The Ultimate Human with Gary Brecka - 253. Dr. Jessica Shepherd: On Menopause, HRT, and Longevity Tips for Women

Starting point is 00:00:00 We've always idealized medicine as direction in order to give someone what they need to do in order to be their best health. So why is it that we have the best of research and the best of resources and we're not applying it in the way that people can actually live longer and live well? The system is very expensive. And by shifting some of that health care spending to the preventative care, it's almost keeping people out of the system. We're classically trained as humans to ignore what your body is telling you until it tells you. you something where it's catastrophic. This is why there is such a prevalence of autoimmune disease in women because where does autoimmune prey? It preys on the week. I am really trying to capture women before they hit menopause to give them the best building blocks so that at 60, 70,

Starting point is 00:00:46 and 80, they are optimized instead of waiting for it to be a catastrophic fall off the cliff. Especially for the women and for the men that are listening. Where do they start? You know, Gary, that is the million dollar question. Well, I do have several answers. One is What if I told you that 50 million women have unnecessarily suffered for decades because of one misquoted study? Today's guest is someone I've been trying to get on this podcast for months because my wife, my team, and this entire community have been demanding it. Dr. Jessica Shepard is a board-certified OBGYN, menopause expert, minimally invasive gynecologic surgeon, and the founder of modern meno, a global community empowering women through midlife and beyond.

Starting point is 00:01:39 But here's what makes her different. She didn't stay. in the system. She could have kept her head down, made a great living, and played by the rules. Instead, she chose to blow the whistle on how women's health has been catastrophically mismanaged, and she's rewriting the playbook. In this episode, we're tearing down the myths around hormone therapy. We're talking about autoimmune disease and how it attacks women at epidemic rates and why perimenopause starts in the 30s, not in the 50s, and what the hell happened with that FDA black box warning that terrified an entire generation of women. We're also diving into the frozen shoulder mystery, the maternal mortality crisis, and why muscle is your metabolic currency,

Starting point is 00:02:16 and how creatine isn't just for bodybuilders anymore, it's for brain health. This is one of the most important conversations we've ever had on this podcast. And if you're a woman or you love a woman, you need to hear this. So welcome to the ultimate human podcast. I'm your host, human biologist Gary Brecker, and today we're going to go down the road of everything women's health, menopause, longevity, and the science that will change your life. Let's go. Hey guys, welcome back to the Ultimate Human Podcast. I'm your host, human biologist Gary Brecker, where we go down the road of everything, anti-aging, biohacking, longevity, and everything in between. Today is one of those extraordinarily special podcasts. I have been wrangling to get this guest on the podcast for a while

Starting point is 00:02:57 because my wife, my staff, and my community are huge fans of hers. So today, welcome to the podcast, Dr. Jessica Shepard. I am so excited to be here. We've been meaning to do this for some time. Yeah, we, you know, it's funny, we've been together in other places, like in Saudi, but then it didn't happen in Saudi. And you're from Texas, Miami, so eventually we wrangled it here in Miami. We did it. So, you know, the, by way of background, you know, for my audience, I say this a lot. There's a theme that kind of runs through a lot of my podcast guests,

Starting point is 00:03:30 whether they're a soccer mom that solved the problem, an addict to fix their addiction. but they're the most impactful and passionate purpose-driven people in the world. And I know that you're a classically trained physician. Yeah. But at some point, there was a shift in your career and your career choices. And I'm always fascinated by that because comfort would dictate that you just stay in the system, do what the system tells you, you make a good living. Kind of keep your mouth shut.

Starting point is 00:04:02 Don't raise your hand. But I wonder if there was, what preempted that shift? You know, there are really pivotal moments in your life where everyone gets choice and to decide what they want to do with that moment. And my background, a little behind the scenes about me, is I got my undergraduate degree in kinesiology, exercise physiology. So I really understood what the body could do, what it could adapt to, when it's optimized. So I feel that the beginning of my medical career was in the best of,

Starting point is 00:04:40 the best of what the body can do. And so going into medicine, obviously we know how to fix train wrecks. We deal in illness and disease, which is great. We do need that side to society. So now practicing 15 years of seeing the worst and fixing disease and operating. I did a fellowship in minimally invasive of gynecology. So it's high volume surgeon. But what I really started to understand is the story. The story behind the scenes of all these women that I would see in the exam room. And I knew deep down, I was like, there's something else going on. And that something else is all the behind the scenes thing that allow people to show up with disease, whether that's with nutrition, exercise, stress, emotional issues that are going on, actually feed into how we present in chronic

Starting point is 00:05:31 as well. And so I think that that was the pivotal moment that I said to myself, I have to do something different. And that's when I ventured more into looking at root cause, looking at lifestyle, being able to actually educate while empowering women about their life, especially in midlife. And I think that's like probably as a category the most underserved in this whole biohacking longevity space. Because, and I say that with absolute conviction because, my wife and I went on her journey. We did it as a couple, you know, through menopause. Yeah.

Starting point is 00:06:09 And what I learned by going on that journey with her was, number one, the paucity of good information that is out there for women to cling to. I think recently when the FDA removed the black box warning from female hormone therapy, I think that was sort of the shock heard around the nation that, wow, maybe we got this all wrong. and maybe hormone therapy is not as detrimental for women. And I would certainly love to spend some time. I want to delve into cortisol and I want to delve into why autoimmune disease

Starting point is 00:06:42 is found 82% of the time in females because it's certainly not sex selective. So why is it selecting women? What makes them fall prey to the vast majority of autoimmune? But also, you know, the pre-perry and menopausal phases for women because in my own personal journey with my wife, I was surprised how early in life this can start for women. I think most say, if I still have a period,

Starting point is 00:07:08 I can't be in that phase. Yeah, I think we affix a period or a menstrual cycle to functionality in the sense of nothing's wrong, right? Or nothing is changing. And that's really not even biologically how our bodies work. Nothing shifts overnight. It all is a process. And so when we think of perimenopause starting in our latter 30s,

Starting point is 00:07:28 all the way through our 40s. I think it's very astounding. Even when I tell my patients that that is really the duration of what happens, they sit and think about it. It's like you see the light bulb go off because one, either they're going through it and have been for years or two, really sitting to say, oh, my body is going through a transition that took years.

Starting point is 00:07:47 That's how the cells work. That's how we see changes in the body. And especially with hormones when we see the flux between estrogen and progesterone, whether they're, you know, counteracting each other. they didn't before or on a decline, that takes years. And you know, I think if there was just one way to torture a woman, it would be like the estrogen lever, right?

Starting point is 00:08:07 Oh yeah. Oh, saggy skin, mood disorders, libido leave in the building, poor sleep, brain fog, you know, crushing fatigue, all with one little lever. Yeah. And, you know, testing for it, I think, is also something that's really poorly understood. I think most people will do blood tests that are snapshot in time and I can't tell you how many women came through our functional clinics, and their blood work was quote-unquote fine, you know, within normal limits.

Starting point is 00:08:35 And that's what you'll typically find is that you're just fine. I, you know, classically trained as a physician. That's what we were taught is we're really looking for abnormalities. And I said that before is we live in the world of illness and disease. So we're always looking for something that is really wrong. When really what we should be looking at as the human body is it transitions for both men and women, but for now women is even in the moment of it looks within normal range, how are you feeling? So we have not kind of brought the experiential part of perimenopause onto the actual

Starting point is 00:09:09 fundamental science behind it. And that's where we are now is being willing to hear women when they say, I feel A, B, C, D may not show up in a lab. As a hormone malfunction or dysfunction, it actually is experientially what the receptors to the hormones are experiencing, which gives them the symptom. So we just have to listen more. Yeah. Imagine that. Listening more. Men are classically trained to not do that. Yeah. Halfway through your sentence, we're getting out the pool box and we're going like, let me tell you how to fix that. Right. So imagine that laundry list that you were talking about of sleep, of anxiety, of periods changing, of hot flashes night. So that list is pretty hefty. So imagine going through that list when you're in a doctor's

Starting point is 00:09:51 office, but there's nothing on a lab to say, yeah, I understand what you're saying. Yeah. You know, And when we really started peeling back the layers for my wife, it really began years before, whatever you wanna call, she hit the wall. And I would say hitting the wall was like the obvious hot flashes. And I was like, oh, you're in menopause. Okay, so now I know what to do. She also had frozen shoulder, which was pretty wild.

