Well with Arielle Lorre - 267: Your Guide to Healthy Hormones, Part 1 with Endocrinologist Dr. Jordan Geller, MD
Episode Date: August 23, 2023Dr. Jordan Geller is a dual board-certified physician spezializing in Endocrinology and is on staff at Cedars-Sinai Medical Center in Los Angeles and Jupiter Medical Center in Palm Beac...h County, Florida. He manages complex hormonal disorders at his offices in Los Angeles, Palm Beach, and through telemedicine consultations in New York. He joins the show to discuss what hormones are and how they function in the body, how our lifestyle affects our hormones, and where to start when treating hormone imbalances. He explains how endocrine disrupters that we encounter all throughout our day influence our hormones, how to make simple changes in our diets, products we use and lifestyles to support our hormones, the pillars of health that contribute to hormone health, natural interventions to improve hormone related issues, acne and other skin conditions and so much more. 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.Go to MoonJuice.la/blonde and use the code BLONDE at checkoit for 20% off Get 20% off your first order of Sakara at www.Sakara.com/Blonde or use the code BLONDE at checkout. Go to BeisTravel.com/blonde for 15% off your first purchase. For a limited time, listeners get 20% off their first order by going to vegamour.com/blonde use code blonde at checkout. Save 30% off your first month on subscription, lock in member pricing, free shipping for life and some amazing freebies when you visit JustThriveHealth.com and use the code BLONDEFILESGo to SundaysForDogs.com/blonde or use the code BLONDE at checkout for 35% off your first order of Sundays.Produced by Dear MediaSee 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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Welcome to the blonde files podcast. I'm your host, Ariel Lori, 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. And do I have a good show for you?
In fact, I have two shows on this topic of hormones. So today and then next week, I have part two,
where we do a lot of specific questions. We take some listener questions and we really get into the
fine details of hormones, but we get into a lot of that today as well. So let me rewind a little bit.
I'm talking to Dr. Jordan Geller. He is somebody that I wanted to have on the show for such a long
time and I'm so grateful that I got him on two separate days for multiple hours to give you guys
the ultimate hormone episodes. So I've had many people who treat hormones and look at hormones from
physicians who practice internal medicine to people who practice women's health, OBGYNs, things
like that, but I've never had an endocrinologist on the show. So Dr. Geller is a dual board certified
physician. He earned his medical degree from the University of Southern California. He completed a
postdoctoral fellowship at Cedars Sinai Medical Center in L.A. as well as an NIH fellowship in
clinical research. He was the past clinical chief of the Division of Endocrinology, Diabetes and
Metabolism at Cedars-Sinai Medical Center. Dr. Geller has lectured at National Symposia and authored
numerous publications in the field of endocrinology. And he, like I said, is dual board certified
in endocrinology, diabetes and metabolism, and internal medicine. And he's on staff at Cedars
Sinai in L.A. and Jupiter Medical Center in Palm Beach.
He manages complex hormonal disorders at his offices in L.A., Palm Beach, and through telemedicine consultations in New York.
So there was so much to get into, which again is why we broke it into two episodes.
Today's episode is very comprehensive.
We do an overview of what exactly hormones are.
I think when people think hormones, they often think reproductive hormones or things like testosterone,
progesterone and estrogen.
But there are so many hormones in the body and we discuss what they are, how they function.
And we talk a lot about how our lifestyle affects our hormones.
Dr. Geller is very passionate about the fact that rarely does he see a true hormone imbalance
or disorder that originates in a gland.
He argues that most of it is lifestyle.
So we talk about where to start when treating hormone imbalances, different manifestations of hormone imbalances.
He explains a lot in this episode about endocrine disruptors.
So he kind of walks us through the day and all of the different endocrine disruptors that we encounter, how they influence our hormones, and how to make simple realistic changes in our lifestyle and in our diets and in our products that we use.
and all of that. So this is not fearmongering. He is just giving us the facts. And then we can choose
how we want to incorporate these things in our lives. He's very realistic about the fact that,
you know, we live in this modern world. We are encountering these things all throughout our
lives. And so we just make modifications where we can, where it is, you know, again, realistic for us.
And that's going to be different for everybody. So we talk about the pillars.
of health that contribute to hormone health. And then he has some great natural interventions to
improve hormone-related issues. We talk about acne and other skin conditions that are related
to hormone imbalances. We talk about stress and trauma and hormones. We talk about alcohol.
We talk about OZempe and just so many fascinating topics. I think you guys are going to love
this episode and again, come back next week where we get into a lot of specifics and next week
we also talk about things like PCOS and endometriosis and thyroid issues and all of that. So
please enjoy Dr. Jordan Geller. Welcome Dr. Geller. Great to be here. Really excited to have you here.
You have been on my list of dream guests for a long time. I think I first heard you on lipstick on the
a couple years ago, if I'm correct.
You did one a while back, right?
Yeah, we've done a couple of them now.
And then you've done some subsequently.
But we've been talking a little bit before you came to record.
And, you know, we've been talking about how hot of a topic hormones are and how prevalent, quote-unquote, hormone issues seem to be.
