August 2, 2024 • 57 mins
Are you struggling with hormonal balance and knowing where to turn for more information regarding hormone replacement therapy? Dr. Tassone is board-certified in obstetrics and gynecology, and by the American Board of Integrative Medicine. He holds a medical degree, in addition to a PhD in mind-body medicine. Dr. Tassone is a highly regarded patient advocate. His work includes studies and publications on spirituality in medical care, whole foods to heal the human body, and integrative medicine. (https://www.drshawntassone.com) I learned a ton from this conversation and I hope you will as well.
What we discussed:
- Shawn's backstory and what led him to integrative medicine (1:25)
- Integrative medicine, criticism, and standardization (3:37)
- The safety and efficacy of a new medical product, with concerns about data manipulation and potential complications (9:53)
- Hormonal fluctuations in women, particularly during perimenopause and menopause, with a focus on symptoms, diagnosis (17:48)
- Hormone replacement therapy (HRT) and its effects on menopausal symptoms and breast cancer risk (26:39)
- Benefits and risks of HRT (31:19)
- Hormone use and its effects on health, including birth control pills and synthetic vs. bioidentical hormones (38:11)
- Supplements for hormone balance, including wild yam and dim, with explanations of their effectiveness and potential side effects (42:09)
- Hormone imbalance and its impact on women's health, with a focus on estrogen and testosterone levels (47:06)
Where to learn more:
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Well, hello ladies and James Robert Sykes, Keto savage.com.
Today I've got special guest doctor Sean Tassone on the line.
He is a certified gynecologist. He is an OBGYN and we dive into
all things hormonal health as itpertains to women.
We talk about perimenopause. We talk about hormonal
fluctuations as it pertains to them in younger years.
Talk about birth control. We talk about HRT.
(00:22):
We talk about bioidentical hormones and synthetic hormones.
We talk about how to go about things optimally, from a natural
standpoint, what supplements onecan take well, the difference
between going naturally or usingHRT.
So we dive into all kinds of things as it pertains to Women's
Health and hormone function. So thoroughly into the
conversation. I took a lot of things from
this. I learned a ton.
(00:42):
I've got no doubt that you will as well.
So that further delay, sit back,relax, get your notepad out,
take some notes, learn somethingwith Doctor Sean Tesson and we
are live Doctor Sean Tesson. How are you Sir, doing?
(01:03):
Good. How are you?
I'm doing wonderfully well myself, so I've had multiple
guests on the podcast talking about hormonal health, Women's
Health, all that good stuff. You've been in this sport or not
sport, but I have, I guess, industry for quite some time.
I'd love to kind of just get some back story on what
compelled you to go this direction to begin with and what
kind of put the curtain back on what you've learned in the
process. Well, when you are in your 4th
(01:28):
year of medical school, you kindof have to decide what you want
to do and you set up your electives, if you will, kind of
in that area. And I thought initially that I
really wanted to do more medicine, just general internal
medicine. But what I found was that I
really wanted something that wasmore diverse.
(01:51):
And you'll also notice that certain professions in medicine
have their own, how would I describe it, personality traits.
So like, what I noticed was thatthe OBGYN residents were all
really, you know, fun. They were people you'd want to
hang out with. And, and, and then looking at
it, you know, there really isn'ta whole lot of death in, you
(02:14):
know, you're delivering babies. And there it's, it's more of a
kind of a fun profession. And so I just, it just seemed to
resonate more with me. The interesting thing was as I
proceeded through residency, my mom was diagnosed with ovarian
cancer in my second year of residency.
(02:36):
So I knew a lot about that disease process and I had access
to things. What I wasn't prepared for was
when she got through the chemo and all that stuff.
I've, I'm an only child and I felt really limited in what I
could do for my own mother. And I, I really was, I struggled
(02:56):
for a long time. And that's why I went the route
to answer your question of kind of the integrative approach was
that I, I couldn't help my own mother, like feel better just,
you know, live the last few years of her life with, you
know, some semblance of a normal, you know, happy life.
(03:19):
And so I felt really limited andjust vowed that I wasn't going
to let somebody else go through that.
And so I went the integrated route and did a bunch of extra
training, hoping that I would have more in my, you know, my
bag, as it were. I love it.
I love it. So when you went the integrative
(03:39):
rent, how far, how far were you into, you know, traditional
Western medicine in the sense, Imean, you were in your residency
at that point already, right? Yeah, when I, well, when I did,
I graduated from residency in 98and then I didn't start.
My mom was diagnosed in like probably right around then,
(04:01):
right around 98, and then she passed in 2001, and I didn't
start the integrative medicine stuff until about 2003.
Gotcha. Did you get a lot of support
with your peers that you went toresidency with and going that
route or were you kind of met with some criticism there?
(04:21):
You know, that was an interesting time because it was,
like I said, it was around 2005 and integrative medicine was
new. There was absolutely no such
thing as functional medicine. And so none of that was even
around. You know, that was kind of back
in the day of the Med spas kind of like popping up everywhere
(04:44):
and there was a lot of change going on.
But yeah, so if you want to talkabout what was happening back
then, it was funny. The reason I did it in the 1st
place was because I was reading this book at the time called 8
Weeks to Optimum Health by Andrew Weil.
And in that book he was talking about, which at the time was
(05:05):
crazy Omega threes, you know, fish oil, coq, 10 things now
that we kind of take for granted.
But back then was like land, youknow, land breaking.
And to think of, you know, hormone replacement and
bioidentical hormones, that was a little bit kind of outside the
box. So I got a little bit of
(05:26):
criticism, yeah, but I've never actually been a person to really
give a crap about that. Yeah, no, I totally relate with
you there. I feel like now the world of
innovative health functional medicine is, I mean, super
commonplace. Like, I don't feel like there is
that much. Again, this is not my
wheelhouse, but I would assume that there's not that much, you
(05:46):
know, criticism from someone going from one train of thought
to another as near as much as itwas 20 years ago.
But I would assume that's prettywell respected these days to
some extent, right? I think it's, you know, it's
really funny. I, I think it's completely, it's
very dichotomous because there are so many people out there
(06:09):
that still I don't. The problem is, and it's human
nature. I think functional type medicine
gets a lot of kickback because there's a lot of people out
there that abuse the word functional.
And so they sell a lot of tests,they push a lot of supplements
that don't have a lot of, you know, support.
(06:30):
And so my colleagues will grab onto that and they will say, oh,
well, this is another snake oil salesman or whatever.
I think if it was done in a morereasonable and moderated
approach, it would probably be better.
But the lines, you know, I'm in some physician Facebook groups
and the my colleagues are alwayscomplaining about how they, you
(06:53):
know, oh, that my patients go into this naturopath or they're
going to this doctor or whatever.
And my response is like, well, why are they going there?
They're going there because you are not providing them with the
care that they want. You're telling them, oh, I don't
need to order labs. Why would you want to do that?
And so they're going to go to somebody that will do they want.
And so we're kind of causing theproblem in a sense.
(07:17):
And yet then where you sit around and complain about it.
So it's quite, it's quite an interesting space to be in
because I've got one foot in in each space, you know.
Yeah, which I think like that's why I'm excited to talk to you
because I feel like I've talked to several people that are in
one wheelhouse or the other, butI've talked to a few that are in
(07:39):
both. And I think you just your, your
words carry a little bit more weight because you have that
perspective from both sides. And I feel like another issue
with the functional medicine space is that, and correct me if
I'm wrong, but I'm assuming it'snot quite as standardized in, in
this part, what you're saying with the moderation, but it's
probably not as standardized as traditional Western medicine.
I mean, you don't have there's, there's some instances where the
(08:00):
barrier to entry is much lower and the criteria to, you know,
obtain some form of certification is also probably
lower with some schools. And that would likely create
some frustration with people from the traditional space, I
would assume. Well, you know, as you know, you
can be now a doctor of anything.I mean, doctor of Divinity, Dr.
(08:25):
there's even stuff that's, you know, made-up now like doctor of
natural medicine. I mean that you can be a doctor
of anything. So I think what we've sort of
seen in the last five years is what I call the death of
expertise, because everybody on social media can be an expert.
And the problem is that's that'swrong on one side because
(08:46):
obviously you can't be an expertin everything.
Like I would never pretend to bean expert in men's health
because that's not what I do. But there are people out there
that will claim that. But then on the other side, the
doctors aren't really digging deep.
So like, let's say OBGYN and I use this, all of this analogy a
(09:07):
lot. If you look at every pregnant
woman that comes in, that's about a 2 1/2 thousand to $3000,
you know, investment or return on investment for the doctor.
You have a woman walk in that stays 60 and she wants to talk
about hormones, That's probably $100.
And you got to actually spend more time with that woman than
(09:30):
you do with the pregnant woman because that's pretty standard
in most cases. And then you talk about a return
appointment being maybe $50 after insurance, they just, if,
if a doctor is seeing 50 patients in a day, they're going
to gravitate more towards the bigger return on investment.
I think that's human nature. And so it really makes it hard.
(09:53):
That's why these other folks that are out there doing quote,
UN quote, you know, functional medicine, they, you know, that
one of the criticisms by the physicians is like, oh, they're
just doing it to make money. Well, we all make money.
I mean, none of us do anything for free.
So it's kind of a silly argument, but the patients are
paying it because they want the time, you know, and they want,
(10:14):
and I and, and unfortunately there is a misconception out
there that the more you spend, the better it must be.
But but yeah, it's it's, I thinkit's a confusing space for a lot
of women. Yeah, no, I totally agree.
As far as you know, this space in general, like I want to kind
of rewind the clock even further.
Like what What made you want to go the route of Med school,
(10:36):
becoming a physician? Like what was the the catalyst
for that? You know, it's funny, I really,
you know, even back probably a bit before I started college,
when you start thinking and like, what do I want to do?
I'm the only one in my family that went to college.
(10:56):
So it's not like I have this long history of doctors.
I didn't specifically feel like it's, you know, some doctors you
can figure it out like, oh, oh, this kid as a kid, this guy had
a seizure disorder or this person who was a childhood
diabetic and then they go into medicine because they want to
help other people. I didn't have that either.
(11:18):
But I think, you know, it's kindof sad to say, probably in the
beginning I realized that I wasn't an inside the box type
person. Like I couldn't envision myself
going to a job where I would go from 8:00 to 5:00 and do
investments or, you know, work in some big company because I'm
(11:39):
not good. I'm not good being told what to
do. Probably most of us in this
entrepreneurial space have some of that.
I knew I wanted to make as big an impact as as I could, and it
made sense to me that it just kind of, it wasn't really ever
something that I thought twice about.
(12:00):
I just knew that that I saw my stepdad kind of get ruined by
traditional business. Like he was a personnel manager
for some big company and it justdrove him to drink and, you
know, be stressed out all the time.
And I thought, well, I'm going to go into medicine because
then, you know, I can help a lotof people.
(12:20):
People can't tell me what to do.And but what's funny is when you
get into medicine, everybody's telling you what to do.
You got the insurance companies telling you what to do.
