October 8, 2025 • 41 mins
Do you know... hormones are essential chemical messengers that regulate various functions and processes in the human body? They influence everything from metabolism and menopause, to reproduction, mood, and weight. An endocrinologist is a doctor who focuses on hormones and the glands that produce them. Martha's guest in this podcast is Dr. Rekha Kumar - a board-certified endocrinologist who practices at the prominent Weill Cornell Medical Center in New York City. She's a leading voice in the field of obesity medicine and has brought her expertise into telehealth as a chief medical officer of Found, a resource for weight management. Martha and Dr. Kumar talk about the importance of hormonal balance and wellness, some of the most common hormone-related problems and conditions, and ways to restore hormonal stability within the body's systems. Take a listen.
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Episode Transcript
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Speaker 1 (00:03):
Doctor Rika Kumar is a board certified androcronologist who practices
at YL Cornell in New York City. She has a
leading voice in the field of obesity medicine. She has
brought her expertise into telehealth as the chief medical officer
of found a Resource for Weight Management. I know doctor
(00:24):
Kumar from our Plates studio. We regularly take classes together,
so I've seen firsthand her personal commitment to fitness and health.
Welcome to my podcast, doctor Kumar.
Speaker 2 (00:36):
Thank you so much.
Speaker 1 (00:37):
How are you Reka? Absolutely? I always call her Reka
and uh Reka is a beautiful young How old are you.
Speaker 2 (00:47):
I'm going to be forty five next week.
Speaker 1 (00:49):
Oh I thought you were like thirty five. You make
like thirty five.
Speaker 2 (00:52):
I thought you were twenty five.
Speaker 1 (00:54):
What is an endrocrinologist? Everybody wants to know exactly what
is it.
Speaker 3 (01:00):
An endocrinologist is a doctor that studies and treats diseases
of hormones, and not everyone knows what a hormone is.
A hormone is a chemical messenger in your body that's
released by something called a gland that and the hormone
travels through your bloodstream and does its job somewhere else,
(01:22):
and that job could be related to metabolism, fertility growth,
appetite regulation, body temperature regulation. So hormone health is very
complex because it doesn't involve one organ, but rather how
all of the organs communicate with each other through these
messengers called hormones.
Speaker 1 (01:43):
And how do you know if your hormones are in
order that? Because that seems to be a very big
subject matter right now, and you're right in the middle
of the entire controversy or I guess discussion we should
call it.
Speaker 3 (01:56):
Yeah, I agree with you, though it has become a
controversy because people are interested in their hormone health and
people don't feel like they are getting the answers from
their doctors.
Speaker 1 (02:07):
Which and what kind of doctors would be giving you
answers to hormone health, So there's a range.
Speaker 3 (02:14):
The most specific doctor would be an endochronologist, but there's
not enough endocrinologists in the country or the world to
see every patient that has a question about their hormones.
So a regular primary care doctor, which I'm a primary
care doctor as well, should be able to answer the
(02:35):
basic questions about hormones. All doctors pediatrics and adult medicine
are trained in basic hormone health, meaning basic reproductive health,
thyroid health, being able to manage straightforward diabetes when things
get complicated.
Speaker 1 (02:52):
Some diabetes related to your hormones.
Speaker 2 (02:54):
Yes, and I forgot that that's not obvious. So I'll explain.
Speaker 3 (02:58):
Diabetes is related to blood sugar regulation, which is done
by a hormone called insulin.
Speaker 1 (03:05):
Which hormone. There, I didn't know that. I didn't think
about it. Actually, I just didn't think about it. So
the insulin is a hormone.
Speaker 3 (03:13):
Yeah, And actually I would say most people don't know
that insulin is a hormone that is made by the
pancreas in response to blood sugar. Insulin leaves the pancreas
and goes and does its action on fat cells, muscle cells,
the heart, the liver, and the job of insulin is
(03:35):
to put blood sugar into cells to create energy. And
when this is disregulated, people get diabetes.
Speaker 1 (03:42):
So is it the pancreas that's creating the hormones for us?
Speaker 3 (03:46):
Or pancreas is creating the hormones that regulate blood sugar?
Speaker 1 (03:51):
Okay? And where does testosterone originate?
Speaker 3 (03:55):
So, in men, testosterone primarily from the testicle. In women,
testosterone is made in the adrenal glands, which are glands
that sit on top of the kidneys. Postmenopause, women's ovaries
may make more testosterone than they had previously.
Speaker 1 (04:15):
We need a chart and we need to understand more
about this because this is a very The human body
is the most complex organism, right, one of the most
complex organisms.
Speaker 2 (04:25):
Not only is it complex, but it is very smart.
Speaker 3 (04:28):
So when we try to manipulate it, or when our
modern environment, such as our modern food environment, impacts our body,
our hormones do all sorts of different things to try
to adapt to what we've given it.
Speaker 1 (04:43):
I see, So when does a patient need to see
an undracrinologist?
Speaker 3 (04:47):
So there are probably two scenarios. The most obvious reason
to see an endochronologist is if a primary care doctor
actually makes a diagnosis of an abnormal hormone life level
or symptom. So a primary care doctor at your annual
physical may screen for thyroid disease every year. That's pretty normal,
(05:08):
a basic screening test. If that's abnormal, some primary care
doctors may feel comfortable treating the thyroid disease, but if
they feel that it is too complex, they will refer
to an endochronologist. So the first reason would be referral
for a disorder based on the primary care doctors of.
Speaker 1 (05:26):
Valuable What is the what is the hormone that the
thyroid creates.
Speaker 3 (05:29):
It's called thyroxin or thyroid hormone.
Speaker 1 (05:32):
Okay, and that does what's your body? What is a
what is a too low a level of thyroxinde to
your body?
Speaker 3 (05:41):
So your thyroid gland to begin with as a butterfly
shaped gland that sits just below your voice box or
your atom's apple, and it makes thyroxin or thyroid hormone,
which regulates body temperature, heart rate, metabolism, or how quickly
or slowly you burn calorie body temperature. If I didn't
(06:01):
say that. So that's the job of thyroid hormone. If
the level is too low, if your thyroid gland is
not making enough, you feel sluggish, you may gain weight,
retain water, feel cold. If you make too much thyroid
hormone or hyperthyroidism, it's like the thermostat is revd up.
(06:22):
You feel hot, your heart is racing, you may have insomnia,
unintentional weight loss. That is more rare. An overactive thyroid.
An underactive thyroid is actually pretty prevalent. Potentially six to
eight percent of the population has an underactive thyroid. The
reason it's tricky to diagnose is that the symptoms look
(06:44):
like a lot of other things, fatigue, weight gain, those
are a lot of people have those complaints but don't.
Speaker 1 (06:50):
Have a loss hair loss. I have a dog who
has a low thyroid and she's lost a lot of
her hair.
Speaker 2 (06:58):
Oh my gosh, I know her.
Speaker 1 (06:59):
He is poor little and for his chin, and we've
regulated it. There is a medicine that you can take
for that, but her hair's not coming back. So it's
very serious to get imbalance in your hormones, isn't it.
Speaker 3 (07:13):
It is serious, And in some ways I feel like
the field of endochronology is so beautiful because you can
replace the hormone and regulate the disease. But there are
scenarios where the synthetic hormone or the medicine that's given
may not be exactly the same as what we would
have made in our body, and so people may still
have some symptoms. Or your dog, like the hair symptom,
(07:36):
like she's treated, but she still hasn't grown back her
hair right.
Speaker 1 (07:41):
Well. It's one of the more complex medicines that you're
involved in. Very complex and very interesting, by the way,
and everybody's now worried about weight and concerned about weight
and interests it in all the new weight loss drugs.
How does weight change specifically in women as they age?
That's a hormone.
Speaker 3 (07:59):
Yeah, So weight is complex because there's many hormones involved
in body weight regulation. And even more complex than the hormones,
there's two hundred to five hundred genes implicated in the
ability to gain excess weight. So unlike cancer or certain
other diseases, where you can point to one gene and
(08:22):
create a therapy that targets that one gene and treats
a person, we're not there yet.
Speaker 2 (08:28):
In obesity.
Speaker 3 (08:30):
There's so many genes that are implicated, and in order
to help people control their weight, for some people, not everybody,
they may need medicines that target hormones that are involved
in body weight.
Speaker 1 (08:45):
So are the ozempics treating hormones.
Speaker 2 (08:48):
Believe it or not, Ozembic is a hormone?
Speaker 1 (08:50):
Oh okay, I didn't know that.
Speaker 3 (08:53):
Most people don't, and I actually don't even think anyone
has really asked me that question before. Ozembic is a hormone.
Speaker 1 (09:00):
Wow, is it in your body normally?
Speaker 2 (09:02):
Yes?
Speaker 1 (09:02):
Oh, okay.
Speaker 3 (09:04):
It is a hormone called GLP one glucagon like peptide one.
We make this hormone when we eat a meal. We
release this hormone naturally in our intestines. It signals fullness
to the brain and lowers blood sugar. So ozembic is
what we call a GLP one analogue. It's a longer
(09:26):
acting version of our own GLP one.
Speaker 1 (09:28):
Okay, So the doctors who started to popularize ozembic knew
all this.
Speaker 3 (09:33):
Not necessarily, I will first, I would say that Kim
Kardashian popularized ozemviic, or pop culture popularized it in terms
of the doctors that were prescribing. So there were some
people like myself that studied the drugs and clinical trials
early on, and we realized its therapeutic potential in diabetes
(09:55):
and weight control. But in terms of the degree of
popularity for you know, just losing a few pounds or
fitting into a dress, or these more cosmetic like cultural
desire to be fitting, the issues are that I don't
think any doctor anticipated this.
