Live Like a Girl with Dr. Mindy Pelz - How to Balance your Hormones to Maximize your Immunity with Dr. Sara Gottfried

Episode Date: July 13, 2020

This episode is all about rebuilding our microbiome and why food can be our biggest hero or our worst enemy.  Sara Gottfried M.D. is a wife, mother to two incredible young women (ages 15 and 20), scientist, researcher, speaker, connector, scholar, seeker, and Harvard-educated MD with 25+ years of experience, board-certified gynecologist, and author of three New York Times bestselling books, The Hormone Cure, The Hormone Reset Diet, and Younger. Her latest book is Brain Body Diet.   In this podcast, we cover: Why people are immunocompromised  How stress is damaging us  Why the food system is a big part of America's health problems About rebuilding our microbiome  How birth control impacts our microbiome  Counteracting the lack of connection during COVID Why we didn't focus on an integrative approach to sheltering in place  How Black communities fall victim to our toxic health care system Our sponsor of this episode is: Revelation Health for Gut Support. Use code ResetterPodcast for 10% off your next order.  If you are interested in our next Metabolic Reset, we'd love to have you! RESOURCES MENTIONED IN THIS EPISODE: Dutch Test Dr. Sara's Hormone Quiz Sara Gottfried Sara's Facebook Sara's Instagram Sara's Pinterest Brain Body Diet  

The information discussed in this episode is intended as general information only. It is not intended for one-on-one medical advice, and you should always consult your healthcare practitioner before making any changes. And if you like the content discussed in this episode, please go leave a review so that others can benefit from it as well. I am a woman on a mission that is dedicated to teaching you just how powerful your body was built to be. I like to do that by bringing you the latest science, the greatest thought leaders, and applicable steps that help you tap into your own internal healing power. The purpose of this podcast is to give you the power back and help you believe in yourself again.

My name is Dr. Mindy Pels, and I want to thank you for spending part of your day with me. Letters, so our next guest is going to blow your mind. So it's Dr. Sarah Godfrey, and she is a Harvard-educated OB-GYN. And she is also a New York Times best-selling author. And I want to read her bio because I love people's missions and bio. And I think it's really important when you understand the heart behind somebody. I'm such a fan of people that are heart-based. So let me, yeah, right? Let me read you her bio. And then Jessica's going to pop in and tell you some of the logistics. took to get this interview going. So let me start off here and here's her bio. She's a wife and mother of two. She's a scientist, and you'll see that in this, a researcher, a speaker, a connector, you'll see that, scholar, seeker, and Harvard-educated MD with 25 years of experience. She's a board-certified gynecologist, and she's the author of three New York Times bestselling books, the hormone cure, the hormone reset diet and younger. And she has a new book called Brain Body Diet.

And you're going to love this conversation because we, it is very current and topical about what we're going through with our immune systems and hormones and how they play a part. So this is also an interview for both men and women. This is not just a woman-centric interview. So don't you think, Jess? Yes. Just hearing you read her short snippet of her bio. God, she's a rock star. She is a rock star. Genius. It took us like, we battled back and forth between January and February just to get something on the calendar because she is, I mean, she's got her Gottfried Institute up in Berkeley, I believe. Yep. And then obviously she's writing books. She's got press stuff that she's doing all the time. She was on Goop. Yeah, she was on Goop with Guedadro.

Oh my gosh. Yes. Which we still need to go watch. Yeah. I know. Yeah. So you guys, but here's what's awesome. And I think what you'll see it is that she is on a mission. She has a heart. She is obviously really bright. She cares. And she had so much fun in this conversation. There's a lot of depth to it. So resetters, enjoy. This one is, you know, I always say it's one of my favorite. I think I just love people. But this was definitely one of my favorite interviews. So we're excited to share it with you. Okay. So let me just start off by, welcoming you. And I don't know what you know about my resetter group, but we are across all our platforms for like 200,000 strong, very involved, right, really involved people. And what we love to do is fast together. So I don't know what your experience. I know you've been talking a little bit about intermittent fasting. It's just been such a beautiful way to bring everybody together. So I'm really excited to have you here. And I'm also, what's really ironic is that when we sent you an invite, I really wanted to dive into hormones and sex hormones. And there's so much through keto and

fasting that we can do and talk about. But now we're in a pandemic. Life has really changed. So one thing that I want to talk about that I just don't think is talked about enough right now is why the heck everybody's so immune compromised? And where do hormones fit into that? Where does metabolic syndrome fit into that? Because this is something that I would personally like to bubble up to the surface and make people really aware of. So let me just start off with that question to you. Love that question. You know, I feel like you're absolutely right that this pandemic is pointing to certain things that we really need to pay attention to. And I would say hormones are actually at the center of it, not just because I love hormones, but because what I see,

and I'm actually giving a talk on this, on the role of stress, toxic stress, and the immune system in terms of inflammation and how we create mind-body resilience. So I'm steeped in the literature. Mindy, I just looked at, you know, about 2,500 studies on this topic. So let's get into it. Yeah, no, you and I are the same. We literally, my husband and I have like geeked out on the, on the science on all of this stuff. And like, we're down a rabbit hole. So I'm excited to chat with you on it. Awesome. Well, so let's start first with there's the stress response that I learned back in 1989. So that's when I went off to Harvard Medical School. And I learned this particular way of thinking about the stress response.

And I wonder if it's maybe what you learned as well. But it was, I would say, pretty simplified. Very simple. Right? Like where you take in a threat, your amygdala and your limbic system takes in a threat. And it kicks off this cascade of events. It triggers corticotrophin releasing hormone. And then that goes from the hypothalamus to the pituitary and the brain.

That then triggers ACTH, which then goes. the adrenals and releases cortisol. So I am getting to the immune system eventually. Yeah, no, I'm following you. So I would call this version 1.0. So this is the way that your body responds to stress. So you sense, you know, a trigger. And that could be a virus. It could be, you know, a fight with your husband. You have this trigger and it releases all of these hormones. But the other thing that happens is you have this rise of cortisol produced by your adrenals. We call this the HPA axis, as you know.