Starting point is 00:10:16 She had adhesive capsulitis and she had actually an orthopedic that wanted to do manipulation under anesthesia, put her to sleep and basically break these, you know, adhesions and we saw them on an MRI so they were there never in a million years did i ever correlate that back to menopause i didn't even correlate that to menopause for a long time until you know recently maybe in the last three years at looking at the data and the science but now connecting it to what experiential when women were like my shoulder my shoulder hurts right that's just coincidence right yeah i mean and hers she i mean she couldn't get it above here and it was so painful. Like she could ski like a crazy person. She's probably would have been a professional

Starting point is 00:11:01 skier if she's, she was born in a steamboat. Um, but then, you know, leaning down to a like unbuckle her boot would take her to the ground. Yeah. And, and then we started really talking about, you know, like rain fog and like, you know, for, for almost a year, she just couldn't wake up in the mornings. Like, she just could not get out of first gear. And we couldn't figure it out. I'm like, you really slept, you sleep scores decent. You know, we're tracking everything.

Starting point is 00:11:30 And like, I'm always looking at, like, the data never linked it back to menabal. So I wonder if we could just back up and for, especially for the women and for the men that are listening. Where do they start? Like,

Starting point is 00:11:41 what are some of the early warning signs? Is it mood changes? Is it weight gain? Water retention. Is it all of the above? It is. It's really all of the above. I say that,

Starting point is 00:11:51 you know, every woman who enters this midlife phase is really a moment. for them to be more self-aware. Self-aware in the sense that I'm actually going to pay attention to me. Imagine that, right? So pay attention to what's going on in my body because guess what? The story is going to be different for the next one beside you and thereafter. And so that can come in the brain fog.

Starting point is 00:12:14 I would say even for me, my journey, it was brain fog. So imagine this. I'm a board-certified OB-GYN, menopause expert, wrote a book, and my first symptom was that brain fog. that executive functioning, clarity, memory, and it took me roughly about six months to put the pieces together. Right, because there's also denial that goes with this, right?

Starting point is 00:12:35 Yeah, yeah, yeah. The plumber always has a leaky faucet. Yeah, you know, there's nothing really going on. Or you attribute it to something else, I'm stressed, this, that, this. And finally, I was like, holy hell, Jessica, you know, you are perimenopausal age and you are having symptoms. the good thing is that I had the kind of the self-awareness to kind of put the pieces together, but I also had the tools and the resources.

Starting point is 00:13:00 So immediately I was like, well, hormone therapy is what I'm going to choose. But for women who maybe don't have that luxury of knowing everything, and I'm sure we'll dive into that, is the symptoms that start are very subtle, but in that is the consistency behind it, right? Symptomatology usually is based on not a one-off or something that happens and you never experience it again is now it's coming, maybe not as frequent, but I notice that it's there. And so not to dismiss those feelings of what you're feeling

Starting point is 00:13:28 and then finding someone to discuss that with you. Someone who, again, is going to put the experiential part of hormone changes in midlife onto you are actually going through it. So that can start anywhere from latter 30s, 38. I'm not going to put an age out there, but latter 30s. And going all the way up until you actually hit, like you said before, that wall of menopause, which is where your estrogen now is like flatlined.

Starting point is 00:13:52 It's like we're not here anymore. But all before that is the fluctuation. It's high, it's low. It's like I'm going to stay steady here. Now I'm going to go lower. So all that time is when you're going to start to feel these symptoms either start, become more frequent, more intense, or more severe. And, you know, I'm so glad that you say that because that's exactly what we experienced.

Starting point is 00:14:12 You know, she sort of no longer became a morning person. And then she's, you know, we started our business together. She's intensely organized. She's a list taker. She's a list checker. Like super, super organized, you know, financially and the operations of the business. And I was teasing her about, like, did you just leave your brain at home? So did she attack you then or later?

Starting point is 00:14:39 Oh, no, every day. I basically just woke up every morning and apologized. Good morning, babe. I'm sorry. And for what? For what? I don't know. I just want you to know.

Starting point is 00:14:48 Yeah. I'm sorry. and she wasn't going crazy but you know it was it was you know the lack of libido yep it was the brain fog which she never had you know and then it was she's she's very thin and and she just started noticing dramatic changes in her skin she's always had beautiful skin and like around her jowls like seemingly all of a sudden and i wasn't linking any of this back to you know um menopause and until the frozen shoulder in the night sweats. That was like, you know, and I think everyone knows that the night sweats are classic.

Starting point is 00:15:24 But what did your journey and what do you recommend for women who are starting that journey and like, wow, that sounds like me? Where does the test start? What does the testing look like? Because you hear people say we can get it all from a blood test. We did one called a Dutch test, which actually gave us a lot of information. I was fascinated by how accurate that was and how the results mapped directly to the symptoms that she was having, there wasn't almost a single ailment that wasn't unanswerable

Starting point is 00:15:53 by those results. So if a woman came to see you in this phase, what would that sort of transition look like testing and what having? The transition. So testing is a little tricky because, again, the estrogen and progesterone are still there if you have a cycle. Right? So we know in menopause you do not have a cycle anymore, which states that the ovaries are not eliciting enough estrogen release to give you a cycle. So while you're still having a cycle, whether it's infrequent, if it's a regular or regular in the perimenopausal phase, we know that estrogen and progesterone are giving off enough to give you a cycle,

Starting point is 00:16:28 just not enough where the rest of your target organs, your brain, your muscle, how your fat is distributed, are now actually responding to that flux. So the goal is in testing is not necessarily to tell you, am I perimenopausal, it's a good starting ground for a conversation. Because what, at the end of the day, is the most important, the experience of what you're doing. So I can come on the back end and saying, I still think you're worthy of hormone therapy. If that's what you choose, this is where we're going to start. Now, the Dutch test, I think, is good for looking at metabolites or variations of your estradiol

Starting point is 00:17:05 and your progesterone and what they're actually doing, right? It's a good follow through to see exactly where their peaks are, where it's a lot of, It's maybe going down a little bit. That is more extensive. But if someone's just basically trying to see where am I, I always say, yes, your estrogen and progesterone, your FSA is good to look at, but also things like cortisol, thyroid, also your vitamin D. Because now you're going to start to see deficiencies in other parts of your body

Starting point is 00:17:34 because you're going through this transition. In medicine, what we typically do, like I said, we are good at disease. I am really trying to capture women before they hit menopause to give them the best building blocks so that at 60, 70, and 80, they are optimized instead of waiting for it to be a catastrophic fall off the cliff. That's really what we're trying to do

Starting point is 00:17:56 when we think of longevity, looking at hormone therapy in mid-age, is really that opportunity, that chapter to say, my next chapter is coming, 40% of our lives are spent in the post-menopausal phase. What do I want this chapter to look like? Let's start mixing up the recipe a little bit.

Starting point is 00:18:11 Yeah. You know, and I think it's important to note that these are not things that jump out of the labs, right? Do not. And I think we always wanted to be so black and white. Okay, hemoglobin A1c6.4.

Starting point is 00:18:20 That's what we told women. Bribetic. Yeah. This is incident. It's not that clear. It is not. It's the whole picture. And I love how you are talking about

Starting point is 00:18:28 the symptomology, the subjective part of the health history that says, this is how I feel, this is how I wake up. This is how I think. This is my mood, my emotions, my libido, my energy levels.

Starting point is 00:18:40 I mean, those are all classic signs. And I think just as adults, I mean, men and women, we intentionally try to sometimes ignore these. Oh, we are classically trained as men and women, as humans to ignore what your body is telling you until it tells you something where it's catastrophic. And that's when we say, I may need to take care of that. So it's trying to kind of front end that with being like, let's pay attention to our bodies so much that the moment something, is changing, we can start the conversation and not wait until it's a train wreck. Yeah. And I think, so the blood panel testing, I will say that three weeks, almost to the day, after my wife started hormone therapy, complete game changer.

Starting point is 00:19:28 Isn't it? And you were seeing this like first hand. Yeah. I mean, libido came back. Yeah. And I think sadly in a lot of a lot of marriages and relationships and relationships. relationships, you know, when libido leaves the building, you know, they think that love and attraction has left the building and it starts to create a lot of unnecessary friction in a relationship. So libido came back. Her sleep almost immediately in that period deepened. The frozen shoulder went away and after the three-week period, probably 10 days after that. That's amazing.

