Well with Arielle Lorre - 225: How to Support Aging from the Inside Out with Daniela Ezratty, ACNP-BC

Episode Date: January 23, 2023

Daniela Ezratty is a Nurse Practitioner and owner of Ezratty Integrative Aesthetics, a medical anti-aging and aesthetics practice in Atlanta, GA. She joins the show to discuss how a terrifying diagnosis changed the trajectory of her life and inspired her to leave her job in acute care to pursue her true calling of helping people live—and age—well, from the inside out. We talk about the pillars of a healthy lifestyle, anti-aging lifestyle factors to be cognizant of, how to manage hormonal fluctuations and deficiencies, peptide therapy, supplementation, semaglutide for weight loss and so much more.     Visit athleticgreens.com/blondefiles for a FREE 1 year supply of immune-supporting Vitamin D and 5 FREE travel packs with your first purchase.     Produced by Dear Media.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

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Sonderger Go to your Reisadviseur Orsoniccars. The following podcast is A Dear Media Production This show is sponsored by

I know that I feel my best when I have mental clarity, but oftentimes life gets in the way, and this is where therapy has always been so helpful for me. So if you're thinking about giving therapy a try, BetterHelp is a great option. It's convenient. It's flexible. It's affordable. And it's entirely online. Visit betterhelp.com slash files today to get 10% off your first month. That's BetterHelp H-E-L-P dot com slash files. Welcome to the Blonde Files podcast. I'm your host, Ariel Lorry, and I'm here to talk all things wellness. From how to achieve optimal health and well-being to the best beauty tips and everything

in between, no topic is off limits. I know there's so much information out there, so I'm bringing on expert guests and sharing my own experiences to help you sift through all the wellness stuff without the BS. Enjoy the show. Hi, everybody. Welcome to the show. I'm really excited for today's episode. One, because it's with a friend of mine. I think it's always fun to hear conversations where the people already have rapport. But two, because although we're talking about subjects that I cover often here on the show, we're kind of covering them from a different angle. So I'm talking to Daniela Azradi. She is the owner and founder of Azradi Integrative Aesthetics in Atlanta, Georgia. EIA is a medical aesthetics and anti-aging medical practice, and Danielle's philosophy on anti-aging is really a 360 approach, which we talk about in depth in this episode. She focuses on making sure her patients are aging well externally and internally. She loves injecting Botox and

fillers as much as helping her patients with thyroid and hormone deficiency. Danielle is an acute care nurse practitioner with a Masters of Science in Nursing from Emory University. she spent 20 years taking care of critically ill patients before she pivoted her career to help people look and feel their best. She is a graduate of the Institute of Integrative Nutrition in New York City and she holds postmaster's degrees from Cornell University in plant-based nutrition and plant-based medicine. So the way that I think of this episode is obviously about beauty, aesthetics, wellness, but also about supportive aging. I don't think of. I don't think of. I think of this episode. I don't think of, of it so much as anti-aging because her approach is really about supporting women through the process and through the often ignored years of like the 30s, maybe early 40s. But no matter what age you are, there's definitely something in this episode for you. So we are talking about her experience as a critical care nurse practitioner and what it was like taking care of really sick and dying people. And then she had this experience where she was diagnosed with a tumor and face.

with mortality and it really changed her perspective and it pivoted her life in a different direction and she left that career and started pursuing her other interests in holistic health and she's just so knowledgeable so we talk about the pillars of a healthy lifestyle from that holistic perspective we talk about women's hormones perimenopause we talk about sleep we talk about Hormone replacement. We actually get pretty in depth into hormones, how they start to fluctuate and what to do to support your body. We talk about lifestyle factors that women should be cognizant of. We talk a lot about what to do on the inside that will reflect on the outside. We talk about weight management and semi-glutide because it's such a hot topic right now. But really, this episode is not so much about the outside as it is about how

to take care of ourselves on a really deep level and that will radiate externally. And Danielle is just so fun to talk to. She's such a good friend. Definitely somebody that you want in your corner. If you live in or around the Atlanta area, go see her at EIA. Like I said, she's so knowledgeable. She's so skilled. And she will make you look and feel your best. So with that, please enjoy. Daniela is ready. Welcome, Danielle. Thank you, Ariel. I'm so excited to be here. Me too. I feel like we've been talking about doing this for a long time. For everybody listening, we have to just right out of the gate tell everyone how we know each other. We are both masqueries. We're both. I know he's listening too. We are part of the exclusive Dr. Miguel Mascaro Club. That's how we met. And you've become a dear friend of mine. And you're so. knowledgeable about all things, health, wellness, aesthetics. So we're going to get into all of that today. So sweet. And I have to say that you've elevated me to rock star in my own family.

Because for everybody that. Hi, John. It doesn't know. My husband is a super fan. So there's people like me who are like Howard Stern superfan and things. But no, John is a super fan. And sometimes I'll get into his car and Ariel's podcast will be on. Yeah. Shout out John. I love the support, not the demographic that you would think when you think of the blondefiles listeners. Right. But he's there. We have to get him some merch. We do have to get him some merch.

I should have brought some. Well, why don't you start by telling everybody a little bit about yourself. And I would love to hear about your story with your own health because I feel like it's really kind of shaped your approach to everything that you do today. Definitely. So my background, I'm a nurse practitioner. and I also have three advanced degrees in nutrition, so a little bit different than traditional route. But I started off in critical care and worked as a nurse practitioner for years in the hospital taking care of very, very ill patients. I worked at an academic facility. I also worked at

private hospitals. And so everything from cardiothoracic to oncology critical care to pulmonary critical care. And I, you know, got to a place where I was questioning, you know, my career path because it was a lot of, a lot of sorrow. And you see people dying often and you feel like you can't help them. The only thing you can really do is help them die well. And there's some success stories, but it was getting to a place where it was starting to feel different. And it's always hard to make a career change. And I had my own health scare that really kind of woke me up and made me decide that it's now or never. So I, not for a long story, but I had a very rare tumor on my scapula that I was fortunate enough to find and had one of the

best surgeons in Atlanta take it out. And it was very scary. And it was like I'd never been in that situation before. And there was two weeks that we had to wait for pathology to come back. And in those two weeks and everybody has their own spiritual who they talk to, what they do. But there was a lot of begging and bargaining and saying I would never do this again if I was spared and all of those things. And the biggest thing that I said was that I need to make a change because I've been in this career for quite some time and I feel like I'm not making a difference. And so when the pathology came back and it was as good as it could get, I decided that I had to stick with what I said. And so I immediately figured out how to do that, enrolled in different programs, and then

change my focus to try to keep people well and try to keep people out of the ICU because so many of the diseases, they are directly related to the way that we live our life. And so if I could help people live better, then that's what my goal was. So it started with nutrition, it started with lifestyle, and then it morphed into aesthetics. And so we're trying to disrupt the space at EIA, which is the wellness and ascetics business that I own. We're trying to disrupt the space and take care of the patient from a 360 approach, not just come in and get Botox. If you come in and sit in my chair, we're going to talk about all the things. So that's a little bit about me and how we started.

