Peri-Menopause and Female Hormone Balance Solutions | Podcast #213

Peri-menopause can be hard on some women. It brings fatigue, mood swings and sleep troubles, a stressful transition that can last for months or years before menopause.

In today’s podcast, Dr. Justin Marchegiani explains the process of peri-menopausal stage and its effect to the body. Learn how the lowering levels of progesterone make one’s system more estrogen-dominant, the different issues brought by peri-menopause especially stress, mood issues, hot flashes, depression. Also, learn how to minimize its effect. Continue for more and don’t forget to share. Sharing is caring!

Dr. Justin Marchegiani

In this episode, we cover:

02:26    Adrenal Gland

04:31    Female Hormone Cycle

07:31    Hormone Physiology 101

26:27    Stress Response Buffering

12:35    Effects of Estrogen Exposure to Men

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Dr. Justin Marchegiani: Hey guys! It’s Dr. Justin Marchegiani, welcome to today’s podcast. Uh, congratulations to Tom Brady and the New England Patriots, great go- not really a great game on the offensive side, great defensive game. Uh, 6 superbowl victory for Tom. And I did a podcast on Tom’s performance secrets 2 weeks ago which become even more pertinent today based off of his victory. He is officially the go- greatest of all time. So, really good uhm- to go back and revisit that podcast, lots of good insights in regards to sleep, in regard to hydration, in regards to nutrition, reducing inflammation, uh various training techniques, all these things I think are, a conglomerate of tools that uh- Tom uses to improve his performance, heal fast and keep his uh, pliability and performance up the uh- at the, you know, at the highest age possible. Really, to be a successful quarterback in the NFL, it’s pretty amazing.

So, today, we’re gonna open it up here for uhm… here, I kinda like- maybe a little live podcast here. Anyone wants to chime-in in these specific topics they want me to go into today, we can just choose a topic and just go off the cup and go live. I’m on Facebook as well so, feel free and check in with me on any of these mediums here so far. I’m gonna dive in one topic here today. We’ll go in on peri-menopause. So peri-menopause is really interesting. This is the kind of the phenomenon where you’re in this transition time of going into full menopause or- typically peri-menopause is just starting to miss some periods, you’re maybe in your mid- ty- typically upper 40s. Usually menopause starts between 48 to 51 and it can take 10 years, meaning the symptoms that you deal with during menopause, that can take up to 10 years sometimes. The hot flashes, the mood issues, the depression, uh anxiety, uhm those type of sleep issues, scrappy skin, all those things can kind of con- you know, consolidate and happen over a long period of time. Typically, peri-menopause is that- one year. Once you get in the menopause- menopause typically is like, once you’re been no cycle for 12 months. So, peri-menopause is this in-between time  where skipping cycles, maybe you have a period every 4 months, or 6 months, or you’re kinda lost your cycle regularity, you know, fertility may not quite be there, you may not be ovulating as much- uhm- you start to see your cycles just getting more and more irregular, typically in you’d mid- typically upper 40s when that starts to happen.

Now, what do we do about that? So, first thing is, make sure you’re not getting exposed to toxic hormones in your foods or in the environment. That’s number 1. Uh, number 2, the biggest hijacker of your hormones is gonna be your stress hormones, A.K.A. cortisol and adrenaline. So it’s really important that you get your adrenals looked at if you’re worried about peri-menopause because, DHEA Sulfate, this is the major sex hormone precursor that’s made by your adrenal glands. This is actually coming from your adrenals and it’s a precursor to make more estriol in women. It can go more testosterone in men. But estriol is that predominant estrogen that you’re gonna have when you start becoming more menopausal. Typically when you’re cycling and fertile, it’s more estradiol, E-2, the “di” is kinda- right, 2. And then estriol, or the TRI, that prefix for 3. So you start to make more estriol, and that’s gonna be more anticancer. It’s gonna be- it’s have some really good anti-aging benefits. Estriol’s really important for hydration, that’s why low estriol- low estriol can- can create vaginal dryness. It’s also a really good anti-inflammatory, it really helps with brain inflammation. This is why a lot of mood issues and brain fog and cognitive issues start as you become more and more uhm- peri-menopausal into menopause.

So we have to look at the adrenal glands, that’s number 1. Because these adrenals make DHEA, also cortisol hijacks your hormones. Cortisol increases blood sugar, and also decreases protein synthesis, meaning, you have less protein going to build up your brain chemicals and build up your muscle tissue, and that protein is primarily running through gluconeogenesis where it’s shredding up that protein and making more glucose out of it. That’s what stressed us. People get more flabby, they get more cellulite because of cortisol. Breaks down connected tissue, and it breaks down amino acids. So, your- getting your adrenals looked at is really important.

Uh, number 2 is looking at your female hormones as many women as they go more into peri-menopause, they become more estrogen-dominant. And the reason why is, because we talked cortisol hijacking, your hormones- it does so, ’cause it pulls progesterone downstream to make your stress hormone. So this is important. The more stressed you get, the more you deplete progesterone, that puts you more into an estrogen-dominant state. Typically, we have more progesterone than estrogen. It’s about a 20 to 25 to 1 ratio progesterone to estrogen, and when you start going estrogen-dominant, people think, “Oh, that means estrogen goes higher”. No, it just means there’s ratio, it starts to drop. So you still may have more progesterone, there’s that ratio drops down a little bit, and you start to see estrogen creep up, but you may not see estrogen ever go above progesterone. Just keep that in the back of your mind. That’s gets commonly confused.