And when I put up a question box for you on Instagram stories telling people that you're coming on, I was just inundated with
questions. We're going to do a really comprehensive episode, maybe two parts. But to start,
why don't you just introduce yourself to the audience a little bit, tell them a little bit about
yourself, and then we'll just briefly go over like what exactly our hormones. Got it. All right,
well, thanks so much for having me. I love talking about this stuff, as you know. I am a native
Angelino, grew up here. I did my training at USC Keck School Medicine and then Cedar Sinai is where
I did my fellowship and postdoctoral training and ended up kind of through a circuitous route.
I had a really good mentor and ended up in endocrinology.
It's a long story.
I won't bore you with.
But it turned out, you know, it's a really interesting field that I didn't appreciate it at the time all that was, you know, to happen.
And it just seems like not only does everybody have hormones, but everybody seems to have a hormone problem these days.
And, you know, I think it was kind of an older stuffy field.
There's sort of this myth of, or not a myth.
like stereotypical, like old white guy and a bow tie sort of professorial type of endocrinology.
And now it's just, you know, a hot upcoming field, as you know, and I'm really, you know,
happy to be a part of it.
Yeah.
And I feel like there are a lot of people who are not endocrinologists who are treating hormones.
You just gave me a look.
Oh, God.
Yeah.
It's a blessing and a curse.
And honestly, that's, you know, that's a reflection, I think, of like the failure of medicine.
like just kind of sticking their head in the sand.
And again, this sort of traditional conservative medical paradigm where, you know,
if something is not, you know, black and white and obvious on a blood test and available
as a pharmaceutical, that it just doesn't get the attention.
And I think that really opened up the, you know, door for so many non-medical practitioners,
which is fine.
I'm not opposed to, you know, people who legitimately want to help others as long as it's done,
you know, in a safe way.
but there's a lot of quacks out there too and people need to be careful.
Yes, and I think it's hard for the laymen to navigate and know who to trust, who's legitimate and who is not.
But I'm curious how your approach to endocrinology has changed, if at all, since you started your practice.
And if you've seen people's hormones changing essentially maybe as a result of this modern world that we live in and things that we're exposed to.
Absolutely. I mean, my practice has definitely changed probably because I've just become so much more open-minded.
And honestly, I've learned a lot from my patients. A lot of what I do and what I've learned didn't come from medical school or from, you know, the postdoctoral research and work that I did.
It was learning on the job as a, and, you know, I'm constantly researching literature and papers and learning from my patients.
With endocrinology, I think what's really important when I see a patient who has a complete,
is the first thing I need to decide is like, is this like a significant like medical problem
or is this something that's more, you know, lifestyle, like an imbalance related thing. And that's
sort of the first thing my mind always goes to. Okay, let's rule out like serious stuff that
could be, you know, cancers or other, you know, serious things. And then we could start to go down
the path of, you know, hormone balancing, so to speak. Yeah. So let's just quickly define hormones.
Like what are hormones?
Because I think a lot of people think hormones, estrogen, progesterone.
But really, there are so many more, right?
I mean, there's hundreds, perhaps thousands of hormones.
They're still being discovered in our body.
But basically, think of a hormone as like a chemical messenger.
It gets secreted from one gland, one part of our body, and it travels to another where it acts.
So it's just a chemical messenger.
And we have lots of glands in our body that make hormones, such as the adrenal glands.
people may have heard over, of course, the ovaries or testicles,
pituitary gland, thyroid gland.
But, you know, our gut makes hormones, for example.
So there's big systems, you know, our skin can manufacture hormones.
They're made everywhere.
And, you know, one of the biggest things that I have seen in my practice,
you asked me, what have I noticed changing over the years?
Besides the awareness of, you know, hormone imbalances,
just there's such an increased prevalence,
especially with autoimmunity, which can affect, you know,
thyroid and other hormones.
And we're really starting to see the effects of like lifestyle, toxins, stress, chemicals, diet,
how it affects hormones.
Yeah, I was going to ask you about the stress component.
I was diagnosed with PCOS in my early 20s.
And then I had a lot of gut issues later down the line.
And I was told that, you know, we really couldn't address like the reproductive hormones
without addressing the stress and the gut issues because that influences the reproductive
hormone.
Everything is interconnected.
did. So have you seen that a lot as well? gut issues, stress, all of that kind of trickling down to
everything else. Absolutely. Stress, you know, the whole definition of stress is like, you know,
our body's response to change. And, you know, that that fighter flight stress system that I know
you've spoken about with other guests, particularly the, I forget her name that did the podcast on
gut bacteria and probiotics. Anyways. Tina. Yeah. So that was a really good episode, by the way.
Stress is an ancient pathway that causes modern problems.
And again, I know this has been repeated before,
but this sort of fighter flight system that was designed to get us out of an immediate situation
of like being chased by a buffalo or something.
Nowadays, you know, we're chronically stressed from work or from pandemic or being in traffic
or from any of a myriad of things.
And because of that, the cortisol stress hormone and our adrenaline are constantly activated.
These are hormones that were meant to be like spiked up for an hour or two, not constant.
And what our body does when it's under stress is it downregulates a lot of the other
what are deemed non-essential hormones.
So that's why when cortisol is high, women will stop getting their periods or they'll get
irregular.
You know, men's testosterone goes down from stress.
It's the body's way of trying to protect itself from reproducing during a time when it's, you know,
not safe to do so.
