resilient metabolic health.
Starting point is 00:03:46 You're a licensed naturopathic physician and chiropractor and a podcast host. Yeah. I don't know how you manage all of those things, but congratulations. Thank you. I'd love to start just by hearing how you got into this field to begin with.
Starting point is 00:03:59 On the subject of GLP-1s in particular? Just in naturopathic medicine in general. So I was a very sick little kid. I was just, from the time I came out the chute, a very, very sick child subjected to a lot of interesting medical interventions and gas-lit and ignored and didn't have my questions answered. Even as a child, I would ask good questions to doctors
Starting point is 00:04:26 and they wouldn't answer me. And putting on a litany of drugs that many have since been taken off the market and it turned out all in all, it was really just like low-key autoimmune nonsense happening for my entire life. And I had to go through naturopathic medicine, the training process just to figure out what was wrong with me and what was going on. And really I became a naturopathic physician so that I could learn and help myself, which I think many of us go on the journey of medicine to do,
Starting point is 00:04:59 but more importantly to protect my family because I knew the system as a whole, as we've really seen the past few years, is pretty busted. So to keep my loved ones out of that as much as possible, because I don't like doctors, I went down this route. And then I specialized in regenerative injection therapies for the bulk of my career. And that involved obviously a lot of injections of natural substances into joints to regenerate them, but also bioidentical
Starting point is 00:05:28 hormone replacement, because that's a huge component of pain and immune modulation, and then peptides. So getting into the GLP-1s was just a natural transition for me because I was like, oh, well, this is just part of the toolkit, right? And it's a really powerful tool. And so started incorporating that into my own personal life, really just discussing it with anybody who would listen, all of my colleagues. I asked, are you guys trying this for anything outside of weight loss? Have you dove into the literature on this? Are you seeing what I'm seeing? And
Starting point is 00:06:01 really, it was just a lot of crickets and people wanting to utilize higher doses regardless. So we can talk about that. Like the real concept of microdosing versus what a lot of doctors seem to be doing. Not to say it's wrong, but there's just some difference of opinions there and all in all, thoroughly blown away with the impact. And while I don't have my big practice anymore, I cannot believe what a massive lever puller, this one peptide is in particular. And I think had I had this tool when I was seeing,
Starting point is 00:06:35 you know, dozens of patients a week, I definitely would have utilized it more because it checks off all the boxes. At the beginning, when you first started incorporating it in your practice, what was some of the initial success stories you saw? Or was it yourself? It was me. Okay.
Starting point is 00:06:55 Me and then my daughter wanted to try it. She like many young women had, you know, an excess 20 pounds or so that just wouldn't come off. PCOSOS just very common. This is this is so many young women's story right now. And I think it's because we are generationally into a pretty adulterated food supply and a toxic burden in the world and a litany of interventions that are applied to us as children. And I think that all that adds up
Starting point is 00:07:27 to a lot of women struggling, and then they end up in their 20s and 30s and dealing, they're maybe not even aware that that's what's going on, and then they end up infertile. And this is a crisis right now that no one's talking about. Even the women doing all the things, right? Like everything, right? And then it still seems to be a problem.
Starting point is 00:07:48 So I don't think people realize what's happening with fertility rates. It's insane. And it's a very emotional thing to go through. And I feel like I had zero understanding of just how, I feel like in life you can work really hard at things and make it happen. Like I feel like a lot of what I've done,
Starting point is 00:08:08 I've just worked hard at. And this is the first thing in my life where I feel like I'm working hard and it's not making a difference. And the more I talk about it publicly, the more responses I get from girls my age, older, younger, struggling with the same thing. And it's confusing when you eat healthy, exercise, do all the right things, sit in front of red
Starting point is 00:08:30 light panels, like you do everything and it still doesn't work. Yeah. And then the social media influencers make you feel terrible because they have the one thing, the one magic thing, you know, the one, just do this and this is the way and just eat this way and do this. And it's just not that simple. Well, have you seen the trends of like mucinex? Girls are taking mucinex.
Starting point is 00:08:50 Wow, just to thin out. I mean, I don't really know how it works, but probably to thin out. It's a it's a mucolytic. So it's probably to thin out the mucus, which would change the composition of the mucus at the at the cervix, which would potentially change the entry of sperm ability. I mean, I might try it, honestly, at this point. On TikTok, you see all these things happening. Well, NAC is a mucolytic, though.
Starting point is 00:09:14 So NAC and iodine are both mucolytics. Okay, so you could take that too. Pretty potent ones. So I think I heard you, when you were speaking about your daughter's PCOS and how semaglutide help her, I think you mentioned cystic acne too. Yeah, really severe cystic acne.
Starting point is 00:09:30 And how does GLP-1 help with that? I think it helps in a myriad of ways. So first and foremost, it impacts the immune system. That was what was most interesting to me. So for me personally, it was about the impacts on the neurologic system and on the immune system because I'm an auto-immunie girl and many of us are. I mean, I think my story is I was experiencing what so many young women are experiencing now
Starting point is 00:09:58 only I was an outlier in my generation. So I'm Gen X and I was one of the few and everybody's like, oh, you're fine. Especially when you're thin and you look fit and healthy. They're like, what could possibly be wrong with you? And I've had so many neurologic immune driven issues. And so for me, that was it. So the immune impact I think is huge. We are seeing overall some definitely some impacts on the hormonal system because I don't know about the friends that you know that who have taken it,
Starting point is 00:10:30 but women will often report shifts in their menstrual cycle as they adapt to the GLP-1. So even at really tiny doses, I'm noticing that to some degree, but it tends to normalize. So it reminds me much like when women go on HRT, when they're hitting menopause, there'll be like a 90 day adjustment period where they might have some breakthrough bleeding or they might have some shifts in their menstrual cycle. So it seems to be favorable, not unfavorable. It tends to regulate that out and make it become a little bit more normalized for the woman. Or I shouldn't say normal, but just more predictable. Because there's no definite number of what the perfect cycle is.
Starting point is 00:11:12 I think that we see massive changes in metabolic health overall, which ultimately is what's driving PCOS. I think the confusing part is, you know, currently we have some folks going around on the podcast saying, oh, you can completely reverse PCOS with diet and you can do it in 12 weeks. And that's incorrect statement. That study was actually 12 weeks of showing initial shifts in PCOS symptomology. It wasn't a cure all. There's no, there's no button that we can push on PCOS to say this is it. Fix your insulin resistance, it's gone. I wish it were that simple, but as someone who has actually been
Starting point is 00:11:50 a treating physician for decades, it is not that simple. We have to pull several levers with PCOS and it really comes down to the individual and what's driving it for them. And I think what people don't appreciate is that your mother's health is having a significant impact on whether you have PCOS or not, your grandmother's health. So this is an epigenetic lineage that's happening. And so young women today are experiencing infertility and their doctors are like, oh, here, just do this. And in fact, some of the allopathic interventions are great, like spironolactone.