So we have the progesterone there. And typically, when cortisol’s prolonged, this also affects the HPA, H-P-A-T, H-P-A-T-G-G: hypothalamus, pituitary, thyroid, adrenal, gonadal, gut access. So it affects that feedback loop from the brain, and the hypothalamus and the pituitary ups- upstairs to that feedback loop of the glands secreting hormones downstairs. And this is important, so we start to see cortisol rhythm operations. The cortisol rhythm starts fluctuating. We start to see it in women with their cycle operations. A lot of times we just see a lot of PMS or the extreme PMS is PMDD, which is that week or so, before you actually menstruate or bleed. And then we also see a lot of- a lot of times, sometimes shorter cycles, going from 28 to 26 to 24 to 22. So we start to have a shorter luteal phase, just really important ’cause your luteal phase is that primary phase where you’re making more progesterone. So we do test while we actually look at progesterone every other day for a full cycle. And one of the things we’ll start to see is, your overall progesterone that you make throughout the whole month, typically should be above that 3000 marker so, it starts to drop. You start to see it drop. And that’s big, ’cause that’s kind of like looking at your overall progesterone sum, we start to see it drop, and a lot of times that can happen when you compress that luteal phase when you shorten it, ’cause you just have less days where you’re even making progesterone. Uhm, that’s a big one. So we start to see cycle aberrations there, we could see a shorter luteal phase, we could see a longer follicular phase, we may be out of sync, or we’re not ovulating at that right time and your ovulation could be totally off, or maybe you’re not even ovulating. ‘Cause, you know, to have that good ovulation to signal, we need a- [clears throat] a rise in estrogen followed by rise in progesterone and then estrogen kinda pitters out while progesterone stays high and drops. This is kind of our typical rhythm, and how women’s cycle work. So, just kinda first thing that happens, those gotta- kind of hormone physiology 101.

So, we start off by menstruating. That menstruation is typically signaled by a drop in progesterone and estrogen. First thing, progesterone and estrogen drop. That’s step 1. 2, menstruation happens after that, that’s the shedding of the uterine lining. We want brighter blood that’s more oxygenated, more fresh, for starting to see browner, thicker kind of clottier stuff, it just could be- uhm- the uterine lining from previous cycles that didn’t flush out. So, 1, drop in progesterone and estrogen, 2, menstruation, that’s gonna happen for a few days, anywhere between 3 to 7 days, okay? We don’t wanna go more than 3 to 4 tampons per day on average. For our average high, is if not we lose too much blood, we go hemorrhagic, we go anemic because of that. Step 2 is FSH starts to increase. FSH is our brain hormone, follicle stimulating hormone. That FSH start to make the follicle grow a little bit. That follicle starts to produce estrogen. Estrogen starts to rise, right? As estrogen starts to rise, that starts to signal luteinizing hormone, which is our other brain hormone that talks to our ovaries. And then progesterone starts to rise typically around day 12 to 13 after that. So here we are at day 12 or 13, estrogen’s kinda topped out, that signals LH, then we have progesterone going up like this. So progesterone’s going up, and then at some point, estrogen starts to fall again, progesterone stays up, and then around day 28, they crash together and that signals the whole entire step again.

So, drop in estrogen progesterone, signals bleeding, FSH, increases, FSH creates more estrogen, more estrogen creates more LH, more LH creates progesterone, estrogen starts to drop, progesterone stays high, estrogen and progesterone drop and then signal bleeding at the end. So that’s kind of a general uhm, cycle physiology 101, Most people are clueless about that. When I talk to a woman, I say, “Hey how long is your cycle?”, the biggest kind of common misconception, “Oh, it’s 3 days or it’s 7 days”, like no, not your menstruation, your full cycle. Your cycle is from day 1, first day of bleeding to next day 1, typically 28 days later. Uhm- most people get that confused your cycles, your full hormonal rhythm, day 1 to day 1, how much you menstruate is gonna be your- your bleeding, your period time so to speak. Hope that helps. That’s a common misconception.

