Menopause, Perimenopause, Hot Flashes, and their Natural Solutions | Podcast #207

In today’s podcast, Dr. J. and Evan Brand discuss the different symptoms of the menopausal stage. Watch as they tackle in detail the transitional years of menopause, or perimenopause and the different natural ways to minimize the effects of hot flashes.

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Dr. Justin Marchegiani

In this episode, we cover:

00:28    Hot Flashes

07:31    Progesterone

13:57    Surgical Induced Menopause

22:16    Pueraria Mirifica

27:10    Perimenopausal on an Early Age?

Dr. Justin Marchegiani: Hey it's Dr. Justin Marchegiani here. Hope everyone is having a phenomenal day. I'm outside of my office today. Get a little construction down, so I got my little mobile office setup here goin'. Excited to chat today about hot flashes. Evan, how you doing today?

Evan Brand: Hey man, happy Monday to you. I'm doing pretty well. I got from the chiropractor this morning, they're working on my neck, so hopefully they're gonna be a miracle worker. I wish I could come to you but, I'd have to drive kind of far.

Dr. Justin Marchegiani: [Laughs] Totally. I get it, yeah, finger's crossed. So they– they figured out kind where the issue are— where were the issue as in the spine in there, workin' on. So that's really good. Excellent. So why do we chat about hot flashes? So first off, hot flashes tend to happen as the follicles in the ovary, you know, go down, and you goin' to what– what's called menopause. So average age of menopause is 48 to 51. And typically, what happens, you only have a set amount of follicles in the ovary that eventually turn into eggs, right? And those, you know, responsible for a significant amount of estradiol that's produced throughout the month. So we have like the first couple days, so you fir– the start of the cycle is basically kind of be when you have your period. And then you're gonna have FSH starting to creep up which is your follicle stimulating hormone. So it's stimulating the follicle to grow. As the follicle grow, it spits out estrogen. And estrogen kind of maxes out in your cycle at around day 12, 13th. Where then progesterone starts to come up because LH is increasing right after FSH increase. So FSH kind of, what's the follicle, the follicle makes some estradiol. Estradiol that helps the follicle also grow and mature. And then right around day 12, 13, right before ovulation, LH is already going up in the background and progesterone starts to grow up. So you kinda have this like– you bleed, okay, then you have FSH kind of creeping up like this, and then estrogen kind of goes up like this, and then right around day 12 or 13, LH is already creeping up, then progesterone starts to go up. And this is where the– your ovulation starts. Right in this area, right between day 13 or 15 or so. And then right after that, progesterone continues to go– go– go– go. And then at some point, it either drops out if there's no egg that's fertilized, right? So sperm comes in feds the egg and fertilizes, that progesterone kind of keeps going and it's supported by human chorionic gonadotropin, HCG. Or there's no e– there's no uhm— you know, the egg isn't fertilized and then you have a period and then it all starts all over again, so this is important. So as the follicle start to– you have a set amount of follicles, as a follicle start to drop, then you don't have that estradiol output. And then you start to go into menopause. And estriol now becomes that primary hormone. And this is important because estriol can be made from DHCA. And DHCA is a precursor hormone that comes from– in your adrenal gland. So if you're really stressed, if you're in a situation where you've been under a lot of stress and your adrenals are on top position, you've lot of blood sugar issues, a lot of cortisol– dysregulation, your adrenals are gonna take a lot of the ___[03:02], and the DHCA will start to be depleted over time as your adrenals have dysfunction. And that lower DHCA will decrease that kind of stored capacity to buffer estrogen with estro— estriol. So we have estradiol primarily when you're cycling. You have estriol more, it starts to become what you rely more on when you're menopausal. And then you have this other one in there in the background called oestrones. So oestrone– O-N-E– that's E1, oestrodi–dial, di for 2, that's E2 for short, and then estriol that are tri for 3. So we have E1, E2, E3. So we got a window in all three of those estrogen. Then E2 is more when you're cycling, E3 or estriols more when you’re menopausal. And then what happens overtime is that FSH and LH signaling start to go up as the ovary's– as the follicle starts to deplete. The uhm— LH and FSH start to go up and up, and up, and up, and up, they're raising the volume. It's like having an alarm clock where if you don't hit the sleep button on it, the volume keeps going up, and keeps going up, and keeps going up, so that's kind of what's happening. And then if that FSH and LH go up, they can– they can have especially the FSH a– a lot of vasodilating effe— effect. So that's what happens for a lot of these hot flashes.

