← Extend Podcast with Darshan Shah, MD
Extend Podcast with Darshan Shah, MD
181. Dr. Taz: The Hormone Conversation Women Should Have Before Birth Control, IVF, or HRT
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Dr. Darshan Shah
Before we get started with this episode, I'd like to invite all of you to the first ever next Health Longevity Summit happening in Nashville, Tennessee at the Conrad Hotel on Saturday, September 12, 2026. This is an all day summit where
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you're going to be hearing from some
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of the best speakers in longevity medicine,
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including Dr. Vonda Wright, Dr. Luisa Nicola,
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many of the podcast guests that you've
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heard here on the Extend podcast, and of course I'm going to be there curating the entire day. We also have incredible vendors coming so that you can try the latest technologies in health, wellness and longevity.
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Go to next health.com summit and buy your ticket today. We only have 400 spots and they're going quickly. That's next health.com summit.
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I look forward to seeing you all there.
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Welcome to extend with me, Dr. Darshan Shah, a podcast dedicated to cutting edge science, research, tools and protocols designed to help you extend your health span. Having become one of the youngest doctors in the country at the age of 21 and trained and board certified at the Mayo Clinic, I've accumulated three decades of practice as a board certified surgeon and longevity expert. Over that time I've discovered that a mere 20% of health knowledge yields 80% of the results. When it comes to your health span, we are living in a new era where we are creating a new healthcare system no longer focused on disease management, but achieving optimal health and vitality. Join me as I interview world renowned experts offering you a step by step guide to proactively avoid disease and most importantly, extend your health span. A lot of women are taught to think about hormones only when something needs to be fixed. A painful period becomes a birth control prescription, acne, hair loss, weight changes or PMOs. Symptoms become separate problems to manage. Fertility struggles often becomes a visit to an IVF doctor. Then perimenopause arrives and suddenly we focus on hrt. Each of those tools have a place, but when every stage is treated separately and differently, we're missing the bigger pattern in a woman's body that has been showing up for years. My next guest, Dr. Taz Bhatia, has spent her entire career looking at this pattern differently. She began in emergency medicine and then she moved into integrative and whole body care after her own personal with fatigue, hair loss, joint pain and weight changes. She then received a diagnosis for pmos and that showed her that many doctors treat women's symptoms without ever explaining what's driving them. Her message is simple. Hormones are not only about reproduction and symptoms, they are part of how our body communicates they affect your brain, skin, hair, bones, mood, metabolism, energy, all of how a woman moves through her life at every stage of life. Today, Dr. Taz and I follow that thread through birth control, PMOs, inflammation, gut health, stress, nutrient depletion, and the hormone conversation women should be having long before they reach a crisis point.
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Dr. Taz, thanks for coming all the way from Atlanta to join me on the podcast.
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Dr. Taz Bhatia
Oh, I'm excited to be here. Honored.
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Dr. Darshan Shah
I'm honored to have you. And, you know, it's always great to talk to a fellow physician that's gone through all the same things that we all go through and ended up here trying to educate the public on all the things that they should know about. But I think a lot of times, like, people just don't hear it enough from their doctors, and putting this information out there just really gives people the opportunity to really take their health under their own control right into. In their own hands. Right, Is what I'm trying to say. And you've done a lot of this education for so many years, so can't wait to have my audience hear from you.
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Dr. Taz Bhatia
Oh, well, thank you. I know. I think, you know, until we have a medical system that really works for people, we can't put out enough content to help people.
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Dr. Darshan Shah
Exactly. Yeah. And, you know, being in Western medicine, and I'm sure you found this, too, working in the emergency room, we just always wait way too long before we start paying attention and taking care of people. And so I really feel the only way to get people to stay healthy and reverse chronic disease is to put the power in their own hands 100%. Right. So let's talk about all of that.
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Dr. Taz Bhatia
Okay, let's do it.
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Dr. Darshan Shah
Your model and your clinics and everything that you've done is incredible. Incredible what you've done. So, you know, tell us a little bit about how you started in medicine and then what brought you to the place you are right now.