You got the hospitals telling you what to do, and it's just
like, it was kind of like one ofthose things where I was like,
oh, great, you know, 'cause I thought it was going to be
something different. But as you evolve as a person
and as a doctor, the beautiful thing is you can also evolve
(12:42):
your practice. And so I stopped doing OB about
seven years ago and was really able to focus on the hormones
and on the GYN stuff. Gotcha, gotcha.
So, so kind of break apart your your practice as it sits
currently. So you're not really doing, you
know, deliveries anymore, I would say assume.
(13:03):
I haven't done deliveries in about seven years.
And then I wrote a book in 2021 called the Hormone Balance
Bible. So since then I've really even
developed in the last three years more into a hormone
practice. But I also have this other piece
where I, it wasn't something that I was planning on, which is
(13:24):
how things tend to work. I did a, there's a, there was an
implant that was put in fallopian tubes from 2002 to
like 2018 called E Shore Essure.And it was a little metallic oil
that we would slide into the fallopian tubes and then over
three months it would scar shut.And there were about a million
(13:45):
of them put in. And what we noticed was women
were starting to have lots of pain, autoimmune reactions,
heavy periods, you know, all kinds of stuff.
And so I started removing them, which had to be done surgically.
And I, I sort of evolved into the guy in this country that
(14:06):
removes these coils and it probably done 1500 cases.
And so I have women, so not onlyhormones, but I have women fly
from around the country to have those coils removed.
So I do surgeries still for likefibroids and endometriosis and
and then I work with women on hormones.
Gotcha. Gotcha.
I'm assuming like most things inthe medical space, when they
(14:28):
were putting those in initially,what was the main, the main
reason for those? And was there, I guess, any
telltale signs at the time that those could be problematic down
the road? Well, there's a book coming out,
not by me, but there's a great, a great author that's writing a
book on the whole story. And suffice it to say, when you
(14:50):
look back at these medical devices, and I'm not saying all
medical devices, but there's always a back story.
And this particular company that's no longer in existence
called Conceptus is the company that came out with this product.
And we had been waiting for years, decades, for a procedure
where you could do sterilizationand you didn't have to do
(15:13):
abdominal surgery because guys are wimps and they won't get a
damn vasectomy. So women usually have to bear
the brunt of this kind of stuff.And So what happened was when
this came out, doctors were super excited because it was
this minimally invasive procedure.
Anyways, yes, it's coated with polyethyl trephylate fibers,
(15:37):
which is polyester. It's got nickel, titanium,
stainless steel. There's all these things in
there that can cause issues, especially nickel because a lot
of people have a nickel allergy.And what we noticed was that the
data, so we were given data through the FDA where there were
no pregnancies, there were no serious complications, women
(15:59):
that were doing fine, you know, and you know, come to find out
22 years later that a lot of it was fabricated.
And because what system where you have a company that spends
millions and millions of dollarson developing a product and then
you allow that same company to do the pilot study to say how
safe it is, just not a good system because they're going to
(16:23):
be biased towards their product because they've invested all
this money, right? They're not going to come out
and say, oh, it had all these problems because they're going
to lose millions and potentiallybillions of dollars.
And so it's just, it's got a seedy underbelly to it.
I don't like to be a conspiracy theorist, but it's not the best
way to do things. Yeah, there's been a few
(16:45):
instances of that happening in our not too distant past.
A lot of them, a lot of stuff. I mean, it's definitely, you
know, you see it with medications like Vioxx where you
know it it, you know, same thing.
It passed all the stuff, but then come to find out it
actually had a lot of complications that weren't
reported. Were were you with from a time
(17:07):
frame standpoint, were you performing the procedures on the
women like in in implanting those when that was cleared and
now it's now 20 years later you're the one removing them?
I had put a few in in my day. I stopped.
The reason that I made the, thatI made the shift to stop putting
(17:30):
them in and taking them out was because I had had a patient get
pregnant. And like I said, there wasn't a
way. I had never seen that before.
And then when I looked on the data and everything, there were
no reported pregnancies. And I was like, well,
something's not right. And so I started looking around
(17:52):
and found a couple Facebook groups where at the time, there
might have been 2000 members. And these were all women who
were having issues that I'd never heard of before.
And so I just kind of sat like afamily on the wall for months
and and kind of looked at all the stuff that they were
suffering with and then over time just started taking them
(18:16):
out. So it was just women that were
complaining about it. That kind of shifted the way I
was thinking. Yeah, no, it's, it's very
interesting. All right.
So I, I kind of want to put the curtain back on all things
women's hormonal health because this is something like I said,
I've had several people on the podcast that have dove into this
and I'm obviously not, this is not my wheelhouse.
(18:37):
It's not my strong suit where itis yours.
But I'd love to kind of just dive into, you know, what all
that entails, kind of like the lifespan of hormonal
fluctuations, you know, from puberty onward through
perimenopause, what to expect there.
I know that the talk of, you know, hormone replacement
therapy is, is very prominent right now.
(18:58):
I've had several people on the podcast diving into that.
Everyone seems to have their ownunique stance on it.
So I'd love to just kind of I peel the curtain back on all
that. So the the the floor is you're
just enlighten us. About which aspect?
I guess just for the listeners, can you kind of educate them
from a introductory view, like what happens hormonally speaking
in women throughout the different lifestyle stages?
(19:19):
Like what? What can be expected there
naturally? And then what does HRT do to
combat then? Well, I think the biggest, the
biggest, a misnomer out there that I'm seeing right now is
it's a, it's quite, a, quite a catch phrase now to use the word
perimenopause. And the problem is, is now
perimenopause and menopause are turning into a big business
(19:40):
because the the Boomers and now the Gen.
Xers are getting into that age group.
And there's a lot of publicity. And you have all these
celebrities now that are hitting5055 and they're discovering
this supplement that nobody knewabout for the last 50 years, and
it's helping all their symptoms.And so it's a big market.
(20:03):
Which is good because it brings attention.
But the problem is perimenopauseis being utilized as a word that
it's like a disease. Perimenopause is not a medical
disorder. It's, it's a, it's a word.
So perimenopause simply in Latinjust means around menopause.
So I have women say, oh, my doctor told me I'm in
perimenopause and how do I fix it?
(20:25):
Well, it's not a, it's not a disease process.
It's just a word and it's like saying that you're around
menopause, but what you want to focus on is what are the
problems? You know, what are the issues
that you're having in that, in that area?
And, and women, you know, I would say perimenopause if we're
(20:46):
looking at an age range and it's, this is not defined, it's
just me saying stuff. Probably somewhere between 35 to
55 is perimenopause. Menopause by medical definitions
is when you haven't had a periodfor 12 months and you're of that
age group. I personally think that's a
really ridiculous definition andwe should do a lot better than
(21:08):
that because that basically saysthat, oh, you have to suffer for
12 months before we'll actually help you and give you the
diagnosis. But you can make the diagnosis
of menopause with labs also. So women don't have to to wait,
but they can, you know, ask their doctors for lab tests and
(21:29):
stuff like that. So it's just one of those things
where we have to, you know, we have to draw labs, we have to
listen to patients. But suffice it to say, any woman
that is in that age range, and Isee women younger than 35, the
women in their 20s that also have some of these symptoms.
So it's really not something youhave to like meet some strict
(21:51):
criteria, but let's just say you're in that age range, 30 to
50, typical signs and symptoms. And usually I say these signs
and symptoms, if you are noticing that they are starting
to kind of interfere with the way that you live your life or
the way that you want to live your life, have you just have
(22:14):
like insomnia for a couple of nights?
I probably wouldn't worry about it.
But if it's an overriding issue for you.
So like, insomnia is a big one. You know, obviously the ones we
know all about hot flashes, night sweats, mood swings,
weight gain, decrease drive, desire, you know what I call
(22:35):
meh. You know, you just don't feel,
you just don't feel like you normally do.
You just feel just kind of blah.You're just not the same person
you would want to be. And it's just one of those
things where you have to ask, you ask questions.
And, you know, the problem is a lot of women these days get
(22:58):
gaslighted and told like, oh, you're too young, oh, you look
fine or you're too old. It's just part of getting older.
And so this is causing some of the problem.
And then the other thing is doctors will say, oh, you don't
need to do labs. You're, you're, you know, your
levels fluctuate so much, why bother doing labs?
And so there's so much out there, misinformation about
(23:21):
there. The doctors aren't really
defining the issue and helping women.
They're kind of gaslighting. So it's really causing this, you
know, kind of issue where women don't know what to do and they
don't know where to get the help.
Yeah, no, I totally, totally agree.
And when it comes to one thing I've always kind of questioned
is like what is how much of their hormonal flux now is, is
(23:45):
totally natural versus a result of, you know, confounding
factors that are coming from an environmental standpoint.
Like we have obviously much moretoxins in our environment now
than we did 100 years ago. The foods that we're consuming
now are a little bit different. Like how much of that is truly
impacting that fluctuation hormones, or how much of that is
just simply natural fluctuationsin hormones as people age?
(24:07):
Well, like I said, the, you know, the I, my book is called
the Hormone Balance Bible. And a lot of my colleagues will
get hung up on the word balance and they'll say, you know, oh,
the hormones are never, never balanced.
They're, they're always fluctuating.
And that's true. So even during your cycle, your
hormones are going up and down, you know, second-half of your
(24:27):
cycle, progesterone's high, first half and estrogen's high.
When you ovulate, testosterone'shigh.
And so it's just, it's just that.
But what what we know is I know on day 21 you should have a
spike in progesterone. So while it's fluctuating, we
kind of know where they should be.
(24:48):
So it's not like you, you can't do it, you know, you can't check
and you can't look at it. So I think that's an issue is
that this, this idea of, of imbalance and fluctuation, it
can be normal. There are times in life, a
woman's life, when fluctuation or, you know, imbalance is
(25:10):
normal. Puberty's one for sure.
Pregnancy's another one. And menopause is one, you know,
menopause is a natural state. It's, it's not abnormal, normal,
it's what your body does. And I always say it, it can
suck, but it's not an abnormal state.
And so when women come in and they say, well, I want to do
(25:32):
this naturally, well, that wouldbe doing nothing because that's
pretty natural. But you know, then if you don't
like the, if you're coming in, it's probably because you, you
don't like the way that that feels.
So you want to do something. So I think we need to get over
this concept of fluctuation and an imbalance in the sense that
(25:53):
there can be times when that's normal, but we focus more on,
OK, you have this symptom and you have this imbalance.
So those are probably something we need to look at and fix.
Totally. So when it comes to menopause,
if they're, if that is as it is a natural phenomenon, would
women like what kind of dictateswhether or not it's tolerable or
(26:13):
not? Is it like more so a personal
threshold or I mean, it's, it's a recent phenomenon that we are
taking HRT during menopausal years to make that less sucky as
you say. But I mean, how much of that is
going to be just personal threshold based?
Like is it going to be relatively consistent across the
board? Is there any implications for,
(26:36):
you know, getting off HRT once those menopausal years are over?
Like what? What's kind of the the best way
to go about that? I don't think it's new.
I was prescribing hormones, gosh, back in the late 90s.
