Live Like a Girl with Dr. Mindy Pelz - Lifestyle Steps to Heal Your Menopausal Brain - with Dr. Annette Bosworth

Episode Date: May 1, 2023

This episode with guest Dr. Annette Bosworth goes deep into the surprisingly simple lifestyle steps that you can take to help heal your brain.  To view full show notes, more information on our guests, resources mentioned in the episode, discount codes, transcripts, and more, visit https://www.drmindypelz.com/ep173. Dr. Bosworth has worked as an Assistant Professor and Medical Doctor in Internal Medicine helping students and patients combat chronic diseases such as obesity, depression, autoimmune problems, and addiction. Check out our fasting membership at resetacademy.drmindypelz.com. Please note our medical disclaimer.

On this episode of the Resetter podcast, I bring you Dr. Annette Baez. Now, she has been on this podcast before and if many of you may know her from her incredible YouTube channel where she really talks all things insulin and glucose through the lens of the ketogenic diet. And she is, every time I talk to her, I learn something that blows my mind. So if you haven't heard that podcast that I did with her before, please go listen to it. But on this conversation, what I wanted to talk to her about was brain health and neurotransmitters.

And outside of her love for the ketogenic diet, she was an internist in practice for many years and her specialty was brain health. And I really wanted to dive into the dopamine system, serotonin, what we can do to make sure that we keep that system working at its best. and what you're going to learn in this podcast that I think will blow your mind as well, is that just like hormones, it's not enough just to make a neurotransmitter. With neurotransmitters, there's a whole recycling process, and our lifestyle affects that recycling process. So let's use dopamine as an example. We all, or many of us are dopamine

junkies. I would call myself a recovering one, where we are, searching for those bursts of neurochemical hits that tell us life is good, I'm joyful, this is great, let's do more. I mean, dopamine is that neurotransmitter of motivation and will pull you towards your goal. But once you actually make dopamine, you don't need to keep making it. You need to make sure you are recycling it and that it's going back through the neuronal system so that it can be reused. It's the most fascinating discussion I have ever had with somebody on the neurotransmitter system.

She explains exactly what we need to be doing in our life to make sure that every neurotransmitter is not only being produced, but it's being recycled and it's being used by the neurons in our brain. This conversation will blow your mind. I mean, I literally, I could have talked to her for hours and we did it live, which was really fun. So if you want to know how to keep your neurotransmitter system up, you want to know what lifestyle is going to keep your moods and your and your motivation and your behaviors, exactly where you want them. This is the episode for you. Dr. Annette Boz, enjoy.

Hey, Dr. Mindy here. And welcome to season four of the Resetter podcast. Have I got a lineup for you this season? Lots of deep thinkers, a lot of brilliant minds. all with one focus to move the needle forward on your mental and physical health. So please know that this podcast is all about empowering you to believe in yourself again. And I want you believing in your body. I want you believing in your mind. I want you believing in your spirit. If you have a passion for learning, if you're looking to be in control of your health

and take your power back, This is the podcast for you. Enjoy. Okay. So for starters, I just going to say, welcome to the live version of the Resetter podcast. Only the second time we've done this. Sweet. So what made you start doing this version of it? It's such a great question. I, and I think you would relate. It ties in so well to what we're going to talk about. I'm super clear. I am a face-to-face person. Like, this whole Zoom world has not been good for me. No, the two-dimensional version of people, it's like it's hard to connect to their heart.

Super hard. Trade information. Yeah. But it's that soul to soul that I'm lonesome for that too. It's real. So well said. So we just decided wherever we were going, especially at like a conference like this where there's so many brilliant minds.

Let's just gather everybody and do as many podcasts as we can. And the other thing is, do you realize like on Zoom, there's always like you're kind of interrupting people. The art of conversation just doesn't have. happen the way it should. Yeah, I think that you also perfect the art when you're talking to patients. Right. So you put 25 years into like, oh, I'm watching your body language. I'm going to see you're about to say something you shouldn't say and I'm going to help you say, let's just go in this direction and not go down that rabbit hole. But you cannot do that on the Zoom. That is so true.

Yes. That is so well said. I have noticed that that the art of like every day having patient after patient after patient absolutely changes your communication style. Right. And you can't, it's really hard to have that kind of communication on Zoom. So, oh my gosh, so brilliant. So I've had folks ask me, I've moved to Tampa in the last year and a half and said, well, when are you going to start your practice? And they said, well, you've got all these people across the country that want to see you.

And I'm like, I didn't now want to see patients that way. I didn't know what to see patients that way. I'll do anything if I don't have to see patients that way. Please don't make me do that. Yeah. It's different. It isn't, it's a great follow-up. It's a great, you know, bridge for times when you can't meet.

But for that to be the only way you connect to people that you're trying to intimately intervene in their life. Yep. So this, believe or not, this does tie into what we're going to talk about, which is neurotransmitters. And I want to talk about the lifestyle that we need to be living to enhance our neurotransmitters. And I'll tell you something that hit my heart. I don't know if you saw this a couple weeks ago. but Oprah came out with this master class on menopause.

And she was like, I'm going to start the conversation. We're not talking about menopause enough. And I thought, oh my gosh, yay, Oprah, this is amazing. Like you're the one to do this is amazing. Wow, I haven't heard this. Okay. All they did is talk about HRT. They didn't even talk about bioidenticals.

It was just like women need more access to HRT. And what I've learned is that I feel like we're not bringing lifestyle into any conversation, whether it's menopause or whether it's weight loss even. You know, everybody's all into the medication that's going to help them lose weight right now or whether it's mental health. We don't emphasize the lifestyle. So if I was to ask you, what's the lifestyle we need to keep our neurotransmitter system up? Oh.

What would you say? Boy, you teed this up well. Thank you. I had a master on that. So thank you for noticing. So the other day I was interviewing a new person on our team. And at the end of every interview, I let them ask me questions. And they asked me, what's your favorite thing on your resume?

And I said, well, number one, I'm a woman in medicine and I'm still married after 30 years. That's probably my favorite thing. But number two, my kids aren't in rehab. And I was asked by the Department of Defense, their counterterrorism unit, to teach them if I was going to heal a brain, what would I do? Amazing. And the course is 12 hours long. It's my favorite work.

It's my favorite work because it is not the prescriptions. And, you know, hats off to Oprah for having the conversation. Yeah. But with a stumble out the front door to think that you're going to replace the symptoms that are plaguing an audience like those. Millions. Right. Millions. Yeah.