Speaker 1 (10:15):
But it's become the rage.
Speaker 3 (10:16):
It has become the rage, and it is so interesting
because when I went into this field fifteen years ago,
if anyone was taking these meds or we prescribed them,
they were hiding it from the entire world. It was
this secret that people would have, even from like their
own families. They didn't want anyone to know they were
(10:37):
on a medicine to help control their weight. But today
everyone's talking about it always.
Speaker 1 (10:42):
I mean, I don't think I need a weightless drug.
Speaker 2 (10:46):
You one hundred percent do not. In my medical.
Speaker 1 (10:50):
Sometimes I think, oh God, if I have my stomach
feels fat or looks fat, I think maybe I should
go on ozevik.
Speaker 2 (10:57):
I mean, I think a lot.
Speaker 3 (10:57):
Of people are having these thoughts now, and that's that
is not healthy for us.
Speaker 2 (11:02):
Right.
Speaker 1 (11:02):
If I can't sip up my gene, I think, oh gosh,
do I need ozempic. I don't want to do that.
I think maybe another day of pilates might help. But
is that true?
Speaker 3 (11:11):
I mean, this is the thing that's not ever what
these meds were for. And I think we're all having
these thoughts now because we not just for looks.
Speaker 1 (11:19):
It shouldn't be for looks at all at all. It
should be for general health.
Speaker 3 (11:22):
Right, Yes, yes, and it really should be for what
we call metabolic health. Like the endgame of this is
how do we not die of a heart attack or
stroke prematurely? Yes, and that is why we care about weight.
That's why we care about blood sugar. That's why ozembic exists.
But it's become this tool for people to you know,
(11:45):
lose five pads when they feel bloated.
Speaker 1 (11:48):
But these drokes were originally developed for diabetes. Yeah, it
helped tremendously, haven't they.
Speaker 2 (11:54):
Yeah, we prescribed them twenty years ago for diabetes.
Speaker 1 (11:57):
And then who's whose bright idea was it for just
weight loss?
Speaker 3 (12:00):
So it was pretty clear from the early days that
not only did these medicines lower blood sugar, but they
controlled appetite and reduced body weight.
Speaker 1 (12:09):
That's how it works, by controlling your appetite, making you
not want to eat.
Speaker 3 (12:13):
So it's one of the ways it works is that
it goes through what we call the blood brain barrier,
so it has the ability to travel to the brain
and target the weight regulating center. So we have an
endocrine gland in our brain called the hypothalamus. In endochronology,
we call it the master gland. It is literally the
(12:36):
body it sits kind of if you had to go
directly up into your nose to the base of your
brain and then straight up. Oh, it's kind of a complicated.
We can maybe show a diagram one day. The hypothalamus
has a center in it that's literally the appetite and
weight regulating center that is in communication with the rest
(12:58):
of the body. It's post to sense fulness when somebody
is in the fed state. What GLP one or ozempic
does is that it goes to that area of the
brain even when the person isn't truly fed, and tells
the brain that it's full.
Speaker 1 (13:17):
Well, how complicated, but how interesting. So diabetes can now
be very well controlled. And is it all over the world.
I mean, is India still a nation of diabetics because
it was so dangerously high in diabetes. Yeah.
Speaker 3 (13:34):
There's a word called globesity or global obesity, and you
see it in these developing countries where you have malnutrition
and obesity coexisting.
Speaker 2 (13:46):
And because of the food they eat. Because of the
food they eat.
Speaker 3 (13:49):
But it's the rapid change from farming communities to urbanized communities,
and so you go from literally within one generations working
doing manual labor farming to moving to urbanization, moving into
a city and eating KFC. So the places you might
(14:10):
see this are parts of India, certain African countries, parts
of China where within one generation you could go from
malnutrition to obesity.
Speaker 1 (14:20):
I see, are the drugs being really widely used now?
Speaker 3 (14:24):
Yeah, the latest statistic we have is that twelve percent
of the US population has taken one of these drugs.
Speaker 1 (14:31):
That's huge And those are just the ones that are
there any other drugs like that other than thailand oil
or espirin.
Speaker 3 (14:37):
Probably statins like lipatour which many people would say these
are the biggest breakthrough in cardiovascular health since cholesterol lowering meds.
Speaker 1 (14:55):
So once you go on a GOLP dash one is
that a use one?
Speaker 3 (15:00):
Yep?
Speaker 1 (15:01):
Can you go often without regaining your weight?
Speaker 3 (15:04):
So the traditional thinking if it was prescribed to who
it's indicated for, meaning somebody with obesity or type two diabetes,
those people will typically regain two thirds of the weight
within a year if the medicine has stopped. What is
different today versus what was studied is there's a lot
of off label use, meaning people using it to lose
(15:28):
less amounts of weight that don't actually have a metabolic problem.
So say, I used it to lose two pounds. Could
I stop it and keep the two pounds off? Probably
with some work, Yeah, but some self restraint correct. Okay,
But once somebody is so disregulated in the state of
type two diabetes or severe obesity, restraint doesn't work anymore
(15:49):
because the signals aren't working anymore. That fullness center I
mentioned in the brain is not sensitis drug to me exactly.
Speaker 1 (15:57):
I see, Wow, gets very complicated. Yes, And so how
long can you take safely take like an ozembic drug, So.
Speaker 3 (16:06):
If you're supposed to be on it, you can technically
safely take it for your lifetime.
Speaker 2 (16:12):
And there's a key reason.
Speaker 3 (16:14):
About two and a half years ago, we learned that
people that took the class of medicines that's ozembic or
we go V, which is FDA approved for weight loss,
had a twenty percent reduction in heart attack, stroke, and
cardiovascular death.
Speaker 1 (16:29):
That's good.
Speaker 2 (16:30):
So if you want that benefit and.
Speaker 3 (16:32):
You are high risk of cardiovascular disease, you want to
stay on it. But that's not like the average person
you and I are meeting these days, that's taking it.
Speaker 1 (16:41):
True, And can they become a crutch?
Speaker 2 (16:43):
I think they can become a crutch.
Speaker 3 (16:44):
I really emphasize lifestyle intervention and adherence on and off
these drugs, but there's certainly people using these medicines that
are not changing their lifestyle, and my concern for them
is muscle loss.
Speaker 1 (16:59):
Is how absolutely so the gym is an absolutely essential
part of your life once you start taking these I.
Speaker 3 (17:07):
Would say it's more essential. Protein consumption and strength training
when you're on these medicines is essential to prevent bone
and muscle loss.
Speaker 1 (17:20):
I mean, so many of my friends are obviously on it.
Many of my men friends have just you know, changed
their looks entirely and for the better. You know, they
just look so much better.
Speaker 2 (17:31):
And they feel better and they're confidence.
Speaker 1 (17:33):
Yes, more confidence has appeared, and I think it's nice.
And the women I take it look so good and
so that's an encouragement. And the results elsewhere, I mean,
I've read some crazy statistics, and tell me if they're true.
Like the reason that airfares have started to come down
is because fewer people, fewer overweight people are using air travel,
(17:55):
so they don't use as much fuel consumption on the airplanes.
Is that true?
Speaker 2 (17:59):
I heard that statistic too, And then.
Speaker 1 (18:03):
The clothing industry too, is using less fabric in their
in their designs because they don't need to make them
so big. Yeah.
Speaker 2 (18:11):
I mean the people hardest hit are the junk food makers.
Speaker 1 (18:14):
And rightly so. Yeah. I wish, I wish, But I.
Speaker 3 (18:17):
Have heard and you may have seen this that the
junk food industry is trying to find ways to manipulate
their ingredients to work around these drugs.
Speaker 1 (18:27):
Wow. I did not see that. That is horrible. It's horrible, horrible.
Oh my gosh, how's silly. How's silly too?
Speaker 2 (18:35):
It's evil? Yeah, it is evil.
Speaker 1 (18:37):
Geez. I have not heard that, and so listen up,
audience please. That is not a good thing.
Speaker 3 (18:44):
Yeah, And it really goes back to this topic of
these meds aren't going to cure anything if we can't
change food policy, if we're actually letting the food industry
manipulate our hormone health like that, Wow, We're gonna have
to keep making better drugs.
Speaker 1 (19:02):
Right. I'll keep working in your job, Raco, because it's
very important obviously. The other night, just you know how
algorithms are working on social media these days, appears an
ad with Oprah Winfrey and a few other famous movie
stars talking about Japanese ozempic. What is Japanese ozempic. I
(19:25):
watched this. It went on for like an hour and
twenty minutes, this infomercial. Have you seen it?
Speaker 3 (19:31):
No?
Speaker 1 (19:32):
Oh, I think it's entirely fake. And it ends up
with a ozembic like drug being sold as capsules in
a bottle.
Speaker 2 (19:41):
Wow.
Speaker 1 (19:42):
But I don't believe that Oprah Winfrey is really representing
this company because she's talking about a natural supplement that
you can create out of certain nerves and things that's
known as Japanese ozempic. I mean, this.
Speaker 3 (19:55):
Whole fig actually sounds like a deep situation.
Speaker 1 (20:01):
I think it is. Yeah, and yet nobody has talked
about I haven't seen any news. I've seen it more
than once. I think it's on I've seen it about
three or four times on law.
Speaker 3 (20:10):
Yeah, it's particularly concerning because I think people could be misled,
being that Oprah has been generally outspoken.
Speaker 2 (20:18):
About ozemba, about ozemba.
Speaker 1 (20:19):
Yes, but Japanese ozempic is not ozempic, absolutely not.