Alright, so we talked about adrenals, we talked about our female hormone cycle, we talked about hormones in the environment toxins. These things are really important because they disrupt, they put more stress on our metabolism to be our- to be our detoxification system to be able to metabolize hormones. Gut functions’ so important because this is where we absorb a lot of the nutrients from our food to make our hormones, right? Hormones are made from good cholesterol, right, it goes cholesterol pregnant alone and then 27 different hormones that spit out on the stress side, on the mineralocorticoid side and on- then on the anabolic estrogen progesterone, testosterone side. So we- we need to be able to absorb these nutrients so we can make our hormones. We need to be able to absorb nutrients to help buffer the stress response. Magnesium, L-Theanine, GABA, they help us buffer that stress response so we could- think of it as like, imagine buying a car where you can only shift it from first gear to second to third or fourth, fourth to fifth. So, all you can do is bring that car up from low to high but you can’t downshift. And a lot of people are in this place where they cannot downshift their metabolic car, so they constantly feel stressed, they cannot ever bring it down from fifth gear back to first gear. And this is one of the biggest issue- biggest issues we see, and if we can’t absorb our good amino acids, and- and- and make our good inhibitory nerves, transmitters like GABA, through L-Theanine, through magnesium, through dopamine through serotonin, we’re gonna have problems. And typically, this starts to mess up sleep. Starts to mess up our melatonin cortisol rhythm which is the next step. And that’s gonna be basically- melatonin goes up at night, cortisol goes down at night. We have this inverse relationship – melatonin up, cortisol down, right? We get this big “X”. And when cortisol stays high at night time, it disrupts sleep, it prevents melatonin from coming up. Melatonin is a powerful antioxidant, it’s powerful anti-cancer, it’s very anabolic, it helps you heal, recover, turn-over your neurotransmitter successfully and heal your body, ’cause you really tap into ’em, make a lot of your growth hormone in that first half of the night, 10:00PM to 2:00AM. So we wanna be asleep so we can plug in and access that growth hormone.

Okay, so we got our rhythm, cortisol, adrenals, digestion, absorption, and then also, the amino acids that we absorb through our digestive system, also help run our detoxification system. So, we wanna stop the toxins on one side, not drink out of plastics, not consume pesticides, consume organic, right, get, you know, higher quality step-4, step-5, if we’re using the whole food, step-method works, more grass-fed, pasture-fed, organic, the whole nine yards that’s gonna help us make more of the nutrients, absorb more of the nutrients where we can actually detoxify as well.

And then we talked about those hormones helping with sleep, helping to buffer stress. Uh, very-very important components to female hormone health, as well as make hormone health. Uhm- males really get the sure end of the stick, because there’s a lot of estrogens in the environment, you don’t have a lot of synthetic androgens in the environment, so men really get clavier because when men get a whole bunch of estrogen exposure, it starts to inhibit LH. LH is that upstream hormone in the brain that talks to the gonads, right? With the uh- the cells lay dig in the testicles to make more estrogen… I’m sorry, to make more testosterone so that estrogen disrupts that signal. Now we don’t talk to our testicles to make more testosterones, it starts to inhibit that. And it’s a- it’s a really a vicious cycle. With women, they just become more estrogen dominant, which is a good, that starts to mug their cycle. With men, it starts to decrease testosterone. And you start to see things like gynecomastia – man boobs. Uhm, maybe guys even being overly emotional because they’re- it starts throwing off testosterone-estrogen balance as well. So that’s gonna affect their mood and- and focus on- on the male side as well. And of course for the woman, it- it causes same things, ’cause they can create more PMS which can create irritability, breast ___[13:48], back pain, moodiness, irritability, sleep issue, all those things that you know, women do not like. And men don’t like them either, of course. It’s a two-way cycle in that for sure.

So we think we hit all the major things. I’m gonna open it up to questions, primarily on the peri-menopause, female hormone side of the fence. And again, this is total live podcast here. Uhm- again, I just- I interject a lot of clinical information ’cause I work with patients in the trenches. So if you have any of these issues and you wanna dive in, click below to make sure you subscribe, hit the bell, and schedule a consult with me and my staff. Let’s see what kind of questions we have here off the bat. Try to keep it pertinent on the topic if you can.

Alright, let’s see here. Uh, “How bad- how can a bad gut affect hormone?”. So it’s going to affect the two-wa- oh, couple of ways. We absorb all of our nutrients to create our hormones to our gut. Number 2, we absorb the nutrients to our gut to help us detoxify – number 2. And then number 3, dysbiotic bacteria increases an enzyme called beta-glucuronidase. And beta-glucuronidase, uhm deconjugates estrogen. So we have an estrogen molecule right? It is floating in our bloodstream, we conjugate it, we bind it to a protein, to escort it out of the body. It’s kinda like, hey guys in the night club, whatever rock and rowdy, security guard comes up, like puts the guys hands behind his back and like escorts him, out of the club, right? That’s kind of, when you conjugate, think about as putting- err- handcuffs on that rowdy hormone. And de-conjugation is just someone coming around with a handcuff key, and uncuffing each person, right? Think- that’s what’s happening with dysbiotic bacteria… dysbiotic bacteria, bad bacterial overgrowth, increases beta-glucuronidase, then we have the- the handcuffs, are taken off the hormone, and they can be rowdy again. So those are the big 3 ways that can affect that.

Okay, excellent. Any other questions, feel free- uhm, feel free and chime in. I’m- I’m more than like- I’m more than willing to answer any more questions. Okay. I think we hit all the major things here. Try to think of anything else we can do. Pa-pa-pa-pa-pa, awesome… Tssssss… ‘Kay. “What’s a good mindset to have when you are feeling hard bowel, and of crohn’s flare up right now?” So, ob- obviously, gut issues can affect hormone health too, right? So question is, how did it happen? I want to feel like I’m in control of the vicious cycle. I wanna know what the heck happened. So, I wanna look back and at least gain control over how I gotten into this flare up. Maybe the first thing I wanna know. And the second thing is what actions are you gonna take to get out of that flare up? So, feel free and check video 2 to 3 weeks ago on how to, you know, reverse an autoimmune condition flare. Take a look at that video. I go over a lot of good steps that are needed to- to be addressed.