Evan Brand: Aaah– Okay, so you're saying that this– this process is gonna happen no matter what. But you're saying to what extreme may be determined by the adrenal status?

Dr. Justin Marchegiani: That has a big– big effect, absolutely.

Evan Brand: Okay, so, if a woman is having– let's say she's having a good– a good healthy lifestyle, she's got stabilize blood sugar, she's going to bed on time, maybe she's taking some adaptogenic herbs, you're saying she's can– she still wanna go on to menopausal and likely have symptoms of that, but you're saying she may have minimal to no hot flashes versus a woman who has bad blood sugar balance: eating processed carbohydrates and sugars, maybe has synthetic estrogens from her environment, eating lot of plastic–

Dr. Justin Marchegiani: Right.

Evan Brand: —she's gonna have more issue?

Dr. Justin Marchegiani: Yeah, because we're gonna have more fluctuations of cortisol to help curb the inflammation, to curb the blood sugar swings, and that's gonna then put stress on her progesterone, and it's also gonna put stress on our DHCA. Remember the more stressed the adrenals are, DHCA output can decrease. And then the more stressed our cortisol is, the more cortisol can pull from progesterone. So then we can start to have these kind of estrogen dominant swings where progesterones starts to drop a little bit relative to estrogen and make it start– start to have some of these uh– c– we– get– we get push more into estrogen dominants, we begin start to see more cramping, more bloating, uh– increased bleeding, hemorrhagia, those kind of things. And then of course uhm— if we don't have enough DHCA from adrenal stress, DHCA is gonna buffer that estriol more as well. And that's important for some of these issues too. So we gotta get to the root cause, right? You know, what's the underlying cause of the physiology to move in that direction? Stress, diet, infections, not enough fat and cholesterol. Remember hormones are made from healthy cholesterol and fat. So I've seen lots of women, you know, that were a victims of the 80's and 90's in this low fat, low cholesterol era. And a lot of them have– are going in the menopause over the last 10 years. And they don't have just a lot of building blocks even there because of all of their poor dietary stressors.

Evan Brand: What about if they were on a statin medication?

Dr. Justin Marchegiani: Well statin will definitely effect because that's gonna decrease cholesterol internally. Remember most of your cholesterols made in your body, so we take a lot in, we take some of your– your diet, which has a lot of fat soluble vitamins, but then we're also make a lot too. So if we take a statin which is an HMG-CoA reductase inhibitor. That stands for hemato— ___[06:46]. And if you block that enzyme you don't make statins but if you block that enzyme, this– this pathway called the mevalonic acid pathway, and that pathway is also responsible for internal CoQ10 production. And then if you start mugging that pathway then you're gonna have less CoQ10 to run your mitochondria and generate– and generate ATP which is really important. So then you could start to have more energy issues and you start to have mitochondrial dysfunction. And then it's common with that to have more pain, to have less energy, cognitive issues, mood issues, chronic muscle soreness, rhabdomyolysis, those kind of things can happen with those kind of stressors.

Evan Brand: So, can we talk about progesterone a bit? I mean you look at like T.S. Wiley in her book “Lights Out”, you look at a lot of people talking about hormones, menopause, progesterone always comes up in conversation. And people say, “Oh, it's natural, oh, it's bioidentical”. I mean, is it a– is it destiny for these women to have– to end up on progesterone, or is it just the ___[07:52]?

Dr. Justin Marchegiani: So there's a couple strategies like number 1, if they're perimenopausal, meaning they're like im— you know, they're late 40's, early 50's and they're starting to transition to menopause, we'll use progesterone as synthecal augmentation fashion, certain times of the month, to help kind of gently nudge and easier transition in the menopause, that can be really helpful. And we try to use lower levels like– like– you know, if here's is our physiological level of progesterone, we try to use lower levels and just try to fill in the gaps if you will.