If you say start with prescriptions and that's where the conversation begins, you are a stumble out the front door. It is truly like that 12-hour course at the end of the course, the one little thing at the end I talk about a prescription. But the rest of it is, I don't know, if you want a brain that's working right, there are some rules. And when I would have folks in my, I had a branch of my clinic that was for recovery. And I wouldn't take people in the recovery unless they agreed to take the 12-hour course.

And at that time, the course, was held like a church or, you know, a Saturday, Friday, Saturday event at continuing education for a jail or something. Like, they were not like convenient, but I'm like, if you want me to take care of your kid, I can't do this unless everybody around him or her is changing the way they think about how this brain is ever going to heal. Amazing. Because those neurotransmitters, well, they are a lot like the hormones of menopause. Oh, my gosh. We talk about hormones, but we're actually neurochemical beings. and that we have to include neurotransmitters in the conversation, and we're not doing that, especially in menopause.

Right. I like especially using the neurotransmitter, noraphenephyran, because it is one of the best ones that's, yes, it's outside the brain and it's inside the brain. But guess what? The chemistry to make it is still inside the human being. And when you start with a broken human being and say, well, just add some noraphyran.

Or they come and say, Doc, I want a shot a growth hormone. You can do that. And it's a really sub-specialized thing, for an endocrine person with children with short stature, expensive as heck, very specialized to give it. But people will Google it and say, well, I know you can get a prescription of it. And I'm like, not if you want to turn out not looking so funny. It's going to do strange things to a human that's not in the place where they can receive

that hormone and they can do the right thing with it. Right. Because this is both in, as we progress forward on the neurotransmitter discussion, it's the same thing with hormones, it's the same thing with thyroid. Yes. Taking the pill doesn't mean it solves the problem because that chemical still has to get into the cell and create this activation process. So all we're talking about when we talk about HRT or antidepressants or any kind of medication that affects the brain is just bringing in the actual chemical but not the process of how to use that chemical. Right.

I think, I mean, let's just start with some. We'll go to antidepressants because those are the ones people mostly know about neurotranses. transmitters of the brain. You take SSRIs and it's a serotonin reuptake inhibitor. You take an SNRI. It's a serotonin and noraphenephrent uptake inhibitor. These two are the Prozaxel Zola Selexa effects or Simbaltas of the world, right? And they go into the brain and they are, when those neurotransmitters, they come out of one end of a neuron and they hang out in a little space called a synapse. They tickle the next synapse. And then in healthy people, a little vacuum sucks them back up into the original side, and you do it all over again.

Oh, it's like recycled. It is recycled. And when I give that drug Prozac, I block the vacuum. I keep it in the space. Okay? So if you're not making any, I'm not vacuuming nothing. Okay? So you have to keep taking the drug because there's no recycle process.

Right. Well, there's two parts to that. A neurotransmer is only going to last so long in a human body. So, but it has a life cycle of being recycled through that little, you know, vacuum process, you know, of a six-month process. If you are healthy, if you are not healthy, you can recycle it a couple of times. And then you're depending on more to be made upstream. When we would take animal models and you'd really deplete them of serotonin, and then you would just leave them to their devices in a poor-nourished, under-slept. So they did not allow them to sleep much.

high stress situation, they would never reset that neurotransmitter. They never got back to normal. That's crazy. When you would put them on Prozac and they were at this super low, like if we took all the serotonin out of your body and we piled it in a little pile and you're in the tiny little bitty pile because, and you're depressed. You don't have enough serotonin to do what's supposed to do. But now we're saying, I'll give you Prozac.

So you're recycling this tiny little amount, which was it, you know, it can make a difference. people will take it, you'll make a difference. But nothing like what happens to say, let's get you making more of those neurotransmitters. Yeah. I mean, Chris Palmer and his team of how you can impact and change the trajectory of how a deep depressed brain or a brain that cannot hold a mood, a cycling bipolar brain goes up and down. And yes, we have medications that will alter the outside symptoms. But it is way better to start with, how about?

or you replace the tools that help you make serotonin. So you have, yes. So you go, it's one step deeper. Deeper. Yeah. Exactly. So, okay, so what's the, what is the, you, I want to go back to something you said about 10 minutes ago, which was there are very clear lifestyle things you need to do to

keep this system working at its best. So the first one that I like to teach through is I would give the, the, the, my first audience for this, this information was teenagers. Yes. And they have these beautiful brains that are... Yeah, their teenage brain, I mean, as mothers, we know, is fun to try to manipulate. That's not the right word.

Yeah, that's the right word. I'm a mother. I am a master manipulator of children. But manipulate is a little bit of what we're doing. Create. Yeah, there you go. Okay, you're so nice. My children should have you as the mother for a little while.

You're just, you're obvious about it. You're like, I just manipulate it. No, this is what I do. Hopefully my daughter will. never listen to this podcast. Well, I'll tell you, it's such a thing, you know, the wisdom of, you know, we've both been around the sun. I'm 51.

And you do understand what your parents were trying to say and do. But it took us 30 years to get to that point. Like, ah, they were probably right. Yeah, so true. But as you watch teenagers and you see, there are some really cool facts about teenage brains. So I put them in my workshop and I tease them with, I give them four, or I give them a statement. about hippocampus. And then I'll say there are four true statements there and there's one false.

And then there's a scratch-off test that they have to work as a team to find the right answer. And of course, there's nothing better than four teenagers telling everybody they know everything, right? These are hard questions. And so then they have to agree what to scratch off. And if the little star isn't under their scratch-off, World War III starts out on their table. But the point is they're struggling over these facts about what's going on in your brain. And that hippocampus is a powerful predictor of success. So when you get people coming to you for, you know, improving my brain,

what they're really asking is I want to be more successful. And I'm not using that in the financial component. I'm measuring success with what's the length of the relationships you have in your life? How quickly at the age of 50 can you learn to do something new? And when you learn that something new, can you deliver that new skill in a emotional state that doesn't repel everyone. Right. Okay.

Well said. Right. So you look at brains in that teenage year when they're starting and stopping the growth of their hippocampus. And that is a great teachable moment to say, yeah, your hippocampus isn't developing and doing things well because it's got a stunted growth from the recent carbohydrate binge you just went on. You drank alcohol the other day.

And it's going to not grow, that hippocampus is going to not grow for up to six months. And during that time, your emotional state is going to be a teenager. Exactly what we see. This is for adults too. Yeah. The hippocampus is really unique, though, because teaching it during those teenage years, the hippocampus does a huge growth in utero and for about a year after. Then it kind of pauses in the way it grows until puberty.