Starting point is 00:12:21 I mean, some of those are wonderful because spironolactone lowers your androgens which ultimately can help balance the hormonal profile, right? It's not that we want anything high or low, we just want it working in somewhat of a balance which is then going to impact your metabolic health. GLP-1s do a similar thing with the metabolic health and ultimately we have to pull several levers if we want to normalize out the experience for that young woman. So I also think it helps rev the mitochondria which is going to supercharge detox pathways. There's a piece there too, right? So there's just all these different components and I'm always thinking of simplicity and
Starting point is 00:13:04 compliance. I mean, why would you want to take a litany of supplements, pharmaceuticals and basically starve yourself into orthorexia because you're worried about all the foods you're putting in your mouth at such a microscopic level of nuance? Or can we potentially bring in a peptide like GLP-1 and have many of these systems regulate out. So maybe you can have a glass of wine once in a while and live a normal life or maybe you can have a slice of pizza with your girlfriends when you go out and it's not, you know, you're not sitting there beating yourself up. There's just, there's impacts here. And I'm not saying it's the lazy way out either. It's just why not? Why are we white-knuckling things?
Starting point is 00:13:57 It's the holiday season and we are all cooking. I just hosted Thanksgiving at my house and I got tons of compliments and questions about my caraway cookware. I had it all out, my sage green pans, my bakeware, and I said, guys, it is caraway cookware. I had it all out, my sage green pans, my bakeware, and I said, guys, it is caraway cookware. I am absolutely obsessed. And the reason I'm obsessed is not that it's just adorable, but it's also non-toxic. It's free of dangerous chemicals. During the holidays this year, I want to be serving things that are made in healthy materials, and I'm not leaking chemicals into everyone's food. Plus, it can make cooking so easy, it's super easy to clean and wash and get gunk off the pans and they make it really easy to organize. It comes with an organizer that you can just slot into one of your cabinets.
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Starting point is 00:15:16 Everyone's hosting family, visiting family, or it can just feel really, really isolating. One thing that helps me around this time of year and in general is therapy. It has been such a huge part of my life. Honestly, since I was 14 years old, I don't know what I would do without it. I'm also starting to think about what I want the rest of my year to look like and what I want 2020 to 5 to look like. And therapy is just a great place to get out ideas, share feelings, sort of get things out in
Starting point is 00:15:45 the open and get an unbiased opinion. It really can be such a useful tool at this time. If you're thinking of starting therapy, give BetterHelp a try. It's entirely online, designed to be convenient, flexible, and suited to your schedule. Just fill out a brief questionnaire to get matched with a licensed therapist and switch therapist at any time for no additional charge. Take a moment, visit betterhelp.com slash pow to get 10% off your first month. That's betterhelp, H-E-L-P dot com slash pow. Right. It's really interesting you say that with PCOS because so I had cystic acne on and off for 10 years of my life and I was the person who was terrified of eating the
Starting point is 00:16:33 wrong thing. I mean, like I was eating pretty much meat, fruit, and that was it. Yeah. And like weird coffee replacement. And I was just doing all types of things because it was making me feel better. Mentally, I thought that these foods were causing my acne, but it was so much deeper than that, I think. PCOS confuses me because I feel like there's no true definition. I feel like everyone just has this cluster of symptoms. I know I have a high follicle count, for example, I've had acne, I've had hair growth, I've had different symptoms, but I live a very healthy, clean lifestyle. I have a regular menstrual cycle, I ovulate, I test for those things. But it's really
Starting point is 00:17:19 intimidating when you get a PCOS diagnosis, you kind of feel like trapped in it, and you don't really know how to move forward from there. So very interesting that microdosing this semaglutide could be helpful for that, because I think, I mean, I'm hearing tons of women responding to my show telling me they have PCOS. I think it's a syndrome, and unfortunately, a syndrome is sort of a blanket umbrella statement
Starting point is 00:17:43 in medicine where we're like, we don't know. But it really is. It's a culmination of symptoms. And it's happening to a specific cohort of women. I was diagnosed with PCOS when I was 19. And I was skin and bones and didn't have any cysts on my ovaries. So it's a terrible name in the first place because you don't have to have cysts on your ovaries.
Starting point is 00:18:03 It was just one identifying feature of the disease process. And again, it's not a disease in my head. When a patient walks in and they say, oh, I have PCOS or I see a series of lab markers that are pointing to it. For example, my daughter was showing on lab, she was showing symptomology also at age six. And I told my entire family, she is going to have PCOS when she grows up, if we don't intervene with, at the very least, the foods we're letting her eat. And because she was between households, because I was divorced,
Starting point is 00:18:33 everybody was sort of feeding her however they wanted. And I'm over here like watching a train wreck in slow motion, right? And so lo and behold, she hits her adult years and it's like, boom, we have PCOS. And with that comes, I mean, she's 24 now, and it's like, boom, we have PCOS. And with that comes, I mean, she's 24 now, right? It's a decade. It's been a decade of really severe acne, which is devastating to your social life. It's devastating to your courage and confidence.
Starting point is 00:19:01 And then people want to start splitting hairs whether it's okay to take a GLP-1 and I'm like, well, that's nobody's business. First of all, our medical decisions about what we do is nobody's business, never has been. I don't know why it was popularized in 2021 to suddenly start asking everybody about their personal medical information. But if we have something that we can apply that's inexpensive, seemingly very safe. I mean, the safety profile in these peptides is showing itself to be pretty incredible
Starting point is 00:19:30 and pretty cool data is coming out showing it's protective mechanisms on all the things we're concerned it might be causing. And I do think that the dose matters here to some degree. We'll see. I mean, maybe even at the high doses that the studies are showing really great protection dose matters here to some degree. We'll see. I mean, maybe even at the high doses, the studies are showing really great protection against certain things that seem to plague
Starting point is 00:19:49 us as humans these days. So what if we could do away with the whole arsenal? Like the average PCOS girly is on birth control. She's on spironolactone. She might be on an antidepressant, you know, then there might be a metformin thrown in as she's getting a bit older. There's usually some weight that's stubborn that doesn't want to come off, that's driving all the inflammation. And it's just this vicious downward spiral for these girls. And they ended my age and they're a complete disaster. So I'm over here like, hey, can we sprinkle a little GLP-1 on this and actually correct it from a root cause perspective? It is healing. It's anti-inflammatory.