Speaker 3 (20:23):
And the fact that people could like fall for that
an ozempic and a capsule and the whole thing.
Speaker 1 (20:30):
It's all very very weird, So beware and really work
with a reliable androcrinologist. If you are contemplating taking any
of these weight loss drugs or on weight loss drugs,
make sure your doctor is well aware of what you're doing.
I think this is so important to listen to your doctor.
Speaker 3 (20:48):
Yeah, then that is a key here is that if
you're going to be on this medicine, even if you
happen to get this medicine from some place that you're
embarrassed to say, I've heard of hair salons and things
like that, having somebody sitting there prescribing these even if
you are embarrassed to say where you got this medicine,
Please see a good doctor that can help you manage
(21:11):
it going forward.
Speaker 1 (21:12):
Are there a fake GLP?
Speaker 3 (21:14):
There are counterfeit There are black markets. There are there are,
but that's also become a gray area because there's also
compounded GLP ones which have a huge market, and they're
not necessarily all black market or counterfeit. They're from compounding
pharmacies that make hormones like it, so they are efficacious,
(21:35):
they are, but they are not FDA approved, so why
would you get it there? There are shortages of the
brand name versions. The shortages are over now, but for
years they were in shortage, so this market grew rapidly
of compounding pharmacies making.
Speaker 1 (21:52):
That's a whole other subject that I'm very interested in
because I was recently diagnosed as being a little low
in testosterol even though I take primarine tslosterone, and then
they sent me a compounded teslosterone. Is that good or
not good?
Speaker 3 (22:09):
So I would say it depends on where it's from
and what your symptoms were. I wouldn't say that it's
necessarily good or bad. But one of the reasons to
use compounded testosterone for a woman is right now, any
prescription testosterone that's commercially available is only formulated for a man.
(22:32):
So I actually do write prescriptions for testosterone for women.
And when I prescribe androgel, which is the one that
we use for men, if I want to give it
to a woman, I have to write the instructions as
if I was prescribing for a man, or the pharmacy
won't dispense it wow because it's not formulated, or the
(22:53):
way the dosing is is only recommended for a man.
So like one or two pumps a day that we
say for a man, I have to write the prescription
like that, and I tell my female patients I'm writing
it like this, but just take a pe sized amount.
Speaker 2 (23:07):
Which that can be that can be dangerous.
Speaker 3 (23:09):
I'm writing something else on the prescription, but that's the
only way to get the pharmacy to give it to
the woman. And so the other alternative is going on
compounded testosterone, which could be totally fine.
Speaker 1 (23:18):
Right. Well, this is, as I say, a very complex
and interesting issue, the whole issue of hormonal health.
Speaker 3 (23:26):
Yeah, and giving testosterone to women is becoming more common.
Speaker 1 (23:30):
Yes, I know because my gynecologist told me that years ago.
They were worried about results like cancer or other things
if fooling with your hormones. But it's helped tremendously. And
using premarin for premenopausal women has helped tremendously so many women.
And I totally, I totally believe in replacement if it's necessary,
(23:52):
absolutely so. But you have to find the right doctors
like doctor Raka Kumar and others who are experts in
the field. Field. So, what we've learned about these medas
how these what have you learned about how these medications
impact diseases beyond diabetes?
Speaker 3 (24:09):
Yeah, So if we think of all the hormones we
just spoke about glp ones, estrogen, progesterone, testosterone. There's the
initial things that we thought they were for, such as diabetes,
hormone replacement therapy, but we're entering this new area of
medicine that's longevity health, and that is why many people
(24:32):
are choosing to go on hormone therapy even in the
absence of symptoms. Many people want to be on estrogen,
progesterone and testosterone because of the possibility that it can
affect their health span and their brain health. And there
are people taking glp ones or microdosing them with this
(24:53):
thought that they can prevent Alzheimer's and reduce inflammation. And
there are early studies that these things are possible but
not proven.
Speaker 1 (25:01):
What do you think.
Speaker 3 (25:02):
I think, on a case by case basis, I am
open to using the medicines like this with a very
thorough discussion of risks, benefits, knowns versus unknowns.
Speaker 1 (25:15):
So I've been taking premar and since I was forty
as a hormone replacement. What do you think of that.
Speaker 3 (25:20):
I admire you for being a bit of a rebel
because you continued your Premarin during the Women's Health Initiative fallout,
and there are some women that I take care of
as well that literally said when that study came out
that said that hormone therapy could increase the risk of
breast cancer and stroke, some women like you fought back
(25:41):
and said, no, I need this for my well being.
Speaker 1 (25:44):
I needed it for energy, I needed it for skin.
I needed it, you know, just for what you know,
good hair, good everything on it. It has helped me tremendously.
I think, you know, I had had a simple hysterectomy,
just my uterus was removed and kept my ovarrease. But
I never felt that I went through what we call
menopause because because it was so smooth, Yes, because of
(26:05):
the I think because of the implementation of additional premarin.
Do you think so?
Speaker 3 (26:10):
I believe that that really could have helped you and
made that transition smooth. I was a medical student when
the Women's Health Initiative study.
Speaker 2 (26:18):
It was scared, it was scary.
Speaker 1 (26:19):
And do you stop just being do you stop because
of it? And my doctors all they were, I guess
they were pretty progressive, said no, don't stop.
Speaker 2 (26:26):
That's great. Yeah, yeah, I remember. Yeah.
Speaker 3 (26:29):
So I was a medical student and my mom must
have been in her fifties and she was on premarin
and I think I told her to stop it at
the time. You do Now, I'm like, I kind of
hope she didn't listen to me. You should ask, Yeah.
Speaker 1 (26:40):
Your mother's in good shape. Yes, So what is the
potential for longevity or what is the big term now?
Anti aging? What do you think for hormones in general?
Speaker 3 (26:51):
First, I think nothing can replace the effect of diet, exercise,
and sleep for those that need sleep. Some people don't
need as much sleep, and I know you don't sleep.
I think that there's tremendous therapeutic potential for anti aging interventions, supplements,
(27:12):
and medicines, but our system is not built for it.
We have a healthcare system that is for sick care.
Speaker 2 (27:20):
You get health care.
Speaker 1 (27:21):
For health care. It is not for health Isn't that weird? Yes?
Speaker 3 (27:24):
But if you look back, like we have employer based
healthcare in the United States. That's how people get their
health insurance. That was set up during World War Two
because they couldn't increase wages, so it was a way
to keep employees was to give them health insurance through
their work.
Speaker 2 (27:40):
But it was really for catastrophes.
Speaker 1 (27:42):
Yes, So what about GLP ones impacting alcohol use? Does
it help you stop drinking if you're a drinker.
Speaker 3 (27:50):
For some people, there is a good research study that
shows that it can reduce alcohol consumption by seventy percent
in heavy drinkers. But it doesn't work like that and everybody,
but we do see that.
Speaker 1 (28:02):
I've been looking at my friends who drink I think
too much, but it doesn't seem to have affected them.
I didn't know that that it also appetized I guess
appetites in general, right.
Speaker 3 (28:14):
Yeah, but I think that maybe amongst some of our
friend group, the women do like to drink, and I
hope they're not replacing whatever calories they're taking in with wine.
Speaker 1 (28:34):
Tell us a little bit about your background, because it's
very interesting to me. You're a young, vital mother in
New York City and in Westchester on weekends, and you
seem so active and so interested in not only learning
more and more and more. But tell us about your background.
Speaker 3 (28:49):
I grew up not far from where I spend my
weekends with you, and I was always interested in fitness,
nutrition science.
Speaker 2 (28:57):
But I had many interests.
Speaker 3 (28:59):
I love school, I love learning, and I would say
that I knew I would land in a career that
involved the intersection of lifestyle biology, how our environment affects
our health, and that could have been anything.
Speaker 2 (29:13):
It could have been like running a fitness club.
Speaker 3 (29:16):
But I kept going down the science path, which landed
me in medicine. I loved women's health. I loved the
idea of connecting everything back to women's hormones and how
our bodies are always changing. That brought me to the
field of endochronology. And I think a lot of doctors
may be content once they find a specialty, and they'll
(29:39):
do that for fifty years. As an avid learner and
someone that loves the pursuit of knowledge, there has not
even been one year in my career so far that
I have wanted to just stay where I am. I
want to learn the next thing. If the medicines that
I am involved in are good to treat another condition,
I want.
Speaker 2 (29:59):
To learn that.
Speaker 3 (30:00):
And I feel really lucky to be where I am.
And I have a where did you go to school? So?
I grew up in Westchester, Briarcliffe manor that I went
to Duke University where I.
Speaker 2 (30:10):
Met my husband. He was in my freshman dorm. You
know him well then?
Speaker 3 (30:13):
I went to New York Medical College and I've been
at wild Cornell literally my internal medicine residency, my endocrine fellowship,
and I've stayed on the faculty there. I became the
chief medical officer of found Health three years ago.
Speaker 1 (30:26):
Those what found Health is? Did you found that? Or
I was?
Speaker 3 (30:29):
I am there first and only chief medical officer. I
didn't found the company. We have wonderful founders at Atomic Ventures,
and it's the first weight loss company that combined behavior
change with the use of medicine to help people have
good metabolic health. And the company existed before we go
(30:52):
v or before the ozempic for weight loss really and
so this is something that we had a vision for
in terms of expanding access to this type of care
for years.
Speaker 1 (31:02):
And how many people belong to Found Health?
Speaker 3 (31:04):
So we have done one million consults or over a
million consults. We cover over one hundred and twenty million
lives through insurance.
Speaker 1 (31:12):
Do you treat people in your offices? Is there an
office to go to for Found Health?