And puberty actually marks about two years before when this really important part of the brain grows in length and volume. So you watch how well you can during the time when a brain is supposed to be growing really well, and then you learn what doesn't make it grow. Such does. Yeah. So those are the places where all these lifestyle things come in. So yes, they apply into adulthood. But the stuff I'll talk about, the evidence, when you say, well, where's proof of that?

Best proof is in teenage brains and their hippocampal growth. Because it's like a research. Yes. And of one of research that you can see. Right. So we're starting with the hippocampus, and I'm thinking then that is probably because that's the most important. It's the most important. Excellent. Okay.

So if you look at, if you got to pick one part of my brain that I want to say, you're going to give me a stroke. Okay. Stay out of my brain stem. But then don't touch my hippocampus. Okay. Not hippocampus. As an adult, the replacement of the cells in my hippocampus is possible. Again, when I went to medical school, they had a test question that says the nerve.

all cells you're born with or all you're going to get. Right. And then in my residency, they change the rules and say, no, no, no, no. This little protein called BDNF is what is like the miracle grow of our brain. And specifically, it can do a stem cell-like effect to the hippocampus. Amazing. Yes. Like, you know how you can cut off the cervix and it grows back?

Cut off part of the liver and grow back. There's the hippocampus where it can grow back. Yeah. So as much as I don't want you to touch my hippocampus. campus, if I do, I'm going to do these things to help it grow back, or I'm going to help it be the best it can be. So BDNF is the trigger of that. Right.

So the things of lifestyle I'm going to tell you about are what it does to a teenager and what it does to BDNF. Perfect. Great. So number one is sleep. You cannot grow BDNF. So BDNF is this little protein. If I checked your cerebral spinal fluid, I would pull that fluid out of your body, and I could

find the protein in your brain, in your, in your, the liquid of your brain. The amount of BDNF in your brain would teach me how well you'll recover from an injury, how well dementia is headed your way, how well the depression or anxiety that if you're ebbing and flowing towards that or away from that where you're at with that, it predicts suicide attempts. I mean, when I was in medical school, BDNF was just being found. And if you wanted to get funded for any type of research from the NIH, you just needed to add the words BDNF. Those four little letters, you could say, I want to study what color of the tail of a bunny turns out.

And if you said the word BD and F with it, you got the money. Everybody wanted to know why. When was this? This was 1980s, 98 to 90, right around plus or minus 1990. That research was, I mean, it was impressive. At the time, we didn't understand why did depressed people have these tiny little hippocampi? And there were several people's opinions being played out in the journal. that you would say the opinion part of the journal.

You would hear these really smart people saying they're born with it. You can't remake a neural cell. They have to be born with that small. They were destined to get depression. Okay, that's a terrible thing to tell anybody. No, that's not true. That did not turn out to be true. Then the other people were, well, once they're small,

you can never get it back. You never get back. Yeah, that used to be the old. Yeah, right. And honestly, that's where the people with fibromyalgia, where what's wrong with the people with fibromyalgia, they start out with this life where they don't sleep well. Very commonly begins right after they've had that baby.

And they are the best of mothers listening in the other room, or God forbid the baby stays right in their bedroom and the mother never sleeps. Wow. She never sleeps for long enough to build her BDNF back up. So how much sleep do you need? Yeah. So you need the kind of sleep that gets you into deep sleep. Yeah, I wondered.

Okay, so how much deep sleep do you need? Oh, so take a guess. how many minutes a night, on average, an adult brain who makes healthy BDNF gets. This is the EEG version, not your eyewatch version. Your EEG version, I have you hooked up. You're in a sleep lab. You come in and I get to measure, and not was me, but the researchers measure, what was the people who had the highest BDNF?

What was the number of minutes they spent? This is that kind of sleep where if you're a baby, I could change your diaper and you don't wake up. Right. So deep, deep, deep sleep. I'm going to say an hour. Yeah, 15 minutes. And my, my understanding is we need two hours or more. No, you need 15 minutes. You only need 15 minutes. Of the delta sleep to make BDNF. So here's the problem with that. You get it. In that first part of the night, you get more of it. So it takes about two hours to sink into that 90 minutes to two hours, depending on your brain, to sink into the depth of sleep. But once you get to that, that layer of sleep, if the fire alarm goes off while you're in BDNF, you can't wake up.

Right. It is a dangerous phase of sleep for preservation, for evolution, right? Right. So as your brain gets to that lower level of sleep, that is where it will check your heart rate, look at this, and just cycle the crap out of your BDNF. That's where this protein is made. And you only need 15 minutes of that. So then you only stay there for three minutes, two to three minutes.

And then you're going to wake up and you're going to check on your body. Then you're going to come back down and you're going to grab another two to three minutes. My aura ring shows me all the time. Yes. So in the way it looks on your aura ring and your Apple Watch and what it looks like in the sleep lab, there is a correlation. But it is not the same timer. So that's where when people say, well, how much should I have on my watch? I'm like, heck if I know.

I got the studies that come from an EEG and they are not the same. Yeah. So how does the everyday person know? Right. So you look at that aura watch and what I tell patients is that deeper sleep should be getting into that 90 minute mark should be because it's not the same measurement. Right. So there is a device out there that, have you ever seen the muse headband? Yeah, yeah.

Yeah, yeah. So they're, I mean, aura ring and muse headband are very similar in the way that as far as their correlation and accuracy for getting to deep sleep. So those are the two that I, if you've got an aura ring, then I'll watch that data. and then it correlates to how much. Oh, interesting. Okay, I'll have to, okay. Anyway, so sleep's number one. Sleep's number one.

And what's happening during that sleep is your hippocampus is growing if you're a teenager. Your BDNF is being made. I like the dishwasher effect is really what's happening. So we have lymph cells, lymph systems in our body. There's a lymph system in your brain as well. And that lymph system will open up and do a dishwasher effect of the brain cells, pulling out that tau proteins and all the things that you never want to get in your brain because they are highly correlated with the diseases of aging for the brain.

And that neurotransmitter effect is, and how well that grows, is related to the depth of sleep. Not that you've got one night, but what you got cumulatively over the last several days to weeks. And when you have healthy people who, oh, they slept like I did last night, which is in a hotel room. If I've been doing my part and sleeping well for the nights prior to that, your brain will, it will play catch up. Yeah. It will, you know, when it gets to that deep sleep, it will hold tighter. It will hold longer trying to repair from the night before.

