The Livy Method Podcast - Let's Talk Hormones and Weight Loss Part 2 with Dr. Olinca Trejo - Fall 2024

Episode Date: October 24, 2024

In this Guest Expert segment, recorded on October 24th, 2024, Gina talks hormones (specifically perimenopause, menopause and postmenopause) and weight loss with Dr. Olinca Trejo. Dr. Olinca is a licensed, board-certified Naturopathic Doctor in the province of Ontario. She also holds an honours degree in Kinesiology and has achieved her certification and internship in bioidentical hormone replacement therapy (BHRT).You can find the full video hosted at:https://www.facebook.com/groups/livymethodfall2024Topics covered:Welcoming back Dr. Olinca TrejoThe difference between hormones in men and women and how women are finally part of the conversationWhat is andropause and what do men need to know?Are there hormone supplements for men?Perimenopause: when can it start, what does it look like and how does it impact weight loss?Understanding that medicine (and HRT) comes down to trial and errorThe importance of being informed and proactive when seeing your doctorThe top 3 things to focus on in perimenopauseMenopause and when we should consider taking HRTHRT and antidepressantsDiscussing postmenopause and what you can doThe benefits of being in postmenopauseOur goal is to empower you with knowledge - you’re already doing so much!Dr. Olinca is joining us at the National Menopause Show this weekend in TorontoDr. Olinca will be joining us in our Menopause Add-On beginning on Monday - there is still time to sign up!You can contact Dr. Olinca at [e-mail] learn more about The Livy Method, visit www.ginalivy.com. Hosted on Acast. See acast.com/privacy for more information.

I'm Gina Livy and welcome to the Livy Method podcast. This is where you'll have access to all of the live streams from my 91 day weight loss program. With a combination of daily lives, guest expert interviews and member stories, there is something new almost every day. Miss the morning live? Want to re-listen to one of our amazing guest experts? Well, this is the place. This podcast is hosted on Acast, but it's available on all podcast platforms, including the one you're listening to right now, Spotify, Apple,

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Visit Peloton at onepeloton.ca. This is an opportunity to become curious. To learn some things. How do we help you feel less overwhelmed so you can continue on your journey? Keep believing in yourself and keep trusting the process. Just be patient. Hormones and weight loss. Can I lose weight if I have hormonal issues? What a loaded question. Dr. Alinka Trejo is back. She joined me on Tuesday to talk about hormones in general, things like cortisol, insulin, gut hormones, hunger hormones, which is why it's such a loaded question when people say I have hormonal issues. Whether you have diabetes and you're dealing with insulin or thyroid or whatever that might be, if you missed it, definitely go back and listen to that conversation. It was a good overview of all the hormones involved in weight loss in general.

Today, we are getting into the conversation of not just menopause, perimenopause, postmenopause, but also andropause. There's been a lot of conversation about all the pauses around here. And I don't want the men in the program to feel left out because they do deal with their own hormonal issues that affect their weight. It's just that it tends to be a lot more gradual and not hit them like a ton of bricks like it does with women. And I think with women, we are really just getting into the conversation because a lot of our standards in the medical world have been around men. We just assume that women are smaller versions of men and in reality, we are completely different. But when it comes to hormones, especially this conversation,

men have estrogen, women have testosterone. It's not like we have this completely different set of hormones. So first of all, Dr. Linka Trejo, hi, thank you for joining us again. Hi, it's so nice to be here. Good morning, everyone. Now you must get this a lot. You must feel like this is a giant conversation. Yeah. No, I do on it. I mean, my practice is primarily hormone health and it's so interesting because, you know, I think that with the power of social media, women have finally found a voice to feel also validated with, right? Because for so many decades, really, one, we weren't part of studies and two, it really felt like we were being gaslighted and invalidated when we'd come to the

doctor and be like, I know something's off. I know something is changing. I don't know what it is. And the hard thing about all of these hormones is because your hormones change throughout the day. Your hormones change throughout cycles. Your hormones change throughout lifetime. It's actually really hard to test hormone imbalances that are not true endocrine disorders, like a tumor or diabetes or something like that. Right. And so it leaves a lot of like that gray zone for a lot of people that you're like, I know that my doctor says that I'm within the normal range, but when you look at the normal range, it's from like two to 3,297. And so if you are a four, you're still like, I have a lot closer to that end than that end,

but your doctor's still like, but you're within the memory range. And so I do think that this space and right now has really helped us understand, like, I'm not alone. I'm not crazy. And maybe there's help for me, which is actually why I think that this has become so loud right now and inner space. And it's like, I mean, as a clinician, it's the best. Because also people want to get education on it right now. It can also be the worst because I think and this is actually why you've created the menopause add on. Right. Because I do think that sometimes not not sometimes, but not all information is the right information.

And so trying to filter through all of that information sometimes can feel very overwhelming. And so this is what we're having these conversations, guys. Well, and I think this conversation that's exploding with women in menopause is going to help men in andropause as well. I remember going back to my doctor a couple of years out and explaining, oh, I got vertigo and frozen shoulder and I'm just not, I'm just moody and I'm not feeling this. And of course she prescribed an antidepressant. And now I just saw her a few months ago. She's like, you know, how are you feeling with everything? And I, at the time I'd been nine months without a period. I'm like, I'm actually feeling

so much better. And she's like, well, you know, we have all this HRT, uh, come see me, you know, we'll figure out what you need. You want, you want some pills, a patch or whatever. And she's just like, oh, it's very exciting. She's going to all these conferences and she's learning all of this stuff. And I think it's sort of a known thing that doctors haven't spent a lot of time in terms of hormones, unless it's specific, right? To thyroid diabetes, whatever that might be. And the reality is we go through a variety of different hormonal changes throughout our lives when we are young, when we are pregnant, as we transition and get older, and that's natural and it's normal. But for a lot of reasons, it can really mess with our health and wellness and specifically our weight. So because we are a weight loss program, and there are so many conversations

