May 10, 2025 • 20 mins
Karen addresses the troubling rise in early-onset cancers among adults under 50, particularly women. Drawing on the latest research, she discusses contributing factors—from delayed screenings and family history to gut health, environmental exposures, and systemic inflammation. Karen also highlights how current healthcare gaps, lifestyle factors, and even prenatal influences may be playing a role in this growing health crisis.
Visit our website itchyandbitchy.com to read blog posts on the many topics we have covered on the show.
Visit our website itchyandbitchy.com to read blog posts on the many topics we have covered on the show.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
The content of this podcast is provided for general informational
purposes only and is not intended as nor should it
be considered a substitute for professional medical advice. Hello everyone,
(00:22):
This is Karen Nickel, family nurse practitioner, and this is
Itchy and Bitchy, a podcast that provides answers to your
many unanswered health questions. A quick reminder about my course
called the Perimenopause Answer. If you are going through this
phase of life called perimenopause, I would love to have
the opportunity to talk to you about the course to
(00:43):
see if it's the right fit for you. There is
a link on our website itchymbitchi dot com and our
Facebook page I and B Podcast where you can schedule
an appointment for a zoom call with me. When you
make an appointment, I will be sitting at my desk
waiting for you to join the one on one zoom call.
(01:04):
When launching into the decades of young adulthood, the focus
is usually on starting a career, making new friends, or
finding a partner, traveling the world, or just having fun.
One thing that is not on the list is worrying
about cancer. Unfortunately, cancer is occurring in more adults at
(01:27):
younger ages before they turn forty or fifty, or sometimes
even earlier. In the twenty twenty five release of the
American Cancer Society Statistics publication, the report reveals that for
women younger than fifty, the risk of developing cancer is
eighty two percent higher than men, up from fifty one
(01:51):
percent since two thousand and two. This marks the first
time cancer incidence rates in women under fifty have surpassed men.
What in the world is happening. The higher incidence rate
is contributed to the cases of breast cancer, which predominantly
(02:12):
affects women, and younger women tend to get more aggressive
forms of breast cancer than older women. Why is this happening? Well,
higher obesity rates, increased alcohol use, and having pregnancies later
in life have for a long time been identified as
risk factors for breast cancer. However, we're finally acknowledging that
(02:36):
there are still lots of unknowns. There are plenty of
young women diagnosed with breast cancer who have none of
the three risk factors of obesity, alcohol use, or waiting
to have a baby later in their productive life. So
what else is at play here? We have lots of
research on breast cancer prevention measures for women over fifty,
(03:00):
but not surprisingly, we have very little research involving younger women. Also,
many individuals in this age group are too young for
recommended routine cancer screenings. For example, mimmography screening typically starts
at age forty and cholonoscopies at age forty five, and
(03:21):
those ages were fairly recently lowered from fifty years old
for both screening tests. So what needs to happen here?
Because doctors and researchers don't yet know why early onset
cancers are increasing, the focus has shifted to increasing efforts
to diagnose these cancers early, when they are typically more treatable.
(03:46):
Prevention would be ideal, but we're working on finding the
cancers as early as possible, and family history has emerged
as a key factor in early diagnosis. For example, if
there is a family history of either colon cancer or
colon polyps, we usually start screening with a colonoscopy ten
(04:09):
to fifteen years before the family member who had it
was diagnosed. So if a first degree relative like your
birth mother or your birth father was diagnosed with colon
cancer or polyps at age forty five, your screening colonoscopy
should be scheduled at age thirty. The same is true
(04:32):
for breast cancer screening. If you are a woman who
has an average risk not high risk, for breast cancer,
you may start mimmography screening every two years, beginning at
the age of forty. But if you have a family
history of breast cancer, screening mimmography should start ten years
(04:54):
prior to the age of that family member's diagnosis. For example,
if the family member was diagnosed at age forty, you
would begin receiving screening mammograms starting at age thirty. In
addition to the issue with timing of the screening test,
young people's busy lives make it difficult for them to
(05:16):
keep up with routine primary care visits. During these visits,
a family history might alert the provider, who could then
recommend earlier screening. Others may not go to the doctor
because they have limited or no health insurance, that happens
all the time, or they believe their health problems are
not serious enough to warrant a visit. This can result
(05:40):
in a delayed diagnosis, which means the cancer may not
be diagnosed until it has reached a more advanced stage, which,
of course can be harder to treat. For young people
who have a significant family history of cancer in the family,
some providers are starting to refer them to a high
risk clinic to undergo a risk assessment. A high risk
(06:04):
clinic is one that includes a team of specialists including physicians, geneticists,
genetic counselors, and advanced practice providers who work together to
provide cancer genetics education, and coordination of the genetic testing
to help determine cancer risk. Many medical centers across the
(06:25):
country now have high risk clinics, including Yale Cancer Center,
Mayo Clinic, Cleveland Clinic, and Dana Farber Cancer Center, just
to name a few. Memorial Sloan Kettering Cancer Center has
programs for those already diagnosed with cancer, including young women
with breast cancer, the Center for Young Onset Coorectal and
(06:48):
Gastrointestinal Cancer, and the Lisa and Scott Stewart Center for
Adolescent and Young Adult Cancers. More on early onset cancers
and wyatt head happening after this quick break welcome back.