Evan Brand: Okay.

Dr. Justin Marchegiani: So it's kinda like you got– you got a rough table, we're just tryna use a little sandpaper just to fill in the gap, smooth everything out, just to nudge– nudge up or nudge down the high's or lows, uhm— that can be helpful. And then uhm— your question was–

Evan Brand: Is it destiny?

Dr. Justin Marchegiani: Now with the T.S. Wiley method, that's different because she's basically trying to get menopausal women to cycle again.

Evan Brand: Aaah–

Dr. Justin Marchegiani: I think you can do that too, I mean, a lot of women that are menopausal, are like, “Wohoo!”, like no more periods, like, they're– they're happy about that. So then, we just– we'll supplement a little bit of progesterone and estrogen throughout the month at a very low level just to curb out some of the hot flashes. We may keep them kind of in the upper physiological end of the range for menopausal. I mean, mid to lower physiological end of the range for a cycling women. And we just kind of give it every day, we're not cycling. Were T.S. Wiley would probably do like an estrogen in the first half of the cycle, a progesterone in the last half. So that's like, oh I think she times it up, uh– according to the lunar phase. So typically, full moon equals fertility, so that's like day 14 or so. So you'd start your progesterone on the full moon, and then you'd stop it on the new moon, and then start your estrogen the following day or so. And for– for 12 days. So that's kind of how T.S. would do it, she would do like a progesterone for– 2 weeks, lu– lunar cycle unless we– you know, have a calendar on when your normal cycle was, or you could just plug in those dates so that was continuous. So progesterone day 14 to 28, full moon to new moon, wait a day or so, estrogen day 2 to 12, stop, allow a couple of days in there for ovulation and then she would typically– even though there's no egg, right? We're just trying to mimic normal physiology, and then throw a little bit of DHCA or testosterone in the background as well. We like to use DHCA over that because [sighs] uhm— just– it's a building block to more hormones. Does that make sense?

Evan Brand: Even if you're saying DHCA is a preference over using testosterone? is that what you're saying?

Dr. Justin Marchegiani: Uhm– yeah, just because it has more– it can go more directions–

Evan Brand: Yes, understood.

Dr. Justin Marchegiani: And again, testosterone can work, a woman has low testosterone, it can really help. Uhm– but my concern is just to fix the underlying issue and try to give more building block precursor hormones. Building block hormones are here and they can to lots of different things, and stage hormones are down here. Now, sometimes that's good. It can be helpful because it can have a more therapeutic effects and– and we'll use it with progesterone. We'll even use a little bit estriol as well from time to time.

Evan Brand: Okay, so– take the conversation in the different direction if you would like, but a question that I have that many others probably have is, how would you compare and contrast something like a progesterone cream? First is some of these herbs that are commonly recommended that we use for menopausal symptoms like progesterone cream versus a vitex or chaste tree versus, say, red clover, or American ginseng, maca, things like that.

Dr. Justin Marchegiani: Yeah, so there are herbs that can help some of the FSH and the LH levels to calm 'em down. They can also help the feedback; they can also improve follicle health as well which can help with internal hormones. They help with the receptor sites, they can have a down regulator, up regulate the receptor sites. So imagine like uhm— uh– a lock sometimes, you have a lock in your house or you may have locks and you try to put the key in and then get a really jiggle it around to get it in the– the keyhole, the receptor sites kind of not quite working properly. Uhm– it's either mo– more sensitive or more dough, hard to get the key in or too easy or hard to turn, right? So think of some of these herbs, it really helps clean out the receptor sites, make the receptor sites work better. Think of that as, you know, getting a better, you know, key hole for the– for the key to work. And then some we may actually give a little bit of hormone as well to help, that can make a big difference. So we'll get maybe a little bit of progesterone or estrogen. And we'll time that up accordingly, that can make a big difference. And like you mentioned some of the progesterone herbs will be like chaste tree or shepherd's purse. I'm a big fan of the specific types of maca. I have a menopausal formula and a cycling formu— formula that I use that have different phenotypes of maca that work well. If you go to justinhealth.com/shop and you click on the female hormones category, you can see some of those. But with female hormone issues, you really wanna see a trained functional medicine doctor that can do specific test and to see where you're at. And that can be tricky. And a lot of times people, especially when they don't– and a lot of even medical doctors they don’t understand how the gut interplays with the hormones, so they come in there and they're just giving hormones, or they're not even looking at the adrenals, or not looking at the gut and they have really poor absorption all these important amino acids and minerals and essential vitamins. And they need these nutrients to actually have good hormonal output on their own. And they're just– they're just supplementing that with extra hormones. We really wanna make sure we're looking at the gut. And the gut is so overlooked when it comes to hormonal issues.