that we could have about it, let's talk specifically. People are here. They're trying to lose weight. They're trying to understand what's going on in their bodies. And let's start with men off the top. Then we'll do menopause. Then we'll do menopause. And then we'll do post menopause. What do men in the program need to know? First of all, what is andropause? Is it just the male version of menopause? And what do they need to know that can give them, you know, the edge or a leg up or insight into what they need to do moving forward with the program? Yeah, so andropause, I would say, is not necessarily a recognized term in medicine. You don't go into the you know diagnostic criteria book that

helps us uh um diagnose diseases and you don't see like andropause there's a lot of talk about it but i do think that there's a little bit of like that emerging research that says like oh this is you know this is when things start changing for men but as you said because it's such a gradual process it's a little bit hard to term it as like, this is when we diagnose it. But we do know actually that your testosterone or men's testosterone gradually starts declining typically by about 1% or so after the age of about 30 or 40. And in that same interim, you start also loosing growth hormone really rapidly. Actually, there's research that says that growth hormone can decline by about 50% every seven to 10 years after the age of 25, which is

actually like really dramatic. And what I want you to understand about these two hormones is that, yes, well, you have estrogen, progesterone, all of these things. These two hormones for men primarily is what's driving a lot of their muscle mass building and their muscle mass, like at staying on their body, right? And muscle mass is your most metabolically active tissue that you have. And so that's, what's going to give you a lot of your metabolism outside of like age and you know, your thyroid and all of these things, that's your, your metabolically active tissue at rest. And so what starts happening when it comes to weight loss is that around 30, 40, you know, before that you like, you could live this 20 times and grow a bicep like, and men,

because you have so much more testosterone and you know this. Yeah. I mean, you, you train men and women, you knew that, you know, with the same workout, men get different results than women do because they have testosterone. And then at about 30 to 40, with those declines in hormones, it starts becoming a lot harder to grow those muscles. It starts becoming a lot harder to maintain those muscles in your body, right? The changes that also happen because testosterone growth hormone don't only have to do with muscle mass. They also have impacts on things like your bones, your brain, your sleep, your mood. And so we start seeing is that again, gradually men start also feeling like, you know,

I just don't like, I'm a little bit more tired. I feel like when I go to the gym, I'm not as energized as I used to. I feel like I have to work a lot harder at the gym to get the same muscle mass. I feel a little more irritable or I've started to feel a little bit more like flat or sad. I feel like, like I have mood swings. I feel like my body composition is changing. And now I'm starting to get these like man boobs that I didn't have before. I'm starting to like not be as interested in sex, right? Like a loss of libido. I feel like my sleep, even if I'm sleeping well, like it's just not as restorative. Like it's just, it feels like everything and nothing. And it's again, because it's gradual, right? You wake up at like 60, sometimes maybe, maybe something sometimes younger and just be like i just don't feel like the best version of myself and i feel like i am tired i'm a little bit chubbier i have

little man boobs i'm like moody all the time i'm not really interested in sex like i'm just feel like so so with men we're talking testosterone and growth hormone are the two big ones. And when testosterone drops, they're losing muscle mass. Their bodies are also increasing fat storage as well. It obviously makes it harder for them to maintain their weight and even leading to them gaining weight, also slowing their metabolism down as well. And then also issues with insulin. So very similar, very similar to women, very similar. 100%. And you know, if you think about even the symptoms that are actually happening outside of when it comes to the fatigue and the mood and the irritability and the libido,

it's very similar, right? You also start getting joint pain. It's actually very similar because all of these hormones tend to be very anti-inflammatory. And because testosterone also has an indirect relationship to insulin, that's actually why you also start seeing a higher rate of adiposity right around your belly and also deposit right around your breast tissue, right? Because your fat also becomes, we call it like an endocrine organ, but it's almost like it takes the little hormones that you have around and it actually converts them into estrogen and converts them into other things that actually predispose you to build more fat stores when you don't want it to be.

Yeah, because I heard when women are going through menopause and their estrogen is dropping, men actually have more estrogen than women at that point. But would you say for men, the issue with weight gain primarily and their bodies, you know, dropping the muscle mass, the body allocating it around, you know, the midsection of where men store it, it's the drop in testosterone mainly for men and it's the drop in estrogen mainly for women that is causing this same same but different yeah same same but different yes i mean it's in you you know it's um and i think that the tricky thing which is why i think it's so important that you guys listen to the conversation that we had on tuesday is that because all of these hormones are connected right

the low the the drop in testosterone the drop in in estrogen also has a cascading impact on all of the other hormones, right? On insulin, on your, in like, when you're not sleeping, there's like, there's things that are going to happen to your hunger where you're not, you know, at sleeping and you don't feel well, you're, you're going to move less. So it's, it's so, uh, everything is so intertwined, but I would say that the main drivers for sure are going to be the testosterone and the estrogen, for sure, sex specific. But you're right, actually, at men, there's a certain point after actually

around that postmenopausal transition that men actually have more estrogen than women do. It's so interesting. So again, the conversation that we had on Tuesday, foundation, it's about all the hormones in your body and any issues that you're having with your testosterone or estrogen. That really all comes down to what's going on with your cortisol, with your insulin, what's happening when you're stressed and sleeping and the way your body's processing and digesting foods. It all feeds back into that foundational conversation we had on hormones on

