The Real Science of Perimenopause & Menopause | Ep. 258 - The Aging Well Podcast

Episode Transcript
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(00:04):
Welcome to the Aging World Podcast, where we explore the
science stories and strategy behind living a longer,
healthier, and more purposeful life.
In this episode, we're joined byscience writer and provocateur
Amy Alcott, author of the groundbreaking new book Going
Menopostal. What You and Your Doctor Should
Know About The Real Science of Menopause and Paramenopause.
Amy's work pulls no punches. She exposes the unsettling truth

(00:26):
about how much of modern medicine, especially around
Women's Health, isn't grounded in solid evidence.
And it's not just about menopause.
From the broken medical systems to the myths around diet,
exercise, and aging itself, Amy shows us how we can reclaim our
health, our vitality, and even our identity as we age.
We talked about how to outsmart our biology and behavioral

(00:47):
patterns to build sustainable habits without needing to be
Saints of discipline. Amy shares the most powerful and
efficient ways to eat and exercise for cellular health and
longevity, why inflammation and insulin resistance are at the
root of much suffering, and how we can get the benefits of
metabolic health without eating food that tastes like particle
board. We also get into her

(01:08):
unapologetic take on aging, why old is the new Black, how aging
can be your superpower, and how to rewrite the narrative on what
it means to live a vibrant life in your 60s, seventies, and
beyond. Whether you're a male or female,
35 or 75, you're going to walk away with insight, inspiration,
and Amy's refreshingly candid take on how we can all age well

(01:28):
armed with real science. Well, Amy, welcome to the Aging
Well podcast. I really love your work and your
unapologetic take on the sciencecommunity.
Can you tell us a little bit about yourself and how you came
to write about science and to beknown as the advice Goddess?
I actually no longer known that way.
And it's actually a name. I hate it.

(01:50):
I pictured a moment's notice andI was really sorry.
And then I changed it to the science device goddess, which
didn't help. But this all started actually,
this is my accidental career. I thought I would write probably
TV or movies, and I was living in New York and I needed I'm
from the Midwest. You know, your parents don't
send you to Graduate School for film.

(02:10):
They we're going to be free to watch movies.
Like a lot of money. They thought that was hilarious.
And I got a job in advertising for commercials.
And this was Ogilvy and Mather. And it was in the 80s really
fun. It was the heyday of
advertising. And I had two friends and we
would do these madcap things. And one of the things we decided
to do was like Lucy from Peanuts, have a, you know, the

(02:31):
advice 5 cent stand on a Soho street corner.
Only we thought, nobody's going to give us a nickel, so we'll
just make it free. So we have this sign, free
advice from a panel of experts presented by the advice ladies.
And all these topics listed, like wigs and beards, proper
spelling. I mean, I didn't even take
psychology in grad school, in college.

(02:54):
So it wasn't like we had specialknowledge.
And we thought people would walkpast us.
We'd be a visual joke, and they'd just walk past and laugh.
We gave laugh. All is good.
You know, New York, the sign said free.
They lined up around the block and people would ask us the
silly questions on our sign, butthey also would ask us serious
questions. And I felt really irresponsible

(03:16):
because what did I know? But I've always been this crazy
reader and I just voracious. And so I read through all of
psychology and I was shocked. Freud was just this huge
charlatan. He just made all this stuff up.
It's ridiculous. And I discovered the work of
Albert Ellis, which really dovetailed with my, you know,
the foundation of me, which is being rational and thinking

(03:40):
critically and being a skeptic. And Albert Ellis founded one arm
of cognitive behavioral therapy,but his is called rational and
he was very influenced by Epictetus, who was one of the
Stoics who said, basically, paraphrasing, it is not events
that disturb us, we take of themand that and Ellis would say
you're disturbing rationally. And so this was where I started

(04:03):
getting into science first. I had reasoning in my column.
Oh, so sorry, I skipped skipped ahead a little bit.
So the advice, ladies, we're just doing this on Saturdays.
We do it and it's really fun andyou know, it's rewarding.
People are really help by us somehow.
And so when we become a thing, this guy, Eric Messenger writes
his story about us for the New York Times for the style

(04:26):
section. Now there's photos and stuff.
Everything gets cut. It's like a two paragraph
article. But being this enterprising
person from Michigan and wantingto get ahead, I run with this.
And I get us a deal with De Niro, a book deal, a column in
the New York Daily News. And we were doing all this
stuff. And then one of my partners, she
had a drug problem. And we split up and I took over

(04:47):
the column. And what I didn't know was that
Albert Ellis, who I was a fan ofhis work.
I'd read all his books. I have one right here somewhere
because they're just endlessly useful.
And he was a fan of my column because it was so reason based.
And so he became something of a mentor.
And I was all worried about credentials, thought I'd go to

(05:09):
college, you know, for grad school and get some kind of
degree. And he said don't do that.
It'd be a waste of time. You know, you know what you need
to know. And the truth was I'm more
science based than Ellis ever was.
And so I didn't know what I needed to know.
And I felt an increasing responsibility, actually, I felt
there was a huge hole. I, I thought I need to have a

(05:31):
column where I give advice. It needs to not just be
rational, but evidence based. And so that's when I began
learning behavioral science, going to these conferences,
showing up, people were very nice to me, especially in the
evolutionary psychology world where I'm, you know, even though
I'm not an academic, that's my area of expertise.
And so I'm doing this. And then what happens is around

(05:55):
2007, a science writer friend invites me to dinner with this
guy, Sandra Green, who is one ofthe top biostatisticians and
methodological reformers in the world.
He's the co-author of the Seminole textbook in
epidemiology, Modern epidemiology.
And he's also really generous. And so I was very worried about,

(06:16):
you know, how would I evaluate the science properly, behavioral
science, you know, you, you still it's not complicated.
It's not as as weighty as, you know, as medical science because
if I interpret that wrong, you could die.
And if I interpret the psychology studies wrong or
don't notice, oh, you know, there's something missing or

(06:38):
whatever the problem is, maybe you go on a bad date.
And so Sander started to coach me over the years on how to vet.
This is really important. And then he also started sending
me articles and papers about medical fraud and error and
abuse. And so I became better and
better through scoldings, meetings.
Those are metaphorical actually with his looking at my column

(07:02):
and we talk and everything. And So what happened was this is
like 2016, 2017. I, oh, I, I forgot to say I
syndicated like going backwards.I syndicated my column that was
in the Daily News and sorry, I think I'm out of focus again.
I'm sorry. And then to to a whole bunch of

(07:25):
papers. And I was doing very well.
And then I get this hot flash and you know, what you want to
do is to say, oh, Oh my God, I'mso uncomfortable.
I'm going, I'm going to go to the doctor and say, what should
I do? But I knew better from Sanders.
So what I do is I dive into the research and I look at the
research as compared with the practice standards and there is

(07:49):
this just this vast. I'm deeply upset and so I
understand what I need. This is perimenopause with that
I was in this hot flash was it came during the transition years
to menopause. The three this like 3 to 10
years when you're quite uncomfortable if you're a lot of
women and then it's and people don't know as much about it.

(08:12):
It's, there's more knowledge about it now, but I figured out
that what I needed was oral micronized progesterone and my
not, not estrogen. This is to make up for what's
missing. Basically what goes missing in
perimenopause, which is the progesterone that's made and you

(08:33):
ovulate. It's made from the the egg that
the SAC that ruptures with the egg in it, that litter from the
ruptured SAC, it's yellow and waxy.
It's called the corpus luteum and that's the progesterone for
the second-half of your cycle. But if you don't ovulate, which
happens in perimenopause, and women have these periods that

(08:53):
seem normal, as disturbing and yucky as the rest of them, you
don't make progesterone. And this can cause you all sorts
of problems. For example, if you have a
really bad perimenopause, as I did, I really like noise.
I'm kind if you're not making noise in front of my house at
3:00 in the morning. And I became this just rage

(09:15):
filled bitch and I didn't act itout, but I wanted to, you know,
someone's in the hardware store line, some nice man.
You can see he's nice, probably got grandkids.
He's humming. I want to smother him with him.
I want to murder this man because everything bothers you.
And then you have the hot flashes and there are other
symptoms like nausea, sleeplessness, and then you have

(09:37):
brain fog because of that. So I see that oral micronized
progesterone is the thing that will help me and I go to my
medical provider, Kaiser Permanente, big HMO, and I asked
my gynecologist who's really a terrific guy, can you please
prescribe me Prometrium? That's the brand drug for the

(09:58):
oral micronized progesterone, but in generic form.
And that's what Kaiser does and I support that so more people
can afford medical care and I'm very explicit about which drug I
want and everything. And he puts the prescription
through, She's sure, yes. And I justified why I wanted, I
explained it to him and and thenI check my prescription just to

(10:24):
be careful. And I see that actually, Oh no,
this is, I sorry, I got there. And it was medroxyprogesterone
acetate, which is the synthetic knockoff of progesterone, which
has very negative effects on your cardiovascular system, your
brain, your breasts. It can increase your breast
cancer risk, finds the wrong receptor in the breast, the

(10:45):
glucocorticoid stress receptor in the breast.
And so you don't want to take this if there's this slightly
more expensive drug that is sameas progesterone in your body,
but FDA approved. That's very important.
And so I end up fighting 3 battles with Kaiser to get the
drug, to get it covered and to get the amount they take in

(11:06):
France, which is 300 milligrams.Now in America, they give people
100 and 200. Why?
Particular reason they haven't compared the effectiveness of
these different doses here. Now there's starting to be more
research on this, but there wasn't that.
And the, the dose in France is important because we don't know

(11:26):
how we metabolize steroids. Are we rapid metabolizers or you
know, or do we, do they, which means you clear them quickly or
do they stick around in large quantities?
And so that's why 300 milligramsis important because it protects
your endometrium, your uterine lining from becoming, it's

(11:50):
called hyperplasia from the estrogen driven overgrowth,
which can become cancerous. And progesterone is also very
important because what it does in breasts is it takes these
delinquent cells, these cells that are just generic cells and
it differentiates them. It causes them to mature into
breast cells. So basically you've given them a

(12:11):
job so they can't be delinquent and then just double and double
into cancer. So progesterone is really and
important to take and medroxyprogesterone acetate, the
drug on Kaiser's formulary you don't want.
So I was quite lucky because my doctor is, he's such a good guy,
my gynecologist. And then I basically snowstorm

(12:34):
with all these papers on progesterone and you know, from
France it dose everything. And so he brings in his boss and
I forgot. I had to pitch to a pen to tell
them why I needed this drug thatwasn't on their formula.
I needed it covered because it was quite expensive and things

(12:57):
were getting hard for those of us right for newspapers.
And so I had this medical plan. It's supposed to cover drugs,
and you only get the drug that can increase your cancer risk
and cause all these problems. That's not OK.
So the panel I pitch, I do this whole thing, you know, with all
the details and the studies and citations and packet, and I

(13:19):
finished the meeting. And then what's the answer?
No, declined. And So what I learned was there
was not even a gynecologist or an endocrinologist on the panel.
They knew nothing about what I was talking about, no
background. And all they did was call some
gynecologist and say, what's Kaiser's standard of care?
Well fantastic. That's that's really terrible.