It's just that the options, the options that we had at that time
(26:58):
or somewhat limited, we basically had Premarin and
Provera and birth control pills.We had other things, but nobody
really used them. They were these, you know, kind
of what's happening now is we have women because they want
more quote UN quote natural forms like that are made from
soy or wild yam, you know, bioidentical progesterone,
(27:19):
bioidentical estrogen, testosterone.
I think that there's a shifting towards a different type of
hormone replacement. And because of that, and like I
told you earlier with the marketing and what not, I think
it's just driving this concept for women that, you know,
there's other things out there that we can do and that we can
(27:40):
use. So like I said, the the
prescriptions haven't really changed a whole lot in the sense
that we're prescribing. We've always been prescribing.
What's funny though, and this iswhat's really fascinating to me,
is that we might be prescribing,but there seems to be more
resistance. And a lot of the resistance to
(28:02):
prescribing hormones actually comes from the Women's Health
Initiative, which was that horrible, horrible study that
came out about 15 years ago thatbasically scared an entire
generation of women and doctors from using estrogen.
That was because of the supposedincrease in breast cancer,
(28:23):
right? Yeah, that study, what's funny
is that study had two arms. It had an estrogen only arm and
it had an estrogen progesterone arm.
And keep in mind the hormones used were Premarin and Prem Pro,
which were made from basically horse urine.
So they're totally synthetic. And what they found was that the
(28:45):
arm that had estrogen and progesterone are the Prem pro
had an increased risk of breast cancer, increased risk of deep
venous thrombosis. What's interesting is that we
always knew that was a risk because it was in the package
insert. It was no different than what
was already in the package insert and it was just
publicized to no end and women were freaked out.
(29:09):
The interesting thing was the estrogen only arm or the
Premarin only arm did not have an increased risk of breast
cancer. It was the combination of the
two medicines. So the estrogen only arm didn't
have any problems and actually had a 50% decrease in colon
cancer rates. But you didn't really hear about
(29:30):
that because it wasn't as exciting for the news channel.
So you really have to look at these things with, you know,
different aspects every once in a while because you have to, you
have to read through the data and it just wasn't, we didn't
get good data. Yeah, yeah, no, data.
Data is key. And if you get junk in, you get
(29:51):
junk out for sure. And I feel like there's just so
much misinformation out there and people don't know what to
put their faith in as it pertains to and what the studies
show and what's going to actually happen when when it
comes. I'll just do a hypothetical
example here. Like let's say we have the a
clone of the same individual. We have two of them and we have
them going through menopausal years and one OPS to take in HRT
(30:13):
during those years and one OPS to keep things totally natural.
Can you kind of give us a play by play on what those two
hypothetical characters could expect through menopause but
then also beyond? You mean looking at you're
saying somebody that wants to doit naturally versus someone that
wants to use medications? Exactly.
(30:34):
I mean, the person that wants todo it natural is like I said,
it's one of those things where it's, you can try to supplement
your way out of it, but it's really, really hard because you
can't really give yourself you can.
(30:54):
I, I, I looked at this once to try and see like how much soy
would you have to eat to get ridof, you know, the get rid of the
symptoms and you would have to literally drink about 8 glasses
of soy milk a day to get anything even remotely close to
what you would want therapeutically.
(31:16):
And who's going to do that? So the interesting thing is if
you want to, you know, we can help symptoms.
We can do like, you know, black cohosh or I'm a big fan of Mako,
which is a root plant from Peru.I'm a we can do Vitex maybe to,
(31:36):
but the problem is when your ovaries are done, when they when
they stop, you know, your estrogen progesterone basically
go to zero and your testosteroneeasily gets caught by about 50%.
And there's really no way to fixthat.
There are some studies now on stem cells, which could be
promising in the future. So natural is really tough
(31:57):
because you just, you know, you might focus say on the top one
or two things like, you know, hot flashes, insomnia, you know,
I might say to somebody with insomnia, hey, we can try hops,
you know, because I get women off of sleeping pills all the
time with hops or like I said, black cohosh or maca because
they can help with hot flashes and stuff.
(32:17):
So there are things that we can do to try and help alleviate
some of the symptoms like if a woman's having vaginal dryness
and that's her overriding symptom, you can use just a
vaginal application of estradiolthat may not get the systemic
levels up particularly high. So there's less risk.
(32:37):
Somebody that wants to do thingswith medications, it's one of
those things where we can, you know, basically I always draw
labs. I mean, even in menopause, I
like a 75 year old woman, somebody's like, why would you
draw her labs? Well, I know her estrogen and
progesterone are going to be 0, but what's her testosterone?
What's her DHEA? What's her, what's her thyroid
(32:58):
panel look like? You know, and then not to just
look at normal or abnormal because what's funny is like,
let's look at testosterone and normal free testosterone can be
zero to 6.4. What's fascinating about that
statement is 00 is considered normal.
(33:19):
And I don't know why. I don't know why we would
consider zero to be an A normal number, especially when it
doesn't feel particularly good. Now the interesting thing too
is, is let's say most women comeback around .4 on their
testosterone and they, the, I could multiply that #15 fold and
(33:41):
it would still be normal. So there's a huge range, right?
And it's one of those things where I, I don't know what, how
you feel. So you have to combine these
things with symptoms as well. It's not just numbers and it's
not just symptoms. So it's a combination of those
(34:01):
things. And if, if she's low and she
wants to try stuff, I use, you know, bioidentical HRT, which,
you know, kind of looks like your body's natural hormone that
you, that you would normally make.
And there's different options like there's topical creams,
there's sublingual tablets, there's capsules.
(34:22):
And I'm not a fan at all of pellets and injections, but
those are available out there too.
Is there many of your clientele pool that that do the HRT
throughout the menopausal years and then get off of it after
they're through menopause? Or they typically stay on some
form of HRT indefinitely. So I get that question a lot.
And the answer is there's no easy answer.
(34:45):
But women are always worried about, OK, well, they'll feel
better. Let's say we get them feeling
better. And they'll always ask, how long
can I do this? What's funny is men don't ask
that. You get, you get a man, you
know, feeling better. And they just, I'm going to do
this forever. Women worry about it because
there is still that lingering fear from the Women's Health
(35:06):
Initiative. And my, my answer to them is,
well, you can do this however long you want.
There was a recent study that came out about two months ago
that showed women over the age of 65.
There was 10 million women in this study.
So it was quite good over the age of 65 that were using HRT,
(35:28):
they had decreased rates of breast, colon and lung cancers.
They had decreased rates of dementia and they had a 19%
decrease in mortality. So I don't know.
I mean, to me that's like take it forever.
But if you have somebody that wants to, you know, try to
(35:50):
decrease their dose, I always, you know, say, hey, you can
taper down your dose at any timeand see how you feel.
That's the main thing is if you feel like good then why not
continue? Would there be any benefit to
the people that go naturally to not?
I mean, because once they're through menopausal years, those
(36:10):
levels, those blood markers are down relatively low anyways.
Like, is there any inherent benefit to going the natural
route once they get through those menopausal years and
things are less, you know, they,they feel, they feel more
stabilized. The problem is they they might
feel OK, but the things that aresilent are osteoporosis and
(36:36):
heart disease and more women dieof heart disease than any other,
you know, issue. But and we know that women who
are menopausal in their 60s and 70s that break a hip have a
mortality of about 50% because they're not walking and so and
those are silent. So I think if you wanted to go
off things probably wouldn't be a bad idea to keep up with your
(36:59):
DEXA scans your bone density so we know what your bone density
is doing and to maybe do a CT calcium arm cardiac calcium
score of your heart. See if you have any calcified
plaques in your heart. So you so you just knew you know
what was going on. Have there been many studies
done comparing a cohort that is taking HRT and those that aren't
(37:23):
looking at those two measures bychance?
Well, yeah, we know. I mean, we know for a fact that
women that don't use HRT will lose bone.
So, you know, The thing is that estrogen slows bone loss and
testosterone builds bone. So the combination of those two
is kind of a 1-2 punch for for that osteoporosis.
(37:45):
And we know that estrogen will raise HDL and will lower LDL,
the good cholesterol and the badcholesterol.
And it puts that's why women have lower rates of heart attack
than men because of the protective effects of estrogen.
We know that women who go into menopause that don't use
estrogen have the same rate of heart attack as men for the
(38:06):
first time in their entire lives, and it's because of that.
Gotcha. OK, Very interesting, very
interesting. Yeah, I feel like like I'm
asking some of these questions self because my mom, you know,
she's of that age and she's gonethe natural route, but she's
super active. And I would imagine that, you
know, being very active, doing resistance training, those are
all things that are very obviously environmental factors
(38:28):
that would reduce, you know, bone loss and and muscle loss.
It definitely helps because you know, probably more than I do
the increase. You know, a good friend of mine,
Gabrielle Lyon, she talks about muscle density and longevity,
and we know that the more muscleyou have, the longer you live.
Yeah, totally, totally. What about kind of flipping the
(38:51):
script and going on the earlier end of the spectrum talking
about hormones in in the youngerdemographic?
You know, it seems as though there is, you know, people are
people are using a lot of, you know, birth control pills
starting at a very young age andthere's not a whole lot of
information or there's probably a ton of information, but people
are probably not prioritizing the assimilation of that
(39:14):
information. So knowing what you know now,
would you, you know, put a word of caution out there?
Just how would you recommend people that are in the younger
categories go about that? Like should they focus more on
using those birth control mediums, modalities or should
they focus on, you know, tracking that and and not taking
in those hormones early on? Is there like a train of thought
(39:35):
there? Birth control pills are
completely different beasts because they are synthetic and
so they don't fit the keyhole the same way that a normal
hormone would and because of that they can exert more
influence and and change things.And so we know that birth
control pills can increase the rate of breast cancer.
(39:57):
However, we also know that girlsor women that take.
Birth control pills for at least12 months during their life have
a substantial decrease in the rates of ovarian cancer.
So that's that when we know theyincrease the rates of blood
clots and stroke and blood pressure issues.
It's really rare, but it happens.
I always say this, birth controlpills are great for birth
(40:20):
control if a woman needs because, you know, men, we don't
often take the, you know, we don't have many options.
We got condoms, that's about it when we're younger.
And so all the birth control or most of it is geared towards
women. So unfortunately, women have to
bear the brunt of family planning throughout most of
(40:42):
their lives. And the birth control pill is an
option and it gives them a good option, especially when they're
younger. So I don't like to dissuade
women from using birth control because it's, it's been around
for decades. It's for the most part, the
amount of hormone in the pills anymore is probably 1/5 of what
(41:02):
it used to be. So it's a lot lower.
The risks are a lot lower. When I have a problem with using
birth control pills is when we give them to women for
everything from polycystic ovarian syndrome to
perimenopause to menopause to depression.
I mean, we're using it for so many other things.
(41:23):
And it's more of a knee jerk because to me, I kind of call it
the get out of my office prescription, meaning doctors
don't have the time. So they're like, oh, we'll just
try this birth control pill and we'll see how you feel.
You know, it's and, and by the time you're shuffled out the
door, you're like, I don't want to do this, but it's like you're
(41:44):
already in the parking lot, you know?
Yeah. No, that makes total sense.
Speaking of the synthetic versusbioidentical, let's let's kind
of peel the curtain back on thatbecause I feel like a lot of
people are familiar with the term, but they may not be
familiar with what it means exactly.