And you then trigger this whole inflammatory release. So you have these cytokines that get released and the immune system gets activated. The problem is the system is designed to turn off, usually within a few hours. And it's not designed to be triggered a lot. it's certainly not designed to be triggered every single day like I see in so many of my patients. So I would say a fundamental problem in terms of why we're so immunocompromised and why we're seeing this pandemic is that we have chronic toxic stress. Now there's, of course, other pieces there too, and I want to like integrate your comments about this. There's our lack of sleep, the sleep debt that

we have and how that makes us, you know, it raises our cortisol further. It raises insulin, it then goes down that pathway of metabolic dysfunction, which you talk to so beautifully. It also is associated with the food that we're eating, which can cause food stress and food intolerances. It's related to, you know, social connection or lack of social connection, or epidemic of loneliness. So there's all these different threads, and that's just a few of them. So how does that land? I feel like you and I could talk for hours. Yes, like, Ditto, ditto, I absolutely agree with you. And one of the things that has been like just tugging at my heart right now is that the whole

world is arguing masks, no masks, social distancing, no social distancing. And I'm sitting over here going, why aren't we talking about the immune compromised body and everything that you just said, how we have got this cascade of stress that is damaging people and people are walking around appearing to be healthy and they are not and now we're all quarantined ourselves but we're not helping those healthy people become healthy so such an important point because all of this isn't seen so you can't see this whole stress response i mean sometimes you see someone who's who's really traumatized and has post-traumatic stress disorder or has depression and you can see it visually. But as I'm sure you see in your practice, the vast majority of my patients

who come to me look completely normal. And no conventional physician has ever bothered to measure their cortisol levels or their dried urine or their cortisol metabolism or what's happening with their allostatic load or their biological age. All these things that contribute to are risk of getting exposed to SARS-CoV-2 and then infected and potentially developing the disease, COVID-19. So I think that's a really important part of this. And chronic disease is linked to all of this as well. As you know, it's linked to the hypertension and the dementia and the atrial fibrillation that puts us a greater risk of COVID-19. Yeah. Yeah. So where my brain goes is how are we going to get out of this? And I actually put a post on my personal Facebook page, and I made a comment that the enemy wasn't the virus. The enemy was the food industry. And it was really interesting the response that I got. And a lot of people said, well, I don't understand. That doesn't make sense. And so I actually followed it up with an article. It was an editorial piece from the British Medical Journal that said the obesity epidemic is making people more susceptible to infect.

to this to this infection and the obesity epidemic is coming from the food industry. So yeah. And what about people who poor people? How are they going to get access to healthy food? Like there's so many legs to this that I'm trying to figure how we how we can help people get out of it. Well, I love that you want to focus on solutions because I think we could depress each other. We could. We could.

Talking about some of the problems. Oh, my good. I agree with you. I think the food system is a big part of the problem. And I think, you know, there's these other factors as well when we have an integrative functional perspective like the two of us have. And I would also say that I think your point about metabolism is really well taken because we know, for instance, if you just look at the microbiome, so, you know, those set of microbes that I'm sure you've talked about before in your gut and their DNA. When you look at kind of that collective group of the microbiome, what we know is that it gets damaged, number one, by food. So food is the worst disruptor of the microbiome. And it can lead to so many different problems, as you know, it can lead to dysbiosis or an imbalance between the good and the bad microbes.

It can lead to increased in permeability, also known as leaky gut. and it especially leads to a decrease in diversity. And this point that you're making, kind of connecting the dots to obesity, I think is so important because when you look at obesity, it's not just body fat. That's the problem because that fat is metabolically active. And we also know that if you look at the gut, there's some fundamental gut problems too. There's a loss of diversity. There's, you know, this, the way I think of it as the microbiome,

gut brain axis, which involves that hypothalic pituitary adrenal axis. It involves the parasympathetic and sympathetic nervous systems. And it also involves the microbiome. Have you followed any of Dr. Zach Bush's work? Oh, absolutely. So yes, good friends with Zach. I met him a few years ago. Incredible man. You hear him talk once and you're just... So when the pandemic first happened, And we actually called him and said, hey, can I get, can I interview you? And he, he actually, it was, it was a great interview. The challenge that we had is that he Skyped in from Fiji. So his sound was a little off. Anyways, one of the things that he said that stuck in my brain was that we have been so focused on killing bacteria that the bacterial world has now, is now decimated. And that these

bacteria have been keeping the viruses at bay. And now that the bacterial world is decimated, now that we've antibioticed everything, we have nothing to keep the viruses under control. So my question and my thought is like, okay, well, then what can we do to start to regrow our bacteria? How can we start to get bacteria strong again, especially if I'm somebody who's been eating antibiotic-rich meat. I've been putting hand sanitizer on my skin all day long. I've been taking antibiotics and I've decimated that system. What can I do to start to rebuild it? Super juicy question. And fortunately, we've got a lot of deed on this. So we know, for instance, that food is the most important disruptor of the gut, but it also is the number one healer of the gut. So I would say

this is a food-first philosophy. It starts with Whole Foods. I'm a big fan of a well-formulated ketogenic diet, and we can talk about that. Combined with fasting, I think the two together, especially the backdoor to ketosis is very helpful. And when it comes to food, you know, what food in particular besides Whole Foods, we know that having species variety is incredibly important. So what I try to do personally is I aim to get somewhere around 20 to 30 species per week. And that's a lot of species if you're trying to period over time. I eat very little fruit, but the fruit that I eat includes avocados and olives. Those are my favorite sort of low glycemic index fruits. We also know, you know, if we go back to, I'm going to put my OB-GYN hat on. Of course.