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Dr. Taz Bhatia
You know, I started very traditionally in medicine. Probably like yourself. I actually really love medicine. I have to start with that. Like, I've always been fascinated with how things work, how the body works, what's going on with it. But early in my career, coming out of med school and residency, I was drawn to, I would say, like, high intensity medicine. I liked the icu. I like the emergency room. My intention was, actually, I had moved back to Atlanta after residency. My intention was I'd worked the ER just for a short period of time, but I was gonna go on and do an ICU fellowship. And I think what drew me into Those careers was first of all, the adrenaline rush, right? The proceed, you know, this as a surgeon, the procedures, you know, being able to see things turn around really quickly, you know, instant gratification in terms of results, but also the underneath of the physiology and the chemistry and how you have to really understand that in either of those disciplines. So I loved it. I 100% I loved it. I love going to the ER. I love the variety. I loved, like what I saw. But in that journey of being an emergency room physician, there are a number of different things that happen. First of all, you know, you really can't carry the ball forward for someone, right? You're like the hero that comes in and saves the day, but after that, you never know what happens. And at that time, and I'm sure now too, the emergency room was primary care for a certain sector of the population, right? So it's a very uncomfortable position to be doing primary care, but not really having the systems to follow through with an individual or a family and to be able to have the time, right. Ers like this, you don't have the time to have in depth conversations. So there was the medicine and the patient care component of it. There were some really horrific things that happened there too that hurt my heart, you know, and so I'm taking all of that in. And meanwhile my health is deteriorating and I am, you know, having all these symptoms and having different conditions that are slowly turning me into a different version of me. And so I started to get tired. I'm usually super high energy, probably annoyingly so, you know, I started to have some weight gain. I started to have a lot of like joint, joint pain and joint aches and those type of symptoms. And then the one that I actually paid attention to is that I started to lose my hair. And you know, our family, we have like this big, massive amounts of hair. We're known for it. And all of a sudden, like my hair's falling, but it's still, still not really noticeable until it is. And patience, you know, started to not look at me, but started to look up here when I was talking. So I started to get really self conscious, you know, and, and started to be like a little bit insecure when, you know, I was getting dressed or going out or doing those things. And you know, ironically, at one of these like times when you don't feel that great about yourself, I still had my family around me. I had my, you know, husband who we were dating at the time, but, you know, eventually got married, who are observing all of this as Outsiders and who are like, something's wrong. You are not yourself, you know, and really encouraged me to go and get answers and to find out what was going on. And so I did. And there's a little bit of ego in medicine, too, right? Where you're like, I can figure this out. I got this, you know, so you. I grudgingly started making these appointments, you know, and it was just a very frustrating journey, you know, and I don't want to belabor it too much, but over 18 months of maybe 10 to 12 different doctor's visits, I was categorically told, I'm. Remember, I'm 26 or 27 years old at the time, I'm a young woman. And I was categorically told that, you know, that I'm stressed, I'm anxious, you know, you know, maybe it's this or maybe it's that. And finally, I was referred to a hair loss specialist because everyone was just fixated on that who prescribed a medication that we both know that is supposed to help. And he was like, if you don't take this, you're going to be bald in the next few years. Which, again, I'm 26, 27 years old, you know, don't tell me that. So I take the medication without questioning and without, like, digging deeper into it. But it had side effects, you know, and those side effects, especially for somebody like me who already runs low in terms of blood pressure and blood sugar and some of these things were pretty consequential, you know, like, I took it on a particular day, got in my car, had worked out, and ended up. Ended up having a sinkable episode, essentially. So the end of that story is basically like, I've gotta take this into my own hands. I've got to figure this out. So that led me to this whole other world of medicine that we were never introduced to when we were going through our medical training and residency and all the other things. And it landed me, you know, first with a weekend conference in holistic medicine, then understanding Chinese medicine and becoming an acupuncturist, then going and certifying in nutrition. Like, it just. I kept, like, finding pieces that I wanted to pursue. And through this, I'm getting better, like, I'm figuring myself out. And then I finally did the fellowship in integrative medicine with Dr. Andy Weil. And that allowed me to take, like, my conventional training and all the medicine I had learned and marry it with all these other systems of medicine and practices that I was now learning and how to kind of, you know, Flex back and forth between these worlds in a really neat way. And meanwhile, I'm getting better. People are asking questions. People are seeing a physical change in me, an energetic change in me, right? And they're like, well, what do you do? And so then it was like, well, what do I do for this? Or what do I do for that? And so my husband, who's over here in the corner kind of watching, is like, I think you need to do something with all of this, you know? And so he was really kind of like, the kick that was like, just. Just do something. Just start, you know, like, why are you overthinking this? So he was starting his dental practice, and he, like, gave me two rooms at the back of the dental practice. He's like, just show up once or twice a week. You can still work the error. And so I did. And I don't think either of us expected what happened next. Where that same kind of like, hunger, shame, dissatisfaction, whatever you want to talk about it, where you just feel like you've not been heard and you feel like you have nowhere to turn to, and you don't know where to get answers, was just a repetitive echo in patient after patient after patient. So I got busy really fast and at a time when we didn't expect to be busy, you know, and ended up taking over some of his dental chairs on the day he wasn't there. And so as that kind of unfolded, you know, I think it just took a couple years and the realization between the volume and the patients and their stories, I was like, I can't do this halfway. I can't, like, give you a plan and send you out the door, and then five other doctors tell you that I'm a quack or this information's wrong, you know, and then expect you to get better. And then, you know, so many stories from so many patients over the years, but a couple in particular, where I'm like, people need to have a medical home.