So can you kind of compare the two?
Yeah. So basically you have to think
of it like, you know, it's funnybecause you'll get a lot of
(42:06):
people will say, well, everything's synthetic because
it has to be made. And that's true.
So like say estradiol and progesterone bioidentical
meaning that it looks almost exactly the same as your body's
natural hormone. They have to make those from
wild yam or soy. The interesting thing is you'll
(42:27):
find a lot of creams on like on Amazon and other places that are
called wild yam cream. And the the fascinating thing is
women buy that stuff all the time and it is the literally the
biggest scam on the planet because what happens is wild yam
has a chemical inside of it called diaspora.
(42:47):
And that chemical is what they use to make the hormone like the
progesterone, say. The problem is your body can't
use the dioscoria. So you can put it on, you can
slather it all over your skin, but you can't convert it in your
body from dioscoria to progesterone.
It has to be done in a lab. And so that's what I mean, is
(43:10):
that synthetic? I suppose.
But what I mean by synthetic is when they alter the chemicals so
that it's still looks similar toyour hormone, but they've
changed some bonds or they've added hydroxyl groups and
whatnot. And the reason they do that is
because you can patent it. You can't patent estradiol, you
(43:30):
can't patent testosterone, you can't patent from progesterone
because they're naturally occurring compounds, but you can
alter them and then you can patent them.
So the problem is when it's synthetic and it doesn't look
the same. If you tried to open a door with
a key that almost fit but didn'tquite fit, it might work, but
(43:52):
you're going to damage in a way,you're going to hit that
receptor different. And sometimes those when you hit
those receptors, they can have more side effects or they can be
super strong, or you can get different things that happen.
And so when I talk about synthetic versus bioidentical,
I'm basically meaning not so much that they're made, but that
(44:13):
they just don't look bioidentical meaning looks like
your body synthetic. I usually throw that into the
category that where they have changed it so that it's not
quite the same. Gotcha that makes total sense.
On on the note of the the wild yam scam, are there other pretty
prominent supplements that are popular in the industry people
(44:34):
getting them on Amazon that are a lot of just smoke and mirrors
not really effective. I know a lot of people use that
DIM supplement or have you heardof that?
Oh yeah, is that DIM is probablyone of the number one most
misprescribed supplements ever. The reason that most physicians
or practitioners will give DIM is because they they tell the
(44:57):
patient that it will help lower their estrogen levels.
DIM won't do anything. First of all, DIM diindo
methane, also something called indole 3 carbinol or I3C comes
from cruciferous vegetables likebroccoli, Brussels sprouts,
things like that. And the thought process is that
it helps you lower your estrogen.
(45:17):
It doesn't do anything to estrogen levels.
What happens is estradiol in your body turns into a
metabolite or another estrogen called estrone.
Your body then gets rid of estrone in different ways.
Your liver helps process it and then you basically get rid of
the rest of it through your GI tract.
So when your body breaks down estrone and this is a bit of
(45:40):
boring biochemistry, but it changes it into 16 methoxy
esterone bore methoxy esterone or two methoxy esterone, 16
methoxy esterone just kind of recycles back into the system. 4
methoxyestrone is labeled as a carcinogen and two
methoxyestrone is we think cancer protective.
So obviously you would want a patient to get rid of her
(46:03):
estrone by going more towards the two methoxyestrone pathway,
right? What DIM does is it takes a
patient who pushes more towards that carcinogenic form of doxy
estrone and helps her move to the two methoxy estrone pathway,
but it doesn't lower your levels.
Now if you wanted to lower estrogen or help your body, I
(46:24):
just had a patient earlier todayhelp your body get rid of
estrogen. Then you want to use something
called calcium D glucorate when when you eat more fiber.
So I first tell women that have high estrogen, you eat more
fiber. What happens is estrogen gloms
onto the fiber in the stool and then you poop it out.
We have an enzyme in our GI tract called glucuronidase that
(46:48):
cleaves the estrogen off and allows it go black back into the
bloodstream. And so calcium D glucorate
inhibits that enzyme. So you'll poop out more of your
estrogen more naturally. So that in tandem with the
increased fiber is pretty much the best tangible way to
decrease estrogen naturally. Got you Got What about sex
hormone bonding globulin? So sex hormone binding globulin
(47:11):
is a protein that circulates in the blood and it's basically
it's only job is to deactivate testosterone.
So women will whenever we get hormone levels, we our
testosterone, we get, we'll get a sex hormone binding globulin.
And So what happens is then that's what I tell women all the
(47:33):
time. When you are getting your
hormones checked, 90% of doctorswill order a total testosterone.
The problem with the total testosterone is that doesn't
tell you what's active in your body.
The active form of testosterone in your body is actually free
testosterone. So when you get a testosterone
(47:54):
level, you want to get free and total and a sex hormone binding
globulin. So the higher the sex hormone
binding globulin, the the lower your free testosterone.
So you could have a really good looking testosterone level, like
say your total is 60, which is right at the upper limits of
normal, but you could have a lowfree testosterone, which is the
(48:19):
active form. So you don't just want to look
at the one number. The, the number one thing that
raises sex hormone binding globulin and lowers testosterone
is estrogen, specifically birth control pills.
So women that are younger that are on birth control pills,
we're now finding that they haveno libido.
(48:39):
And part of that is because of the deactivation of their own
testosterone levels. So you have to kind of watch the
sex hormone binding globin if you're giving somebody estrogen.
Got you. What would be the best way to
decrease that SHBG naturally? You can do a couple things.
You can obviously look at the estrogen levels.
(49:03):
If your estrogen levels are high, then we want to do what I
talked about getting your getting your body to get rid of
more estrogen. But basically the big things are
going to be getting rid of body fat, working on a diet that's,
you know, less processed foods, sugar, lowering sugar and
(49:24):
getting your insulin levels under better control.
Got you. Yeah, No, that makes sense.
I would imagine with the trend upward in obesity, that's
probably had a pretty qualitative effect on the trend
with the hormone. Right, so birth control pills
probably #1 #2 is obesity. Yeah, that makes total sense.
(49:46):
Makes total sense and and your book is out currently, right?
Yeah, it came out in 2021 through Harper Collins.
It's on Amazon. Nice, nice.
I think that would be a awesome resource for many people.
What what, what is what is in the pipeline for you now?
What are you excited about working on at the moment?
Currently, I'm really focusing on reaching as many women as
(50:08):
possible. And you know, it's funny because
of those of us that are in this space.
I know you're on Instagram. I'm on Instagram, you know, just
there's so many things though, TikTok, YouTube, you know what I
just found out is that the female 6060 plus age group, I
mean they're all on YouTube. I had no idea.
(50:31):
I was amazed and and it's so exciting when you see like I
think I put out a video about the over age 65 estradiol study
that I talked about and 250,000 views and I was like, you see
the power and the potential of social media to get out good
information. So I'm trying to come up with a
(50:53):
membership site so I can share that information in a more
focused way rather because you know, you can't really talk in
specifics about medical stuff when you're online because you
don't want to give medical advice.
So I'm trying to get people moreinformation through a, more of a
membership site so they're more engaged.
(51:13):
I I still am really trying to push the aspects of patient
advocacy, I think especially women, getting them to be able
to ask the questions they want to ask and how to ask, how to
talk to your physician and things like that.
Do you feel like things are trending in the right direction
overall? Or as you're digging deeper into
(51:35):
just the language on online right now, seeing kind of where
people's heads are at, is it just like you're hitting your
head against the wall because there's so much misinformation
out there? Like is it, are you optimistic
or pessimistic, I guess about the way things are trending?
I'm optimistic I I'm pessimisticabout my colleagues and their
ability to change. However, as with all businesses,
(51:58):
if women vote with their voices and their feet and their
wallets, as patients start to leave the medical system and go
to alternative practitioners or nurse practitioners and doctors
start losing volume, they're going to start making some head
scratching moments where they'regoing to go wonder what's going
(52:19):
on. And well, maybe I should look at
this, you know, maybe I should figure this out.
But I'm, I'm optimistic with thefact that, I mean, I'm sorry, 10
years ago, nobody talked about this.
I mean, nobody, I was. But there were no, you know,
women out there talking about, you know, there's a, there's a
movie coming out, a biopic aboutaerimenopause and menopause.
(52:42):
So there's definitely things that are coming and, and you
know, the, the like I said just the other day, I'm like, I put
up this video and I had posted so many videos prior of hormones
and what not. But for some reason this one
podcast that I did on the estradiol thing after 65, I
(53:03):
mean, it was pretty exciting to just see the number of 65 plus
that were out there gathering information.
It was kind of cool. Yeah, I mean, I feel like
they're like 10 years ago, like you said, it didn't seem like
anybody was really going the route of integrated medicine.
You didn't really have anybody talking to you that was going
the route of functional medicine.
It was everyone going to their family doctor.
And I feel like now just in the podcasting that I've been doing,
(53:25):
I feel like almost everyone knows or uses a family medicine
doctor or a functional medicine doctor rather.
And they just they're, they're much more in the know.
They've got they're, they're speaking the language.
And it just seems to be this desire and push for digging
deeper than you know, a just a simple doctor visit and a
prescription. Well, look at, you know what's
(53:47):
funny? Look at, I mean, I'm 56.
So I remember way back when, when my grandmother was probably
50. And the women that are 50 today,
maybe it's because I'm 56, but they're pretty gorgeous.
(54:10):
The way that they look, the way that they deal with their
fitness, the way that they eat compared to women, you know,
30-40 years ago. It's just a different women are
living differently and they're, you know, they're, they're
behaving differently. And I think it's just, it's
time, you know, I think women are finally getting the health
(54:32):
care and the the look that they deserve.
I just think that it's been bad for so long that we're finally
getting there. Yeah, No, I totally agree.
I think overall we're trending in the right direction.
It's like, you know, there's certainly a lot more unhealth in
the society, it seems, but the same time that the people that
are are focusing on this, are digging deeper, are putting that
(54:56):
as a priority, seem to be getting healthier than ever.
So I feel like that the extremesare on both ends, basically.
Definitely. Well, awesome, Doctor Sean
Stone, I really appreciate the time.
I appreciate the the insight. Where do people go to find out
more about you and and dig deeper into your world?
As I said, Sean Tassone MD on Instagram.
I do daily or on weekly Saturdayquestions if you ever have a
(55:19):
question can't answer specifics but I'll try to give you as much
as I can. YouTube Sean Tassone The hormone
balance Bible is available on Amazon.
It's always a good place to start. 500 pages.
I think they're, I don't know how they do this and make any
money, but it's on sale for like$15 and it's really a good, a
(55:42):
good place to start. Nice, nice.
I will link out to all those make it easy for people to find
you. Is there any idea as to when
that memberships that you're alluding to might be going?
I am probably going to launch itthis month, so this is July.
So hopefully by mid to end of July we will have that going And
anybody that goes to my book or if you go to tassonemd.com, back
(56:05):
slash quiz, we all have quizzes,but mine's like 36 questions and
it's weighted because my book isall about the 12 most common
hormone imbalances and then I talk about them through the
language of archetypes or stories.