No, no. We can talk about sex hormones. It's okay. I just want to point out that we have a bigger issue going on here. Anyways, go ahead. I'm so glad you did because I, you know, I think a lot of folks who are really struggling with COVID don't have the microbiome that they need to really support their immune system. And so, you know, like me, when I was born in 1967, my mother breastfed for about 10 minutes. And, you know, I was then formula fed. And that just sets. up this hit to your microbiome. You just don't have the diversity that you would like to have. And so the good news is, no, I'm not going to drink breast milk, but I can get some of those proteins. I can get human milk oligosaccharides. I can get some of the prebiotics that are from breast milk so that I can feed my good microbes. So the way I think of that is we want to really give the gut plenty of prebiotic fibers. So that can include the human milk oligalaccharides,

HMOs for short, but it can also include, you know, just classic non-stargey vegetables. And I get a ton of those. So I aim, ideally for about 35 to 50 grams of fiber a day. That's a lot of fiber. Wow. That's great. Like, don't start that immediately. You want to like slowly work your or else don't leave the house. Yeah, exactly. Your husband will be like, oh, no. Yeah. Yeah. So I think that's a really important piece in terms of healing. The other people, pieces, we know that when it comes to rebuilding the immune system, and especially that, you know, microbiome gut brain axis, there's so many different parts that are important here. So I would say food is the first driver. The second is getting the sleep that you need. We know that seven to eight

hours is really ideal for the immune system. And some of the best repair in terms of immunity happens in your deep and your REM sleep. But we also, know that your perception of the quality of your sleep matters a lot. Interesting. So you don't have to have an aura ring. Yeah, I was going to say, I have an aura ring. And sometimes it tells me I got worse sleep than I anticipated that I got. I didn't think I got that.

So that's interesting. Well, it's one of those studies where I just was like, there's some days where I don't want to show anyone my aura readings. Right. Yeah. So, you know, sleep is so important. We can talk about some of the nutraceuticals that I think can be impactful. But we also, you know, we want to be thinking in terms of a pleiotropic approach.

Like what are some of those small hinges that swing big doors? And I would say, you know, your food, your sleep, your state of mind are the most important. Oh, I love that. I love that. And the plant diversity is something that we've been talking about. I've done a bunch of videos on it on YouTube. because I interviewed Terry Walls, Dr. Terry Walls, and she said that she recommends people get 200 different types of plants in a one month period. Now, if you try to count that up,

it's actually kind of hard to do. It is. Because we eat the same plants over and over again. But let's then add that. Let's put your OB hat back on. What if somebody was born by C-section? What if we've been on birth control for 20 years? Like, how do all... of those impact the microbiome and how quickly do you think eating 20 different plants a week can repair that microbiome and the damage big events like that have done? Yeah, great questions. And I don't know that we have a really clear answer to all of those, but certainly when you're born by a cesarean section or if you're not breastfed, it's a hit to your microbiome. It's a hit to your diversity. It's a hit to, you know,

this theory that we're both alluding to, the terrain theory, where it's less about the germ theory, the point that you were making, that it's not, yes, we need to focus on the virus, but it's not just the virus. We need to think about the individual in the terrain that is meeting that virus in the middle. So when it comes to birth control pills, and there's a risk of me getting on a soapbox here, so just reel me in if you need to. No, go for it. Because actually, we really want to address this because we get this question a lot. So go for it. Get on your soapbox. Yeah. So the birth control pill, you know, I've probably prescribed, I don't know, 20,000 prescriptions for the birth control pill. So I am totally guilty here. But what I realized when I was about 35 and I went to my primary care doctor and I said,

listen, I've had two kids, I'm a mess, I've got PMS, can't lose the baby weight. I'm stressed out. I have no sex drive. The first thing he said was, why don't you go on a birth control pill? And that infuriated me because I think so many conventional physicians bless them. I trained along with them. I'm not blaming them. They reached for the birth control pill as almost a knee-jerk response to any hormonal problem a woman has.

And not just during reproductive years, because now it's being prescribed into menopause. So I feel like it's used way too readily for acne. that teenagers have for a little dysmenorrhea that could be treated with fish oil. And it's used as a contraceptive choice. And I'm a big fan of choice, contraceptive choice, but there's alternatives that don't screw up your hormones. So what does it do to your hormones? A few highlights here, it robs you of testosterone.

So the rise in this intermediary carrier protein sex hormone binding globulent, it's like a sponge that soaks up all of your free testosterone. We need that testosterone as women, not just for sex drive, but for confidence, for agency. Increasingly, we know it's involved in the immune system. And especially what I see in my patients, and maybe you see this too, is low testosterone, low DHA in my patients with autoimmunity. All the time. It's a consistent, consistent.

We do the Dutch test. Yes. And it's like consistent, low testosterone, low DHA, almost on 90% of the women. It's incredibly common. And for a physician or clinician to cause that by prescribing the birth control pill, that's what makes me crazy because this is an iatrogenic endocrinopathy. So this is clinicians causing a hormone imbalance. So it's not just testosterone. It's also other hormones as well, including the thyroid. It makes your stress response system that hypothalamic pituitary adrenal axis, less responsive. So you can't kind of have this flexibility to deal with threats the way that you once did. Interesting. And we know less about the microbiome. There's a few studies that I've seen. I imagine it's not good. I mean, that's sort of a takeaway that I've seen. I've seen some on Candida that it sets up an environment where candida can proliferate. Yeah. So you can have,

you know, small intestinal fungal overgrowth. You can have, you know, problems with, I think, multiple microbes, not just candida. But I think we're not quite there yet. I mean, the problem with the microbiome, let's be honest about this, is we're still in a place where we don't totally understand how to make this clinically relevant. And so I'm a total nerd who's been doing shotgun testing of my patients for years, like way before there's any sort of clinical relevance proven. And I think we're still struggling to understand, you know, what makes a healthy microbeats. bioaum, although we can make some of these statements about prebiotics are one of the most important influencers. Food is really crucial. And to connect back to that point you made from Zach Bush,

the role of antibiotics. And I remember in one of the first talks I heard by Zach, he was going through this data from 2015. And he said that one or more courses of antibiotics, broad spectrum, is associated with a 15 to 44% increased risk of anxiety. And I was seeing in the audience just feeling anxious because I had just taken my first course of antibiotics. I had a prophylactic mastectomy. And I tried and tried to talk my surgeon out of giving me these antibiotics and was unsuccessful.

So I took this course of antibiotics and I felt anxious and gained about 15 pounds. It changed my metabolic arc after taking this month of antibiotics. So I could really take in what he was saying. There's also a greater risk of depression associated with that learning problems, cognitive function. So what I find so helpful from the work of Zach Bush is that he's the one who introduced me in 2015 to this concept that one or more courses of antibiotics can change your mental health, can change your cognitive function. So there's something like a 15 to 44% increased risk of anxiety, 23 to 47% increased risk of depression, learning problems, focus problems, and especially insulin problems. And in my mind, as hormone girl, I think insulin is the most important hormone to pay attention to.