Right. But the chronic sleep deprivation is, oh, it's pervasive in our population, in our brains. What happens if we take medication or we drink or marijuana, like even though we may be asleep for a certain period of time. We are not necessarily getting that deep sleep. Right. So that's where the best brains to teach through is the teenage brains because they're growing. You can do a functional MRIs at week one, a week three, a week eight. My favorite image for a teenage brain is to show the scanners where you're watching brain activity as they do a puzzle in their brain in the machine. And you can see how much brain activity is being used to solve the puzzle. Okay. And

we do it in elders, and we do it in people with Alzheimer's, we track the brain activity. So they have a 15-year-old boy, two 15-year-old boys. One of them is the high school partier, and he gets stinking drunk on Saturday night, excessive drinking every Saturday night. He's known for that. That's what his thing is. This test is on a Wednesday. It's not a hungover day.

It is Wednesday. And when you watch his brain compared to the other teenage boy, first of all, both teenage boys have very little brain activity. I had a teenage boy. He's now turning into a young man. How the hell did we let them drive? I could have told you that without a research study. In South Dakota, they let them drive at 14.

I'm like, this is suicide. What are we doing? Yeah, that's right. There's a lot to be said. Who came up with 16? I know. Okay, for a driver. So as they're sitting there, that boy who's got the healthy brain,

who's not had any alcohol, his activity, is, well, it's normal, but it's a teenage boy. The one next to it has one little ditzel that is able to wake up that brain on the Wednesday. This is not yesterday's drinking happen. This is what looks like when you pull alcohol into the body. That alcohol is a chemical. It crosses the blood brain barrier very readily, and it does this thing where it pulls water wherever it goes. And for anybody who's maybe has been drunk or hungover in your life, and you've got that

morning after where everything's swollen. You can't get your ring off. And you feel dehydrated. People say, oh, drink water after you, you know, in a hangover. Well, where'd all the water go? Oh. Yeah, the water went into the cells because it followed the alcohol. Okay.

And the highest rate of delivery is as it goes into the brain cells. So the alcohol, which is what you're drinking it for, is going to dissociate. It's going to cause the brain to act differently, right? It's going to cause a release of dopamine and all the lovely things that alcohol does the first time you drink. And it's going to pull in its wake for water molecules. So the rate of alcohol you pull in

is proportional to the rate of water that gets pulled into the brain. And those brain cells swell. Just like a concussion. Wow. So you put energy into a brain with a baseball and that energy waves through the brain and that trauma swells the brain.

Wow. If the swelling of the brain is so terrible after a car accident, you're laying in my ICU, we're doing a calculation saying, uh-oh, uh-oh, we're worried. The space in that brain is about to run out, and the spinal cord is going to push down into that, you know, frame and magnum at the bottom of the skull. And when we do that, there's a nerve there that if we pinch it off, you stop breathing. Yeah, that's brain dead. And then we start talking about organ donation.

And if we get really worried about the trauma in that brain, that swelling in the brain, well, we'll cut off part of your skull, lay it next to the table for two days as your brain swells upward. Wow. So that you don't die. That's fixable. You know, a scar on your head isn't pretty, but you're alive. So that's happening, alcohol. Wow.

So that actually, so where my brain goes with that is, you know, what I see with women after 40 is as you lose estrogen. Mm-hmm. You also lose that precursor to dopamine. because estrogen will stimulate dopamine. So, and then you're losing progesterone, which is helping you make GABA. So that glass of wine becomes like this new tool to give you that, that euphoria and that relaxation. But the problem that we've got is that's a short-term, a solution creating a long-term problem. Absolutely.

Yeah. So just like it's a problem for the teenager drinking on a Saturday night and not performing on Wednesday. Yeah. So that has to be a part of the brain rehab, I would think, for as we age. So you look at what that lady is doing to say, I want to drink some wine and feel, you know, relax, they'll call it, right? What they're doing, that alcohol goes across the blood brain barrier. It pulls water across the blood brain barrier. And her 50 plus year old brain now swells every place that alcohol goes into the brain. And when it's a repeated swelling, well, that trauma from the alcohol now has to repair. And the tools to repair that begin with, well, they begin with a, I like to tell people,

ketogenic state is the place. If you've got ketones floating around, you know that you can move that fat, the fat that's needed to supply the estrogen, the cholesterol is really what you're beginning with. So that you can move that cholesterol to the places in the body that will then turn it into estrogen, turn it into testosterone, take those neurotransmitters and the downline chain of all the ones in the brain then can be supplied. So I think the key to looking at when people say, Doc, you know, I'm, you know, and God bless Oprah, if we just put estrogen at the end of the line, well, let me let me help you. Let me put the estrogen at the end of the line. But what's before that

and before that and before that is this sunken phase that estrogen in and of itself for your brain, it's like sprinkling Prozac on to somebody who's got a little bitty pile of serotonin in their brain, and I'm going to recycle the serotonin in that little spot for their brain, and it's going to make them feel a cinch little bit, a bit better, but not the restoration of their soul, of feeling good. That comes with, yeah, the whole, that comes with the long game. Yeah. The long game is saying, all right, you can't fix this without sleep. The sleep has to be deep enough that your BDNF is being made. We have very good evidence that without that process, I don't care how good my prescriptions are working, you can't make them work unless you're

sleeping well. Yes. The second thing was don't drink alcohol. Okay. Alcohol was, I mean, I love a glass of wine. I'm not perfect here. I just know the science behind if I want my brain to age well, this isn't the tool you want it to be. Right. And having a process or a habit in your life where you say, this is what I do two to three nights a week and now it's four nights a week and now it's every night a week because I'm in menopause. Right. And the red wine is supposed to help me. Okay, don't play that game.

Right. You're going on the wrong direction because the depth of sleep that you get. This was a great story. So I did my residency in Salt Lake City, Utah. And I'm from South Dakota. And when I told my parents I wanted to do residency in Utah, they're like, well, you know, what's the first thing you think of when you, if your kids were going to go to, this is 30 years ago too. so it's much different now.

Mormon. Mormons, right? Yeah. So I didn't even know, I didn't know anything about the Mormon faith of the time. I'm like, well, I'll figure it out, Dad. I'll be fine. So I get there and actually on the tour, they said something to me that I was like, isn't that strange? You get to look at the beautiful mountains and they tell you you can ski, which is totally

a lie because there was no time for skiing. But then they say, and, you know, there's not that many alcoholics you'll have to take care of. Oh. Oh. And I said, huh, is that a thing? Turns out it's a thing. First year residency, you take care of recovering alcoholics. They come in the ER, you detox them, don't let them have a seizure.