But we see other problems, you know, blood sugar goes up and diabetes.
diabetes worsens, the immune system crashes. People gain weight when they're stressed. Their sleep gets
messed up, which then, of course, causes all sorts of other hormone problems. So stress definitely
leads to a cascade of negative hormone effects. No question about it. I am going to Paris next week.
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basestravel.com slash blonde. We are talking a lot about stress in this episode and how much
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first month of a subscription, member pricing, and free shipping for life. Hi. My name is Morgan
Cohen. I'm a 25-year-old girl that's still trying to figure out life just like everyone else.
I'm starting this podcast to make sense out of all the messes I've made in my life. And believe me,
when I say I've made countless amounts of messes in these last 25 years. On the Morgan B. Cohen
show, we will talk about everything people are too scared to say out loud, anywhere from falling in
love with the wrong person, surrounding yourself with the wrong people, bad friendships, friendship,
struggles. You know that feeling when you want to throw a party, but you don't know if anyone will
show up. Well, that's how I feel right now. So if you are here, welcome to the party. I know you'll
have a great time. I've had other doctors on the show who have talked about hormones kind of being
downstream, where some of these other things are more upstream. Is that your belief as well? Is that
kind of what you're saying there? Yeah, absolutely. That, you know, the hormone is not the problem often.
And it's just the symptom.
Like the hormone imbalance is the symptom of something else.
And so I often tell my patients partially to reassure them, but also because it's true,
you know, like 90% of the time when I see somebody with a hormone imbalance,
it's not that they have a disease in their gland or a tumor or an autoimmune,
although certainly we've seen all that.
It's that something else is screwing up your hormones.
And that's something else most likely is stress or poor diet or some other lifestyle.
And increasingly, I'm convinced,
to 100% that it's these endocrine disruptors.
Yeah, I'm scared to delve into this topic because I'm sure I'm dousing myself in endocrine
disruptors day and night. I have a really healthy lifestyle, but, you know, I feel like some of
these things are unavoidable. So I'm really interested to have you kind of walk us through
a day of endocrine disruptors. When I think of them, I think of, you know, beauty products
and my perfume that I'm spraying on myself and inhaling probably and environmental toxins, right,
and household products and things like that. But you had the great idea of kind of starting in the
morning and let's just walk through day to night and talk about some of the things that we are
encountering that can influence our hormones. Absolutely. And it's scary. Like as I was preparing
for this talk and you and I spoke the other day, the more I thought about it, it's literally is, you know,
we do spend the day with endocrist disruptors.
And it's not that, you know, unfortunately, we cannot avoid them 100%.
You know, my goal is really just to educate people so they can make the best choices
throughout their day as to what they can eliminate or substitute and be aware.
And, you know, those things that we can change and those that we want to just continue,
that's cool.
That's someone's choice, you know.
But, you know, I'm not letting go of my perfume.
So in the morning, you know, you.
You know, you wake up, somebody wakes up and brushes their teeth, which is like a really healthy
habit everybody does, but there's an endocrine disruptor called triclosan.
It's an anti-like bacterial agent that's in toothpaste, which disrupts our hormones.
The plastic, you're going to hear plastic as a recurring theme in my talk, but plastic, you know,
is in toothbrushes or plastic in the bristles.
And some people will substitute bamboo now apparently is available.
And certainly there's healthier products.
Floss, dental floss, has allates.
which is a plasticizer and may have antibacterial chemicals that are bad.
So just brushing our teeth from the minute we get up is a problem.
I'm already fucked.
Did you say it was triclossin?
Is that in like generic kind of brand name, big toothpaste?
You can find it in like toothpaste and other like, you know, cosmetic products.
You'll see it in.
Oh no.
And, you know, there's a lot of these chemicals.
They're hard to remember.
They're hard to pronounce.
I try to use the analogy for my patients to learn to.
read a label on a skin care product like we do in the market.
Everyone knows now how to go read a label on a carton of Greek yogurt or something,
and we need to learn.
By the way, I'm glad that's metal or not classic.
Thank you.
I know.
This is my small win for the day.
So, okay, so we brush our teeth.
What else?
Skin care, unfortunately, is just loaded with these products, particularly a chemical called
phthalates, which are used to sort of give substance to some of these products.
you know, the skin is like a really great way to get good and bad things into our body.
We use it for medications if you think of certain acne medicines or topical steroids or sunscreen
or, you know, hormone, bioidentical hormones.
So the skin is a fatty substance that is really accessible to the interior of our body.
But unfortunately, bad things can get in there too.
I never really think about it that way.
I only think about the good things.
Like one of the things that I have tried for my hormone imbalance was topical progesterone.
What is the efficacy of that?
So topical progesterone is generally safe and can be effective.
It may not be as effective at protecting the uterus lining, the endometrium, and someone who's on hormone replacement with estrogen.
But if you're just using it for its progesterone purpose, it's fine.
I didn't find that I had the nice progesterone feeling.
I have very low progesterone.
So I can always tell like now I'm digressing,
but the period in my cycle where it's raised
because I feel amazing.
I feel normal slash amazing,
like just more calm and I'm sleeping better and all that.
I didn't feel that with the topical.
That's my point.
It doesn't always get the absorption.
That's one thing about the skin too
is like the absorption of hormones or medicine
can really be variable depending on the concentration
or the vehicle in which they make it.
So there may be a gel or a cream, but then there's also many different nuances to how the compounding pharmacies make up these things.