Starting point is 00:20:27 It's healing and it's regenerative to these tissues. So what if applying it to a younger woman might actually help her avoid that hot mess completely when she gets to be my age? And ideally remove some of those pharmaceuticals from the list. Yes. I mean, or get them down to a dull rora dosage. Yeah. Yeah. Right.
Starting point is 00:20:46 The very least that that's always the goal is like, let's improve lifestyle so that we can get all the pharmaceuticals, including the GOP one. So you can dose that too high, you can eat right through it, you can drink yourself right through it, you can lifestyle yourself right through that low dose, and it won't work anymore. So that's why it's so critical that people do all the other things so that we can keep the dosages of everything we're on super low. What other benefits have you seen low dose GLP-1 doing for people? So we said hormones, obviously weight loss. What else have you noticed?
Starting point is 00:21:18 So the metabolic implications are pretty huge and that's happening on a couple levels. We get improved insulin signaling, so it signals when it a couple levels. We get improved insulin signaling, so it signals when it's supposed to. We get improved insulin reception, so the cells actually start to hear it instead of becoming insulin resistant. We see certain metabolic pathways revved that are favorable for not only glute four translocation,
Starting point is 00:21:41 which is the ability of the cell to uptake glucose and use it as fuel, but improve mitochondrial performance. So like the AMPK CERT-1 pathways are favorably pushed with the use of GLP-1s. We see just sort of body-wide inflammation coming down, which is going to improve metabolic health overall. Metabolic health isn't as simple as like glucose into the cell and we want to make it you everyone hears about insulin resistance but that's not the only way that glucose gets into the cell and then once it's in
Starting point is 00:22:12 the cell is it being utilized as fuel properly that's up to the mitochondria so all of those systems are favorably impacted with the use of GLP ones. We start to see some of that inflammatory fat come off, particularly the visceral fat, which is driving, it's like a chicken and egg downward spiral when it comes to metabolic health. We see this with young women with a PCOS, and I would say the mirror image of that in the older woman my age is when all of a sudden is what was happening to me, like boom, 15 pounds around my midsection.
Starting point is 00:22:43 Like we all turn it, I joke, and I don't mean this in any derogatory term, but you know how when you start to approach puberty as a child and that like eight, nine year old girl, they all turn into little potatoes? You know what I mean? All the little, we all went through it. Like we all turn into a little potato shape
Starting point is 00:23:00 for a hot minute. We turn back into a potato shape when we hit menopause or perimenopause and that's insulin resistance. So I'm over here waving the flag like ladies we got to jump on this I've been telling my patients for decades like you have to nip that in the bud but we didn't have anything great to nip into nip in the bud and we're doing the same thing as you were doing we're doing all the things. There's no more levers to pull.
Starting point is 00:23:27 And we induce this orthorexia into people, which is just as bad. I am a lifetime survivor of anorexia and I've been through orthorexia and it's like you can't go out, you can't travel, you can't do anything without having... You feel like you live in a bubble. It's like a walking bubble. And we've glamorized it on social media. Like who can be the most restrictive? I only eat beef and salt.
Starting point is 00:23:54 I've been there. I mean, I know exactly what you mean. Yes. Like I, I, when I think about living in LA and the way I used to live my life, I feel horrible for myself. Yeah, me too. And now I feel like I can have a glass me too. It's sad. I know. It's sad.
Starting point is 00:24:07 And now I feel like I can have a glass of wine or it's not about living an unhealthy life. It's about living with freedom. Right. And I think that there's friendship in food and there's culture and there's... I joke because every time I go to LA or any of the bigger cities to do podcasts, my friends have all their friends are on the higher doses of the GLP ones. Yeah. And they're like, it's no fun anymore. Nobody goes out to dinner. Nobody goes out for drinks. Like none of their girlfriends want to put
Starting point is 00:24:32 anything in their mouth. So they're literally dosing themselves into their orthorexia. Yeah. So anyway, I'm just arguing for a moderate, there's a middle ground, we have to live and we also have to keep ourselves in check. We live in a current state of toxic soup on this planet and so all bets are against you as a woman because of the estrogen receptors that we have. These toxins act as xenoestrogens and so we're just kind of swimming through this. You were born into it. I was basically fed into it. I was the first generation with the really adulterated food supply
Starting point is 00:25:07 that when they really started messing with things. And so for young women of your generation, I just feel terrible. Like I feel terrible the way you guys were, you came out of toxic moms. It's like dodging bullets. Yeah, and there's just so many young, and I'm not advocating that we throw children
Starting point is 00:25:27 on GLP-1s, but there are some young girls out there coming into puberty and all bets are against them just by means of the fact that they were swimming in insulin and utero because their moms were so metabolically compromised. And they're marked now genetically and epigenetically for life to have a significant risk for obesity and type 2 diabetes. And why are we waiting until people are obese or type 2 diabetic at all? There's decades in there where interventions could happen. So just on that, and again, I'm not arguing for GLP-1 as a weight loss tool.
Starting point is 00:26:04 That is a whole other argument I could make. I could go on for hours about that. Because obesity is complicated. But why are we waiting until people are so far down? I'm just over here saying, hey, we have a tool. Let's just put it out on the table that personalized, individualized dosing, maybe not even call it microdosing. I kind of want to kick myself for spreading that term around
Starting point is 00:26:25 because it's really just personalized, individualized, inclusive dosing. Yeah, right. Like what dose do you tolerate that's going to help you move the needle for the goals that you have, which may have nothing to do with weight loss, but it will always have something to do with metabolic health just by the state of the world we live in. And why are we not discussing that as an option? Are you looking for something simple and delicious to add to your wellness routine? I recommend trying Manukura honey. It is ethically sourced Manuka honey from New Zealand. Plus, it has so many health benefits and it's delicious.
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Starting point is 00:29:17 I think sometimes when people hear metabolic health, they think, oh, that doesn't apply to me because I'm not obese. Would you say that applies to everyone? Yes. Okay. How come? Well, 2018 data, let me just go back. I started in practice in 2008 and literally my mentor taught me to screen everybody because he was talking about metabolic health back in the 90s. He was like, get off the treadmill, lift weights, eat meat, avoid, there was no carnivore diet. There was no paleo diet even. He was just like, stop eating white foods that are high in starch and carbs. And out of his time. Yeah.