Tuesday. So to summarize, even for men, you are already addressing these hormonal issues by following the Libby method, by eating good nutrient-rich foods, by trying to move your body more, by managing your stress, your sleep, which is why all those things are really important. Are there hormones for men? Can men take hormones? What, like, are there supplements, hormones specific to men? Yeah, you know, this is the beautiful thing about being male, is that if you have low testosterone, which is actually, we have, we have very great research on what low testosterone is for men. One, the one message that I want to get across is that if you are going to your doctor and you're saying, I need to get my testosterone levels checked, most often doctors don't remember,

know, or whatever, that your testosterone needs to be tested first thing in the morning before 10am. Otherwise, it doesn't actually mean anything. And you may not get the adequate support that you need because it was not timed properly. And so go to your doctor, ask for a testosterone test, get it done before 10 a.m. And if it is low, we have patches, we have pellets, we have injections, we have creams. We have so many treatments that we can offer to men. And I do think that it is also really important to emphasize that like for men, a lot of the lifestyle things become just as important,

if not more than they are for women. Because, and I know you and I chatted about this when we had the sleep conversation as well, but men who don't sleep well because they have obstructive sleep apnea and men are more predisposed to obstructive sleep apnea, right, up until about like when we hit menopause and they were about the same, but men who don't sleep well and sleep for about less than about five to six hours every night tend

to have testosterone levels of men who are about 10 years older than they are. Simply by just focusing on the foundation that we're trying to teach you through this program, you may be fixing your testosterone enough to actually just be in a range that makes you feel less symptomatic than you do right now. Great. Let's talk perimenopause because I want to leave enough room for menopause, although menopause is one day, and then postmenopause. This is an important conversation, I think, also for anyone who feels like this conversation isn't relevant. Maybe you are younger, and I'm sure all of us who are older wish we knew what we knew now and wish this conversation was happening because, boy, there was a lot of things probably we would have done different. Because the state of your body when you're entering perimenopause, menopause, postmenopause, it will make a difference. Making sure you are managing your stress and your sleep, those more basic foundational hormones. Make sure you are exercising and not just cardioing

your ass off, but making sure you're lifting some heavy weights, getting in that resistance training, maybe keeping up with your vitamin D levels and your magnesium and omega-3. So I think let's talk about perimenopause. When does it start? Just to give us an age range. So people who may not be in perimenopause yet can be like, oh, okay, maybe I'll start, you know, keeping an eye on some of these things. What can that look like? How is it more importantly affecting, um, weight loss journeys? And then, you know, are there specific things that we can do about it above and beyond what people are doing on the program? Again, I know that's a lot. You have 15 minutes ago. Yeah. I'm like, okay. I should be like the girls. It started like writing things down,

you know, and I'm like, I'm going to do, um, okay. So, um, perimenopause really starts anywhere between seven to 10 years before that last menstrual period, right? And if I take you back to that last menstrual period can be anywhere between 40, if you have premature ovarian insufficiency, which is like real early, or for most of us, it's going to be anywhere between 45 to 55. That actually might mean that mid thirties, you start noticing that things start changing when your cycle, right? And perimenopause truly what it is, is that when you, after you, during your reproductive years, truly, um, you start, um, actually, let me take back. You were born with all of the eggs that you're going to ovulate for the rest of your life, right? You were born with like a couple million eggs. And by the time that you hit 30, you're left with about like, I don't know, maybe like 10% of them actually. Like it's,

it's actually like real, real dire. And so when, um, when you're trying to release these eggs, what's, what's going to happen is that you get these beautiful surges of hormones, right? Like estrogen actually for the first phase of your cycle kind of gets the egg ready to grow. And then once the egg is ready to be ovulated, it gets released and then progesterone kind of takes over so that if pregnancy happens and progesterone can maintain and sustain that pregnancy. But for most of us, for most of our cycles, what happens is you just kind of get this like beautiful dance of hormones to your cycle that is very rhythmical and on time.

And it makes you feel really balanced because your body knows what to expect. Perimenopause is when things start changing because your body starts running out of eggs. And what happens is that your brain actually really loves estrogen and is constantly searching for estrogen. And in perimenopause, you're at like the end of your toothpaste tube, right? Like you are like squeezing those ovaries, like to get one egg out. And really what happens is your brain is searching for that estrogen. And it's like, you guys, you got to give me more because like the estrogen is too low. And you're always like, I don't know what to do, man. Like I'm really trying to send the signals and it's like,

it's not responding. And so your ovaries start working so much harder and eventually like maybe they find an egg maybe they don't maybe you know uh you're uh you find like two eggs or like one egg in one cycle one with again the other cycle so you end up getting this like um haphazard production of hormones and haphazard production of estrogen specifically because you start losing the predictability of your cycles that you had maybe in your early thirties or in your twenties. And so what happens then is that because your brain really likes estrogen and all of your tissues arguably have estrogen receptors.

Yes. It starts becoming, and one of my patients said this the other day, and it's a perfect analogy perimenopause is like being on a roller coaster without wearing a seat belt yeah because you just have no idea what's going to happen you lose that like really nice beautiful steady stream of hormones that made you feel balanced and made you feel happy and now you're getting splurts of hormones every so often. And you might

have one cycle when it's beautiful and you're like, oh my God, this is great. And you might have two cycles that make you feel like you're 90 and you're like, there's something off. And so because it's so unpredictable, perimenopause can feel a little bit like a shit show. Yeah. And, and, and estrogen is also anti-inflammatory. It's very protective. Um, it's in our organs. It's in our, it's the receptors are in our brain. It's, it's, it's literally everywhere. And so this is sort of, you know, there's a difference between aging, right. And, you know, perimenopause symptoms. Like if all of a sudden you are like super achy and can't get out of bed or your shoulder is frozen or, you know, you wake up with vertigo, you know, a lot of times these things are blown off as other things. Oh, you're just aging, you're getting old or you're

this or you're that. When reality there, there could be a lot more to it. And, and the difficult part of this is that everybody is different. I remember in my forties, um, I was like getting night sweats and not hot flashes. No, I would never have a tip. I've never to this day at 51 years old. And I, I, I went nine months without my period. It's back for the last two months. Yay me. I just finished it. Um, um, never have I had a hot flash that I've seen on the people going like, Oh my God, I'm so hot. Never. But I would have night sweats and my mom would be like, Gina, it's like, it's, it's the change. I'm like, no mom, fuck off. No, it's not. It's the wine I had last night. And then a couple of years ago, I, I gained like 20 pounds in a month and I was like,

what is going on? And I blew it off as stress. And I did have a, I did have like a stomach issue where I did need some antibiotics. And then I felt like I was really, I changed. And even Tony noticed because I used to be like, so calm, cool, collected. Like I was just so chill. You ask any of my friends, they'll be like, Gina is just so chill. I'm like, whatever. It's fine. Live in the moment. And I thought it was the pandemic that made me edgy and bring on anxiety. All of a sudden I didn't want to leave the house. I had a hard time going to the grocery store. I was like, didn't have patience. I am the most patient person on the planet and that my patients were gone. And I was like, what is going on with me?