Starting point is 00:20:01 I mean, she went from here to just being able to put her hand straight up in no pain. And these were adhesions. Wow. And I've been down the rabbit hole of, you know, what is the mechanism of that? Because I just thought I never made, you know, drew that correlation. And then I think like we talked about when the FDA, you know, removed the black box warning from female hormone therapy. And the chairman of the FDA came out and said, hey, 50 million women have unnecessarily suffered because this study was misquoted. And the mainstream media loves controversy.

Starting point is 00:20:35 Oh, they love sensationalizing. This is going to kill you and they're going to die. And I think so many women, millions and millions of them, just completely hormone therapy was off the table because of. I think we look for, you know, in general direction, especially when it comes to your health. That's what we've always idealized medicine as direction in order to give someone what they need to do

Starting point is 00:21:00 in order to be their best health. So when the WHA, you know, kind of came out with this, kind of catastrophic message, it really did, one, misaline what providers thought, you know, we do no harm. And if we're thinking, oh my goodness, I gave something that may be of substantial harm to a patient, the first thing we'll do is saying, I'm not doing that anymore. So now you have kind of the director of this relationship between physician and patients being like, I can't give that to you. And then patients also seeing it on their level because it was brought in the media way that it was brought was to everybody, right? So now the public is like, oh my God, now I've done something

Starting point is 00:21:40 to harm myself. And so that really annihilated the benefits, which we now know and have known for years of what hormones can really offer you not only for symptoms. And that's, you know, something that we can discuss is hormone therapy. Yes, there's symptoms that we've discussed over and over again now, but also longevity. What is it due for preventing chronic disease? what does it do for brain health or bone health later on in life? Those are the conversations that we really should have focused on when looking at the benefit of hormone therapy. Yeah, I wholly agree with you.

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Starting point is 00:23:20 Join the VIP community at the Ultimatehuman.com forward slash VIP and step into your ultimate potential. Now let's get back to the Ultimate Human podcast. I think a lot of women, you know, they're getting into this too late. And I've heard you talk about target timeframes where, like, there's a good, better, best, right? There's never a time where there's no hope, but there's a time where it's good, a time where it's better and a time where it's best. And relative to hormone therapy, what does that look like for women? That was one of the things that the WHA did get wrong in the study, because the idea, fundamental of the study was cardiovascular risk and what can we do to decrease

Starting point is 00:24:01 cardiovascular risk because heart disease is the number one killer of women so that you know when we're looking at a study we're like this is this is good we're gonna look at something that has great outcome unfortunately who they used hormone therapy and in the study were not the best and we're talking about good better best of who we should have been using these were women who were on the average older than menopausal age so they were way in their elder 50 into 60s, smokers, people who had history of heart disease. So again, that's not ideally who you want to start hormone therapy in.

Starting point is 00:24:33 Who you do want to, for anyone who's listening, is in that late perimenopause into early menopause transition, which could mean if you wanted to put a tag on it on age, maybe 45 through 55. And that is when we start to see the flux in hormones and perimenopause, you're still having your cycle into that early time frame, probably within the first five to 10 years of not having a cycle is the ideal time. Do you want to know why? I think you want to know why. He's like, I kind of already know. And my audience wants to know why. But we're, we're dealing with symptoms, so we're minimizing and resolving some of those symptoms, which can make a woman's life very

Starting point is 00:25:10 frustrating. But the other part and benefit of estrogen and progesterone and testosterone is that it has such stark relationships that are beneficial when we think of glucose metabolism, brain health, decreasing inflammation. Estrogen really is. is one of those robust hormones that is an anti-inflammatory, right? We know that inflammation is one of the main causes of disease. Root of all evil, yeah. But it is. And then we talk about glucose, right?

Starting point is 00:25:37 So sugar. Like how is it manifesting in a way where it's going to control your glucose better? And then the last thing is your organs need estrogen. Your estrogen receptors all over. So we're losing muscle mass. So when estrogen is lost, we're not able to kind of get our lean muscle mass like we like, our gut health. Gut health is imperative for future in disease prevention,

Starting point is 00:25:59 but also heart muscle and brain. So bones even. So I could go on and on about the receptors that are needing estrogen. So when you lose it, your body is like, what do I do now? Yeah. So I really think that timing is important,

Starting point is 00:26:12 that 45 through 55. And that's loose numbers. That's not saying if you start after the age of 55, that you're not going to get the benefit. But we want to get you before the body starts to have the inflammatory response. Now you've been exposed to your heart muscle not being optimal. So you're increasing atherosclerosis and things that are going to cause heart disease.

Starting point is 00:26:31 You know, I think, too, it's important to talk about the impacts on hormones that are not directly related to hormones. Yeah. Things like stress, like, and we're going to get into diet and lifestyle choices, but hormone mymetics, you know, cosmetics, yeah, but microplastics. I mean, these things, that don't make their way into the mainstream discussion in mainstream academia. But we've seen mold and micro toxin infections, severe heavy metal toxicity, and just the overburden of micro toxins, you know,

Starting point is 00:27:10 between the glyphosate and the paraquot and the microplastics. And individually, maybe individually these things are not catastrophic on their own, but at some point you're just overstressing the system. Yeah. And women, I think, in general, have a tendency to develop things like caregiver syndrome where they put the needs of everybody else before the needs of themselves. You know, they're used to raising a family or taking care of a spouse or kids or coworkers or their career or any number of things.

Starting point is 00:27:41 And they sort of start slowly putting themselves into the back seat. They are usually in the bottom of the list and the back of the line. And that's why I was saying earlier this time. to focus on you is very hard. For someone who's put everything else ahead of them or in front of them is to now being like, what? I have to pay attention to me and pay attention to my symptoms and what's really bothering me.

Starting point is 00:28:06 And then being able to come back and say it to someone is actually a leap from what they have done for so long. So there's a little bit of like uncomfortableness with kind of guiding women in the sense of, I actually want you to pay attention to you. and actually then come back and be able to tell me how you're feeling. And they're like, say what? Like, you get to be selfish.

Starting point is 00:28:30 You need to talk to my husband and tell him. Write me a script for this. Yeah. Because, and I think this is why it starts to give us shed some light into why there is such a prevalence of autoimmune disease in women. Because where does autoimmune prey? It preys on the week. And what makes you more susceptible? you know, anything that degrades the immune system, chronic stress, being in, you know, a sympathetic

Starting point is 00:28:56 state for too long. I think women very often don't feel safe in their own bodies. That makes sense. They are taught that, not to feel safe in their own bodies. And this is where I go on, like, my emotional kind of like landscape. Do rip it. Let's go. My Woo Woo MD version is we have been taught that, but also the chronic stress, we absorb. We are emotional. absorbers of everyone else around us and that actually wreaks havoc internally increases inflammation the body keeps score if there's traumas that they've endured early in their life how we socialize women to think is a big part of that as well but you know dr. Gabor Matte he is an MD but he is a psychiatrist and focuses on

Starting point is 00:29:42 trauma and what trauma holds in the body but he also understands that the trauma can and then reveal itself externally as autoimmune disease. So, you know, it's all linked in how our bodies are responding internally, which sometimes we don't see externally, which is hard to capture, is that it manifests as autoimmune disease. But also estrogen is a potent anti-inflammatory. So it only makes sense that you start to see autoimmune diseases impacting women or the diagnosis of in their 40s and 50s.

Starting point is 00:30:13 Yes. And so that is everything together. Yeah. Yeah. there's a parabolic spike. And you know, what's interesting is now you bring that up is I was looking at epidemiological data and men analyses. And men and women tracked very closely until that sort of mid-40s time frame.