Evan Brand: Absolutely. Well, I'll add on to that. And we're looking at the marker on the stool test. That beta glucuronidase marker, we'll see that people are recirculating toxins and hormones, and so this maybe why they actually could be overdosing on their hormones. If their doctor keeps bumping up and bumping up their hormones, if they have a recirculating problem, that's not good. The liver plays into this too, you mentioned the gut bugs affecting absorption. We know too, if you're filtering bugs all the time, all these different toxins, bacteria are creating, isn't that adding liver stress, which is then creating even– a bigger cascade of hormonal symptoms?

Dr. Justin Marchegiani: A hundred percent. Yup, so we wanna get to the root issue. We got a great question in here from Susan, wrote, “What's the best supplement to take for surgical induced menopause? I've hysterectomy 18 years ago, I'm now 45, uhm— I have breast cancer in all female immediate family members.”  So, couple of things, I wanna know why did you have your hysterectomy? What was the cause of it? What's there endometriosis? Were there fibroids? Were there ovarian cyst? I wanna know the underlying issue. Okay, that's number 1. Uhm– number 2, I mean, your family members may have a predisposition, but you'd want to really look at estrogen dominance. I mean, the big thing is, a lot of these estrogen sensitive cancer. Now of you don't have a cancer, right? That's– that's good. You may do really well with some specific herbs and a little bit of progesterone. ‘Cause progesterone’s tend to antagonize estrogen. And even people that have hormone sensitive cancers you'd wanna check with your oncologist and say, “Hey, is my cancer estrogen-sensitive or not?”. And then I would look at potentially using a small palliative level of progesterone. But just confirm with your oncologist first and make sure your cancer's not progesterone-sensitive. Most are just estrogen-sensitive that's it's breast-induced. So you really wanna get some info on that. And I wanna understand the root cause of why you had a hysterectomy, fibroids, uhm— adenomyosis, ovarian cyst, all those types of things. I wanna understand what the root issue 'cause almost all the time, those underlying pathological situations tend to be induced from estrogen dominance. So we can work on the root cause because the root cause is still there. Just a tissue that was being destroyed is being cut out. So the underlying imbalance that cause everything is still there and something else will not happen. That make sense?

Evan Brand: It makes perfect sense. Yeah, my mom, she– I don't think she had really any issues. I don't remember, maybe it was like cramping or something but she got a hysterectomy at like 38. For hysterectomy, they took out the uterus as well.

Dr. Justin Marchegiani: Yeah. So Susan ___[15:57], I had endometriosis. So, there's a couple of strategies, you wanna work with the good functional medicine doctor, you wanna get your hormones looked at, uhm— if you– err– on the fif— if you don't have cancer, then I would just lean more to progesterone and specific herbal support to help. You gotta get your adrenals looked at. You gotta work with someone that can test you and see where your hormone profile is at. And then it's up to you, I mean, there may be some preventative m– cancer markers you can look at like the CA 125 androgen for various cancers. And you can kind of look at some of those markers prevented and lets you to see how you're doing in those areas. That may give you more uhm— let's just say peace of mind that you're on the right track. And then of course, uhm— if you have a full hysterectomy, the question is do you still have your ovaries, or was it the partial and your uterus uh– was the only thing removed? So if your ovaries are gone, you really wanna work on supporting the hormones too.