I want to rewind a little bit. There are so many questions that I have. But just to go back to the tumor, did you have symptoms? How did you find that? Yeah, so this is what's so crazy. And it's interesting because two or three weeks prior, we had gone to a black tie event and I had a strapless dress and I bent over and John actually strapped, put me in the dress. And the tumor was so large, it would have been seen at that time. And so it wasn't there. And we were on a trip to New York and we had this beautiful weekend and we came home in the next morning. I got out of the shower and I was drying myself off. And I saw this really, really, large tumor. And it's funny because, like I said, I've been in medicine for so long, but I was just like, hmm, did I hit myself? And I touched it and didn't hurt. And there was something inside of me that obviously knew that there was something off. And it's funny because we laugh in our house

because my husband's an anesthesiologist, as you know, but they don't know. And so we always say he's not a real doctor. He just puts people to sleep, you know? So like we don't ask John for like medical advice. That's like with my dad too, though. He's a cardiologist, but he's like, I don't know anything like outside of that region. So don't ask me. Exactly. Exactly. And so I'm like, he's not a real doctor. He's supposed to be able to say. But there was something that I drove over to the hospital because I wasn't working that day. And I showed him. And John is extreme. I mean, he's just the calmest. He's not an alarmist. And he was just like, oh, I don't know. You know, okay. It's like, okay. So we were out of town. So I went off to the grocery store and thought nothing

really more about it. And he called me on my phone. And he's like, Dr. Rizzo is waiting for you. And I was like, what? And I knew who she was, knew that she was a surgical oncologist. And I was like, why would Dr. Rizzo be waiting for me? And he's like, she's waiting for you. And I'm like, oh, okay. So I continued to grocery shop. I was in a little bit of denial. And he called me. He's like, where are you? I'm like, I'm at Whole Foods. He's like, you need to get there. So I had no symptoms. I had no pain. I had nothing. It was just it showed up out of nowhere. And so I went to see her in the office. And based upon the location and based on the type of surgeon that she is, she kind of gave us three scenarios of what it would be,

One, a lipoma, which is very benign. It's like a fatty tumor. Dogs get it. One would be an invasive sarcoma. And the third one was kind of like, we have absolutely no idea. So I saw her on Wednesday. She scheduled an MRI for Thursday. And then she called me Thursday afternoon and she said, we need to operate.

And I was in the operating room on Monday. I know. It was fast. Wow. It was. Wow. And even at that point, I was still. thinking like it was very superficial. For some reason, I just really wasn't thinking that this was

anything big. And so I was going to sleep in the operating room and they said, you know, they say your name and why you're here and kind of your markers of who you are. And they said, she's here for a radical chest wall dissection. And I was like, no, no, I'm not. I'm here just for you to remove this little, this thing, you know? I didn't think, I was like, oh, I remember falling asleep. That was the last thing I heard. And then when I woke up in the recovery room, it was clear that they did pretty invasive surgery. What is a radical chest wall dissection? So it's where they go. So like if you had like, let's say a lipoma that's in the subcutaneous or the fatty tissue, they just removed that. So with this, they had to go all the way down and continue to follow the

tumor down to where they got to basically to lung. And then unfortunately there was a little margin left that they weren't able to get. And we found that out pretty with the pathology pretty soon after we got all the results, we knew there was a little bit left. But I've been fortunate that we haven't had any recurrence in past the five years. So I have a pretty gnarly scar. It goes from here all the way to my mid back. And my surgeon is this beautiful, smart Italian woman. And she looked at me and she said, do not ever put a tattoo over this. She said, I don't want you to come in with angel wings or anything. She said, do not do that. And so I took that to heart and I listened to it. But it's still there.

It's, you know, but it's a reminder kind of of what I've been through and how my life and story changed after. So it's, it's one of those scars that I don't mind having. I'm packing to go to the East Coast for a few weeks. And you guys know I'm all about micro habits and these little wellness hacks that have a huge benefit. And one that comes in handy so much, especially when I'm traveling, are my travel packs from athletic greens. So the travel packs are a serving of AG1 and it's so great for when you're packing, traveling, because that has everything that you need in it. It has vitamins, minerals, antioxidants, prebiotics, probiotics, basically everything that you would be packing in

supplement form condensed into this tiny packet. So you guys know that I drink my AG1 daily. I have it on an empty stomach when I first wake up when I'm doing my meditation. and I absolutely love it. It's something that I crave every single day. So with one scoop of AG1 from Athletic Greens, you are getting 75 super high quality vitamins, minerals, and whole food sourced ingredients that deliver benefits like mood, immune system, sleep support, sustained energy, gut support, all of the things, and all working together as one. So I think it really helps the gut. And as We know the gut is so important in whole body health, and it was actually developed because the founder was struggling so much with gut health. So if you weren't aware of the origin of Athletic Greens and AG1, that's what it is.

So if you want to take ownership over your health today is a good time to start. Athletic Greens is giving you a free one-year supply of vitamin D and five free travel packs with your first purchase. Just go to athletic greens.com slash blonde files. Again, that's athletic greens.com slash blonde files. Check it out. I think that's so profound. And I wonder what I would reevaluate if I were in that situation. And I wonder if like everybody listening thinks about that for a second.