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Dr. Darshan Shah
Yeah.
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Dr. Taz Bhatia
They need a place to come and not be judged and present their questions and be able to make decisions in a way that. That works for them, but without, like, pressure and ego and all these other things. And, you know, and there were. There's so many stories, but, like, one in particular, you know, a woman who had such a bad experience with the conventional medicine system that she refused to go to doctors.
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Dr. Darshan Shah
Her breast.
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Dr. Taz Bhatia
She was having breast pain, but she refused to go check it out. And she finally shows up in my little, tiny back of the dental office office and is like, well, I heard you're different. So I thought I'd come here and we go to examine her breast. She's got a rock hard breast. She had breast cancer. Right. And so, you know, we guided her on that journey, tried to support whatever needed to happen next. She fought for, I think like a year and a half, maybe two years. Then she passed away. But it was stories like that where I was like, I can't do medicine light. I can't do this halfway. People need to have a medical home. This has to be systematized. This has to be where we can really embrace the whole patient. And it was, I think 2012 was the last year I worked in ER shift and I moved into my own building and started to really put my head down and build a team and try to bring other practitioners in, grow from like the one employee, my sister in law being front desk to actually having a real business with a real team. And it's just been a journey. I don't know how else to describe it ever since. It's been like twists and turns and like learning as I go and innovating as I go, all the different things. But it is one that I feel called to and it's one that I would not change for anything else in the world.
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Dr. Darshan Shah
Yeah. So I mean, incredible story and almost exactly similar to my story. I think to highlight a few things that you said that I think are really important for the audience is, and I see this all the time, the people that come to Next Health, our clinics, and also just even yesterday, some of the wealthiest, most well connected people in the world have the same exact experience.
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Dr. Taz Bhatia
Absolutely.
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Dr. Darshan Shah
Where they find themselves at their wit's end and they give up on the medical system to take care of a problem that they've been experiencing and they just live with it. And just like you experience, you know, with your hair loss medication, they're just treating the symptoms, addressing the, the cause of why we're here in the first place. It happened to me, you know, I'm. I tell the story all the time in my podcast that I spent $25,000 for a concierge medical physician that I thought was going to get me better. And I ended up, you know, getting
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more medications, more pills. Right.
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And so I think what we're doing in real time here is talking to people about, about this new system that we're developing.
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Dr. Taz Bhatia
Yeah.
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Dr. Darshan Shah
And it is, like you describe it, a medical home, but it a place where people need to start, you know. And you and I are both from India.
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Dr. Taz Bhatia
Yeah.
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Dr. Darshan Shah
Where there's a huge System built around Ayurvedic medicine.
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Dr. Taz Bhatia
Yes.
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Dr. Darshan Shah
And Ayurvedic medicine clinics are inside of hospitals now because they realize that these are two sides of the same coin. There's a side that keeps you well and reverses disease, and then there's a side of the coin and does what the emergency room does. It takes care of you when there's a major problem. Right. And so I think people need to understand, like, from what you're doing in your clinics and what we're doing in Nexile, that you need both. You need both systems. You need one for when you really get into trouble, and you need one to keep you healthy, keep you in a place where you don't feel like you're powerless. Right.
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Dr. Taz Bhatia
To take care of yourself very much. I mean, I think that's what drew me to Chinese medicine. And Ayurveda was always kind of in our home a little bit. Like, I didn't really understand what my mom was saying or what people were saying. But, you know, you realize later, after studying Ayurveda, that these are a lot of traditions handed down. But in having to study Chinese medicine, they were very proactive. It wasn't like, let's wait till X, Y and Z happens. It was very much like, okay, your energy shifting. This is off, that's off.
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Dr. Darshan Shah
Let's look at your tongue.
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Dr. Taz Bhatia
Let's look at your tongue. Your pulse, you know, where's your shen, which is your emotional sort of wherewithal, you know, so they were. The relationship with a provider or a healer was a proactive relationship, not a reactive. Like, well, what's your problem today? Type situation, you know, it was very much something that you went to this person. They were integrated into your community because it was to keep you well, you know, not to treat disease. You know, and that's the difference.