Evan Brand: Okay let me ask you this: if– yeah, let me go a little further with that. So if you have a full hysterectomy, ovaries, uterus, everything's gone, can you out supplement your way out of this using herbs or you suspecting there's gotta be some hormone support added in–

Dr. Justin Marchegiani: Yeah. Yeah you're gonna need some hormone support. The question is, if there's underlying cancer in the background, we– we gotta be really careful with estrogen potentially, and we can just confirm with the oncologist. A lot of times that can be tested. Typically, progesterone tends to be good, ask the oncologist though. Uh– and then if there's no cancer issues, that definitely we can use a little bit of estriol and progesterone and we can use some specific herbs to help modulate those receptor sites, and that can make a big difference. Kind of get that key hole to work a little bit smoother so that key can turn better– far better.

Evan Brand: That makes sense. Well 'cause I– I get this question a lot from women. It's like, “Well am I gonna have to be on this bioidentical progesterone forever, or can I end up taking say maca instead and get off progesterone”.

Dr. Justin Marchegiani: The stronger your adrenals are, yes. But you may have to be on it for a period of time to get stable.

Evan Brand: Okay.

Dr. Justin Marchegiani: And then from there, as the adrenals get stronger, and if you're managing stress well and you have your sugars under control, and your diet's really good, nutrient-dense, you have good blood sugar stability, you're eating and digesting good proteins and fats, your detoxification's working. Remember, gut dysbiosis can increase in enzyme called beta glucuronidase which can uncleave conjugated estrogens. Meaning, estrogens that are put in the strait jacket, they're being escorted out of the body. And then this enzyme comes in and unzips that straight jacket and allows that estrogen to go back into circulation. So a lot of women and doctors don't understand that gut dysbiosis can affect your body's ability to get hormones removed. And that can be another driving factor of estrogen dominance which is gut issues. Or dysbiosis or sibo.

Evan Brand: Yeah, and–  yeah– and– and this all could've started because a woman had say, urinary tract infection and got pumped full of antibiotics, we killed off all the good bacteria in the gut, candida moved into the neighborhood, maybe some dysbiotic flora moved in like we see a lot of clusterity infection, and then you– maybe go to a gastro doc, maybe they pumped you full of more– more antibiotics because they're trying to kill h-pylori, or maybe they're trying to kill sedef, and then you get even more dysbiosis. So if you've been through the ringer with your gut, if you're having constipation, diarrhea, stomach cramps, if you've got skin rashes, that could be a manifestation from your gut. If you've got dark circles under the eyes, that could be a symptoms going in the gut. So this is why it's so foundational. It's amazing to me that even though, you know, I am not a hormone expert like you, but I've still been able to resolve hormone issues just by resolving gut issues. And it's really fun to see how the body systems connect like that.

Dr. Justin Marchegiani: Absolutely. Someone writes in uh– about antimicrobials for dogs. I'll answer this one question. Uhm– you can do diatomaceous earth is really good. But you can also do mimosa pudica that works really good as well. And you can also do some garlic too, be careful if it can caught— it– sometimes it can cause an anemia, more in cat's though. But I definitely recommend getting some good probiotics in powder for afterwards. So mimosa pudica, you can do DE, diatomaceous earth, those can be really helpful, you know, ways to address that with animals.

Evan Brand: Well did you know, uh– the formula that you've recommend that I take several years ago, AP-Mag, remember that one?

Dr. Justin Marchegiani: They have a better veterinary formula too, yes.

Evan Brand: The one for pets–

Dr. Justin Marchegiani: Yes.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Hard to get down, I mean, it just depends. Some animals– some pet owners have dogs or cats typically dogs that will eat anything.

Evan Brand: Yeah [laughs].

Dr. Justin Marchegiani: Oh, my dog, I could not get the Ap-Mag down–

Evan Brand: Ooh.

Dr. Justin Marchegiani: Like it's just impossible. But uhm— I can get powdered probiotics in her, I can give like mix a little bit of cod liver oil in her food. My pets, I have a powdered multi though, I mix them with their food with a little bit of probiotics every now and then and they'll do okay with it. Uhm– so yeah, just depends on how f– how fastidious or difficult the animal is. Some dogs when you just put peanut butter on anything, I mean, there could be anything and they'll just eat it. So you just gotta do your best with that.