Because I feel like that would be so telling. And it was in your case where all of a sudden you're like, wait, I'm not. living the life that I want to live. And if I have another chance or if I'm okay, this is what I'm going to do. What would you do differently? And it's kind of crazy that I'm sure we all have things that we would do differently, but we don't. Right. Unless we're faced with that situation. Right. So what were the things that you changed? Obviously, you left critical care and you told us a little bit about what you do now, but what were the steps that you took after that? What was your lifestyle like before and after. So I think the biggest, I think the biggest thing was that you really realize that

every day is a gift and it's not promised. And you realize that if you're not sick and you're not in a hospital or you're not having to go day after day to doctor's offices or get chemotherapy, and your life is pretty darn good. And, you know, I kind of had a lot of that already from the career that I had. But, you know, I'd have to go and see the oncologist, which is a terrible place to go. And, you know, you sit in that waiting room and you see people that are not as fortunate as you. And I had a lot of guilt with that, that, you know, why did I get spared? Why am I not having to get chemotherapy? And you realize that when you have your health, you really have everything. And so I tried to always put that as the first thing that I go with, that like if something bad

happens. I'm like, it's okay. No one's in the hospital. We're fine. And so the little fender bender, or when you hit your car, you know, you hit your rims on the, you know, the curb, it's okay. No one's in the hospital. You know, those are the annoying things. That changed. And then my motivation to just be a good person. And I could be a little spicy at times. And I tried to really tone that down and always come from a place of you, you know, never know what's going on in people's lives and to try to give them some grace. And remember that you don't know really what's going on and just give them grace. So I think those are the biggest things that changed for me.

When you were working in critical care, were there universal things that people were doing maybe lifestyle-wise that were contributing to their illness? Obviously, there are so many factors, but not to place the blame on anybody, either in that situation. But being in that industry for so long, I'm sure that you notice. Yes. And the biggest thing, and you know, we can never blame the person or the patient because they don't necessarily have access to all of the knowledge. But the health system itself is where, you know, really the problem is, is that doctors are overworked. Primary care is not great for prevention. And I always say that if you need surgery, you need your gallbladder out, you're having a heart attack.

A hospital is a wonderful place. Western medicine is a wonderful thing. But prevention and keeping people well, we just do a terrible job. And there's multiple reasons why that happens. And most of it is based upon the amount of time that providers have to spend with their patients. And I think there's also a lack of knowledge with a lot of physicians or providers that don't seek alternative education. They don't learn about nutrition. They don't learn about lifestyle.

And some of the information that they give patients is not really. applicable and it's focus. So I think that's the number one breakdown. And then, of course, smoking is a bad one. You know, you have multiple, multiple issues with that. You get lung cancer, heart disease, vascular disease, diabetes, unfortunately, when it's not controlled well, it wreaks havoc on every single organ in your body. And then drugs and alcohol. You know, you can really hurt yourself with alcohol. And it's hard for people to understand because it's so readily available and it's everywhere. But I have to say that those are some of the tragic young and old, and it's not a good way to die. I think those are kind of the bigger ones that I would say are

lifestyle related. Obviously obesity, you know, it hits every organ. Usually obesity ties into a lot of the other things. They're a smoker, they have diabetes, but sometimes you can just be purely obese and it's bad. You become immobile. Your joints hurt, so you work out less. menstrual is a problem. So obesity is an epidemic in this country. And it's not okay to talk about. People get really upset. And we've stopped addressing it because of the way people react to it. But there's nothing cool about being obese. Yeah. And I had this conversation with, I think Vanessa Rosetto, who's a registered dietitian. She was on my show recently. And we were talking about how not everything is diet culture. I think that. the pendulum has swung to this kind of extreme where, like you're saying, you can't talk about it. You can't want to lose weight. Right. Right. Because it's all kind of labeled diet culture, but it's not. Okay. So you have these advanced degrees in nutrition and you do a lot of, I don't want to say alternative therapies, but preventative therapies. And like you said, you look at the whole person when somebody is

coming in to see you. Yes. So what are the fundamentals of somebody's lifestyle, including nutrition, like all of the different aspects? What are those to you? Like, what are the pillars? So when I sit down and talk to somebody, whether they're coming to see me for Botoxin filler or we're actually doing a medical consult, the first thing I want to know is, how are you sleeping? Uh, right. So sleeping is, it's huge. That's when our body gets to rest and repair itself. And I tell my clients, I'm like, if you're not sleeping, then you can't work out. So, you know, you have to pick and choose. So sleep is always the first thing I ask for.

And sleep over a workout, hands down. If you're tired, you need to go to bed. You don't go to that Pilates class at 5 p.m. You go home and you rest. So sleep is what I always ask for. And there's multiple reasons because when you ask about sleep, sometimes it will allow people to talk to you about their anxiety or their depression or maybe they're drinking alcohol at night.

maybe they have a partner that is snoring and needs to be seen by a doctor and he has sleep apnea and he doesn't want to. So sleep is a benign question that you can ask that's not like, what are you eating? Yeah, that's so interesting. Like I feel like nobody gets defensive when you ask about their sleep and they won't lie. Yeah, exactly. So the sleep is the first thing. And then I get to ask why. Then the next question is why what's happening.

And then we can go from there. So that's always my number one question is sleep. And most people are just more than. happy to tell you about their sleep. Oh, yeah. I'd like to tell everyone about my sleep right now. I did. In fact, I walked in.

I told Anna, I told my last guest. Everybody, I slept like three hours last night because my husband was snoring. It's terrible. Like, what the, I mean, I felt attacked. I was recording it. So I could play it for him later. I was doing this at three in the morning. And then when cooler heads prevailed, I was like, maybe I don't.

Maybe I don't need to play this for him. Maybe that's a little mean. He's getting over it cold. It is. Yes, exactly. Well, our sleep partners matter. Yeah. It really does.

And disruptive sleep is really bad. You know, we tell new moms, like, as long as you're getting three or four consistent hours, that's about the bare minimum, but you can function with. It's the every hour, it's those things. And then with women, you know, typically, once you hit 35, we hear over and over again, I wake up at 2 a.m. that's progesterone. So, you know, for females, progesterone is probably the most important hormone that we have. And as we age, our progesterone decreases.