And I, and I, I blew it off as the pandemic. I also blew it off as stress and I blew it off onto wine. And now that I look back, even frozen shoulder, I was like, and I was like, what? And then one day I woke up, it was gone. My frozen shoulder was gone. I'm like, was like, what? And then one day I woke up and was gone. My frozen shoulder was gone. I'm like, how the, what? And now I look back and I'm like, oh, oh, oh. And I think that, you know, and I think that that's actually what's been so hard about perimenopause. We can't really test it because your hormones change all the time. And so there's

one cycle that you might look like you're 13 years old. There's a cycle that you might look like you're 75, but because you have estrogen receptors everywhere, it can be, you know, for your heart, it can be palpitations for your brain. It can be anxiety and depression. It can be your sleep. It can be your weight. It can be, you know, it can be joint pain. It can be muscle aches. It can be like, it can be lack of concentration. It can feel like you all of a sudden develop ADHD. Like it can be so many things. And I think that that's probably what's felt like we've been gaslighted for centuries. Because truly, up until recently, the only symptoms that we truly recognized,

I was like, oh, it is that time. It's hot flashes and night sweats, right? And that's probably because they can't really be blamed on anything else outside of like maybe tuberculosis. And so when you have those and you're maybe in your 40s, it's like, oh yeah, maybe it's like the estrogen because that's like the one thing that's really easy to diagnose. But if I tell you like, I feel tired, I feel off, I feel moody, I feel all these things, you can blame it on anything.

You can be like, it's a pandemic. It's stress. You haven't been sleeping well. Oh my God. But like your parents are aging. Your kids are getting older. Like panic attack, anxiety. Yeah. A hundred percent. And we, and we now are starting to understand that again. And I think that that is one of the hardest things about us being taken out of research studies for so long, right? Because the reason why we weren't part of studies is because, oh, well, we couldn't account for hormones for women. And so we didn't, there's a giant gap in medicine

where we stopped studying women and stopped understanding what happened to them. And so we just took it as like a part of a normal transition. And the challenge is that we also are living longer because of the advances of, you know, modern medicine, medicine, medicine story,

which means that we're going to live about our third, arguably a third of our lives in this like post-menopause state, right? And so how you show up to menopause largely to an extent will dictate your experience through that post-menopause. And so having these conversations about perimenopause, maybe if you're in your thirties and you're like, that doesn't apply

to me. It's like, girl, sit down. It does apply to you because what you choose to do in your forties and your fifties largely is going to dictate how you age in your sixties, your seventies and your eighties. Yeah. Well for me, and let me tell you about those heart palpitations. I like got tested. I wore an Apple watch for months, afraid I was going to have a heart attack legit. And no one said to me, Oh, it's quite normal to have those. I literally thought I was on the verge of having a heart attack again, because of stress. So I'm a weight loss expert. The program works really well for people who have all sorts of hormonal issues. For me, what happened is that a few years back,

I got really sick and ended up losing a lot of weight and ended up losing a lot of muscle mass and never really recouped that my entire life, but then super active. And I remember Tony was be like, where'd your muscle go? And then you add on top of that stress, right? And these factors just got blown out of control. So if you can imagine people who have diabetes and dealing with insulin issues, thyroid issues, PCOS, right? You bring that in, ADHD even, because we know it affects your brain, the drop in estrogen levels. So that's a lot to deal with on top of trying to lose weight at the same time. Now, my perspective on why it is much harder for weight loss is because if you've spent years and years of dieting, starving, depriving, neglecting, disconnecting from your body, you're not really rolling into this transition feeling and being as healthy as possible in order for your body to handle it. And we talked about the loss of muscle mass in our conversation on Tuesday, when your body's breaking down your foods, converting them into glycogen, that excess is being stored in your

liver, normally in your muscles, and then in your fat. If you don't have that muscle mass, it's going to go more towards your midsection where you really start to notice it. So let's talk about then, and I do want to get what we can do about it, but I do also want to remind people things like vitamin D, magnesium, omega-3. If you are paying attention to the conversation that's happening out there, and collagen, what are like the top four supplements that are being suggested out there to help address, right? And these are all on our basic supplement list. So all the things that you do to help with weight loss are going to help with perimenopause and the other way around. Okay. So testing is difficult. Although if you go to your doctor, they might do some tests just to

rule out certain things. Because your hormones are always fluctuating, it's hard to get a handle testing-wise on what's going on. From what I've learned, when it does come to HRT specifically, is that it's like a trial and error. Try this, try that. But I think that's medicine in general. I'm going to tell you a story real quick because I don't want to eat up the time on this one. But my husband, my last husband who recently passed away, when he first got sick, he ended up having total organ failure, heart, spleen, liver, kidneys, all of that. And so he was left with heart issues. And he was prescribed all these medications. And I remember he had this

crazy cough. I think it was from Carvedilol. I remember because I talked to some people and they're like, well, what is he taking? And I'm like, this is what he's taking. Like, oh, this cough is a side effect of this medication. So I go to the heart specialist and I say, hey, like he's having this really, it was like really bad cough. And he's like, Oh yeah. Okay. Well, let's just take that one off and double up on this one. And I was like, what do you mean? Don't we have to do a blood test? Like this medication is keeping this man alive. Like surely we don't just like, well, take that off and double up with this one. I'm like, why was he taking that one in the first place? And why is it that's it? That's not very scientific. And he said that this is medicine. We have medications that we know work. We take the symptoms that you're having. We try them.