I mean, I care a lot about cortisol and other sex hormones, but insulin, that is the name of the game, especially if you want a really long health. span. Yeah. So again, there's like so many pieces to this, right? So then I think, again, as I'm listening to, I'm like, so we have a virus that comes to town in the human species that has had multiple antibiotics. You take a woman who's been on birth control for 20 years and she's been eating bad food. And now she's going through menopause and her estrogen is all over the place. Progester is tanking, testosterone's down and her insulin is up. How vulnerable do you think she is to this virus? She's hugely vulnerable. I mean, the one thing she has in her favor is that she's female. Because we know when it comes to SARS-CoV-2, we know that women are at less risk than men.

So I just was looking at some data from China showing that men die at about 2.5x the rate of women. Why is that? We know that women tend to mount a stronger immune response compared to men. And so even that, why is that? Yeah, why do women have a stronger immune response? I think there's, I don't know that we totally understand this. What I understand is that the X chromosome tends to impart a greater immune response compared to the Y chromosome. So women tend to have more. But the, you know, the other, the other flip side of that, is we can respond sometimes too aggressively to things like vaccines. And it can lead to problems of autoimmunity, which is why women tend to suffer from autoimmune diseases much more than men do. So if we take that woman, I love this hypothetical woman that you raise because it sounds like you're looking into my medical practice. I was going to say there's a lot of them out there.

There's a lot of them. And the thing I tend to start with is what's going on with your hormones, we know that that is going to be an important part of the terrain. It's not the whole story, but it's an important part. And what I often find with these women is that they've had this chronic stress response, chronic activation of the hypothalamic pituitary adrenal axis. And we know that if you're chronically elevating your cortisol like I used to do in my mid-30s, that leads to inflammation. It leads to insulin resistance and it leads to inflammation. So there's this connection between cortisol and insulin that I think is really important to understand. It also takes you down that path of higher blood pressure, hypertension being one of those risk factors

for COVID-19. It also, you know, what happens with the menopausal transition is that women catch up to men in terms of cardiovascular risk. And, you know, we're still trying to understand that. We know that estrogen is protective, cardioprotective, but there's a point where, where giving estrogen back may or may not help you with that deficit. So with that woman, I would say, you know, the food is a factor. Stress is a factor. I'm trying to remember all the things you mentioned. She's probably not sleeping adequately.

Yeah. Sleep. Yeah. Women suffer at twice the rate of insomnia as men do. Yeah. And we also know that, you know, her social connections are really important. And, you know, we're in this time where I hope, I'm still in shelter and place here in my part of the Bay Area.

I don't know if you are. We're so close. We have been in shelter and place, our county. We want the first in the whole country. And we're still not. We're barely out. It's crazy. Well, you and I are the same there.

So same thing happened in Alameda County in San Francisco County in terms of being under shelter in place. You can kind of see my roots growing hair. And so, yeah, you know, things are still not open. But what happens with a lot of women is, you know, they can connect on Zoom. They can connect with their family. But in order to respond magnificently distress, we need that tendon befriend. So there's some proxies for it. You know, I feel my oxytocin rising just talking to you, Mindy.

Oh, thank you. I'll take that as a big compliment. It's a huge compliment. If I could raise people as oxytocin, that's like my mission in life. So, well, it's a big deal. And women tend to be better. at it because of the connection between estrogen and oxytocin. So the two together kind of give you more. They create synergy. And so women tend to be better at creating oxytocin. That's why you have to hug a guy

like three times as long to get the same rise in oxytocin. But interesting. But when women are held back from that tendon befrient and they're not able to get together with their girlfriends and they're not going to yoga, you know, twice a week and they're not getting some of that social tendon befriend, it can really cause problems with their stress system, which can then, you know, kind of snowball into problems with their immune system and problems with their endothelial function and their cardiovascular system and so forth. That's, and that was the other thing that I said when we went into quarantine is like the human need for connection, we can do it temporarily, but we can't do it long term. So you're a woman that's going through menopause. What have you done in this pandemic?

Have you done anything different to try to counteract the lack of connection? And have you done, are you taking different supplements, getting more sleep, getting more vitamin D? Like, do you have a regimen that's changed? I do have a regimen that's changed. I mean, first of all, I went from traveling about 80% time to nothing, which was like the best thing ever. Yep, me too. system. Yep. I live with two daughters and my husband and a dog. So all of those things are really good for my immune system and my stress response system. But here's the things that are different. What I realized right away was that I needed longer meditation and I needed it twice a day. So I used to get away with, you know, 15 to 30 minutes in the morning. Now I do it twice a day, especially before I go to bed because

I noticed I had more bruxism at night. I think just the stress of the pandemic. I'm gardening. I'm gardening. every day. So with gardening, I get my hands in the soil. It helps with that terrain theory. And it also gets me vitamin D. So I have a regimen of once a day, at least for 30 to 60 minutes. I'm outside in the soil. With exercise, you know, the interesting thing, Mindy, is I've backed off a little. So I'm kind of a type A personality. I don't know if that shows through. Well, you can't have done all the things that you've done and not be type A. Well, I feel like I'm a recovering type A. But, you know, what I really love endorphins.

I love high intensity interval training. I love to go outside and run hard with some girlfriends. And I realized I needed a gentler version of an exercised regimen. So I'm still lifting weights. You know, I had to change that because I couldn't go to the gym. But I'm doing more moderate exercise compared to before. And I just felt like I needed that for recovery. I'm allowing myself to sleep more, trying not to wake up with an alarm. And then in terms of supplements, you know, I don't think that you can out supplement a bad diet or a bad lifestyle. So I'm really cautious about talking about supplements. But what I found, you know, kind of looking at the inflammasome and what seems to be helping with what's proven to help in randomized trials of influenza, what I started to do was to take a couple of things. I'm drinking green tea, even though I have to be careful because I'm a slow metabolizer

of caffeine, but I think the components of green tea definitely help and has been shown to help in health care workers in terms of reducing respiratory infection. I'm taking vitamin D along with what I get from being outside. I'm taking vitamin C. I tend to be low in it, and I know it helps also with progesterone production. And I need that. I'm in perimenopause. I'm still cycling. And there's a few others that I've experimented with, like P-E-A and astrologists and a few components of traditional Chinese medicine like skull cap, I don't know that I noticed any difference with any of those. I think the key ones are the ones that I've mentioned. Yeah, and I really, really agree with this idea that we look at supplements as like the cure-all,