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Dr. Darshan Shah
You know, you said something else that's really important. I think you and I both come from a traditional medicine education.
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Deep.
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Like, we did residency, emergency room, trauma surgery. We kept people alive in the ICU sometimes, you know, 10 people at a time.
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Dr. Taz Bhatia
Right.
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Dr. Darshan Shah
And so to keep people alive when they're intubated on a ventilator with multiple medications going, it takes a lot of deep knowledge of human physiology.
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Dr. Taz Bhatia
Very much. Yeah.
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Dr. Darshan Shah
And in that level of knowledge that you have, when you go into what we're doing now, which is reversing chronic disease and also keeping people healthy in the first place, like, it's so valuable. Like, it's. I can't see myself starting in this new path of keeping People healthy without that level of deep understanding of what can potentially go wrong.
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Dr. Taz Bhatia
Right, right, definitely. And I think that, you know, I love the physiology and I love the medicine. It still, it still serves me today, you know, as much relational work as I do or as our entire team does. Understanding the physiology and the medicine allows us to navigate the options for a particular patient in a really unique way, you know, because it's very easy to send somebody out with 20 supplements. Right. Or with, you know, hormone replacement therapy, but to understand their physiology and the uniqueness of their imprint or footprint, you know, versus somebody else's is a different game, you know, And I feel like you need the science, you know, along with the relational part to be able to deliver this information effectively, you know?
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Dr. Darshan Shah
Absolutely. And having the practical, real world experience, definitely unmatched in my opinion. So it's so funny because I have some people come on my podcast every once in a while, and, you know, sometimes they're talking about the thyroid gland and explaining the anatomy of it. I'm like, oh, trust me, like, I've removed the thyroid gland.
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Dr. Taz Bhatia
Yeah, we know about it.
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Dr. Darshan Shah
We know exactly what it looks like. I've actually been operated on it many times. I know where every blood vessel goes, all of it. So it's like having the ability to look at the advice that's being put out there now, which is great. Like, thank God people are talking to
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Dr. Taz Bhatia
people, patients, which is what I didn't have. Right. Something. 30, however many years have gone by, but, like, we didn't have social media then, so I didn't have a resource other than trying to figure it out on my own. So now people have everything. I think it's almost. I don't know, sometimes I'm like, is it better or is it not better? I don't know. Because now people are feeling very overwhelmed with all the information coming at them.
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Dr. Darshan Shah
You know, I always tell people, you know, health is overwhelming, obviously, but I get overwhelmed when things are infinite. Right. And there's not an infinite number of things that you need to know. There's probably like 30 or 40 big picture things that really move the needle of your health that you need to know about. And those are the recurring topics on our podcast.
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Dr. Taz Bhatia
Right.
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Dr. Darshan Shah
And then you have people like you and me that are trained in the deeper knowledge, and then you have specialists that can go even deeper. But if most people know 20, 30,
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40 things, they're going to be able
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to really have a completely different health experience than what most Americans are going through or most people in the world. The Western world are going through.
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Dr. Taz Bhatia
Yeah, very much.
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Dr. Darshan Shah
And you know, once again, podcasting, books, all of this is incredible for people to have access to now. Hi, Dr. Shah here. I want to take a minute to talk to you about cellular health.
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So in my clinics, I've actually seen
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30 year old people with cells that look like they're pushing retirement.
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And I've also seen 60 year olds
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with cells that look like they're 40 years old. So what's the difference? It's really about how fast their telomeres are breaking down. Your cells, you see, are like phones and they have limited cell phone battery, poor sleep, stress, processed foods. All of these things can drain that battery way faster than it should. So this is the reason why I partnered with ima. IMA powers that cellular battery. It's not just another multivitamin. It's a comprehensive 92 ingredient formula designed
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specifically for cellular health and longevity.
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I'm talking 900 milligrams of vitamin C. That's like 20 oranges worth of DNA
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protection, the clinical dose of CoQ10 that you need to power your cellular engine.
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You also get zinc, selenium, vitamin E, alpha lipoic acid. All of these work synergistically for cellular repair and protecting your telomeres.
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So instead of taking a handful of
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pills every day and all these supplements, Im8 actually gives you everything that you need in one scientifically form. And this isn't just a theory anymore. IMAID had partnered with Oxford University, the International Space Station San Francisco Research Institute, and they've done studies and they've gotten this NSF certified to truly power your health. Most people are aging twice as fast as they should. Unfortunately, you don't have to be one of them. Try im8. I actually have a discount secured for you if you go to DrShaw.com Imhot or go to ImaidHealth.com discount DrShaw and you can get 20% off with my discount code. Dr. Shah, you can also find the link below. You know, on the philosophy, like I love talking about the philosophy of healthcare because I feel like we're in this moment in time where everything is changing. Right. You know, how do you feel people should approach their health now in 2026? What should they do instead of using their insurance to go to the doctor when they're sick and potentially like, you know, the yearly primary care.