And the number one thing I hear in the offices, I fall asleep, but I'm up at two or three in the morning. The thing I think about with that is alcohol because it decreases your GABA and it inhibits your GABA and then it becomes hyper excitatory at 2 or 3 in the morning. Yes. Yes. So that's a big red flag. So when I hear people that say I wake up at 3.

am and they've had a bunch of wine, it's usually that. And then with women, it's your progesterone. So progesterone is a grounding hormone for us. It makes us feel amazing. Yes, it's the best. People know when their progesterone is off. Well, my progesterone was popping for the last week. It was amazing. It was, because I would go to sleep at like nine, like so calm. I always say it's like, yeah. It feels like I'm taking Xanax. Like, I mean, I love it. It's like this just. It's amazing. It's amazing. It's a calmness that descends.

Yes. So progesterone and replacing progesterone for women can be very profound. So we can, you know, get that in the sleep history. We can say, oh, our hormones are starting to take a dip. And the problem with perimenopause is your hormones are a snapshot. So getting lab value in perimenopause is difficult to really assess. So I like to say that I listen to the story and I treat the symptoms. The lab values are important, but they're not the most important thing because what's important

is how you're feeling and how you're doing. The labs, there's certain labs that, yes, drive how we do things. But if you're 35, you're by definition in perimenopause. And if you're not sleeping through the night, that's low progesterone. So we just replace it. And it's very easy to do. And people have very little side effects. Too much progesterone can make your breast very sore.

You can get a little bloated. So you have to be careful. So too much is when people are like, I don't feel well. It's a little bit too much. My issue, because I was doing bioidentical progesterone, and I felt fucking fantastic. And I was doing it like day 14 to 28 of my cycle, and that was because of my PCOS. But I was bleeding all the time, copious amounts to the point where I was like, I can't do this. Right.

Is that a common side effect? Yeah, it can happen. But we, so the problem is when you start bleeding like that, sometimes your doctors will tell you to increase your progesterone to stop the bleeding. and then when you decrease it, you have a shed. So we do use it to stop bleeding, but then when you decrease it, you can shed. So it can happen. Anytime you augment hormones, things can happen. Do you always like to do hormone replacement or are there lifestyle things that you do for the people that you treat as well?

That can help definitely level that. My only know is to pellets. That's my only know. That's where they take. Basically, they take an instrument and they make a little track inside, like usually your hip area, and they insert progesterone, estrogen, testosterone, in a pellet form that lasts for three months. Why do they, oh, long-lasting? And does it not go into, like, your blood?

It's in the subcutaneous tissue. The issue is that, oh, there's so many issues with it. I don't know. Someone's going to get mad at me for this. But I hate them. So usually when I see patients. that are on the pellets, women are typically being seen by a male doctor who is giving them excess amounts of testosterone. Testosterone and women I have a lot of thoughts on. If you look at a male,

look at when a male gains weight, where do they gain weight in their abdomen? They have more testosterone. They have more androgens than we do. People with PCOS tend to have more abdominal weight. So I don't agree with giving women all of this testosterone. And so there's some anti-aging doctors out there that will say, oh, but it increases your sex drive and it'll help you get lean muscle. The amount you'd have to give a woman to do that is just not too much. So when you look at women when we're younger and we're voluptuous and our skin is glowing and we have a sex drive, it's our estrogen. It's not our testosterone. So they're typically have too much testosterone in the pellets.

And also, if you don't do well, you're stuck with it for three months. It's if your skin starts to break out or your hair falls or you just feel crazy. It's like I have a lot of women that come in my practice and they get an IUD and they've to take it out four days later because they're like, I am psychotic. Yeah, did I know you when that happened to me last year? I got the IUD. I can't remember which one, but it was supposed to be really low dose progesterone, but progestin. And I felt like I can't even describe the anxiety.

It was insane. I felt like my senses were on fire. Like everything was too much stimulation. My peripheral vision was like stronger than my regular vision. I would like see things from the side and sounds were loud. And I was crawling out of my skin so anxious I could barely breathe. And they said, no, it's not from that because it doesn't go into your blood because it was in. Right.

And I had it taken out. You were fine. And yeah. And it took maybe a week or so. I can't remember exactly how long. But yeah, then after that, I was fine. And then somebody else I was talking to was like, yeah, but sometimes it's just mental because you know that you have it in there. And I was like, all right. No. I know. No. I don't agree with that at all. I see it all the time at my office. So yes, we do do. So the biggest thing with hormones is, you know, you need fat to transport your hormones. And a lot of times as women, we don't eat enough fat. So as we start to age, that becomes more and more important that you need to have some good healthy fats to help the little hormones that we have left be able to circulate. So you got to have your avocados, your good olive oil, all of those things to help, you know, with that. And then calming down inflammation. So as we age, our inflammation really starts to

skyrocket. And I think just in today's culture, inflammation is there. The things that we're eating, what we're consuming, the lifestyle that we live, we're on adrenaline rushes all the time. Our phone is constantly in our hands. We're consuming, you know, all types of media and they're sometimes loud and TikTok and all of the things. So our inflammation gets really high. So we want to calm down the inflammation. And I love to do that with adaptogens. So we use a lot of aschua gonda, holy basil, and some other CBD, some other things that I don't want to bore everybody, but I love to do that. And then I also like dim. So dim is a supplement that's crucifers, vegetables. And I like women to take them in cycle. So three months on, one month off. And people tend to do pretty well on dim. It helps with a lot of symptoms.

You can have some breakthrough bleeding with it. So if you have breakthrough bleeding, then we stop it. But I'm going to be very honest, most women, unless they're just either their mother didn't have a really difficult perimenopausal or they just, they just don't have a hard time with it. Most women end up on some sort of hormone replacement and they feel so much better. And we know now that it really is very protective for our brain. Estrogen is really important for our brain. So there was a study that they used oral estrogen at really high doses, and it freaked everybody out because there was all this cancer. It's an old study, and some people will still refer back to that.