Starting point is 00:30:30 Then there's this sort of parabolic spike and they start to depart the, you know, men in autoimmune disease. So if we were to go back into lifestyle choices, diet, sleep, exercise, exercise, and, you know, hormatic stresses. So for the women that are listening to this, what does a low-inflammatory pro-hormone, if you will, healthy immune system lifestyle look like? What are some of the interventions that you do that are not hormone-related or supplement-related? Yeah, I think that goes down into gut health. And this is where I think this is imperative that we do a better job at creating infrastructure where gut health is very important because the gut also has estrogen

Starting point is 00:31:17 receptors. And so the ability for the gut to have less permeability rather than more, which is what happens with aging alone, but also with estrogen decline, we do see that the gut takes a very big hit in what it actually allows for it to come out, which is the thing that should stay in and vice versa. And so what we need to do is focus on anti-inflammatory ways to heal our gut or keep our gut safe as possible through anti-inflammatory foods, but also this is where you start to see more deficiencies in vitamins as well because of what our gut is kind of pushing out, which really shouldn't be pushed out. So I always say that the way to best treat the gut is to decrease, obviously, your processed foods. It sounds easy, but when you actually look at diet of most Americans

Starting point is 00:32:05 and in the westernized population, processed food is still a very big part of what we consume. And then the other thing is more whole foods and protein. And whole foods in the sense of make your plate the rainbow, incorporating more less cooked, less processed foods, and then protein. We have not established for women especially how important protein is for our diet in order to sustain lean muscle mass, but also it helps with our brain, with our brain health too. So our gut talks to our brain. Oh, And so when we were talking about brain fog, it does. And clarity, a lot has to do with what we're putting into our bodies. I would say, even though it's considered supplementation, I do find a space for supplementation. The best way to get your vitamins and your nutrients is through your whole foods, what you consume. But we usually are lower than we should be. So I would say, people always ask me, what's your top three? I usually say it's very individualized and personalized because when I have people come to me and I read through their labs, everyone will have a different story. But, Most women will have a deficiency in vitamin D, in vitamin B 12. Catastrophic, yep.

Starting point is 00:33:17 And fiber and protein are the other two that I feel need to be kind of heightened when we think of what we need to do with our diet, but really looking at things that are going to help decrease inflammation, but also substantiating the parts of our body that is like, we are really at a deficit right now. How can you help me? Yeah, and I think that protein, you know, consumption by women is woefully inadequate. thought leaders like you, Dr. Gabrielle Lyon, you know, talk about this a lot. And hey, thankfully, we just flipped the food pyramid upside down.

Starting point is 00:33:46 Yes. I mean, literally we pulled it out for the ground, turned it upside down, set it back down again. And people were crazy, but we, you know, when I see we, because I'm aligned with the maha action, Bobby Kennedy's Maha action. And by doing this, we ended the war on saturated fat. And we ended the war on protein,

Starting point is 00:34:09 and we really began the discussion about how much of our caloric intake is just coming from high glycemic carbohydrates, you know, so many people being insulin resistant and the impact that that has on your hormones because, you know, I feel like it's very rare in human beings for multiple systems to just break down all at once. You know, there's usually an early domino that starts to fall. It's just like that one that like tips the line.

Starting point is 00:34:35 Yeah, right. And, you know, I think bloodshur, is one of those. Oh my gosh. It is like, I don't even know if it's a slight tip. When the glucose goes out of control, I mean, those dominoes are like going down. So how is important is it for women to meet their protein equivalent and to control their blood sugar?

Starting point is 00:34:54 And if they don't know what their blood sugar looks like, what does a lab test look like for them to get the data that they need? I love, so I think that blood glucose is definitely something that we are good at in labs, right? And so we're good at what is that when we usually draw a glucose, people will be like, my glucose was great. I'm like, but that was at the time. At the time that I drew your lab, that's what your glucose is showing me. So whether you had something that had high glycemic index before or not, that's what it's showing me. One of the best ways that we can do that is a

Starting point is 00:35:23 hemoglobin A1c, which is our glycosylated hemoglobin, which really shows us retrospective analysis of what your body does in order to manage glucose. Because it's really the management of it. Right. And what your body has in reserve versus what your organs are able to, to shuttle glucose as a fuel into it, especially your muscle and your brain. And when we look at a hemoglobin A1C, it's really giving us a three-month kind of picture of where your body is and how it metabolizes glucose.

Starting point is 00:35:54 That really is the best way for us to say, this is where you are. We don't want you to go into pre-diabetic phase. We don't want you to be a diabetic. But if you're close to that number, here's what we can do to kind of offset that. another way to watch your hemoglobin A1C. I really like a CGM.

Starting point is 00:36:12 So constant glucose motor. Continuous glucose modern. And the reason why that's important is because you and I will have different responses because of gender, but also maybe movement, maybe lifestyle, of how we utilize glucose. Foods also in response to how our bodies do that is quite different as well. So I have people who just ethnically are going to be able to metabolize rice better than some other.

Starting point is 00:36:36 And so if you don't know that information, then you are going to go by a template of what is good for you. Right. And sometimes that's not the best way to feature how nutrition is being implemented into your body and your body is able to utilize that glucose in the best way. If you want protein to build lean muscle, but without the caloric impact or need to cut, you need perfect amino. It's pure essential amino acids, the building blocks of proteins in a precise form and ratio that allows for near 100% utilization. in building lean muscle and no caloric impact. So we build protein six times as much as way, but without the excess body fat we normally get during bulking.

Starting point is 00:37:16 This is the new era of protein supplementation, and it's real. If you want to build lean muscle without having to cut, you need perfect amino. Now let's get back to the Ultimate Human podcast. And so once we have this information, you start to, I think the CGM is a great idea because I, I wore one for a while and I was surprised by a lot of things

Starting point is 00:37:39 I did too really surprised I was fascinated there's one thing I love telling the story what your body does in response to lifestyle I had to see GM

Starting point is 00:37:48 and I just I did mine for just two weeks I'm not the one who like where is it 12 months a year it's like a wooing it can sometimes be paralysis of analysis I know I know I'm like take it off I had a good night sleep no you didn't right

Starting point is 00:38:00 it's like you're on on the line of like looking too much at it I had a CGM on and I did a coal plunge. And it went down within, it brought my glucose down significantly after doing a cold plunge. So imagine if we know, yes, your body was responding to that stressor in the best way possible. So imagine we had that data in order to know not only the food that I'm intaking, but maybe if I take that 10 minute walk after I eat a big meal. What if I'm able to do sauna and cold plunge every day? What is that going to do to my glucose?

Starting point is 00:38:33 So I think it's just a great way to see how you can instill every part of your lifestyle and nutrition into what's keeping your glucose maintained at the level that you needed to. Yeah, I think, you know, I had a group of people that put these on for a couple of weeks. And I think most people were astounded that after fasting all night and sleeping, getting up in the morning, they would start to move around and all of a sudden their blood sugar would start to rise. So like, how is this possible? Right, right. I'm even eating. I'm like, well, that's your liver actually. Yeah.

Starting point is 00:39:00 You know, going to work. This is a good sign. And, you know, it's taking the glycogen, the stored sugar, and creating glucose. Because they needed it. They're like, don't pass out. Yeah, yeah, yeah. It's fascinating. The body's a beautiful machine.

Starting point is 00:39:12 It's such a beautiful machine. If we treat it right. The more I study it, the more I believe in God, too, because I just don't think this whole thing happened by chance. I don't think you and I, or even, you know, as many thought leaders in the world could have put it together better than. The greatest team of engineers give it all the AI you want to give it. You're still not going to figure it out. I mean, this is such a beautiful design, so architected, so incredibly. But, you know, I was very surprised by that.

Starting point is 00:39:37 And I think the group that I was doing this was really surprised by that. And then also, like you said, you know, looking at higher fat, higher protein, high fiber meals versus high glycemic meals. And the duration of the elevation for a lot of these timeframes after meals, it just gives people a really good way of saying, I'm, I now have a roadmap for, how I should be eating and the positive impact. It's just a 15-minute walk after a meal. Do you know how key this is, what you're saying right now, to when we would bring people in

Starting point is 00:40:13 and give them diabetic counseling, right? So now it's on paper with some messed up, you know, food pyramid that is not even relevant anymore. And I'm trying to explain an educational way, like, this is why we need your glucose, the glycemic diet does this to it. but it was never a picture of what they're actually doing in real time. Yeah.

Starting point is 00:40:35 So now for someone to see it is only incentivizing them to being like, oh, I want to keep it there. Yeah, yeah, exactly. I want to keep it at that good level. Yeah, you kind of gamified. That is the best way for me as a like high, you know, research, evidence-based physician to bring something to someone and being like, this is you at its finest. What do we do from here?