That's your job. So you don't have a lot of those in Utah because it's number 50 for alcohol. So a couple years later, I'm in residency and now you're used to that you don't see alcohol, but we put alcohol in a pill. And we did that actually, the person that did it was somebody who was a recovering, a son of a recovering alcoholic. And he said, if I could just put alcohol on a pill, my dad wouldn't go to the liquor store. And so that was his theory and part of what motivated him to study out, booze and a pill.

So he put booze in a pill, gave it to all the people. My goodness, they've never stopped drinking so well. The study was incredible. They are, they didn't want, Doc, I feel like, I feel normal. This feels great to me. And in the back of the study, they're decreasing the dose of the pill that they were. Oh, over time. Over time, and as soon as the pill got to a certain threshold, they all went back to drinking.

Okay, so the moral of the story, you do not replace a drug with the same drug if you're trying to get off of a drug. Okay? So what is the name of those medications? If you want the booze to last for five days, we call it Valium. If you want the, Librium, excuse me. If you want the booze to last for three days, we call it Valium. If you want the booze to last for two days, we call it Clonopin. If you want the booze to last for a day, we call it Xanax or Ativan.

This is benzodiazepines. Wow. That benzodiazepine class, parks. in the receptor that is that alcohol parks in except it does it for five days or three days or two days or one day. Yeah. Wow. You want me to detox somebody?

Just give me booze. Way easier to detox them off that. Than those. Yeah. So, okay. So sleep's number one. Number two is alcohol. Alcohol.

Get off alcohol. The sleeping aids that people use. So what do they use those for now? They use them to sleep. So they say, well, what else should I be doing to make my brain do better? Well, don't sleep with benzos on board. So inside this, in Salt Lake City, Utah, I would help with the sleep lab. And you would hook them up to these things.

And we would, we did this. This was probably shameful. But we would make a bet. Based on the people coming in, you would get one or two words out of them. You don't get to look at their medication list. You just get to hook them up to this machine. And you say, are they on a benzodiazepine? And because it's a chronic use of alcohol, you could watch their gait.

You could sometimes get it in their speech. But a lot of things do that to your speech. It was truly a game of, let's make a bet, who's on a benzodiazepine and who's not. Wow. And of course, you can have, the ultimate tell was what happened in their sleep. Like, you can say you're taking a benzodia, but when your sleep never gets to that reparative zone where you make the BDNF, I don't care. The correlation for dementia announced in 1991 by the FDA was, the longer they're on these benzodiazepines, the more dementia-related behaviors, and pathology we see.

That's crazy. So as you find a chronic alcoholic destroying their brain through chronic alcoholism, the same chronic depletion happens when they would take these benzos long term. So you say, sleep sounds like this little thing like,

yeah, you should get sleep, get an aura ring. But I'm like, save your money on the aura ring. Get a therapist or something that helps you get off of these medications because falling asleep with booze or with your benzodiazepine prevents your brain.

You cannot go into stage four sleep when benzodiazepines or alcohol where in your system. And so then if you're doing that three nights a week, then you've got to wait until the alcohol is metabolized if it's alcohol. So now from about three in the morning until six in the morning is the only time you could possibly, because the other times you're metabolizing the drug. Right. So, and then what I also heard was ketones.

Ketones are what? Like, so, I mean, I'm not making a case for drinking alcohol, but if you want to speed up that process of repair, put yourself in a ketogenic state the next day. Yep. And that's the one thing I think that is misunderstood about ketones. Everybody wants to make ketones because they're like, it killed my hunger and it gave me so much energy. But my brain is like, yeah, but it's going to go up. It's going to start to repair neurons.

It's going to upregulate GABA. And what you just said is it's going to help bring down that inflammation. Yes. That might have been happening from the poor lifestyle that you had before. So it is truly a biohack. It's a way to go in and speed up that healing process. Right. The other part of that is when they put in those medium chain triglycerides, those strings of fat

that do cross the blood brain barrier. That's really, people sometimes miss that. C-10 cross the blood-brain barrier. They are metabolized in the brain as energy. And that process between ketones and those strings of fat, that is a reduction in inflammation on the inside of that brain. That's powerful. You want neurotransmitters to be made.

Get those things in circulation in the place where you're making them. Add some estrogen, sure, you could probably do a little better with those ketones plus estrogen. But start with, it's like the guy who comes in and says, Doc, I want a shot of testosterone. Yeah. But I'm a type, you know, too diabetic and I give myself 100 units of insulin. Right. I'm like, you should shoot the testosterone in the air. It will do you more good to smell it than it will to put it in your bowl. And that was my big complaint about this Oprah discussion.

I mean, again, so happy she's opening the conversation. But it was like, no, no, now everybody's going to go, hey, Oprah said get on HRT. I'm going to go get on HRT, but I'm still going to find that I'm not feeling well, which we've seen. happen over and over again. And you know what is the saddest part about that is they have so much hope at the beginning of those prescriptions. They want this to work. Yeah.

It would be nice if it was that easy. Right. Right. And then you turn within and you go, oh, it must be something that I'm doing that's wrong. And so I actually would say in your brain protocol, I love that sleeps first. I love that we got alcohol and medications. But I would say number three has to be dip in and out of the ketogenic state. Yeah, absolutely. Module 3 talks about that.

Oh, really? I could help you create that. Amen. But that's what I see so much with ketones is that, yes, it became this hero for weight loss, but I think of it as the brain hero. It's the brain thing, absolutely. That's, I mean, that is how I got into it, is the podcast that said, if you want the brain to heal fastest, I mean, that's that brain trauma,

it is about how inflamed is it on the inside? And then how slow are those repair, repair teams? working in your brain or how fast. And so how much goo is in the way? That's the inflammatory, post-inflammatory, talproid, all the stuff that is there for long-term. And then how quickly can you, like, biohack your way around that and stay in the lane?

Because it isn't ketones for a day. They have to stay in a state of ketosis long enough to repair that process. The younger they are, the quicker they repair. What do you think? I don't know if we've ever talked about this, but this is something I used to recommend to my patients in my clinic when they had aging parents that had dementia, Alzheimer's. I would always say, can you get them on a ketogenic diet?

And then usually the response was like, no, they won't go on. Well, what if we use exogenous ketones? Right. Plenty of evidence that shows clearly when the brain had access to ketones, much better response. The other part that I don't skip over because it's much less expensive is the medium-chain triglycerides. Those medium-chain triglycerides, it takes a lot. And, you know, again, if they're not fat adapted and you just give them a fistful

of, you know, MCT capsules. It doesn't work out so well. They get diarrhea. You got to start your way up, right? You have to tight check that. That's a sustainable plan. I mean, as sad as this is to say, as the elders come for help, if you tell them there's a few pills to add to their pile, like, okay, whatever.