Sometimes we have to change them. And so I think people don't understand this when it comes to medications. They just think I have this. Here's a medication. And so you can imagine with hormones, it's the same thing. So it's just a matter of figuring out what's working. So if you are going through that process and frustrated and be like, why can't my doctor get it right? A lot of medicine is really trial and error when it comes down to the individual. If you're looking for flexible workouts, Peloton's got you covered. Summer runs or playoff season meditations, whatever your vibe, Peloton has thousands of classes built to push you.

We know how life goes. New father, new routines, new locations. What matters is that you have something there to adapt with you, whether you need a challenge or rest. And Peloton has everything you need, whenever you need it. Find your push. Find your power. Peloton. Visit Peloton at onepeloton.ca. Yeah. And you know, in a lot of medicine, especially in this transition is first making sure that it's not something else and that it's not, you know, it's especially

because we can't test it. We can't do it. And it's like, is it thyroid? Is it this? Is it that? Is it autoimmune conditions? Because inflammation increases, right? Because cholesterol markers increase because of all of these things. But it is, because of our genetics, because of our environment, because of so many things, because of who we are, not everybody responds to the same things, right?

My brother-in-law is a psychiatrist and he always said to me, the thing is that we have theories as to why these things, right? And my brother-in-law psychiatrist, like he always said to me, you know, the thing is, is that we have theories as to why these things work, but I have no idea why it worked. The exact same medication works for you. And it doesn't work for your sister who is genetically like linked to you, who has the exact same symptoms and she might have side effect. We have no idea. So we just like try something else because we there's a lot of things that we don't there's a lot of things that we understand about our bodies and there's a lot of things that we don't understand um and with HRT it's true like it especially in perimenopause honestly because um and this is a hard conversation to have with

patients that just assume that you're going to be on one dose and then that's it like I see you in a year and it's like no no because your ov because your ovaries again, right. For three months might be like, we're 50 and we need a ton of estrogen. And then they might kind of kick, kick it back in and be like, okay, no, yeah. Sorry. Sorry about that. You guys like we're back to being 25 years old and we're going to ovulate the rest of the eggs. And so it can feel like a little bit of like a trial and error where you, and you know, and I've had to see my patients being like, do you know what you're doing? And I'm like, no, I do know what I'm doing. The problem is that your ovaries don't know what they're doing right now.

And so we're just like trying to match that, right? Because it's such a rollercoaster. Let me tell you, if I was to go back two years ago and have that conversation over with my doctor, it would be different, not because of necessarily what she knows, but because of what I know. And I was blowing off a lot of my signs and symptoms because I'm not, you know, I'm this and I'm that, and I'm healthy and I know what I'm doing. And I run a weight loss program and I got it. And so this is why I think these conversations are really important. Doctors go into the profession of being a doctor because they care. They want to help you. But we all know our healthcare system is taxed. They don't have hours and hours and hours to spend with you. So the more informed

you are and the more understanding of what's going on in your body, the more proactive conversations you can have with your doctor. And this is where you can, okay, this is what's going on with me and walk in there with a whole list, right? And I don't want to say go be Dr. Google, but I think educating yourself, you know, on, on what's going on and what you can do outside of medical intervention. So I love again about the Libby method is, is just the things that you are already doing. You're already going in there like, yeah, I'm eating the nutrient rich foods. Yes.

I'm taking these basic supplements. Yes. I'm understanding how sleep is important and I'm getting it trying to get better sleep. Yes. I'm taking time to actively manage my stress and yes, I'm actually moving my body. That's the conversation you don't need to have with your doctor because you are already doing those things so that by the time you go in there, you can have a much more leveled up, productive conversation with them. A hundred percent. And, you know, and I think that when it comes to weight specifically,

because I know that everybody's interested in weight loss, this is what you're listening to as you guys, you have to understand that there's changes in your body that happen because you're aging that we're not able to control and there's a certain degree of that that you know outside of menopause for example we all are going to gain about one to three pounds a year right in that middle age um because our metabolism starts slowing down arguably between five to ten percent every decade after the age of 40. And that's something that we are trying to target, but like that is part of like the, that's part of our picture. But truly what we're trying to get you to do too, is understand that the hardest thing about

this transition is that this haphazard release of hormones for sure are going to impact your body composition because you lose that estrogen protection for your muscle mass, but they mostly impact how well you feel, right? Because if you're not feeling well, you don't, that's actually why we see the changes in, in weight. A lot of the times, like when women don't feel well and men, when, when we don't feel well, we sleep inefficiently or worse, which then means that our hunger and satiety hormones are going to be off the next day, which means that then we're going to move less, which means that like, it's a cascade of things. And so this is actually why programs like, not programs like

yours, because it doesn't exist, anything like that. But your program is so great, because it's laying down that foundation to be like, I am doing everything that i can to feel better so that the only thing that i can't is that you know can't control is the estrogen and in you know going back to the conversation even hormones and hormones are your friend there's also this theory about how part of the reason as to why your body outside of the cortisol and the insulin and all of the things, but part of the reason as to why your body tends to deposit that abdominal adiposity right in or around your belly, that muffin top around this transition as well is because with that drop of estrogen, your body doesn't like that because it feels inflamed. It feels itchy. It feels itchy. It feels, it feels odd. It feels sad. It feels all of the things. And so

because fat is an endocrine organ that changes hormones back into estrogen to an extent, arguably right now it's being proposed that your body's also doing that to try and get you a little bit more estrogen so that you don't feel like this. Yeah. And then what do we traditionally do? We starve ourselves. We deprive ourselves. We mentally berate ourselves. We disconnect ourselves in an effort to combat that weight gain, right? Which is like the opposite. And so I think you have to take the perspective of your body is doing its best. It wants you to stay alive. It's not trying to screw you over, make you fat, feel like shit, any of those things. And there's a transition period. And I think the healthier you are, the easier that transition period is going to be. The more knowledgeable you are, the more understanding you're going to be of the things that you can do to transition through this phase. Just to recap, before we move on to menopause, so I'm in perimenopause, I'm trying to lose weight. What are your top three things that you would suggest are really important to focus on? Okay. Anti-inflammatory diet. Wait, are we talking like we are already assuming that we're on the G-Livy method or no? Because it's

going to be completely different. We're assuming. Already already on that means that you already have the anti-inflammatory diet down which is great because inflammation is a real thing during this yeah um you're also sleeping well because you listen to all of these amazing experts the sleep week and you know how important sleep is so we we know that um but truly the magic for you is going to be exercising and exercising efficiently and so and i know that. But truly the magic for you is going to be exercising and exercising efficiently. And so, and I know that we're going to chat a lot about this even during the menopause add-on, but part of what, so estrogen is a beautiful thing in the sense that it directs fat where it's supposed to go, right? It directs fat like away from your abdomen and into anti-inflammatory areas.