Speaker 3 (31:16):
So it's purely telehealth, Oh, it is. We are in
all the states. I don't see patients for the company.
I'm involved in doing their medical strategy. So I only
I have my practice in New York, I see my patients,
and then I do medical strategy for Found Health.
Speaker 1 (31:31):
Are there doctors on staff? There?
Speaker 2 (31:32):
There are about ninety doctors.
Speaker 1 (31:34):
Oh wow, So it's a big big thing telehealth. Yeah,
and making it accessible to people anywhere. Absolutely, how great
that is. And men and women.
Speaker 2 (31:45):
Men, women.
Speaker 3 (31:46):
We see people starting age eighteen, and we prescribe what
we call the widest toolkit of medicine. So not just
GLP ones. Part of the mission that Found is making
care accessible and affordable. So one thing we didn't mention
about GLP one is they're still really cost prohibitive for most.
Speaker 2 (32:05):
People that need them.
Speaker 3 (32:07):
How much a week the cash price for a GLP
one can be twelve hundred dollars a month.
Speaker 2 (32:12):
Wow with insurance.
Speaker 3 (32:13):
Now, if somebody has coverage, the prices are coming down,
but only thirty percent of insurance plans will cover medicine
for weight. People have coverage for diabetes, but if somebody
wants to take this for weight, they're often paying out
of pocket.
Speaker 1 (32:28):
So why are patients increasingly churning to services like Found
in New York Is there's several sort of conglomerate medical
centers rather than the traditional root of primary care medicine.
Think people want ease of access, one stop shopping, one
stop shop. People want efficient care. This like weight, they
(32:49):
need it, I think. I think they need it, they
need and launch it.
Speaker 3 (32:52):
Yeah, so the system is antiquated and we need to
respond to patients and people's needs and evolve.
Speaker 1 (33:00):
I think it'll become more and more like that, more
central centralized medicine than individual practitioners, I think. So.
Speaker 3 (33:07):
I think that there will be hybrids of brick and
mortar that have a lot of telehealth services so people
can access care quickly. And I also hope that these
you know, traditional older systems partner with these innovative startups
like found that can treat so many people at a
good cost quickly.
Speaker 1 (33:27):
What do you think about the pros and cons of
screenings like perneuvo and the gallery chas. These are more
things that that are so interesting to me. Describe what
perneuvo does.
Speaker 3 (33:39):
Yeah, So, perneuvo is a preventative full body MRI to
detect for abnormalities in your organs, possibly cancers and other
defects that wouldn't otherwise have been found.
Speaker 1 (33:54):
Not skeletal organs. So tissue off tissue, Yeah, yeah, so,
and how accurate is it?
Speaker 3 (34:00):
That's the problem is that you know, when you see
these early technologies, especially in healthcare, that live in the
consumer world versus the traditional health care system, you really
have to have a conversation about what is the risk
versus the benefit of doing a pernuvoscan or getting this information.
How often does a pernuvo scan have a false positive
(34:23):
or false negative? Those numbers are still high, which is
why many people don't advocate that their patients do this.
Speaker 2 (34:29):
My patients that would like to.
Speaker 3 (34:31):
Get a pernuvo scan, I am happy to have the
conversation with them to go over the risks versus the
benefits the unknowns. But I would say I really reserve
it for people that have a really strong family history
of cancer and people that are extremely anxious and won't
be satisfied without having looked at everything.
Speaker 1 (34:52):
How is your approach to hormone replacement therapy changed since
you started practicing medicine.
Speaker 3 (34:57):
Well, my training is in hormones, so I came in
to practice with an advantage of actually understanding this. But
even as an endocrinologist, I didn't receive a lot of
training in hormone replacement therapy for menopausal women. The way
US doctors are trained is on all of the really
serious acute illnesses. So even in my endochronology fellowship training,
(35:20):
my training was at New York Presbyterian and Memorial Sloan Kettering,
I saw the worst of the endocrine diseases, but not
typically what you would see in an outpatient practice. So
things like PCOS, polycystic ovarian syndrome and menopause care are
these things that live in the outpatient world, and they're
more involved with like well being, which is so important,
(35:40):
and it's involved with health. But but the way we're
trained is on all of like the really serious diseases, right,
rather than life transitions, which are equally important.
Speaker 1 (35:50):
Terribly important. And I've noticed that there are there conferences
now dealing with menopausal problems. Women are gathering in movie
theaters to your speakers speak, and it's kind of interesting
and it's now an open subject. It's no longer something
to shy away from.
Speaker 3 (36:07):
I know, have you heard of the menopause? Oh no,
it's that the menopasse is a group of women. Many
are doctors that are really trying to.
Speaker 1 (36:17):
To make people understand what it is, right, Yeah, Okay,
that's menopause, posse, the menopause. Oh god, but I'm good
because because everybody just says menopause is cranky, cranky ladies,
They're all cranky and complaining, and that's not what it
is at all.
Speaker 3 (36:34):
No, and women have the potential to be extremely productive,
if not more productive after that part of their life.
Speaker 1 (36:41):
As they get as they get older. Yes. Indeed, if
you come to see doctor Raka Kumar, what kind of
hormone replacement therapy do you talk about? How do you
do a chest? What's a chest?
Speaker 3 (36:52):
Well, first I have to talk to someone for a
long time to understand who they are and what is
bothering them, and then we will do biomarkers or blood tests.
But I like to treat the whole person, not just
their lab work. And so, depending on what stage of
life they're in, if something's actually deficient, of course will
replace it like thyroid hormone. If they're symptomatic and menopausal,
(37:15):
we'll give them estrogen progesterone. Where it gets tricky is
this confluence now of perimenopause, still desiring fertility, developing early
symptoms because people are having children later. So someone may
come to me and say, I think I'm in perimenopause,
but I have an embryo transfer scheduled.
Speaker 2 (37:33):
In three months.
Speaker 3 (37:34):
I mean, that gets complicated because I can't put that
person on hormones. And there still are lifestyle interventions in
the very early days of hormone transitions that can be
very effective in terms of reducing alcohol, switching up sugar
and carbon take for protein and vegetables. There are lifestyle
interventions in the early phases that people could see a
(37:54):
benefit from.
Speaker 1 (37:56):
Very interesting. You see, it is complex and you should
be listening to this because all women, especially right now.
But what about men? You see men too?
Speaker 2 (38:05):
I do see men.
Speaker 3 (38:06):
I work in a women's health center, but I do
see husbands, sons, and then other men that choose to
come in, and I address all the metabolic stuff with
them too. We do testosterone replacement and if a GLP
one or met foreman which we didn't discuss, is appropriate,
we would do all of that.
Speaker 1 (38:25):
I just want people to know I'm sitting in front
of a very fit and very intelligent and very active
mother of two husband, active, beautiful life. What do you
do personally for yourself?
Speaker 3 (38:38):
My weekends in Poundridge are a huge part of my
self care getting out of this city. I love my
life in the city, but I need to balance it
with what I know to be comfortable, which is Northern Westchester.
Speaker 2 (38:53):
The trees being outside.
Speaker 1 (38:55):
Your garden, which you're actively involved in now, which I
loved so much. I went over to see Rayka's house
recently and she's really into, you know, fixing up the outdoors.
It's so nice.
Speaker 3 (39:07):
Yeah, well, you inspired me and you inspired my daughter,
so now we have to do it. She comes over
to your house.
Speaker 1 (39:13):
She's like's not even twelve, and she's a nice active gardener.
How nice?
Speaker 3 (39:17):
Yeah, all thanks to Martha. And how do you approach
your diet balanced? I can't say that I do anything restrictive.
I enjoy eating. My husband is a foodie, so I
don't think that that would go very well if I
like tried to be on any strict diet. I'd say
I eat a little bit of everything, stay active. I
love going out to eat. I enjoy food and wine.
Speaker 1 (39:37):
What do you avoid?
Speaker 3 (39:39):
I'd say I avoid like just processed sugars. Like I
don't think I would eat like something at a package
that's like a package baked good that's probably what I
would avoided.
Speaker 1 (39:50):
I never opened cans or jars. You're so good. I
am good. I am good about that. No jars, no cans,
except for sargines, isn't it funny? I love sargines, good
for you. Yeah, but they come in the can. Yeah,
and uh so, so that's and now I'm looking for
fresh sargines, which are so tasty on the grill, Oh
my gosh. Oh yeah yeah, with a little olive oil
(40:12):
and a little tiny bit of sea salt. Oh they're
so good grilled to take about two minutes to cook.
I'm coming over, and you eat the whole fish, you know,
it's so good, you eat the bones. It's they're so tasty.
But it's interesting. So no, just don't don't open those packages, right, yeah, yeah,
it's it's important, don't you. And your exercise besides pilates, which,
(40:32):
by the way, when she's hanging off the plates rings
a pie on a reformer. It just makes me so
jealous because I can't do some of that stuff. Besides pilates,
what you do?
Speaker 3 (40:43):
I live weights twice a week. Yeah good, And I
would say I walk a lot.
Speaker 1 (40:47):
Yeah, you know, walking is very good for you. And
what about sleep? Are you a good sleeper?
Speaker 2 (40:51):
I am a good sleeper and I need my sleep.
Speaker 1 (40:54):
Well, thank you so much, doctor Kumar. I have learned
a lot today to sell our listeners where they can
get your help through Found or other channels.
Speaker 2 (41:03):
Yeah, sure, well, thank you for having me.
Speaker 3 (41:04):
You are such an inspiration to women that want to
be healthy for the long term. You can find me
at Wildcornell Medical College. You can find me at joinfound
dot com.