Evan Brand: Yeah, pets can be a vector for infection. So if you all have pet, so we're not saying that that is the cause, but I mean, we know lot of pets like random, you know, adventures I've taken with my dog out, you know, she'll go start drinking out of a random pond in the woods and that could have giardia in it and then if I'm playing with her slobbery toy and then I pick my nose, I mean I could've passed bugs to myself from the dog.

Dr. Justin Marchegiani: Yeah. And you can probably dilute some ___[21:09] silver in– in water with them. I would just kind– kind of dose it up according to weight. But I think anywhere between you know, a teaspoon or so for 25 pounds I think would be fine. But you can dose it out.

Evan Brand: —test that with people like how common that the dog is the vector for people when you see their infection?

Dr. Justin Marchegiani: I always ask like do you do a lot of kissy face with your dog, I mean, like I kiss my dog a lot but right on top of the head. So– 'cause– 'cause that feeling [laughs]. I do the math and like, where is it– where does her– where can her tongue not reach? And I'm like, okay right on top of her head. So I'll kiss her like right on top of the head, and that tends to be uh– a pretty safe place to kiss her, but everywhere outside, I try to stay clear and uhm— we'll do, yeah, so she gets baited once a week with some good stuff and then we'll throw some DE in or some probiotics in. I've a good multi– whole food multi powder with– there's a whole bunch of like ground up glandulars uhm— in there– we'll throw that in her food and that works pretty good.

Evan Brand: Cool.

Dr. Justin Marchegiani: Excellent. Uhm– any other things you wanted to address here Evan regarding female hormones, regarding menopausal issues, hot flashes, anything else?

Evan Brand: So there was an herb, and this is just like an off the cup thing that I have read about and recommended to couple females that have had great results with it. And I don't– I don't know if you've heard of it but it's called a– a pri— can't even pronounce it correctly, it's called pueraria, it's spelled P-U-E-R-A-R-I-A, and then mirif— mirifica, pueraria mirifica. There's a brand who carries it called nature's answer. And I gave this to a female client and she had tried everything for– 15, 20 years, including bioidentical progesterones, etc., and this supplement, within 6 weeks, knocked down her hot flashes 98%. Did you find it?

Dr. Justin Marchegiani: Uhm– I'm not familiar with that herb, I mean, there's a lot of herbs that are out there especially some of the more oriental ones that are like, you know, they're just more, they're not like in the mainstream functional medicine world that can have a lot of estrogen me– me— uh– metabolizing, or– estrogen receptor site modulation effects.

Evan Brand: I believe that's what it's doing. Some women have said their breast have grown, which is pretty weird 'cause that makes it sound like it's an estrogenic type formula. So–

Dr. Justin Marchegiani: Yeah, may– it may just have– I mean, you know, it just depends. Are these menopausal women?

Evan Brand: Yeah, these are menopausal.

Dr. Justin Marchegiani: I mean, you know, there's a lot of of receptor sites for estrogen in their– in the breast tissue and as women go in the menopause, the breast can just get flatter. And– and that may help kind of uh– bring some life back into the breast tissue because estrogens's important for like collagen integrity, right? And then also can attract some fluids, so that may bring the breast integrity back. But like with menopausal women, you know. sometimes we'lls use chaste tree or motherwort. A lot of times, things like black cohosh, ___[23:56], and some of the, you know, the specific maca blends, with PMS we'll use a higher dose typically a chaste tree. And then a lot of times uh– like ginger or red root can be great because those really help with uhm— the lymph. So if you have like a lot of fluid retention from the hormones, that can really help kind of drain the fluid. And then sometimes we'll do like the uhm— the dong quai can be really helpful, the motherwort can be really helpful, those can work really well, modulating what's going on. And then of course, you know, we wanna work on the adrenals. The adrenals become a significant reserve site for a lot of the hormones. We wanna make sure the adrenals are working very well.

Evan Brand: What did you say for the– the lymphatic water retention? ___[24:37].

Dr. Justin Marchegiani: Yeah, red roots' really good. Uhm– and then ginger is really good for that too so if like you're a patient of mine listening, you can do the ginger tea's really good. You can always get some red root, I think they sell some red root tea–

Evan Brand: Yeah.

