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Dr. Justin Marchegiani and Evan Brand engage in a discussion about menopause. Join them as they share their expertise on women dealing with menopause, including the associated symptoms, hormones, and health factors creating an impact to this period.
Menopause is a naturally occurring transition in a woman’s life. It is a period wherein women undergo a lot of changes in their bodies. This talk will give you important information about these changes caused by hormones, including hormone function and drug interaction. Find out about the effects of infection, as well as other health related issues involving the adrenals, blood sugar and stress making menopause a more challenging experience than it already is. Learn about the natural ways and solutions to keep your health in check during the menopausal period.
In this episode, we cover:
6:26 Menopause: definition and symptoms
9:17 Adrenal gland and hormones
13:40 Conventional Solutions
17:08 Testing hormone preparations
19:31 Bioidentical hormones & herbs
29:20 Dietary recommendations
Dr. Justin Marchegiani: Hey, there! It’s Dr. Justin Marchegiani, alright. I’m hooked on this Youtube live thing. We’re doing our podcast today, Evan and myself. So we are- So we talked about doing menopause uh, today. That was a topic I was listening and learning and reading a lot about it yesterday. I’m honestly dealing with menopause patient for the last decade but always brushing up on my info. Evan what’s going on, man? How you doing?
Evan Brand: Hey, I’m doing awesome. This is fun. Isn’t it great today?
Dr. Justin Marchegiani: It is. I love it. Very cool. So how’s your morning goin’?
Evan Brand: It’s pretty good. I still think that the, the best car for me is gonna be the Tesla because it is the HEPA air purifier in it.
Dr. Justin Marchegiani: Oh, nice. You in the market for a new car?
Evan Brand: Well the Honda Accord, I mean I love it, trust me but, taking in all those diesel fumes like I was telling you about even with the re __ on, I went over to the dealership and they were like, “Sir, you’re never gonna be able to block all of the fumes outside.” I said, “I will if I could have a HEPA filter.”
Dr. Justin Marchegiani: Totally, man.
Evan Brand: I think those Tesla’s are like biologically, like they put biological warfare down or something they will still be safe.
Dr. Justin Marchegiani: Yup, yup. Crazy. Oh, we’re live today. And we’re gonna be chatting aboutmenopause which is an exciting topic for me. I love my menopausal female patients because they’re really motivated. Number one, uh they need a lot of help. Number two, in the conventional medical options for them is pretty poor. So, yeah.
Evan Brand: I’m excited to be able to help. Yeah. Totally.
Dr. Justin Marchegiani: And we got a live chat going in the background which is exciting. So people wanna ask some questions. We may interject here and go live to some of their questions. That’s really exciting, too.
Evan Brand: Where shall we start?You wanna go over symptoms? Talk about- what, I mean most women if they’re dealing with menopause, they’re gonna know about the symptoms but people listening you know- Hey, Butter. Sometimes-
Dr. Justin Marchegiani: She’s Independence. She’s my biggest fan.
Evan Brand: Awesome.
Dr. Justin Marchegiani: Actually, my wife’s my biggest fan. She’s probably second.
Evan Brand: Sometimes you know- whatwe’ll find is with women you know- if they get their ovaries removed, they’re basically gonna skip perimenopause or just gonna go straight to full-blown menopause. Which is what’s happened, for example with my mom, getting the full hysterectomy, for example. You know at 40 something years old, she had already been put into full-blown menopause, basically. And so, she was experiencing a lot more symptoms a lot more rapidly. And say a woman who’s naturally gonna transition.
Dr. Justin Marchegiani: Totally. I have to say, Evan. Honestly, I’m mesmerized by that chest hair that’s coming out, man. I’m sorry.
Evan Brand: I know.
Dr. Justin Marchegiani: I was just like “Whoa! okay.”
Evan Brand: Can you believe that?
Dr. Justin Marchegiani: I know.
Evan Brand: I just actually, I just, I just show my wife last night and said,“Babe, this thing is growing north right now.”
Dr. Justin Marchegiani: Absolutely. Well on hormones, you know- hair,or hair growth will be a big connection with that. So we can chat about that today. Very cool.
Evan Brand: First thing, I need to button up this extra button here, so I’ll do it.
Dr. Justin Marchegiani: I don’t know, man. It’s gonna be really hard for me to pay attention during –
Evan Brand: Alright, alright. Let me button this up then. I apologize for my manliness.
Dr. Justin Marchegiani: No. You’re good, man. You’re good.
Evan Brand: Alright. Go over symptoms. What should we- I mean hot flashes are gonna be very common. Of course, everyone’sgonna know about hot flashes. They’re probably bored of hearing about that. But something that we see a lot, too is depression and mood swings. Something that could definitely be fixed if we take a look at the adrenal glands. And I guess were to hit on that adrenal connection, too. Because the backup generators, which are the adrenals, which should hopefully be kicking in and supporting women. A lot of times they had adrenal fatigue already. So when the ovaries and hormones go down, the adrenals are already tanked. So you’re not gonna have that backup generator that’s gonna help you out.