Right. They're like, add a few more. So put some MCT pills. So this is beyond just putting MCT oil in your coffee. Right, right. You got to have, I mean, when you look at an MM, mini mental status exam, 30 is perfect. 25 is cognitive impairment, and 20 was dementia.

So to keep them at 25 or above, the studies that have looked at that have 30 to 45 grams of medium chain triglystores. Oh, amazing. That's a lot. I don't even, I mean, you would be going to the bathroom all the time for sure. Yeah, they had a lot of dropouts when they were doing the test. So you would have to, but you can work up to that. So I've been saying MCT oil is this beautiful. way to switch you into the ketogenic energy system in a quicker way. I also think when you use it,

it can kill hunger. Yes. And that's really great. But now what I'm hearing you say is it also can go in there and bring down the inflammation of the brain. And the fact that people, I mean, I think people learn this and then like me, you forget, oh yeah, that one crosses the blood brain barrier. It gets over that. That's not a very common trait for most fats. So the fact, these can cross the blood brain barrier. And we know that it's not just C8. C8 got really popular when the ketogenic diet first started a chain that really does spin out a lot of ketones. When you have a shorter chain, like a C6 or a C4, the ghee that's in butter, it's just small little chains. So the amount of ketones that come out of that are very, they're smaller. Interesting. So as you get to C8, there's a bunch that come out. But C10

is, again, a nice production of ketones and was left out. Somehow C8 won the popularity contest. But I'm like, no, no, no, C-10 still crosses the blood-brain barrier. Interesting. And there is something about that, like, in brain repair, the people on both did better. C-8 alone didn't do as well as C-8 plus C-10. Wow. And so don't leave that. So both of them together.

Yeah. I don't even know, like, I just put MCT oil in my coffee in the morning. But now you got me thinking, I know there's a lot of C-10 products and C-8 products out there. The part that I, when I tell you. people is, okay, the Latin word for goat is capric. So just look at the capric and capric and capric. That's C8 and C10. Goats are where there's a bunch of medium chain triglycerides in their milk. Now, I don't know why we don't get C8 and C10 from there.

I used to drink goat milk all the time. My mom would buy goat milk instead of dairy, a cow's dairy, and she always would say this is better. And then I didn't really understand why. and we just grew up under, you know, on the taste of goat milk. Oh, see, that's way, but my husband hates it. Yeah, it's a very different taste. Like feta cheese is from goat, right? So that's that, again, different taste. Yeah.

Non-dairy. But when you look at the C-12 is loric, and so that's where you say that's not a medium chain. That does not fit across the blood-brain barrier. Okay. So it has to be C-8 or C-10. And goat's milk has that. So I'm always about how do we create more diversity in the foods? that we eat. So what I'm now going to add to that is why do we, if you're going to do

dairy, why do we always do cows dairy? Why aren't we bringing in some goat? So I love that. Okay. So we got ketones, no alcohol, no drugs, sleep. What else can we do for our brains? The next one is the, I touch on marijuana, the marijuana part where, again, this neurotransmitter comes in and it's got your anabinoid is the neurotransmitter that's in our brain. T-teens. is the look-like that comes in through marijuana. And when just like any of the other receptors for acetylcholine or GABA or glutamate, when your body stimulates the production, an atomide is the neurotranspenter in your brain that really does help us with euphoria.

It leads to dopamine, but it also does it in a way that has this calming, focused, dissociative effect that is natural. And when you put THC in there, it will park in that same parking spot and it will override, just like alcohol would, that now we can stimulate this much heavier, much faster, much more often. And then you deplete what, first of all, your anatomide, natural anatomide that you're making becomes much less produced. And they all stimulate downstream for dopamine.

and at first you have this huge wave of an effect. But just like any drug, any alcohol, any nicotine, that when you do that at first, you have a improvement in the amount of dopamine you make, and then the dopamine doesn't get recycled. And without the recycling of dopamine, you have a depletion of that eventually as well. So I think of this like thyroid.

How many people have you heard, like go on thyroid medication? And they're like, I don't feel any better. Or they felt great for like a month. And then they're like, I don't feel any better. And the theory that I had always heard was that meant that you're just your body's not making the same amount of thyroid hormones because it has an exogenous source. So what I'm hearing you say is that when you're doing marijuana, you're also creating this system where all of a sudden dopamine's not going to be made and recycled as much. So you may feel euphoria in the moment, but because it's an outside exogenous source, over time, you're going to be dopamine depleted.

Amen. That's exactly right. And the hardest part about the folks that are struggling with coming off of marijuana is that, first of all, it's become this popular place to say it's the Zen moment. This is how you live life. You're meant to have this. I've got a receptor in my brain that looks just like it. I'm like, yeah, we have that for every chemical people.

I mean, you're right. It looks just like it. But that doesn't mean that you were naturally made. It's like a mimiker. Yeah. Because your body should make, and I think this is really important, your body should make CBD. Yeah. Like it's in CBN and CBG and all these.

Like it's inside of us. Right. But why we've been so attracted to these exogenous sources is because we're not making it on the inside as much. So then we now have to look at the exogenous. So that's so brilliantly said. So the other part that's most dangerous about alcohol versus marijuana is the alcohol is a water soluble substance.

So, yep, it goes into those cells. It will swell the cell for that, you know, 48 hours. The damage from that cell is going to take time, but the alcohol is going to be gone at like 72 hours. Right. Now, you've got to, you have the consequences of what it does to that hippocampus for the next six months.

But in a fat soluble one, it crosses that blood-brain barrier, gets into the brain. And then if all the parking spots are filled by that THC, the every axon, has a fatty coating and the excess amount that doesn't bind into the receptor and in today's amount of marijuana it is so potent. So many molecules of THC in the substances.

It's a more, yeah, because we've done everything bigger and better. Right. But was 1% in 1971. Right. We are at like ever clear as crazy. Whoa. Yeah. That's fascinating. You know, that's fascinating. So, but again, I go back to like the plight of the menopausal woman, which is, okay, I'm still losing like progesterone and estrogen and gaba and I can't calm myself. I can't sleep. So it's become sort of socially accepted, the glass of wine, a little gummy at night to be able to put yourself to sleep. What can we do to start to help women as they navigate this neurochemical loss so they don't dip in to those activities? So, yeah, if they're already doing that and they're coming off, I think letting them have

the appropriate expectations, first of all, that when you take away those stimulants that you've been, you know, surplanting onto your brain as a substitute for what your brain was supposed to make. Well, your brain hasn't had the signal to make those for as long as you've been doing that. So now, or it's had a, you know, fenestrated. It'll have it for a while, then you'll have a glass of wine. So that on-off stimulus instead of that constant saying, okay, we need to be making these neurotransmitters. We need to be doing this in our own body. When they come off of those substances, they do not feel good. marijuana has a pretty deep dip for three to four weeks afterwards.