Dr. Justin Marchegiani: And you can get that, that's really good. You can also do I think just juice celery, can also, I think Anthony Williams talks about that, the medical medium guy. But like ju— celery juice can be really helpful with lot of minerals in it and that can be helpful for kinda fluid retention as well.

Evan Brand: Cool. Excellent. I didn't have the questions pulled up. So that I know if there's anything else you wanted to– to read off?

Dr. Justin Marchegiani: I think we hit all the major stuff. I've got a lot of questions coming in here. Some are off topic so—

Evan Brand: Okay.

Dr. Justin Marchegiani: The best– the best time for off-topic questions guys is when I'm doing a live FAQ. Anything uhm— that's like pertained to the topic, I try to put it in the– the show knows at the top. Uhm– like hey, this topic is menopause, this topic is– whatever. And then just try to keep your question pertinent to that, that way we can answer it so it stays on top– on topic. But I'm gonna be trying to do more FAQ's. Just give us that thumbs up guys give us uh– give us the share, make sure you subscribe. A lot of people listening are like, you know, they listen to the recording and like, “Well how do I get notifications?”. Subscribe but also hit the bell, the bell's really important. Make sure your YouTube application on your phone, like make sure it pops up or gives you a little noise. So if you're not sure, if I'm not sure, what I'm gonna do at some of my schedule's super busy, so if I have a– half hour between patients, I'll jump on and do one of these chats. That way you get notified. And I'm trying to put these notifications up sooner so then you can kind of put your questions in there the night before. And that way it can kind of queue up over the next night.

Evan Brand: Cool.

Dr. Justin Marchegiani: So I hope that helps you all. Anything else you wanted to let me know about?

Evan Brand: If people wanna reach out, they can uh– get a hold of Justin at his site. It's justinhealth— so justinhealth.com, and you could schedule consults. Uh– him and I both, we work with clients around the world. So, you know, we've got clients in places you would not believe. And so, we can send these lab testing kits that we're talking about through the mail. So especially for the dutch test that Justin often runs on female patients, that is done using urine. And you could ship that through the mail. And it's not too bad, so feel free to reach out at justinhealth.com. And if you'd like to check out my site, you can do so– evanbrand.com, either way, we don't care, as long as you all get help. So if you can find somebody on your own that knows what they're talking about, and you wanna be seeing locally, great. If you want us to help you, that's what we're here for. We love our jobs, we're super grateful for the opportunity to help you all.

Dr. Justin Marchegiani: Absolutely. Let me answer to ___[27:12] question here. This is good. He wrote, “My girlfriend is only 26 years old and she has hot flashes. Do you know if uhm— the supplements you spoke of will work for someone like that?”. So number 1, that's significant and it's really sad I'm seeing more younger women, just their hormones are decimated, like– this girl is 26, seems like she's already starting to go into almost like an early perimenopause uh– kind of thing, and this is sad because the hormones– hormones should not be this out of flux, out of balance this early in someone's life. So I would ___[27:43], I would not be just jumping on herbs right now, I would get your girlfriend tested, with some of these comprehensive functional  medicine test. See a good functional medicine doctor. And uhm— get that looked at. I mean, of course, like the diet can be done right away, that's foundational stuff. ‘Cause a lot of people, their diet are just do bad they don't have the good hormonal building blocks, but we need to get tested to see how out of balance or not your girlfriend's at. We really wanna work on supporting them with herbs and maybe even some bio-organicals to kind of jump start the hormones if you will.

Evan Brand: Yeah, I– I mean there could be adrenal issues there—

Dr. Justin Marchegiani: Yes.

Evan Brand: –could be thyroid, could be gut, could be all of it.

Dr. Justin Marchegiani: Yeah it's really sad, I see lots of women hormone levels on these test, and they're just decimated. And I think it's just the combination of the foods getting worse, I think uh– oral contraceptives are thrown around too much–

Evan Brand: Yeah.