Starting point is 00:29:50 And he was telling me to keep a check on waist circumference at all costs, keep a check on blood pressure, keep a check on waist circumference and make sure people are strength training to optimize their bone mass and their muscle mass. And you know, live in moderation and get outside, make sure you get sunlight. I mean, all the things that are popularized now, like I was hearing this straight out of college in the mid 90s. So I go into practice and I start running metabolic markers on everybody and everybody has some version of compromised metabolic health. It's glimmers sometimes. It's not like full Frank disaster zone. It's just, hey, you're headed down this path.
Starting point is 00:30:25 And if we don't do something like maybe we're seeing some changes in lipids, we're seeing some changes in serum insulin, we're seeing some changes in your blood sugar handling, we're seeing some changes in your inflammation. Maybe you're not able to get your vitamin D levels up because you're inflamed. Like these are all glimmers. And when they add up together, they add up to a story. And then you look at the individual in front of you and how they literally appear, and you take some measurements and some vital signs, and then you take their history and you're like,
Starting point is 00:30:51 okay, you are headed down this path. And the only way to get out of that is everything I just mentioned. And my colleagues would give me shit. They were like, Tina thinks everybody has metabolic dysfunction. And here we are in 2024, 2018 data showed that roughly, you know, gosh, 94% of US adults have busted cardio metabolic health.
Starting point is 00:31:13 That was pre-lockdowns. So God only knows what it is now. And so, yeah, I would say metabolic health concerns applies to everyone, including children. And so it has nothing to do with what size you are. You can be skinny fat, which is that thin on the outside, fat on the inside, where you're just fat and bone. I saw this all the time in practice.
Starting point is 00:31:34 I don't know how many of your friends probably still, the ones who brag, oh, I can fit in my jeans from high school, but they haven't seen the inside of a gym and they wouldn't know a squat if it hit them in the face. And I'm like, well, good luck with your hip fracture when you're 80. Have fun with that. Right? I like that one. That's a good one.
Starting point is 00:31:51 I'm going to pull that out. Have fun with that when you're, you know. And then I'm in the gym this morning at the hotel and we're in a pretty bougie hotel and it's all these skinny women with their little dumbbells. I made a post about it on Instagram. I was like, ladies, we're trying to build bones in an ass. We're not trying to tone our arms. Like what are you doing?
Starting point is 00:32:07 You know, the word tone drives me insane. If people tell them they say the word tone to me, I'm like, what does that mean to you? Like what is the definition of tone? Because what they what it actually means that you can see muscle and to get muscle you have to lift heavy. Yeah. Yeah, I agree with you. It was literally a bunch of skinny squishy women with little tiny dumbbells going like this,
Starting point is 00:32:30 like doing this like angel thing for their arm sculpting. And I was like, Oh my God, just go do some pushups. I'm glad you're saying this and not me because I agree with you, but I don't have to say it. Pick up something heavy, do some squats. We're trying to build an ass because when you build your butt, the big muscles of your thighs and your booty are what keep your metabolic health in check. Metabolic disease starts in the thighs and butt. So for that middle-aged woman who was like, I used to have an ass and now it's completely flat.
Starting point is 00:33:00 I don't know what happened. That's your insulin resistance starting. That's what's happening. And when you end up insulin resistant, especially if you look at diabetics, they get the visceral fat and the big belly and then they start to atrophy and the appendages. It's a feed forward mechanism. So you literally start to lose muscle mass in your legs and arms. As your insulin resistance and your metabolic dysfunction is blooming, if you will, and then that makes it worse. Yeah.
Starting point is 00:33:27 So they end up frail, weak, fat in the wrong places, even if they're still thin, they're still fat in the wrong places, and then their bones are brittle and then, you know, that's my age cohort. This makes me feel better about having muscular legs because I feel like a lot of girls want stick legs because it's kind of the trend, you know? But I mean, helpful to know that having muscular legs is going to help us later in life too. Every time I see pictures of you on Instagram, I text Drake and I'm like, she has such a great lower body.
Starting point is 00:33:58 How do I get that? Oh my God. Best case scenario for me, I'm like, I'm going to be the potato shape no matter what, you know? So I'm always over there like, how do I get hips and thighs? You are so to be the potato shape no matter what. So I'm always over there like, how do I get hips and thighs? You are so far from a potato. You look amazing. Thank you. But I mean, I am prone to, my whole family is a bunch of little apples with little stick legs. And so, no bet. And I'm like, can't lose the booty. I'm trying to keep the thighs.
Starting point is 00:34:20 You look great. Thank you. I always said I had rugby legs growing up because my dad's Welsh and he's got sick legs too. So I don't know, but I'm going to keep lifting weights. I feel good about it now. It's great. Trust me.
Starting point is 00:34:32 This is going to help you age and this is you're going to be way better off than your skinny girlfriends when you're my age. Fee, that's us. I've also heard you say that GLP-1 can help with the microbiome. How does that work? And I think you told a story of your mother's Crohn's disease. How does that help the microbiome? So all the studies I'm finding show that it shifts the gut microbiome.
Starting point is 00:34:57 So we have favorable organisms and we have pathologic organisms. I hate to make it that blanket of a statement though because I think of the gut microbiome, I think of everything as symbiotic until it's not. So everything has a place, like we all have strep in our throats right now, it's just a matter when people say oh I got strep throat, I'm like no you have strep in your throat, it's just a matter of how your immune system's doing as to whether the strep gets to take hold and have a party. And so we have a mishmash of fungus and bacteria in our gut and they're all well and good until they're not.
Starting point is 00:35:33 And so we never want one group to take too much power, kind of like our political system, right? We never want one group to take too much power. We want to balance in the force. And we have organisms that are favorable usually but they can also be unfavorable. So we're always looking for the balance there. GLP-1 seemed to be that regulator. Best way I can put it from all the data that I'm looking at that it just seems to shift the microbiome. I do think that when people start on these
Starting point is 00:36:03 there is a little breaking in period where they'll start to see a shift. A lot of people report that they actually have improvement in their bowel movements. So they'll say, wow, my bowel movements are way better formed. They're much more comfortable. Others will say, now I'm constipated and it's uncomfortable. Others will get diarrhea and it takes a minute for that to sort out. I think that's the gut shifting. So I think if people are dosed too high, too fast, it can be a really uncomfortable shift. And that's where we're seeing some of the nausea and vomiting.
Starting point is 00:36:35 It's not just the GLP-1 directly impacting gut by slowing gastric motility or causing nausea. I think it's actually a die-off reaction of a lot of these organisms in the gut getting shoved too fast. Interesting. So again, my reasoning behind slow and low, because we just want to nudge the system. So we want to nudge the individual who's taking whatever it is we're giving them, and we want to nudge their microflora. That could be your skin microflora, that could be your gut microflora.