(13:40):
So these panels are basically for people to go cry and feel
heard and then be denied by people who are uninformed,
ignorant in the area you're talking about.
And don't listen to the science,they assume you're some dummy
who googled or something and, and not somebody who brings like
the arm loads of science. And So what happened was I, I do
mediation and I use that to helpmy homeless clients to get

(14:03):
bureaucrats to behave themselvesand waive DMV paperwork and give
them, you know, fix the tow feesand everything.
And so I used that on my poor doctor and his boss.
And so they kept saying no, but then she had agreed his boss
very fair. She's a head of gynecology then
not anymore. She's big, big way in the

(14:23):
hospital now. She agreed to me.
And so I again snowstormed them with all this research and I
said, wait, you're not 'cause I was sleeping, I I hadn't been
sleeping. One of the horrible symptoms for
some of us is not sleeping, really having terrible insomnia
and I had had all my life. It was like I someone clocked me
with a large frying pan nighttime, put my head on the

(14:45):
pillow, you know, 6:00 in the morning, I wake up beautiful
sleep. And instead I was having just, I
mean, I like a toast and a psychotic toaster up, down, up,
down, like 5 or 6 * a night. And it's really terrible because
what happens is you don't get the clearance.
There's a system called the lymphatic system in the brain.

(15:05):
This is research by Megan Nerigard, this cool
neuroscientist, where she and her colleagues found that your
brain is too big in your skull to get cleaned out during the
day. And only at night, when your
brain shrinks through decent sleep, is it small enough that
the cerebral spinal fluid can wash through and get rid of the

(15:26):
Taco Bell cups and whatever elseyou've got in there, like the
backseat of a teenagers car. So anyway, where was I in all of
this? I got, I got the progesterone by
them, which was really wonderful.
And I said, look, I assume any risk, knowing that I didn't have
risk, that I was doing the smartest thing, the most
protective things for my bones, for my heart, for my

(15:48):
cardiovascular system. And then I asked this question.
So you'll give these this progesterone, this will be on
your formula. You'll give it to other
patients, right? Naive.
Were you born yesterday, Amy? Apparently so.
And so I was so angry at this, all these women being put at
risk, you know, and you know, you couldn't they they could

(16:12):
have a panel read the science and actually expert panel read
the science that I presented andto verify it.
But no, they denied it to women.And I was so angry that I wrote
this book. Here's my book.
And it is a book born of outrageand a lot of really black coffee
going menopostal, which describes both the anger that I

(16:34):
had and that women should have at the betrayal of of of all
women who are seeking care in this area and actually in other
areas of medicine. All of us where we're not given
evidence based, you know, and wedeserve that.
And we're not also, we're also not given care from people with
any expertise in menopause and perimenopause.

(16:54):
This is the untold scandal, The Secret of Gynecology departments
that I bring out in the book that most of the doctors are
what I call baby doctors. They're maternity specialists
and reproductive specialists. No training, no expertise in
treating menopausal women, but they're made to do it anyway.
Business as usual here. See her.

(17:15):
And then there are practice standards.
They can go by lists of here's what you do in this case, but
that's not the same as knowing the science and they're often as
based. So this is really, really
terrible and it's actually a violation of medical ethics.
This is malpractice as usual, where they expect gynecologists
to treat women when they have noexpertise in the problems of

(17:36):
women are bringing in. And it's just what goes on.
And there it's not disclosed to the women.
No, that's not ethical. I hope this woman, I think her
name, Sarah Hall, who's a cardiologist who says her
patients will sometimes say, Hey, would you prescribe me some
more allergy medicine? And she says, I'm really sorry,
I can't, I need to send you backto your allergist or the primary

(17:59):
care Doctor Who provided it because I don't know this area
or the science and I could prescribe the wrong drug for
you. And so it's it's what's
medically responsible, medicallyethical.
And this is some of the stuff that just fueled me writing this
book because I was just so mad. It's just so contrary to what we
believe about medicine. That's the biggest, the big
shocker of this book, you know, is, is, and writing this book in

(18:23):
this process was seeing how little evidence, how little
training in various areas like diagnostic reasoning and risk
analysis goes into medical education.
And, and those medical schools and medical institutions are
ultimately the ones responsible for turning out doctors who are
scientifically and statisticallyilliterate and basically need to

(18:46):
go by practice standards in order to treat you.
In many cases, not all doctors are like this, but doctors don't
have time to do what I do, whichis I'm, I sit in this chair, you
know, all day and all night, obsessing, reading research.
And, you know, they have all these electric electronic
medical record keeping requirements and they see

(19:08):
patients at Kaiser chop, chop, chop, 20 minutes, 20 minutes.
And so and people want lives. You know, I'm OK with degree,
but people go home to families and they go on dates and that's
to be expected. So you can't expect doctors to,
you know, stay at work and read studies into the evening.
And then there's the problem of doctors not being trained to
read studies, how to read them, how to evaluate.

(19:32):
And that that's what this is. Some of what we don't understand
this is there are these myths ofmedicine that we need to really
disabuse ourselves of to be ableto protect ourselves.
You're leading into my next question.
But before I say, I got to tell you, there are so many great
lines in that book. I started trying to keep tally
of them. You know what, what can I bring
up in the the interview? And the first one to really grab

(19:53):
me was I'm going to read it here.
It's a science can't do its job be a search for truth with a
vigorous openness to being proven wrong when scientists
minds are made-up like beds which sheets glued down.
I thought that was great. And that's just like.
One of the tamer quotes in the book, I think.
And I think if I have one critique for the book, it's like

(20:14):
you don't really tell us how youfeel.
Right. Yeah.
No, what? You know, it was really
important for me. And this is important as a
nonfiction writer. If you're not honest with your
readers, why are you writing? And so I expose everything when
I'm stupid, you know, when I've had some belief that wasn't
appropriately skeptical or when I was wrong.
For example, I in 2002, I'm sick.

(20:38):
How old am I, 61? What year is it?
I'm not going to do the bathroom, but you don't have to.
It was a long time ago, and I was a ways off from menopause.
And the Women's Health Initiative study came out then.
And this is what has caused justenormous medical myth to replace
medical care because of the horrible methodological errors

(20:58):
and distortions of that study. And so women like me, I thought,
Oh my God, I heard about it cursorily because I wasn't.
It wasn't my thing then, but I thought estrogen is safe.
I am never taking estrogen. Hi dummy.
That's not scientific. And what happened was I had that
belief going into this book and I started to read You must read

(21:22):
the science. And I thought like, oh, they
were wrong. And what happened with Women's
Health Initiative study that is so terrible.
The dishonesty of these scientists is egregious.
They announced, when they first announced this, they said that
breast that estrogen caused all these breast cancer, Alzheimer's

(21:42):
disease, all these horrible things that they had found, you
know, in the in the patients in their study.
And what what they said was in help menopausal women.
Well, that was a lie because thewomen in their test, they were
looking their 70s, you know, I think was up to 70, age 79.
What we've learned since then isthat a critical window to take

(22:04):
estrogen after menopause, and it's right after menopause.
And it's if you're a healthy, just menopausal woman, estrogen
at that time is safe, active, but you really have to be
healthy. You need to check out your
arteries and, you know, metabolic disease to really make
sure and then make an assessmentbased on your individual health
metrics. And you know, it may be hard to

(22:26):
find someone to help you do that, but ideally more will
become specialists in menopause and perimenopause as it's
becoming a sort of hot top. So this this study caused all
these women to toss their estrogen prescriptions, others
to not want estrogen based on the distortion and dishonesty
and then doctors to refuse to prescribe estrogen to this day,

(22:49):
to this day. And I have to tell you, it's so
disturbing. Little evidence is in our
medical care. I'm just going through something
with my provider, my wonderful gynecology.
This is gone till August. And so I have I'm the rapid
metabolizer. I got something done called
pharmacogenetics, which will become a thing more and more as

(23:13):
somebody did this for me for free because the work I do and
it was measurably helpful because what I learned is what
we don't know how well do you metabolize this drug or that?
So I'm a rapid metabolizer of steroids, which means I clear
the hell out of them. There's a whoosh, you know, so
I'm not getting the, the steroids.

(23:33):
If I take this amount, I'm not getting that amount that this,
that that woman over there wouldget who is just a regular
metabolizer. And so and then I have other
issues too. So, so I'll just tell you
because people don't know this, I eat a carnivore diet and I am
just at my healthiest because ofit.
It's really important, especially as you age, to really

(23:53):
go swat team on inflammation, insulin resistance, the two 30

(24:19):
6. This is extraordinarily high,
really, really high. And so binding as in it binds
with testosterone and estradiol and whoosh, sells them out of
you. Basically, you're not, they're
not getting into your tissues because it, it locks them up.

(24:41):
And so this is yet another problem.
And then I take Modafinil. You can probably tell I have
ADHD. Little rambling back and forth
and Modafinil, it keeps airline pilots awake and it's really
helpful for my focus. And that tanks your estradiol
level like 11 to 18%. So what my tests show is that I

(25:02):
basically have almost like very little of the estradiol I take
and it's not treating my symptoms.
And also what we've learned in recent years is that estradiol
is protective, A cardiovascular system of the brain and of the
bones especially. The strongest evidence is for
the bones and then the others, cardiovascular is coming along

(25:23):
and the brain. I see enough evidence that you
know, I am concerned about thoseareas, you know, in terms of
getting enough and getting estrogen early enough.
Because for example, with your cardiovascular system at
menopause, if you don't take estrogen, your own body's
estrogen clients, you know, it'sis there's some left that
menopause that it declines more and more.

(25:45):
You lose the estrogen receptors in your endothelium that that's
the arterial lining. And this is really important
because estradiol protects your cardiovascular system very
powerfully as just progesterone,which is an ignored drug and
hormone, which is really terrible and unfortunate.
And I in the book I reference the work of this incredible

(26:08):
endocrinologist, Geralynn Pryor.She's at UBC and she's a
wonderful site I want to recommend to women.
It's called Semcor, CEMCOR, the Center for Menstrual Cycle and
Ovulation Research and then its.ca.
And she fought and fought to have progesterone recognized,

(26:30):
you know, as as an important force for Women's Health and
also to have perimenopause, thattransition time to menopause
recognized for the unique, you know, hormonally unique time.
It is. Whereas part of the unscience in
gynecology and the treatment in perimenopause and menopause is
that doctors treat perimenopauselike menopause light, meaning

(26:54):
they think it's just just a timeof declining estrogen when that
is anything but the truth. And the women who get the
craziest, like I did have estrogen that spikes and then
dives and this causes provoke stress hormone reactions.
And that's why you go a little bit nuts.
It's like drug withdrawal. You know, that the same kind of
thing. They have the same symptoms, hot
flashes, wired and angry, all ofthis.