Starting point is 00:40:53 So I want to bring it back to the autoimmune discussion because it's such a, it's, It's such a prevalent challenge in society. And a lot of times when I do stage talks or lectures, and I've got a big audience out there, I'll say, raise your hand if you or someone you love has been diagnosed with an autoimmune disease. 75, 80% of the hands go up. I'll say, raise your hand if you or someone you love

Starting point is 00:41:20 has been diagnosed with more than one autoimmune disease. That's the part that really astounds me. at least half the hands that went up go up again. And it's purely anecdotal and subjective, but I've done this all over the world in very large audiences, and it is astounding to me. I didn't go three, four, five, but how many people have compounded chronic conditions?

Starting point is 00:41:44 Absolutely, yeah. And I think that one of the areas where there's a lot of posse of information is, what does a lifestyle or a morning routine look like that really empowers the immune system? Like how do we, women especially, strengthen our immune system? How do they feel safe in their body? What are some of the lifestyle practices that they can engage in?

Starting point is 00:42:06 Oh, I love this question because I think, and not to kind of throw shade at male biohackers. You don't. Well, you're on a male biohacking podcast, so being careful. I know, right? But for females, like we said before, they're cut this part right out. You're like, and cut. Thank you for coming, Jessica. And we're done.

Starting point is 00:42:25 But they take on so much that sometimes they don't find the time for themselves. So going back to that, that really was the point I was making is teaching women to take time for themselves. Even if it's just 10 to 20 minutes a day, these small implementations in their daily life can do outstanding work. So some of those things are, I'm a firm believer in some form of meditation. So good. Because when you have mind-body, if we think about autoimmune in general, it is literally the body cells attacking its own. own, right? Yeah, yeah. So we know that there's inflammation. We know that there's some type of attack going on. So when we think of mind-body medicine is really regulating the mind in order to

Starting point is 00:43:07 kind of tell the body what to do. The body is just a vehicle of what is going on in the mind. So true. And so if we look at it just like if someone could just take a step back, whoever's listening and saying, wow, I never thought about it that way, is that your body is literally just doing what the mind is telling it. So if we can find a way to quiet the mind, mind, there is a lot of data that shows that meditation in some form of mindfulness can actually help with disease process, decreasing chronic progression of a disease. So starting with that, firm believer in that. And it can just be 10 minutes, 15 minutes a day. The other part is what you put in your body. Really taking a good look at food log, right? What have I done?

Starting point is 00:43:46 I challenged my patients to do this. I'm like, just give me two weeks of what you're eating. Don't try and eat the healthiest things. Just give me like raw data. I just need to know. know what's going on. From that, I can make adjustments to being like, this is not serving your body well as far as inflammation because that's the fuel for autoimmune diseases. It's like inflammation. If it's got it, it's like, I'm on. Fire is lit. Matches or lit. So there's diet. And one of the best things that you can do in the morning is because that's when your cortisol is really high is not to create more cortisol, right? And so what are the things that you can do? I think that having something as simple as water with lemon is a way to

Starting point is 00:44:25 kind of neutralize and get your body ready for what you're going to put into it for the rest of the day and not eating a high glycemic thing first thing in the morning, right? So we're really trying to keep inflammation down. We agree with that. And you can have more sustainability throughout the day with energy if you start with protein. And the last thing I would say is always exercise, right? So however that can look. It does not need to be a full out hour. A lot of people don't have time for that. So I always appeal to, I say this even in medicine, if we're talking about disease progression is if you can take care of the person who has the least resources, then you're reaching everybody.

Starting point is 00:45:02 I completely agree. So I can't always, great, I want all the gadgets and all the things, but I got to go to work. Unfortunately, I still got to go to work. So I'm like, if I can take care of someone who has all of these responsibilities and taking care of all these people, then I know I've reached everyone. So that could be, again, it could be jumping rope, right? It could be taking a walk for 10 minutes.

Starting point is 00:45:23 Imagine if you did that routine for every day, getting up a little bit earlier in order to give yourself this 30 minutes, 45 minutes of self-care, you will show up a better person at 70, 80, and 90. And that's what we're trying to accomplish. You'll not only show up as a better person then. You'll show up as a better person almost right away. You know, I made a choice about six years ago that I would schedule all of my meetings. and travel around sleep and exercise. And there's exceptions to this sometimes scheduling-wise. But, I mean, if you open my phone right now, you will see, I mean, my morning is blocked in there. And I won't make exceptions to this, but by and large, I mean, you could go three months out of my schedule right now and see, okay, well, if I'm in London, the meetings don't

Starting point is 00:46:16 start before then. If I'm traveling, rather than take the red eye, I spend the night and leave the next morning at a reasonable hour. Just that small little shift and then realizing that self-care is not selfish, it's actually the best way to be selfless because you can, you take this time for yourself and then give the rest of your day away. Yeah. You can give so much more when you are filling your reserve. We were even talking about that earlier. When someone falls ill or is sick or is not feeling their best, a lot of it, you can't ever evade that, right? But the goal is, what have I invested in myself are given back in self-care that when these things happen, I have reserve and I have

Starting point is 00:46:56 recovery. Yeah. Yeah. You know, being affiliated with this MAHA committee, we looked at some of the broad statistics of healthcare spending, pushing about $5 trillion a year, healthcare outcomes. We essentially lead the world in morbid obesity, type two diabetes. Which is, isn't that weird? It's incredible. It's really fascinating that that's, that's, that's, that's, we're number one in that. Like that's not what we're trying to be number one in, but somehow we have gone there. But, and then there's a lot of evidence that, you know, we lead the civilized world in infant and maternal mortality. That one brought me to a full stop. Yeah.

Starting point is 00:47:35 Right? Because all you have to do is walk around Disney World to realize why we're leading the world in morbid obesity. Yeah. But, and I've heard you talk about the crisis in black women. Yes. Which are three to four times more likely to die of childbirth, which is astounding to me. you know, and when we look at when disease and pathology seems to be selective, like autoimmune disease and women, we have to take a step back and say,

Starting point is 00:48:02 okay, what is what is happening there? Because these, you know, mortality is not sexually selective either. And it's also, I wouldn't assume, racially selective. So what is the impetus? What is the bad story? You know, Gary, that is the million dollar question. Well, I do have several answers. One is a black woman myself, but also an OBGYN.

Starting point is 00:48:22 This is something that I'm seeing like every day in my training and seeing where we're missing the mark and such the gap. And I said it earlier, unless everyone takes a step back and I'm glad you framed it that way, that it should be surprising. And it should cause pause in everyone. It's not just only the people who are involved that it should cause pause in because until we take care of a community that has the least resources and access, then everyone's not okay. So until we choose to make choice, everyone has choice, but make that choice where we're invested in people who don't have as much or as much access, then we're not taking care of everybody.

Starting point is 00:49:03 And so the reasons that that happen is it's systemic. I mean, I think that, you know, I always just like to say it like it is because I don't think it's offensive and the more that we can talk about it, the less people will be offended is there's systemic racism. Yeah. It is what it is. I see it, I've lived it.

Starting point is 00:49:17 So once we understand that there's that and we can be like, What do I need to do as an individual, an organization, an institution to address that? Then we're actually going to get somewhere. Instead of us kind of like being like, oh, that's not me or I'm offended or, oh, I don't want to talk about it. It's too dicey. No, just say what it is. And then how do we make change? The other part of that is, again, going to diet.

Starting point is 00:49:41 Typically what you'll find in communities that have lack of access and resources are the foods that are not the best. And so when you have increase in inflammation, then you're going to have increase in diabetes, which gestational diabetes is a big part, but also cardiovascular disease. So when we think of preeclampsia, which is another reason why we see these morbidity and mortality rates that high, it's a vascular issue, which is because we have increased risk of heart disease. So all of these things, it's the domino effect. Once you kind of start the domino moving, then everything else is going to fall.

Starting point is 00:50:18 So I think we need to all take a step back and say, where do we start with this discussion? Because the discussion that we've been having is not getting us anywhere. And so I think the discussion needs to change between all stakeholders. It's an all stakeholder conversation, not just one. I think you have now some of our governmental elites, I'll say in a positive way, I believe are well-intentioned about this Maha movement. Like how do we get, you know, the toxins out of our food supply? How do we improve the nutritional foundation for our children,

Starting point is 00:50:53 especially our public school programs? And I think the, you know, women's health in general is where there's a lack of understanding of kind of what to do. But I will tell you, emphatically, I know these statistics are making their way into the right ears. Yeah. As long as we make sure that the people who need to understand. or being impacted by it rather, understand what's being done and changed. So we have to make sure that the message is going all the way downstream

Starting point is 00:51:24 to the people who really, really need it. Yeah. What would you say, you know, to the administration, HHS, CDC, FDA, NIH, if they're listening, and they're very likely they are. They're probably listening and we don't even know it. Without us even knowing, right? What would you say, you know, in broad context, here's some of the changes I would really love to see at that level to address things like 3, 4x increase in black female mortality over the general population.