Uhm, “Is fatty liver curable? What supplements would you recommend to help?”. So, yeah, it is, I mean, it’s typically gonna be a combination of insulin resistance. And insulin resistance has a major effect on female hormones. How? Because high amounts of insulin, are going to up-regulate specific enzymes that can increase androgens in women. So that can really throw off androgens, and then of course high amounts of androgens can- can mess up proactive, and prolactin can screw up uhm, estrogen and progesterone, right? So, this is a really, you know, concerning thing. So, high fructose, corn syrup, insulin-resistance are gonna be the big things that are going to cause that.

Uhm, “Thoughts on IF in regaining cycles, avoiding IF until cycle returns”. So, uhm- typically, what I would recommend, is that you do not engage in any intermittent fasting until you get your hormones back and under control. Not eating food for a long periods of time can actually be a stressor on your hormones. ‘Cause we need nutrition to run our metabolic systems. But if you are more stressed, it- it may be too much stress on your body avoiding these foods, these nutrients. ‘Cause then, longer periods of time may cause your adrenals to make more cortisol, and adrenaline and gluconeogenesis to regulate your blood sugar. The more stressed you’re at, uhm- the more stressed you’re at, the better you’re going to absor- the more stressed you are, the more gluconeogenesis, the more you’re gonna rely in other hormones to pick up your blood sugar. If those hormonal systems are weaker, you’re essentially gonna need more of those other systems to pick it up. Now, by eating and stabilizing your blood sugar, that’s gonna take stress off those hormonal systems that are weaker, and give them the chance to get stronger. It’s kinda equivalent if you break your ankle. You walk around on crutches for a bit, the goal of walking around on crutches is going to be to take weight off your ankle so it can heal.

Alright, excellent. Very good. Uhm, “Can low progesterone in ladies cause low libido?” It definitely can. Low progesterone can definitely cause, uhm, low libido in ladies. Uh- lot of times it’s just the estrogen dominants that starts to pick up, that can be the big issue.

Uh, Samuel writes in “Hey doc, been drinking a little more alcohol recently due to football games and hunting season, seems to have messed up my circadian rhythm a bit. Uh- what would you recommend for a reset?”. Uhm, more than likely, I would just stop with the uhm- stop with the alcohol kind of down a bit. You could do more vitamin-C and more sulfur amino acids, uhm, to help your body heal.

Excellent. Uh, let’s see here. Any other questions? Barbara Scott writes in, “Could chronic muscle pain impart of the menopause phase of life?”. Well, yeah, I mean, it definitely could. I mean, it’s very possible that, uhm, your adrenals are weaker, and then that’s gonna help- that’s gonna impair your body’s ability to manage inflammation well. It’s very possible. Uh, a lot your hormones have really good anti-inflammatory fats-progesterone estrogen, it just depends on what the root cause is. Did it happen from food? Did it happen from… uhm- stress? Did it happen from poor sleep? So, I wanna get a- a window in what the heck is happening there as well.

Okay, excellent. Let me keep on rolling here. Uh, “Can a hair analysis tell you a lot of accurate info?” Uh, I think a hair analysis can potentially give you some good info, the problem is, it’s all downstream information because all those nutrients that get into your hair, the half that come in through the gut. So if you have impaired gut issues, that’s going to affect what’s in the hair. So if people are looking at the hair, they’re looking at all these different mineral ratios in the hair, but if we have a gut issue, I consider that to be a lot more upstream.

Uh, “What’s the best way to balance out estrogen and progesterone in ladies?”. So, off the bat, uhm- you gotta at what the underlying reason is. Is there toxicity issues, number 1? Is there uh, absorption issues in the gut, number 2? What’s your adrenal strength at, number 3? How is your hormonal rhythm, number 4? And then I also wanna look at just uhm, you know, exposure to conventional, uhm hormones in the food. Those are all gonna be big ones, they’re off the bat.

Ugh, let me just see if I can continue to do that. “Tom Brady’s a beast last night”, not in- actually, all I had during the game was one kombucha, during the game, I got some keto-cups which are like one gram of sugar, uh- coconut, like peanut butter cups but that uses coconut oil instead. And then I had a pizza which is a cauliflower crusted, and then I use the dial almond cheese. So that was the big one that I had there.

Uh, “What would you recommend to naturally treats- treat sinus-headaches brought on by cold?” So, if you go to my site, and look at recommended products, justinhealth.com/shop, and then you look at recommended products. I have a couple of links to amazon products that I like for that. I like either a combination of the nasaline or a sinus- just injector, and essentially uhm, the Xlear Sinus Rinse. I think that works really good. The NeilMeds, good but the Xlear has a lot of the xylitol in there, which is great at killing different kinds of bacteria and also flushing things out, and it’s really helpful with that post-nasal drip as well.