(07:20):
The American Cancer Society Annual Report showed continued increases in
such common cancers as breast, prostate, coorectal, cervical, and endometrial
cancers in young adults. The increasing incidence rates of a
number of cancers across generations like millennials or gen X,
(07:42):
have led some epidemiologists to suspect that exposures in early
life may be risk factors. Epidemiologists are looking at the
earliest parts of life, like fetal development in the womb, infancy,
and childhood, trying to figure out what is happening during
this important developmental time that's related to the risk of
(08:06):
developing cancer in adulthood later in life. One epidemiologist, doctor
Caitlin Murphy, a professor at ut Health Houston School of
Public Health, has been evaluating the data collected in a
study back in the nineteen fifties and sixties of a
big group of pregnant women enrolled in that study, Those
(08:29):
women and their children who they gave birth to have
been followed over time to the present day, so now
more than sixty years. It has allowed doctor Murphy and
others to look at those things early in life that
may be linked to cancer many decades later. In looking
(08:49):
at the data, they have found things like medications prescribed
during pregnancy that may be related to risk of coorectal
cancer in young adult office spring. These meds are commonly
prescribed for women during pregnancy, including anti NASA meds, antibiotics
for an infection, or synthetic hormones to prevent pre term birth.
(09:13):
They've also identified maternal characteristics like a mom's BMI body
mass index before she became pregnant or how much weight
she gained during pregnancy as important risk factors. Researchers are
also looking at the health of the gut microbiome and
its role in the development of early onset colorectal cancer.
(09:38):
I talk about the gut microbiome in my course for
perimenopausal women. This microbiome is comprised of bacteria, fungi, and
viruses that number around one hundred trillion. That's ten times
more cells than make up the human body. Because the
(10:00):
health of our gut microbiome is overlooked, it is often
referred to as the invisible organ. So when we're.
Speaker 2 (10:09):
Looking at colorectal cancer and the early onset of that
type of cancer, we have to think about the fact
that the cells that get mutated and form the cancer
are the ones that line the gut. These are the
cells that are in direct contact with the contents of
the gut, which includes food or whatever else we put
(10:32):
in our mouths, including a variety of environmental exposures, and
more importantly, the gut microbiome. So getting back to how
exposures early in life can influence our cancer risk. When
someone is exposed to antibiotics early in life, we know
that those antibiotics get rid of the bad bacteria, or
(10:55):
at least that's the plan, but it also kills good bacteria,
which sets the stage for other forms of bacteria that
are not so good to grow in the gut. So
researchers are looking into the link between an unhealthy microbiome
and the risk of early onset colorectal cancer. Figuring out
(11:19):
what puts us at risk for developing colorectal cancer early
in life is a critically important task because colorectal cancer
is now the leading cause of death in men younger
than fifty years of age and the second leading cause
of death for women younger than fifty. In addition to
(11:41):
looking at the microbiome, researchers are also investigating potential environmental
factors and lifestyle changes, such as increased alcohol, ultraprocessed foods,
and the use of prefasts, also known as forever chemicals.