Dr. Justin Marchegiani: Exactly. I’d say the big is, let’s define menopausal a bit more. So menopause is that time where typically the ovarian function, the ovarian output of hormones is-is running low. It starts to get depleted. And that’s typically because the follicles that a woman is born with, they start to run out. So a woman typically has you know, hundreds of thousands of follicles at birth. And then eventually, only maybe 400 or so are viable. So you fertility for a woman typically, let’s say on average, is gonna be from maybe 13 to 15, depending on when they have their period at first all the way up to the early to mid 40s. Some even late 40s uhm, today as well. So that’s kinda like your- your viable uhm, window for fertility. So when those eggs start to run out, and what starts to happen is your ovarian function starts to diminish. And then that typically, it’s about, consider it about a one year time frame until you actually get in to uh-menopause. That’s the perimenopausal timeframe. It’s about one year until you- One year without a period is what you consider to be menopause. And obviously if you get a, your ovaries removed, like hysterectomy wise, obviously that’s instantaneous menopause, right. Coz you’re missing the hormone output. For most women it’s about 12 months about a cycle. And that’s when you technically hit menopause. And then menopause typically can last until you’re instantly postmenopausal. Can typically last about 10 years. So that can kinda scare some women. And if you get your universal move, like a partial hysterectomy- you keep your ovaries but you get your uterus removed- women typically will go through menopause about four years faster. So the uterus does have some hormonal interplay. So again, because you- let’s say have a partial hysterectomy and still have your ovaries, you still will go through menopause. And it’s important that you get that support. And a lot of women they get their uterus removed. It’s typically because, maybe endometriosis or severe fibroids, or some kind of excessive hemorrhage, or bleeding. They cause them to get removed in the first place.
Evan Brand: Well even I’ve heard of some women saying just because they don’t wanna have a period anymore and doctor will still do the surgery.
Dr. Justin Marchegiani: Yeah. That’s not a good move because your uterus does have some effect on hormonal output. Again the research and people don’t quite have their head around it, that you have, around hundred percent. But there’s still a reason why that is there. So the first aspect is you know, the definition, one year without a period. That’s number one. Number two we have that perimenopausal timeframe, which is about 12 months. And then once you’re in menopause, about 10 years until your technically postmenopausal. Now all the symptoms that we talked about earlier, what are they? There gonna be hot flashes, of course, right.There gonna be mood issues, lack of femininity, right. Feeling less like a female, less like woman, uhm called the sagging breasts. Uhm, I would say a little loss of elasticity in skin. As your estrogen drops, that can shrink breast tissue. It can also stimulate or decrease the stimulation of collagen. So the skin starts getting- losing that quality, and that elasticity, and that nice healthy useful tone, hair loss, mood issues, brain fog, osteoporosis, obviously vaginaldrynesss, depression. So these are all symptoms of the ovaries losing their ability to function. And then what starts to happen is your adrenal glands really have to pinch-hit and come to the table.
Evan Brand: Yup. So if you got infections or your adrenals are tanked, when the- if we use the pinch-hit term, they’re not gonna be able to doit very well because you’ve got these other problems. Or the diet is not good, you’ve got blood sugar swings. So without healthy blood sugar, it’s gonna be tough to have healthy adrenal function.
Dr. Justin Marchegiani: Exactly.
Evan Brand: You know the thing that’s interesting is a lot of women get talked to about menopause like it’s a disease. But it’s not really a disease. It just seems that the modern world in terms of either too much or too little exercise, and a diet that’s not rich in good fats and good proteins, those are the modern things that we’re up against. So menopause is becoming more prevalent. And then also, it’s gonna be more severe, too. Because our ancestors they’ve dealt with menopause. You know, this is a natural transition, but now we’ve- were up against these new things that the modern world present. So therefore, we have to play the cards a little bit smarter, make sure we’ve got the nutrition down, make sure we’ve got the exercise portion down, and then we always get to the underlying issues that could still be affecting things or making things more intense. Like say, an infection which you and I find hundreds and hundreds a year. And menopausal women, a lot of times there is adrenal issues calls from infections.
Dr. Justin Marchegiani: Absolutely.And to- I wanna add, we’re actually doing this podcast live. So anyone watching live right now, feel free and write in a question or two. And we’ll be able to see if we can intermingle the questioning with the podcast. Sothis is gonna be this kinda new little set up here. If people are likin’ this, we may do more of it. So we’re pretty excited about it. I did a couple YouTube lives this morning and people want a couple questions answered. But still do it as long as we can get a turn into the topic.
Evan Brand: Yup. So-
Dr. Justin Marchegiani: I got a little Kombucha right now. I’m getting my ginger Kombucha in here.Nice.Love it, love it. Nice.
Evan Brand: I’m drinking uh, Vitamin C actually right now. Vitamin C tonic out ofout of little mug that says having tea with a friend brightens any day.
Dr. Justin Marchegiani: Here, here. Touche on that one. Excellent. So we talked about hot flashes a little bit. Can you talk about- Can you go into like, the adrenaland why the adrenals are so important for women that are getting ready to go into menopause?