and yet we should really start with lifestyle and change lifestyle and use a supplement. for exactly that. It's a supplement. You use it to supplement and then you should get off. And I don't know about how old your parents are if they're still alive, but my parents are in their 80s. So when this first happened, my number one concern was actually them to try to, you know, what do I need to do? And they love the garden. So I turned to my 80-year-old mom and I said, mom, you got to do exactly what you're doing. I'm like, you need to get out an hour a day in the sun and get your hands in the dirt as much, you know, as much as you can. And it's something as simple as that. But why do you think in our culture, like, if you look at what we're doing right now,

we're sheltering in place, we're masking, and we're praying for a vaccine. And yet nobody is saying, get out into the garden and get your hands in dirt. I just saw a whole study that shows that the coronavirus actually can camouflage itself in fructose, specifically high fructose corn syrup. And I'm like, why did Gavin Newsom not get up and say, put your mask on and put your soda down and get into the garden and get your hands dirty. Why do you think we're not talking about this stuff? It's a great question. I mean, first of all, Gavin's from San Francisco. So he's hoping that no one's got a soda in their hand. But I think there's a few issues here. And I think this also

gets to some of the racial disparity that we're seeing with COVID-19 because there's social determinants of health that make access very difficult. And so when I think about, you know, why didn't Gavin focus on a more integrative approach to sheltering in place? Probably because he doesn't know any better. Sorry, Gavin. I think he's used to mainstream physicians and he's used to this old model of, you know, let's use the CDC guidelines. I'm not going to take issue with those because I think they've been helpful. Yes, we know that masking reduces transmission, but I agree with you. I think you have to look upstream. at what you're putting in the body and really improve that terrain.

So that the mask is still important, but not quite as important as we may think. So I think there's a number of different issues here. When I look at, you know, why is the focus on masks and a vaccine? I think a lot of it has to do with resource allocation and what we value. There's not, I wish there was a value placed on preventive medicine. And there's just not. It's a hard sell. People don't care until they get sick.

And so I wish that people cared more about prevention. I would say I've spent my career really focused on different ways of talking about prevention without using the prevention word. So I talk about biological age because I think that's so intuitive. I talk about, you know, allostatic load because I think that's maybe more comprehensible than prevention. So I think it's resource allocation. I think it's policy. I think it's politics. And making mask is now a big industry. And it's helping economically for a lot of folks that are really suffering. Do you think, I'm going to put you on the spot here. Do you think that a vaccine is coming?

Well, I would say based on what's happening with the FDA and the incredible scurry that I'm seeing with pharmaceutical companies, I do think a vaccine is coming. And the best estimate I can see from experts that I'm talking to is it's probably going to take, you know, six to 12 months, maybe longer. So I don't think it's going to be the answer to all of our prayers, the way that people are hoping. I think we have to look upstream and we have to do these things that, you know, like gardening, like eating healthy food, like getting the sleep that you need, maybe some of those bioactives that we talked about. But we need to do those things, even though there's no financial. incentive or people kind of rallying for them. So as I've been down the research, and Jeffrey Bland just put out an incredible article. I don't know if you saw it, but it was the pandemic within the pandemic, and it was all about

the metabolic syndrome. And I just am baffled as to why people aren't talking about this. And I do agree that we have an outside in healthcare system where if you can give me a pill and put a mask on me, that that would be easier than putting my soda down. And I respect that and understand that, but I also think to get out of this, we need to start talking about putting the soda down. Just my strong opinion. And I'm concerned that we're all sitting around hoping that the vaccine will be the hero of the day without looking at the side effects that a vaccine could create. But that's a whole other topic.

So you brought up the racial piece of this. And one thing that I thought was interesting in looking at your Instagram is that you're biracial. and you wouldn't know that by looking at you. So I'd actually like to talk a little bit about that because one of the things that I hear from my audience is, well, yeah, it's easy for you to say, take this supplement and eat this healthy food when you have the financial resources to do that.

So typically some of the poor areas and definitely the black community in general has been a victim to a talk. toxic health care system. Yes. So can you talk a little bit about that? Because I think this is so important to bring up. Well, thank you for raising it. And I'm happy to talk about it as long as you would like. Yes, you know, yes, I pass as a white person and I have relatives that are half black. So it's, it's something I haven't talked a lot about in part because my family doesn't want me to. And I felt like starting about a year and a half ago, and especially since May 25th when George Floyd was murdered

before our eyes on video, I felt like I just couldn't respect their wishes anymore because it's who I am. And it's important for me to speak up because I agree that white silence is deadly. It's violent. So I'm happy to talk about this. You know, what we know if we just start with COVID-19 is that, you know, I just was looking at a study that was published preprint from Yale that showed that black Americans are dying at 3.57x the rate of white Americans. And, you know, I've seen a number of different data points here. I don't know that that is the be all end all. And maybe what we were seeing initially, this was published back in April. What I've tracked is Ibram X. Kendi's racial tracker with COVID-19. He's working with a couple of journalists from the Atlantic. And I last checked it two days ago.

And at that point it said, you know, up to two days before, it was 1.5x. So 50% increased risk of mortality if you're black. And as I started to write about this on social media, maybe you saw some of this, Mindy, I was amazed at the response from folks. And some of the response was positive, but a lot of the response was quite racist. And, you know, people, I think just through a lack of information and education, we're saying, well, look at what black people eat. Of course, they're dying more from COVID-19. And I think it's important to really sort of stop the presses at that point. And to say it's not behavior.