But the challenge of studying the effects of chemicals on
(12:03):
the human body is that there are millions of chemicals,
so which chemicals should be chosen to study first. Also,
if you study one chemical at a time, we'll never
get an answer, at least not in our lifetime. We
just don't have time to wait for scientists to test
(12:24):
one chemical at a time. However, tools have been developed
for a task such as this, testing maybe ten thousand
chemicals at a time, but the research has to be
funded and that process takes time, and frankly, under our
current presidential administration, funding for medical research has been significantly cut,
(12:48):
so it will likely take even more time. Fortunately, there
are long term studies out there, like the one I
mentioned earlier on newborns and their mothers that started twenty
or thirty years ago and have been followed over that
entire time. So now as those newborns in the study
(13:09):
are aging into cancer risk, samples that were collected in
those studies might be used for this purpose, even though
that wasn't the purpose of the studies at the time
that those studies began. Are our younger people just more
inflamed Could that be a contributing factor? This very thing
(13:30):
has been examined, and one piece of info that comes
through loud and clear is that when you look at
the cells, the same colon cancer cells that you find
in young versus old patients, identical type cells, identical type cancers,
the younger patients' cancer cells have much stronger evidence of
(13:53):
injury and inflammation. Are our younger people living in a
more inflamed environment than the one in which I inhabited
when I went through childhood and young adulthood? And what
are the things that are causing that inflammation to happen?
Definite contributors to inflammation include, but aren't limited to, diets
(14:13):
high in bad fats, obesity, and smoking. Another thing researchers
have explored is the cellular aging by looking at blood
biomarkers for aging and guess what, they found that in
patients who have young onset colarectal cancer as well as
some other early onset cancers like breast cancer. They see
(14:36):
that the aging blood markers seen in much older people,
which we expect to see in much older people, are
already present in these younger patients, suggesting a form of
accelerated aging. We have long been of the mind that
it is just one thing, or one or two things
(14:58):
that put young adults at risk for developing early onset cancers.
But doctor Murphy, the epidemiologist I referred to earlier in
the episode, feels that a shift in our mindset is needed,
moving away from the belief that it's just obesity or
alcohol consumption or any other singular thing as the cause
(15:22):
changed that to truly looking at the possibility that it's
something we may have never considered before. I've always believed
in thinking outside the box, and we're going to have
to think outside the box a little bit to figure
out what is going on here. It could be sleep,
it could be stress. It could be poverty. It could
(15:43):
be environmental chemicals. It could be diet. It could be
sedentary lifestyle. It could be all of those things one
other thing. There are special considerations and concerns when treating
young adults when they're diagnosed in their when d's thirties
or forties, first family planning. Since some cancers and treatments
(16:07):
can create challenges with being able to become pregnant or
produce sperm, patients may need to make a decision about
freezing eggs or embryos, or whether to consider sperm banking.
Worries about whether or not insurance will cover the family
planning is another stressor. Younger women may also be concerned
(16:29):
that cancer treatment could cause early menopause. Chemotherapy may induce menopause,
or hormonal treatments that are specifically designed to produce an
early menopause may be necessary. Early menopause obviously shortens the
fertility window and can have other negative effects on overall
(16:50):
physical and emotional well being. Body image may also be
a concern for some. The hair loss that occurs with
chemotherapy is very stressing. The results of breast surgery can
also negatively impact self image, and when younger people are
diagnosed with cancer, they may struggle with the impact the
(17:12):
cancer or the treatment of the cancer can have on
their sexual health and how they feel about their bodies.
Some describe a sense of loss and fear related to
developing or sustaining intimate relationships after being diagnosed with and
treated for cancer at a young age. They still have
(17:33):
decades of life ahead of them, and so the possibility
of recurrence can be a significant source of worry for some.
I want to close with a couple of thoughts. If
you are a person under the age of fifty, or
you are close to people who are under the age
of fifty, please remind yourself or remind them to seek
(17:55):
medical advice in a timely manner if you have new
and or concerning symptoms. For example, if you are twenty
eight years old and you have an episode of rectal
bleeding for a day or two, don't blow it off.
Schedule an appointment to be seen. Yes, it may be hemorrhoids,
(18:15):
but that needs to be determined by a medical professional. Also,
to learn about how to support a healthy gut microbiome,
please listen to the Itchy and Bitchy episode titled trust
your Gut No, I mean trust your literal gut that
is dated November fifth, twenty twenty two. Healthy gut is
(18:38):
so important. Thank all of you for listening. Wherever you
listen to this podcast, please leave a review and rate
the podcast. Your reviews and ratings matter. Also, make sure
you follow the show so that it will be automatically downloaded.