Evan Brand: Yeah. Absolutely. Well so, if we look at the top of the food chain of hormones, if you type in steroid hormone pathway chart online, you can see where cholesterol, which is going to come from diet. Also of course the liver and all of that. But you got cholesterol at the top of the food chain here. Then downstream we’ve got progesterone. You’ve got pregnenolone. You’ve got your estrogen, your estriol, your estradiols, your testosterone, your DHEA’s. You’ve got your aldosterone. You’ve got cortisol. You got all these hormones that are depending on a pretty good balance. But as we pry talked about before, what happens is the pregnenolone steal, some people debate that. Some people say that it’s not true. But just based on what we have done, and what we do, to me it makes perfect sense of the pregnenolone steal is perfectly real. Which is the process where men and/or women that are under significant stress, the body is going to prioritize cortisol production over the production of these other hormones like your estrogens. And so when menopause is occurring, and the levels of estrogen and progesterone are dropping, now you’re just dependent on the adrenals and this cortisol, this whole adrenal cortisol- and I guess we’ll call it backup generator- to do the work that was being done by two generators before. Now you’ve got one generator doing the same amount of work. Now, if you’ve already been in sympathetic fight or flight mode, for significant amount of time, you’re gonna have trouble. So when we pull your adrenal cortisol results, we’re gonna see that you’ve likely got low free cortisol. Which means since you’re not outputting the amount that you should be. So the analogy I use is the smartphone. So a lot of women where looking at, they could be, we would like to seem around 28 or 30 units of free cortisol. I’ll make a bio health test, for example. But a lot of women are showing up anywhere say 10 to 15 units of cortisol. So that’s like you starting your day with your smart phone battery charged at 50%.
Dr. Justin Marchegiani: Yeah
Evan Brand: And you’re trying to get through the whole day. It’s gonna be tough. And so this is why having healthy adrenals and having a good adrenal protocol in place, for me is essential not only for men and women that are you know, younger. But older women especially are going to benefit from some of the adaptogens and strategies that we can chat about.
Dr. Justin Marchegiani: 100%. Now, looking at the adrenals, I always thought patients are like a backup generator, right. They’re gonna produce a significant amount of DHEA which can go down the hormonal cascade and can become testosterone andro and primarily at a female, we’re gonna go down more of the estrogen pathway. So if you look at testosterone andro it can also float downstream into either estrone, or estradiol estrone, and estradiol.And then from there it can get converted in the liver to estriol. Estriol is gonna be about 80% of all the estrogens in your body will be estriol. During reproductive age, estradiol will predominate as your main estrogen. And then when you go into menopause, estrone will be what predominates when you’re menopausal. So let’s break that down. We have E1, E2, E3-really simple. The names have a good giveaway. Estrone has O-N-E in it. So that’s E1. Estradiol, D-I, right. like 2 dice, E2.And then estriol, T-R-I, that’s gonna be E3. So you’ve E1, E2, E3. E1, estronethat predominate when you’re menopause. E2, during reproductive age. E3 will be what’s there the majority of the time. Uhm- but it’s weaker, and it will significantly predominate when you’re pregnant. So what happens is when you’re going to menopause, E2 starts to decrease, and we start to get more dependent upon the E1. The problem is E2 and E1 are stronger estrogens and could be proliferative. Meaning, they can increase risk of cancer and other health issues. So, if we are gonna support a female with some bioidentical hormone preparation- Bioidentical meaning the hormone molecule matches what’s in your body, typically plant-based.We’ll do it with estriol, E3. And we’ll even typically combine a tiny bit of progesterone in there to support the female hormones.
Evan Brand: Should we talk about the conventional solutions,like hormone replacement therapy? Like the one that comes to mind here about a lot as Premarin?
Dr. Justin Marchegiani: Yeah. But yeah- yet but you Prempro or Premarin Provera?
Evan Brand: Yeah. I mean- That’s- that’s it. That’s linked with increased risk of heart disease now.
Dr. Justin Marchegiani: Yeah, in cancer- I mean the women’s health initiative study uhm- found that about 10-15 years ago. So it’s- it hasn’t been prescribed as much for hot flashes and menopausal symptoms. But it’s still is being prescribed. Their more natural, kinda anti-aging doctors are out there, typicallymedical-based. They’re prescribing hormones. The problem with it is they prescribe like it’s candy. They prescribe it like it’s a vitamin or nutrient. And hormones are really, really powerful, right. Hormones are measured in like nanograms, which is like one speck of salt in like a swimming pool, right. So it’s like very- you know- very, very sensitive. You know, amounts of these things. So looking at hormones, we wanna make sure we don’t give it like a supplement. We wanna make sure we actually test. So, we’re not guessing when we prescribe it. It’s specific to what the patient needs. Number two- number two, is we actually have to make sure the diet and lifestyle is dialed in coz that’s a really, really important starting point. And I would say even more important, most medical doctors or bioidentical doctors totally ignore the adrenal portion of that. So the adrenal is just totally not even on site. And we know how important the adrenals are for that backup generating of the sex hormones, especially when you on menopause. So imagine that backup generator, if it’s on empty, or the smartphone analogies on low, that means symptoms. So you gotta turn the generator when the storm comes in, it’s not on full. Guess what? Your power is not gonna work. There’s gonna be a lot of things in your house aren’t gonna work, like you have full power. And what that equates to a menopausal female, is symptoms. Mood issues, skin issue, hot flashes, of course, vaginal dryness, low libido, right. So those are the things we gotta be very mindful of, when we’re dealing with menopausal females.