Uhm, I think we hit a lot of good things here. JACK ATTACK writes in, “How do you feel about citrus pectin?”. Well on the context of hormones and peri-menopause, it’s really good at binding up a lot of these metabolized hormones that may have a problem getting escorted out, and it kinda puts the handcuff back on these hormones to help it escort outside the- of the body. So I think it really helps with detoxification of hormones. Thanks Jack, appreciate it.

“I’m an active 30-year-old male on a paleo diet suffering from bloating, loose stools every morning, find myself wanting to eat more starchy vegetables for energy.” Yeah, so I mean, that’s kind of a broad statement, but in general, I would look at the gut and figure out what- uh, the next step is there because the gut needs to be addressed.

Okay, try to keep all questions related to the topic of peri-menopause. Uhm, that’d be super helpful for me so I know what’s going on. ‘Kay, very good… Anything else guys? What else is going on? “What cauliflower crust pizza did you do?”. It’s a local place by my house that- that does an organic cauliflower crusted pizza, I’m not sure the actual brand. Uhm, and I did the diet cheese. So it’s kinda  lower carb too which is nice, so, I don’t get all bunch of a carbs either, feel pretty good afterwards too which is nice.

Alright guys, hope everything’s going well. Make sure you guys subscribe over to my thyroid reset summit, thyroidresetsummit.com, we’re going live in a month. We got a whole bunch of free stuff I’m giving out as well. I’m giving out the first like, 25% of my thyroid book. So, really excited for that get out. Hopefully it’ll provide a lot of great information. Everything I try to put out there s- I wanted to be action-oriented, so you guys can use it to actually start getting better. I help more people through my content than I actually do in person. Obviously, you know, having a personal relation, if you can’t substitute that, but this is a great way to get good information out to people here. So, make sure you sign up.

“Best lab to discern HA versus early menopause?”. Uhm, can you define what HA is? Uhm, much or- I mean, it’s probably something very common. I just- give me what that meaning is there…

Uhm, “What’s the difference between ox bile and bile used by conventional docs…”, uh- I think you mean “urso… “, uh- I’m not sure how you pronounce that – ursodeoxycholic acid. So typically, a lot of bile- ox-bile’s typically used as a bile salt supplementation when they take it from oxes or- I think bovine sources it sounds like, and they’re using that supplement as wise. Now, my line and Liver Supreme, we will use bile salts, we will use beet roots, we will use… uhm- french tree, or ___[24:47], things that are really supportive for the liver, supportive for the gallbladder, thinning out the bile, and then we’ll also help provide uhm- extra bile as well because if we can’t break down our fats, typically we’re gonna have a hard time breaking down our cholesterol, right? And if we can’t break down our cholesterol, that’s gonna really hurt our hormones. This is a really important question ’cause if you’re dealing with peri-menopause, this may significantly affect your hormones not being able to break down good quality fats.

Uhm, so- “Hypoth- hypothalamic- hypothalamic amenorrhea versus early menopause?”. Okay, so amenorrhea. So amenorrhea is like you’re still in that cycling age, it’s premature, you’re not having your period, okay? I have a woman who is 40 years old, uhm, this last couple months, started to get her period back. I see that happen many times, she wants to have a second child. Her period’s back for the first time in two years. Why does that happen? It’s a combination of typically poor gut issues, you’re typically under- you’re getting underneath nutrition, and it can be a combination that you’re not eating enough, or you’re not breaking down and absorbing enough. And then of course, all of the hormonal stress that compound for math, ’cause of course that creates adrenal issues, and that creates female hormone issues, and that detoxification issues ’cause if you don’t absorb, then you can’t run- put the nutrients in and run detoxification systems as well. Uh, so best labs to discern that, I mean, you wanna run a high-quality month-long test, and then also want to run some blood work and also some uhm- some adrenal testing as well. So you’d wanna dig in, find a good functional medicine doc to get that set up for ‘ya.

Oh, great to hear Irma, glad you’re registered, awesome. Uh, another great question just came in here. Try to keep it to the female hormones today guys… Uhm, “If I see anything remotely sad or happy tears, is that an estrogen issue? Will that affect gut health?” So, it’s hard to say, is this a- a guy you asking this question or female? Uhm, but, yeah, definitely, hormonal imbalances can affect the emotions. And you know, it’s gonna be- you’re gonna be looking for that change in emotions, maybe more emotional’s typically what you’re gonna see, but yeah, that can definitely have major effects on your emotions as well.