Starting point is 00:37:02 We're just trying to gently walk you down the line to better health and to optimization and set up like, hey, let me slam you with this, you know, and hit you with a brick. So I think that there's a potential for people to have a really difficult transition on these if it's done too abruptly. What are people doing wrong with Ozempic? Because I guess my first experience seeing it in action,
Starting point is 00:37:27 I was living in LA when it got popular. LA is a very aesthetic place. There's a lot of models, people, you know, who make a living off of the way they look. And a lot of like really lean girls getting on the medication and getting really, really skinny. Yeah. What's like going on there? Are people addicted to it? girls getting on the medication and getting really, really skinny. What's going on there?
Starting point is 00:37:47 Are people addicted to it? Let's talk about the way people are using it wrong. I think people are addicted to being thin, which I have been guilty of. It's pretty addictive. I do think too that there's such a profound impact on the brain with GLP-1s that people feel really good on it. And I don't, I dare say the word antidepressant, but for me that, and for others that I know, that has been a really favorable side effect is just this mood boost.
Starting point is 00:38:16 And we have data to support that of it reducing anxiety and improving mood pretty significantly. I think you can overdo it there and you can put yourself into this like state of not wanting anything. And that's not great either. We don't wanna overdose people into not wanting to eat, not wanting to seek joy, not wanting to have, you know, any kind of intimacy with their partners.
Starting point is 00:38:39 Like you can go there too with it. But I think that there's a sweet spot and they feel good and that part's addictive. You're always chasing the dopamine, right? And it does impact dopaminergic pathways so people and serotonergic so we're getting serotonin and dopamine on board. So that might be the reason people think more is better. And then of course being really thin is that's just been going on forever though. Like the whole being skinny addiction like that has been popularized for many generations. It just comes in and out. I heard the other day that the the Kardashian hips and butt images out and now they're calling it
Starting point is 00:39:18 the ballerina body in the you know the plastic surgery clinics and I'm like this this is ridiculous, we're all built differently. Why don't we just optimize how we're built? Doesn't it make you wonder how long celebrities have been using Ozempic? Oh yeah. You know? Yeah. Like I'm sure for longer than we realize.
Starting point is 00:39:37 Yeah. Right? Yeah. And now we're watching influencers, I mean, people throw allegations around all the time and I don't think many people are open about it, but you can kind of tell when someone just suddenly dropped 30 pounds out of nowhere. Yeah.
Starting point is 00:39:53 And what is that? So I obviously had a large weight loss journey in 2017 before Ozempic, which is really funny to think about. Like I've had a lot of people ask me, like, would you have used it back then? I don't know if I could have afforded it, but I'm almost I'm glad I didn't have it then because I think I learned a ton. Like, I wouldn't have learned what I learned if I had had that as a tool. But now I'm learning more about the other benefits it has.
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Starting point is 00:41:00 different shades. I feel like it would also make a really good gift for the holiday season. I am absolutely obsessed. I'm also obsessed with the Skims new holiday line. I got the pajamas. They're just so freaking cute and comfy and I got a robe. Skims is just the best place for comfort and for gifts. The Fits Everybody collection is available in sizes extra extra small to 4x. You can shop now at skims.com. After you place your order, be sure to let them know I sent you, select podcast in the survey, and be sure to select my show
Starting point is 00:41:31 in the dropdown menu that follows. And if you're looking for the perfect gifts for the whole family, Skims just launched their biggest holiday shop ever, also available at skims.com. I'm just curious, like, what's your favorite holiday shop? And if you're looking for a good one, available at skims.com. I'm just curious, like these people dropping weight this quickly, like what are the side
Starting point is 00:41:53 effects of that? Yeah, let's talk about that. So first of all, it induces neuroplasticity. So there's, your brain is rewiring when you're on it. So whatever you're doing in your lifestyle during that period is getting hardwired in Which can be really cool If you think about it if if this person is being supported with all the lifestyle changes and they have this window of opportunity To learn all the ways of taking good care of themselves through diet nutrition and you know
Starting point is 00:42:23 Optimizing their sleep and all that jazz then then that's going to get more hardwired in. So they're creating new habits in a much more intense way, which is very cool. But if we go too far, especially too fast, you do end up losing muscle and you do end up losing soft tissue and you end up potentially much worse off than you started. But again, that's been going on since the beginning of time. Back when I was a teenager, it was like Kate Moss and heroin chic, everybody, we were all trying to be, I was guilty of it. I mean, we were bone thin. I was always, I have these big gymnast wrists because I, you know, from landing all the time in gymnastics. And I was
Starting point is 00:42:58 always trying to make sure that my upper arm was as small as my wrists. Wow. That is how I live. That's crazy. So I changed, we just chain smoked our way into it. upper arm was as small as my wrists. Wow. That is how I lived. That's crazy. So I changed, we just chain smoked our way into it. You're like, we use cigarettes. We just chain smoked and starved ourselves and lived off coffee. Great. Yeah.
Starting point is 00:43:16 I wonder why I was sick all the time. So and induced all my autoimmune disease. That's been going on forever though. You know, so this is just another tool. Yeah. And you end up crashing out your metabolism for the long term. So now as I hit menopause, I am struggling with metabolic dysfunction, even with the best of intentions, even, you know, I started training when I was 40. I wish I had found strength training earlier, but I didn't start till I was about 40 because I did
Starting point is 00:43:42 not want to walk into menopause and have it be a total train wreck disaster. So I trained for menopause, but even with the best of intentions, I still ended up with this like low key insulin resistance and that's loss of estrogen too. I mean there's other pieces to this puzzle, but that's what you do. You think about, I don't know if you remember any of the rock goddesses from the 70s, like, oh, Stevie Nicks, of course you know, and then Linda Ronstadt, and they were all super skinny and beautiful, and they were all on cocaine. And that was the tool they used, right? We've all had our tool. So every generation has its tool.
Starting point is 00:44:22 So my generation had FenPen, right? Everybody had a tool to get themselves rail thin, but there is a cost to living at rail thin without muscle. And that is years later, your metabolism completely turns on you. And it's a train wreck. So all of those women ended up ballooning and getting quite big, right?
Starting point is 00:44:40 And so it's a balance. The only way out truly is through muscle and good health and good nutrition. And then we have tools that we can use. So I think to answer your question, I think these women are just using the GLP-1 as the only tool. That's a disaster waiting to happen. And not changing their lifestyle with it. Oh, that's a disaster. But you know what? That's on them. Like we all worry so much about what everyone else is doing. And I'm like, well, good luck.