Starting point is 00:51:59 Yeah, coming from someone like me who's been in the industry of women's health for so long is I think we need more representation. Representation with more women at the table, but also people of color. I think that that's imperative because you know. never really can understand or know the journey of a group of people if you're not them. I know. I think it's so arrogant to what it is. Yeah. Sort of debate that.

Starting point is 00:52:24 Yeah. And then the other thing that I would say is make sure that what's being provided is understood by the group that it's impacting as well. And I can even say this for myself, you know, trained as a physician. When a lot of patients come in and see me, it doesn't matter what they're coming in for. I speak to them in doctor talk. And they're like, what the hell are you talking about? And so it's my responsibility, actually, to ensure

Starting point is 00:52:49 that whoever is in my office is walking out, understanding what I said. It's not their responsibility. They can ask me questions. But if I'm just talking above their head with stuff that they're like, I don't know what you're talking about, I'm not doing anything essentially. So I would say that making sure that whatever we're changing

Starting point is 00:53:07 or whatever messaging or whatever resources are being, improved that the people who it's for actually know. You know I'm all about optimizing performance. And lately, I've been using the ion weighted vest during my workouts. And it's been a game changer. It isn't your average weighted vest. It's designed to fit like a second skin, activating your core, improving blood flow, and even helping you with recovery while you train.

Starting point is 00:53:32 What I love most is that the weight is perfectly distributed. It doesn't pull on your shoulders or throw off your alignment, whether I'm doing strength training or cardio or just take. I'm making a walk, I'm burning more calories, building muscle and pushing my endurance even further. If you're serious about leveling up your training and unlocking your full potential, check out the ion-weighted vest at iongear.com. That's A-I-O-N-gear.com. And you can use code Ultimate for 10% off and start training smarter today. Now let's get back to the Ultimate Human Podcast. You even talked about insurance coverage and workplace environments for like Metabolical.

Starting point is 00:54:11 Because I can tell you as someone who is deeply embedded in the industry, nobody is having that conversation in the workplace. Absolutely not. And I don't think that we are addressing for women, you know, the need for management of menopausal symptoms, you know, at that level. And, you know, women, when they're reaching the upper echelon of, you know, at least the socioeconomic echelon, of, you know, the corporate hierarchy, and then they're hit with menopause, you know, it makes things infinitely more difficult. What did you mean by we need to have this conversation around insurance coverage and workplace awareness for? Yeah, I think when we think of women's health, we have seen, even outside of maternal mortality and morbidity is when we were just to look at mid-level.

Starting point is 00:55:11 life stage of women in menopause, there are so many women who actually leave the job force because of a menopausal symptom that they're just unable to kind of cope with, factor into their work life, their family life, and they're like, this, I have to give this up. And many of them don't necessarily want to give it up. So obviously the conversation is not being, again, held by the person who's being impacted. And the person or the organization who can say, huh, what do I need to do as a responsible party in this relationship in order to meet women where they are? And women's health in general has not been researched, you know, women in general have not been placed in research for a very long time. We're very new to that. We have suddenly

Starting point is 00:55:56 realized that women are not little men. And so we're like, oh, let's actually include them. It took me 50 years to figure that out, actually. Let's put them into research. I call bunch, you go home. I'm intermittent fasting, you're intermittent fasting. Exactly. And so now that we finally gotten there. We're like, yes, women are not little men and we'll put them in research is actually saying, okay, with these outcomes and these data, especially in menopause, and I know that now it's impacting brain health. Now I know that it's impacting the ability for them to not sit at a desk or a meeting and, you know, self-combust with heat for hot flashes. Right? Literally, how do I make room for this? Because it was only maybe 10, 15 years ago that we made

Starting point is 00:56:38 actionable items in the workforce to accommodate lactating mothers. Right? So now we're at the stage where we need to approach midlife in the same way of finding ways to have coverage in insurance for whether that's getting labs, whether that's getting menopausal care, like actually making a package that is adjusted to women in mid-age and providing for them in ways where they're like, I now can safely go to the doctor to talk to them about it because I also know I'm being supported. Yeah.

Starting point is 00:57:10 Through my insurance and my workplace. And I think selfishly, this is a, this will have dramatic, positive financial impact because, you know, it's almost keeping people out of the system, right? The system is very expensive. And once you get into that system with a chronic disease and you start that management process and you've got thyroid and hypertension and or diabetes or autoimmune, I mean, these are extraordinarily expensive, costly. And if we did some preventative care

Starting point is 00:57:43 and sunk some of the funds into preventative care, dietary lifestyle, which you're talking about, all of these subjective factors, and actually found a way to compensate physicians for making these kinds of recommendations. You're speaking my language now, Gary. Good. Dude, but you see how it came back to,

Starting point is 00:57:59 how do we prevent chronic disease? I don't think that it's that difficult. to do. Yeah. I think what we have been messaged in society as what is, what life is, what the outcomes and expectations are, is actually not a fairy tale.

Starting point is 00:58:17 I don't want to necessarily just get old and then I can't do anything. So basically what we're seeing now is people are getting to retirement, but then they can't do anything after. Because they're frail, they've broken a hip, they have a chronic disease, and they have to carry around an oxygen tank.

Starting point is 00:58:33 So why is it that we have the best of research and the best of resources, and we're not applying it in the way that people can actually live longer and live well. Yeah. And I think from a purely, just purely black and white capitalistic perspective, it would be the best thing. Because this is the largest, and $5 trillion a year, is last time I checked, that's a lot of money. Yeah. And it encapsulates like the next six or seven countries combined. And we have these kinds of outcomes. And by shifting some of that, health care spending to these screenings and preventative care. And, you know, I think the jury's still out on AI.

Starting point is 00:59:13 My feeling is it's going to be positive for medicine. Yeah, I, you know, how I have come to think of AI is it's an extension of. When AI, you know, kind of first appeared on the scene wide scale, I would say about four or five years ago, I was scared as a physician. I'm like, it's coming for my job. Yeah. I got to watch my job. Hell with those robots.

Starting point is 00:59:34 You know, what I've seen is there's always going to be that scare of something that's very new and unsettling. But what I have seen is the ability to be to make physicians more efficient with their time. But also with the wide scale of research and data that we have, now it's helping me accomplish something better for the patient in a shorter amount of time. And I think that the more that we're able to do that, the more that I can give back to patients and also help myself not overwhelm myself and burn my mind. myself out. Yeah, I think that, you know, the ability to take potentially trillions of pieces of independent data and create an actionable result, I think that's fascinating. I mean, I think you combine artificial intelligence, early detection, and big data. We start to see, wow, look at these patterns that are emerging. And I think you have really positive impact on health care. You know what I

Starting point is 01:00:27 love about it too, now that as you're, you know, kind of putting it into that package is personalization. personalization of how we look at longevity and functional medicine, quite frankly, is outside of the data sets that we have that traditional medicine uses and is for the greater part of it really good. Yeah. But we still have an N of one at some times where we're like, how do we make that applicable to use an individual? Yes.

Starting point is 01:00:53 I think that that's what the AI has a capability to do. And I'm fascinated at what I'm seeing now. Yeah, I do too. I think it's good for my audience to know too. you published a book on Generation M. Yes. I did. In my spare time. I know how hard it is to write a book.

Starting point is 01:01:10 I've been writing a book for three years. And it's just because you wanted to be perfect. And at some point, you know, I know some granular PhD is going to go, look at that. You're excited this. It's a very humbling experience, I would say, too. Yeah. Yeah.

Starting point is 01:01:28 Yeah. Because you're very vulnerable, I guess, when you, you know, because this is your work and then you put it out there and then you know it's just going to be scrutinized. I know to the highest degree. Yeah. But it's been very well received. And I know you've done a massive book tour.