Nora writes in. Hey Nora, “Got acne around my jaw since June 2018. Last consult you asked if I had started doing anything different around that time but I didn’t recall. Later I found I re-introduced some thyroid support for hypothyroidism around that time. Since tests show no more hypothyroidism now, is it okay to stop the ‘Thyro balance’?”. Uhm, so in general Nora, we’d wanna make sure that we’re testing your hormones on the thyroid side, and as you’re dropping that down, we’d wanna make sure that your hormo- your TSH stays within a good functional range, as well as your hormones stand a functional range. So, it’s not something you’d wanna just drop out by itself, you’d- you’d wanna test you, and make sure as we drop it out, there could be, you know, that you’re doing good there. And then regarding any jaw acne that happens, I mean, we’d want to make sure number 1, insulin is okay, right? Insulin’s good. Uhm, ’cause if you’re doing too much insulin that’s gonna drive more androgens and then that’s gonna activate the sebaceous glands to make more oil, and that can cause the acnes. So we wanna make sure insulin’s good, wanna make sure detoxification’s really good. So- and for me to add in more sulfur amino acids and detoxifying support to run those systems, that’s good. Number 3, potentially various fibers to help bind up some of these junks so it gets or- escorted out your gut better, and then I would say number 3, if we’re still having issues you may wanna add in some prostate glanding support like black currant seed oil, and email my office if we- if we-  I don’t have your protocol up in here in front of me yet, so when patients ask me about questions here, I- I may be having some incomplete info to go off of, so if we haven’t added any black currant seed oil, we may wanna do that to help with the prosta gland and then some help with the jaw issue. And the next thing will be to- to retest your hormones with the DUTCH test to look at also how you’re metabolizing your estrogens to make sure that’s getting better. But don’t adjust anything until we chat.

Yeah, vitex is gonna be a great hormone- a great herbal support, A.K.A chastry, that’s gonna be really good at helping progesterone balancing for sure, really good.

Uh, “After getting through menopause does one need to stay on additional hormone help continually through life?”. It really depends. So what I recommend is get all your hormones symptoms under controlled, number 1. Test your hormones, make sure your adrenals and your female hormones are relatively good, uhm, from lab-testing standpoint based on your age. And then I recommend gently tapering down your hormones and see how well you do. See if you can keep your symptoms, your menopausal, se- was under control, sleeping good, your mood’s good, vaginal dryness is okay, brain fog’s good, and if you can maintain that benefit while dropping that bioidentical hormone support, that may be an option but Barbara, you’d have to deal with that at a consult, and continue to monitor that and keep that dial on going, but that’s a great question.

Okay, great. Uhm… just kinda kind of- come in here guys if I skip your question, don’t take it personal, tryna go to the questions that are most pertinent to this conversation. Zoe-Holistic writes in, “Would you be worried about a 54-year-old woman, still cycling and ovulating? Would you recommend supplementation as a- oestrogen is very high”. It just depends if you’re 54 and you’re still cycling and- and- the cy- cycle’s relatively stable and lengthen, PMS-wise, I wouldn’t too wor- I wouldn’t be too worried, I wanna know more about your parents and this is something that your sisters or- aunts- aunts, and/or mom or, you know, mom went through as well, our grandparents went through? I wanna know a little more about the history. And doing some testing, right- I think would also be good just to see where your levels are at, I think that’s a really good thing. I’ve- I typically more concerned Zoe with people, uhm, prematurely going into menopause, that’s my bigger concern, that’s the thing I’m seeing these days. But I think it’s always good to get tested.

“Is there a connection between hypoglycemia and adrenal fatigue?”, yes! Great- great question Olga. I see a lot of low-blood sugar symptoms’ really being a big stressor on the adrenals, and then that can create a lot of lower progesterone issues, creates a lot of stress. I definitely see that being a concern.

“What is the average acceptable age for menopause?”, typically 48 to 51-ish.

Ik O, “Best test for progesterone levels?”. I mean, you can run a typical progesterone blood test, you know, we like to be at least 10 to 15 on that, around day 20 of your cycle, right? Considering your cycle being like 26 to 30 days, and/or like a- a good high-quality DUTCH complete panel that we’ll run around day 19 to 22.

Nora, you’re totally welcome. So, email my office if you need that black currant seed oil, I’ll put you on 2 capsules of that twice a day if your skin is still having some issues. Two caps, twice a day and I have a couple recommended brands.

Jessica Lynn writes in, “Does liquid vitamin-C raise estrogen? I read studies say that there’s a connection”. I’m not sure that it would raise it. I will typically give vitamin-C in fiber to actually help with estrogen detoxification, so I don’t think it would raise it, maybe there’s some modulate- maybe there’s some modulation effects, or may help modulate it but I couldn’t imagine it actually raising it, like taking maybe uh, hormone would.

“My kidney pain by eating a honey, age 27, serious problem?”. Uhm, yeah that’s a good question, kinda little off-topic, but in general, I would be careful with the too much fructose.

“Will chaste tree help with progesterone?”. It will, it’s gonna help with LH, luteinizing hormone which is gonna help talk to your- your ovaries, and that kind of female hormone area to make more progesterone?

DesignLover writes in, “Took birth control pills for 1 year for adult acne, it worked. Now I’m 37 and it’s creeping back around the jaw line. Connection to sugar or more estrogen related? Or more cortisol? Also, hard time sleeping.” Now again, like birth control pills can help, even though you’re actually giving more estrogen with the birth control pill, it does kinda level out your hormones, so you’re not getting swings. So, I think a lot of the hormone swings can really be a big effect there so we can kind of level stuff off. But I also see, you know, birth control pills cause more issues. You can see melasma as well, which is the estrogen, kind of stimulates the melanocytes and more pigmentation, you can kind of get that pregnancy mask, while on the birth control pill, and someone that can actually make their acne worse. I’ve seen it on both sides. Is there connection to sugar and more estrogen-related, yeah, there’s definitely a big connection with sugar because sugar will actually increase more insulin. And insulin will create more ___[33:23], which will cause the bacteria to feed off of your skin and create more acne.