If you have other products on your skin, it may affect how something's absorbed.
There's a lot of factors.
We can move out of the bathroom for a minute and maybe we go down at the kitchen, right?
And like non-stick cookware is a really common source of endocrine disruptors.
These chemicals call them PFS.
It's an easy one to eliminate by getting a regular pan that doesn't have that coating on it.
stainless steel?
Yeah, stainless steel, which is a pain in the ass at first, you know, but you can learn to work with it.
But like, you know, they've done good studies showing non-stick cookware like accelerates the onset of menopause in women.
Like there's good evidence for that.
A cutting block, a cutting board in our kitchen that a lot of them are plastic or nylon.
So you get little like micro-shavings of plastic in your food when you slice your food on it.
So just using a wood cutting board.
Obviously plastic, you know, our food is all in plastic in the fridge.
That's nothing that we can control mostly.
how it's, you know, what it comes in at the store, if you're fortunate to find something that's
in paper, but that's a problem, you know, the food that's in plastic.
If we're in the grocery store, should we not use the little plastic baggies for produce?
Aside from the impact that they have on the environment, but is that enough exposure to the food
to get microplastics?
Probably not, to be honest with you.
It's probably not the contact of it unless it was sitting in a hot car for some length of
time, but yeah, the environmental part. Anyway, by the way, I always say shop in the periphery
of the supermarket. The deeper you go, the worse it gets. Anyway, unless you're at Air One.
Exactly. Then you're safe. So, you know, the kitchen, the cookware, the plastics,
moving on throughout the day, like fragrances in cleaning products. You know, cleaning products themselves
are full of toxins of endocrine disruptors. That's not to say there's not healthier alternatives,
because for all of these things, there are healthier alternatives.
But fragrances also can be endocrine disruptors.
Let's say, you know, it's mid-morning and someone's going off to their yoga
Pilates class.
I'm not going to name any particular brands, but, you know, yoga wear sheds like micro fibers
of plastic, and that gets into our environment.
And in fact, all of us are said to ingest about a credit card of plastic a week now.
A week?
A week.
And they've done studies.
Oh, my God.
I gave a fun talk called Your Fantastic Plastic Poop a couple years ago.
It was about all of this that when they look at our stools, we all have microplastics in our stool now.
Wow.
Yeah, so we're ingesting it. It's getting in.
So it's shed from yogaware.
It's in dust in our homes.
So again, having like really good air purifier systems, changing the filters in your home.
These are all little things that we can do throughout the day that can make a difference.
And actually studies have shown when people start to eat organic, and we haven't even talked about that yet, when they eat organic, when they eliminate a lot of these products and BPA and plastic water bottles and whatever, their levels change in their body and they're healthier.
What hormones do the plastics influence the most?
All of them?
I was going to say all of them, but it's not like estrogen or something.
Thyroid and estrogen are the biggest ones.
Okay.
But, you know, they can actually mimic estrogen, which some people would think would be a good thing, but it's not if you're a man or if you're a boy developing or if you're an animal.
And that's how so many of these endocrine disruptors actually first were discovered.
It's actually a really interesting story.
Back in like the 1920s, farmers had noticed that some of their animals were having like fertility problems.
And there was a mold infestation that caused the, they're called mycoestrogens.
They're basically like were endocrine disrupting chemicals growing in the animal food.
So that was a discovery.
And then they discovered, you know, pesticides were causing harm to their animals.
And then there was this famous book called Silent Spring, which came out, which had to do with the effect of DDT on wildlife.
And so this has been an evolving story.
Actually, even though endocrine disruptors are a hot topic now, because, you know, it never really mattered if it was affecting farming.
But God forbid, like, you know, if people are getting breakouts and, like, irregular people,
periods, now it's top of the list. I was going to ask, though, why does it seem like there is
pushback from people regarding this? You know, people who say, like, well, it's the dose that
makes the poison. And, you know, these are tested so heavily before anybody can use them. And
you do kind of hear both sides of it. Right. And I'm really glad you brought up the dose as
the poison. We're going to talk about that. So I think part of the problem is that this is a, it's a
silent issue. Like, you don't really feel it. If I go drink out of a plastic bottle, I'm not going to
feel poorly right now. So it's a silent issue that sort of accumulates over many, many years.
The chemicals get stored in our fat cells and slowly released. Whatever the endocrine
disruptor chemical is, that's sort of a general pattern that they follow. So it's something that
accumulates over a long period of time that we don't feel bad from immediately. And it's,
let's face it, it's a pain in the ass to, like, avoid these things. It's not.
not easy. Any of the things you and I just discussed, not to mention eating organic, which is
really expensive for a lot of people and not an option. But that's a huge source of these
chemicals, the pesticides and atrazine, which turns, you know, frogs into female frogs. And
that's a chemical in strawberries and pesticides. Just one example. But getting back to your
comment about the dose makes the poison. So traditionally, it was always felt that, you know,
the higher the level of a toxin, the worse it was for us. That's
that kind of seems intuitively to make sense.
But it turns out with endocrine disruptors,
they may follow something,
and I don't want to get too technical here,
it's called non-monotonicity.
I like technical, my audience likes technical too.
Okay, I know you have a smart audience,
because a lot of them are my patients.
And I've listened to your podcast,
and I know that you have a special group of people out there.
Yeah, we like the science.