It's not genetics. It's these social determinants of health. It's public policy that has led to, you know, I'm in the Oakland, California area, a place where, you know, there's some parts of Oakland, where there's three farmers markets, per week. And then, well, not right now, but usually. And then there's other parts of Oakland that are in absolute food desert, where the only food you can get is from the liquor store. So there's this policy that I would say is a legacy of slavery that has hugely impacted

the risk of a black person's chronic disease. So there's a lot of different factors here. I'll just give you a few statistics. Yeah. Blacks have much higher rates of hypertension, cardiovascular disease, they have higher mortality. They have double the rate of dementia. They get their limbs amputated at three times the rate of white Americans. So there's a long list of racial injustices. And the thing that I think is close to my heart is that I always thought as a physician that taking respectful care of my patients, no matter what their skin color is, was important. And I still think that's important, but what I realized is that it's not enough. It is insufficient in terms of addressing the systemic racism that we have in medicine and health care. So that requires, I think,

a very different approach. And I've been, you know, here's another place of hope. I've been really excited to see the Black Lives Matter movement. It's been amazing. It's been amazing and it's great to see different medical centers respond to this in a thoughtful, powerful way. You know, I was looking at some of my alma maters over the past few weeks and I was a little disappointed in Harvard, frankly. I thought it was, you know, they just kind of linked to an old diversity page that they had. UCSF wasn't too far ahead of them. But I saw some other places like Jefferson Health, which is based in Philadelphia, they took a bold stamp. They said, you know, here's five things we're going to do to make medicine anti-racist.

And it was signed by three stakeholders, the president and the dean, all white males. But, you know, you got to start somewhere. There's a few white males out there. There's a lot of white males. So I have a lot of hope. You know, it's going to be messy. I think it starts with this internal process of kind of looking at our own racism and our own racial bias. I think, you know, change is possible.

When I dove into trying to understand that statistic that you started off talking about, I was like, is it poor food? That was the first thing I thought, like, do they, there's more poverty. They're eating, you know, from a liquor store. Like, that's the food they're eating. But then when I dove into it a little deeper, it was pure racism when they walk into the doctor's office. And the two examples that I heard that were really interesting is one, that white.

are more affected, were more affected by the opioid crisis because doctors didn't believe blacks when they were told them they were in pain, so they therefore didn't give them a prescription, whereas if a white, you know, woman walked in, they were happy to give her a prescription. And then the other piece that I heard was like, if you're black and you show up with like signs of sickle cell, they're going to just jump and go, oh, well, that's a black disease. So let me just label you with that. There's a labeling and a belief system that is racist in our health care system. That's right. And I appreciate you pointing out the difference in care that patients get based on their skin color. And this shows up in a lot of different ways. It shows up, certainly in the opioid

crisis. It shows up in COVID-19 treatment. I've been so heartened to hear from health care workers who are speaking up and saying, listen, I'm at a hospital where the white people are getting treated than the black people in terms of the same symptoms of COVID-19. So I think that's a really important piece. There's also access issues. There's issues with, you know, certainly there's a problem with poverty, but this gets back to the social determinants of health. That it's not genetics, because regardless of skin color, even though I'm part black, you and I have 99.9% the same DNA. So it's not genetics, and it's also not necessarily behavior. There are some behavior differences, but if you look at something called racial weathering,

which I think is a really important term to know about, there was a couple of publications starting in the 90s from the University of Michigan looking at this. And what it's looking at, weathering is defined as the difference between your chronological age and your biological age. And I think this is really helpful to understand. What we know is that blacks age much faster than whites. Interesting. And it's not necessarily socioeconomic. So there was a very interesting study published by the same group of researchers where they looked at four different places in the U.S.

They looked at Chicago and Minneapolis and Birmingham, Alabama and Oakland, California. And they found that the people that were aging the fastest were black women. Interesting. They were aging faster than black men. Now, black men have their own problems, especially with excessive force from the police. We keep seeing that documented. We need to do something about it. And especially faster than white women and white men.

And when they looked at part of the why and they teased out socioeconomic status, they definitely saw that the impoverished black women had the fastest biological age, aging process. But the second fastest was black women who were not impoverished. So I think there's this embedded, accelerated aging that comes with being black in this country. And it's even worse for black women than it is for men. So the accelerated aging was happening because of stress. Was it happening because of the way they're treated in the health care system? Like did they continue on, especially for the,

the person who had access to healthy food? You know, because of the study size, they had something like a little less than 2,500 people. It was hard to parse out in these different groups, what was causing what. So the causal piece is not clearly elucidated yet. But I think what I recall that they were able to parse out is that socioeconomic status is a problem.

And that's something we can fix with policy. We also know that social connection, was protective. So I think social protection, you know, this tend and befriend that women especially are able to do is a really important part of this process. Yeah. And you've even started a new Instagram site. Is that right? You're talking about this. And I think to me, when the pandemic first hit, I walked around in this sort of disbelief of like, oh my gosh, the whole world is focused on their health. Like, I'm in Silicon Valley, and I have been trying to get people to care more about their health than the next car they're going to buy. And it's, and now they're all focused on it. Well, I feel the same

way about the race card here is that it has really bubbled all this stuff up to the surface. Yet, like, we started off this conversation, there's just a lot of problems that we've got that we have just been mirrored. So on the racial discrimination that's, racial discrimination that's, happening in health care. How do we change that? Yeah, this is a great question. And it's, you know, it's, it's similar to how do we deal with this immune compromise state in that it requires an integrative holistic approach. So what I've learned is that it starts with an internal process. And I was watching a video that my daughter sent me yesterday. It's like difficult conversations with the black man, which is on YouTube.

Oh, I've seen that. Yep. Yeah, I totally love it. His second one, he has a conversation with Matthew McConaughey. And he talks about how it starts on the individual level. Like, that's how once we learn about the ways in which we're racist, and I'm not using that in a negative way, I think it's really important to admit racist behaviors. You know, Ibermex-Kendi, who's the new head of the Boston Center for Anti-Racist Research, he wrote this beautiful book, How to Be an Anti-Racist, where he starts off in the introduction saying, I'm a racist. Let me show you all the ways that I'm a racist. And what I loved about that is that he opened the tent for all of us to say, well,

if this guy is saying he's a racist, then I must be a racist too. Let me look at my behaviors. So I think it starts on the individual level. It then goes to the family. It goes to those dinner conversations at the family table. It then goes to, you know, looking at the friends that my daughters bring over and having a conversation about diversity. It goes to the medical clinic where we need to make sure that we're taking care of patients of, you know, of great diversity and also socioeconomic diversity. It then goes to more of a policy level. Gavin, are you listening? You know, and from there it goes to government, to states, to the country. I think, you know, another piece that I've learned about is cultural humility.