Speaker 1 (41:15):
Doctor Raka r E k h A k U m
A r okay. And you also have an active Instagram account.
Yeah that's kind of active. Well, it'll be more active
after our podcast, I think so. And the more information
that you can impart to all of us needy needy people,
the better. We really appreciate your knowledge.
Speaker 2 (41:37):
Of course, thank you for having me, Thank you for
joining us.
Doctor Rika Kumar is a board certified androcronologist who practices
at YL Cornell in New York City. She has a
leading voice in the field of obesity medicine. She has
brought her expertise into telehealth as the chief medical officer
of found a Resource for Weight Management. I know doctor
(00:24):
Kumar from our Plates studio. We regularly take classes together,
so I've seen firsthand her personal commitment to fitness and health.
Welcome to my podcast, doctor Kumar.
Speaker 2 (00:36):
Thank you so much.
Speaker 1 (00:37):
How are you Reka? Absolutely? I always call her Reka
and uh Reka is a beautiful young How old are you.
Speaker 2 (00:47):
I'm going to be forty five next week.
Speaker 1 (00:49):
Oh I thought you were like thirty five. You make
like thirty five.
Speaker 2 (00:52):
I thought you were twenty five.
Speaker 1 (00:54):
What is an endrocrinologist? Everybody wants to know exactly what
is it.
Speaker 3 (01:00):
An endocrinologist is a doctor that studies and treats diseases
of hormones, and not everyone knows what a hormone is.
A hormone is a chemical messenger in your body that's
released by something called a gland that and the hormone
travels through your bloodstream and does its job somewhere else,
(01:22):
and that job could be related to metabolism, fertility growth,
appetite regulation, body temperature regulation. So hormone health is very
complex because it doesn't involve one organ, but rather how
all of the organs communicate with each other through these
messengers called hormones.
Speaker 1 (01:43):
And how do you know if your hormones are in
order that? Because that seems to be a very big
subject matter right now, and you're right in the middle
of the entire controversy or I guess discussion we should
call it.
Speaker 3 (01:56):
Yeah, I agree with you, though it has become a
controversy because people are interested in their hormone health and
people don't feel like they are getting the answers from
their doctors.
Speaker 1 (02:07):
Which and what kind of doctors would be giving you
answers to hormone health, So there's a range.
Speaker 3 (02:14):
The most specific doctor would be an endochronologist, but there's
not enough endocrinologists in the country or the world to
see every patient that has a question about their hormones.
So a regular primary care doctor, which I'm a primary
care doctor as well, should be able to answer the
(02:35):
basic questions about hormones. All doctors pediatrics and adult medicine
are trained in basic hormone health, meaning basic reproductive health,
thyroid health, being able to manage straightforward diabetes when things
get complicated.
Speaker 1 (02:52):
Some diabetes related to your hormones.
Speaker 2 (02:54):
Yes, and I forgot that that's not obvious. So I'll explain.
Speaker 3 (02:58):
Diabetes is related to blood sugar regulation, which is done
by a hormone called insulin.
Speaker 1 (03:05):
Which hormone. There, I didn't know that. I didn't think
about it. Actually, I just didn't think about it. So
the insulin is a hormone.
Speaker 3 (03:13):
Yeah, And actually I would say most people don't know
that insulin is a hormone that is made by the
pancreas in response to blood sugar. Insulin leaves the pancreas
and goes and does its action on fat cells, muscle cells,
the heart, the liver, and the job of insulin is
(03:35):
to put blood sugar into cells to create energy. And
when this is disregulated, people get diabetes.
Speaker 1 (03:42):
So is it the pancreas that's creating the hormones for us?
Speaker 3 (03:46):
Or pancreas is creating the hormones that regulate blood sugar?
Speaker 1 (03:51):
Okay? And where does testosterone originate?
Speaker 3 (03:55):
So, in men, testosterone primarily from the testicle. In women,
testosterone is made in the adrenal glands, which are glands
that sit on top of the kidneys. Postmenopause, women's ovaries
may make more testosterone than they had previously.
Speaker 1 (04:15):
We need a chart and we need to understand more
about this because this is a very The human body
is the most complex organism, right, one of the most
complex organisms.
Speaker 2 (04:25):
Not only is it complex, but it is very smart.
Speaker 3 (04:28):
So when we try to manipulate it, or when our
modern environment, such as our modern food environment, impacts our body,
our hormones do all sorts of different things to try
to adapt to what we've given it.
Speaker 1 (04:43):
I see, So when does a patient need to see
an undracrinologist?
Speaker 3 (04:47):
So there are probably two scenarios. The most obvious reason
to see an endochronologist is if a primary care doctor
actually makes a diagnosis of an abnormal hormone life level
or symptom. So a primary care doctor at your annual
physical may screen for thyroid disease every year. That's pretty normal,
(05:08):
a basic screening test. If that's abnormal, some primary care
doctors may feel comfortable treating the thyroid disease, but if
they feel that it is too complex, they will refer
to an endochronologist. So the first reason would be referral
for a disorder based on the primary care doctors of.
Speaker 1 (05:26):
Valuable What is the what is the hormone that the
thyroid creates.
Speaker 3 (05:29):
It's called thyroxin or thyroid hormone.
Speaker 1 (05:32):
Okay, and that does what's your body? What is a
what is a too low a level of thyroxinde to
your body?
Speaker 3 (05:41):
So your thyroid gland to begin with as a butterfly
shaped gland that sits just below your voice box or
your atom's apple, and it makes thyroxin or thyroid hormone,
which regulates body temperature, heart rate, metabolism, or how quickly
or slowly you burn calorie body temperature. If I didn't
(06:01):
say that. So that's the job of thyroid hormone. If
the level is too low, if your thyroid gland is
not making enough, you feel sluggish, you may gain weight,
retain water, feel cold. If you make too much thyroid
hormone or hyperthyroidism, it's like the thermostat is revd up.
(06:22):
You feel hot, your heart is racing, you may have insomnia,
unintentional weight loss. That is more rare. An overactive thyroid.
An underactive thyroid is actually pretty prevalent. Potentially six to
eight percent of the population has an underactive thyroid. The
reason it's tricky to diagnose is that the symptoms look
(06:44):
like a lot of other things, fatigue, weight gain, those
are a lot of people have those complaints but don't.
Speaker 1 (06:50):
Have a loss hair loss. I have a dog who
has a low thyroid and she's lost a lot of
her hair.
Speaker 2 (06:58):
Oh my gosh, I know her.
Speaker 1 (06:59):
He is poor little and for his chin, and we've
regulated it. There is a medicine that you can take
for that, but her hair's not coming back. So it's
very serious to get imbalance in your hormones, isn't it.
Speaker 3 (07:13):
It is serious, And in some ways I feel like
the field of endochronology is so beautiful because you can
replace the hormone and regulate the disease. But there are
scenarios where the synthetic hormone or the medicine that's given
may not be exactly the same as what we would
have made in our body, and so people may still
have some symptoms. Or your dog, like the hair symptom,
(07:36):
like she's treated, but she still hasn't grown back her
hair right.
Speaker 1 (07:41):
Well. It's one of the more complex medicines that you're
involved in. Very complex and very interesting, by the way,
and everybody's now worried about weight and concerned about weight
and interests it in all the new weight loss drugs.
How does weight change specifically in women as they age?
That's a hormone.
Speaker 3 (07:59):
Yeah, So weight is complex because there's many hormones involved
in body weight regulation. And even more complex than the hormones,
there's two hundred to five hundred genes implicated in the
ability to gain excess weight. So unlike cancer or certain
other diseases, where you can point to one gene and
(08:22):
create a therapy that targets that one gene and treats
a person, we're not there yet.
Speaker 2 (08:28):
In obesity.
Speaker 3 (08:30):
There's so many genes that are implicated, and in order
to help people control their weight, for some people, not everybody,
they may need medicines that target hormones that are involved
in body weight.
Speaker 1 (08:45):
So are the ozempics treating hormones.
Speaker 2 (08:48):
Believe it or not, Ozembic is a hormone?
Speaker 1 (08:50):
Oh okay, I didn't know that.
Speaker 3 (08:53):
Most people don't, and I actually don't even think anyone
has really asked me that question before. Ozembic is a hormone.
Speaker 1 (09:00):
Wow, is it in your body normally?
Speaker 2 (09:02):
Yes?
Speaker 1 (09:02):
Oh, okay.
Speaker 3 (09:04):
It is a hormone called GLP one glucagon like peptide one.
We make this hormone when we eat a meal. We
release this hormone naturally in our intestines. It signals fullness
to the brain and lowers blood sugar. So ozembic is
what we call a GLP one analogue. It's a longer
(09:26):
acting version of our own GLP one.
Speaker 1 (09:28):
Okay, So the doctors who started to popularize ozembic knew
all this.
Speaker 3 (09:33):
Not necessarily, I will first, I would say that Kim
Kardashian popularized ozemviic, or pop culture popularized it in terms
of the doctors that were prescribing. So there were some
people like myself that studied the drugs and clinical trials
early on, and we realized its therapeutic potential in diabetes
(09:55):
and weight control. But in terms of the degree of
popularity for you know, just losing a few pounds or
fitting into a dress, or these more cosmetic like cultural
desire to be fitting, the issues are that I don't
think any doctor anticipated this.
Speaker 1 (10:15):
But it's become the rage.
Speaker 3 (10:16):
It has become the rage, and it is so interesting
because when I went into this field fifteen years ago,
if anyone was taking these meds or we prescribed them,
they were hiding it from the entire world. It was
this secret that people would have, even from like their
own families. They didn't want anyone to know they were
(10:37):
on a medicine to help control their weight. But today
everyone's talking about it always.