So basically non-monotonicity refers to the fact
that sometimes at a low dose,
a chemical can have a really potent effect,
and at a high dose it may not.
So that general concept of a linearity
where just higher the worse is not necessarily true.
And part of the problem with endocrinology
that makes it difficult is we have a hormone.
It sort of works like a key going into a lock.
So the hormone is what we can measure in the blood
or what we can take as a supplement or whatnot,
but we can't analyze the receptor,
like how sensitive you are to your hormones,
how sensitive your receptors are.
There's just not like a laboratory technique that we can use in every day.
I mean, they do that in research.
So somebody may have like a normal level of a hormone in their body,
but have like a receptor that's not sensitive to it and they feel like crap.
They may have a low level of a toxin in their system,
but their receptor is really sensitive to that.
So we can't just rely on the dose makes the poison anymore,
and we have to really just do our best to avoid this stuff.
we all test positive for BPA in our urine. They've done tests around the country. You and I and
everybody in this building would probably have a positive BPA. But the levels can go down if we
eliminate plastics and canned foods and, you know, thermal receipts and those kind of exposures.
So the take-home messages like we do the best we can. Yeah, I'm curious about how you incorporate
this into your life. Was there a point when you started learning more about?
about this and you started making small changes?
Or have you always been cognizant of this
and tried to not use plastic and cook on stainless steel
and be aware of phthalates and things like that?
I mean, I have to credit my wife and kids for this,
for the actual changes that are in our daily life.
I mean, I brought this knowledge home.
And basically, in my practice, I would see
a lot of young women with hormone
balances, whether it was irregular periods or unexplained weight gain or skin, hair, et cetera.
And we would check their hormones and the hormones would be normal.
And so you're scratching your head thinking there must be something else.
What other variable out there are we not catching?
And at the same time, I started researching more about these endocrine disruptors and, you know,
being convinced that this is the reason why we see so many problems.
So, you know, my wife and I have always lived a healthy lifestyle, but, you know, we talk and we
we make changes at home and and you know I have two daughters and so I'm really hyper aware of this
stuff and you know my girls are really smart like they can go to a skincare product and look on the
label and know if it's good or bad. How old are they? 17 and 20. Amazing. I'm very blessed. So we make
changes at home but that's not just say we're perfect. I don't live like some hippie up in Topanga.
Like there's plenty of bad things in my home I'm sure and like I said we just do the best we can. But I think
You know, the big categories are plastics, plastic water bottles.
Like, these are the big exposures people get with BPA,
which is like the poster child chemical.
So that's big one, eating organic.
And again, I recognize this is not practical for a lot of people
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like, you know, berries and things that are going to be more exposed to pesticides.
And then your skincare products, which I know you're going to glare at me about.
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I went on this skincare journey last, I think it was July, when out of nowhere I got acne.
Never had acne in my life.
Well, I had some breakouts, and I mean like very sporadic breakouts when I was like 14.
And so they just went, oh, here's birth control, as they did back then.
And I'm sure they still do that now.
And then I never had skin issues.
I went off that a couple years later.
And yeah, just out of nowhere.
Last summer, it popped up.
So I was like, give me the Band-Aid, it's baronelectone.
Right.
And then I-
I prescribe that all the time, by the way.
Yeah, and I want to talk about the meds and all of that.
We'll get to that either today or maybe in a part two.
But, and then I went on this very involved skincare routine,
which really did change my skin for the better.
Who knows?
You make a really good point.
Like this skin, I always say like the skin is just a manifestation of like what's going
on inside, right?
So the fact that your periods were irregular as well is, you know,
kind of backs that up. Yeah, and I kind of felt like, okay, I'm going to do this, do the spyrinolactone,
do the skincare, and then I'm going to do some investigating and figure out what's going on.
And I started down that road, but it's a marathon. It's hard. You've got to be patient. And there are
certain things that I was not necessarily looking at, like the plastics and, you know, the things that I'm
exposing myself to. I think it's sometimes easier to just look at the diet, look at the exercise,
look at the sleep, do the medication, the skincare, and then turn a blind time to the rest of it.
Well, it is, it can be overwhelming, like you said, you know, and skin especially because it's,
it's so many different factors. It's our diet, of course, and it's genetics and it's our hormones
and it's, you know, chemicals. So that's a good example. Like,
If there's an endocrine disruptor out there that acts like testosterone, for example, in your body,
then that could potentially cause someone to have more breakouts or signs of excess testosterone
or hair loss in a male hair pattern or body hair excess, those sort of things.
But they may test normal for testosterone.
That's just one example.
But there are good natural protocols, too, that help clear up skin.
There's good evidence for zinc and for probiotics and you know about all this stuff.
but your skin looks great today.
Thank you.
Are there certain endocrine disruptors that affect, like, individual hormones like that?
Or is there something out there that does just affect testosterone, that does just affect estrogen?
I mean, there are some that are noted more like phthalates, for example.
There's a great book out there called Countdown, and it's about the decline in sperm counts.
And the sperm count is declined by about 50% in men.
This is not a joke.
And how long of a period?
And I think like the past couple decades, actually, it's crazy.
And they attributed to thallates, which have a profound effect on testosterone.
And atrazine, which is one of those pesticides, affects our sex hormones.
And BPA can affect thyroid.
But it's rare, just like, you know, how one hormone may have many different actions in our body.