Starting point is 00:45:05 Like you're going to have diabetes and you're going to probably be overweight when you're 50. But have fun with and you know, definitely the osteoporosis. I'm just looking at all their bones. I'm looking at some of these celebrities that are so, so thin. And I'm like, oh, you're going to take a step wrong when you're my age and it's not going to go well. Right.
Starting point is 00:45:23 So I'm always thinking long game. For someone listening, who maybe has been on semaglutide and has lost a lot of weight and is feeling really good about it, but now they are concerned about coming off of it, lowering their dose. I think a lot of people kind of feel stuck and they don't know where to go from here.
Starting point is 00:45:44 What would you recommend they do moving forward? That's tough because they've acclimated their cellular receptors to needing that much of a substance. So that would be like a bodybuilder who's taken a ton of testosterone and then they end up in my clinic in middle age and they're like, I really, you know, they're, they really need some testosterone and they want physiologic dosing and that doesn't always work. Sometimes we have to keep things a little bit higher. So I guess it depends on how long they've been on it, how old they are, what their
Starting point is 00:46:14 metabolic health is overall, how much muscle mass they've preserved. But you can titrate anything down. Right. So this is again, why I'm a proponent of keeping things slow and low. And when I talk microdosing, I'm talking like a fraction of the starting dose. A lot of these clinics and medispas are talking about using the standard starting dose and calling that a microdose. What's the starting dose?
Starting point is 00:46:36 The standard starting dose of semaclotide is 0.25 milligrams and it's 2.5 milligrams of trisepatide. And they're starting people there and they may be jumping them up to the next tier and they're calling that a microdose. That is not a microdose in my opinion, that's a low dose, but that might be what that person needs. It depends on how compromised their metabolic health is. It's completely individualized for the person sitting in front of me. And then I have a whole litany of other things that go in there.
Starting point is 00:46:59 So there's other peptides we use and there's hormones and there's, you know, we're treating them comprehensively. This is what I teach inside my course and it's a course for clinicians but I let the general public in because this is a comprehensive treatment approach so that we can keep the GLP-1. It's just a tool in the tool belt. It's one of many. It's a huge tool but and it's a big lever puller but we want to keep that dose as low
Starting point is 00:47:20 as possible and so when folks are saying like how do I get off of it? Or I stopped losing weight on it, or it didn't work for me. I'm like, well, how are the rest of your hormones? How is your gut health? You know, how's your adrenal health? How's your thyroid? How's your strength training going? How's your muscle mass? These are all things that we have to consider, because that's what needs to be in place. So when someone says, how do I get off this wamp and dose I'm on? I'm like, how's everything else going? Right? And focusing on all of those being in balance
Starting point is 00:47:51 so that we can bring that down to the lowest dose necessary. If it's only used as a monotherapy and it's the only crutch we have, not great. That's not a great long-term strategy, in my opinion. I'm just thinking like, so you're a naturopathic doctor. long-term strategy, in my opinion. I'm just thinking, you're a naturopathic doctor. I feel like if these medispares and places where people are getting it from are putting people on these high doses to start, are they even reset?
Starting point is 00:48:20 I mean, Fee has talked about her ozempic journey on here, so I'm just gonna throw Fee under the bus right now. But like Fee wants to explore microdosing, can she go to her regular doctor and say like, oh, I heard someone recommend this, I wanna try it. I'm like, what could we recommend? Can people request that from their normal doctors? Like a normal doctor is gonna understand that concept. I think any doctor who, so I think doctors are inherently good.
Starting point is 00:48:47 I think they get a bad rap. I think it's the system that's busted that they are forced to practice within that gives them a bad rap. And I think any doctor worth their salt who has a brain is always going to prefer a lower dose of any medication over a higher dose. So a reasonable doctor is going to happily agree to help you titrate down. So just the idea of titrating down to the lowest minimal dose and I think people might be surprised, especially if they're young and healthy and active and they're eating
Starting point is 00:49:18 well, the opportunity to get that dose lower is probably there. If we're talking about somebody who is older, like my dad, severely diabetic and overweight, I only have him on like half the standard dosing journey, though, so, semaclutide starts at.25 and it goes up to 2.5, and I've got him somewhere in the middle, and we took a whole year to get there, and he's having great weight loss and great success
Starting point is 00:49:44 and great changes in his lab markers, So we're just going to stay there. So my argument to everyone listening, whether they're a health practitioner or just the general public is just go slow and low because you'd be really surprised how little somebody may need. Although don't be afraid to give them something more if they need it. I'll give you an example. I have some colleagues who never really talked to me about my strategies and claimed to be microdosing themselves. And they've got patients on these really low doses thinking that that's preferable. And maybe it's helping these folks with their autoimmune symptoms.
Starting point is 00:50:21 But these folks have weight to lose and they do have metabolic dysfunction. And then I check in with these folks because I know them all and I say, how's it going? And they're like, I haven't lost a pound. I haven't lost a pound. I haven't lost any weight. And I'm like, well, you need a higher dose. Why are you not taking a higher dose? You are more metabolically compromised.
Starting point is 00:50:36 The healthier and more metabolically optimized someone is, the lower dose they need is what I found. But that's not, it's individualized. I've got people who are full of muscle mass and eating super well and super healthy with very little weight to lose and a micro dose doesn't move the needle. So we need to go to more of a standard dosing. So it's just a matter of working with the person and then the person being a proponent and an advocate for themselves. And that's where getting educated comes in.
Starting point is 00:51:05 That's why I have my course or all the free content I have out there about this is because like, if you're educated, you're empowered. And I think that any therapeutic that you choose, whether it's hormones, peptides, all of it, the better you go in, the more educated you are, the better conversations you're going to have with your doctor and the better you guys can work as a team. Yeah. Cause I've learned a ton from my patients over the years're going to have with your doctor and the better you guys can work as a team. Yeah. Because I've learned a ton from my patients over the years who came to me with ideas and
Starting point is 00:51:29 strategies that they'd either read about or learned about somewhere else. And I'm like, hey, yeah, let's try it out. As long as it's sound, it's not going to hurt anyone. We have some data to support it. But even if we don't, the reason I came out with this concept of utilizing these GLP ones outside of weight loss and diabetes was because we had all this data showing that they had these impacts on different organ systems of the body. Why not?
Starting point is 00:51:52 We are allowed to use things off label, right? So just to wrap that all up, we're just titrating up to the minimal dose necessary or maybe titrating down. But for those who are really severely metabolically compromised who've been on very high doses for a long time, I don't know if there's going to be a calm down. I don't know if microdosing is in their cards. And microdosing is not a weight loss strategy either. It might be for someone your age and of your health, but it's generally, I'm getting a lot of pushback out there like in news articles and online, people saying, Dr.