But we do it transdermally now in a patch. It's a lower dose. We try to get the lowest dose with, you know, the most effect. And for the shortest amount of time that you need. There are plenty of anti-aging specialists that believe that women should be on it forever. And I think the goal with any time you're replacing anything is to replace. it, not to augment it, right? You want to take it back to what you basically lost. So we're not looking to take your numbers skyrocketed or for you to feel like you're going to fly, just to make

you feel good again. And it's impactful. And I always say to people that women have kind of been a little bit neglected in the medical space. And we haven't really been looked out for it. It's like, oh, well, it's just part of it. Menopause just sucks. Well, actually, no, when you're done with, when you're menopausal, it's done. It's a perimenopause. It's a peri that sucks. And the answer is not just, oh, just deal with it. It's not. I feel like that's the next frontier because I don't think it's really gotten the attention that it deserves because it does affect so many different things. And I think you don't think of 35 as perimenopausal. You know, you think, oh, like, I don't know, late 40s, 50s. I don't really, I don't know when menopause is.

but I've heard it talked about from other specialists and people who are saying, like, this needs attention. So I feel like that is kind of an overlooked aspect of anti-aging. There's this time from maybe your mid-30s to your mid-40s where we're just kind of like left to our own devices. What are some other anti-aging or just lifestyle things that are often overlooked by women? So I think that I tell everybody that what worked for you at 30 is likely not going to work for you at 35 and 35 is not going to work for you at 40. So I think we have to be adaptive and we have to really listen to our body. Like I don't like women to do a bunch of hit classes or high intensity classes if they already have a very stressful job, if they already have a history of anxiety. And I don't like them to do it for more than two days a week. And if they do because it increases inflammation.

And, you know, I like to talk about adrenal glands, a lot of, you know, Western providers don't like that, but I think that there's a real thing there. And, you know, we live in a different society now where our adrenals are being asked to pump out this cortisol all the time. You know, we're working longer hours. When we're not working, we're on our phone and we're being inundated with all kinds of media. We're in traffic. So our adrenals are really working hard. And so I think that there's a conversation that needs to happen. And so if you're doing a high-intensity workout on top of that, your inflammation is going to skyrocket. Then you come in to see me and you don't feel well. So I tell women if you're achy,

if you're bloated, if you're constipated, if you're cranky, we need to have a conversation. And I think we've done a really great job of helping women age gracefully, aesthetically. And we've talked about normalizing, getting Botox and fillers and that we should talk about it and all of those things. But we don't talk about the hair loss that happens. We don't talk about the weight that we can't get off. We don't talk about the fact that we're not sleeping. Or maybe we feel anxious and depressed all of a sudden when we never have before. So I love the fact that we have all these tools to keep women, you know, looking beautiful. But I tell people, we only have so many dollars. And we should sit down and make a plan, an overall plan of like, okay, so we're going to do

Botox this month and maybe a little sculpture. But we also need to talk about peptides or nutraceuticals or NAD and where that fits into it. And they're just as important as what we're doing on the outside. Let's talk about peptides. Because I had Dr. Jessica Cho on here. I think it was in September. And she touched on them. I've never had anybody else talk about them. And from what she was saying, they sound magical. So what exactly are they? What peptides should women be getting? Or is it very individualized? Great question. So I was, I was. trained by Craig Conover in Charleston, South Carolina. He's kind of very well known in the anti-aging, precision medicine space. We use all of his peptides. So he said something to me very

powerful during training, and he says, nothing is going to work for everybody. And nothing is a standalone, you know, magic thing. So I like peptides, and he likes peptides because they're super safe. So they're amino acids. And they're very, very safe. And what we do is we inject them under the skin five days a week, two days a week off. There's different types of peptides. There's peptides for strength, and those will have a growth hormone precursor. So not growth hormone itself, but something that goes into your pituitary gland and asks your body to make its own growth hormone.

So that's why they're super, super safe. We use some for skin. Those normally have copper in them. Those you want to take for about three months and then take some time off because there is copper, but it will make your skin glow so well. There's some that are neuroprotective that are amazing for the brain. There's ones that help with fat loss. I love them because they're something you can do long term.

And they're on this conveyor belt of aging. And what they do is they're a tool on this conveyor belt of aging that's helping us keep up instead of, you know, all of a sudden, like we haven't done anything. And now we're like adding all these things. They're a beautiful way to stay on the conveyor belt of aging. What will happen if you think that this is going to come in and all of a sudden you're going to look like Cinder it's not going to happen. Damn it. Yeah, exactly.

It's not going to happen. So I tell my patients, I'm like, you might notice little changes as we go along. With the glow, your skin will absolutely glow. People feel really good on the ones with the growth hormone precursor. So ours are blended. So the really amazing thing about ours is that they have about five or six different peptides in them. Most traditional practices will use one or two because they're not familiar.

And I'll say this again, and it's not to be shady or, ugly, but you still need to know how to use these and how to prescribe them. And even though they're not a prescriptive medication, you should really know what you're doing. And this industry of aesthetics and wellness is very unregulated. And that's a problem because everybody thinks that they can do everything. Like I don't know how to do a rhinoplasty or, you know, a breast augmentation, but I know all about peptides and NAD and Botox filler skin stuff. But everybody thinks that they're an expert. And so they just give these people things and they don't really know why. And they don't know how to adjust them. And I was listening to Craig talk the other day about how sometimes they give people

a really big doses because they want their patients to feel something so they'll come back and spend more money. What I always say about industries where you're, you know, you're kind of helping people with things they're insecure about. And it's our opportunity to make sure that we do it in the most ethical way and that I'm as trained as I possibly can and then be honest enough to know the things that I don't know and send them to the right people. So that's why, I mean, I love peptides, but I think they need to be in the right place with the right person. I like that you talk about the conveyor belt of time. That's also something that mascara talks about.

Does he say that? Yes. He says, what does he say? You can't stop. I think he says conveyor belt. You can't stop it, but you can move yourself back a little bit. Exactly. Through, you know, obviously with him, it's like surgical intervention and Botox filler, all of that.