Dr. Justin Marchegiani: That can really have some negative effects, I mean, you can google post-birth control syndrome, and that can have some negative consequences. I think  a lot of women are also thrown on antidepressants, 'cause a lot of their– their mood related issues, from the hormone imbalances, and then you can get uhm— tardive dyskinesia which are other issues that happen from long term anti depression, used to– so becomes really– it's really tough for women out there because their cycles can cause so many symptoms that other drugs like antidepressants typically get used, and birth control pills typically get used, which then have more side effects, which then creates more problems. And then if you're on this medication for 10, 20 years, it really can screw up your biochemistry and your physiology, and it can– you know, it can make you not the person you are. You're more moody, you're more irritable, your patience is less, uhm— you just don't get the same satisfaction out of dealing with life that you normally would if your hormones were more balanced and your biochemistry is more balanced. So, we wanna get to the root cause, and– I always recommend try to use more, like you know, a paragard for birth control pill like a copper iud, uhm— or a diaphragm, or just something a little bit more natural in origin, if you can. Uhm– on the profile active hide and see side, that way your hormones aren't getting mug this much.

Evan Brand: Yeah, well said, I was gonna ask what do you think happened to this girl if it was like a birth control thing, 'cause that was my first ___[29:52]. When I heard 26, I mean, man that's young.

Dr. Justin Marchegiani: Birth controls, I mean, just having really-really poor adrenal function.

Evan Brand: Yeah.

Dr. Justin Marchegiani: Yeah. That's common, so–

Evan Brand: Could've been trauma, right? Could've been trauma is part of this too–

Dr. Justin Marchegiani: That's gonna put stress on the adrenals–

Evan Brand: Yeah.

Dr. Justin Marchegiani: Of course. You know, that's gonna be big especially– you know, any sexual abuse trauma, you wanna get that neutralized to EMDR, NLP, EFT kind of techniques. Uhm– techniques that work on the subconscious, uh– a lot of people have done talk therapy, but you know, that just only addresses the conscious mind which is still good to do. But you wanna make sure the unconscious mind is addressed. I mean this is why someone that comes back for more, they're here, you know, a shackle off, and they drop to the ground, right? ‘Cause that subconscious mind is so prime, you really got to release the trauma in the subconscious. So these things don't happen because they're just like– you know, they're just like uhm— you got a lot of programs going on in the background of your phone, and you're like, well your phone's dead half ___[30:48]. What's going on, right? It's kinda like that. People have that kind of, you know, issue with their subconscious sucking from their hormones. We wanna make sure that's resolved.

Evan Brand: Great analogy–

Dr. Justin Marchegiani: ‘Kay? Excellent. Oh, it's To– ___[31:03] write in, “She's extremely athletic and fit so of course, my biggest thing is excessive exercise–

Evan Brand: Yeah.

Dr. Justin Marchegiani: —can be a driving factor hormone issues. Uhm– not eating enough calories, and or not getting enough high quality fats or proteins. Like I said, the diet's really important too.

Evan Brand: Yeah we work with a lot of women and their periods have stopped due to their excess training. You know, we've had a lot of crossed fit burn out victims–

Dr. Justin Marchegiani: Yes.

Evan Brand: —where the period stops. So, I mean, man, I– I'm glad you've got further intel. ‘Cause that would– that would be a totally plausible mechanism.

Dr. Justin Marchegiani: Yeah. I mean it– as a woman, you can be fit as heck, but if your cycle stopped because of your exercise, your mother nature is telling you that your body is stressed to the point where it is not comfortable bringing life into this world. And that's always the big indicator like how healthy you are, typically, you know, during cycling years, is gonna be indexed upon fertility. Uhm– and it's hard too because lot of women are healthy but they just get exposed to things in the environment that can have an implication like toxins or pesticides. So it's not just all what you do, sometimes the environment can have implications there too.

Evan Brand: Yup, well said.

Dr. Justin Marchegiani: Cool. Well today was a great show. Appreciate you guys feedback and thumbs up. And uhm— give us the share, give us the subscribe, hit– hit the bell for notifications. And we look forward to chatting with you very soon.

Evan Brand: Take care. Bye, bye.

Dr. Justin Marchegiani: Evan, take care. Bye.

References:

“Lights Out” by TS Wiley

https://www.evanbrand.com/

https://justinhealth.com/