Starting point is 01:01:42 Yes. 24. Yeah. Yeah. What can women expect from that? Generation M was really a love letter. I didn't know there was Generation M, by the way. Yeah.

Starting point is 01:01:54 I don't know about Generation X. There's Generation M and every woman gets to be in it because at some point they're going to reach that M, right? So every woman is either in Generation M or is aspiring. You're heading there. I say it. Even if you're not aspiring. See what I did there?

Starting point is 01:02:10 Aspiring to be in Generation M. But it really was a love letter from me to my patients, myself, my friends who were going through this. And I wanted it to be something that they would relate to. There's a lot of kind of patient stories in there. So I think community, when women think of what they're going through, community is very important, but also something tangible, something of I can do this, I can accomplish this. This is not overwhelming. We have really cast menopause into this light of

Starting point is 01:02:41 dread and a horror story. And I said, what better way is to change the script and the narrative into something where someone's like, I'm going to, this is a comedic love story rather than a horror movie. I'm going to fall back in love with myself. And there may be some funny moments along the way. But by golly, I can do this. And that's how it's written because it approaches libido. We talk about sex. We talk about muscle. We talk about brain.

Starting point is 01:03:09 We talk about meditation. And also hormones. That's a big part of the book. But it isn't just always about hormones. I feel that once we create an infrastructure or framework in the daily lifestyle in kind of understanding who we are and how we're going to go through this life, hormones is kind of the, I'm also going to create this, kind of framework and provide the best ways for each of those pillars to do it. But if we don't

Starting point is 01:03:34 have those pillars, we're not doing anything. I totally agree. I mean, I think, you know, physicians like you, Dr. Gabrielle Lyon, have really reframed the importance of weight-bearing exercise and weight training and how muscle is our metabolic currency. So for the women that are listening, I mean, how important is strength training, especially midlife and later in life, how important is strength training? Is it a non-negotiable? Is it a luxury item? And where does it fit in your sort of scope of what women should be doing too? Yeah, in the toolbox of women's lives and health and longevity, it is a non-negotiable. I feel that it is something that you can choose to ignore, but what will happen in the end is it

Starting point is 01:04:24 will come back to bite you in the ass. Yeah. Yeah, it surely will because muscle is our of longevity because that's what not only fuels our body and allows it for strength. It really is kind of pushing against our glucose metabolism. It is a sponge. It is one of the largest absorbers in addition to the brain of glucose. And we already lose muscle mass. That's an aging phenomenon that occurs. But what happens after menopause, after the loss of estrogen, is it compounds.

Starting point is 01:04:54 Yes. So now we're losing muscle even more. So what are those ways that we can push back on that is through resistance and weight training and not small weight? It's heavy weight. Our bodies don't underestimate it. Your body is able to adapt to things. Granted, you want to do it safely and adjust it over time, but never think that you were just here as a woman to lose muscle and not build that muscle back. And if you're going to do it with lightweight, that is not the category that we should be living in. And so when I see women that are older, and even looking at the generation behind us, you know, or before me, rather, is it's kind of like you have this view of what women are doing and it's not all their fault. I'm not blaming them. I'm just saying that they weren't given the tools. They don't want to get bulky. They don't want to get bulky. That's not even what happens when you lift weights. It really is, I am now giving back to my body and also my bone and my brain, right? So muscle building your muscle mass back,

Starting point is 01:05:55 one prevents you from frailty, improves your strength, but also impacts your brain health and also your bone health. So you are getting more than bang for your buck when you do weight training. So for me, it's a non-negotiable. So what does a morning routine for you look like? Because my audience loves the tips and tricks. I'm going to ask you about supplementation. I'm going to ask you about morning routine. Maybe even some of your travel tips. Because you, you know, you're not going to talking to you about your schedule before the podcast. I was like, I thought I traveled.

Starting point is 01:06:29 There's a lot of travel in there. No, I love showcasing. I definitely believe if I'm going to talk the talk, I need to walk the walk. And so weight training is a very big part of my daily regimen. Wake up and I definitely do mindfulness meditation. I say...

Starting point is 01:06:45 And what does that look like? So I do guided because I'm not an expert at meditation. So I use guided. I do 10 to 15 minutes. It is a muscle that you need to build as far as meditation. Like an app, your phones. I use an app.

Starting point is 01:06:57 Calm is a good app that I use. I have kind of a meditation, I guess you could say instructor. So I use those guided meditations, right? And I think that there's enough out there that people can really look. Look on your Spotify and literally take in meditation. And find one that's good for you. The other thing is I say, this may sound funny, but I say hello to the sun every morning. I do too.

Starting point is 01:07:20 I literally say hello to it. My kids now do it to you. They're like, good morning, son. it is always there for you. It shows up every day. And you get some vitamin D with that as well. So I do think it's important. That's a part of my routine.

Starting point is 01:07:33 And then weight training. I am a person who, if I don't get it in in the morning, typically my day is so busy. I don't find time later. So I self-care will go to the gym. And I have implemented more weight training that I have in the past used to be runner. And now I am very big on weight training.

Starting point is 01:07:49 I still do cardio, but I maximize most of my time in weight training. It does not need to be an hour workout. I am the queen of a 30, 35 minute workout because I'm focal. I'm intentional. And I'm like, I'm here to get something done. Yeah. And it doesn't have to take up all of your day. It doesn't have to be inconvenient.

Starting point is 01:08:09 So I've got to ask you about some big, big topics. You know, topping the headlines in women's health. One of them is creatine. And I've always been a fan of creatine. I too, even as a biohackers, lean towards it being a, you know, a muscle building supplement. I think when I was in high school,

Starting point is 01:08:30 I was taking it needed creatine to build big muscles. Now the data seems to be emerging about crossing the blood-brain barrier, you know, brain health, cognitive function, inflammation, maintaining muscle mass. Where do you fall in the creatine supplementation for, especially for women?

Starting point is 01:08:49 I always like to start with the concern because most people come to me as a physician and being like, I don't think I can do this. I've heard this. So I'm like, let's dispel that first. People confuse it with creatinin, which is kidney function. Yeah. And so I like to dispel that first is that that's something different.

Starting point is 01:09:06 People who cannot or should not take creatin as a supplement are people who have really, really chronic kidney disease. Okay. So outside of that, right. Outside of that, most people are completely fine to take creatin. And the reason why I think it's imperative that we do that is we do need help. Our body always needs help, right? So that can come in the form of nutrition, supplements.

Starting point is 01:09:30 And when we think of creatin, in order to help muscle, right? I always think that amino acids and supplementation and proteins in order to help the muscle build, that's what you're going to find in creatin. And taking dosage, right? So five grams is where I like to sit every day. Some people I start them out at two. see how they kind of adjust to that, go to five. When we think of brain health now coming into data sets of seeing how it's impacting clarity,

Starting point is 01:09:58 how it's impacting mental capacity. This is the beauty of why we do research and studies. So now that we have a brain health kind of additive added to that, that's when we start to see taking maybe 10 grams and improving brain health. So you are having something that's implementing kind of all body. that's why I like that is one of the top things that you can take in your supplementation kind of toolbox but I am I do take creatine

Starting point is 01:10:23 and I think it's important that people understand what your body needs in order to have those optimal outcomes is it does need help and so that's one of the ways that I think that you can do that. You know, it's interesting, I have a partner of mine that owns a chain of assistic care living in memory care facilities and these are usually inpatient resident Yeah.

Starting point is 01:10:45 And they've just done some very simple, called them longevity hacks and are gathering massive amounts of data. And I would say, you know, they are exposing them several days a week to red light therapy, sometimes even transcranial red light with the helmet on. They've added the food being farmed to table and all whole food. so they've gotten every ounce of processed food out of these cystic care and memory care facilities and creatine. And those simple changes. Now, a lot of these people are on boards of medications and, you know, osteopenoceoporosis. And this is subjective so far, but the improvement that they are seeing rapidly in such a short period of time,

Starting point is 01:11:39 They also have them getting regular sunlight. I know you're going to say that, yeah. These small little gardens. It's not like they're going anywhere. No. Put them in the sun. Exactly. Exactly.