Let's talk a little bit about some of the ex-executive. external stuff. Yeah. You look amazing. Can you tell everyone what you did? Yes. So I look amazing. One, because I have makeup on, which I don't normally wear, and then Dr. Mascar. So we love Dr. Mascarro. And a couple of reasons. And this goes back to what we're talking about peptides is Dr. Mascarro is is very ethical. And he's extremely talented. And he's doing niche surgery. And I think that's also going to be where things are going is that you're a niche, right? Like Dr. Funderb. Burke in New York. He works after Ninstein. He does amazing body work. Like incredible. I mean, obviously, Ninstein does too, but Bundaberg's is beautiful. And then Miguel does really,

really beautiful lip lifts. He does really beautiful, natural facelifts, necklifts. And he's also humble enough to know when he doesn't do something. So I had some creakiness underneath my eyes that were bothering me. I didn't have a fat pad. It didn't have any swelling. So he just took the skin. He pinched it up and sewed it. And then we did see it. to laser, which is a laser that will help tighten the skin. And then him and I thought about it for quite some time, but I got a little lip lip, which I'm so happy about because as we age, our philtrum starts to, or the space between the nose and the lip. It will start to elongate. And so he just tucked it up for me. It looks incredible. And you just did that a few weeks ago,

right? Three weeks ago. Yeah. That's crazy. I'm trying to see the incision under your eyes because I was going to do a skin pinch as well. And then he decided not to, which we just keep on him like I had my lip and he'll eventually. No, I think he said he would do it. He'll eventually give it. But I feel like the CO2 also is such a great option because I think when women start to notice changes in their face, we see our eyes first. And I think even he has said like there's an order of it. Like eyes.

Interesting. I can't remember what else. Sorry, Miguel. But the eyes, I think, are where we first notice it because we have the creepiness or, you know, maybe some brow. or excess skin or your brows are dropping or your under eyes or getting a little bit puffy or whatever the case is. And there are so many different interventions. So if somebody comes to see you and they don't want to have surgery, what are good options

for that? It's hard. So what I always say is that it's my job to be honest and give them, even though sometimes it's hard feedback that if they happen to have a lot of swelling under their eyes, you just can't put filler in there. And I'll tell them, I can't put filler in there and nobody else should. So there comes a point where surgery, if you want to change your appearance, is the only option. But there are lots of things that we can do.

So I'm not huge on energy devices. I don't love them. And I like them in small amounts. Maybe once a year you do a Morpheus or Vivachi or something that's a radio frequency microneedling. I think that it's really, it can have its place, but it can also damage. and get rid of fat, which we need as females in our face. Yeah, that happened to be careful. That happened to me with too many radio frequency.

But I think also people have a misconception about what it can actually achieve because people are clever with their marketing. And I think that people think something like a Morpheus is like a laser facelift, which it's not. And honestly, there was a study that just came out that showed that it really does no tightening. It's great for pores. It's great for fine lines. But it doesn't tighten.

and I'm sure someone's going to be very mad at me for saying that. Just going to say there's going to be people. They're very mad at me for saying that. And maybe they're getting results that I'm just not seeing. And that's amazing. But in general, I think that it has its place. But I don't know that you're going to get a new jawline. So I like to keep things very natural.

So I think skin, skin, skin, skin, skin. You know, when I tell people we have a consultation in my office, I'm like, think about the great beauties of our time. Look at Cindy Crawford. Look at Christy Brinkley. what do you look at when you see them? They have great hair, they have great thick hair, they've got great skin. You don't know if they're 40 or if they're 70, right? You can't tell. That's like everybody in L.A. now, but it's different. It's like, I don't know if you're 25 or 65. Right. They're a little, yeah, right, exactly. Twenty-five-year-olds looking 70 is not the way we want to be

their expressionless. When we can talk about that too. But as an older woman, when we start to age, our hair is really one of the hallmarks of aging and then our skin. So I think that when you're in your 20s, you need to be wearing sunscreen, sunscreen, sunscreen, and protecting your skin. And if you have acne, you know, really need to get on top of that so you don't have scars and hyperpigmentation that down the road is going to, you know, be hard to deal with. I think when you get to be 25, you need to be adding a retinal and some sort of really good moisturizer along with your sunscreen. And then when you hit 30, that's when you start looking at doing some things, a little bit of filler on your cheeks maybe. Definitely some, I think

it's time for neuromodulator. So Botox Disport Juveau. It's time. And is that preventative? Do you believe in preventative Botox and neuromodulators? Or, I mean, at 30, usually people have some stuff going on. I do because there's a couple of places, like right here and here, the 11th, that if you get really furrowed lines there, it's kind of dangerous to put filler in that area because that's the vascular that it feeds our eyes. So most people aren't really willing to put a lot of filler in there. So I tell people, I'm like, that's not something you don't want to get an etch line. I tell people you know you're ready when you have movement. And when the movement stops, there's a line there.

That's when it's time. So if you have movement and there's no line left, then you're probably okay. The minute there's a crease, you need to come in and see me. I have girls who are in their early 20s who DM me and ask me if they should start getting Botox. First of all, I'm not a professional, but I talk about this stuff all the time. So I appreciate that people trust my opinion enough to come to me. and, you know, it's a safe space always. Right.

But I just think back to when I was 20, I didn't have shit on my face. No. I mean, your 20s, your early 20s especially, you're sleeping four hours a night, partying maybe, eating Doritos, like whatever. And you wake up and you look amazing. I know. So I think it's just this kind of culture that we're in now where there are so many young women, young famous women, the people that we see day in, day. out who have had so much done. And I think it's just kind of fed this narrative or just this feeling like, okay, I need to be doing

this so that I can keep up even if there's no issue. Agreed. And so I think that's where the medical provider comes in and says, oh, my gosh, you look amazing. Let's get you some skin care. I'll see you back in three years. And that's where the ethics come in. And that's where I think it's missing in this industry a little bit.

because anytime someone's paying you for a service, it's the right thing to do to say no, but not everybody can do that. So I think that that's where not the adult in the room, the medical provider in the room has to take over because that's where it happens. I think that as far as young celebrities getting work done, that's a whole other issue. And, you know, I'm often asked, people who ask me, like, don't you think they should tell what they've had done and it's not right? And I have a completely different take on it because being in medicine, one of our number one things is to prevent, I mean, to protect patients' privacies.

So that's just ingrained in my brain. And I can't stand it when I see people in my industry like doing before and afters of celebrities and like what did they have done and they're commenting. And I find that to be just very repulsive. I don't like it. I get that it gets them clicks and all of those things, but I don't think it's right. And I also think that these poor young celebrities are in this really. quandary of what to do because if they say they like a lipliner on Instagram, it will sell out immediately. So like, let's say that they said what they had done.