Evan Brand: Let’s talk about what the options are. I mean even if you do go bioidentical, a lot of times you’re going to get hormone creams. But the more, more that we develop hormone creams, I’m finding that- that can disrupt other hormones, and it’s gonna be tough to measure, it’s gonna to be tough to get the right dose. And so now, I’ve been reading a lot about sublingual drops- for bioidentical hormones. Supposedly, that’s the best because you can determine exactly what dose you’re taking. For me that goes out of my- you know, that goes out of my pay grade coz I’m not a prescribing medical doctor. But it’s at least good to know that there are options out there for women because if they are going to go talk to their endocrinologist, or you know- some type of MD that’s more integrated. Hopefully they can know that, you definitely don’t want to go oral, you definitely don’t want to go with the cream. But if you can go sublingual drops, with the bioidenticals. However, in a lot of cases, if we are getting the diet dialed in, orgetting like some omega-3, fatty acid supplements in, we’re removing synthetic estrogens, the plastics, and all the other exposures, the phthalates, and all the other endocrine disruptors, and health and skincare products, and then we’re addressing underlying issues, I’ve had great success with many women- women. I know you have, too. In- we’re not- we’re not saying,“hey, go get this drug”, “go get the struggle get this prescription”
Dr. Justin Marchegiani: Exactly. So when it comes to hormone preparations, number one, how do you test it?Most medical doctors they’re gonna primarily use a serum bound test, a serum blood test to look at hormonal levels. Now the problem is, serum represents a 100% of all the hormones that are in your blood, right. The problem is only about 2% maybe 2 to 5% hormone’s a free fraction. So the problem is because a small- for such a small small percent of the hormones that are free, it’s such a small percent out of the hundred percent. It’s really hard to measure it because you don’t have a small enough gauge to sense it.
Evan Brand: That make sense.
Dr. Justin Marchegiani: So it’s like using a thermometerthat only tells youyou’re either 97- 98- 99.Doesn’t tell you the in between temperatures. So your 97-9, it may say you’re still 97, right. So imagine that’s kinda like the blood testing. So we use a free fraction test that will break it up and look at the free fraction of the hormone. Whetherwe’re using bio house salivary cortisol, or salivary progesterone or estrogen test. That’ll look at the free fraction. Or we use the Dutch testing, that will also look at the free fraction. Excuse me.The Kombucha gets uh- gets me a little bit burpy.
Evan Brand:Ha ha
Dr. Justin Marchegiani: I apologize for that. Uhm- so looking at that, we will wanna do tests that look at the free fraction. Number one- so salivary test or like a really good Dutch test by Precision Analytics is great. Because we get a more fine two-metric of where those free fraction of the hormones are at. Again, there are some blood tests that can- I think you can look at estradiol-free. I don’t think you can look at progesterone-free or cortisol-free on a blood test, yet. You can look at serum cortisol, you- you can look at estradiol-free, you can look at testosterone-free. I do not think you can look at progesterone-free. So again, we wanna be able to look at the free fraction coz that’s what bioavailable and combined into a receptor site.
Evan Brand: Yeah, I wanted to mention the- Dr. Jonathan Wright, which- I believe it’s the same- it’s the same guy who wrote the book on stomach acid, which is I know one your favorites on my favorite books.
Dr. Justin Marchegiani: Yup.
Evan Brand: That he’s got some good info with Mercola about administering bioidentical hormones. And are talking about the version that they call tri S, which is supposedly 80%, estriol, 10% of each estrone and estradiol. So it sounds like- for even you know people like my mom, any woman that’s had you know- a full hysterectomy, it sounds like this is gonna be pretty foundational to- to overall health. It sounds like you can’t really out supplement your way if you have had you know- a full hysterectomy like this. What’s your take?