So like estrogen dominance, likewe talked about is called the
queen and then I go through the queen and how to fix that with
(56:26):
supplements and hormones and spiritual practices and
exercise, nutrition. And so it's a good place to
start because it's free the quizand I yes, I will take your
e-mail address, but that e-mail address will we will be letting
you know that the membership is open and I'll be talking about
it on Instagram as well. Nice, nice.
(56:47):
Well, I'm excited for a minute. It's going to be great.
You are certainly fighting the good fight, Sir.
So keep doing what you're doing.Keep changing lives.
And if there's everything I can do to help spread the word, man,
you just let me know. Thank you.
You bet. Take care, Sir.
You too.
Well, hello ladies and James Robert Sykes, Keto savage.com.
Today I've got special guest doctor Sean Tassone on the line.
He is a certified gynecologist. He is an OBGYN and we dive into
all things hormonal health as itpertains to women.
We talk about perimenopause. We talk about hormonal
fluctuations as it pertains to them in younger years.
Talk about birth control. We talk about HRT.
(00:22):
We talk about bioidentical hormones and synthetic hormones.
We talk about how to go about things optimally, from a natural
standpoint, what supplements onecan take well, the difference
between going naturally or usingHRT.
So we dive into all kinds of things as it pertains to Women's
Health and hormone function. So thoroughly into the
conversation. I took a lot of things from
this. I learned a ton.
(00:42):
I've got no doubt that you will as well.
So that further delay, sit back,relax, get your notepad out,
take some notes, learn somethingwith Doctor Sean Tesson and we
are live Doctor Sean Tesson. How are you Sir, doing?
(01:03):
Good. How are you?
I'm doing wonderfully well myself, so I've had multiple
guests on the podcast talking about hormonal health, Women's
Health, all that good stuff. You've been in this sport or not
sport, but I have, I guess, industry for quite some time.
I'd love to kind of just get some back story on what
compelled you to go this direction to begin with and what
kind of put the curtain back on what you've learned in the
process. Well, when you are in your 4th
(01:28):
year of medical school, you kindof have to decide what you want
to do and you set up your electives, if you will, kind of
in that area. And I thought initially that I
really wanted to do more medicine, just general internal
medicine. But what I found was that I
really wanted something that wasmore diverse.
(01:51):
And you'll also notice that certain professions in medicine
have their own, how would I describe it, personality traits.
So like, what I noticed was thatthe OBGYN residents were all
really, you know, fun. They were people you'd want to
hang out with. And, and, and then looking at
it, you know, there really isn'ta whole lot of death in, you
(02:14):
know, you're delivering babies. And there it's, it's more of a
kind of a fun profession. And so I just, it just seemed to
resonate more with me. The interesting thing was as I
proceeded through residency, my mom was diagnosed with ovarian
cancer in my second year of residency.
(02:36):
So I knew a lot about that disease process and I had access
to things. What I wasn't prepared for was
when she got through the chemo and all that stuff.
I've, I'm an only child and I felt really limited in what I
could do for my own mother. And I, I really was, I struggled
(02:56):
for a long time. And that's why I went the route
to answer your question of kind of the integrative approach was
that I, I couldn't help my own mother, like feel better just,
you know, live the last few years of her life with, you
know, some semblance of a normal, you know, happy life.
(03:19):
And so I felt really limited andjust vowed that I wasn't going
to let somebody else go through that.
And so I went the integrated route and did a bunch of extra
training, hoping that I would have more in my, you know, my
bag, as it were. I love it.
I love it. So when you went the integrative
(03:39):
rent, how far, how far were you into, you know, traditional
Western medicine in the sense, Imean, you were in your residency
at that point already, right? Yeah, when I, well, when I did,
I graduated from residency in 98and then I didn't start.
My mom was diagnosed in like probably right around then,
(04:01):
right around 98, and then she passed in 2001, and I didn't
start the integrative medicine stuff until about 2003.
Gotcha. Did you get a lot of support
with your peers that you went toresidency with and going that
route or were you kind of met with some criticism there?
(04:21):
You know, that was an interesting time because it was,
like I said, it was around 2005 and integrative medicine was
new. There was absolutely no such
thing as functional medicine. And so none of that was even
around. You know, that was kind of back
in the day of the Med spas kind of like popping up everywhere
(04:44):
and there was a lot of change going on.
But yeah, so if you want to talkabout what was happening back
then, it was funny. The reason I did it in the 1st
place was because I was reading this book at the time called 8
Weeks to Optimum Health by Andrew Weil.
And in that book he was talking about, which at the time was
(05:05):
crazy Omega threes, you know, fish oil, coq, 10 things now
that we kind of take for granted.
But back then was like land, youknow, land breaking.
And to think of, you know, hormone replacement and
bioidentical hormones, that was a little bit kind of outside the
box. So I got a little bit of
(05:26):
criticism, yeah, but I've never actually been a person to really
give a crap about that. Yeah, no, I totally relate with
you there. I feel like now the world of
innovative health functional medicine is, I mean, super
commonplace. Like, I don't feel like there is
that much. Again, this is not my
wheelhouse, but I would assume that there's not that much, you
(05:46):
know, criticism from someone going from one train of thought
to another as near as much as itwas 20 years ago.
But I would assume that's prettywell respected these days to
some extent, right? I think it's, you know, it's
really funny. I, I think it's completely, it's
very dichotomous because there are so many people out there
(06:09):
that still I don't. The problem is, and it's human
nature. I think functional type medicine
gets a lot of kickback because there's a lot of people out
there that abuse the word functional.
And so they sell a lot of tests,they push a lot of supplements
that don't have a lot of, you know, support.
(06:30):
And so my colleagues will grab onto that and they will say, oh,
well, this is another snake oil salesman or whatever.
I think if it was done in a morereasonable and moderated
approach, it would probably be better.
But the lines, you know, I'm in some physician Facebook groups
and the my colleagues are alwayscomplaining about how they, you
(06:53):
know, oh, that my patients go into this naturopath or they're
going to this doctor or whatever.
And my response is like, well, why are they going there?
They're going there because you are not providing them with the
care that they want. You're telling them, oh, I don't
need to order labs. Why would you want to do that?
And so they're going to go to somebody that will do they want.
And so we're kind of causing theproblem in a sense.
(07:17):
And yet then where you sit around and complain about it.
So it's quite, it's quite an interesting space to be in
because I've got one foot in in each space, you know.
Yeah, which I think like that's why I'm excited to talk to you
because I feel like I've talked to several people that are in
one wheelhouse or the other, butI've talked to a few that are in
(07:39):
both. And I think you just your, your
words carry a little bit more weight because you have that
perspective from both sides. And I feel like another issue
with the functional medicine space is that, and correct me if
I'm wrong, but I'm assuming it'snot quite as standardized in, in
this part, what you're saying with the moderation, but it's
probably not as standardized as traditional Western medicine.
I mean, you don't have there's, there's some instances where the
(08:00):
barrier to entry is much lower and the criteria to, you know,
obtain some form of certification is also probably
lower with some schools. And that would likely create
some frustration with people from the traditional space, I
would assume. Well, you know, as you know, you
can be now a doctor of anything.I mean, doctor of Divinity, Dr.
(08:25):
there's even stuff that's, you know, made-up now like doctor of
natural medicine. I mean that you can be a doctor
of anything. So I think what we've sort of
seen in the last five years is what I call the death of
expertise, because everybody on social media can be an expert.
And the problem is that's that'swrong on one side because
(08:46):
obviously you can't be an expertin everything.
Like I would never pretend to bean expert in men's health
because that's not what I do. But there are people out there
that will claim that. But then on the other side, the
doctors aren't really digging deep.
So like, let's say OBGYN and I use this, all of this analogy a
(09:07):
lot. If you look at every pregnant
woman that comes in, that's about a 2 1/2 thousand to $3000,
you know, investment or return on investment for the doctor.
You have a woman walk in that stays 60 and she wants to talk
about hormones, That's probably $100.
And you got to actually spend more time with that woman than
(09:30):
you do with the pregnant woman because that's pretty standard
in most cases. And then you talk about a return
appointment being maybe $50 after insurance, they just, if,
if a doctor is seeing 50 patients in a day, they're going
to gravitate more towards the bigger return on investment.
I think that's human nature. And so it really makes it hard.
(09:53):
That's why these other folks that are out there doing quote,
UN quote, you know, functional medicine, they, you know, that
one of the criticisms by the physicians is like, oh, they're
just doing it to make money. Well, we all make money.
I mean, none of us do anything for free.
So it's kind of a silly argument, but the patients are
paying it because they want the time, you know, and they want,
(10:14):
and I and, and unfortunately there is a misconception out
there that the more you spend, the better it must be.
But but yeah, it's it's, I thinkit's a confusing space for a lot
of women. Yeah, no, I totally agree.
As far as you know, this space in general, like I want to kind
of rewind the clock even further.
Like what What made you want to go the route of Med school,
(10:36):
becoming a physician? Like what was the the catalyst
for that? You know, it's funny, I really,
you know, even back probably a bit before I started college,
when you start thinking and like, what do I want to do?
I'm the only one in my family that went to college.
(10:56):
So it's not like I have this long history of doctors.
I didn't specifically feel like it's, you know, some doctors you
can figure it out like, oh, oh, this kid as a kid, this guy had
a seizure disorder or this person who was a childhood
diabetic and then they go into medicine because they want to
help other people. I didn't have that either.
(11:18):
But I think, you know, it's kindof sad to say, probably in the
beginning I realized that I wasn't an inside the box type
person. Like I couldn't envision myself
going to a job where I would go from 8:00 to 5:00 and do
investments or, you know, work in some big company because I'm
(11:39):
not good. I'm not good being told what to
do. Probably most of us in this
entrepreneurial space have some of that.
I knew I wanted to make as big an impact as as I could, and it
made sense to me that it just kind of, it wasn't really ever
something that I thought twice about.
(12:00):
I just knew that that I saw my stepdad kind of get ruined by
traditional business. Like he was a personnel manager
for some big company and it justdrove him to drink and, you
know, be stressed out all the time.
And I thought, well, I'm going to go into medicine because
then, you know, I can help a lotof people.
(12:20):
People can't tell me what to do.And but what's funny is when you
get into medicine, everybody's telling you what to do.
You got the insurance companies telling you what to do.
You got the hospitals telling you what to do, and it's just
like, it was kind of like one ofthose things where I was like,
oh, great, you know, 'cause I thought it was going to be
something different. But as you evolve as a person
and as a doctor, the beautiful thing is you can also evolve
(12:42):
your practice. And so I stopped doing OB about
seven years ago and was really able to focus on the hormones
and on the GYN stuff. Gotcha, gotcha.
So, so kind of break apart your your practice as it sits
currently. So you're not really doing, you
know, deliveries anymore, I would say assume.
(13:03):
I haven't done deliveries in about seven years.