(27:17):
And so what's happened is that you estrogen's proliferative and
it, it, you know, it jacks you up and you don't have its
partner hormone, the second hormone of the menstrual cycle,
progesterone. It's like the calm down hormone.
It's a body's Valium, I sometimes say to counterbalance
it. So, you know, if you're like me
and you have, I think I had quite high estrogen in my

(27:41):
perimenopauseal years because I had the .7 waist to hip ratio of
the Barbie body and that tends to be, you know, estrogen driven
among other things. Anyway, it was the worst.
I, I had terrible, terrible symptoms.
About 10 or 15% of women are just floored to the point where

(28:02):
I suddenly began getting carsick.
This is unbelievable. I got, I got carsick and both
sick and everything as a kid. But you tend to grow out of
this. And I did in my 20s and 30s.
And then in my mid 40s, I live in Venice and Santa Monica's
like it's like a mile and a halfaway.
I would get Carson from my Venice to Santa Monica and I had

(28:22):
to be support this community activist in some court thing.
And I drove there and I threw upon my shoes.
Like I had to give someone else my time after I prepared
something and it was so unexpected.
And you this is this is one of the symptoms nausea.
And then I would if I got reallysick, vomited, I would be out

(28:43):
for a week with sort of Vertigo like symptoms is really
terrible. And so, and women, the, the big
problem in this area of perimenopause and menopause is
that there are all these symptoms that each on its own,
you know, it's just, oh, that's weird that happened.
But when you put them all together, you just women start
to feel basically mysteriously unwell.

(29:05):
They're all these things going wrong with them.
It feels like you're falling apart.
Like, is this, this is old age now?
I'm just done, you know, I'm 43 or whatever.
And just like, OK, pack it in. You're going to suffer the rest
of your life because that's whatit feels like if you have a
terrible perimenopause. So because doctors are not
trained in perimenopause, they don't know the symptoms and what

(29:26):
happens. One pernicious thing that Gerald
and Pryor talks about, the endocrinologist, is that women
seek diagnosis to explain all the horrible stuff going on with
them. In my behavioral science writing
in these books that I've done before I took on medicine, I
explained that uncertainty is one of the most disturbing
feelings for humans. So we would prefer to, you know,

(29:48):
have a, put a name on something rather than, you know, it's so
disturbing to us to not to not have any sort of this is what it
is kind of. And, and so women can get
treated for diseases they don't have simply because they're so
disturbed, not knowing what theyhave.
And that's why it's, it's so pernicious that doctors don't
know. Oh, I, I was mentioned something

(30:09):
to head of gynecology. This is so terrible at the big,
you know, Kaiser, I'm dealing with these two doctors who
basically one of them has menopause trainings.
You know, it's through the menopause society.
They basically take an online course.
It's not like me pouring over thousands and thousands of

(30:29):
studies and worried and what's the methodology here?
And let me contact the statistician and see, I don't
understand this like I'm nuts. A good thing because it I turn
out this book and I was very, very careful and got in fact
checked in. But you have these people.
I mean, they know medical ethics.
She's the head of gynecology. She told me I should taper S

(30:50):
estradiol at 60, you know, and Igot really afraid she's going to
take away my drugs. OK, this is very old advice.
And it was never, you know, the the science does not warrant
this number one. And you know, OK.
And she told me I love this whenpeople say they read the
science. Now, I was a little bit of a
because I said to her just sort of spouting off because I was

(31:12):
upset that I had to meet. But I said the truth, which is
that doctors are not trained to read the science.
They're not trained to evaluate it and they don't have time to
read it. And she said, oh, I read the
science. I read the science in this.
Well, no, she didn't. And in fact, not only she'd not
read the science, she didn't just read the like, easy book
from the Menopause Society. And this was like, this was last

(31:34):
week that I had this appointmentwith her 2025 in 2022.
And these people are like late to the dance with a lot of
stuff. The Menopause society, they
finally come out and say, oh, look, there's there's no
stopping rule. You don't have to stop.
It should be made based on, you know, individual's health with
their doctor looking at their health metrics and, you know,

(31:54):
their needs and values and everything which is right.
This is how this is modern precision medicine.
And she's telling me to taper, OK.
And I, I'm really scared becauseshe has power.
She's a gatekeeper, like an ignorant gatekeeper.
And so, you know, I explained toher, no listening on her part
where she said, you know, I was saying, but you need to take

(32:17):
estradiol into your later years because if you stop taking it at
60, you not only lose the protection you have for bones,
it's very powerful protection. Your bones, your bones reverse
like the health reverses. And the truth is when you need
estradiol, you know, to still betaking it, is when you're 79.

(32:41):
That's when we break bones, and we break bones through falling.
You know, you're taking two medications.
You're clumsy if you're me, leave purple garden clogs in the
middle of your floor. And, you know, I'm just trying
not to have a concussion and diebefore what comes out.
That would really suck, you know?
And so here's this head of gynecology, Oh, and she's in
charge of doing the formulary for gynecology for Kaiser.

(33:03):
And I thought that the woman whohas had before, who I respect,
you know, who listened to me and, and listened to the science
and agreed on my individual needs to give me the
progesterone and cover it and everything.
I thought that she was the boss.So I was writing this, this
letter to say, like this woman, she should recuse herself from
choosing drugs for the see lackadaisical assessment

(33:56):
of science, if they even read it.
I don't believe that either one of these women has read the
science. You know, Andrew Gelman says,
you know, you can't expect them.He's a statistician.
You can't expect them to read the science in medical school.
They're not trained to do that. You know, Gerd Gagarinzer, who's
big on risk, teaching about risk, he says there's a moral
obligation to how to read the science.

(34:17):
And the doctors, even if they don't have time to read all of
it, they need we look things up and not just Willy nilly say
things. So this woman the the second one
that you know, she's younger andshe's their supposed menopause
expert. She tells me I should take
testosterone. OK, well, first of all, I'm not
if she my stats, I'm not technically low in testosterone.

(34:39):
What I recognize is that my freetestosterone to total
testosterone ratio is not what it should be because of the sex
hormone binding globulin. But I corrected this in the
responsible way. Not everybody can do this.
This work for me and I understand and DHEA, which is a
supplement and you have to be careful with supplements.

(34:59):
I go to consumer lab to find outif they have rat hair and
arsenic in them. It's a membership site.
Really worth it. But I used DHEA, which is a
hormone to correct. This is my guess that I
corrected and I got tested and it was corrected, correct my
testosterone levels at least to a reasonable level.
I don't know if they're still, you know, reasonable because

(35:21):
eating carnivore does such a number.
Before I was just low carb. So this woman says you should
take testosterone and I said, but it's it's not safe to take
testosterone. These data just aren't there.
I said yes, they are. And she said she read the
studies, OK, maybe you read themand are unable to critically
evaluate them. But we need to look for stuff

(35:43):
like, have they tested this for a sufficient amount of time to
know whether what are the effects on the cardiovascular
system, You know, on cancer, breast cancer, we don't know.
And there's currently no FDA approved estrogen.
I'm sorry, testosterone prescription for women and the
safest form for men is the pellet form.

(36:03):
And women will sometimes get these from some sketchy
compounding person or pharmacy, but only the accredited
compounding pharmacies should you ever use.
And even then it's, you know, maybe you're not getting, you
know, the same kind of drug you do, you know, with everything
that's wrong with the FDA, they regulate drug reduction, except
the ones just screwed. So avoid those drugs too.

(36:24):
Catherine Eben, who's a colleague of my bottle of lies
in the in generic drug industry.So I'm rambling a little bit,
but this woman saying this, you know, and she said, Oh, I, I
friends that they're fellows in sexual medicine and you know,
well, that's nice. But if they're telling you it's
safe, they're wrong too, you know, and this is the thing that

(36:44):
I have discovered. I have respect on a scientific
level for exactly one of my and because he's truly evidence
based. And he will also tell you I I
needed a sleep drug at a certainpoint, progesterone and
menopause was not doing the job to keep.
And I tested all these like every supplement with any kind
of like, you know, a bit of evidence pointing to it being

(37:06):
legit for keeping you, for, you know, helping you sleep.
Nothing worked. And So what I didn't want to do
is take benzodiazepines, Ambien,these drugs that can have
terrible cognitive effects. And so I was testing these
different drugs and I asked him about then these new drugs are
Rex and receptor antagonists. And he just said, I don't know

(37:28):
anything about them. And then he read about them.
But that's the kind of doctor I trust where they say I don't
know and not like my primary care doctor.
I left where I said, well, how do you justify not giving me AC
reactive T test, which is, you know, it's it's discover roughly
inflammation in your body doesn't tell you it's there.
It just tells you how inflamed you are.

(37:48):
And he said it had no relationship to heart disease.
OK, I just wrote 3 chapters in cardiology.
But like, you know, and, and so I asked what, what's your
justification? He said, because I'm the doctor
and that's my clinical judgment.So my friend Susan named him
Doctor God. And so he's gone now.
But you know, this is such a common thing is it's the

(38:09):
defensiveness of doctors who don't know instead of having
when you, when you do know things, you can be more secure.
You know, I'm good at like 5 things and then the other things
I don't know. And I'll just readily tell you
I'm a, I'm a financial moron. Like I should never if there's
stock that I think some someone should buy, avoid it because the
company will go to business in amonth.

(38:30):
So I bought Bitcoin recently, I bought $2.00 worth and it's
worth like 2-9 going down to 270.
I'm 170. So you know, my track record, my
my change. Well, we won't go through the
three. Myths that you talked about in
the book, we'll make people buy the book to to learn more about
that. But in all these statements
you're making about doctors, it really surprises me that you're
able to get Robert Lufkin to write the foreword for going Oh,

(38:52):
he's fantastic. So I've known him for all these
years. It's so funny.
We both came to this place, but I actually there's I should find
it in my book. He I so admire him because he,
you know, was a Med school professor.
He wrote a book called lies. I taught in medical school.
Let's see if I can find this. Oh, I'm looking at a screenshot

(39:14):
here. OK, let me find this.
I I so admire this. OK, so he said this is a tweet
from Rob Lufkin, a neuroradiologist USCUUCLA
prestigious schools he taught at.
He's the he invented the Lufkin needle for biopsies during MRI
scans, he said. I want to also add my apologies

(39:36):
to all for the wrong advice I'vegiven over the years when I
recommended a low fat diet and largely ignored the dangers of
processed foods and refined carbohydrates.
The great thing about science isthat with enough evidence, we
can change. Oh my God, I have chills.
And I actually wrote a tweeted back props for saying so.
This is 2021 and this is a kind of doctor, a scientist.

(39:57):
You want intellectual humility, willing to admit mistakes, you
know, it's just so important. And so that's integrity.
And that's that's the sort of thing, you know, that that is
missing from a lot of the defensiveness that I see with
doctors where. Because they're actually just
going by practice standards, these guidelines given to them

(40:18):
by medical societies or that institution, they're not that
able to be nimble and make creative judgments.
I don't mean creative like let'sgive you, you know, or
something, but about well, OK, what, what might be causing this
problem you have, you know, and how do we treat it?
Which brings me, I want to just get into this, this thing that
is another thing I dealt with recently.

(40:40):
It's it's umm from Randy Nessy the was at fault.
He is the Co founder of evolutionary medicine and a
psychiatrist and he causes the viewing symptoms as disorders
error. And this is where doctors, you
come in complaining of a symptomand they treat the symptom.
That's not OK. If you have a headache, is it

(41:00):
because you, you know, are stressed out or do you have a
brain tumor? If you have a brain tumor, we
don't want to make your headachego away because it's like, you
know, turning off the fire alarmlike it's going to put out the
fire. It's crazy.
And so I went to dermatologist who tested my ferritin level
and, and which is a form of ironloosely.
Where does it fall? So I'm gonna loosen that.