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Dr. Taz Bhatia
Right.
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Dr. Darshan Shah
Physical, like, what's, what's the difference? What's the new approach?
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Dr. Taz Bhatia
I mean, I've been advocating for a really long time on this whole, what I'm calling A holistic approach, right, which includes many of the buzzwords we're hearing right now. It is inclusive of functional medicine, inclusive of integrative medicine. Right. Inclusive of many of the other different systems of medicine. The difference is this holistic approach takes into consideration the entire body, right? And not just you, but also you in the context of how you live, where you live. You know, what I call the community body. When we first of all have a mindset shift and move from symptoms to understanding that the body is interconnected and that one symptom is one whisper of what's happening with you. I would like to see, when we're thinking about how to utilize the medical system today. I think I would like to see everyone being a little bit more proactive with, you know, doing the things I didn't do early on, like being a little bit more attentive to symptoms and symptom shifting, be a little bit more proactive with biomarker testing and tracking. Right? We don't have to go crazy, you know, we don't have to be Brian Johnson here, but like, you know, just being a little bit more aware of and then kind of debunking. You know, I read a stat recently that men only show up to the doctor's office when they're. When something's wrong, you know, or something like that. I think it was like one in seven men haven't even been to a doctor in X amount of years. But like, understanding, like, just like you would go get a haircut or you would maybe, you know, go for women, go get your nails done or go get a facial. Like stepping in to get routine visits and routine screening that are in a holistic functional model are going to be more of a win because they're going to look at some of these root cause issues, right? Or root cause markers, I should probably call them, that often get people into trouble. And this applies to children as well. And so I feel like we just need to have a complete mindset shift because what many people still do, you know, you know, I always. People always ask me, you know, like, well, who comes to your clinics? You know, who is it anyways? You know? And, you know, in the beginning it was the very, very educated. So they wanted to know, like, you know, they had read everything and they wanted to know what was going on and they had the disposable income to spend on that, or it was the very, very sick. And it was divided into those two populations. Like we would have people that had been to Mayo, had been to Hopkins and They didn't get their answers. Now we've seen a shift because the clinics have been in operation for about 15 years or so. So now we've seen a shift where it's not just the worried, you know, like the worried well or the very sick. We're also getting people starting to ask the right questions, like, I wanna know where my hormones are, I wanna know where my inflammation load is currently, you know, what do I do to be optimal at 60, 70, 80, you know, when I'm 40 today? So they're asking those more pointed questions. So ideally, the way you're using the medical system today is that you have a partner. You have picked out your partners that are gonna help you on this journey in terms of understanding your unique bioch, what the challenges are to you and what those challenges are across five layers. And I call that the five body map. Right? And those five layers are always physical. You know, that's the physiology, your chemistry, your nutrients, all the very tactical things that we can measure. Then they're emotional, right? Because one of the beauties of older systems of medicine is they talk about the emotional impact on your physical chemistry. And now the research is catching up to all of that. There's the cognitive component, which we have to understand. We're seeing cognitive issues as early as our young elementary and middle school children. Why are we ignoring those and just band aiding those with an ADHD medication? Right. That today is tomorrow's dementia. Right? So there's the cognitive component of what's going on. Then there's sort of what I call the spiritual or energetic piece. Right. I think that we know that spirituality plays a role in healing and health. And I think to ignore it is doing a disservice to humanity. Right? So are you connected to something? You know, and that is the energetic, that is the shen that Chinese medicine talks about, the prana that Ayurvedic medicine talks about, right? Are you connected? And if you are connected, how, how do you express that connection? How do you practice that connection? Right. I'm not here to debate religions or anything like that, but it's just that connection that we know when we look back to research, if we're going to bring the research arm in over and over again, those people do better when it comes to health. And then lastly, it's your community. And community is the family that you live in, the city that you live in, right. The planet that we're on, all of those are going to interplay into the expression of your health. And so you need a partner. That's willing to go there with you. Right. That's willing to uncover those layers with you. Maybe not all at once because you know, again, we don't want it to be overwhelming, but is ready to help show you how each of those layers are intersecting. To kind of show or for you to present themselves in a particular way. So let's get it back to tactical examples, right? People that have unexplained anger, where is that coming from? Chinese medicine says it's a liver meridian issue. Right. Conventional medicine says it's a blood vessel issue or a heart issue. Right. Where's the truth in that? You know, is there a genetic story there? Is there a trauma story there? You know, are you consuming something that's driving that? So those are, those are ways these things intersect into how you feel and how you're going to show up in your life. And that's just anger. You know, let's talk about your stress tolerance, right? How much stress can you handle or can you not handle? People are always like, I don't know how you do it. You have this like these kids and these clinics and the show, like blah, blah, blah, blah. But I also take a lot of interest in my own health and self care, which allows me to expand my bandwidth to manage stress. Right. So these are the things that, you know, I feel like you can be a different person depending on how you are approaching this health and medicine conversation. And it's not only that you're a different person, you will be a different partner, a different parent, a different employee or boss in terms of how you're approaching this conversation. So it's very much, you know, trying to help people grasp that all of this is interconnected, that we as humans, you know, thankfully don't exist in one plane and we have to think about our health in a multi dimensional way.