And then I wrote a book in 2021 called the Hormone Balance
Bible. So since then I've really even
developed in the last three years more into a hormone
practice. But I also have this other piece
where I, it wasn't something that I was planning on, which is
(13:24):
how things tend to work. I did a, there's a, there was an
implant that was put in fallopian tubes from 2002 to
like 2018 called E Shore Essure.And it was a little metallic oil
that we would slide into the fallopian tubes and then over
three months it would scar shut.And there were about a million
(13:45):
of them put in. And what we noticed was women
were starting to have lots of pain, autoimmune reactions,
heavy periods, you know, all kinds of stuff.
And so I started removing them, which had to be done surgically.
And I, I sort of evolved into the guy in this country that
(14:06):
removes these coils and it probably done 1500 cases.
And so I have women, so not onlyhormones, but I have women fly
from around the country to have those coils removed.
So I do surgeries still for likefibroids and endometriosis and
and then I work with women on hormones.
Gotcha. Gotcha.
I'm assuming like most things inthe medical space, when they
(14:28):
were putting those in initially,what was the main, the main
reason for those? And was there, I guess, any
telltale signs at the time that those could be problematic down
the road? Well, there's a book coming out,
not by me, but there's a great, a great author that's writing a
book on the whole story. And suffice it to say, when you
(14:50):
look back at these medical devices, and I'm not saying all
medical devices, but there's always a back story.
And this particular company that's no longer in existence
called Conceptus is the company that came out with this product.
And we had been waiting for years, decades, for a procedure
where you could do sterilizationand you didn't have to do
(15:13):
abdominal surgery because guys are wimps and they won't get a
damn vasectomy. So women usually have to bear
the brunt of this kind of stuff.And So what happened was when
this came out, doctors were super excited because it was
this minimally invasive procedure.
Anyways, yes, it's coated with polyethyl trephylate fibers,
(15:37):
which is polyester. It's got nickel, titanium,
stainless steel. There's all these things in
there that can cause issues, especially nickel because a lot
of people have a nickel allergy.And what we noticed was that the
data, so we were given data through the FDA where there were
no pregnancies, there were no serious complications, women
(15:59):
that were doing fine, you know, and you know, come to find out
22 years later that a lot of it was fabricated.
And because what system where you have a company that spends
millions and millions of dollarson developing a product and then
you allow that same company to do the pilot study to say how
safe it is, just not a good system because they're going to
(16:23):
be biased towards their product because they've invested all
this money, right? They're not going to come out
and say, oh, it had all these problems because they're going
to lose millions and potentiallybillions of dollars.
And so it's just, it's got a seedy underbelly to it.
I don't like to be a conspiracy theorist, but it's not the best
way to do things. Yeah, there's been a few
(16:45):
instances of that happening in our not too distant past.
A lot of them, a lot of stuff. I mean, it's definitely, you
know, you see it with medications like Vioxx where you
know it it, you know, same thing.
It passed all the stuff, but then come to find out it
actually had a lot of complications that weren't
reported. Were were you with from a time
(17:07):
frame standpoint, were you performing the procedures on the
women like in in implanting those when that was cleared and
now it's now 20 years later you're the one removing them?
I had put a few in in my day. I stopped.
The reason that I made the, thatI made the shift to stop putting
(17:30):
them in and taking them out was because I had had a patient get
pregnant. And like I said, there wasn't a
way. I had never seen that before.
And then when I looked on the data and everything, there were
no reported pregnancies. And I was like, well,
something's not right. And so I started looking around
(17:52):
and found a couple Facebook groups where at the time, there
might have been 2000 members. And these were all women who
were having issues that I'd never heard of before.
And so I just kind of sat like afamily on the wall for months
and and kind of looked at all the stuff that they were
suffering with and then over time just started taking them
(18:16):
out. So it was just women that were
complaining about it. That kind of shifted the way I
was thinking. Yeah, no, it's, it's very
interesting. All right.
So I, I kind of want to put the curtain back on all things
women's hormonal health because this is something like I said,
I've had several people on the podcast that have dove into this
and I'm obviously not, this is not my wheelhouse.
(18:37):
It's not my strong suit where itis yours.
But I'd love to kind of just dive into, you know, what all
that entails, kind of like the lifespan of hormonal
fluctuations, you know, from puberty onward through
perimenopause, what to expect there.
I know that the talk of, you know, hormone replacement
therapy is, is very prominent right now.
(18:58):
I've had several people on the podcast diving into that.
Everyone seems to have their ownunique stance on it.
So I'd love to just kind of I peel the curtain back on all
that. So the the the floor is you're
just enlighten us. About which aspect?
I guess just for the listeners, can you kind of educate them
from a introductory view, like what happens hormonally speaking
in women throughout the different lifestyle stages?
(19:19):
Like what? What can be expected there
naturally? And then what does HRT do to
combat then? Well, I think the biggest, the
biggest, a misnomer out there that I'm seeing right now is
it's a, it's quite, a, quite a catch phrase now to use the word
perimenopause. And the problem is, is now
perimenopause and menopause are turning into a big business
(19:40):
because the the Boomers and now the Gen.
Xers are getting into that age group.
And there's a lot of publicity. And you have all these
celebrities now that are hitting5055 and they're discovering
this supplement that nobody knewabout for the last 50 years, and
it's helping all their symptoms.And so it's a big market.
(20:03):
Which is good because it brings attention.
But the problem is perimenopauseis being utilized as a word that
it's like a disease. Perimenopause is not a medical
disorder. It's, it's a, it's a word.
So perimenopause simply in Latinjust means around menopause.
So I have women say, oh, my doctor told me I'm in
perimenopause and how do I fix it?
(20:25):
Well, it's not a, it's not a disease process.
It's just a word and it's like saying that you're around
menopause, but what you want to focus on is what are the
problems? You know, what are the issues
that you're having in that, in that area?
And, and women, you know, I would say perimenopause if we're
(20:46):
looking at an age range and it's, this is not defined, it's
just me saying stuff. Probably somewhere between 35 to
55 is perimenopause. Menopause by medical definitions
is when you haven't had a periodfor 12 months and you're of that
age group. I personally think that's a
really ridiculous definition andwe should do a lot better than
(21:08):
that because that basically saysthat, oh, you have to suffer for
12 months before we'll actually help you and give you the
diagnosis. But you can make the diagnosis
of menopause with labs also. So women don't have to to wait,
but they can, you know, ask their doctors for lab tests and
(21:29):
stuff like that. So it's just one of those things
where we have to, you know, we have to draw labs, we have to
listen to patients. But suffice it to say, any woman
that is in that age range, and Isee women younger than 35, the
women in their 20s that also have some of these symptoms.
So it's really not something youhave to like meet some strict
(21:51):
criteria, but let's just say you're in that age range, 30 to
50, typical signs and symptoms. And usually I say these signs
and symptoms, if you are noticing that they are starting
to kind of interfere with the way that you live your life or
the way that you want to live your life, have you just have
(22:14):
like insomnia for a couple of nights?
I probably wouldn't worry about it.
But if it's an overriding issue for you.
So like, insomnia is a big one. You know, obviously the ones we
know all about hot flashes, night sweats, mood swings,
weight gain, decrease drive, desire, you know what I call
(22:35):
meh. You know, you just don't feel,
you just don't feel like you normally do.
You just feel just kind of blah.You're just not the same person
you would want to be. And it's just one of those
things where you have to ask, you ask questions.
And, you know, the problem is a lot of women these days get
(22:58):
gaslighted and told like, oh, you're too young, oh, you look
fine or you're too old. It's just part of getting older.
And so this is causing some of the problem.
And then the other thing is doctors will say, oh, you don't
need to do labs. You're, you're, you know, your
levels fluctuate so much, why bother doing labs?
And so there's so much out there, misinformation about
(23:21):
there. The doctors aren't really
defining the issue and helping women.
They're kind of gaslighting. So it's really causing this, you
know, kind of issue where women don't know what to do and they
don't know where to get the help.
Yeah, no, I totally, totally agree.
And when it comes to one thing I've always kind of questioned
is like what is how much of their hormonal flux now is, is
(23:45):
totally natural versus a result of, you know, confounding
factors that are coming from an environmental standpoint.
Like we have obviously much moretoxins in our environment now
than we did 100 years ago. The foods that we're consuming
now are a little bit different. Like how much of that is truly
impacting that fluctuation hormones, or how much of that is
just simply natural fluctuationsin hormones as people age?
(24:07):
Well, like I said, the, you know, the I, my book is called
the Hormone Balance Bible. And a lot of my colleagues will
get hung up on the word balance and they'll say, you know, oh,
the hormones are never, never balanced.
They're, they're always fluctuating.
And that's true. So even during your cycle, your
hormones are going up and down, you know, second-half of your
(24:27):
cycle, progesterone's high, first half and estrogen's high.
When you ovulate, testosterone'shigh.
And so it's just, it's just that.
But what what we know is I know on day 21 you should have a
spike in progesterone. So while it's fluctuating, we
kind of know where they should be.
(24:48):
So it's not like you, you can't do it, you know, you can't check
and you can't look at it. So I think that's an issue is
that this, this idea of, of imbalance and fluctuation, it
can be normal. There are times in life, a
woman's life, when fluctuation or, you know, imbalance is
(25:10):
normal. Puberty's one for sure.
Pregnancy's another one. And menopause is one, you know,
menopause is a natural state. It's, it's not abnormal, normal,
it's what your body does. And I always say it, it can
suck, but it's not an abnormal state.
And so when women come in and they say, well, I want to do
(25:32):
this naturally, well, that wouldbe doing nothing because that's
pretty natural. But you know, then if you don't
like the, if you're coming in, it's probably because you, you
don't like the way that that feels.
So you want to do something. So I think we need to get over
this concept of fluctuation and an imbalance in the sense that
(25:53):
there can be times when that's normal, but we focus more on,
OK, you have this symptom and you have this imbalance.
So those are probably something we need to look at and fix.
Totally. So when it comes to menopause,
if they're, if that is as it is a natural phenomenon, would
women like what kind of dictateswhether or not it's tolerable or
(26:13):
not? Is it like more so a personal
threshold or I mean, it's, it's a recent phenomenon that we are
taking HRT during menopausal years to make that less sucky as
you say. But I mean, how much of that is
going to be just personal threshold based?
Like is it going to be relatively consistent across the
board? Is there any implications for,
(26:36):
you know, getting off HRT once those menopausal years are over?
Like what? What's kind of the the best way
to go about that? I don't think it's new.
I was prescribing hormones, gosh, back in the late 90s.
It's just that the options, the options that we had at that time
(26:58):
or somewhat limited, we basically had Premarin and
Provera and birth control pills.We had other things, but nobody
really used them. They were these, you know, kind
of what's happening now is we have women because they want
more quote UN quote natural forms like that are made from
soy or wild yam, you know, bioidentical progesterone,
(27:19):
bioidentical estrogen, testosterone.
I think that there's a shifting towards a different type of
hormone replacement. And because of that, and like I
told you earlier with the marketing and what not, I think
it's just driving this concept for women that, you know,
there's other things out there that we can do and that we can
(27:40):
use. So like I said, the the
prescriptions haven't really changed a whole lot in the sense
that we're prescribing. We've always been prescribing.