One chemical can affect many different hormones.
So we've kind of walked through the morning.
We've gone to yoga class.
What about the afternoon Botox appointment?
I mean, Botox I don't think of as an endocrine disruptor.
Okay, great.
So there's probably something about it.
I don't know.
Honestly, I haven't really looked into it, but it doesn't come across the radar.
And fillers and things like that.
To be determined.
I mean, I've seen, you know, react, certainly local autoimmune reactions with fillers.
And, you know, if you look at breast implant illness, which again, another great podcast you did, we can talk about that as well.
No, that's not.
I just got mine a year ago.
Yeah.
So, you know, these inert chemicals, probably it's more just in certain susceptible people
that those chemicals cause a problem.
Right.
Unlike the endocrine disruptors we've talked about, which get literally into our gut and we drink them
and eat them, you know, as opposed to like a filler, but I haven't looked into it that much.
You said something interesting earlier where you said, you know, people will be exposed to all
these things and have manifestations of hormone imbalances, whether that's not having a period
or myriad other symptoms, which we could talk about, and then they go get their hormones
tested, and they're all normal. So these really are silent influencers, essentially. I mean, they can't,
there are tests that you can actually do for these endocrine disruptors. There's some companies out
there that are offering these. I guess the issue is whether they're there or not, the recommendation
is still going to be the same. Like, if you test a negative for BPA,
I'd still tell you don't go drinking out of plastic bottles.
So I often think of like we should order a test if we're going to do something with that information.
So yes, it can be, there are companies now that can test for it.
And I've had some patients who we have sent them out to do those tests.
And it demonstrates to them, you know, this is a toxin in my body.
And then they start to make changes.
And we retest them six months or year later and those levels are lower.
And that's awesome.
So, yeah, it is nice to be able to be able to have a market.
darker. But this is one of the problems of endocrine disruptors is they hide out. They're in very,
very small quantities, even in our, you know, in our body. And they may get released over, you know,
many, many years and affect fertility or weight or some other symptom down the line.
What do you see the most in your practice? I mean, if you can say, like, what is the average
patient that comes to see you dealing with? I would say it's typically, you know, y'all.
a woman, let's say, college age to metapausal.
So it's a pretty broad spectrum.
And as you know, at every stage of our lives,
we have different hormones and importance.
And I see men also.
I see men who have low testosterone and those issues.
But the typical person is usually struggling with irregular periods,
weight gain, oftentimes skin issues as well.
It's usually sort of a trifecta.
But what I often try to tell my patients is that these are often
just all different manifestations of one issue.
So someone may think they have like 20 things wrong with them.
It's really not.
They're just different, you know, different manifestations.
And, you know, we try to get to the root source of things whenever we can.
And again, I always tell my patients, like, I'm not a pill pusher.
Like there's a role for medicine and I prescribe medicines all the time when they're appropriate.
But there's got to be a discussion about, you know, lifestyle.
There's always got to be a discussion about lifestyle in my office.
And if someone's not open to whatever the issue is, whether they're talking about diabetes with me or their weight or their skin, you've got to talk about diet and how you manage stress and your sleep and your lifestyle and what bad habits you may or may not have.
Because if you're just looking for like a pill for your answer, like I'm not your guy.
Don't go to Dr. Geller if you're just looking for Spiro.
Right.
Spiro.
Spiro.
But I'll give Spiro along with the discussion and maybe recommend some natural.
thing, you know, spearmint tea has been shown to help prevent acne. It treats acne, probiotics,
and we'll discuss it. Most people don't want to take medicines. People, it's a different era now,
you know, it's not like in the past where there was a pill for everything. Yes, for sure. Yeah, and even
when I went on it, I went on it thinking, okay, I'm going to do this short term and figure out
everything else and then go off of it, which obviously work in progress. But are there, it sounds like
there are kind of foundational things that you recommend to everybody, regardless of maybe what their
levels show, what are some of those things? So obviously looking at nutrition, you know, do you look at
like mindfulness for stress? Do you look at sleep? Like what are those things that people should
look at in their own lives and make sure that they have kind of locked down? These are sort of what I call
the pillars of our health, you know, our sleep, our stress management,
our diet, our exercise, you know, of course, our relationships with others, our leisure time,
spirituality, whatever that means to different people.
But we talk about all these things in my practice, and somebody may come into me for our consult,
maybe they have a thyroid nodule or some specific thing.
And we're sitting in my office, kind of like you and I are sitting.
I sit and we talk for like an hour.
And I go through all this.
Sometimes they'll look at me, you know, wonder like, why is he asking me all this stuff?
but it starts to become evident why it's because we can't just look at something in a vacuum.
So these are all things that I think are really important that I practice in my own life
and that I encourage my patients to.
And stress, I would say, of all these issues, like stress management is the biggest one.
And my patients will say, but how am I supposed to make the stress go away?
You know, I have a business or I'm getting divorced or it's the pandemic.
And my answer to that is always stress is not going to go away,
but just how we deal with it is what we can modify.
And I always use that image of that line between fear and panic.
And fear can be good.
It can propel us and help us, you know, expand.
And panic is not good.
And so I tell my patients, like, this is what stress does to your hormones.
And I list all the things that we talked about earlier.
And really try to impress upon them that, you know, good health.
Yes, it takes a lot of time and it takes a lot of effort, but the payoff is worth it.