And this is something that is not so easy for us who are white or like me, passes white because we have a blind spot around it in terms of white privilege, white supremacy, the ways that we, you know, our thought process just is too passive when it comes to recognizing racism and doing something about it. But what cultural humility aims to do was developed by two black physicians that are based in the Oakland area. Once at UC Davis, a professor, the other ones here in Oakland. They talked about three things.

The first is a commitment to lifelong learning, the self-inquiry to inventory and to self-reflection and self-criticism. This is not pretty. A lot of it's not pretty. The second is a recognition of the power and best. balances and how to fix them. And the third is institutional accountability. So I think you need all three of those as part of the solution. I think that's an important way to start. And the point that these women were making is that, you know, the decades that we've had of cultural sensitivity and

cultural competence, it's not enough. We need to go to the next level. I love that. And again, thank you for talking. I know you have a hard stop time. But I have to ask you the question. I always ask everybody that I interview, if you had, and it probably changes all the time, but if you had one message for the world that you could just implant into everybody's mind and you could just scream from the tallest mountain, what would that message be? Be an anti-racist. So I would say it's changed. It's changed in the past year and a half. I just launched this book, Brain Body Diet and it would, you know, a year and a half ago, it would have been care about your brain, like make your brain your best friend, care about the gut brain axis. But I think right now with the crisis we're facing

with five times as many black women dying in childbirth as white women, it's being anti-racist. Figure out how to do it. And don't ask your black friends how to do it. Like figure it out yourself. Right. And I love this idea of just self-inquiry and self-learning and being willing to look at where you may be showing up. And I think this applies to the immune issue too. Look at where you you might, you could improve on all of these levels. And if we all look within, wasn't it Gandhi that said be the change you want to see in the world? It's truly, truly. So I could talk to you for hours. And I think I think it's pretty funny that I started off wanting to talk about sex hormones with you back in February. But this was a way more fun conversation. So I loved it, Mindy. Thank you so much for

having me. And thank you for the change that you are creating on YouTube, the rest of your social media. I'm so grateful to be part of it, and I love what you're doing. Love you. Thank you. So grateful. Have a beautiful day. You too. Thanks. Bye. Okay. So Jessica and I are here for the recap of that amazing interview. So hopefully you all really enjoyed that. But okay, she's mind-blowing. Didn't you think so?

Oh, my gosh. So mind-blowing. So smart. She's like, so smart. like one of the smartest people I've ever heard, there were definitely words that I was thinking, I don't know what that means, but what you're saying is so smart. Well, what I love about someone of her education, you could see it, you could hear it in her voice. Like she would give the technical term, but then, you know, she's a emotionally intelligent person. So she would turn around and then just sort of like explain it knowing that our audience wasn't going to fully know the technical term. Like, okay, well, but it was like her, her name.

language was all the medical terminology. And you couldn't get it out of her. Like that was just the way that she spoke, which is awesome. And it reminds me so much of Zach Bush. Yes. She's like the female version of Zach Bush. And like they both just have so much heart and passion for what they're talking about that even though you may not understand all the words and what she's saying, you like can

understand the emotion of what she's trying to convey. the thoughtfulness. I came home and was telling Sequoia about the interview because I just loved our synergy. I loved. I enjoyed the conversation. And I said she is so thoughtful with her words. Like she's thoughtful with the way she's thought through the immune system and hormones and the pandemic and racism in the health care system. Everything was thought out on such a deep level. That's very much like what Zach Bush does. Yeah. Yeah. And she gave like some great things that I'd never heard. before, like she said something about the female, how females are more prone to, was it anxiety or the X chromosome? Oh, yeah. She talked about how the female has a stronger immune system. A strong immune system, yes. I got to go research that. So I'm really excited to figure that out and why. And then she really danced around this a lot, but I think this is part of what she was saying is the need for human connection for females is so strong. And that that's part of our DNA. And so in this pandemic, we have to find ways to connect because if we don't, then we're immune compromised at that

spot. Whereas men may not need that as much as whereas women do. And that was really, again, deep thinking, a level of insight that I hadn't thought through. Yeah, absolutely. And, you know, just some of the tips that she gave for like what she's doing right now to keep her immunity strong, especially, you know, comparing it back to the part about being a woman, but she talked about like getting in the dirt, being outside, like simple things that can boost our immune system. I loved that she, when I asked her, so what's your plan? What was your pandemic plan for your immune system? She was like on it. Like she knew. She had a plan. It wasn't like, oh, that's a good question. Let me think about it. She was like, yep, I had a plan, and this is what it looks like. And it was, she meditated more.

That was awesome. And then got out in sun more. Like, those were things that, that we've been talking about on all of our platforms, we've been talking to our patients about. And it's, it's so interesting to me how it's possible, we can push those little small things aside and think they don't make a big difference for our immune system. But here we got a Harvard trained medical doctor who's saying, get out in the sun, meditate. more and put your hands in dirt and your immune system's going to be stronger. Okay, we need to listen to that. Right. Well, and then you guys brought up the point of like, why aren't more people talking about this? Like, why isn't our politicians talking about this during the, you know, during the pandemic? But I think it's so interesting. Those things don't make anybody any money.

Right. And not, why would somebody get up there and talk about it? It's not making anybody any money where, you know, our mask industry right now, every company now has a mask that they're offering. And it's a business. Putting your hands in dirt isn't a business. That's so interesting to think about that what we're hearing on social media and in the news is all backed by companies that have a financial gain. But nobody has a financial gain in you getting out in the sun or putting your hands in the dirt or meditating. Yeah. Oh my God. I hadn't really thought that all the way through. You're absolutely right.