Dr. Justin Marchegiani: Right. Remember what I said? I said 80% estriol, right. So think about it, right. With a tri S, what is it? 80-10-10. 80% E2- I’m sorry-E3, estriol that’s the tri S. So 80% estriol, E3. 10% estradiol and 10% estrone. And that’s good if you can get it compounded that way. That’s fine. Again it’s still gonna be a cream and the problem is some women don’t do well with the cream because it super saturates in the subcutaneous tissue and starts coming out in uncontrollable amounts. You don’t get dosed into the bloodstream as efficiently let’s say, as a sublingual. They can go right into your sublingual tissue in your buccal tissue, go right to the blood, and there’s no like real fat in the mouth. Soright in there, and your good. Now the differenceis Dr. Jonathan Wright’s talked about this. If he does sublingual’s- I’m sorry-If he does the creams, he typically does it inter vaginally because of the submucosa down there. They can go right into the bloodstream. So that’s helpful. But again, you know, I’ve dealt with a lot of women that do the creams and such,inter vaginally, which can work decent on menopausal women. Not so much on cycle, and I’ll tell you why.But again– it’s some issues issues. I mean not to get too graphic here, you can get to the underwear, you can come out. Uh- it’s okay if you can do it at nighttime when you’re lying down. But sometimes you get discharge and they can wrap women’s underwear. They can be a little uncomfortable. So it just depends on what you like. If women have already done that- done it that method. And then they’re doing well, and the hormones are stable, and they didn’t have any of those issues that I mentioned, fine. If not, we’ll typically recommend some of the sublingual drops. Some of the estriol and/or progesterone drops. We’ll also support the adrenal glands themselves. And then will also use some specific herbs to help modulate the sex hormones. We’ll use wild yam. We’ll use chaste tree, or vitex. We’ll use dong quai. We’ll use black cohosh. Uh- we’ll use some of those herbs to help modulate the receptor sites. I’ll even use some specific phenotypes of mock guys. Some specific phenotypes for cycling women and/or menopausal women that- that will help with even some of those symptoms of the receptor site level, depending if we have a cycling or a menopausal issue.
Evan Brand: How about soy during this time?
Dr. Justin Marchegiani: Well if you’re using specific soy isoflavones, that can be helpful to modulate estrogen receptor sites. Again, we’ve talkedvery negatively about soy, but again soy if you extract the isoflavones, you’re also not getting all of the proteins and the in the goitrogens, and the trypsin inhibitors. All of the negative effects. And of course, it’s gonana be extracted from a non-GMO source. So my opinion, you can still get some significant benefits. But where it’s the genestein the other types of soy isoflavones can be helpful for modulating, yes, receptor sites.
Evan Brand: Sure, sure. And I briefly mentioned omega-3’s but that’s another good one. Just plenty of omega-3 fats so good, high-quality triglyceride form of fish oils, which is what you and I use. So if you are takin’ a fish oil and you get fish burps, it’s probably ethyl ester. And that’s not good. If it smells fishy, most of the time,that’s not good, either. And you want to-
Dr. Justin Marchegiani: You want the triglyceride form.
Evan Brand: Yeah.
Dr. Justin Marchegiani: That’s it.
Evan Brand: Which is basically is as close as you can get to the raw form or the form that you would get if you’re just actually eating the fish.
Dr. Justin Marchegiani: Absolutely. So looking back at all the different things we talked about some herbs to help modulate receptor sites. We talked about using potential bioidentical hormones, our biases more towards the sublingual. If you were to do intravaginal cream, if have to be intravaginal, ideally not on the skin as much. Because of the super saturation in the subcutaneous tissue. And I see it on test. When you see like literally women are off the charts. You’re like, “hey, your doctor’s just measuring blood.”And because it doesn’t have a small metric to pick up that unit 2% or so, it may look okay in the blood, but not the okay in reality in- in the spectrum of looking at the free.
Evan Brand: Yeah. I’ve seen that, too. I’ve seen it with men, too. Which is all other conversation but testosterone replacement therapy, where just go so far above the 6, 6000 about 6000. That’s like where the test maxes out. And its like, “whoa! something’s not right.”
Dr. Justin Marchegiani: Exactly. Now, looking at cycling women, why do I wanna avoid creams altogether? Well for the most part with cycling women, their hormones are gonna be at different place in the cycle. The first half of the cycle is gonna be the follicular phase, where estrogen starts to go up around day 2. Day 3, it taps out around day 12 to 13. And then it drops as progesterone rises. That’s where your ovulation is.That estrogen drops and progesterone rise is where ovulation is. Progesterone comes up to the top. Estrogen nears down low and they both dropped together around day 27 and day 28 to signal bleeding. And again, the reason why this is an issue is, because if you if you can’t pull estrogen or pull progesterone all at the right time, then that can throw off the cycle. Because if estrogen and progesterone aren’t dropping exactly when it should, you’re not gonna have adequate menstruation. It may delay things. It may slow off your cycle. So because of that, I don’t like creams on my cycling female patients. I like to be really specifically progesterone exactly what days. I don’t want any spillover on either end. And I typically don’t use any estrogen with female hormone patients that are cycling because most women are estrogen dominant. And will typically be able to support the estrogen via the adrenal side via some of the DHEA and pregnenolone and some of the modulating herbs.
Evan Brand: So if you went to a standard MD or like an integrative MD, are they can be able to provide those sublinguals? I mean- how common is that? I know were talking about- sometimes we talk about subjects where the optimal thing is just unheard of in conventional. But I mean- is this sublingual, is this popular enough for some woman could go down the street to a clinic and get- get help with that?