What about trauma? This just popped in my head. Is that something that you have seen or there have been any
studies where they look at like how trauma, even if it's not conscious, but if somebody had something
that happened to them years ago and they're still experiencing that at some level in their body,
seems like that would affect maybe stress and then that would eventually affect hormones as well.
Absolutely. And that's something that, you know, people have shared with me or trauma may, of course,
just lead to underlying behaviors that make it harder to make, you know, the changes that someone
needs to do.
One, like, pretty glaring example is autoimmune thyroid disease.
There's a condition called Graves disease, which is a hyperthyroidism.
So the thyroid's revved up.
People are really hot, sweaty.
Their heart's racing.
They lose weight, which people enjoy.
But other than that, it's really not healthy.
Anyway, there's very good evidence that a traumatic experience, like a major stressor,
triggers the onset of Graves disease.
Interesting.
And I've seen that in my practice.
I've had many patients with graves,
and I always ask them about this question,
and many times we find there was some precipitating event.
And also in patients who are in recovery,
in remission from grave disease,
but then something terrible happens in their lives
or some stressor, it'll recur.
So that's just one example,
but it's a pretty striking one when you see it.
Is there something that people can ask their doctor for
because it seems again back to what I said in the beginning, based on the questions that I got and even the experience that I've had,
you can kind of hit a dead end here because you go to your doctor, you get your hormones tested,
everything is within normal range with whatever lab and that's that. But, you know, we know our bodies and we know when something is off.
is there a certain test or are there certain levels that people can ask their doctors to check
that may be a little bit more advanced than just the typical blood work that they might run?
Yeah, and people do need to educate their doctors.
And doctors are not always receptive to that, as you know.
But one important thing is testing hormones at different times of the month.
For example, if we're talking about estrogen and progesterone, some doctors are to a random one.
But you have to know where the patient is in their cycle, if they're having a cycle, to proper.
interpret the normal result. Testing cortisol, which is a common thing that
people want tested, there's a lot of nuances to that based on time a day or if
somebody's on oral birth control and why not. So yes, there's lots of tests for all
of these hormones, but you just need a doctor who I think is going to listen and
you know have enough competency. That's the easy part. It's really that you want
someone who will listen to you and take your story and and do the right test that
appropriate for that situation. So it sounds like find a different doctor if they're not.
Instead of find a test, find a doctor that is competent and they're looking at this stuff.
And there's so many of these now self-administered testing places people can get their own blood
test for all these hormones or they go to other providers, non-physicians, which again,
we can talk about that separately. Sometimes patients will come into me with all these tests they've
ordered, but they don't have anyone to review them with or their doctor doesn't know what to do
with this information. So that, you know, that's created an interesting scenario now. How do you feel
about something like a Dutch test? I know that those are really popular. And I've heard physicians say,
no, it's not accurate and you don't really get any direction afterwards. I don't think. I don't know.
I haven't done it. Well, the cool thing about the Dutch test, so again, with hormones, when we do a
blood tests, we're getting like a snapshot of time. But all of our hormones fluctuate. There's circadian
rhythms for thyroid and adrenals and estrogen and everything. So the Dutch test allows you to
capture through urine testing like many time points. So that does potentially give a more accurate
representation of what's going on. So the concept is right on. The hard part about the Dutch
test, again, for me is I'm going to order a test if I can do something with that information
to help my patient. And the Dutch test gives this like 10 page report of all these metabolites and
things I haven't studied about even in medical school, I don't know what to do with this information.
It's really frustrating. It talks about estrogen and cortisol and thyroid and, you know, that's
fine. But then it talks about all these downstream metabolites that we can't really change and I don't
really know what to do with basically. So that's a little frustrating, the Dutch test. They seem to have
also like a real like cookie cutter rubber stamp set of recommendations that I've seen. They recommend
dim, which is a great supplement, they recommend, you know, the same sort of few things to
everybody.
So that's always a red flag to me.
Sorry if the Dutch company is out there listening.
Thankfully, they're not a sponsor, so we can rip on them.
And they never will be now.
Yeah, no, never.
Okay, so we talked a lot about the things to be wary of in our lifestyle.
Is there anything that we can all incorporate to support our hormones universally?
we talked about obviously things like stress management,
but you mentioned dim.
Are there other supplements?
And I think this would probably depend on somebody's age, maybe,
whether they are in menopause or still ovulating.
But, yeah, are there supplements or, you know,
foods that we should incorporate into our lives?
So, I mean, there are specific supplements for different hormone imbalances.
So that would take, you know,
that list would be really long, but, you know,
dim is a good supplement for people that have symptoms of so-called estrogen excess
or estrogen dominance.
Vitex is a great supplement for women who have a lot of PMS symptoms or breast tenderness.
In men, there are supplements as well, like, you know,
maca, which is also used in women or DHEA that can improve androgen.
So there's millions of supplements, but before you even get to that level,
just as far as nourishing the hormone, like what ultimately makes hormones,
you know, our body makes hormones from nutrients and food.
and I think having a really healthy diet, especially a lot of protein, is really important
to give our body the substrate to make hormones.
If we're nutritionally impaired or underweight or unhealthy, again, the body will downregulate
the production of hormones in order to conserve resources for more important organs.
It's like a common theme.