(41:22):
But and then told me I should take slow Fay iron.
Well, wait a second. What if I have thyroid issues?
You know, what's the, what is causing the low ferritin, you
know, that needs to be figured out because if you, if I take
that and I, you know, I could damage my cardiovascular system.
This is not OK. This is the most careless
medicine and it's routine. And this is the thing I wrote

(41:43):
this chapter 2 in my book and this book, even though it's on
menopause, there's a lot of stuff in there for guys and not
just being a shameless salesperson, but on diet and
exercise on the cardiovascular system.
But also, Chapter 2 I had to write is called Why You Won't
Believe, Why You Won't Want to Be and Why You Should Because as
I had people read bits of my book, they were determined that
they were so horrified at the unscientific medical care

(42:07):
they're being given, they wantedto disbelieve.
Katie, my old copy editor's wifefor years and years of Creative
Syndicate. She knows how careful I am on
science. But she said, if I believe you,
it's terrible. It means I can't trust my
doctor. And then where are you?
You know, I can read a pile of science and go in and say, OK,
we need to change my steroid prescription for my eye into

(42:28):
Lotemax from the Prednisolone acetate, which has terrible
systemic effects, you know, and and, you know, justify it and
everything with with good evidence.
But most people like, you know, people use AI, AI lies.
If you don't know of medicine, don't ask Chechi BT will make
stuff up make up citations. I had an alpha to alphabetize
part of my bibliography. It dropped things and then just

(42:49):
inserted studies that like didn't exist in my blood.
So you were asking a question about was it about the myths of
medical care? Yeah, I said.
I think we could just just kind of let the readers go back to
this because I think you kind ofaddressed them all and I'll read
through them quickly now that webrought back to it.
But Myth 1 is doctors make decisions about drugs and
treatments to give us based on scientific evidence.

(43:11):
And you've talked about that. We know that's not the case.
Myth 2 is doctors are highly trained in and skilled at
diagnosis, the reasoning processto determine the underlying
cause of. They're not worried about,
they're looking at strictly. It's like I, I've had my blood
work done again. My cholesterol tends to be a
little bit high, usually becauseI end up having meat or
something the night before my blood.

(43:32):
Well, wait a second, how's? Your how are your triglycerides?
That's what matters, I think. They're in the more normal
range, but my LDL, my total cholesterol was like in the
three hundreds, but my HDL is like 72, which gives me a HDL to
total cholesterol ratio. That is it's on the high end of

(43:52):
normal, but still in the normal range.
And I'm not denying that my cholesterol is high, but I've
been looking at, OK, well, there's, I know my sleep has
been off and I haven't been ableto lose weight.
I could diet and my weight's notgoing anywhere and, and just
monitoring sleep and my stress level.
I got a Garmin watch and I try and monitor all that.
There are behavioral things I know I can do.

(44:14):
I have a suggestion and. This.
That's very easy and you might do this, but I just want to say
the lipid hypothesis that cholesterol causes heart disease
has not been proved. And it's looking more and more
like it's starchy foods, sugary and starchy foods provoking
insulin resistance and, and basically, you know, elevated

(44:34):
blood sugar that these are the things that seem to provoke
heart disease. And I have my cholesterol is
like 354 or something like that.I'm so happy because it's
protective. High cholesterol is protective
in women over 50. My triglycerides are my HDL is
one O 2. And this comes I eat a carnivore
diet and and I take some supplements to make up for the

(44:55):
few nutrients I don't get. But with my eye because I had my
doctor gave me an overdose of Cortico steroids because I
didn't have time to read. I was doing stuff for the book.
I basically fell into the car and fell onto the Gurney and you
know, she's got the stabs your eye and so she's expert in that.
But I didn't realize that there was a huge host of steroids and
this gave me adrenal suppressionwhere your immune system like is

(45:18):
basically not fair. All these horrible effects.
I've Tacocardi and Bradycardi inthe same day.
That's dangerously, dangerously low herpes as a person.
My BP is like 99 / 62. I'm healthy, but so one of the
things that I saw to do from theresearch was to the book about

(45:43):
how to, you know. Ketogenic duct, which is very

(46:04):
important where you are, for example, you know, you'll need
more salt And so I put because Icarnivore to maintain this salt
in my body appropriately in potassium, the electrolytes, I
put potassium through Morton like salt in my water and then
salt two things and it sounds disgusting, but you get used to
it. Now I miss it if there's not

(46:26):
salt in my water. And so, you know, these are some
of the things you can do and never spending a day sanitary
and also doing weightlifting. This is what I talk about in the
book to slow speed weightliftingjust, you know, can do.
And all I do, I do one set a day, very slow speed.
You muscle failure, you like youlike 5 seconds up, five seconds
down is very cheap. And then the last one that you

(46:48):
can do before you get all squirmy, you know, you really,
and you could probably do one more where you think you're that
is muscle failure. And what happens is you've
created tiny tears in your muscles and over the next day
they're repairing and that's creating, you know, healthy
quality muscle. And what's really important
about this, number one, what youdo for muscle, you do it's, it's

(47:08):
sort of like, it's like a telephone thing.
It gets a little later, but and,and muscles and bone are
metabolically active. So they actively work to reduce
insulin resistance and inflammation when you're working
them. And so I don't go a day without.
This is very important. These habits.
I used to when I in perimenopause, I sometimes got
migraines. That was the only reason I could

(47:29):
get out of my my push ups in themorning is if I was really done.
And so, and that's important. You just, it's just do it.
You know, this thing of like your feelings, I wrote about
this in my last book. Your feelings are not the boss
of you. Are you uncomfortable?
Do you not want to do that? Get down and do 20, you know,
and that's how you have to treatyourself.
And so, and it's sort of funny if you yell at yourself and all
these things, it makes it sort of more palatable.

(47:51):
Yeah. I teach exercise.
Physiology. And it's funny, you know, when I
interviewed Dr. Lufkin late lastseason, I said, you know, I, I
probably should write a book, The Lies I Taught and Exercise
Science science class, because, you know, I, I was raised when I
got my masters degree and even to a certain extent still with
the PhD where you were teaching,you know, high carb, low fat

(48:13):
diet and everything else. And it's like, Oh my, we were so
wrong. And cardio, cardio, cardio.
And it's like now I'm like, you got to be lifting weights more.
You know, you got to if you're going to eat carbs, you're
eating them around your workout time and that's going to be with
you on this. Stephen Finney Avalik and Finney
2 dietary researchers. He is an avid, you know, like

(48:36):
near professional cyclist and you can you you know, he tested
and and then did the, you know, work for him too.
And one eating a low carb diet for potentially eating exercise.
And so I don't quite recall whathis studies all said, but this
is really important to look at because carbs what I see is that

(48:58):
for me, it's that I want to avoid eating things that cause
me harm. And there's I can eat such a
delicious grease log of, you know, that don't cause
carnivores delicious. And so, you know, eggs.
I eat eggs and hamburger and salmon with seared crust on it
and everything. And it's just that's very

(49:20):
exciting and it to forego the things that I enjoy, you know,
French fries or whatever. It's, it's, I see it as a
positive thing of, you know, work.
I'm investing and having not suffering and and good health in
older age. And then to not be too ascetic
because you don't want to binge.When I go to a party, I'm like a

(49:40):
scientist to assess them with a microscope.
It's really just my eyes, but I they chocolate to a cook expert
of experts. And so it's like, were these
made by a vegan with that horrible stuff that's not, you
know, butter and eggs and everything or they made with
like the real stuff. And then I'm assessing is the
white chocolate chip one. It's this, this thing.
And so then I'll eat, I mean to eat one and I'll eat 3 'cause

(50:01):
I'm a hedonistic, I'm gonna admit that.
But so this is how I, you know, manage I'm mostly not eating any
sugar or flour. And then I eat at home.
So I'm eating butter and you know, and these are the, these
are the healthiest forms of fat that you can eat, has a high,
whatever it's called has a high smoke point.
So you can sear meat and fish with it without it burning like

(50:23):
butter. And it's just delicious.
And then I eat, because I'm eating carnivore, I'm not eating
carbs. What I do is I eat butter off
the stick. It's delicious.
I love it, you know, and, and soand I'm not getting fat from
this because I'm not having the carbs and my, you know,
insulin's not, you know, seesawing all over the place.

(50:44):
And, and you really don't want to have that.
Basically what happens is a broken blood sugar response
later in life where there's so much back and forth insulin
working, you know, to bring downthe blood sugar and you it
eventually in many people that that breaks and then you're left
with inflammation, which is low grade inflammation that where

(51:05):
there's basically got low grade fire in you all the time.
And So what happens is when yourimmune system is needed, Hey,
send out the warriors, the little white blood cells like
deal with this injury here. They're tired, they're burnout.
And so that's that's a really vital thing to not have happen
because you need that as you getolder.
I'm 61 you you see that you're much less robust.

(51:27):
I got a bruise on my foot. I wrote about this, I think my
in the book unless I cut it. I had this bruised toe with, you
know, an old me, you know, bruise.
OK. Oh, it's better tomorrow, you
know, and this is the sort of thing that you see this that's
scary. And then you I also look at it's
it's tragic. The old people like where I go
get my eye treatment for my eye surgeon for this.

(51:48):
It's a genetic disease called folks dystrophy.
And you can see these people menis suffering every throughout
their day and that's pretty good.
And I just wish that they had sold the bill of goods with the
standard diet with our Commission and these two
fraudsters, what's his name? Hegstead.
And then Fred stare at Harvard, who scammed the American public
on the take from Big Sugar saying that, oh, you know, sugar

(52:10):
is fine. It's it's those, you know, it's
meat and all the things that areactually held for us that are
that are bad for us. And so they turn the American
public unhealthy for. It's disgusting.
Yeah, I think we. Agree on the information that
the medical community has given us over the years.
And I spent a lot of time in class and I teach a
pathophysiology and exercise class and we really deal with

(52:31):
this is what the medical community says, but this is what
we can be doing and there's it'spretty simple.
I mean, you really bring it downto eat a healthy diet, exercise,
get good sleep, maintain a healthy body composition, don't
smoke and have healthy, you know, social connections and oh,
absolutely that's. So important and I encourage
people also, you know, when you're feeling terrible, there

(52:54):
are times people want to isolate, but I find and and it
is a thing for people that social connection is so part of
our evolutionary history and andsuch a healing thing.
Call somebody. And I mean, I would make myself,
I got depressed during COVID andmaybe April of whatever, 20, I
couldn't even dial A phone. But I made myself, found my
friend Catherine, and she alwaysmakes me feel better.

(53:15):
And you did. And then also to move when
you're feeling down because one of my books is on embodied
cognition. It's a book with the Malaya of F
words, except for this one on F word ology.
And what that is, it's how the mind is bigger than the brain
and that emotions and actions are actually bidirectional.

(53:35):
So you can change your emotions with your actions and your
actions change your emotions. And So what I made myself do,
because our brains kind of, I mean, miraculous and marvelous,
but stupid, is that I realized the brain thinks that, you know,
being all head up from exercise is like being all head up
because you're excited. And there's social science in
this area that's very interesting.