When you lose that messaging of estrogen, right? That's like sending that extra fat to your bum or to that gluteal femoral area of your breast. Then you start depositing that fat around your abdomen, which is actually what happens. But then you start losing muscle mass really, really rapidly. That's going to happen anyways, because you age, but it starts like really, really happened super rapidly. And because as we said earlier during our conversation, your muscle mass is your most metabolically active tissue at rest. That means that we want to protect that muscle mass at all costs. And we want to

work on growing those muscles as much as possible. And believe me, when I say this, it is almost impossible to burn fat without building muscle. You cannot do that. And so exercising like we did in the 80s and the 90s of like high reps and like step ups and all of these things, unless you're wearing a weighted vest, you are completely wasting your time. And it's not to say that activity is not good. Activity is great and all types of movements are great also because cortisol increases and we have this very clear in the data cortisol without doing anything else um cortisol will increase in this perimenopausal transition um and so the the um

exercises that help you decrease cortisol like like walking, like HIIT training, like resistance training, and not necessarily like marathon running or doing like super, super, and cardio is amazing. But if you work out and you feel like gassed after your workout, that is not the right type of workout for you.

And so truly the data for perimenopause and menopause says like heavy weight lifting to failure doing less reps than what you were doing before doing a lot of what we call the like that you know non-exercise um activity like thermogenesis which really means like the walking and walking with weight events you know i'm like a huge proponent of them. But adding in movement whenever you can, it's like my number one, two, and three tip probably. Love it. So moving on to menopause, which is the whole thing's just confusing because technically we talk about menopause being perimenopause, menopause, postmenopause, but we got to break them down. Menopause really is just one after you miss your cycle for a year. It's one day.

And so I went nine months, nine months, so close yet so far away. My period came back and then it came back again. And I'm like, okay, all right. So I've got to start the whole, but I do have to tell you I am, and I'm not on HRT. I take my supplements and whatever, and I'm feeling remarkably better already. And I was starting to feel better, which, but I've also done a lot to manage my stress. I'm moving my body more and I'm also doing those things as well. So menopause, it's one day, one full year of missing your period. Beyond weight, also things like I noticed like your cholesterol levels that's one of the things my cholesterol was going up you um you know dealing with you're more insulin resistant there's a lot going on there um do we start taking hrt if we're interested in that and i do have to

say this whole hrt conversation it's not like every woman needs hrt and hrt is not the norm i think the problem is is that we could have been taking it all along. But years ago, there was a study that came out that was just glorified for all the wrong reasons and said that HRT causes cancer and this and that. We now, that's been debunked. So I don't want to spend too much time HRT and that's a conversation with your doctor. But taking HRT, although it absolutely should be available for everybody who needs it, it is not the norm. And taking HRT is not going to necessarily directly help you lose weight unless you are doing the kinds of things that you're also doing on the Libby method. But for health reasons, it can be beneficial. So when should we consider taking HRT? Is it a year after we've missed our period? Is it in perimenopause? Is it after that one day menopause and we're in postmenopause? Oh my God, we only have 14 minutes. Okay. I know. So listen, the truth of the matter is that

while the WHI study, which is the study that you were referring to, it was very glorified for a bunch of really, really bad reasons. It gave us a deeper understanding as to when to start and when not to start HRT. The hardest thing about this is, again, because the conversation has just truly started. It's been like a millisecond in the history of medicine. We don't have a ton of research as to what the benefits, I guess, are the drawbacks of HRT in perimenopausal women. We don't.

It truly has been historically something that we've studied after menopause. And so this is actually where a lot of the talk is going to come from when like your doctors be like, no, no, until you've missed your period for a year, I can't give you this. And that is a little bit more up to your clinician than not. But the only two FDA approvals, I guess, or indications that we have for HRT, believe it or not, are vasomotor symptoms, so hot flashes and night sweats that are moderate to severe or impacting the quality of your life, or the risk or decreasing the risk of osteoporosis in women. Not treatment of osteoporosis, decreasing the risk. Those are actually the only two FDA indications, right? And so it's, it's, it's hard. Yeah. And it's actually really

hard because, um, again, this medicine moves really slowly and there's a lot of data now that says also, right. When you have a perimenopausal woman that experiences a major depressive episode that has never suffered from depression in the past or has had depression in the past, but was completely controlled. And in perimenopause, when her hormones start changing, develops it again. Instead of just saying like, hey, should we put you back on your SSRI or increasing the dose? Perhaps we should have a conversation about do we add estrogen or not? Yeah. And even with the frozen shoulder, right, that you were talking about, Duke University did a beautiful study that actually showed that women that are on hormone replacement therapy actually tend to have significantly lower rates of what we call like arthralgias and the musculoskeletal syndrome of menopause.