Speaker 1 (10:42):
I mean, I don't think I need a weightless drug.
Speaker 2 (10:46):
You one hundred percent do not. In my medical.
Speaker 1 (10:50):
Sometimes I think, oh God, if I have my stomach
feels fat or looks fat, I think maybe I should
go on ozevik.
Speaker 2 (10:57):
I mean, I think a lot.
Speaker 3 (10:57):
Of people are having these thoughts now, and that's that
is not healthy for us.
Speaker 2 (11:02):
Right.
Speaker 1 (11:02):
If I can't sip up my gene, I think, oh gosh,
do I need ozempic. I don't want to do that.
I think maybe another day of pilates might help. But
is that true?
Speaker 3 (11:11):
I mean, this is the thing that's not ever what
these meds were for. And I think we're all having
these thoughts now because we not just for looks.
Speaker 1 (11:19):
It shouldn't be for looks at all at all. It
should be for general health.
Speaker 3 (11:22):
Right, Yes, yes, and it really should be for what
we call metabolic health. Like the endgame of this is
how do we not die of a heart attack or
stroke prematurely? Yes, and that is why we care about weight.
That's why we care about blood sugar. That's why ozembic exists.
But it's become this tool for people to you know,
(11:45):
lose five pads when they feel bloated.
Speaker 1 (11:48):
But these drokes were originally developed for diabetes. Yeah, it
helped tremendously, haven't they.
Speaker 2 (11:54):
Yeah, we prescribed them twenty years ago for diabetes.
Speaker 1 (11:57):
And then who's whose bright idea was it for just
weight loss?
Speaker 3 (12:00):
So it was pretty clear from the early days that
not only did these medicines lower blood sugar, but they
controlled appetite and reduced body weight.
Speaker 1 (12:09):
That's how it works, by controlling your appetite, making you
not want to eat.
Speaker 3 (12:13):
So it's one of the ways it works is that
it goes through what we call the blood brain barrier,
so it has the ability to travel to the brain
and target the weight regulating center. So we have an
endocrine gland in our brain called the hypothalamus. In endochronology,
we call it the master gland. It is literally the
(12:36):
body it sits kind of if you had to go
directly up into your nose to the base of your
brain and then straight up. Oh, it's kind of a complicated.
We can maybe show a diagram one day. The hypothalamus
has a center in it that's literally the appetite and
weight regulating center that is in communication with the rest
(12:58):
of the body. It's post to sense fulness when somebody
is in the fed state. What GLP one or ozempic
does is that it goes to that area of the
brain even when the person isn't truly fed, and tells
the brain that it's full.
Speaker 1 (13:17):
Well, how complicated, but how interesting. So diabetes can now
be very well controlled. And is it all over the world.
I mean, is India still a nation of diabetics because
it was so dangerously high in diabetes. Yeah.
Speaker 3 (13:34):
There's a word called globesity or global obesity, and you
see it in these developing countries where you have malnutrition
and obesity coexisting.
Speaker 2 (13:46):
And because of the food they eat. Because of the
food they eat.
Speaker 3 (13:49):
But it's the rapid change from farming communities to urbanized communities,
and so you go from literally within one generations working
doing manual labor farming to moving to urbanization, moving into
a city and eating KFC. So the places you might
(14:10):
see this are parts of India, certain African countries, parts
of China where within one generation you could go from
malnutrition to obesity.
Speaker 1 (14:20):
I see, are the drugs being really widely used now?
Speaker 3 (14:24):
Yeah, the latest statistic we have is that twelve percent
of the US population has taken one of these drugs.
Speaker 1 (14:31):
That's huge And those are just the ones that are
there any other drugs like that other than thailand oil
or espirin.
Speaker 3 (14:37):
Probably statins like lipatour which many people would say these
are the biggest breakthrough in cardiovascular health since cholesterol lowering meds.
Speaker 1 (14:55):
So once you go on a GOLP dash one is
that a use one?
Speaker 3 (15:00):
Yep?
Speaker 1 (15:01):
Can you go often without regaining your weight?
Speaker 3 (15:04):
So the traditional thinking if it was prescribed to who
it's indicated for, meaning somebody with obesity or type two diabetes,
those people will typically regain two thirds of the weight
within a year if the medicine has stopped. What is
different today versus what was studied is there's a lot
of off label use, meaning people using it to lose
(15:28):
less amounts of weight that don't actually have a metabolic problem.
So say, I used it to lose two pounds. Could
I stop it and keep the two pounds off? Probably
with some work, Yeah, but some self restraint correct. Okay,
But once somebody is so disregulated in the state of
type two diabetes or severe obesity, restraint doesn't work anymore
(15:49):
because the signals aren't working anymore. That fullness center I
mentioned in the brain is not sensitis drug to me exactly.
Speaker 1 (15:57):
I see, Wow, gets very complicated. Yes, And so how
long can you take safely take like an ozembic drug, So.
Speaker 3 (16:06):
If you're supposed to be on it, you can technically
safely take it for your lifetime.
Speaker 2 (16:12):
And there's a key reason.
Speaker 3 (16:14):
About two and a half years ago, we learned that
people that took the class of medicines that's ozembic or
we go V, which is FDA approved for weight loss,
had a twenty percent reduction in heart attack, stroke, and
cardiovascular death.
Speaker 1 (16:29):
That's good.
Speaker 2 (16:30):
So if you want that benefit and.
Speaker 3 (16:32):
You are high risk of cardiovascular disease, you want to
stay on it. But that's not like the average person
you and I are meeting these days, that's taking it.
Speaker 1 (16:41):
True, And can they become a crutch?
Speaker 2 (16:43):
I think they can become a crutch.
Speaker 3 (16:44):
I really emphasize lifestyle intervention and adherence on and off
these drugs, but there's certainly people using these medicines that
are not changing their lifestyle, and my concern for them
is muscle loss.
Speaker 1 (16:59):
Is how absolutely so the gym is an absolutely essential
part of your life once you start taking these I.
Speaker 3 (17:07):
Would say it's more essential. Protein consumption and strength training
when you're on these medicines is essential to prevent bone
and muscle loss.
Speaker 1 (17:20):
I mean, so many of my friends are obviously on it.
Many of my men friends have just you know, changed
their looks entirely and for the better. You know, they
just look so much better.
Speaker 2 (17:31):
And they feel better and they're confidence.
Speaker 1 (17:33):
Yes, more confidence has appeared, and I think it's nice.
And the women I take it look so good and
so that's an encouragement. And the results elsewhere, I mean,
I've read some crazy statistics, and tell me if they're true.
Like the reason that airfares have started to come down
is because fewer people, fewer overweight people are using air travel,
(17:55):
so they don't use as much fuel consumption on the airplanes.
Is that true?
Speaker 2 (17:59):
I heard that statistic too, And then.
Speaker 1 (18:03):
The clothing industry too, is using less fabric in their
in their designs because they don't need to make them
so big. Yeah.
Speaker 2 (18:11):
I mean the people hardest hit are the junk food makers.
Speaker 1 (18:14):
And rightly so. Yeah. I wish, I wish, But I.
Speaker 3 (18:17):
Have heard and you may have seen this that the
junk food industry is trying to find ways to manipulate
their ingredients to work around these drugs.
Speaker 1 (18:27):
Wow. I did not see that. That is horrible. It's horrible, horrible.
Oh my gosh, how's silly. How's silly too?
Speaker 2 (18:35):
It's evil? Yeah, it is evil.
Speaker 1 (18:37):
Geez. I have not heard that, and so listen up,
audience please. That is not a good thing.
Speaker 3 (18:44):
Yeah, And it really goes back to this topic of
these meds aren't going to cure anything if we can't
change food policy, if we're actually letting the food industry
manipulate our hormone health like that, Wow, We're gonna have
to keep making better drugs.
Speaker 1 (19:02):
Right. I'll keep working in your job, Raco, because it's
very important obviously. The other night, just you know how
algorithms are working on social media these days, appears an
ad with Oprah Winfrey and a few other famous movie
stars talking about Japanese ozempic. What is Japanese ozempic. I
(19:25):
watched this. It went on for like an hour and
twenty minutes, this infomercial. Have you seen it?
Speaker 3 (19:31):
No?
Speaker 1 (19:32):
Oh, I think it's entirely fake. And it ends up
with a ozembic like drug being sold as capsules in
a bottle.
Speaker 2 (19:41):
Wow.
Speaker 1 (19:42):
But I don't believe that Oprah Winfrey is really representing
this company because she's talking about a natural supplement that
you can create out of certain nerves and things that's
known as Japanese ozempic. I mean, this.
Speaker 3 (19:55):
Whole fig actually sounds like a deep situation.
Speaker 1 (20:01):
I think it is. Yeah, and yet nobody has talked
about I haven't seen any news. I've seen it more
than once. I think it's on I've seen it about
three or four times on law.
Speaker 3 (20:10):
Yeah, it's particularly concerning because I think people could be misled,
being that Oprah has been generally outspoken.
Speaker 2 (20:18):
About ozemba, about ozemba.
Speaker 1 (20:19):
Yes, but Japanese ozempic is not ozempic, absolutely not.
Speaker 3 (20:23):
And the fact that people could like fall for that
an ozempic and a capsule and the whole thing.
Speaker 1 (20:30):
It's all very very weird, So beware and really work
with a reliable androcrinologist. If you are contemplating taking any
of these weight loss drugs or on weight loss drugs,
make sure your doctor is well aware of what you're doing.
I think this is so important to listen to your doctor.