What's funny though, and this iswhat's really fascinating to me,
is that we might be prescribing,but there seems to be more
resistance. And a lot of the resistance to
(28:02):
prescribing hormones actually comes from the Women's Health
Initiative, which was that horrible, horrible study that
came out about 15 years ago thatbasically scared an entire
generation of women and doctors from using estrogen.
That was because of the supposedincrease in breast cancer,
(28:23):
right? Yeah, that study, what's funny
is that study had two arms. It had an estrogen only arm and
it had an estrogen progesterone arm.
And keep in mind the hormones used were Premarin and Prem Pro,
which were made from basically horse urine.
So they're totally synthetic. And what they found was that the
(28:45):
arm that had estrogen and progesterone are the Prem pro
had an increased risk of breast cancer, increased risk of deep
venous thrombosis. What's interesting is that we
always knew that was a risk because it was in the package
insert. It was no different than what
was already in the package insert and it was just
publicized to no end and women were freaked out.
(29:09):
The interesting thing was the estrogen only arm or the
Premarin only arm did not have an increased risk of breast
cancer. It was the combination of the
two medicines. So the estrogen only arm didn't
have any problems and actually had a 50% decrease in colon
cancer rates. But you didn't really hear about
(29:30):
that because it wasn't as exciting for the news channel.
So you really have to look at these things with, you know,
different aspects every once in a while because you have to, you
have to read through the data and it just wasn't, we didn't
get good data. Yeah, yeah, no, data.
Data is key. And if you get junk in, you get
(29:51):
junk out for sure. And I feel like there's just so
much misinformation out there and people don't know what to
put their faith in as it pertains to and what the studies
show and what's going to actually happen when when it
comes. I'll just do a hypothetical
example here. Like let's say we have the a
clone of the same individual. We have two of them and we have
them going through menopausal years and one OPS to take in HRT
(30:13):
during those years and one OPS to keep things totally natural.
Can you kind of give us a play by play on what those two
hypothetical characters could expect through menopause but
then also beyond? You mean looking at you're
saying somebody that wants to doit naturally versus someone that
wants to use medications? Exactly.
(30:34):
I mean, the person that wants todo it natural is like I said,
it's one of those things where it's, you can try to supplement
your way out of it, but it's really, really hard because you
can't really give yourself you can.
(30:54):
I, I, I looked at this once to try and see like how much soy
would you have to eat to get ridof, you know, the get rid of the
symptoms and you would have to literally drink about 8 glasses
of soy milk a day to get anything even remotely close to
what you would want therapeutically.
(31:16):
And who's going to do that? So the interesting thing is if
you want to, you know, we can help symptoms.
We can do like, you know, black cohosh or I'm a big fan of Mako,
which is a root plant from Peru.I'm a we can do Vitex maybe to,
(31:36):
but the problem is when your ovaries are done, when they when
they stop, you know, your estrogen progesterone basically
go to zero and your testosteroneeasily gets caught by about 50%.
And there's really no way to fixthat.
There are some studies now on stem cells, which could be
promising in the future. So natural is really tough
(31:57):
because you just, you know, you might focus say on the top one
or two things like, you know, hot flashes, insomnia, you know,
I might say to somebody with insomnia, hey, we can try hops,
you know, because I get women off of sleeping pills all the
time with hops or like I said, black cohosh or maca because
they can help with hot flashes and stuff.
(32:17):
So there are things that we can do to try and help alleviate
some of the symptoms like if a woman's having vaginal dryness
and that's her overriding symptom, you can use just a
vaginal application of estradiolthat may not get the systemic
levels up particularly high. So there's less risk.
(32:37):
Somebody that wants to do thingswith medications, it's one of
those things where we can, you know, basically I always draw
labs. I mean, even in menopause, I
like a 75 year old woman, somebody's like, why would you
draw her labs? Well, I know her estrogen and
progesterone are going to be 0, but what's her testosterone?
What's her DHEA? What's her, what's her thyroid
(32:58):
panel look like? You know, and then not to just
look at normal or abnormal because what's funny is like,
let's look at testosterone and normal free testosterone can be
zero to 6.4. What's fascinating about that
statement is 00 is considered normal.
(33:19):
And I don't know why. I don't know why we would
consider zero to be an A normal number, especially when it
doesn't feel particularly good. Now the interesting thing too
is, is let's say most women comeback around .4 on their
testosterone and they, the, I could multiply that #15 fold and
(33:41):
it would still be normal. So there's a huge range, right?
And it's one of those things where I, I don't know what, how
you feel. So you have to combine these
things with symptoms as well. It's not just numbers and it's
not just symptoms. So it's a combination of those
(34:01):
things. And if, if she's low and she
wants to try stuff, I use, you know, bioidentical HRT, which,
you know, kind of looks like your body's natural hormone that
you, that you would normally make.
And there's different options like there's topical creams,
there's sublingual tablets, there's capsules.
(34:22):
And I'm not a fan at all of pellets and injections, but
those are available out there too.
Is there many of your clientele pool that that do the HRT
throughout the menopausal years and then get off of it after
they're through menopause? Or they typically stay on some
form of HRT indefinitely. So I get that question a lot.
And the answer is there's no easy answer.
(34:45):
But women are always worried about, OK, well, they'll feel
better. Let's say we get them feeling
better. And they'll always ask, how long
can I do this? What's funny is men don't ask
that. You get, you get a man, you
know, feeling better. And they just, I'm going to do
this forever. Women worry about it because
there is still that lingering fear from the Women's Health
(35:06):
Initiative. And my, my answer to them is,
well, you can do this however long you want.
There was a recent study that came out about two months ago
that showed women over the age of 65.
There was 10 million women in this study.
So it was quite good over the age of 65 that were using HRT,
(35:28):
they had decreased rates of breast, colon and lung cancers.
They had decreased rates of dementia and they had a 19%
decrease in mortality. So I don't know.
I mean, to me that's like take it forever.
But if you have somebody that wants to, you know, try to
(35:50):
decrease their dose, I always, you know, say, hey, you can
taper down your dose at any timeand see how you feel.
That's the main thing is if you feel like good then why not
continue? Would there be any benefit to
the people that go naturally to not?
I mean, because once they're through menopausal years, those
(36:10):
levels, those blood markers are down relatively low anyways.
Like, is there any inherent benefit to going the natural
route once they get through those menopausal years and
things are less, you know, they,they feel, they feel more
stabilized. The problem is they they might
feel OK, but the things that aresilent are osteoporosis and
(36:36):
heart disease and more women dieof heart disease than any other,
you know, issue. But and we know that women who
are menopausal in their 60s and 70s that break a hip have a
mortality of about 50% because they're not walking and so and
those are silent. So I think if you wanted to go
off things probably wouldn't be a bad idea to keep up with your
(36:59):
DEXA scans your bone density so we know what your bone density
is doing and to maybe do a CT calcium arm cardiac calcium
score of your heart. See if you have any calcified
plaques in your heart. So you so you just knew you know
what was going on. Have there been many studies
done comparing a cohort that is taking HRT and those that aren't
(37:23):
looking at those two measures bychance?
Well, yeah, we know. I mean, we know for a fact that
women that don't use HRT will lose bone.
So, you know, The thing is that estrogen slows bone loss and
testosterone builds bone. So the combination of those two
is kind of a 1-2 punch for for that osteoporosis.
(37:45):
And we know that estrogen will raise HDL and will lower LDL,
the good cholesterol and the badcholesterol.
And it puts that's why women have lower rates of heart attack
than men because of the protective effects of estrogen.
We know that women who go into menopause that don't use
estrogen have the same rate of heart attack as men for the
(38:06):
first time in their entire lives, and it's because of that.
Gotcha. OK, Very interesting, very
interesting. Yeah, I feel like like I'm
asking some of these questions self because my mom, you know,
she's of that age and she's gonethe natural route, but she's
super active. And I would imagine that, you
know, being very active, doing resistance training, those are
all things that are very obviously environmental factors
(38:28):
that would reduce, you know, bone loss and and muscle loss.
It definitely helps because you know, probably more than I do
the increase. You know, a good friend of mine,
Gabrielle Lyon, she talks about muscle density and longevity,
and we know that the more muscleyou have, the longer you live.
Yeah, totally, totally. What about kind of flipping the
(38:51):
script and going on the earlier end of the spectrum talking
about hormones in in the youngerdemographic?
You know, it seems as though there is, you know, people are
people are using a lot of, you know, birth control pills
starting at a very young age andthere's not a whole lot of
information or there's probably a ton of information, but people
are probably not prioritizing the assimilation of that
(39:14):
information. So knowing what you know now,
would you, you know, put a word of caution out there?
Just how would you recommend people that are in the younger
categories go about that? Like should they focus more on
using those birth control mediums, modalities or should
they focus on, you know, tracking that and and not taking
in those hormones early on? Is there like a train of thought
(39:35):
there? Birth control pills are
completely different beasts because they are synthetic and
so they don't fit the keyhole the same way that a normal
hormone would and because of that they can exert more
influence and and change things.And so we know that birth
control pills can increase the rate of breast cancer.
(39:57):
However, we also know that girlsor women that take.
Birth control pills for at least12 months during their life have
a substantial decrease in the rates of ovarian cancer.
So that's that when we know theyincrease the rates of blood
clots and stroke and blood pressure issues.
It's really rare, but it happens.
I always say this, birth controlpills are great for birth
(40:20):
control if a woman needs because, you know, men, we don't
often take the, you know, we don't have many options.
We got condoms, that's about it when we're younger.
And so all the birth control or most of it is geared towards
women. So unfortunately, women have to
bear the brunt of family planning throughout most of
(40:42):
their lives. And the birth control pill is an
option and it gives them a good option, especially when they're
younger. So I don't like to dissuade
women from using birth control because it's, it's been around
for decades. It's for the most part, the
amount of hormone in the pills anymore is probably 1/5 of what
(41:02):
it used to be. So it's a lot lower.
The risks are a lot lower. When I have a problem with using
birth control pills is when we give them to women for
everything from polycystic ovarian syndrome to
perimenopause to menopause to depression.
I mean, we're using it for so many other things.
(41:23):
And it's more of a knee jerk because to me, I kind of call it
the get out of my office prescription, meaning doctors
don't have the time. So they're like, oh, we'll just
try this birth control pill and we'll see how you feel.
You know, it's and, and by the time you're shuffled out the
door, you're like, I don't want to do this, but it's like you're
(41:44):
already in the parking lot, you know?
Yeah. No, that makes total sense.
Speaking of the synthetic versusbioidentical, let's let's kind
of peel the curtain back on thatbecause I feel like a lot of
people are familiar with the term, but they may not be
familiar with what it means exactly.
So can you kind of compare the two?
Yeah. So basically you have to think
of it like, you know, it's funnybecause you'll get a lot of
(42:06):
people will say, well, everything's synthetic because
it has to be made. And that's true.
So like say estradiol and progesterone bioidentical
meaning that it looks almost exactly the same as your body's
natural hormone. They have to make those from
wild yam or soy. The interesting thing is you'll
(42:27):
find a lot of creams on like on Amazon and other places that are
called wild yam cream. And the the fascinating thing is
women buy that stuff all the time and it is the literally the
biggest scam on the planet because what happens is wild yam
has a chemical inside of it called diaspora.