Dr. Justin Marchegiani: Uhm, most conventional medical doctors aren’t gonna- aren’t gonna be able to do the sublingual coz it’s just not in their wheelhouse. Uhm- some do troches which maybe a close second, right. A lot of them will do the pellets, and then most of them will do the creams. Just how they’re taught. You know, if you look at a lot of the ___, some of the anti-aging physicians, they’re gonna do more the creams. Dr.Jonathan Wright does this, but at least respect that it’s intravaginal. So you don’t have the subcutaneous build up. But again, I think the more important piece here to look at, is the adrenal aspect. We gotta look at the adrenals. And if anyone’s viewing right now, and wants to chime in, and ask a question via chat, feel free to do that. And we’d love to answer any of the questions that are on or related to the topic. This is a new thing we’re testing out. So the more people that engage or comment on this afterwards, that’s gonna motivate us to do more of these.
Evan Brand: Totally. Yes. So, the- you’ve hit on the good point, which is, yes- you can go there with the hormone replacement therapy. It has done good things. It can do good things, but I’m not prescribing it and I’m getting- I canprescribe but I’m not a prescribing MD. But just doing the stuff that I’ve done, I’ve been able to make 80, 85, 90% better in terms of symptoms that menopausal women are experiencing. And that’s with no drugs. That’s looking at the adrenals, that’s getting the gut infections taken care of, that’s looking at mitochondrial health, that’s getting rid of candida problems, that’s making sure they’re going to bed on time, that’s making sure they’ve revamped any type of cleaning products in their house. They’ve got the chemicals out, they ditch the plastic Tupperware’s. So all that stuff your adding 5%, 10%, 15% and then it just keeps adding up and then eventually, people are gonna feel much, much better.
Dr. Justin Marchegiani: Oh, absolutely. And I think the bit thing is you’re working on the adrenal piece like I mentioned. You’re also working on the diet, right. Your stabilizing blood sugar. One of the biggest stressors on the hormonal system is going to be blood sugar swings. The more you stabilize those blood sugars and keep that dialed in, you’re gonna takea lot of stress off the hormonal system. Also stress is gonna eat up progesterone. So kinda like the pregnonolone steal, which is you know-it’s theoretical. It makes sense. It’s just- Here’s howI tell patients. We’re prehistorically hardwired to allocate our resources to stress and inflammation now versus healing and recovery in fertility tomorrow. Why? Why is that? Well because if we don’t get through now, tomorrow never comes. So it’s like the 12-year-old boy procrastinating on the homework. If you’re chronically stressed, you keep on putting off the fertility in the recovery, in the- the recuperation that is needed. So we’re chronically hardwired to deal with stress right now. So the goal is to decrease that stress, so then your body can start to allocate that, and put the healing and recovery in the fertility higher up on the priority list.
Evan Brand: Well said. Yeah. And it’s crazy to me how you can go and you could complain of the symptoms up sounds like you’re in or you’re going to menopause.Here’s cream and have a nice day. And none of this other stuff is discussed. I mean, we’re looking at massive pieces of the pie that are just completely ignored.
Dr. Justin Marchegiani: Oh, yeah. Absolutely I would say the biggest issue I have when I was at the menopause summit last week with the with uh- with Bridget- Bridget Dainer, and one of the things they came off that we talked about was, I would say, one of the biggest things that is driven more menopausal patients to me, is this low-fat era. Avoiding animal proteins and healthy fats because that’s where a lot of your hormones come from. So if you don’t have that diet piece dialed in with the hormonal substrates, and the building blocks, and the healthy amino acids, you’re really at a significant disadvantage to being able to make your hormones on your own. So healthy fat-soluble nutrients, through grass-fed meat and Pasteur-fed meat and Pasteur-fed eggs, organic, free range, none of the chemicals. You don’t wanna add more Zeno estrogens in our meat to the- to the table, right. And throw off our hormones more. Healthy fish, egg yolks, if you can handle grass-fed buttering ghee, that’s great. Lots of vegetables, a glycemic or carbohydrate uh- balanced meal for you. So depending on starch, or no starch.Keeping grains out, keeping inflammatory foods out, keeping toxins out, and stabilizing your blood sugar, or not letting your blood sugar drop and not letting yourself get hungry is gonna be a great starting point for most people.
Evan Brand: Yes, I mean vegetarians, vegans specifically for women at this time, it’s gonna be brutal on them. If you’re vegetarian, vegan and you’re going into this phase in life, it’s gonna be really, really tough on you.
Dr. Justin Marchegiani: It definitely will be now. If you are in that place, you know- I would try to coerce you in- and sell you on the fact that you probably want to eat some of these healthy animal proteins. At least cajole you and maybe some egg yolks, or tiny bit of fish, if I can do that. If I couldn’t do that, I will at least try to get you on some collagen proteins, uh- some really good P-protein. I’d even recommend you get some free form amino acid supplementation. I recommend lots of healthy fats via avocado- avocado oil, coconut oil. I will do Chia seed. Uhm- again, olive oil, low temperature. AndI would really work on the good fats, and I would make sure not going excessively high in the carbs. A lot of vegetarian by default become carbotarians. Again, I got in a lot of flak on this on YouTube, but it’s true. I’ve looked at hundreds of food logs of these types of patients and people. And I’ve seen it over and over again. The difference between me and you Evan, and the general public, is most people in the public, they only have an N=1. They have a torr experience. So if they extrapolate themselves, as is what everyone does, we seen it many, many hundreds, if not thousands of times over, most vegetarians become carbotarians with the grains and the excessive starch. So again, may not be an issue for you. I may not be speaking to you directly, but again that’s an issue that we do find on the vegetarian side.