I think that it's hard to be to say that that's going to normalize it for young girls. I think that it could in some sense push young girls into getting surgeries that maybe they don't need or they can't afford and then they get them from not reputable providers. That's what worries me. And so, you know, I don't know. I think that they're in a they're in a tough situation. they can't win. When it comes to lying about it, you know, that's different. We've all done it. I mean, I've even lied to my husband about what I've done. I mean, we've all done it. So I get it. The lying is a little bit of a different story, but I think that everyone has the right to share when

they're ready. I was telling a patient of mine the other day because she was complaining about it. And I said, you know, if Kylie General, let's say, for example, because she's so influential, I don't know anything that she's had done. But if she went on Instagram and she's like, hey, guys, I had like my lower intestines taken out because I'm so skinny now, you know. well, somebody would open up a clinic and take out these poor girls lower intestines. You know what I mean? Yeah. So. Yeah, I never thought about it from that perspective. I mean, I've talked about this so much on the podcast where I agree with you. I think everyone has a right to privacy. And I cannot even imagine the scrutiny that they're under because I get it on such a teeny tiny level and sometimes it's overwhelming. So I agree with you. I don't think they can win. I think the lying. I mean, there does come a point where it's like, you're doing an interview. You can say, don't ask me this. I'm not going to talk about that or no answer and they're not going to include it. And the lying part, I think, is a little bit like gaslighty, not to overuse that word, but because it's like,

well, we have eyes. But I never thought about it from the perspective of it's kind of dangerous. Because some of them are so influential. I never thought about it from the provider aspect where, you know, they might go to any like old med spa or somebody who's really not qualified and get botched, especially when you're that young. Right. That can just be devastating. Yeah. Or they go into another country and they're alone having surgery there.

And that's really, you know, medical tourism is a thing. And so that's where I feel like that, I think that that could be a problem. And I don't know that them telling what they did is going to be very helpful. You have your own eyes. If they have all of a sudden huge breast and they didn't have them before, you can put two and two together. And you're like, oh, she had a big job. Like, it's very clear. You don't need them to tell you.

Yeah. So, and, you know, we're kind of doing that now with sum of glutide. Like, we're really, like, we're all over people for using sum of glutide. And I have a large practice that we use a lot of sum of glutide. And it's a very helpful drug. And I think it has its place. And I can tell you from working with it for so long that some of glutide will help you lose weight.

But if you don't do all of the other things, lifestyle changes, diet, working out, it's just going to lose, you're going to lose weight for a little bit of time and it's not going to last. And so we're all over these celebrities of like, oh my God, they're just using some of gluteide. They're not. They're still eating well. They're still working out with their trainers. They're still doing all of the things. It's just a tool in our toolbox.

And obesity, like we talked about, is really not healthy for you. And so if we can help somebody who's obese, lose weight and along the way, learn how to eat and how to exercise, and why would we shame them into using something that's, so helpful. It's not a stimulant. It's not something that, you know, is harming their body. Granted, if you walked into my office, I would tell you no. You don't need it. You know my philosophy will never jeopardize the face fat. That's right. Exactly. Somebody told me there's like an article right now that's called Ozempic face. And I was like, oh my God, I have to read it. Pancake face. Yeah. I mean, we have sculpture for that. I can fix it. Don't worry. I can fix it. So they can't win for losing, right? It's just.

just it is what it is. Yeah. I know. Okay. What do you think? I kind of asked you this before, but if you could just like list, what are the fundamentals that every woman should be including in their lifestyle? Amazing. Sleep, some sort of self-care. And that means something different for everybody. Some women will never go get their hair done. They want it to be gray and they're not going to be buying, you know, medical grade skin care. So then their self-care might be taking a walk or doing of meditation, I think that something that self-care for you has to happen because we take care of so many people. We're business women.

We're doing all these different things. So some sort of self-care. And that gives you time to pause, to think, and also just to actually do something that feels good for yourself. So I think that's very important. I think being as anti-inflammatory as you can possibly be is really important. So we know that inflammation is pro-aging. It just is.

So if you're drinking a lot of alcohol, if you're eating a ton of sugar, if you're living a very stressful life, then you're inflamed by definition. And you need to calm down the inflammation. Meditation, walking, adaptogens. Those all need to come into place. You need to stay on your hormones and your thyroid as far as getting your labs checked at least once a year. Most women are going to have some sort of thyroid dysfunction. I see it all day long. It's become almost an epidemic.

And so if you're not feeling well, if you're tired, if you're slow, sluggish, don't just brush it off and don't allow somebody just to get a TSA. So many Western doctors will just get a TSA. It doesn't tell me anything about how you're doing. We need to know the markers of T3 and T4 and really get to the root of your thyroid issue. So staying on top of that, replacing your hormones if and when the time comes. Thinking about doing PRP for your hair to keep your hair healthy and to fertilize those roots, because we know it starts to shed as we get older. I feel like I need to do that around here. It looks, it's great there. It's a great place to do it.

I saw a reel that you recently posted and it was amazing. I know. All the hair growth. All the baby hairs. It's great. So PRP, I think, is a really, is a really great one. And then I think staying on top of doing, unfortunately, some cosmetic things. I think that, you know, if you want to look younger and you want to remain youthful, you're going to have to.

And I tell people, you don't have to change the way you look, but you want to soften the way you look. And if you're always furrowed here because that's where you keep your tension, let me put a little Botox in there. We don't have to change anything, but you won't furrow. People won't look at you and be like, she's angry. Do you feel like that helps people mentally as well? Like if you are holding all your tension there, I mean, I know, like I do it in my jaw sometimes because I clench at night. And that's where I hold all my tension, my jaw. I fucking, it's just, that's it. Like, there and my stomach, like I clench my stomach. But the bow. I don't really do it for cosmetic reasons. I do it to, you know, alleviate that.

Yes. And it does help me in other ways. So it is kind of therapeutic. Because a lot of people will come in and they'll say, look at my photo and they'll say, I don't like the way I look in this photo. I'm like, what is it that? You don't like? I look angry. So we can do just a little bit to change that. We're not saying you have to get a blephalplasty. We can just change that little thing. I think supplementation as we start to get older is really important. None of us are getting all the nutrients. We need glutathione, vitamin C, or two of my favorite. I use it post-stop on everybody. I think it makes the incisions heal amazing. I know you've heard me say this a million times because you told me. It makes the incisions heal.