Starting point is 00:52:25 Tina said microdosing is amazing for weight loss and it's not working. And I'm like, no, I never said that actually. It's for other things. If you are metabolically optimized, it can help you lose weight if you're metabolically optimized at the microdoses. But if we are talking about 30, 40, 50 pounds, we probably need a more standardized dose and we may need to go up a little bit. I think there's like a gray area, right? And people don't really like to talk about the gray area. They want the black or the white.
Starting point is 00:52:53 They want, you know, a definite answer. Are you a fan of cycling of like going on, going off, going on, going off? Yes. I think cycling anything. So we're always trying to keep the receptors sensitized. We always want to make sure that the receptors hear what we're giving. So even with hormones, right?
Starting point is 00:53:11 So with progesterone, we take the week of menstruation off. I may even take time off in between estrogen dosing, depends on what we're using it for. Testosterone, same thing. I've got several patients in my career, I've had several patients that were young men who had histories of traumatic brain injury because maybe they played hockey or they were football players or whatever. And they needed testosterone because they'd really done damage to their brain earlier in their life and that impacts
Starting point is 00:53:38 your hormones down the line. And they didn't want to be on it 24 seven because they wanted to have children and they wanted to be fertile. And so utilizing testosterone in a cyclical fashion, and that might be a couple times a year, it might be taking, you know, doing a cycle and then taking a cycle off. It might be with the GLP ones, I've got people taking a couple weeks off in between shots. We've got people taking a couple months off. It really just depends on what we're using it for. And what is the difference? Okay, there's ozempic, mangiaro, trisepatide, wagovi. Okay, so semaclutide is the generic name, the FDA approved drug version of that, which
Starting point is 00:54:19 is that's your ozempic. Ozempic isn't actually for weight loss. So it's kind of funny that everybody's throwing around ozempic for weight loss. It's still semaclotide. It's just FDA approved for type 2 diabetes is ozempic. FDA approved for weight loss is Wegovi. But it's all semaclotide. And then we have terzepatide, which is the generic name of Monjoro, which is FDA approved for type 2 diabetes and ZetBound, which is FDA approved for weight loss. And now ZetBound comes in bioform, not just the pen.
Starting point is 00:54:52 So there's opportunities for more individualized dosing there. Again, I want to hit myself with the microdosing thing because that definition has gone. I mean, I've got I've seen people on TikTok. They're like, I'm splitting up my dose throughout the week. So I guess I'm microdosing now. And I'm like, no, no, no, no, no, that's, all I'm proposing is that we just consider individualized dosing because even in the realm
Starting point is 00:55:12 of weight loss and type two diabetes, there's still some folks who cannot tolerate that standard starting dose. It makes them too nauseous and sick. Why are we making them suffer until their body adapts or they get off of it and they say, it's not for me. I think it's exciting that there's Zep-bound now in a vial and we can use compounded of course,
Starting point is 00:55:31 but the vial gives us opportunity to individualize that dose. Right, and why are people choosing certain forms of it than others? Like are some better than others? Is the price different? Like what's the differentiator? With the brand names, there doesn't seem to be much of a price difference.
Starting point is 00:55:47 It's all just exorbitantly ridiculously expensive, which is silly because there was a study that came out recently showing it costs like five to $7 for them to make it and then they're selling it through pharmacies for a thousand, roughly a thousand bucks, give or take, sometimes less, sometimes more. The same exact drug is being sold in Germany and Canada for like a couple hundred bucks. So I don't know what's going on there. That's a whole other thing. The compounded version, semaclotide is easily the most affordable.
Starting point is 00:56:18 Terzepotide is three to four times as much in the compounded versions. Semaclotide is just a GLP-1 agonist. So it sits on the GLP-1 receptor and it acts as GLP-1. It's basically bioidentical to our own endogenous bodily made. So we make GLP-1 in the gut and we make it in the brain and that's where it's used. It's used throughout the body. But the fact that was what got me excited. I'm like, wait, if it's made in the brain, there's probably a reason it's in the brain.
Starting point is 00:56:44 That's not just appetite suppression. There's other things going on there. So that's semaclutide. It just has been tweaked to keep its half-life longer. Endogenous naturally made GLP-1 is in and out. It's produced and then it's used up or becomes inert very quickly within hours. And the semaclotide is good. The half-life on it's like you know four to seven days. And then terzepatide is a GLP-1 agonist and a GIP so it's acting on glucagon as well directly. I think the implications there are going to be more applicable to those struggling with a bit more insulin resistance and a bit more metabolic dysfunction. So your PCOS girlies are probably going to find some benefit with that GIP. Interestingly, with glucagon, whether we agonize it or antagonize it, it seems to have good
Starting point is 00:57:34 impacts on the body. So we don't have anything, we have some coming to market it looks like that might impact glucagon the opposite way and still have a favorable impact on the GLP1's ability to do good things in the body. So that's a nerdy way of saying we don't entirely understand how these are working, but it's pretty cool that we have that little extra added. I will say though in somebody like myself, tersepidatide can really bottom out the blood sugar. And so that's something that I have several women that I know that are my age who you would look at them and be like, oh my gosh, phenomenal figures,
Starting point is 00:58:10 you know, six pack abs still, really, really great muscle mass and physiques, doing everything right, eating like saints, and all of a sudden their blood markers, their blood sugar handling is starting to get wonky. And that's just part of the transition into menopause. And it's, you know, they've got familial stuff going on and it's really frustrating for them. And so we try a tersepidide and a little bit too much can be a lot too much in those folks because all of a sudden they're calling me freaking out and I'm like, check your blood
Starting point is 00:58:38 sugar and it's just bottomed out. And it can hit you at the most inopportune times where I'm like driving and I have to pull over and eat something. So that GIP, that's what I'm getting at. Having that on board can really start to impact the insulin and sometimes it's not so favorable. So those are folks that I might try going to the semaclutide and saying maybe that's more appropriate. Okay.