“My natural doctor put me on liquid vitamin-C and I’m having short cycle, 26-27 days with very light bleeding and prolonged bleeding”. Yeah, I would need more info, I’d wanna test your hormones, see where you’re at. A lot of my younger female patients will use herbs to help the signaling upstream from the brain to your ovaries and then we’ll also- a lot of times give a little bit of bio-organical progesterone, but we’ll give it in a specific cyclical augmentation fashion while we’ll taper it up and down. But we really wanna be specific in how we do that.

Amelia V writes in, ” If taking T3 you mentioned in past, needing it uh- multi-x-day due to half life. Why am I only- why am I only RX dosage for the AM?” Uhm, so, yeah, if you’re just taking T3, I don’t recommend only taking it in the AM, and like if you’re doing a Cytomel or liothyronine, you’re gonna be dropping off on your- uhm- on your T3 within 4 to 5 hours, so you definitely want to uh, not do it that way. In the thyroid re- reset summit, we had ___[34:26] on the uhm- summit talking about these exact things. So make sure you subscribe thyroidresetsummit.com, make sure you subscribe.

Olga writes in, “Can longtime use of Mirena iud cause energy problems?”. Yeah, Mirena can cause a lot of side effects. Merina is a synthetic progesterone, and there’s an iud to secretes that. So, yeah, it can definitely- I mean, my biggest issue with that is it just kind of seeps in your bloodstream throughout the whole month at least with like, birth control pills, you kinda take a reminder session, you know a 6 to 7 day reminder where you kinda- drop out your hormones and then- and then that can cause bleeding where you kinda have this steady state of hormones with the Merina, which I think’s a little bit unnatural because you don’t have any drop at all. That’s concerning, so- I always recommend my female patients if they want- uhm- an iud to try the ParaGard which is a copper-iud that’s non-hormonal.

Uhm, “‘Can’t miss’ interview from the thyroid summit? What was your favorite interview?”. It’s a great one, I’d had a lot of a really good interview. It’s hard to say which one was the best. It really depends on the topic. ‘Cause we’re really connected the thyroid to the gut, thyroid to the emotions, thyroid to the adrenals, thyroid to fertility, thyroid to female hormones, thyroid to- even male hormones or gut inflammation, or gluten, or autoimmunidase. So those, you know, it- it was so many different areas, it’s really hard to say.

Paul writes in, “In menopause, how to stop hot flashes?”. Well, a lot of times, the hot flashes can be from a lot of these upstream hormones in the brain like FSH going really high. ‘Cause think of the ovaries, right? Your brain makes hormones that talks to the ovaries to make more hormone, more female hormone. So, as the brain- as the ovaries aren’t, you know, don’t have the follicles coming in, and we’re not making as much hormone, the brain is trying to rev up the volume that talk to the uhm, downstream glands. And that FSH as it goes higher can really increase vasodilation so, giving certain herbs can really help with the signaling and help kind of decrease the volume a little bit, modulate the volume, and then giving some bioidentical hormones can also help modulate the volume as well. ‘Cause the brain says, “Hey, I’m getting a little bit more hormone in there naturally, we can lower the volume as well”, and then we deal with the herbs to help with the receptor sites too. So there’s a couple different ways that we can do it. But that’s kinda one of the major philosophies regarding FSH, and regarding a lot of the hot flashes.

Uhm, ” Is Chaste Tree something you can take to see how you feel…?”, I mean, you really want to be working with the functional med doc on this. A lot of variables when it comes to that.

DesignLover , “Is there a connection to an imbalance of hormones in women who haven’t bore any children?”. Potentially, I mean, women that haven’t born- birthed children, they don’t have that progesterone increase that happens, uhm- throughout pregnancy, so that- you that- 8 or 9 months where progesterone goes up because of HCG, that goes up significantly higher. So that may- let’s just say, you have a greater chance just kind of being more an estrogen dominance, over your- your cycling fertility time-frame so to speak, where hormone, who is uhm- pregnant one, they’re not gonna be using up the follicles as much ’cause you’re not cycling when you’re pregnant and a lot of time during the breastfeeding process. So, you’re not going to cycle through your eggs as fast. And then number 2, you’re more overall an average having a higher input of progesterone, so that has some effects as well.

Uhm, Zoe writes in, “Do you find the people with more severe menopause symptoms always have more adrenal issues when testing, is that your finding?”. I wouldn’t say always but I- ’cause it’s- it’s-  I don’t- I’m not a big fan of absolutes but I would say yes. I would say on average, that is a significant correlation, more menopausal issues have more adrenal issues. And also, peri-menopausal issues, more adrenal issues, and I’ll even go one step further, cycling female issues, right? Definitely adrenal issues.