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Dr. Darshan Shah
Yeah, so true. I think what you're saying is a few things. One is don't wait until you're sick to go seek this kind of care.
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Dr. Taz Bhatia
Correct.
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Dr. Darshan Shah
And then when you're trying to find this kind of care, find a partner, like you said, which is multidimensional, taking you down all of these different five pathways in time, over time, in like a partnership and a journey versus like a one time intervention.
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Dr. Taz Bhatia
Correct. And that's a mindset shift. Right. This is a journey, this is a roadmap. This is not a step on, step off and you're done type situation, you
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Dr. Darshan Shah
know, and sometimes you do step off and you need to just get right back on and have your partner still there with you for sure. So I think, you know, like, one of the things that I want to talk to you about too, is you were a part of kind of like integrative medicine history training with Dr. Weil.
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Dr. Taz Bhatia
Right.
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Dr. Darshan Shah
And I would love to, love to break down, you know, that piece of history in medicine, basically, and what your experience there was like and what you learned. And what is integrative medicine and why does that even exist?
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Dr. Taz Bhatia
Integrative medicine is interesting because we have all these terms now, right. It can be so confusing. So Dr. Andy Weil is like the father, I think, in this country of integrative medicine. And it's very much a school of medicine which still honors traditional, conventional Western medicine. Right. We're not saying medications are bad, we're not saying surgery is bad. There is that foundation that is expected first when you do integrative medicine and then. But what it will do is now embrace all these other different healing modalities, whether it's the mind body component, whether it's Ayurveda or Chinese medicine, homeopathy, you know, and then employ some of those tools into a plan or into a healing strategy. So, you know, I graduated from that fellowship, I think it was 2008, and it's been such a joy to see what some of my colleagues have been doing over the years. Some teach, some, you know, are writing books, some are researching, some have clinics, you know, but very much I would say it was the first foray into thinking about health differently. Right. Not. None of us like the word alternative. Yeah, I think we all bristle a little bit. So alternative used to be the word. Right. And I think integrative was like, hey, we're medically credentialed. This is rooted in science. Right. If we're gonna throw around that term evidence based, you know, this is evidence based work. But at the same time, bringing in all these other systems of medicine.
- [30:18]
Dr. Darshan Shah
Yeah, I think it's really important that people, if you're interested in some of these other systems and bringing them in to look at integrative medicine and maybe read some of the stuff with Dr. Wilde.
- [30:31]
Dr. Taz Bhatia
Yeah, definitely.
- [30:32]
Dr. Darshan Shah
And I know you guys have worked together as well.
- [30:35]
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- [32:22]
for up to 35% off your next order. Let's talk about, like, one of these aspects that you talk a lot about, which is hormone health, right? And so let's start with women, and let's talk about a woman's hormonal journey. Like, does it start.
- [32:39]
Do women need to start thinking about
- [32:40]
their hormones when they're going through perimenopause, or should they start earlier than that?