Well, I think sometimes people forget that the news is a business. It's not a free platform. out there, like, it's a business. Those people are getting paid to get on and talk to you about what's happening in the world. So of course, you know, you're going to have, there's a whole business model behind it. And, you know, the sun doesn't revolve around that business model. Yeah. That's so interesting. I love that thought. And it's just a reminder. I found when we first went into quarantine, I was so protective about what information I was allowing in my brain. And I think even now I want to say I've gotten a little sloppy with like the conversations that I'm having and I really need to still go back into more protective mode because

there's so many agendas that people have right now around this pandemic. And you heard her say, like she's down a rabbit hole of research. We've been down rabbit holes of research and before. And it's just understanding the research is so difficult because the research studies are backed by pharmaceuticals and backed by industries. So you have to go and look at who backed the research study up. Right. Well, and I think that's what's so great about people like you and Dr. Sarah and even like Zach Bush is you guys are bringing forth science to that, because I mean, the normal person doesn't know how to go search. I mean, I don't know how to go search for those things. I rely on you. Yeah. So the fact that you guys are bringing that to your followers and your

subscribers and the people that like love hearing your message, it's really important so that, you know, you guys are doing the hard work for all of us out here that don't know how to find that information. Yeah. Yeah. Well, and it shouldn't be hard work, right? Right. It shouldn't be hard work. It should just be like, here's a good research study and we can all like lean into it and decide for ourselves. Right. So yeah, amazing. So the other question I had is I got a vibe like, did she know Gavin Newsom? I know. She was like, Gavin, if you're listening, and the way she said it was like, I feel like she might know Gavin Newsom. So maybe we'll send him our podcast and you can understand that the next time he gets up and talks about masks, he should talk about soda. Right. And putting your feet in the dirt and

letting the sun bask on you. And then the other couple of things that I really lined up with her on that I really would love our audience to know is you cannot out supplement a bad diet. Or lifestyle. Like there's so many components and legs to that. But we see this in our detox, right? Where people come in and they're excited to detox, but then they're excited to detox. But then they're not really excited to change anything else in their lifestyle. And so then we get up against, well, supplements are powerful, detoxing is powerful, but eating crappy food over and over again is a form of toxin yourself. Right. So toxifying yourself. Right. Well, and like putting chemicals on your body and then you're surrounded by negative thinking people and you're not filling your brain with positivity.

Like all those things, people, I don't think, understand, accumulate to what you're feeling in moment or how your body is reacting. Yeah. Yeah. And then I'm really proud of her for standing up on the racial issue because there is, I mean, I will be completely honest that the whole Black Lives Matter movement that has formed, I didn't realize the depth of racism in our country. And I definitely didn't realize the depth of racism in health care. Right. I heard a really interesting podcast where they were talking about the fact that the opioid crisis happens to white people. people because doctors don't believe black people are, they think they're faking. I'm like, what? How can that be going on? And she obviously was well skilled in that. And she did,

I love the way she phrased, she appears white. Yeah. Yeah. She said I appear white, but I'm half black. Yeah. Yeah. So. And she had some, uh, some great studies that she had taught, she had, she had mentioned, we're going to have to go find those, but she had some great studies that she mentioned on racism within the health care and medical system. And then the last thing we have to talk about because we get this from our community all the time is the birth control question. Oh, yes. Well, we're dealing with mainly a lot of women, so they all want to know. Yeah. So that was really interesting just how toxic birth control is and how it shifts the hormones. Now, what was interesting is that the way I had always learned it was that birth control really sets

subbed environment in the microbiome and poor one and it can create problems with candida. She hadn't heard that. Hers was more around that birth control alters hormones in a way that makes it very negative and it's an endocrine disruptor and toxic that way. So it was interesting to me to have that conversation with her, but also her knowledge on the microbiome, you can tell she's very interested in it and she's, she made some really good points about we're just beginning to understand it. We don't really have, and I think that's so important for people to understand that we are literally at the beginning of a whole world of medicine unfolding from changing our bacteria. Right. That, you know, I really, it's important, I think, for women to understand that

if you've been on birth control, decade after decade, there has been damage that has occurred to your microbiome and then she's also, you know, showing that there's damage that has occurred, you know, to your hormonal system. Right. And we don't know how long. I think it's not as simple as like you've been on birth control and then you hop off and now your microbiome's going to regrow back or your hormones are going to shift back to normal. Like we don't know that amount of time of, especially depending on how long you've been on the birth control, how long it's going to take for all that whole ecosystem to rebalance itself. But I found it, I did find it interesting that she just said that's kind of their answer to any hormonal problem for any age of a woman. So I was thinking

back to that was exactly why I remember I was prescribed birth control was for acne. Yeah. I'm thinking to myself like, why wasn't like, hey, get off dairy, sugar and, you know, horrible foods and see if that clears it up. Yeah. Nobody gave any kind of other lifestyle or diet recommendations. It was just, oh, you're having migraines. Oh, try the birth control pill. Right, like it's like you're now have an outside source that's controlling your hormones. So if your internal hormone system is off, then let me put an external control system in there. Right. To me, that's the same thing as like a vaccine.

Like, oh, if your immune system is not strong enough, then let me put a vaccine in there so I can control and try to manipulate your immune system. Right. And I think what we're learning is that this idea that we put medicine into us to manipulate our human body. And we're really, we're a hundred, we have a hundred to one bacterial cells over human cells. We're trying to only manipulate a small part of our physical health. Right. But we're struggling. That's the part of health care that's not working. And you heard her say that in a different way. Right. There's just too many, there's too many other

variables that people aren't thinking about. And it just reiterates the cycle of one pill or one thing is going to cure all your issues. And it's just not working. Yep. Absolutely. I wish I had asked her which birth control she would recommend. I know. I thought about that. I thought about that after we left. But I think I'm going to go search.

Yeah, I'm going to go search for the answer. Okay. Yeah. And that's a whole other discussion, but I know like Dr. Sonia, who is a natural path in Canada, she believes in a low dose progesterone pill. So I wanted to talk to her about that. Maybe we'll bring her back on. We'll bring her back on.

Yeah. But I wanted to know which birth control. So that was really interesting. But that was awesome. You know what I loved about this? Was that when we put, she got on our calendar in February. That was done on July 1st. In February, I wanted to talk about menopause and hormones.

And, you know, since the pandemic, I've been really looking and asking myself why the world is so immune compromised. And I felt like she was dying. to have that conversation as well. Agreed. And that was really exciting for me. It was beautiful. Yeah. It was so amazing.

So let us, you guys, let us know what you think. Find us on Instagram. Leave a review of this podcast if you loved it. But we'd love to know what your feedback is and what you thought of this interview. Organic food in and you shake bad toxins out. That's what it's all about. You put fast cycling in seven fast types out. You download Carp Manager

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