So the classic scenario is somebody who's restrictive eating, their hormone, their thyroid
goes down, their estrogen goes down, growth hormone goes down, everything's something.
suppresses, that's the body's way of trying to like, you know, conserve resources. So having a
really healthy diet, lots of protein, and supplementing with vitamins if needed, I'm definitely in
favor of. Does protein source matter? I think, you know, plant versus animal or? I don't know that it does
if you ultimately are getting a good balance of amino acids, which, you know, it's the amino acids
that matter, right, not the protein. It's the building blocks that really matter. I'm going to ask you
about something maybe controversial.
I don't think it should be, but I'm curious about like a Zemphic and semi-glutide
because I have heard that people are using it kind of off-label for things like PCOS,
and then obviously a lot of people are using it for weight loss.
I would imagine it could affect hormones positively for people who it's appropriate for,
maybe people with PCOS who have insulin resistance issues,
but then are people who maybe don't need it as badly,
or they're really not eating at all,
are they then not getting the nutrients
that they need to produce hormones?
I have a lot of opinions about Ozympic.
I've used it a lot,
and I've seen fantastic results
with all those drugs,
Ozympic, Monjaro, and Mubovia.
In that group in which it's targeted,
it's profound, you know,
that overweight, diabetics and whatnot.
But yes, a lot of people,
a majority of people are taking off label.
And it does, you know,
whether it's PCOS or metabolic syndrome,
or pre-diabetes, it's like the rising tide that lifts all the boats. When you decrease
their weight and their inflammation, even if their weight doesn't change that much, but their
diet changes and they're feeling so much better, that's really profound. So, you know, we do see a lot
of benefits. And the other really fascinating thing with these drugs, which we've noted anecdotally,
but now there's science is about the addiction that they interfere with, you know, people's
cravings for alcohol, for drugs, and even for smoking. And that's fascinating. Yeah.
I am very curious about that.
I don't know if you know, but I've been sober for nine and a half years.
I know people who have taken Ozambic, Monjaro, the different ones, and they have all said,
yeah, I didn't even want a glass of wine or like one of my friends didn't even want her coffee in the morning.
And I just thought that was so interesting.
And I wondered what that's going to do down the line, you know, whether it's going to be used off-label as well to help.
people with cravings and I think they're gonna I mean I'm sure that the pharmaceuticals are seeking approval
and they're doing trials to get it approved just for that issue yeah it's it's fascinating and by the way
which could be a whole other topic I think the ultimate endocrine disruptor and this maybe ties in
towards the end of the day of someone's day with endocrine disruptors before they get to their non-organic
pillows with off-gassing and all that stuff is alcohol alcohol has got to be the most common
endocrine disruptor in the world it's not considered we don't think of it as like
a toxin like that because it's not in, you know, rocket fuel or, you know, firefighting
equipment or any of these other toxins. Alcohol is a classic endocrine disruptor. It disrupts
really. Pretty much every hormone in our body. Every kind of alcohol? Any kind of alcohol.
Okay. It's not, most of the studies are done to people who chronically consume alcohol,
but it can be small amounts on a chronic basis, but it can lower thyroid growth hormone.
it raises estrogen, which is okay sometimes, but not if you're a man.
It lowers testosterone.
It raises cortisol.
It, of course, damages the pancreas and insulin.
And so alcohol really should be classified as an endocrine disruptor.
I've always wondered how much damage I did to my hormones.
If I did irreparable damage in the time that I was drinking and using,
I'm kind of laughing.
I can laugh about it now because I also did copious amounts of cocaine.
and I'm just thinking of the things that I probably snorted. TMI, everybody, but solution, I'm sure they were cutting it with. But is, you know, can your body recover from things like that? Not necessarily the cocaine, but like if somebody has drank a lot and they decide that they want to start implementing healthier habits into their lives is their hope. Absolutely. I mean, the body, one thing about our body, it has an incredible regenerative capacity. It's just a matter of like, at what point in our lives do we stop making stupid decisions?
you know, before it's too old to be too late.
And, but, you know, I mean, literally like, you know, we have basically a copy of almost every organ.
We have two kidneys and we have a giant liver that literally you can cut the liver and it'll
regenerate.
And the lungs, you know, in smokers after 15 years, the lungs are back, or the risk of lung cancer is back to baseline.
So, you know, yes, the body can regenerate.
That's great news.
Is there a place that people can go and learn about the endocrine disruptors?
Because we got like halfway through the day.
And then you mentioned some at night.
But is there somewhere where, you know, they can go and they can learn the main ones
and so they know what to look for themselves?
My favorite resource is the EWG, which is a great resource.
They have a list called the Dirty Dozen Endocrine Disruptors.
And they list these compounds like BPA and phthalates and perchlorate.
And what they are, you know, what are the sources?
in our households and how to eliminate and avoid them. So it's really practical and they have apps
and that's a great one. And then there's apps out there now. I think one of them is called
Yucco where you can actually scan barcode products in the store. It'll tell you if it's
good or bad or something else to use. But EWG is my go-to resource for patients.
Amazing. Well, hopefully we can do a part two. We will. Everyone. So look out for that and tell
everybody where they can find you. They can find me at jordangeller.com. That's my website. I have an office
here in Los Angeles as well as in Palm Beach, and I do telemedicine in New York.
Amazing. Thank you so much. Thanks for having me.
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