Speaker 3 (20:48):
Yeah, then that is a key here is that if
you're going to be on this medicine, even if you
happen to get this medicine from some place that you're
embarrassed to say, I've heard of hair salons and things
like that, having somebody sitting there prescribing these even if
you are embarrassed to say where you got this medicine,
Please see a good doctor that can help you manage
(21:11):
it going forward.
Speaker 1 (21:12):
Are there a fake GLP?
Speaker 3 (21:14):
There are counterfeit There are black markets. There are there are,
but that's also become a gray area because there's also
compounded GLP ones which have a huge market, and they're
not necessarily all black market or counterfeit. They're from compounding
pharmacies that make hormones like it, so they are efficacious,
(21:35):
they are, but they are not FDA approved, so why
would you get it there? There are shortages of the
brand name versions. The shortages are over now, but for
years they were in shortage, so this market grew rapidly
of compounding pharmacies making.
Speaker 1 (21:52):
That's a whole other subject that I'm very interested in
because I was recently diagnosed as being a little low
in testosterol even though I take primarine tslosterone, and then
they sent me a compounded teslosterone. Is that good or
not good?
Speaker 3 (22:09):
So I would say it depends on where it's from
and what your symptoms were. I wouldn't say that it's
necessarily good or bad. But one of the reasons to
use compounded testosterone for a woman is right now, any
prescription testosterone that's commercially available is only formulated for a man.
(22:32):
So I actually do write prescriptions for testosterone for women.
And when I prescribe androgel, which is the one that
we use for men, if I want to give it
to a woman, I have to write the instructions as
if I was prescribing for a man, or the pharmacy
won't dispense it wow because it's not formulated, or the
(22:53):
way the dosing is is only recommended for a man.
So like one or two pumps a day that we
say for a man, I have to write the prescription
like that, and I tell my female patients I'm writing
it like this, but just take a pe sized amount.
Speaker 2 (23:07):
Which that can be that can be dangerous.
Speaker 3 (23:09):
I'm writing something else on the prescription, but that's the
only way to get the pharmacy to give it to
the woman. And so the other alternative is going on
compounded testosterone, which could be totally fine.
Speaker 1 (23:18):
Right. Well, this is, as I say, a very complex
and interesting issue, the whole issue of hormonal health.
Speaker 3 (23:26):
Yeah, and giving testosterone to women is becoming more common.
Speaker 1 (23:30):
Yes, I know because my gynecologist told me that years ago.
They were worried about results like cancer or other things
if fooling with your hormones. But it's helped tremendously. And
using premarin for premenopausal women has helped tremendously so many women.
And I totally, I totally believe in replacement if it's necessary,
(23:52):
absolutely so. But you have to find the right doctors
like doctor Raka Kumar and others who are experts in
the field. Field. So, what we've learned about these medas
how these what have you learned about how these medications
impact diseases beyond diabetes?
Speaker 3 (24:09):
Yeah, So if we think of all the hormones we
just spoke about glp ones, estrogen, progesterone, testosterone. There's the
initial things that we thought they were for, such as diabetes,
hormone replacement therapy, but we're entering this new area of
medicine that's longevity health, and that is why many people
(24:32):
are choosing to go on hormone therapy even in the
absence of symptoms. Many people want to be on estrogen,
progesterone and testosterone because of the possibility that it can
affect their health span and their brain health. And there
are people taking glp ones or microdosing them with this
(24:53):
thought that they can prevent Alzheimer's and reduce inflammation. And
there are early studies that these things are possible but
not proven.
Speaker 1 (25:01):
What do you think.
Speaker 3 (25:02):
I think, on a case by case basis, I am
open to using the medicines like this with a very
thorough discussion of risks, benefits, knowns versus unknowns.
Speaker 1 (25:15):
So I've been taking premar and since I was forty
as a hormone replacement. What do you think of that.
Speaker 3 (25:20):
I admire you for being a bit of a rebel
because you continued your Premarin during the Women's Health Initiative fallout,
and there are some women that I take care of
as well that literally said when that study came out
that said that hormone therapy could increase the risk of
breast cancer and stroke, some women like you fought back
(25:41):
and said, no, I need this for my well being.
Speaker 1 (25:44):
I needed it for energy, I needed it for skin.
I needed it, you know, just for what you know,
good hair, good everything on it. It has helped me tremendously.
I think, you know, I had had a simple hysterectomy,
just my uterus was removed and kept my ovarrease. But
I never felt that I went through what we call
menopause because because it was so smooth, Yes, because of
(26:05):
the I think because of the implementation of additional premarin.
Do you think so?
Speaker 3 (26:10):
I believe that that really could have helped you and
made that transition smooth. I was a medical student when
the Women's Health Initiative study.
Speaker 2 (26:18):
It was scared, it was scary.
Speaker 1 (26:19):
And do you stop just being do you stop because
of it? And my doctors all they were, I guess
they were pretty progressive, said no, don't stop.
Speaker 2 (26:26):
That's great. Yeah, yeah, I remember. Yeah.
Speaker 3 (26:29):
So I was a medical student and my mom must
have been in her fifties and she was on premarin
and I think I told her to stop it at
the time. You do Now, I'm like, I kind of
hope she didn't listen to me. You should ask, Yeah.
Speaker 1 (26:40):
Your mother's in good shape. Yes, So what is the
potential for longevity or what is the big term now?
Anti aging? What do you think for hormones in general?
Speaker 3 (26:51):
First, I think nothing can replace the effect of diet, exercise,
and sleep for those that need sleep. Some people don't
need as much sleep, and I know you don't sleep.
I think that there's tremendous therapeutic potential for anti aging interventions, supplements,
(27:12):
and medicines, but our system is not built for it.
We have a healthcare system that is for sick care.
Speaker 2 (27:20):
You get health care.
Speaker 1 (27:21):
For health care. It is not for health Isn't that weird? Yes?
Speaker 3 (27:24):
But if you look back, like we have employer based
healthcare in the United States. That's how people get their
health insurance. That was set up during World War Two
because they couldn't increase wages, so it was a way
to keep employees was to give them health insurance through
their work.
Speaker 2 (27:40):
But it was really for catastrophes.
Speaker 1 (27:42):
Yes, So what about GLP ones impacting alcohol use? Does
it help you stop drinking if you're a drinker.
Speaker 3 (27:50):
For some people, there is a good research study that
shows that it can reduce alcohol consumption by seventy percent
in heavy drinkers. But it doesn't work like that and everybody,
but we do see that.
Speaker 1 (28:02):
I've been looking at my friends who drink I think
too much, but it doesn't seem to have affected them.
I didn't know that that it also appetized I guess
appetites in general, right.
Speaker 3 (28:14):
Yeah, but I think that maybe amongst some of our
friend group, the women do like to drink, and I
hope they're not replacing whatever calories they're taking in with wine.
Speaker 1 (28:34):
Tell us a little bit about your background, because it's
very interesting to me. You're a young, vital mother in
New York City and in Westchester on weekends, and you
seem so active and so interested in not only learning
more and more and more. But tell us about your background.
Speaker 3 (28:49):
I grew up not far from where I spend my
weekends with you, and I was always interested in fitness,
nutrition science.
Speaker 2 (28:57):
But I had many interests.
Speaker 3 (28:59):
I love school, I love learning, and I would say
that I knew I would land in a career that
involved the intersection of lifestyle biology, how our environment affects
our health, and that could have been anything.
Speaker 2 (29:13):
It could have been like running a fitness club.
Speaker 3 (29:16):
But I kept going down the science path, which landed
me in medicine. I loved women's health. I loved the
idea of connecting everything back to women's hormones and how
our bodies are always changing. That brought me to the
field of endochronology. And I think a lot of doctors
may be content once they find a specialty, and they'll
(29:39):
do that for fifty years. As an avid learner and
someone that loves the pursuit of knowledge, there has not
even been one year in my career so far that
I have wanted to just stay where I am. I
want to learn the next thing. If the medicines that
I am involved in are good to treat another condition,
I want.
Speaker 2 (29:59):
To learn that.
Speaker 3 (30:00):
And I feel really lucky to be where I am.
And I have a where did you go to school? So?
I grew up in Westchester, Briarcliffe manor that I went
to Duke University where I.
Speaker 2 (30:10):
Met my husband. He was in my freshman dorm. You
know him well then?
Speaker 3 (30:13):
I went to New York Medical College and I've been
at wild Cornell literally my internal medicine residency, my endocrine fellowship,
and I've stayed on the faculty there. I became the
chief medical officer of found Health three years ago.
Speaker 1 (30:26):
Those what found Health is? Did you found that? Or
I was?
Speaker 3 (30:29):
I am there first and only chief medical officer. I
didn't found the company. We have wonderful founders at Atomic Ventures,
and it's the first weight loss company that combined behavior
change with the use of medicine to help people have
good metabolic health. And the company existed before we go
(30:52):
v or before the ozempic for weight loss really and
so this is something that we had a vision for
in terms of expanding access to this type of care
for years.
Speaker 1 (31:02):
And how many people belong to Found Health?
Speaker 3 (31:04):
So we have done one million consults or over a
million consults. We cover over one hundred and twenty million
lives through insurance.
Speaker 1 (31:12):
Do you treat people in your offices? Is there an
office to go to for Found Health?
Speaker 3 (31:16):
So it's purely telehealth, Oh, it is. We are in
all the states. I don't see patients for the company.
I'm involved in doing their medical strategy. So I only
I have my practice in New York, I see my patients,
and then I do medical strategy for Found Health.
Speaker 1 (31:31):
Are there doctors on staff? There?
Speaker 2 (31:32):
There are about ninety doctors.