- [32:45]
Dr. Taz Bhatia
Well, in 2023, I wrote the Hormone Shift, and the Hormone Shift did talk about perimenopause and menopause for sure. But one of the key points I really wanted to come across in that book, which is still circulating today, is that this conversation needs to start much earlier because hormone health for women is not just about your 40s and 50s and your 60s. Hormone health is really something. And remember, like, I got into trouble at 26, 27 and I the diagnosis, by the way, was PCOS, right. At the end of the day, which is a hormone disorder. So, you know, this hormone conversation needs to start in the early teens at a minimum, you know, and really young girls need to be starting to understand, you know, what is happening with their hormones. How do they measure their hormones? How do they look at their hormonal health as they make decisions? If you think about a teenager then going into their 20s, like I have an 18 year old who's headed off to college as they, as they are making decisions about birth control and as they're making decisions about fertility, you know, these are all things that are playing up together now. The trajectory for most girls and women historically, and a lot of young girls are pushing up against this now. But the trajectory had been, okay, you hit 13, 14, 15, you're having horrible periods, missed periods, painful periods, right? There's no root cause work there. Here's your birth control pill. Then you stay on your birth control pill, maybe all through high school, going into college, right? Hormones are suppressed. There's a price to pay for that hormone suppression. We can talk about that, you know, if you want. But their hormones are suppressed for this long period of time. Now they're ready to start a family, right? It's not working. And as they're going to get pregnant or whatever else, now the option and sort of like the big thing is freeze your eggs or do ivf, right? So all these young women are running around doing IVF loads and loads and rounds and rounds of ivf. We're not talking about what that means for those women as they hit their late 30s and as they go into their 40s, right? So if you take the woman, let's stick to perimenopause menopause. So this woman has been on the birth control pill, has potentially maybe done ivf, has potentially had a pharmaceutical load for many other things, anxiety, depression, adhd, you name it, and is now approaching perimenopause and menopause and is having a really hard time. So now our answer is, well, hormone replacement therapy is good for everybody. Go on hrt, right? In that entire conversation of this woman's hormonal health, there's been no investigation into why her hormones were off to begin with. What was the problem? My story, gluten was an issue, right? My gut was unhealthy, my thyroid was off. Fixing those few little things changed the trajectory of my hormonal health dramatically. I didn't even notice when I was in menopause, you know, so it's like, I feel like we're entering these conversations at pain points, which I understand, but I wanna challenge everybody with thinking more underneath the hood type situation, right? Like, what if it is related to your gut or a nutrient deficiency that's actually encoded over the Generations. Right. Or an environmental toxin that you need to pay attention to. Like, these are things that we're not having conversations about and kind of band aiding along the journey of hormones. Right. But never, at the end of the day, understanding what's driving it to begin with.
- [36:09]
Dr. Darshan Shah
Absolutely. And I think PCOS is a perfect example and recently gotten renamed to pmos.
- [36:15]
Dr. Taz Bhatia
I'm like, finally. I've been like, it needs a new name. I don't know how many people have been coming into my office. Like, I don't. I. I know I don't have pcos. I don't have cyst on my ovaries. I'm like, that does not diagnose the disease.
- [36:24]
Dr. Darshan Shah
You know, it's not about the cyst.
- [36:27]
Dr. Taz Bhatia
No. It's not about the ovaries, even.
- [36:28]
Dr. Darshan Shah
So, yeah, let's talk about that a little bit because I think, think, you know, this highlights a really important fact, which is that your hormones are connected to other systems in your body. Your gut, for example, you had mentioned gluten. Inflammation in your gut affects your hormones, your metabolic health and your hormones come together. So can you. Because PCOS is a topic that I think every woman needs to know about
- [36:49]
Dr. Taz Bhatia
because a hundred percent. Yeah.
- [36:50]
Dr. Darshan Shah
There's a massive amount of misconception about what it is.
- [36:52]
Right.
- [36:53]
So, yes, please, let's discuss that a little bit in detail.