(53:56):
And so I made myself get on thisexercise bike.
I went to the West and I didn't want to do it, but it's like I
actually talked to myself. Are you paralyzed?
No. And get the hell on the bike,
you know, and so and that helps.And that's, it's just, it's the
sort of stuff that you need to sort of parent yourself on, you
know, and, and the, the one thing I wanted to mention about
exercise, this is another terrible thing about these

(54:18):
medical, you know, institutions.It's the institutions, the
doctors there. It's both medical education and
the institutions that are at fault.
I mean, I get angry at this because, you know, well, I think
I would read the science, but you can't make those
determinations and people get tohave lives.
But here's the thing, they recommend it Kaiser all over the
place to eat this low fat diet, which is not satiating, not

(54:40):
healthy, doesn't have adequate and then, oh, I love this to
walk for osteoporosis. That's worthless because you
know, you're not putting enough on your bones to tell them
you're like, hey, you who we're going to be needing you better.
Like, you know, bulk up bones and muscles and especially for
elderly, elderly people, it's called sarcopenia, muscle

(55:00):
wasting. You know, you don't want that.
All of this is connected with the insulin resistance and the
whole body just going to pot. And you know, it's just, it
takes very little to you know, you know, in terms of like, oh,
I can be, I can be thin and not everybody, you know, is
metabolically the same, but I can eat.
I don't count a calorie ever. I eat when I'm hungry and I can

(55:21):
do relatively minimal exercise, you know, doing a slow speed
weight train. And then I do do a bit of cardio
because of the chair all day andI need to move.
So I run, but I run in front of the TB and then I run outside,
you know, to get this circadian rhythm, you know, 10 minutes.
I'm in California, so it's, you know, like, so just 10 minutes
is OK, but overcast areas might have to do 15.

(55:41):
That's very important. You know, and these things are
just sort of minor and you can be, you know, the the benefits
for dividends from just doing these things, you know, being a
ton of these areas. But yet, you know, doctors,
they're telling patients with diabetes, oh, here have pudding.
I can always, they feed diabetics, the hospital, this
mind blowing, I mean, insane, like this woman's mother,

(56:02):
diabetes, terrible diabetes. You know, she's on Twitter,
which is my social world right now.
They fed her more sugar for breakfast than I eat in a year.
I mean, it's great pancakes and like dessert and all this stuff.
And this is she's hospitalized with some kind of horrible
attack. I mean, it's mind blowing, all

(56:23):
of this. I'm trying to remember who told.
Me that on the whatever the diabetics associations website
they actually have a recipe for pudding.
It's so insane. It's so insane.
Here's another thing to this a huge pet peeve of mine.
Not a pet peeve. It's so people of color, like
we're all, you know, we're mostly the same all of us, but
so people related to menopause and perimenopause, you know, the

(56:47):
the white middle class women aremost of the research subjects.
So some of the research applies,but not all of it and the same
throughout medicine. So black people tend to have, I
think it's 20% lower triglycerides, I think it's 17%
higher HDL. So you can miss if you're
looking at those metrics based on what my, you know, what the
metrics for me would be as a person who's like white walls or

(57:10):
not even, you know, well then you're you're not treating your
blank appropriately and sending Hispanic women, they are prone
to horrible kind of breast cancer.
If your name is Lopez or Rodriguez.
I mean, you can't always tell someone has Hispanic origins,
But you know, and you should, weshould be attentive to you.
The doctor should notice that and say, Hey, you know, you

(57:31):
might be prone to this, you know, and there are false
positives. There are all sorts of problems
to overtreatment. But I saw a thing, Scripps
Health, and it was some page saying, Hey, black women, pay
attention to your cardiovascularhealth.
Do you think they gave the statsfor black women?
No, you know, and then also there's a cluster of five
metabolic conditions that tell you your risk is raised for

(57:52):
cardio metabolic diseases. And they're high blood sugar or
high blood pressure, visceral fat, which is that when you have
belly fat, you know that it's basically around your organs.
I call that Dunlapse. Disease.
It's where your belly Dunlap over your belt.
What did you say? I call it Dunlapse.
Disease. That's where your belly Dunlap
over your belt. And this?
Oh, I love that. And the other things are, let's

(58:13):
see, what are the other two? Oh, high blood pressure, high
blood sugar, OK, missing one of high triglycerides and low HDL.
And so if you are a white personand you have three of those,
that suggests you have elevated cardio, cardio, metabolic risks
over like heart attacks, diabetes and all these

(58:34):
conditions, stroke. If you're a black person, two
out of those you know that is suggest elevated risk.
This needs to be explained. You know you it's it's it's
malpractice to to not treat people as individuals in these
meaningful ways when we have this information same as this
the the the gynecologist, Oh my God, the five 5000 word like

(58:59):
like rebuttal that I had to write about all the stuff they
got wrong because I want to lay that out.
It's not right that they don't know this stuff, but you know
they're denying me. I want an increase in my
estradiol prescription since I have this high SHBGI rapidly
metabolize the estradiol and then I have the Modafinil taking
my estradiol levels further and these have been tested.

(59:21):
So we see, it's not like I'm just guessing this stuff and
they're refusing that. They said the head of gynecology
tells me it's a super, super physiologic dose that I'm asking
for. It might be in someone who is
not Amy Elcon, but in me. It's what would be necessary to
protect me. I have, I'm like 61.
I've been in menopausal. I still have hot flashes, you

(59:43):
know, and, and I've had symptomsthat have come back because of
the the it's medical harm. It's called iatrogenesis when a
doctor means to help you, but they harm you.
That's the cortisol where the doctor gave me a corticosteroid
overdose for my eyes. These drops, they go
systemically crazy, crazy, crazy, you know, and this woman
had of gynecology and she's saying this and I.

(01:00:07):
Explain to them, look, here are the reasons.
And so in treating an individualmeans giving them, you know,
treatment according to their individual, you know, and and
this is something that's just not done.
And doctors, you know, if there's a defensive medicine is
being practiced and that's when doctors, they don't know,
they're ignorant of something and ignorant, such a rude word,
but it's the case. She's ignorant, you know, of

(01:00:31):
this tapering at 60, all this stuff that she put forward my
appointment, you know, and then they deny you care out of, you
know, either they, they'll give you excess care or insufficient
care based not on what is best for you, but based on their need
to protect themselves from beingsued.
And then also less malevolently,doctors don't want patients to

(01:00:52):
come back in My transplant surgeon, she's wonderful
despite, you know, she doesn't know about steroids and and
there's a reason she shouldn't be expected to.
They should have experts in thatarea.
But you know, she doesn't want patients coming back and crying
in her office that they're losing their vision in the kind
of eye. This is horrible and it's a
privilege. Someone gave me donor tissue.
This is why I'm an organ donor. I started to cry when she told

(01:01:15):
me I'd get donor tissue for my eye.
And you know that my mother had this disease too, by the way.
So thanks mom, you know, and andso I can understand that she
doesn't want those patients coming back.
And then on a careerist level, you don't want your surgical
record to be, you know, you know, a bunch of these failed.
So you know the reasons for this, but that doctor?

(01:01:44):
The whole area of steroids and everything related, the neural

(01:02:06):
science, it's called, I'm touching my head, it's called
the HPA axis. That's what's malfunctioning in
me because of the overdose she gave me.
That's the hypothalamic pituitary adrenal axis.
And there's signaling that goes on and she basically suppress
that suppress my immune system by this idea that in their
field, when they do these corneal endothelium transplants

(01:02:28):
called D Max surgery, it's the least trajectory there is of
transplants because you don't have blood vessels, it's not
vascularized in your cornea. So it's your less likely to
reject. It's like, oh point 7%
possibility of rejection. And probably the metabolic
healthy patients are the ones who reject it, you know, And so
you know, the, the steroids area, she the, the field, it's

(01:02:53):
just out of clinical habit. They think it's evidence based
that they prescribe 4 drops for a day after your surgery to keep
your inflammation down and help you hang onto your transplant.
But it's just based on clinical habit.
You know, nobody compares, oh, what about this or this or that.
And these steroid drops are pernicious.
And here's the other thing. This is how unscientific
medicine is. They give you a Kaiser and other
places too. You get these Prednisolone

(01:03:15):
acetate drops and then antibiotic with back
preservatives in them. BAK parabens are also bad in eye
drops, but they're about to ban these in Europe and they begin
to destroy your cornea in a matter of days.
This is like we got to destroy the village to save the village.
We're just destroying the village.
And so I'm sorry, I would prefernot to take those.

(01:03:38):
Also dry eye and the stuff that makes it even harsher for me.
And this is this unquestioned thing.
I had asked a doctor there before I got to the cornea
surgeon, an appointment, that cataract guy, he prescribed me
eye drops and they had preservatives and I said can you
prescribe some without preservatives?
And he said, are there such a thing?
Hey, you know, do do I need to be the medical genius in every

(01:04:01):
area? And I say that, you know,
sarcastically, I mean, I didn't know.
So he says it to me. So I'm like on the phone and
like with the pharmacy and like asking some pharmacist and like
looking things like, why is thismy job?
I mean, I can do it and I did and I had to.
But like, this is insane. The problem is, if you're not
me, I'm a psychotic nerd, I willlike, you know, I will exhume a

(01:04:25):
body from like 1940 who died in 1943, the scientist with one of
these paper and this, you know, cremains or whatever, whatever
is left, he's still got the paper that shreds.
I'll I'll have him exhume to read that paper.
But you know, I mean, is it too much to expect that our doctors
would just basically evidence based And again, not all, you
know, are this way. I told my psychiatrist

(01:04:45):
wonderfully evidence based. He used this pharmaco
pharmacogenetic testing and I didn't even know Kaiser had
that. But he does it because it's
important. This allows you to know what
someone's genetics are, as I hadmine done to know, oh, how do
you metabolize this drug? Does this drug work for you to
need more of this drug? You know what drugs don't work

(01:05:06):
for your genetics? You know, these various liver
enzymes and it's so important. And so he's providing the most
individualized care to his patients.
It's really, really important, especially with mental health
stuff. There are people who have, I
love the bright lines for mental, oh, you have bipolar
disease. My God, they have to do that to
give them drugs like the DSM, this mess of a Bible site of the

(01:05:27):
conditions. But, you know, people don't have
bright lines around disease. They have this symptom or that
symptom. And there's this attempt to name
it something. And then the insurance will then
pay for OK, we, you know, give you this drug for this.
But that that's not scientific and it's not good medicine in
many cases to just, you know, have to settle on a diagnosis of
something specific when you knowthis and that and the other

(01:05:49):
thing in a kitchen sink are involved.
So how do you think patients? Especially women can better
advocate for themselves in the system that seems to lack solid
evidence and treatments for. I'm so glad you.
Asked that first of all, you know, it's really important.
So we women tend to be more timid, especially in our younger
years. Not all I've these bad friends,

(01:06:10):
but I was I had no friends untilI was 15.
And so I was kind of a suck up and really wanted to be liked
and I worked on that and now I'ma bitch to the observing, to the
deserving. And but so, you know, women tend
to feel it's rude more so than maybe men to ask for a second
opinion or to say, wait, I didn't understand that.