Speaker 1 (31:34):
Oh wow, So it's a big big thing telehealth. Yeah,
and making it accessible to people anywhere. Absolutely, how great
that is. And men and women.
Speaker 2 (31:45):
Men, women.
Speaker 3 (31:46):
We see people starting age eighteen, and we prescribe what
we call the widest toolkit of medicine. So not just
GLP ones. Part of the mission that Found is making
care accessible and affordable. So one thing we didn't mention
about GLP one is they're still really cost prohibitive for most.
Speaker 2 (32:05):
People that need them.
Speaker 3 (32:07):
How much a week the cash price for a GLP
one can be twelve hundred dollars a month.
Speaker 2 (32:12):
Wow with insurance.
Speaker 3 (32:13):
Now, if somebody has coverage, the prices are coming down,
but only thirty percent of insurance plans will cover medicine
for weight. People have coverage for diabetes, but if somebody
wants to take this for weight, they're often paying out
of pocket.
Speaker 1 (32:28):
So why are patients increasingly churning to services like Found
in New York Is there's several sort of conglomerate medical
centers rather than the traditional root of primary care medicine.
Think people want ease of access, one stop shopping, one
stop shop. People want efficient care. This like weight, they
(32:49):
need it, I think. I think they need it, they
need and launch it.
Speaker 3 (32:52):
Yeah, so the system is antiquated and we need to
respond to patients and people's needs and evolve.
Speaker 1 (33:00):
I think it'll become more and more like that, more
central centralized medicine than individual practitioners, I think. So.
Speaker 3 (33:07):
I think that there will be hybrids of brick and
mortar that have a lot of telehealth services so people
can access care quickly. And I also hope that these
you know, traditional older systems partner with these innovative startups
like found that can treat so many people at a
good cost quickly.
Speaker 1 (33:27):
What do you think about the pros and cons of
screenings like perneuvo and the gallery chas. These are more
things that that are so interesting to me. Describe what
perneuvo does.
Speaker 3 (33:39):
Yeah, So, perneuvo is a preventative full body MRI to
detect for abnormalities in your organs, possibly cancers and other
defects that wouldn't otherwise have been found.
Speaker 1 (33:54):
Not skeletal organs. So tissue off tissue, Yeah, yeah, so,
and how accurate is it?
Speaker 3 (34:00):
That's the problem is that you know, when you see
these early technologies, especially in healthcare, that live in the
consumer world versus the traditional health care system, you really
have to have a conversation about what is the risk
versus the benefit of doing a pernuvoscan or getting this information.
How often does a pernuvo scan have a false positive
(34:23):
or false negative? Those numbers are still high, which is
why many people don't advocate that their patients do this.
Speaker 2 (34:29):
My patients that would like to.
Speaker 3 (34:31):
Get a pernuvo scan, I am happy to have the
conversation with them to go over the risks versus the
benefits the unknowns. But I would say I really reserve
it for people that have a really strong family history
of cancer and people that are extremely anxious and won't
be satisfied without having looked at everything.
Speaker 1 (34:52):
How is your approach to hormone replacement therapy changed since
you started practicing medicine.
Speaker 3 (34:57):
Well, my training is in hormones, so I came in
to practice with an advantage of actually understanding this. But
even as an endocrinologist, I didn't receive a lot of
training in hormone replacement therapy for menopausal women. The way
US doctors are trained is on all of the really
serious acute illnesses. So even in my endochronology fellowship training,
(35:20):
my training was at New York Presbyterian and Memorial Sloan Kettering,
I saw the worst of the endocrine diseases, but not
typically what you would see in an outpatient practice. So
things like PCOS, polycystic ovarian syndrome and menopause care are
these things that live in the outpatient world, and they're
more involved with like well being, which is so important,
(35:40):
and it's involved with health. But but the way we're
trained is on all of like the really serious diseases, right,
rather than life transitions, which are equally important.
Speaker 1 (35:50):
Terribly important. And I've noticed that there are there conferences
now dealing with menopausal problems. Women are gathering in movie
theaters to your speakers speak, and it's kind of interesting
and it's now an open subject. It's no longer something
to shy away from.
Speaker 3 (36:07):
I know, have you heard of the menopause? Oh no,
it's that the menopasse is a group of women. Many
are doctors that are really trying to.
Speaker 1 (36:17):
To make people understand what it is, right, Yeah, Okay,
that's menopause, posse, the menopause. Oh god, but I'm good
because because everybody just says menopause is cranky, cranky ladies,
They're all cranky and complaining, and that's not what it
is at all.
Speaker 3 (36:34):
No, and women have the potential to be extremely productive,
if not more productive after that part of their life.
Speaker 1 (36:41):
As they get as they get older. Yes. Indeed, if
you come to see doctor Raka Kumar, what kind of
hormone replacement therapy do you talk about? How do you
do a chest? What's a chest?
Speaker 3 (36:52):
Well, first I have to talk to someone for a
long time to understand who they are and what is
bothering them, and then we will do biomarkers or blood tests.
But I like to treat the whole person, not just
their lab work. And so, depending on what stage of
life they're in, if something's actually deficient, of course will
replace it like thyroid hormone. If they're symptomatic and menopausal,
(37:15):
we'll give them estrogen progesterone. Where it gets tricky is
this confluence now of perimenopause, still desiring fertility, developing early
symptoms because people are having children later. So someone may
come to me and say, I think I'm in perimenopause,
but I have an embryo transfer scheduled.
Speaker 2 (37:33):
In three months.
Speaker 3 (37:34):
I mean, that gets complicated because I can't put that
person on hormones. And there still are lifestyle interventions in
the very early days of hormone transitions that can be
very effective in terms of reducing alcohol, switching up sugar
and carbon take for protein and vegetables. There are lifestyle
interventions in the early phases that people could see a
(37:54):
benefit from.
Speaker 1 (37:56):
Very interesting. You see, it is complex and you should
be listening to this because all women, especially right now.
But what about men? You see men too?
Speaker 2 (38:05):
I do see men.
Speaker 3 (38:06):
I work in a women's health center, but I do
see husbands, sons, and then other men that choose to
come in, and I address all the metabolic stuff with
them too. We do testosterone replacement and if a GLP
one or met foreman which we didn't discuss, is appropriate,
we would do all of that.
Speaker 1 (38:25):
I just want people to know I'm sitting in front
of a very fit and very intelligent and very active
mother of two husband, active, beautiful life. What do you
do personally for yourself?
Speaker 3 (38:38):
My weekends in Poundridge are a huge part of my
self care getting out of this city. I love my
life in the city, but I need to balance it
with what I know to be comfortable, which is Northern Westchester.
Speaker 2 (38:53):
The trees being outside.
Speaker 1 (38:55):
Your garden, which you're actively involved in now, which I
loved so much. I went over to see Rayka's house
recently and she's really into, you know, fixing up the outdoors.
It's so nice.
Speaker 3 (39:07):
Yeah, well, you inspired me and you inspired my daughter,
so now we have to do it. She comes over
to your house.
Speaker 1 (39:13):
She's like's not even twelve, and she's a nice active gardener.
How nice?
Speaker 3 (39:17):
Yeah, all thanks to Martha. And how do you approach
your diet balanced? I can't say that I do anything restrictive.
I enjoy eating. My husband is a foodie, so I
don't think that that would go very well if I
like tried to be on any strict diet. I'd say
I eat a little bit of everything, stay active. I
love going out to eat. I enjoy food and wine.
Speaker 1 (39:37):
What do you avoid?
Speaker 3 (39:39):
I'd say I avoid like just processed sugars. Like I
don't think I would eat like something at a package
that's like a package baked good that's probably what I
would avoided.
Speaker 1 (39:50):
I never opened cans or jars. You're so good. I
am good. I am good about that. No jars, no cans,
except for sargines, isn't it funny? I love sargines, good
for you. Yeah, but they come in the can. Yeah,
and uh so, so that's and now I'm looking for
fresh sargines, which are so tasty on the grill, Oh
my gosh. Oh yeah yeah, with a little olive oil
(40:12):
and a little tiny bit of sea salt. Oh they're
so good grilled to take about two minutes to cook.
I'm coming over, and you eat the whole fish, you know,
it's so good, you eat the bones. It's they're so tasty.
But it's interesting. So no, just don't don't open those packages, right, yeah, yeah,
it's it's important, don't you. And your exercise besides pilates, which,
(40:32):
by the way, when she's hanging off the plates rings
a pie on a reformer. It just makes me so
jealous because I can't do some of that stuff. Besides pilates,
what you do?
Speaker 3 (40:43):
I live weights twice a week. Yeah good, And I
would say I walk a lot.
Speaker 1 (40:47):
Yeah, you know, walking is very good for you. And
what about sleep? Are you a good sleeper?
Speaker 2 (40:51):
I am a good sleeper and I need my sleep.
Speaker 1 (40:54):
Well, thank you so much, doctor Kumar. I have learned
a lot today to sell our listeners where they can
get your help through Found or other channels.
Speaker 2 (41:03):
Yeah, sure, well, thank you for having me.
Speaker 3 (41:04):
You are such an inspiration to women that want to
be healthy for the long term. You can find me
at Wildcornell Medical College. You can find me at joinfound
dot com.
Speaker 1 (41:15):
Doctor Raka r E k h A k U m
A r okay. And you also have an active Instagram account.
Yeah that's kind of active. Well, it'll be more active
after our podcast, I think so. And the more information
that you can impart to all of us needy needy people,
the better. We really appreciate your knowledge.
Speaker 2 (41:37):
Of course, thank you for having me, Thank you for
joining us.
Host
Martha Stewart
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