I was going to say how long, yeah. And that's the time when it's coming out of that fat. It's stored in the fat. So you have that molecule in the brain and it's sitting right there. It's not going to come out and park into the other receptor. It has to disintegrate. And so it disintegrates right there in that axon. And what's left is a little hole where the insulation was supposed to be.

So now the axon doesn't work right. And you need that removal of inflammation, that high fatty, state to repair the brain the fastest. So would it go dipping into a ketogenic state heal that a little quicker? Yeah, that's exactly right. Yeah. So, so, you know, again, putting this in sort of a big picture vision is like, okay, let's get off the alcohol, let's get off the drugs, let's get off the marijuana. And while you're having to go through that process so that you could get to a good night's sleep, let's dip into ketones and LCT oil. Absolutely. The fastest thing that you can be doing saying, okay, what can I do to make this the shortest and littlest as possible?

Well, prick your finger. Make sure you actually have, or pee on a ketone stick. Make sure you actually have ketones in circulation. And people go out and eat keto bars or they do something that is, you know, they think is keto. I'm like, don't play that game. I'm anti-keto, like, pre-packaged food. In fact, I'm laughing because we're here at the Ketocon. Right.

And I'm about to speak in a couple of hours. And one of my big premises is that I feel like we've overcomplicated health. And it started by overcomplicating it in the medical. world and now it's moved into the biohacking world. Like there's so many. Simple is better, right? Yeah, there's so many like keto like bars and tricks and this. And I'm like just fast, more MCT oil and let's just eat lower glycemic fruits.

Let's get the vegetables and meat and like keep it simple. And the key thing is people will instantly ask me, well, how much of that can I have? I'm like, I don't know. Check your chemistry. Because if somebody has been a high insulin state, or they've just come off of injecting their insulin. Like they have more, their insulin doesn't work like yours and mine works. Yeah.

It is insulin resistant. So now the slightest amount of production of insulin from their pancreas will take them out of a ketogenic state. So you should measure that. It's a very easy thing for you to measure. Don't make me measure it. I'm going to measure it one day out of the month. And that doesn't tell you what's going on.

You need to be looking at this as you journey. Yeah. And that's that responsibility giving back to the patient to say, look, it's a crappy way. out of those drugs and poor sleep. But the way in is to heal the brain as fast as possible. And in my brain injury patients, in my post-radiation chemo patients, you know, those, they want out of that nightmare as fast as possible. And that is, you have got to stay in a ketogenic state.

And they can't, like, wake up one day on a standard American diet and the next day go into a persistent state of ketosis. Your insulin isn't going to let you do that. You've wound yourself into this. We've got to wind yourself out. And then you've got to stay out of it. while you repair that body. Do you think that there's a keto dose that's the best?

Because this is the other thing I've been really thinking about lately is that I think dose matters in so many conversations. Oh, yeah. And when you look at like just ketones, we've got the ketoacidosis where you're like weigh in like eight, you know, I think it's like 12.0 higher. 20, yeah, right? So 15 and above is considered that.

But you have to have a high blood sugar to have that. So the two things that are. Have to be matched. Yeah. Yeah, high blood sugar and high ketones. That's ketoacidosis. So, but then we know nutritional ketosis is 0.5 is the door in. Is there like a state amount of ketones that will heal the brain better?

Okay, so the best way to answer that is what's happening to the ketone? Is the ketone being used by the cell? Okay, so all right, let's figure that out. So the dictator for whether or not you can make a ketone is insulin. So if I had the perfect way, you know, I hook you up into my science. fiction lab here, we would have you checking your insulin every, I mean, every few minutes just to see, how's it doing? And then you would learn, okay, here's what my insulin's doing. But you actually couldn't stop there. You would then need to know, well, how well is my body

listening to insulin now? Because that's what insulin resistant is. The insulin can be 20 or 30, but if it's 20 or 30 in an insulin resistant patient, it works like a 40. A 40, a 40, would in the insulin resistant patient. It works like a six would in an insulin sensitive patient. So as you look at, well, how do I know which one I am? Like, that's very confusing. Is my insulin talking to the cells the way it's supposed to? Like, all right, let's move away from insulin.

That's too confusing because it changes over time. Right. So the two chemicals that insulin will dictate is glucose and ketones. Right. So as you are progressing through that metabolic change, we want to know what is your blood glucose and what is your blood ketones at the same time. And that tells us what insulin is doing. This is where the doctor boss is. I was just going to say.

Right. Wait, I know a woman who came up with a really smart ratio. Hmm. I think her name was something began with a bee. And truly, it wasn't, I'll be very careful. It's so brilliant. We use it all the time in my community. I'm always like the doctor brawes.

So tell us with the Dr. Bosz ratio. Well, it came from the research papers of glucose to ketone index, okay? And that's what they have studied for years, on seizures, on medications. But they use different metrics, and that requires math, and you've got to take the ketones down to a one to get it to a ratio. Okay, way too much math. It was really complicated until you came along with the great form of it. And I said, all right, screw this.

Just take the big number, divide by the little number. So the glucose divided by the ketones. And when you have those two in together, as somebody whose insulin resistance starts out, their glucose is really high. Right. But they go into a ketogenic state and they can shoot their ketones up to three and a half or four. I've seen that happen all the time.

Yes. And it's because, oh, yeah, they've lowered their insulin. They've lowered their insulin by a significant amount with that first behavior change of decreasing that carbs. And that let the glucose out, I mean, the glucose can now circulate out of your liver. So you're like, well, my glucose went up a little bit, but your ketones went way up. Yeah. And then their body gets healthier.

So the ketones come down and the glucose, well, it kind of just hovers. It doesn't do much. And so then you get to the next place in your body. Well, what happened there is you're less insulin resistance. That's a good thing. Right. But you can't stay there. Right.