(01:06:32):
But what I emphasize in the bookis that you owe it to yourself,
to your house. You know that to stand up like
that. And if you look at this is some
of the stuff I talked about in aprevious book where it's like
your feelings are not the boss of you, you know?
So, yeah. Is it uncomfortable to go over
and, you know, go pitch your idea to that guy?
You know? Yeah.

(01:06:53):
OK Can you survive like, you know, a minute and a half of
discomfort? I think you can.
And so say you do that and you go over and you fail and he
humiliates you or something. OK.
Well, so there's a way to look at that.
Small wins. You were brave yesterday.
You wouldn't have done that today.
You did it. You grew a pair.
That is so cool. And the more you do that, the
more you see that you know this,the idea that something bad is

(01:07:14):
going to happen is ridiculous and stupid.
And then you get more, more and more brave.
And so women with their medical care need to and people, sorry,
it's not just women need to accept that moment of
discomfort. It's not rude.
It's actually you advocating in the most important way for your
health. And and so you know, you can say
like there's a thing called informed consent.

(01:07:36):
So it's that you need to understand a treatment before
you can agree to it. Well, uninformed consent is not
a thing. And if the doctor hasn't
explained it well enough, well, that needs to be explained to
you. And it might take another
appointment. You know, Kaiser has these 20
minute appointments. You get the bums rush maybe at
the end. I find that doctors tend to stay
with you if you if it's necessary.

(01:07:57):
I don't bash doctors in this book.
I feel that they're also betrayed by this medical system.
Although I think, you know, I get angry with the
irresponsibility of gynecology doesn't know everything she said
to me was wrong. And so with this, you know, that
you need to say, you know, I don't understand this.
I don't understand this. Can we make another appointment?
And then there's six questions that I came up with because I

(01:08:20):
think it's good to have them written down.
I said, if you're like me and your memory goes into hiding
when you're under the slightest bit of stress, you know it helps
to have a lift so you can put iton your phone.
So these are the six questions to ask your doctor before
agreeing to treatment. Can you lay out your reasoning
behind your diagnosis and the treatment you recommend?
Remember doctor God, because I'mthe doctor and that's my

(01:08:40):
clinical judgement, not an answer.
And, and could there be other conditions that are causing my
symptoms? They should do this thinking,
but you can't count on them to do it.
So when you when they give you these answers, that tells you
how evidence based your medicineis or whether you're getting
this sort of symptoms as disorders, error from your
doctor and your diagnosis. Are there risks from this?

(01:09:03):
What are my risks from this treatment?
Are there safer, less invasive alternatives?
What can I expect during the treatment and what sort of
recovery? And do I need to do this now or
could I wait or go without the treatment?
And so, you know, this is reallyimportant and you need, your
doctor needs to explain this in plain language.
And if they can't and won't, youknow, it's expensive for people

(01:09:24):
to get medical care, but you know, this is your health.
And it seems to me it's important to get a second
opinion, you know, if that's at all possible for you, It's
really, really important. And, and to find another doctor
at Kaiser, you can just change doctors, which is great.
I left doctor God and before himthere was like Doctor God the
first, you know, these people who are covering for not knowing

(01:09:48):
things or arrogant and treat youas if you're, you know, like
disrespectfully as a patient. And you don't have to know the
stuff that I know to, to, you know, like need the need the to
to, to like have the evidence based medical.
You need a provider who's going to be honest with you on these
levels or or you see the stuff that they're answering these

(01:10:08):
questions using to answer, showing that this really isn't
based on anything. And and so you may need some
time, you know, to assess what they say.
What people should do is also understand that their timetable
is not yours. You don't have to make snap
decisions. It's your medical care in your
body. You can wait on it.
Talk to friends who are, you know, good counsel, look things

(01:10:30):
up, but you have to be careful because a lot of the stuff
online, I mean, I know this because I know does the science,
you see stuff and it's just yes,and and then the AI lies.
And so if you don't know the medicine, I wouldn't use trachy
because it really just makes stuff up and I use it sometimes
because I need to remember what was, what was the thing?

(01:10:52):
Which part of that? What's it called?
You know, and so, and then it'llremind me and I'll know if it's
wrong. The horrible thing about this is
that basically my friends Gary Taubes and Nina Tai Schultz were
some of the first people writingthese low carb books.
And then Michael Eades and Mary Danny's were providers in
Arkansas helped like 10,000 people get unfat, you know, And

(01:11:14):
so all these people, you know, launched this a low carb wave
and and explain where the science was bereft in the
medicine, where it was missing. And I do this in perimenopause
and menopause. And the truth is we really need
outsiders like me or can even bean insider if they have an
objective view and are willing to look at words and all to take

(01:11:35):
on these subjects and say here'sfor the science lies.
Because I tell you every area, you know, I did not need this
lesson in the endothelium area. You know, this is my eyesight.
I have been so sick for like a month and I had to fight for
tests that I know I need. I had to get the head of
endocrinology to prescribe the test for me because the other

(01:11:55):
gynecologists are endocrinologists said they
didn't have this test called theSynecdithin test where they
stimulate your basically they want to see what your what your
cortisol is doing. If you're a hormone from your
pituitary can get your cortisol out of the grain.
And, you know, and so the idea that of a facility like Kaiser
wouldn't have this with all the diabetic and very sick patients

(01:12:17):
they have. I mean, if it's a outhouse in a
cornfield in Idaho, repurposes amedical clinic, okay, I believe
it. Then of course they have it.
I mean, you know, and this is the kind of thing that that you
deal with. And unless you have the
information on the other side, which books like this can tell
you, you know, Gary's and Nina's, you know, with
appropriate skepticism, you know, it's sort of like you're,

(01:12:40):
you're screwed. Like, I don't know, hematology,
that's blood. I know a little bit about it
because I know the immune system.
But so that's an area where if something happened, I would do
massive amounts of reading. But we can't do that.
That's why we need books like this because it gives you some
idea. And I want to just warned
though, there's a thing I call aMaceball science, like, Oh my
God, it's so fantastic. This thing.

(01:13:02):
It's just like, you know, your cancer will become like, you
know, butterflies and fly out ofyour brain.
You know, I mean, it's just thisthe perfect, great,
unbelievable, you know, quote UNquote science.
It's really important to look tosee that somebody is skeptical.
For example, Gary Tufts. Oh my God, he's the most nervous
person about concluding anything.

(01:13:23):
And so he's my scientific Big Brother because he's a great
role model for not making unwarranted leaps.
And so I looked at him as a rolemodel for that.
And then who else is I thinking,you know, but so in my book, it
is so disturbing to me to not give him an answer because we're
all afraid. So in the breast cancer chapter,
I, I, you know, at the end, I say, I'm really sorry, you know,

(01:13:45):
you want to have this answered. So does estrogen cause breast
cancer? You know, does and, and so, and
the research is too what's called heterogeneous.
This group of women was tested with this drug and that drug and
everything. And you know, there are just so
many problems with it. We just can't conclusively say.
And so I tell people, you know, where I why on this, I have a

(01:14:09):
risk of breast cancer. But women, one out of five women
will die of heart disease right now and very soon.
One out of three breast cancer usually die of heart disease and
and like 90% of breast cancer iscurable.
That's horrible disease. Don't want it chemotherapy.
I mean it's just ruinous and horrible.
But what's most important if youhave to have a trade off for me

(01:14:31):
and and everyone cannot just follow what I do because it's me
taking account my individual health metrics and most people
to help them with that. Oncologists are actually the one
doctor that can probably assess risk better than the rest of the
job really are not good at it. And you know, I'm able to do
that. But the answer isn't just follow
what I do, but to make a reasoned decision with somebody
to help you do about where your individual risk lies and where

(01:14:54):
it's important to in terms of trade-offs.
So you've said you don't. Write for Saints of discipline.
I really love that statement. I write for the mere.
Mortal like me, you know, my friend Steph says.
I'm not lazy, but I am a lazy hedonistic pit.
You know, if I have ice cream inmy house, my little e-mail kind
of snout will be right in that it's going to like dive.

(01:15:17):
There will be none left. And so I just work things out so
I'm able to do like I have have doable initiatives for my
health. So this is something as an
advice columnist that that was areal big part of my practice.
First of all, I never gave advice, which is funny as an
advice columnist. But if you tell people what to

(01:15:38):
do, it causes psychological reactants, you know, and so
which is a rebellion. But so when writing my calm,
however, I would, you know, there'd be the the thing that I
would say would be like the third paragraph, like the near
the end where it would be, you know, a suggestion of like, you
might do this or, you know, thisis a way to something.
I put it in those indirect terms.

(01:15:59):
Excuse me, almost sneeze. OK, maybe I'm not going to seize
false alarm. And So what I would ask myself
is like, hey, I'll kind of I think there is profanity
involved. Is there anyone going to do
this? Is anyone going to keep doing
this? And if the answer wasn't yes,
well, it's like, well, you idiot, go back to the dry bird
jerk, you know? And that's the thing with, you

(01:16:19):
know, the how to eat and how to exercise.
And when I talk to people, I do private sessions with people.
I have no qualification. I'm not a train, but I'm really
good at this because I have one session with somebody and I help
them things and figure out how they're gonna fail and manage
all that psychologically and otherwise.
But, you know, it's this thing of like, well, OK, who are you?
What are your values? What works for you?

(01:16:42):
So I talked to my Asian about, you know, ways to eat.
But she's his kids, teenage boysand gorillas.
But the buffet and they eat so much food.
So she makes chicken thighs for them because it's like you can
afford them. Like for children who would like
eat like, you know, insane amounts of food.
And so I don't eat chicken flies, even though they're so

(01:17:03):
delicious because they're very high, sadly in Omega 6 fatty
acids. And you want to have more
omega-3 and that's in the salmonand other things they eat.
But so, you know, I quit them. But you know, so she needs to
still serve those. And there are, there are people
who are just not willing to stopeverything or they want to go
out for drinks and you know, andstill live a certain life.

(01:17:27):
So you work things out for them what's doable.
And you also help people manage failure.
We all fail. We suck.
We just, you know, we mean to dosomething and we don't quite do
it. And then we feel really bad.
And the important thing is to have self compassion for when
you fail, you're going to fail. And so you need to accept that
It's not, you know, that you're a horrible person or anything.

(01:17:47):
This is just being a human being.
And I like the self compassion thinking of Kristen Nepp, who's
a researcher in that area where she says your failures are what
connect you to other humans. And so that sounds like The
thing is our brain, it's really,like I said, kind of dumb.
You can just tell your brain a story and it'll believe, you
know, and that's how they implant memories.
And these people, you know, secten whatever and crazy stuff

(01:18:10):
and, you know, repeat the story and you repeat it and it becomes
real to you. So that's really important.
And then, you know, to have, forexample, systems instead of
goals, goal, and this is also inmy last book, systems are things
that are overreaching, you know,strategies.
I'm going to be I'm going to take care of myself in later

(01:18:31):
life and live this wonderful, robust life.
I'll be me, but just a little more, you know, need of iron,
you know, and not suffering and sick.
And so that's the system and thegoal is, well, I'm going to eat
perfect a or I'm going to, you know, I'm going to or hike 20
miles or something like that. If you don't do that, then you
fail. You can fail, you know, at

(01:18:51):
meeting your goals, but your systems are ongoing.
And so that helps you sort of amortize failure, you know, And
then also the other thing is that when you do that, that
helps you not just say throw up your hands the way people stop
going to the gym. Oh, I didn't go yesterday.
I wasted some money last month. I'm just not going to go because
I feel bad about not going. No, and just be honest about
that and laugh. I laugh at what a ridiculous

(01:19:14):
fallible dummy human I am. You know, those things you do
where you think like, but that is still good, that food and
then you're like over the toilet.
These things really knew better.You knew better.
You knew better not to open thatthing that you knew was going to
like explode all over the counter with like the dog
gibble, you know, And so laughing at that, that helps you
not be such a recriminating hardperson on yourself.