Starting point is 01:11:48 Put them in the sun. And I mean, in wheelchairs and everything. And it's, man, it's so enlightening and so exciting because, you know, these are not like massive interventions. Some red light, some transcranial red light. Supplementation with creatine. Absolutely fixing the food supply. No more peel off apple sauce, you know, with high fructose corn,

Starting point is 01:12:08 syrup in it. That makes my heart happy to hear that. It makes mine happy to. Because even in that, one, we're addressing a population that needs it, but how inspirational is that for someone to say, with these little steps, I could get that outcome? One, it's never too late to start, but the goal is when can we start so we may potentially not get there? Yeah. But even in a population that was clearly having these detrimental defaults that you can see change in small little steps every day. I'm telling you, lifestyle is everything. Yeah, lifestyle is everything. You know, my mother, Judy, had, she's 78 now.

Starting point is 01:12:47 And she had, years ago, she had bilateral knee replacement. And she went into a post-surgical rehab facility, an inpatient rehab facility because my father couldn't take care of her, you know, after this. And they get you up and they get you moving right away. And what happened was they left her in bed. one of her knees got infected so they were going to have to replace the prosthetic and this facility

Starting point is 01:13:12 left her in bed for 45 days did not get her out of bed in 45 days what was absolutely astounding to me was I flew up there with the family all three of my kids my wife we flew up to surprise her and it was on Halloween and we had like

Starting point is 01:13:30 Halloween gear in balloons and everything and so I walk into her room and we come around the corner and to, you know, we were going to do the big surprise, mom. And I'm an only child. And my mother barely recognized me. Oh, my God. And she thought she was being held against her will.

Starting point is 01:13:48 She was very confused about where she was, about what she was doing in there. It's a dementia. And I'm telling you the rate of cognitive decline as soon as she was immobile. I mean, how I handled this with this facility. It's an old mother story. My head exploded. but the positive side of this was, I mean, she was absolutely frightened and scared, didn't know why all of us were in the room, they didn't even really kind of recognize the

Starting point is 01:14:17 grandkids. And for me, the only child of her not recognizing me, it was a huge issue. And over the next 10 weeks, not only did I mandate that she was up twice a day, five days a week, which they immediately implemented. They were very embarrassed and to go into a whole story about why that they should. this happened, but, which, which made me realize a lot of times, you know, we put our parents in these facilities, and this was an amicic care or memory care. This was just for her post-operative rehab. It made me really start thinking about that next phase of life about assisted care and

Starting point is 01:14:52 memory care. But in 10 weeks, the first thing we did, I've completely dramatically shifted her diet, focused again on fats and proteins, put her on a low-glycemic diet. diet had relatively little intervention. Creatine, I actually put her on a peptide called Cerebralicin, got her mobile, got her hydrated, made sure she was out of bed at least twice a day, doing occupational and physical therapy. In 10 weeks, she was a completely different human being. I think she was better than when, before she had the knee surgery.

Starting point is 01:15:28 Because my dad called me and he was like, your mom wants to redecorate the whole house. She doesn't like any of the artwork. He was like, can you just like dial her back? a little bit. What a positive story because... She just bounced right back. Hearing that, you know, my mind immediately went to, oh my gosh, like it couldn't have gotten

Starting point is 01:15:44 better, right? Oh, it got... And imagine just implementing movement and sunlight and food and nutrition. Sunlight was another big one we did. Movement. Sunlight, food, nutrition, four or five supplements. So anyone who's listening can see that, one, it's never too late, but we're trying to get you to start before it's too late.

Starting point is 01:16:05 but also what the body can do when it's given the right tools. Yeah. Yeah. So true. You know, so I, and I love hearing from mainstream academia. I put you in the mainstream academia bucket, that there is starting to become a greater awareness of this. I mean, you know, I think 20 years ago, stress, mindset, mood, emotion, those were never any things that had any impact on your health at all.

Starting point is 01:16:33 In fact, you shouldn't even talk about those. certainly shouldn't bring them up to your doctor and now realize the impact that stress, cortisol, and, you know, our nervous system being trapped in this sympathetic state. And I saw that with my own wife because, you know, when she was going through this metapausal time, it was really stressful. She's like, I'm not myself. Like she would just break down. It's frustrating.

Starting point is 01:16:54 And just be so frustrated because, you know, I stopped teasing her, I mean, but, you know, she was very frustrated. I can't find my keys in my wallet and did I bring my passport to the airport? I mean, things that would just so... That weren't even thoughts in her head before because she knew that she could... On her game. Yeah.

Starting point is 01:17:10 But now all of that's corrected. So, you know, for my audience that would like to know more about you or how they can find you, where can they find you? So I am on social media. I'm Jessica Shepard, M-D-S-H-E-P-H-E-R-D. But one thing that I've done from last year into this year, especially from the book and how well-received it was, was community.

Starting point is 01:17:33 And so whenever I travel, we travel all over the world is women really thrive on community. And so modern meno, M-E-N-O, so I didn't want to use the whole word of menopause, but modern meno. No one wants to be in a modern-menopause group. No, because everyone's like, I don't want to be in that group. There's still that, there's still that like a little bit of like, I don't know if I want to be in that group. So I'm modernizing it with modern meno is the community that I developed, that women can come in. learn from other women. Hearing other people's stories

Starting point is 01:18:06 makes you feel like you're not alone. You're like, I'm not the only one in this, but also for me to be able to distribute information, having webinars, and then for those who want to see me, you know, through my practice, there's a way that they can do that as well. But the main goal through Modern Meno is to say,

Starting point is 01:18:23 what can I do for myself that I can inch into it, or I can get the information that I need, or if I feel embarrassed to ask a question, how can I ask the question? because from the WHOI and seeing the reversal that we saw, you know, late last year is that it's still not widespread. You and I know it because that's what we live, eat and breathe. But for a lot of women globally and especially in the U.S.

Starting point is 01:18:48 don't know that one, maybe that happened. Two are still very fearful of hormones, but also doctors. Doctors may not have gotten the matter quite yet or don't know how to manage hormones and hormone therapy. Even if they want to. Even if they want to. So we're still at some time out before everyone will either get it on the consumer side and then for physicians to being like, oh, I know how to manage this.

Starting point is 01:19:10 So we still have a gap. And the goal with modern meno is to kind of create community to fill that gap. That's amazing. Okay, so I'm going to link all of that in the show notes so you guys know how to find the modern meno. I have a VIP community too that's, you know, they're the only ones that I tell who's coming on the podcast before they come on the podcast. I got to tell you, I got it right here. I mean, the list of questions, we have never had a response.

Starting point is 01:19:37 Did you hear that? They've never had this many questions. We've never had a response like this in our VIP community to a guest coming on. I mean, and we've had some very prominent, you know, guests on. But they got a lot of questions. We actually broke them into categories, hormone basics, perimenopause, menopause, BHRT, HRT, and so we're going to go into that VIP community. community and get these questions answered.

Starting point is 01:20:02 If you're interested in becoming a VIP, just go over to theultimatehuman.com forward slash VIP. You can sign up to be a VIP and very similar to your community. We do Q&As and live challenges and creating a sense of community. But I think doing it for women, I think, is especially good because there's such a paucity of places that they can go to find that kind of community. And, you know, interestingly, in these big data and Blue Zone studies, studies, we don't talk about it a lot, but sense of community and purpose were non-negotiables

Starting point is 01:20:35 in all of these locations. Yeah, it wasn't specific diet or specific geographical region. It was community. Community and connection. And I think we're so disconnected from just humanity, right? That, you know, we think connection comes to our electronic devices and it comes from doing things just like this. So I wind down all of my podcasts by asking my guests the same question.

Starting point is 01:21:01 So if you're watching my podcast, you know that it's coming. Here it comes, awesome it up in the air. I think you're going to smack it out of the park, Jessica. But what does it mean to you to be an ultimate human? Ooh, I love that question. To be an ultimate human is to look at all aspects of your life and ensure that you're tending to it in the best way where you can serve yourself and be the best version of yourself.

Starting point is 01:21:26 You can show up for everyone. Show up for yourself. Well, guys, I hope you enjoyed this podcast as much as I did. VIPs. We'll see you in a few minutes inside the VIP community for the rest of you. Everything that we talked about, I will link into the show notes, copy of her book, her community, for women, and a lot of her work on social media contacts.

Starting point is 01:21:46 Until next time, that's just science.

The Ultimate Human with Gary Brecka - 253. Dr. Jessica Shepherd: On Menopause, HRT, and Longevity Tips for Women

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