That really matters. I encourage you to visit our Facebook
(18:58):
page I and B Podcast, where you can give us
a like and leave comments or questions for me. Our
website is Itchy and bitchy dot com, where there are
blogs with some of our subjects available for you to read. Also,
on the Facebook page and website, we have the information
about how to schedule an appointment with me so we
can chat about how my Perimid Pause chorus can help
(19:21):
you if you're going through this phase in life. As always,
thanks to Forest Winsle, our producer and composer of our
theme music and the person who does all the behind
the scenes work to make this podcast possible. Thank you
so much, Forest Winsle. Forest is days away from ending
his first very successful year at Peabody Music Conservatory. Boy,
(19:45):
that went by quickly for me, and maybe it did
for him too, but maybe not as fast as it
did for me. Remember that your health is in your hands,
she regard
The content of this podcast is provided for general informational
purposes only and is not intended as nor should it
be considered a substitute for professional medical advice. Hello everyone,
(00:22):
This is Karen Nickel, family nurse practitioner, and this is
Itchy and Bitchy, a podcast that provides answers to your
many unanswered health questions. A quick reminder about my course
called the Perimenopause Answer. If you are going through this
phase of life called perimenopause, I would love to have
the opportunity to talk to you about the course to
(00:43):
see if it's the right fit for you. There is
a link on our website itchymbitchi dot com and our
Facebook page I and B Podcast where you can schedule
an appointment for a zoom call with me. When you
make an appointment, I will be sitting at my desk
waiting for you to join the one on one zoom call.
(01:04):
When launching into the decades of young adulthood, the focus
is usually on starting a career, making new friends, or
finding a partner, traveling the world, or just having fun.
One thing that is not on the list is worrying
about cancer. Unfortunately, cancer is occurring in more adults at
(01:27):
younger ages before they turn forty or fifty, or sometimes
even earlier. In the twenty twenty five release of the
American Cancer Society Statistics publication, the report reveals that for
women younger than fifty, the risk of developing cancer is
eighty two percent higher than men, up from fifty one
(01:51):
percent since two thousand and two. This marks the first
time cancer incidence rates in women under fifty have surpassed men.
What in the world is happening. The higher incidence rate
is contributed to the cases of breast cancer, which predominantly
(02:12):
affects women, and younger women tend to get more aggressive
forms of breast cancer than older women. Why is this happening? Well,
higher obesity rates, increased alcohol use, and having pregnancies later
in life have for a long time been identified as
risk factors for breast cancer. However, we're finally acknowledging that
(02:36):
there are still lots of unknowns. There are plenty of
young women diagnosed with breast cancer who have none of
the three risk factors of obesity, alcohol use, or waiting
to have a baby later in their productive life. So
what else is at play here? We have lots of
research on breast cancer prevention measures for women over fifty,
(03:00):
but not surprisingly, we have very little research involving younger women. Also,
many individuals in this age group are too young for
recommended routine cancer screenings. For example, mimmography screening typically starts
at age forty and cholonoscopies at age forty five, and
(03:21):
those ages were fairly recently lowered from fifty years old
for both screening tests. So what needs to happen here?
Because doctors and researchers don't yet know why early onset
cancers are increasing, the focus has shifted to increasing efforts
to diagnose these cancers early, when they are typically more treatable.
(03:46):
Prevention would be ideal, but we're working on finding the
cancers as early as possible, and family history has emerged
as a key factor in early diagnosis. For example, if
there is a family history of either colon cancer or
colon polyps, we usually start screening with a colonoscopy ten
(04:09):
to fifteen years before the family member who had it
was diagnosed. So if a first degree relative like your
birth mother or your birth father was diagnosed with colon
cancer or polyps at age forty five, your screening colonoscopy
should be scheduled at age thirty. The same is true
(04:32):
for breast cancer screening. If you are a woman who
has an average risk not high risk, for breast cancer,
you may start mimmography screening every two years, beginning at
the age of forty. But if you have a family
history of breast cancer, screening mimmography should start ten years
(04:54):
prior to the age of that family member's diagnosis. For example,
if the family member was diagnosed at age forty, you
would begin receiving screening mammograms starting at age thirty. In
addition to the issue with timing of the screening test,
young people's busy lives make it difficult for them to
(05:16):
keep up with routine primary care visits. During these visits,
a family history might alert the provider, who could then
recommend earlier screening. Others may not go to the doctor
because they have limited or no health insurance, that happens
all the time, or they believe their health problems are
not serious enough to warrant a visit. This can result
(05:40):
in a delayed diagnosis, which means the cancer may not
be diagnosed until it has reached a more advanced stage, which,
of course can be harder to treat. For young people
who have a significant family history of cancer in the family,
some providers are starting to refer them to a high
risk clinic to undergo a risk assessment. A high risk
(06:04):
clinic is one that includes a team of specialists including physicians, geneticists,
genetic counselors, and advanced practice providers who work together to
provide cancer genetics education, and coordination of the genetic testing
to help determine cancer risk. Many medical centers across the
(06:25):
country now have high risk clinics, including Yale Cancer Center,
Mayo Clinic, Cleveland Clinic, and Dana Farber Cancer Center, just
to name a few. Memorial Sloan Kettering Cancer Center has
programs for those already diagnosed with cancer, including young women
with breast cancer, the Center for Young Onset Coorectal and
(06:48):
Gastrointestinal Cancer, and the Lisa and Scott Stewart Center for
Adolescent and Young Adult Cancers. More on early onset cancers
and wyatt head happening after this quick break welcome back.