You have to stimulate your metabolism again, which is where the ketones will burst up. And now the glucose is going to go down a little bit further. And over time, that ketones will slowly return back down to 1 or 0.5 or whatever. That's going to take another two months. If you stay in that lane, you stay in that metabolically stressed zone. Yep. And then it becomes easier. You're like, yeah, I have two meals.

a day, yeah, I kind of pig out at the first one and not so much the second one. And then they stabilized. Doc, I leveled out. Doc, I leveled out. I'm like, yeah, guess what? Your Dr. Baugh's ratio has got a glucose of, now let's say, 100, and ketones down in that point five. So that's, they're not doing much. Right. Right. Right. Brain cells. You're not going to be repairing a brain because the ketones are too low. To get them to go higher, you have to metabolically stimulate again. Well, there's other ways to do it. Add a sauna, do some workouts, or tighten up that eating window, move it closer to sunrise, make sure you're not pigging out so much, meaning that stage of keto is fun. And yes, it's very lovely and easy. But now you've got to tighten it up.

Now you've got to take it to the next metabolic level. And it's through this process where that ketone level, you have to keep stimulating. Just like the bodybuilder needs to keep working out. The person in repair of their brain needs to keep stimulating the mitochondria to say, hey, make me some ketones. We've got a problem to fix. So the ratio needs to. So the ratio needs You had like three levels, and I remember the third level was, what's the ratio? So getting it under 100 is like beginning. That's where you're not going to. Glucose over ketones, divide that should be under 100.

Now you're in the beginning. Yeah, that's in the beginning. So you'll lose weight, especially if you get it under 80. Yeah. Good weight loss under 80. When I get them down to 40, then I can be pretty confident that they're reversing an immune problem. Amazing. And they have to really stay there, though.

That's the key. For how long? Yeah, immune problems. It's a good four to five months. Oh, wow. And what about for brain for just like mood disorder kind of thing? Well, any of the brain stuff, too, that 40 to 60, you can see a really good improvement. When I have a cancer patient or a seizure patient, so again, a brain that's very dangerous, that's, I get there, Dr. Baas, ratio down to 20 or less. Amazing. That's hard. The volume of food has to be smaller. It's got to be very ketogenic, very high fat. and they can't be eating four times a day. Right.

You know, when you talked earlier about the particleized food or the processed food, what I tell them is, look at your food. What's the size of the particles that you have swirled around into whatever it is you're eating? And if it's overly processed, well, you probably can't see the particles. They're so fine. Right. And that particle size really does predict.

So when I get people trying to get to a Dr. Boss ratio of 20, they're having no particleized food. They don't have anything processed. They have a can of sardines in the morning. and a can of sarding. Yeah, and that's where you, fasting comes in. I mean, I always say there's two doors into that ketogenic state, and fasting is probably the fastest one, no pun intended.

No, it's real. Yeah. And it's a lot easier. Like, yeah, this doesn't need to be complicated. Right. This salt and water, black coffee. That's right. There you go.

Exactly. Back to the simplicity idea. So, okay, this was totally fascinating. What I'm really starting to see is this conversation of mental health is just coming to the surface. Yes. And then menopausal women are like, hey, we're over here suffering.

But what I think is not being discussed is that there's a lifestyle that goes with healing the brain as you move through these years. And if you can do that, then maybe you add an HRT, maybe you do a BHRT, fine, but you can't leave this lifestyle out. It's really important because what I see on my end is they've gone to doctor after doctor and they've got, I've been on bioidentical, I've done this, I've done this, I've done this. They're just frustrated. Yeah, well, when you put that.

wonderful tool on top of garbage. It was never going to work. And that's where they lose hope. They lose hope that anybody's going to help them. And so now I say, yeah, it's a long game. And we might do that at the end or we might do that, but it's not going to work until we get that insulin doing its job till we get that. This is a fatty molecule we're trying to move around. It's going to be under the dictatorship of insulin. So if we don't fix that at the beginning, or at least you see, it's very connected to how you sleep. It's very connected to what you're drinking and drugging on. It's very connected to the number of times you eat, the timing that you eat, and your overall health will be improving when your estrogen becomes more effective or able to use,

whether I give it to you, whether you put it under your tongue, you get an insertion in your butt cheek. I don't care how you get it in there in the end. The first biggest step is, do you have the chemistry in your body where you can use that hormone correctly? Amazing. Amen, sister. This is why I wanted to have this conversation with you. Okay. Last thing. I have to ask you this has nothing to do with ketones, has nothing to do with estrogen. This is my, this year on the Resetter podcast, I decided that I was going to pick the theme of self-love. And in self-love to me, it means there's a practice that you do every day where you're giving

back to yourself. And there's an acknowledgement that you're a badass at some aspect of life and owning that. So do you have a self-love practice? And what do you think your superpower is? Oh, wow. So when I think of the self-love, there is. you know, 51, it's changed over the years. Right. Right. Yeah. Well said. I think I mentioned earlier, one of my favorite parts of my resume is that, yeah, I'm a, I'm a bulldozer kind of a woman.

Really? I didn't notice that about you. It would really be easy to not have any relationships left. I could bulldozer all of them. I think this is why I love you. I love bulldozer women. These are my favorite. But I think at that moment where I get nourished. or I get to be the one taken care of is because of what happens in my marriage. That the role that I have as a wife is not the same role I have as a boss. And I have learned to surrender that this isn't the place for me to use my superpower, which is I can see a puzzle and see how to fix it. And this is what I like to do that create the idea of here is a great way to solve the problem in front of me.

But I have to take that hat off and be and receive. instead of give in my marriage. Oh my gosh. So well said. And it makes for much happier marriage. Probably 20 years into choosing that path instead of. And in the world of medicine, it's really easy to be the boss woman, like authoritative, very strong. It's how you're trained too.

Like you know best and you tell everybody what to do. Oh, I love that. But what I love about what you just said is that nobody, I've asked so what we're like four months into this year. Nobody has said that there is a way that they show up in a relationship that is self-love to them. That is what I just heard and what you said. And it was beautiful. Thank you. So I swear I could chat with you forever. So thank you for joining me. Be part of your, especially the beginning. And I wish you all the luck. If there's anything I can do to make it better or to come again, I would be happy to help you. I just love chatting with you. So we'll keep bringing

you back. Any opportunity I get is amazing. Perfect. Well, Let's hope you have some good questions or a good conversation from this on your podcast. Definitely. A little healthier brains. How do people find you, by the way, because you have so many interesting things. Well, the best place is the website, bosmd.com and the YouTube channel. You type in Dr. Bos. You can find me.

YouTube is the number one place where I put my energy. That's what I always say. It's easy to splinter and do in a lot of places, but I kind of focus on YouTube. So smart. Awesome. Thanks. Thank you. You bet.

That was awesome. Yay. Oh, my God. I love talking. Thank you so much for joining me. in today's episode. I love bringing thoughtful discussions about all things health to you. If you enjoyed it, we'd love to know about it. So please leave us a review, share it with your friends, and let me know what your biggest takeaway is.