Starting point is 00:59:01 It depends though. Some people love the semaclutide. Some people love the trisepatite. It just depends on how they feel on it. I don't like semaclutide. It makes me super nauseous. Trisepatide doesn't seem to have the same impact. So I just do what works best. Again, price, what's not only affordable, but long-term, like what can they sustain, right? And so when we start anybody on a medication, I think it's really important to ask those patients because they might get excited and they can do it right now,
Starting point is 00:59:30 but is this something that you can sustain affordably? And when we're talking microdosing with the semaclutide, at the doses I'm talking about, that might be like 30 to 50 bucks a month, really affordable with the potential of not needing other medications, maybe. Maybe it does away with some of these others. And so when people say, oh, it's so expensive, I'm like, well, it depends on what context we're talking in, because I've got folks
Starting point is 00:59:54 who were spending $30 to $50 a month on their simaclotide, and they're not having to spend all this other money on all these other things. Right. I've also heard it's very beneficial for drug, alcohol addiction, binge eating. Why does it help with those problems? So it plays on our dopamine pathways and really interesting. Again, I think too much can sort of bottom out those pathways and make you not want anything.
Starting point is 01:00:22 The term for that is anhedinia, where you just are sort of like apathetic and you don't care and you don't want anything. It's like, I remember when I first started on them, I was like, oh, I'm taking too much because I don't even want chocolate. Like I love dark chocolate and I didn't even want it. You know, I didn't want anything. I didn't want wine. I didn't want food. I didn't want anything. And so when we impact the dopamine pathways, it gives us the onus of control back. I think that's what's happening. And so people are in the driver's seat again.
Starting point is 01:00:48 And so I've had multiple people. I have, you know, I don't have a following your size, but I have a pretty sizable following and I'm getting feedback from tons of people online. And it's been wild. People are telling me they're not addicted to their social media anymore. They're not addicted to online shopping, they're just suddenly they have control back over whatever their dopamine dragon was, as I call it.
Starting point is 01:01:11 And so some people like their alcohol, some people like their marijuana, some people like smoking. We've got data coming out looking at opioid use. I found this one gentleman who I can't think of the name of his blog right now, but he's written these incredible blogs on Substack talking about the potential use of GLP-1s to impact the homeless problem that we're having because a lot of these folks are drug addicts on the street or they become drug addicts on the street because it sucks living out there. And I'm from Portland where like this is a huge issue and it's really difficult to get
Starting point is 01:01:43 medications in folks that are homeless because of compliance, like they don't remember to take it every day, or maybe they don't have access. But the thought of an inexpensive GLP one once a week dosing to give them the onus of control back. Yeah, I mean, there's just these implications when you give people control back over their brains. Who knows what they will choose or not choose to do, although I do think you can, again,
Starting point is 01:02:06 you can eat through it and you can drink through it. So if you override that, it's not like it shuts it off completely, it just dials it down. And that might be enough for somebody to step back into their willpower, right? Cause willpower is fleeting, but it's just a tool to give them a bit more of that leg up.
Starting point is 01:02:23 Yeah, I think that's so powerful. And something I actually didn't even think about was the homeless population and I've seen this greatly benefit people in my life. I've also seen people abuse it when they shouldn't. Yeah, so I think this is a very Interesting and helpful perspective. I'm sure a lot of people listening are wanting to run and start microdosing. So I'm a glutide now. So what would you say to those people who are now eager to start doing this? What should they do first? First make sure you have the foundations in place. And so this is twofold though.
Starting point is 01:03:00 Some folks are in such a bad place that getting the foundations in place seems daunting and overwhelming. And this is where people say, well, when do we bring in the GLP-1? And I'm like, it depends because if you need a little leg up to get started, it really can help. I've noticed a lot of folks go on it and they just want to start moving after a while. After a while, the body just wants to start moving. They feel better. And so it's a great tool to get people rolling in the right direction. However, the, the basics are always necessary.
Starting point is 01:03:29 The sleep optimization, the strength training, the circadian rhythm, you know, going outside and getting daylight throughout the day, uh, making sure that we have stress mitigation and mindfulness in place, like those are all critical and non-negotiable, whether you're on a GLP one or not. And I think that once the commitment is made to, and I see people though, they say, oh, I promise I'll do that. And then they just rely on the GLP-1
Starting point is 01:03:52 and don't do any of the things. So we got to do all the things. And I think that starts with education. So podcasts like yours and making sure, I have a ton of free content on my podcast and on my Instagram and just making sure that you know what you're getting into first of all. And then talking with your doctor, start with your doctor. This concept is getting out there since I've been on the podcast.
Starting point is 01:04:15 So thank you for giving me an audience to say it to because I think more importantly, I just want the doctors understanding that there's opportunity here for them to help their patients in a different way than maybe they thought they could. And so finding a doctor who's open to having this discussion, start with your own doctor. If they're not, then keep looking. I really don't love the idea of MediSpa's doing this, to be honest. I think that that's a, this is not a here's your injections and good luck. Like this is a comprehensive strategy if we really want this to work well for the long term. So it's short term goals, long term goals, right? It's like the short term obvious, long term, not so obvious. good luck. my paid program. And then I have a four part video series that people can opt into. And it's basically part one is just the ways that GLP one impacts the body that we really didn't
Starting point is 01:05:11 entirely get into that are favorable besides weight loss. I talk about all the big scaries where I dispel all the myths because I think there's a lot of myths to dispel and then just other interesting information that they should have as education. And then I have my paid program if they're interested in that. So lots of free content. Where can they find all of your podcasts, your resources? DrTina.com. So it's DrTina and then I'm on Instagram, I'm on YouTube and I have, gosh, I think like 12 or 14 hours of free content just on Ozempic and the topic of GLP ones between all of it.
Starting point is 01:05:43 So incredible. Yeah. Final question that I ask every guest. Yeah. What does wellness mean to you? Wellness to me, it means freedom. If I don't have my health, I don't have anything. And if I don't, I am someone who struggles with chronic pain.
Starting point is 01:05:59 So if I don't have my health, I have pain. And pain is just misery and you do nothing. So really it's freedom. I work every day to stay healthy and optimized so that I can have as much medical autonomy as possible in my life. Fantastic. Thank you so much for coming on the show. Yes, thank you for having me. Thanks for joining us on the Pursuit of Wellness podcast. To support this show, please rate and review and share with your loved ones. If you want to be reminded of new episodes, click the subscribe button on your preferred
Starting point is 01:06:28 podcast or video player. You can sign up for my newsletter to receive my favorites at marieloellen.com. It will be linked in the show notes. This is a Wellness Loud production produced by Drake Peterson, Fiona Attucks and Kelly Kyle. This show is edited by Mike Frye and our video is recorded by Luis Vargas. You can also watch the full video of each episode on our YouTube channel at Mari Fitness. Love you, Power Girls and Power Boys. See you next time.
Starting point is 01:06:54 The content of this show is for educational and informational purposes only. It is not a substitute for individual medical and mental health advice and does not constitute a provider-patient relationship. As always, talk to your doctor or health team.

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