(07:20):
The American Cancer Society Annual Report showed continued increases in
such common cancers as breast, prostate, coorectal, cervical, and endometrial
cancers in young adults. The increasing incidence rates of a
number of cancers across generations like millennials or gen X,
(07:42):
have led some epidemiologists to suspect that exposures in early
life may be risk factors. Epidemiologists are looking at the
earliest parts of life, like fetal development in the womb, infancy,
and childhood, trying to figure out what is happening during
this important developmental time that's related to the risk of
(08:06):
developing cancer in adulthood later in life. One epidemiologist, doctor
Caitlin Murphy, a professor at ut Health Houston School of
Public Health, has been evaluating the data collected in a
study back in the nineteen fifties and sixties of a
big group of pregnant women enrolled in that study, Those
(08:29):
women and their children who they gave birth to have
been followed over time to the present day, so now
more than sixty years. It has allowed doctor Murphy and
others to look at those things early in life that
may be linked to cancer many decades later. In looking
(08:49):
at the data, they have found things like medications prescribed
during pregnancy that may be related to risk of coorectal
cancer in young adult office spring. These meds are commonly
prescribed for women during pregnancy, including anti NASA meds, antibiotics
for an infection, or synthetic hormones to prevent pre term birth.
(09:13):
They've also identified maternal characteristics like a mom's BMI body
mass index before she became pregnant or how much weight
she gained during pregnancy as important risk factors. Researchers are
also looking at the health of the gut microbiome and
its role in the development of early onset colorectal cancer.
(09:38):
I talk about the gut microbiome in my course for
perimenopausal women. This microbiome is comprised of bacteria, fungi, and
viruses that number around one hundred trillion. That's ten times
more cells than make up the human body. Because the
(10:00):
health of our gut microbiome is overlooked, it is often
referred to as the invisible organ. So when we're.
Speaker 2 (10:09):
Looking at colorectal cancer and the early onset of that
type of cancer, we have to think about the fact
that the cells that get mutated and form the cancer
are the ones that line the gut. These are the
cells that are in direct contact with the contents of
the gut, which includes food or whatever else we put
(10:32):
in our mouths, including a variety of environmental exposures, and
more importantly, the gut microbiome. So getting back to how
exposures early in life can influence our cancer risk. When
someone is exposed to antibiotics early in life, we know
that those antibiotics get rid of the bad bacteria, or
(10:55):
at least that's the plan, but it also kills good bacteria,
which sets the stage for other forms of bacteria that
are not so good to grow in the gut. So
researchers are looking into the link between an unhealthy microbiome
and the risk of early onset colorectal cancer. Figuring out
(11:19):
what puts us at risk for developing colorectal cancer early
in life is a critically important task because colorectal cancer
is now the leading cause of death in men younger
than fifty years of age and the second leading cause
of death for women younger than fifty. In addition to
(11:41):
looking at the microbiome, researchers are also investigating potential environmental
factors and lifestyle changes, such as increased alcohol, ultraprocessed foods,
and the use of prefasts, also known as forever chemicals.
But the challenge of studying the effects of chemicals on
(12:03):
the human body is that there are millions of chemicals,
so which chemicals should be chosen to study first. Also,
if you study one chemical at a time, we'll never
get an answer, at least not in our lifetime. We
just don't have time to wait for scientists to test
(12:24):
one chemical at a time. However, tools have been developed
for a task such as this, testing maybe ten thousand
chemicals at a time, but the research has to be
funded and that process takes time, and frankly, under our
current presidential administration, funding for medical research has been significantly cut,
(12:48):
so it will likely take even more time. Fortunately, there
are long term studies out there, like the one I
mentioned earlier on newborns and their mothers that started twenty
or thirty years ago and have been followed over that
entire time. So now as those newborns in the study
(13:09):
are aging into cancer risk, samples that were collected in
those studies might be used for this purpose, even though
that wasn't the purpose of the studies at the time
that those studies began. Are our younger people just more
inflamed Could that be a contributing factor? This very thing
(13:30):
has been examined, and one piece of info that comes
through loud and clear is that when you look at
the cells, the same colon cancer cells that you find
in young versus old patients, identical type cells, identical type cancers,
the younger patients' cancer cells have much stronger evidence of
(13:53):
injury and inflammation. Are our younger people living in a
more inflamed environment than the one in which I inhabited
when I went through childhood and young adulthood? And what
are the things that are causing that inflammation to happen?