Evan Brand: Agreed. Yeah. And we can look at the lab results, too. And I notice YouTube is the place where you get the most hate comments about vegetarian or, or- or veganism. If you’re- if you’re saying that that’s not a good- not a good thing to do, but we got the lab results to prove it. So when you got people out there saying look at this person, or look at this one doctor, or look at this one study, it’s like,“Hmm, I’m gonna look at the stuff that we’re doing in the trenches. I mean, you and I are in the thousands of people that we’ve worked with now. And we see the direct correlation where when people start adding in the eggs, or they start adding in the good fats on a retest of let’s just say, adrenal cortisol pattern, for example. We may notice that the cortisol could get back into a good rhythm. Now granted there’s lifestyle components that were helping, there’s- there’s stress management, there’s the sleep, there’s the watching off of the blue light, etc. Getting good bright light in the morning, which is gonna be helpful. If you’re spending time in a dark room, cortisol is a light driven hormone, so if you’re waking up and you’re not opening the blinds, that’s a big issue, too. Wearing sunglasses, for example, but if your adrenals are stressed, you’re gonna want to wear sunglasses. Some women they’re complaining of a bright light coming in, you definitely wanna get your adrenals tested. Because I’ve noticed that people I suspect- like I look around my family to see, “Oh, I bet she’s got some adrenal issues”,“she’s always wearin’ those sunglasses”. That gets better when we support the adrenals. Bright lights don’t bother you as much.
Dr. Justin Marchegiani: Absolutely. That’s a 100% true. I totally agree. Well, anything else we want to touch upon with menopause. We hit the adrenals. We hit the diet. We hit the blood sugar. We hit some of the supplementation. Again, some womendon’t necessarily need the bioidenticals, but some women do. And it really depends on what’s going on, how unbalanced the hormones are, and how bad their symptoms are. Again, the more their hormones are depleted, you may need a strong bailout, a fast bailout with a little bit of hormone support. So I don’t wanna keep my female patient suffering. So we’ll use a little bit of that. And as long as we’re testing, and were not guessing, were assessing, I feel very confident moving forward with that.
Evan Brand: Agreed. Yeah. Well said. Well people let us know what you think of the live YouTube thing. I’ll be curious to hear the audio quality. I mean, you talking to me it sounds- it sounds perfect. So if it’s as good as us recording through Skype, and other methods, then I say we could just keep doing our shows like this.
Dr. Justin Marchegiani:And again, we didn’t plan uhm- to do this show today. So I did one this morning off the cuff. I posted last night. So we had more viewers, but today was off the cuff so we don’t have too many viewers listening. But if anyone’s listening and wants to ask any questions, let us know. But I plan on- we’ll probably have hundreds, if not thousands, of people listening live very soon. When we start planning these out and it we’ll put it out in our emails. We’ll put on Facebook ahead of time so people know and they can come with your questions. Bzut anyone has any questions, actually we got a question here.What about liver health? And where to metabolize estrogens? Yeah. So regarding estrogen metabolism, this is important because I mentioned this earlier. We had E1, which is estrone and we have E2, which estradiol gets funneled downstream into estriol, okay. And what happened- this conversion happens to be at the liver. So E1 to E3 and E2 to E3, all happens in the liver. So anyone that has a liver issue, is gonna have a female hormone estrogen issue. So we wanna work on the liver. And also on the Dutch testing, we’ll look at the 2- hydroxyl, the 2-methoxy estrogen metabolism and we’ll look at the methylation meter and see if we’re having that one-to-one ratio of estrogen metabolism. So for 2-hydroxy estrogen of 1, do we have a 2- methoxy 1? Do we have this one-to-one metabolism? And that’s the methylation meter that we’re looking at on the test. If not, we could be uhm- essentially not getting rid of all the ashen. We could be re-absorbing that. Also, increase estrogen issues are gonna cause gallbladder issues. So again, you know- that the FFF role gallbladder issues, women that are overweight or fat, women that are- that’s the FFF, that’s just the accrued abbreviation. So overweight female, and 40 or up. So that this estrogen dominance thing. This is what goes, you list- I mean- I remember sitting in the many gallbladder surgeries, and those like FFF. Those are the three things the surgery would say. Are your overweight, female and over 40? Because the high amount of estrogen dominance, right. Makes the gallbladder- makes the bile flow from the gallbladder sluggish. So then what happens is two things. You can’t metabolize your hormones. A lot of that happens via the bile excretion. And then number two, you lose the ability to break down your uhm- fat-soluble vitamins. So gallbladder issues, and then fat metabolism, and then detox are common side effect of estrogen dominance. And that can happen leading into menopause. I can’t tell you how many of my female patient that are cycling have lost her gallbladder. And it really sets them up for nutritional efficiency and poor detoxification down the road.