Uh, Amelia writes in, ” I’ve heard it takes one month to re-balance cycle for every year you haven’t had one?”. Yeah, that pro- that makes sense, I definitely agree with that, I mean, I typically see a major rebalancing in a- in a woman’s cycle within 6 to 12 months. And a major rebalancing is- I thi- I would s- call that, is about a 50% improvement. Alright, and then from there, we continue to compound that improvement month after month.

“Can someone with copper toxicity use a copper iud?”. Yeah, I mean, you can just make sure you’re doing extra zinc, put some extra zinc in your supplementation regime to help balance out the copper toxicity. That would be a good helpful approach ’cause you have the paragard or- is a copper iud and of course that can increase your copper levels. So you gotta be careful with that. You gotta weigh that out with your doc and see if you are really are copper sensitive. I have some patients that cannot do a paragard copper iud, they just can’t do it. Uhm, some can do it great and they have no problems. So you really gotta weigh those options out.

Uhm, “Can peri-menopause cause weight gain in the stomach? I’m 49 years old, no period for 7 months, gained 20 lbs. in the stomach in the last year and I can’t seem to lose it, is it just from unbalanced hormones?” So, remember, a lot of uhm, adrenal issues connect to peri-meno- menopausal issues. And a lot of adrenal issues are coming from cortisol imbalances. And cortisol has a direct effect on your tummy through just cortisol itself, the stress hormones can aff- affect the gut, and also through more sugar being released which can have an effect in insulin which can also affect your tummy. So, adrenal issues, have a major effect with cortisol, and also plug in and connect to insulin as well. So, great questions there.

“Do you think women with polymorphisms in COMT and MTHFR should not take the contraceptive pill? Controversial topic”, I know. Well, I know, in general like COMT like uh- catechol-O-methyltransferase. So when you see, uhm these types of issues, you may have issues with various adrenaline and just being able to deal with stress because these catecholamines are- like, you know, basically your stress hormones, your stress neurotransmitters. And MTHFR typically is gonna have a major effect on folate and then also affect B-12 and can affect methylations. So, uh- birth control pills deplete a lot of those nutrients. So yeah, I think what you’re saying is a very valid topic ’cause those issues can really have an effect on those nutrients. So if you are taking the pill, uhm- you really wanna make sure you’re supplementing with extra methylating nutrients, magnesium. In my line we’d recommend like B-vitamins synergy which has like the extra-activated folate, activated B-12, activated B-vitamins, and also a good multi on top of that, with magnesium and calcium, other important minerals that tend to get depleted.

Uh, “What would cause early spotting and irregular monthly cycle?”. That’s gonna because by typically lower progesterone or progesterone dropping out too soon in your cycle.

“Are there other conditions that cause hot flashes after menopause?”. Uhm, hard to say. I mean, you could- you may notice issues with blood sugar. Blood sugar ___[41:27] may get problem. A low thyroid, you may see some issues with that like if you have autoimmune flares on the hashimoto’s side. So yeah, there’s some potential connections there.

“Thoughts on carb cycling/keto for women with hormone imbalances? Ideal balancing diet?”. So, a lot of women do go with keto initially because they have insulin-resistance, and keto is very helpful with insulin resistance. But if you’re insulin-resistance is dialed in and you’re doing good with your blood sugar, some women starts to do better as they add in a little bit of safer carbohydrates, starches, squash, sweet potatoes, and they may even be better doing it cyclically. What does that mean? You’re kind of lower-carb keto for 2 or 3 days and maybe you have a sweet potato for dinner with your veggies and your meat. So, that I think is- is a very valid point, and I see that clinically.

Uhm, let me see here. Any other questions on hormones? I think we hit everything guys. Give me a thumbs up, give me a share, I appreciate it, make sure you hit that bell. People magically just go off my subscribe list if the bell is not hit. So make sure that bell’s hit, so you get all my notifications. Appreciate, uh today’s chat. Hopefully en- you enjoyed it, if you enjoyed it, give me a comment below. Let me know what you think. Any questions related to the topic, I’ll be back in and address them in future podcast or- we’ll respond here and I’ll look forward to connecting with you guys tomorrow, for a live Q&A.

You guys have an awesome day, and uh, go Patriots! Take care. Bye.


References:

https://thyroidresetsummit.com/

https://justinhealth.com/

Xlear Sinus Rinse Kit

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.

Stay tuned for more and don’t forget to share. Sharing is caring!

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?

Youtube-icon

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 formuformula 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 mirifmirifica, 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/

Natural menopause solutions – Podcast #123

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

 

itune

 

 

youtuve

 

 

 

 

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.


Reference:

notjustpaleo.com


The entire contents of this website are based upon the opinions of Dr. Justin Marchegiani unless otherwise noted. Individual articles are based upon the opinions of the respective author, who retains copyright as marked. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Justin and his community. Dr. Justin encourages you to make your own health care decisions based upon your research and in partnership with a qualified healthcare professional. These statements have not been evaluated by the Food and Drug Administration. Dr. Marchegiani’s products are not intended to diagnose, treat, cure or prevent any disease. If you are pregnant, nursing, taking medication, or have a medical condition, consult your physician before using any products.