(01:19:37):
And then it should really work out well.
Can you do this? How do you make this doable so
you're not feeling like you failed?
And then how can you do you wantto extend yourself a little, do
a little more and a little more.And the thing about building
habits is that the more you do, first, it's uncomfortable.
The more you do it, the more it becomes normal.
And so like for me, I just stopped eating bacon because I

(01:19:58):
needed to go SWAT team on inflammation because this
corneal endothelium transplant. And so the first day herring
with butter, that heat in the microwave, it's actually quite
good. The smoked herring is
inexpensive on Amazon. I was sort of like, well, this
is kind of, but then I done it and I'm sort of like, well, this
is tasty and like, OK, you know,whatever.
And those pork rinds, I still have two of the big, big jars I

(01:20:19):
ordered that are up there and they look at me.
I'll take them to a party. So I don't because it's more
important to me to not have inflammation.
And so it's these sort of things, you know, that are that
are important to do, like to be forgiving to yourself, but also
to set up habits. And this is great advice from
Mary Dan EADS, the one of the authors of Protein Power.

(01:20:40):
These two doctors, they're my friends.
They're really great on evidence.
And you know, the low carb they're like the first along
with Doctor Edkins and she says to her patients and when they
were practicing in Arkansas, OK,I want you to try something.
We try this for two weeks to be faithful to a low carb diet just
for two weeks. And then if you don't like it,

(01:21:02):
you know, be disciplined, be faithful, then you can stop.
And, and this is what happened with me.
I we were taking the book cover photo for I see Rude People
which was three books 4 books ago that many books.
Because of painful. Process each time.
Anyway, so I had had, as I mentioned, my snout in a bat of

(01:21:23):
ice cream for all of March and Iwas like, oh, you know, camera
adds 10 lbs. And so from being friends with
Gary Tobbs, I knew that I could just lose weight if I just like
cut out everything but like meatand eggs and black coffee.
And I did. But also I felt so good from
this, you know, that I just keptkept going with it.
And so and that's the thing likehow habits start.

(01:21:44):
You get used to it and acceptingthe discomfort is just such a
big part of it. And if you even I like to talk
to myself, it's like there's a friend there and it's funny, you
know, the thing of like, come on, don't be such a wussy.
You can do this, like, OK, whatever.
And and that's really like to have things be amusing and not
just grim. That really helps too.

(01:22:04):
So these are some of the ways where you can make, you know,
make exercise and diet work for you that maybe you're not going
to go to 100%, but maybe go to 65% or 85%.
And then maybe you try going a little further and the more you
repeat a habit, it's there's theline neurons that fire together,
wired together. It's actually Carlos shots,

(01:22:28):
paraphrasing Donald had became the original.
I love that though, because it'svery descriptive and important.
It's that when you're neurons inthis neuron, you do some action,
this neuron fires and then and then you do some other action,
this neuron fires and then they begin firing at the same time.
And then the the set of actions become sort of automatic.
And so this is this is a very important thing to to understand

(01:22:51):
in terms of like your habits become habit, the things that
the actions become habits. And so it's also the social
support you mentioned. This is such an important when
you tell other people you're doing something, you don't want
to be a liar. So you're more likely with the
eyes upon you that you to followthrough.
And also it really helps two people and they sometimes do

(01:23:23):
more. And so this is now socially
supported. It's something that they do
together and this really helps. So all those things that can

(01:23:46):
help you manage habits. Another 10, this one from my
friend Eric Markman, who's psychologist.
It's just great. So I wasn't taking my vitamin D
in the morning. I was forgetting.
And so I thought, OK, let me take arts advice, which is build
a habit into your environment. So how do I build that in?
OK, the first thing I do in the morning, grind the coffee beans.

(01:24:09):
So I put the vitamin D bottle inthe coffee beans.
So I had to go through the vitamin D to get to the coffee.
And so I like in less than a week, I was just, I thought
about that. I remembered like I woke up, got
to take my vitamin D and it became a thing.
And so those are some of the things that we used to get
around. I mean, our mere mortal hood.
And recognizing that really helps.

(01:24:29):
You have to know that you're screw up in order to deal with
it. So what do you want the readers?
To take away from going menopausal, menopausal,
menopausal. I have an wrong thing in my
notes. Going menopausal, which is the
cleverness of the title. It doesn't make any sense.
Going menopause. No, no, that's.
Me yeah. So, you know, I want them to #1

(01:24:50):
have the science that they I, I wrote this is the the thing that
was really important to me, right I have this note here
right Every page of this book for Pamela D she's my bus driver
and she's smart, but she doesn'tread science she's just a normal
smart person. Sharp tough I I really like her.
So I wrote this book, you know, in language that you know, if

(01:25:11):
I'm saying something, there are these things that you say when
you you know, if you don't have a PhD and you get a little
insecure where like it's like, is this here because it's
important for your readers or because you want everyone to
know your beliefs and that's thejerk stuff.
I say worst word about that the a health stuff.
And so it's like, you know, thenI yell at myself and I cut that

(01:25:32):
stuff because this is not helpful to readers.
So I want people to use the information in here written this
clear language to go ask their doctors for evidence based care.
And then I also, you know this, let's be realistic.
Hi, can I have this drug? No.
So what I do, however, in this book is that I give them in fail

(01:25:54):
safes for not being turned down.Now you may be turned down, but
this is more helpful. So like like to take your first
morning temperature. This is this is the thing that
tells you the the whole directions in it.
This comes from Jeralyn Pryor, the endocrinologist quantitative
basal temperature taking. It's not for fertility.
This is to figure out whether ornot you have the temperature

(01:26:17):
elevation that shows that you'remaking progesterone and for an
adequate number of days. And if you're not, this is
unhealthy and you probably can'tsleep.
That is the single best excuse, by the way, Not excuse, but like
if you go to your doctor, we need sleep.
What they're going to deny you sleep and you bring this data.
This is legitimate medical data,first morning temperature

(01:26:39):
collected because it shows you, you know, and especially if you
do it for a period of months to show if there's a pattern there
that you're not ovulating, that's what it shows.
And not ovulating means no progesterone because there's no
SAC rupture and nothing, no litter to make progesterone out
of. And so your doctor, how are they
going to be asleep? And you can protest those
things. It's just, you know, it's, it's

(01:27:01):
hard to do and I try not to have.
So that's that's the thing. And then to basically have the
language to partner with your doctor, not to antagonize them,
but to, you know, listen to themand be respectful of them and
then also put your point forward.
And then if you're not able to get a science based medical care

(01:27:21):
out of them, as you see in the book, according to your values,
well, then you can go to anotherprovider.
And that may be hard if you don't have money.
There are also, you know, they're they're here.
We the Venice Free Clinic and places like that.
So it may be difficult, but you,you know, it's worth work to
protect your health. And also you can file complaints
about the way a doctor's treatedif you feel that they are

(01:27:42):
negligent. And I think that being realistic
about medical care, but also there are some other things not
just to get the medical to use the lifestyle elements.
I I, I looked at basically reversing in the cell.
What are the healthiest ways to eat and exercise based on you
know what what we want to happenin our cell and what are the

(01:28:04):
most powerful and efficient? I am not going to, I'm not like
doing manual labor, but for an hour with like iron bars, this
is ridiculous. I'm not, I'm that's the most
boring thing. So I have this like a little
weight graveyard in my house over there in my living room.
And I'll do one set, you know, aday or sometimes more of this
weight lifting muscle failure. It's painful at the end, but

(01:28:24):
it's like 1 set, you know, and, and what you do once you do this
is something I'm sure you know, you don't have to work every
single muscle. Like let me get my right.
You know that muscles when you're working a bunch of
muscles, they transmit the muscle health throughout your
body and sew this and then eating in ways that are truly
healthy, healthy that do do not provoke inflammation, you know,

(01:28:45):
insulin resistance. You know that this is this is
something also the people. And while it's delicious, like,
and I also am lazy, so I do not cook, I heat.
I write books like you write thebook, like I have a book right
here. You know, there's lunch, there's
a plate over there. It's done, it's gone.
So why would I spend all my timeon something that's just gone?

(01:29:05):
You know, and that's how I see it and other people, you know,
like to cook it. But so basically I eat things
that you can flip like 2 steps, flip that's, you know, steak,
salmon, whatever. And, and like those kinds of
things make your life doable, you know, make you able to be
healthy. The, the real, the
realisticness. I was being realistic about what

(01:29:27):
is possible for you as immortal.And these are the things.
And then if you do all of this, the end of my book, I, I throw
off the stigma of aging. Now women at a certain age, you
become invisible. It's the worst thing.
It's the craziest thing. Before, you know, you'd have all
this attention and suddenly 88 or, you know, it's like 60.
All of a sudden, you know, you don't exist on a certain level,

(01:29:48):
you know, because of the way we evolved, men prefer physical,
Men prioritize physical beauty, and women prioritize providers,
which doesn't mean that we look only for, you know, but men
throughout their lifespan are attracted to women in their 20s,
which is kind of 60, you know? And so these are things that
can't help but affect you. But if you understand it through

(01:30:09):
that, then it's not personal. You know, I know this from the
AB psych research I've read. The thing is, if you're healthy,
I have a chapter old as the new black about throwing out the
stigma. I go around, I probably said I
was 60 or 61 from 1 in March. I sometimes forget and say 60,
but I go around telling people my age, you know, like the the
guy who went to Harvard who's like lets you know that before

(01:30:32):
you lick the salt off your martini, I'll live at a
clocktail party, you know, and so, and the reason for that is
that I refuse to accept that aging, you know, the stigma that
is placed on women who age. I'm, I'm old, I'm fabulous.
No, I have fun all the time. A much better person than I was
in my younger years. More courage, wiser, kinder, all

(01:30:56):
these things. And so I wouldn't go back and
you see all these the amazing thing is that because we're
living longer and are able to behealthier despite all the
horrible diet malpractice, you've been foisted.
People have like second careers,you know, like later in life or
like 4th or 5th and they're doing things that they always
wanted to do. I'm going off and living

(01:31:16):
somewhere else volunteering. And my friend Debbie Levin, she,
I met her because I sold my column to the Alternative weekly
newspapers and she was there selling Callahan cartoons.
And so that was what she did. She represented animators and
everything. And she had Callahan the my, my
late friend, the cartoonist. And then now, Oh my God, she is

(01:31:37):
a talented like artists doing ceramics and her ceramics, I
just sought after interior designers buy them all these
stores want them, you know, and she's truly, it's not just, you
know, decorative, it's really it's, it's art.
It's so. And it's so exciting to see her
thrive like that, you know, withthis totally like career #2 like
going gangbusters. And that's, that's the thing

(01:32:00):
that I see a lot with women, youknow, at this age and what's
possible, especially if you're. And so this is that that's the
thing that is possible. That's the end result.
Like to have this great, robust,fun life where you're just you,
but wrinkled and running off to Paris or whatever.
Yeah, I don't think 61. Is old.
I just turned 62 last week. Oh, you are OK?