Definite contributors to inflammation include, but aren't limited to, diets
(14:13):
high in bad fats, obesity, and smoking. Another thing researchers
have explored is the cellular aging by looking at blood
biomarkers for aging and guess what, they found that in
patients who have young onset colarectal cancer as well as
some other early onset cancers like breast cancer. They see
(14:36):
that the aging blood markers seen in much older people,
which we expect to see in much older people, are
already present in these younger patients, suggesting a form of
accelerated aging. We have long been of the mind that
it is just one thing, or one or two things
(14:58):
that put young adults at risk for developing early onset cancers.
But doctor Murphy, the epidemiologist I referred to earlier in
the episode, feels that a shift in our mindset is needed,
moving away from the belief that it's just obesity or
alcohol consumption or any other singular thing as the cause
(15:22):
changed that to truly looking at the possibility that it's
something we may have never considered before. I've always believed
in thinking outside the box, and we're going to have
to think outside the box a little bit to figure
out what is going on here. It could be sleep,
it could be stress. It could be poverty. It could
(15:43):
be environmental chemicals. It could be diet. It could be
sedentary lifestyle. It could be all of those things one
other thing. There are special considerations and concerns when treating
young adults when they're diagnosed in their when d's thirties
or forties, first family planning. Since some cancers and treatments
(16:07):
can create challenges with being able to become pregnant or
produce sperm, patients may need to make a decision about
freezing eggs or embryos, or whether to consider sperm banking.
Worries about whether or not insurance will cover the family
planning is another stressor. Younger women may also be concerned
(16:29):
that cancer treatment could cause early menopause. Chemotherapy may induce menopause,
or hormonal treatments that are specifically designed to produce an
early menopause may be necessary. Early menopause obviously shortens the
fertility window and can have other negative effects on overall
(16:50):
physical and emotional well being. Body image may also be
a concern for some. The hair loss that occurs with
chemotherapy is very stressing. The results of breast surgery can
also negatively impact self image, and when younger people are
diagnosed with cancer, they may struggle with the impact the
(17:12):
cancer or the treatment of the cancer can have on
their sexual health and how they feel about their bodies.
Some describe a sense of loss and fear related to
developing or sustaining intimate relationships after being diagnosed with and
treated for cancer at a young age. They still have
(17:33):
decades of life ahead of them, and so the possibility
of recurrence can be a significant source of worry for some.
I want to close with a couple of thoughts. If
you are a person under the age of fifty, or
you are close to people who are under the age
of fifty, please remind yourself or remind them to seek
(17:55):
medical advice in a timely manner if you have new
and or concerning symptoms. For example, if you are twenty
eight years old and you have an episode of rectal
bleeding for a day or two, don't blow it off.
Schedule an appointment to be seen. Yes, it may be hemorrhoids,
(18:15):
but that needs to be determined by a medical professional. Also,
to learn about how to support a healthy gut microbiome,
please listen to the Itchy and Bitchy episode titled trust
your Gut No, I mean trust your literal gut that
is dated November fifth, twenty twenty two. Healthy gut is
(18:38):
so important. Thank all of you for listening. Wherever you
listen to this podcast, please leave a review and rate
the podcast. Your reviews and ratings matter. Also, make sure
you follow the show so that it will be automatically downloaded.
That really matters. I encourage you to visit our Facebook
(18:58):
page I and B Podcast, where you can give us
a like and leave comments or questions for me. Our
website is Itchy and bitchy dot com, where there are
blogs with some of our subjects available for you to read. Also,
on the Facebook page and website, we have the information
about how to schedule an appointment with me so we
can chat about how my Perimid Pause chorus can help
(19:21):
you if you're going through this phase in life. As always,
thanks to Forest Winsle, our producer and composer of our
theme music and the person who does all the behind
the scenes work to make this podcast possible. Thank you
so much, Forest Winsle. Forest is days away from ending
his first very successful year at Peabody Music Conservatory. Boy,
(19:45):
that went by quickly for me, and maybe it did
for him too, but maybe not as fast as it
did for me. Remember that your health is in your hands,
she regard
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