Evan Brand: Oh, gosh. Well said. I mean- when I hear liver too, I just think of, like the GPL talks that you and I’ve chatted about with the gasoline additives and all these other chemicals in people’s bodies, aspirin and other- you know, pharmaceutical medications that increase the burden on the liver. So whether it was like statins, or hard drugs, or any of the stuff that that’s really tough on the liver. Alcohol, which a lot of women over 40, their stressed, they’ve got these symptoms, so they’re using wine you know, to put themselves to sleep. A glass or two a night which could increase the burden on the liver and messed this whole process up. Plus we’ve got parasite infections. You know 1 in 3 is what we’re seeing of infected people. Say you’ve got the toxic load there. And then if you got methylation issues, like you’ve mentioned, and you’re unable to detoxify, or you’ve got problems with the phase I or the phase 2. And you’re not taking something to conjugate those toxins and rattle them up and get them out your toes. So there’s a lot of different pieces that- that can be improved upon, for sure. Sço we always factor liver in. It’s not a matter of if we factor liver and detox into the protocol, it’s just a matter of when.
Dr. Justin Marchegiani: Absolutely. Now we just say- making sure we- you toss upon earlier with the gut stuff and I think so many mainstream functional medicine practitioners, and I would say even the medical doctors, ignore the digestion part coz again, a lot of the detoxification happens with sulfur amino acids. So we have to make sure we have the sulfur amino acids, the phase 2 sulfur amino acids to run those liver pathway. Socysteine, glutamine, glycine, and the glutathione precursors uh- methionine, taurine, especially for the gallbladder, are gonna be super helpful for liver detox. Also making sure we eat a lot of the cruciferous vegetables. And again, if you have gut issues, make sure they’re cooked so the fiber’s broken down. So we can get the diindoylmethane and indole-3-carbinol, which is gonna be really important for estrogen detox. And again, this is your broccoli, your brussel sprouts,your cauliflower, your asparagus, your kale, spinach
Evan Brand: And your broccoli sprouts. I love broccoli sprouts.
Dr. Justin Marchegiani: Yes, broccoli sprouts. And again we have someone answering uh- or asking this question live. So we’re answering anyone else that wants to ask a question live. We’re both ready to sign out. So anyone else,uh- put something in the chat window, we love the answer to it. So to finish that question, what other herbs can we give? So for gallbladder, we wanna add maybe some extra bile salts. We wanna do some fringe trees, some artichoke roots, and phosphatidylcholine, some X taurine. These are great for the liver. Extra milk thistle, silymarin. These are great things and we may even give extra sulfur amino acids, antioxidants, B vitamins, extra folate. These are all great things to support the liver. And I’d also say make sure you’re not doing all the bad things regarding the pesticides, the chemical, the exogenous hormones. And again, this is where a little bit estriol may need to be given coz that if we have toxic liver, we may not be able to have that liver conversion goin’.
Evan Brand: Well said. Great job.
Dr. Justin Marchegiani: Excellent. And we have a couple of other questions here. Uh- No, I did not go to the Super Bowl. No, not this year. It’s in Houston. I was thinking about it, didn’t make it down there. But I’m a huge Tom Brady fan. I think I know a lot of haters for that. But Tom Brady is the poster child for functional medicine, natural medicine. And the guy’s 40 years old and better shape than ever. And part of it is because of his diet,his eating,his sleeping, his training he sees a chiropractor, he sees an acupuncturist. The guy’s dialled in and is using natural medicine and functional medicine as his go to and not conventional medicine for his go to. So,huge fan of that. Anything else here, Evan?
Evan Brand: I don’t think so. Some people back to the website, check out Justin, justinhealth.com Check me out notjustpaleo.com or type in Evan Brand. You’ll find us both. More content, more info, the ability to schedule consults with us. All of that’s there. So we do both offer 15-minute free call. So if you got questions, you wanna get your questions answered, reach out. You know, there’s no sense in suffering if you know that there’s a possibility to get better, go for it, time’s wastin’.
Dr. Justin Marchegiani: And if you guys listening, like this type of format, we want to do it more frequently. So give us- give us some love,give us the thumbs up. Uh- share it, put it on Facebook, email to your friends. We absolutely love it. And the more feedback we have, the more we wanna do this.
Evan Brand: Absolutely.
Dr. Justin Marchegiani: Excellent. Alright, Evan. Well this- the beautiful thing about this is,this thing goes live right away.So kinda exciting, instantaneous feedback for the listeners. Anything else in your end?
Evan Brand: No man, that’s it.
Dr. Justin Marchegiani: Alright, man. Great chattin’.
Evan Brand: You too.
Dr. Justin Marchegiani: Take Care.
Evan Brand: Bye.
Dr. Justin Marchegiani: Bye.