(01:32:20):
Yeah, well. You know, it feels old when you
have these things that go wrong with you.
Like I used to be a sea across the street, you know, read a
matchbook across the street backwhen I was 20 in the rematch
books. And now I hate these people.
Like whoever does the bottle like Tylenol, I have to
photograph it and like blow up the photograph.
Like really, this drug will killyou if you, you know, if you

(01:32:41):
drink coffee and take it like, OK, we're all dead because
you're terrible people or older.But see, I don't mind old.
I I call myself old. I'm just offended when like I go
to an extreme nerd meet up groupwhere we debate science and
other readings and everything. And some guy asked me if I were
my friends or 40. And so that's not myself image.
I don't have kids. And so I was so deeply, I

(01:33:04):
realized I could be his mother, which is sort of weird because I
don't have the self-image of being as old as I am.
I feel I feel like myself at some other age, like age.
But it's just when these things,you know, go wrong with you
where you're wait a second, my eye, wait a second, my eye is
getting like basically what happens?
Like you get little, the cells die and it looks like pounded

(01:33:24):
copper in there. Then you go opt out, opt out.
Thank you. Like, and not all of this
happens with age, but those kinds of things sort of lead you
to remember all those people, the old people have said, you
know, you need to value your health.
You'll, you know, miss your health when it's gone or
something on your 20th. Yeah, OK, whatever.

(01:33:45):
Not that I'm unhealthy on that level, but the lack of
robustness is just important. So that's the reason why, you
know, you don't just wait. What people do is they wait
until, you know, the house is onfire to buy the fire
extinguisher. And this is normal.
You just think, OK, well, I'm fine now.
My cardiovascular system is not exploding, but what's happening

(01:34:05):
is that the disease is progressing, atherosclerosis is
progressing the plaqued up arteries, and you don't reverse
that. And so it's best not to have the
irreversible disease that's taking off like a little Choo
Choo, like, OK, we're going to kill you now slowly, but it's
going to happen. And it just takes these steps
and we know what the steps are. And So what I would urge others

(01:34:28):
to do are nerds take on him, take on these other areas.
People need to write these books.
You need to know how to criticize and look critically at
the medicine and research. And that takes a certain kind of
person. But we need this for other areas
of medicine because the questions aren't being asked.
You know, you just look at the eye area.

(01:34:49):
They give these steroids that are absolutely terrible.
Well, what are other drugs? Why are people all taking
Prednisolone acetate when there are other drugs that have less
systemic effect, you know, and then cortisone, you know,
corticosteroids, they destroy your bones.
They, they do so much damage in the body.
And you see doctors Willy nilly like here, let me inject you,

(01:35:09):
you know, and they don't tell patients the risk.
So that's the thing. Also, I want to emphasize that
you need to ask a doctor. Do what I do, do what I do.
When I'm looking at papers, I amalways, always prioritizing
looking for the adverse effects.And when they aren't there, I
look elsewhere for them. And then I don't, you know, I
look down on the people. There was just something I read
the other day was where. From India and avoid looking at

(01:36:01):
medical research from China if at all possible if there are
other studies because there's a likelihood that it is fraudulent
and that's that sort of thing. It's scary how much fraudulent.
Literature there is in this country.
I mean, I interviewed Charles Pillar late last summer or
something like that. He did a paper and science on
all of the literature that was on Alzheimer's and the the

(01:36:23):
plaque hypothesis and how, you know, they were falsifying data
just to support their hypothesis, which is insane, you
know, I have to tell you. I see this with various
researchers I respect. People work.
This is human. They work a little too hard to
sell their thing. Someone will be, you know, they,
they, they're strongly their researcher is this drug and not

(01:36:46):
this drug. I don't want to, you know, name
names because these are mostly people who are, you know,
they're doing really great work.And then I just see, you know,
you needed to apply appropriate skepticism here to your own
beliefs. That's the thing about the minds
being made-up with like sheets glued to a bed.
And you see that in everybody. It's very depressing.

(01:37:07):
A social scientist I know wrote a book with somebody who was a
medical doctor and they, they mentioned something and I said
to her, I really like it in my in social science.
But like, wait, this is from like 2000.
Like this is 2020. There was 2024 at the time.
Like that's not valid as supportfor this.
You know, there's been research since then or, you know, I mean,

(01:37:28):
it's just, it's that sort of thing when you see this and I
always go to the citations in a paper, you know, and you see
that long errors, big error. And this is not, I did not come
up with this. You know, this has been a thing
for a while. Geraldine Pryor, I learned about
it from her, the endocrinologistfrom BC, that there's been a
confusion of progesterone, whichis the FDA approved drug and the

(01:37:49):
hormone in your body. It's the FDA approved drug
that's the same molecularly as the hormone in your and then the
synthetic knockoff drug that hasall of these harms called
medroxy progesterone acetate. Scientists, really famous
scientists, they confuse them. There's this paper by a really
famous person in science in thisarea and it's all about how

(01:38:09):
progesterone causes this or thator the other thing.
And I thought and what, what wasclaimed, it didn't make sense if
you know, the, the biology, the actions in our cells and
everything progesterone, I always look at that.
I look, go down to the cells, the, the, the Physiology and
look at all sorts of studies in different areas, not just
clinical studies, but animal studies to see how is that

(01:38:31):
happening there? How is that happening there?
Or do we have some kind of similarity, You know, and this
you go out of the back paper where she said progesterone did
this like, oh, Jacques Hughes, it was all, every citation was
from Medroxy progesterone acetate, which is a totally
different drug. The FDA when you get the little
package insert from your progesterone, it has the the
standards for medroxy progesterone acetate, which is a

(01:38:54):
different drugs where progesterones, you know, unless
you have liver ascites or which are some kind of fluid buildup
or really low blood pressure or there's some other conditions
like rare conditions, basically progesterone, peanut oil, it's
in peanut oil if you're allergic.
Progesterone is an extremely healthy and and low adverse

(01:39:15):
effect drug. The best they could come up with
when they're trying to say, oh, no, we don't want to give this
to you was that it makes you drowsy.
Well, yeah. And I take it at bedtime because
at bedtime drowsy is good. You don't take it at 11 in the
morning, then drowsy is bad. Hello.
You know, it's just so it's justso terrible.
Like, imagine car mechanics who work like, you know, who had the

(01:39:37):
like what we see in my book and elsewhere about the medical
field. You know, you'd never drive your
car home. They connect the the radiator
hose to the gas tank. And I don't know.
I mean, it's just so crazy how much is amiss and how much
betrayal of patients there is. And again, doctors, they're not

(01:39:57):
evil. People say, oh, they're in it
for the money. Go to Kaiser Permanente.
My doctor's not getting a Ferrari for treating me.
My gynecology. He's such a good person.
He listens to you, you know, he treats you like you according to
your values. This is called shared decision
making. You know, it's the same thing.
I do the same thing in my book. Not every woman wants to take
hormones. Some are afraid, some can't take

(01:40:18):
them for various reasons. So I give you know, here's why,
you know, here's the the stuff on hormones.
And here are other things you can do, you know and you can
exercising Estrada after menopause with progesterone.
This is very this is a way to promote optimum.
And remember, I came to that as somebody who came in thinking
estrogen Satan from back in 2002and I saw that I was wrong.

(01:40:43):
And that's important to be appropriately skeptical to look
to see is there, you know, what's what's the downside here?
There is a downside that that kind of thinking protects you
and it's very, very important. Well, as much as I.
Want to be on Joe Rogan's level.I think we're starting to
approach a Joe Joe Rogan level podcast here, so we should
probably be wrapping it up. You probably have some things to

(01:41:05):
do, some pork rinds to take to aparty or something like that.
So where can our listeners Firstoff, you know, find the book and
when's it going to be released at?
It's coming out soon, right? You pre.
So here's my book. Going menopausal, what you and
your doctor need to know about the real science of menopause
and perimenopause. And it will be out May 20th.

(01:41:27):
But if you pre-order it now, I will love you.
Oh, see, no, I'm out of focus. That's so that really helps me.
And it's at Amazon, Barnes and Noble here.
I'll try to come into focus now.And indie booksellers.
And also I came out of advertising, remember, and I was
a producer. I cast a lot of people.
I cast Earth, the kit for a fish, for a Hardee's fish sticks

(01:41:50):
commercial. And so I helped cast this
voiceover Carrington Mcduffie for my audiobooks.
She's a singer. She's so stellar.
She's great. People buy my audio books.
They they sell really well because hopefully cause the
book, but also she reads so beautifully, you know, so that's
another option if you're not somebody who wants to just sit

(01:42:10):
and read a book. Even though I worked very hard
to make it entertaining and say funny things in between all the
terrifying medical stuff, sometimes terrible and then
other stuff just sort of and there's some unbelievable
stories in here. Some of the stuff that's going
on, like about the discovery of progesterone.
And you know, this woman, Geraldine Pryor, how fierce she
is. She grew up in the Alaskan
wilderness. That informs her fierceness

(01:42:31):
about medicine. So you know, this is I promise I
entertain you and I give you thethat what you need to go to the
doctor with to get medical care.That's evidence based in going
menopausal. It is a very.
Entertaining book so I'll give aplug for that I haven't finished
it yet because it is a thick book and it's.
The reason I haven't finished itis because you cannot read it

(01:42:52):
like you read some books where you can just kind of skim
through and you can get the major points.
If you read it like that, you'regoing to miss a lot of the fun,
interesting dialogue and the. Yeah, they're just the the
thought pattern you have in the book.
And so as you were talking aboutit being an audio book, I think
that would be the way to consumethis book because you're not

(01:43:13):
going to miss a word, but it's not going to be so burdensome
that you have to sit down and read.
And it's going to take you months to kind of get through
the book. Just plop in the car, listen to
it as you're driving to and fromwork, pop in, you know,
exercising. You can listen to it.
It's a it's a really, really good book.
And being a male who certainly lack some understanding of

(01:43:33):
menopause, despite the fact thatI have two sisters and a mom and
a wife, it's really eye opening.It's a really well written book
and I loved it. I can't wait to kind of get
through the last few chapters that I have yet to read and so
highly recommend it. We will put links in the
description notes to where they can get the book run out and get
it and enjoy it. It'll be a great book to to

(01:43:54):
read. Thank you so much for.
Having me this is wonderful. Oh, thank you.
Keep. Keep after the medical
profession and keep aging well. Thank you.
Thank you. You too.
Thank you for listening. I.
Hope you benefited from today's podcast and until next time,
keep aging well.

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The Real Science of Perimenopause & Menopause | Ep. 258

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}The Real Science of Perimenopause & Menopause | Ep. 258