(42:47):
And that chemical is what they use to make the hormone like the
progesterone, say. The problem is your body can't
use the dioscoria. So you can put it on, you can
slather it all over your skin, but you can't convert it in your
body from dioscoria to progesterone.
It has to be done in a lab. And so that's what I mean, is
(43:10):
that synthetic? I suppose.
But what I mean by synthetic is when they alter the chemicals so
that it's still looks similar toyour hormone, but they've
changed some bonds or they've added hydroxyl groups and
whatnot. And the reason they do that is
because you can patent it. You can't patent estradiol, you
(43:30):
can't patent testosterone, you can't patent from progesterone
because they're naturally occurring compounds, but you can
alter them and then you can patent them.
So the problem is when it's synthetic and it doesn't look
the same. If you tried to open a door with
a key that almost fit but didn'tquite fit, it might work, but
(43:52):
you're going to damage in a way,you're going to hit that
receptor different. And sometimes those when you hit
those receptors, they can have more side effects or they can be
super strong, or you can get different things that happen.
And so when I talk about synthetic versus bioidentical,
I'm basically meaning not so much that they're made, but that
(44:13):
they just don't look bioidentical meaning looks like
your body synthetic. I usually throw that into the
category that where they have changed it so that it's not
quite the same. Gotcha that makes total sense.
On on the note of the the wild yam scam, are there other pretty
prominent supplements that are popular in the industry people
(44:34):
getting them on Amazon that are a lot of just smoke and mirrors
not really effective. I know a lot of people use that
DIM supplement or have you heardof that?
Oh yeah, is that DIM is probablyone of the number one most
misprescribed supplements ever. The reason that most physicians
or practitioners will give DIM is because they they tell the
(44:57):
patient that it will help lower their estrogen levels.
DIM won't do anything. First of all, DIM diindo
methane, also something called indole 3 carbinol or I3C comes
from cruciferous vegetables likebroccoli, Brussels sprouts,
things like that. And the thought process is that
it helps you lower your estrogen.
(45:17):
It doesn't do anything to estrogen levels.
What happens is estradiol in your body turns into a
metabolite or another estrogen called estrone.
Your body then gets rid of estrone in different ways.
Your liver helps process it and then you basically get rid of
the rest of it through your GI tract.
So when your body breaks down estrone and this is a bit of
(45:40):
boring biochemistry, but it changes it into 16 methoxy
esterone bore methoxy esterone or two methoxy esterone, 16
methoxy esterone just kind of recycles back into the system. 4
methoxyestrone is labeled as a carcinogen and two
methoxyestrone is we think cancer protective.
So obviously you would want a patient to get rid of her
(46:03):
estrone by going more towards the two methoxyestrone pathway,
right? What DIM does is it takes a
patient who pushes more towards that carcinogenic form of doxy
estrone and helps her move to the two methoxy estrone pathway,
but it doesn't lower your levels.
Now if you wanted to lower estrogen or help your body, I
(46:24):
just had a patient earlier todayhelp your body get rid of
estrogen. Then you want to use something
called calcium D glucorate when when you eat more fiber.
So I first tell women that have high estrogen, you eat more
fiber. What happens is estrogen gloms
onto the fiber in the stool and then you poop it out.
We have an enzyme in our GI tract called glucuronidase that
(46:48):
cleaves the estrogen off and allows it go black back into the
bloodstream. And so calcium D glucorate
inhibits that enzyme. So you'll poop out more of your
estrogen more naturally. So that in tandem with the
increased fiber is pretty much the best tangible way to
decrease estrogen naturally. Got you Got What about sex
hormone bonding globulin? So sex hormone binding globulin
(47:11):
is a protein that circulates in the blood and it's basically
it's only job is to deactivate testosterone.
So women will whenever we get hormone levels, we our
testosterone, we get, we'll get a sex hormone binding globulin.
And So what happens is then that's what I tell women all the
(47:33):
time. When you are getting your
hormones checked, 90% of doctorswill order a total testosterone.
The problem with the total testosterone is that doesn't
tell you what's active in your body.
The active form of testosterone in your body is actually free
testosterone. So when you get a testosterone
(47:54):
level, you want to get free and total and a sex hormone binding
globulin. So the higher the sex hormone
binding globulin, the the lower your free testosterone.
So you could have a really good looking testosterone level, like
say your total is 60, which is right at the upper limits of
normal, but you could have a lowfree testosterone, which is the
(48:19):
active form. So you don't just want to look
at the one number. The, the number one thing that
raises sex hormone binding globulin and lowers testosterone
is estrogen, specifically birth control pills.
So women that are younger that are on birth control pills,
we're now finding that they haveno libido.
(48:39):
And part of that is because of the deactivation of their own
testosterone levels. So you have to kind of watch the
sex hormone binding globin if you're giving somebody estrogen.
Got you. What would be the best way to
decrease that SHBG naturally? You can do a couple things.
You can obviously look at the estrogen levels.
(49:03):
If your estrogen levels are high, then we want to do what I
talked about getting your getting your body to get rid of
more estrogen. But basically the big things are
going to be getting rid of body fat, working on a diet that's,
you know, less processed foods, sugar, lowering sugar and
(49:24):
getting your insulin levels under better control.
Got you. Yeah, No, that makes sense.
I would imagine with the trend upward in obesity, that's
probably had a pretty qualitative effect on the trend
with the hormone. Right, so birth control pills
probably #1 #2 is obesity. Yeah, that makes total sense.
(49:46):
Makes total sense and and your book is out currently, right?
Yeah, it came out in 2021 through Harper Collins.
It's on Amazon. Nice, nice.
I think that would be a awesome resource for many people.
What what, what is what is in the pipeline for you now?
What are you excited about working on at the moment?
Currently, I'm really focusing on reaching as many women as
(50:08):
possible. And you know, it's funny because
of those of us that are in this space.
I know you're on Instagram. I'm on Instagram, you know, just
there's so many things though, TikTok, YouTube, you know what I
just found out is that the female 6060 plus age group, I
mean they're all on YouTube. I had no idea.
(50:31):
I was amazed and and it's so exciting when you see like I
think I put out a video about the over age 65 estradiol study
that I talked about and 250,000 views and I was like, you see
the power and the potential of social media to get out good
information. So I'm trying to come up with a
(50:53):
membership site so I can share that information in a more
focused way rather because you know, you can't really talk in
specifics about medical stuff when you're online because you
don't want to give medical advice.
So I'm trying to get people moreinformation through a, more of a
membership site so they're more engaged.
(51:13):
I I still am really trying to push the aspects of patient
advocacy, I think especially women, getting them to be able
to ask the questions they want to ask and how to ask, how to
talk to your physician and things like that.
Do you feel like things are trending in the right direction
overall? Or as you're digging deeper into
(51:35):
just the language on online right now, seeing kind of where
people's heads are at, is it just like you're hitting your
head against the wall because there's so much misinformation
out there? Like is it, are you optimistic
or pessimistic, I guess about the way things are trending?
I'm optimistic I I'm pessimisticabout my colleagues and their
ability to change. However, as with all businesses,
(51:58):
if women vote with their voices and their feet and their
wallets, as patients start to leave the medical system and go
to alternative practitioners or nurse practitioners and doctors
start losing volume, they're going to start making some head
scratching moments where they'regoing to go wonder what's going
(52:19):
on. And well, maybe I should look at
this, you know, maybe I should figure this out.
But I'm, I'm optimistic with thefact that, I mean, I'm sorry, 10
years ago, nobody talked about this.
I mean, nobody, I was. But there were no, you know,
women out there talking about, you know, there's a, there's a
movie coming out, a biopic aboutaerimenopause and menopause.
(52:42):
So there's definitely things that are coming and, and you
know, the, the like I said just the other day, I'm like, I put
up this video and I had posted so many videos prior of hormones
and what not. But for some reason this one
podcast that I did on the estradiol thing after 65, I
(53:03):
mean, it was pretty exciting to just see the number of 65 plus
that were out there gathering information.
It was kind of cool. Yeah, I mean, I feel like
they're like 10 years ago, like you said, it didn't seem like
anybody was really going the route of integrated medicine.
You didn't really have anybody talking to you that was going
the route of functional medicine.
It was everyone going to their family doctor.
And I feel like now just in the podcasting that I've been doing,
(53:25):
I feel like almost everyone knows or uses a family medicine
doctor or a functional medicine doctor rather.
And they just they're, they're much more in the know.
They've got they're, they're speaking the language.
And it just seems to be this desire and push for digging
deeper than you know, a just a simple doctor visit and a
prescription. Well, look at, you know what's
(53:47):
funny? Look at, I mean, I'm 56.
So I remember way back when, when my grandmother was probably
50. And the women that are 50 today,
maybe it's because I'm 56, but they're pretty gorgeous.
(54:10):
The way that they look, the way that they deal with their
fitness, the way that they eat compared to women, you know,
30-40 years ago. It's just a different women are
living differently and they're, you know, they're, they're
behaving differently. And I think it's just, it's
time, you know, I think women are finally getting the health
(54:32):
care and the the look that they deserve.
I just think that it's been bad for so long that we're finally
getting there. Yeah, No, I totally agree.
I think overall we're trending in the right direction.
It's like, you know, there's certainly a lot more unhealth in
the society, it seems, but the same time that the people that
are are focusing on this, are digging deeper, are putting that
(54:56):
as a priority, seem to be getting healthier than ever.
So I feel like that the extremesare on both ends, basically.
Definitely. Well, awesome, Doctor Sean
Stone, I really appreciate the time.
I appreciate the the insight. Where do people go to find out
more about you and and dig deeper into your world?
As I said, Sean Tassone MD on Instagram.
I do daily or on weekly Saturdayquestions if you ever have a
(55:19):
question can't answer specifics but I'll try to give you as much
as I can. YouTube Sean Tassone The hormone
balance Bible is available on Amazon.
It's always a good place to start. 500 pages.
I think they're, I don't know how they do this and make any
money, but it's on sale for like$15 and it's really a good, a
(55:42):
good place to start. Nice, nice.
I will link out to all those make it easy for people to find
you. Is there any idea as to when
that memberships that you're alluding to might be going?
I am probably going to launch itthis month, so this is July.
So hopefully by mid to end of July we will have that going And
anybody that goes to my book or if you go to tassonemd.com, back
(56:05):
slash quiz, we all have quizzes,but mine's like 36 questions and
it's weighted because my book isall about the 12 most common
hormone imbalances and then I talk about them through the
language of archetypes or stories.
So like estrogen dominance, likewe talked about is called the
queen and then I go through the queen and how to fix that with
(56:26):
supplements and hormones and spiritual practices and
exercise, nutrition. And so it's a good place to
start because it's free the quizand I yes, I will take your
e-mail address, but that e-mail address will we will be letting
you know that the membership is open and I'll be talking about
it on Instagram as well. Nice, nice.
(56:47):
Well, I'm excited for a minute. It's going to be great.
You are certainly fighting the good fight, Sir.
So keep doing what you're doing.Keep changing lives.
And if there's everything I can do to help spread the word, man,
you just let me know. Thank you.
You bet. Take care, Sir.
You too.
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