You can like not see the incisions because it's a, they're powerful antioxidants. So you're basically getting rid of the free radicals and you're giving your body all the antioxidants. So you're, you don't get the redness with the incisions and they close and they heal beautifully. What supplements do you recommend all the time? Should we all be using vitamin C, glutathione? Yep. Regularly. If you had the money, and you have the resources, I would say some sort of fish oil or omega-3. So if it's a vegan one, it's algae-based. Or if you're not vegan, then it's an omega-3.

I like Nordic Naturals. I think that they're a great brand. That helps so much with inflammation. It really, really does. Glutathion, vitamin C, I think, are two non-negotiables. And then I love magnesium. I think magnesium for women is really, really great. Does it really help you sleep better at night?

Probably not. But I think that there's so many other benefits to it that I love it. But wait, I beg to differ. Oh, it helps you sleep. It does? Yes. Well, okay, I have this product from Ned, but they have a drink called Shudai Chai. Oh, yeah, yeah.

I take their mellow, which I absolutely, I feel like it just helps me relax, but the chai has adaptogens as well. So that's probably why it kind of like, it helps you to use them to sleep. Yeah. I love that. So Elthian, all of those, my favorite. Lemon, Palm, Pashther, they're amazing adaptogens. So there's a liquid, there's a powder magnesium. that's pretty popular in a lot of the stores you'll see. And I took it one night as like a trial to

see if my patient, you know, and I had the worst nightmares. Was it the calm? I remember you texted me. I literally had the worst nightmares. It was horrible. So I don't recommend that one. Only because my personal experience was not good. I took the gummies actually and it was not the vibe for me. Yeah. No, not the vibe. What else? What else? Movement. So I think women need to move. You know, we sleep. If we're sleeping. We're sleeping six to eight hours a night. We're sitting for work probably six to eight hours as well. So we need movement. We need scheduled movement for a lot of reasons. It's really great for our bones. It helps the integrity of our muscles. It's not great for weight loss, but it's really great for your mental health. Wait, did you just say movement is not great for weight loss?

It's not. That is so interesting. I don't know when this is going to air, but I had Tim Specter. He's also a registered dietitian. He's one of the 100 most cited scientists in the world. He's British, I think. He's amazing, but he said that on the show. He said it's not. And I was like, oh, people are going to have a reaction to that. It doesn't. Yes, if you're Tom Brady and you're working out like that, yes, of course. But for the regular people, no. And sometimes with women, they'll do these hit classes. They'll go to like Orange Theory or do you guys have Orange Theory here? Yeah. And they will rev your metabolism so much they actually overeat. So it's counterproductive. That's Harley's philosophy a little bit. And we worked out with him yesterday. We did. We can't walk. We feel like we rode

horses for a month. But he always says that. He's a big proponent of walking and low impact strength training, which is like what we did yesterday. You're never getting your heart rate really high. And you don't feel taxed at the end because he said like when you do that, you end up overeating a lot. Exactly right. I see that all day long. And then I think sticking with your provider, like if it's me, like someone like me who does injectables and wellness stuff, and then finding your plastic surgeon. I think sticking with somebody is important and conveying your goals for aging.

And I think having a plan, I see people who see multiple different people and their face looks like multiple different people touched it. Yeah, because every doctor has a different style. They're like clothing designers. And I remember Dr. Talley said this because he did my first lip lift. And then I went to mascara and got it redone.

And I was like, oh, God, because I love Ben, I think he's great. He's super talented. But he was like, hey, we're like, designers. Like everyone is going to bring their own style to the work that they do on your face. So they're going to take what you want to have done and interpret it in their eye. And yeah, I think it can get kind of like piecemeal when you're going to a lot of different people. Yes. So I think having communication with your provider is so important and sticking with somebody that you really like and working through because not everything's going to be perfect, but you need to work through it to get to the other side. The most important thing is that you trust them. They're ethical and you have the same aesthetic goals. And then the last. And then the last. thing I think is for people to find happiness in their life. And you can tell people radiate and glow when they're happy and they're loved. And that can be with your animal or with your spouse or with your kids or with your job. It doesn't have to be in the traditional sense. But when you're happy,

you glow. And I think that you age so much better. Amazing. Well, you know what's coming, probably. Or maybe John knows what's coming. One thing we should start doing and one thing we should stop doing. We should stop talking negatively to ourselves. So a lot of women will come in and say, I'm fat, or I hate this about myself. Like I used to tell my kids, if you don't like something, like on your dinner plate, you say, I don't care for that. You can say, I don't really care for the way that I'm aging. That's a nice thing. It's very jarring to the system. And then one thing we should all be doing, I think we should all be wearing sunscreen. What's your favorite sunscreen? I love skin, Better Science. That's my favorite. I love it. I like super goop too, but Skin Better Science is my

favorite. Thank you so much for coming on. Tell everybody where they can find you. So you can find me at Daniela Esradi Estetics on Instagram. I don't have a TikTok because I'm old. And then we're in Atlanta. We're located in the heart of Virginia Highlands in the most beautiful clinic. And we have a gorgeous storefront. So even if you don't want any services, we have fun products, wellnessy products, all the things. And the best candles ever. That's Marrakech, Marrakech, I don't know how to pronounce it. I burn it every morning in my meditation. It is the best smell. My friend went to see you and she was like, the candles are the best smelling candles. They are. Ever. They're amazing. Can they buy those on your website? Yes. And they're named after two of my most favorite places, Manhattan and Marrakesh. And there's

one coming for summer and a lot of you will be able to guess what it's named after. Miami. Exactly. You heard it first here? Miami-Vice. Thank you so much for coming. Thank you, Ariel. That's great. I hope you enjoyed that episode. And if you liked it, and if you liked the show in general, please take a second to rate, review, and subscribe. It goes a long way, and it's actually the best way to support the show. Also, if you want to see more about each episode, you can head over to The Blonde Files podcast on Instagram. You can go to areaallory.com, and I'm always posting about each episode over on my personal page at Ariel Lori. Please note that this episode may contain paid endorsements and advertisements for products and services.

Individuals on the show may have a direct or indirect financial interest in products or services referred to in this episode.