Lived our whole life with estrogen. We've lived our whole life with it. And all these issues are happening because it's rapidly depleting. So it makes sense that adding some back in and because it does have anti-inflammatory and protective properties, that would be a benefit across the board for a variety of reasons. A hundred percent. And, you know, and so I think that this warrants like a really, like you said, I don't think that everybody needs to be on it, but I think that everybody deserves a very educated conversation with their practitioner to figure out whether or not it's

right for them, because we know that, you know, even though it's not FDA approved for decreasing your risk of cardiovascular disease, it does decrease your risk of cardiovascular disease and all cause mortality. It improves your sleep. It like, it does so much for your quality of life. And I do think that a lot of clinicians now kind of look at the whole picture and be like, okay, maybe your hot flashes and night sweats are not bad enough to just warrant the HRT, but could you benefit from HRT for other reasons and for the risk factors of osteoporosis and things like that? And so it's such a deep conversation. But the one thing that I will say, which is so interesting about weight, right? Because there's

a twofold conversation with this. There's women who are afraid of going in HRT, even though they have terrible hot flashes and terrible night sweats and are at risk of osteoporosis because they feel like it's going to make them gain weight. And there are also people that feel like, well, if I just put, if I just get estrogen, then I'm going to be able to lose all of this weight, right? And neither of them is true because we actually have really clear data that says HRT is actually weight neutral, which means that it doesn't make you gain or lose weight because also the goal of HRT is to give you post-menopause, like it's almost like it gives you the estrogen level that you would have been producing on like day one of bleeding in your cycle, which is literally like a lick of estrogen. We don't want to give you the estrogen levels of like a 25 year old.

That is not our goal. Or a pregnant woman. Or a pregnant woman. Exactly. And so I do think that the expectations with HRT right now, because of the conversation that is happening in largely social media are very inflated and people see it as like, it's going to be the panacea to all of my, uh, my issues with weight and fatigue and all these things. And it's not necessarily

true. And it doesn't do much if you're not putting in the work with your sleep and your stress and with like the resistance training and with everything else, like it's, it's not like a, you know, it's not like a magic pill. I mean, it is for some, for some things, but not. Well, then it's just like, it can help all, it can help all around again. And I think this goes back to the conversation we had the other day where medications are great. They can be a game changer and a lifesaver for a lot of people, but it's not your fix for weight loss. There's still a lot of other things that you need to do to address the weight itself. I mean, this is why we are, we're going to do the menopause add on to, to really get address the weight itself. I mean, this is why we're going to do the menopause add-on to really get into the conversation and give it the due diligence it deserves. It is a very big

conversation. So Dr. Olenka is going to be joining us for that. I do want to move into postmenopause. But before I do, I do want to talk about HRT and antidepressants. And there is a major mental health component that you may be dealing with on top of, and may be part of your, your menopausal symptoms. Right. And so I don't want to discount, um, antidepressants because they absolutely can be, uh, you know, a life raft, a lifesaver and a game changer. And I don't think it has to be one or the other. And they are both part of the same problem. So I wouldn't necessarily poo poo antidepressants. Because you think, oh, I need HRT or my doctor prescribed, like there could be reasons why you're being prescribed antidepressants, which can be helpful along with HRT as well. So

it's not a black and white conversation. So I want to say that out loud. Yeah. And there are actually antidepressants that, I mean, there is one antidepressant that's FDA approved for hot flashes and night sweats that may actually improve sleep more than HRT. But there are a lot of antidepressants that help for hot flashes, night sweats, insomnia, mood, like a lot of the other indications that are options for women who are not candidates for HRT, because not everybody's a candidate for HRT, right? Or if you know, you're like, you know, I don't know whether or not I'm a candidate. I'm too afraid of it because I know that the research is there, but I still feel like I'm not sure about it. Like they are great and they can be really, really great. I know that the research is there, but I still feel like I'm not sure about it. Like they're, they're great and they can be really, really great.

I think that this is actually where having that conversation with a clinician is so important, right? There's risk benefits to everything, to everything. The postmenopausal women feel left out. What about us? What about us? What about us? Can we talk about us?

And I get it, right? Because yeah, you're on the other side of that, but that doesn't mean this conversation isn't still relevant to you. And there aren't still things that you need to deal with, um, as well. So let's talk about post-menopause. Let's talk about what's the conversation there. I know, you know, it, I, I mean, truth be told sometimes after the lives that like pop into Facebook and be like, what are people saying? And there was a, there was a comment that I read on Tuesday that made me so sad because it was a, uh, one of the members saying, you know, it, uh, it makes me feel really sad or frustrated. I can't remember her

wording, but that, um, there's nothing that we can do after menopause for belly fat. And I was like, girl, sit down. Like, this is what we were talking about like these and you know and I think that this is why we divided this talk even into two at two different lives because now because your post-menopause means that you don't have hormones like it just means that you may lose you lost a little bit of the connection and like you know instead of now you have you you had in your orchestra three violin players now you have like yeah that's it that's it yes and it's not everybody else helping you can still play your orchestra still can play the music you just you you play a different tune you'd be just playing a different tune yeah and you know and like they're like your adrenal glands still produce the you know estrogen and progesterone and testosterone just to a much lesser extent. And so again, that's like your, your string, uh, uh, quartet went down to like

a single violin, but like you still have estrogen, you guys. And so I just want to say, and I think that's the, what's problematic about the conversation. Um, people in perimenopause, menopause are just, they kind of like they, they gloss over the basic hormone conversation and they wait to talk about the three, right? That's what they're waiting. They're waiting on the estrogen, the androgens, the progesterone. I need to have that conversation and totally disregard the foundational hormones, thinking that doesn't play a role at all. And you're missing such a big part of the conversation. And then I think when people are in post-menopause, they think none of that is relevant to you. They're in their own separate

space that their body's functioning completely different when that foundational conversation, very relevant to you, even what's happening. Okay. With your hormones through that transition important. So you may be on the other side of that, but that, that doesn't mean that you don't still have to do a lot of the work or that this conversation isn't relevant to you. I know. And you know, so again, so post-menopause, so now you don't have necessarily estrogen, but in that transition, actually what will happen is that a lot of our risk factors for diseases that estrogen was protecting us against increase, right? Because estrogen is anti-inflammatory, it's gone. Now you are predisposed to inflammation.

You, we, up until around the, when all of these things start changing, our risk for cardiovascular disease is about 50% of that of men's. And then when we lose estrogen, we H match them. If not, we actually are a little bit higher, which means that we have to be a lot more mindful of things like our cholesterol levels, our blood pressure, like, you know, a lot of those risk

factors, our bones, we lose about 10 to 12% of our bone mass in this transition. So our bones become a little bit more brittle, right? So this is also where things like protein and calcium and vitamin D and exercise become even more important than it was before. You know, you're a lot like to an extent, the vast majority of your tissues, like for example, your brain gets eventually used to that loss of estrogen. It kind of makes up for it by like getting a bunch of different receptors. But the one organ that never really gets used to that is your vagina and your skin, right? We lose so much of our collagen and our moisture and things like that.

And so I think that in post-menopause, it's more about looking at you being faced with the fact that you can't get away with things that maybe you thought that you could get away with before because now estrogen is no longer protecting you. And you actually have to do so much more of the work for cortisol and insulin and your satiety hormones and your sleep and your bone health and the exercise. And so I actually think that this conversation is more like, okay, how to like not shed the bed through perimenopause and menopause, but like, girl, how to live your best life in postmenopause because this is where it's at. Yeah. Yeah, absolutely. Absolutely. And I do want to say about that. There are benefits to being postmenopause, more clarity of mind, being more calm, being more self-assured. Like this is why you see older women. They're like, yeah, whatever.

They say whatever the fuck they want. They're just like calm, cool, collected, you know, like Queens of wisdom. And there's like, there are benefits. It's not like you just, you just, it's a downhill, I don't know, slide into hell. That's not what it's about. Remember your body is on your side. This is just another transition, you know, to like physically, mentally, all of it. So how do you help your body through it address its needs, which are very individual, right? Like it's, it's not a, it's not, you're not skyrocketing to, you know, sliding down to hell here. It's not, you know what I mean?

And it's also, you know, I mean, it's inevitable. We're all going to go through menopause, but we don't have to suffer through it. First of all, it's not, you know, and I think that this is also like a hard thing, right? Like in the media and things like that, like when you get old, you feel like you're no longer like a thriving member of society. You're not beautiful. You're not all these things. But literally I have like patients in my practice. I'm like, yo, I am having the best sex of my life. I am 72. I don't have to worry about getting pregnant.

Like I have like better libido, like my husband and I, and sometimes I get too much information, never too much information for your nunchuck, but you know. And so I do think that we, maybe it's because of the story that we're fed or like whatever it is, like it's sometimes you can be more financially stable. Your kids are like out of the house. This is actually why sometimes also this like menopausal transition is crap, right? You're getting, you and I have talked about this all the time. You get the stress sandwich where like your parents are aging, you're getting pressure

from the top and then your kids are like growing up and like big kid problems and you're getting the pressure from the bottom. And then when you get to the other side, usually both of those kind of like end and then your kids are like growing up and like big kid problems and you're getting the pressure from the bottom and then when you get to the other side usually both of those kind of like end and then you can live like you can arguably be living like the best life in like the most stable happiest sexiest um way but it's also what you make of it and you you always say this we're not victims here like we are you, we're not victims here. Like we are, you know, we are not victims here. We are heroes. And so this is also what we're trying to like talk to you about, right? Like these hormones stay. So now it's like, okay, I don't have to deal with the estrogen, but like, how do I lower my insulin? How do, what do I do

with my cortisol? Now you have the time to do it. Like, let's do it together. Yeah. And it's just, you know, these conversations are so important because it brings a sense of awareness. Again, it's not designed to like overwhelm you or any of those things. It's to arm you with knowledge, to empower you, to take control, you know, control and moderation are two words that I never use. And I don't think belong when it comes to talking about dieting and weight loss. But you do have a lot of control over your life and the things that you can do to be proactive when it comes to losing weight. But beyond that, your health and wellness. And if you were talking about sustainable, maintainable kinds of weights, your foundational

hormones, you need to address those. You need to understand what's going on in your body. You can't just be blindly blowing it off as this and blowing it off as that. There is a lot that you can do. I hope that you found this conversation to be hugely beneficial. I mean, we could probably talk about it all day, every day for 91 days. Take away, you're already doing so much. Whether you are in andropause, perimenopause, menopause, postmenopause, the Livi method is going to work for you. That is your ticket to healthy, sustainable weight loss. This is an opportunity in addressing your hormones to level up, to be even more proactive,

not just about weight loss, but your health and wellness. Thank you, Dr. Alinka. Thank you for everyone who joined us live. Thank you for everyone listening after the fact um come back to this conversation it's a good one along with the conversation we had on tuesday combined with the whole sleep series that we had a few weeks ago combined with the conversations we've had on supplements uh dr alinka trejo will be joining us uh this weekend at the national menopause show so if you want an opportunity to come meet her she's going to be there with us on Saturday. If you're in the Toronto area, you can find more information and reach out to Dr. Alinka by sending an email to info at dralinka.com. If you want to reach out to her, she's also going to be joining

us in the menopause add on, obviously, because who else would we have talking to us about all of this amazing hormonal information? Dr. Linka is going to be joining us for that. And that starts on Monday. So that's where we're going to shift the, if you feel like you need more information or want more to learn more, we are going to shift this conversation out of the weight loss program and now into our menopause add on. Okay. That was a lot. I adore you. I am so grateful for you. Um, thank you. Thank you. I mean, you know that I can do this all day long. So I, one of these days, we're just going to be like, and today is going to be the day where she just talks about this, but honestly, it is my privilege to be here and to talk about this. I really do hope that,

uh, like you said, this isn't, you guys don't feel like this is overwhelming. Our goal is to always empower you and make you walk away with this feeling like I am doing so much, so, so, so, so much. And I can't stress this enough, like the foundation that you are building through this program is going to set you up for success in every which way, regardless as to what we're looking at, you know, insulin versus cortisol versus estrogen versus whatever, whatever hormone it is that you choose. I promise you, you are trying to balance in the best way that you can with the tools that we're giving you. Amazing. Thank you. Thank you. Thank you. See you this weekend. Yes. Whether you're in your running era, Pilates era, or yoga era,

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