- [36:55]
Dr. Taz Bhatia
Yeah. I mean, pcos. Now, PMOS continues to fascinate me. First of all, in our community, in the South Asian community, It's something like 80% of women are impacted by, you know, this PCOS. So, you know, one of the exciting areas of research, and I've had some of these researchers on my show, and I, and I get really excited by some of their work, is that they are starting to paint the fact that the ovary, the uterus are not just reproductive organs. Right. They are actually a part of the entire pathway of the human body and have a lot more responsibility than just our reproduction and our egg quality. So with PCOS in particular, historically, it was only diagnosed like the textbook medical school picture. Right. Like the very obese person, bald with facial hair. That was what we learned for boards and board exams. Unfortunately, there's a huge gray zone of people who don't necessarily fit that picture. They could be thin, they could not necessarily be bald. They may or may not have acne. But the fundamental disorder underneath that, which is what I found as well, is the blood sugar and the insulin resistance, which is driving, like the androgen, you know, the kind of the male derivatives of some of our Hormones driving that high free androgen index that is then resulting in these symptoms, which can vary from everything from a lack of ovulation blocking fertility to weight gain to hair loss, acne, joint pain, inflammation, you name it. So that, that is what we had been seeing and that is what I had already identified in myself. And then in the time since, over these last 15 years, there's a lot of back and forth with patients like, no, I don't agree. I think you have it, look at your insulin markers, look at this, look at that, all this other stuff. And so now we have just, I think it was just like a few weeks ago, right. It's now been renamed, what is it? Polyendocrine metabolic ovarian syndrome or something like that, I think is the acronym. But acknowledging the metabolic component or the insulin component as the driver of this particular disorder. So I think, you know, that to me it's a classic example of how it's not just one thing, you know, it's. I always say there's like a three hit theory. There are usually three things that have come together to create manifestation of symptoms and then ultimately disease expression. So in the case of pcos, it's usually blood sugar regulation, something with the gut, and then some varying third factor. It could be extreme stress or trauma, it could be, you know, environmental exposures, it could be genetic, you know, but there's some third variable that tips you over and causes expression. And in my personal case, I, it was stress and, you know, it was extreme stress, extreme stuff, you know, that I had to carry and bear kind of growing up, that now you add a bad diet, you add med school, you know, you add all the other ingredients. It was the perfect recipe for having something like that. So I think that we have to start thinking this way. You know, we have to start thinking kind of in, in multiple dimensions when, whether it comes to a symptom, whether it comes to a person. And I actually think that's why I love medicine. I think the doctors that are so unhappy today are being forced to be very like straight jacketed into. You have this, therefore this, you have this, therefore that. And so of course AI can take that over, you know, but the multidimensional aspect of what it means to be a human and how to think about things, that's something that, there's still a big, a big gap.
- [40:21]
Dr. Darshan Shah
Yeah. And you know, I love you said that. What are the three things? Whenever I see a patient with any symptom, I always use that as my model too. Just so I don't miss something. I'm like, what are the three aspects of this person's physiology that is adding up to this particular symptom? And almost always there's an emotional health component to it, Right?
- [40:40]
Dr. Taz Bhatia
Definitely.
- [40:41]
Dr. Darshan Shah
And the more the science is focused on how emotions and our immune system kind of interact with each other, how emotions in our gut are interacting with each other, it does need to be another factor that we really consider in every disease process.
- [40:56]
Dr. Taz Bhatia
Yes, for sure. I mean, there's so much research emerging now, too. I mean, I think I was just looking at something like if you're chronically stressed, like whatever the stress is, right. Stress is your own. It could be you have a very difficult child, you could have a very difficult job, you could be traveling all over the world, whatever the stress is,
- [41:13]
Dr. Darshan Shah
even if you're growing a massive business and is doing really well, that is stressful.
- [41:16]
Dr. Taz Bhatia
That's still stressful. But cortisol, you know, works with the immune system up to a point, and then it kind of checks out. The immune system checks out. It's like, I'm done with this. Like, I'm done managing your shit, basically, is what was what the immune system tells cortisol and then down regulate. So then those folks start to get sick all the time. And then that, that first downregulation is probably the first part of it. The second part of it is inflammation. And then after a period of time, they're starting to have many of the signs and symptoms of chronic inflammation. You know, so again, the emotional toll, the physical toll, they're interconnected. Again. I feel like the older systems of medicine did a really good job at this. They said, anger, go back to that. Anger lives in the liver. You know, if you stay angry, your blood pressure will be high. You know, they connected those dots very quickly. Worry lives in the spleen, the spleen meridians. If you're constantly obsessing, overthinking, over worrying, you're going to impact your digestion. And they were able to connect those dots, you know, so it was fascinating how, you know, fear lives in the kidney. If you're fearful, over time, you're gonna impact these other markers over here. So they very. They actually had a formula for it, you know, so in our clinics at Whole plus, you know, we will do these assessments. We'll do a Chinese medicine assessment. We'll do a energy assessment. We will do like the conventional history and physical, you know, we do metabolic testing. We'll put all of that together to get that kind of five body map laid out for Somebody, and then we as providers have to decide where we're going to start. On some people, if their emotional world is in turmoil, that's where you begin a journey. You don't start with taking 50,000 things, you know, for others, if it's very physical, you start the journey there. So that's, you know, an example of how the emotional can overlap with the physical.
- [43:01]
Dr. Darshan Shah
Yeah, absolutely. And you do need someone who's skilled to understand where to start as well. And all of this too. And sometimes you can do things at the same time, concurrently. But definitely focus is where it needs to be focused. Yeah. You know, going back to the hormones, I wanted to just highlight one thing. You said being on birth control pills for a long period of time can have consequences later on in life. Can you expand on that?
- [43:23]
Dr. Taz Bhatia
Definitely. So, you know, it's interesting, the research on the birth control pill is, or any form of birth control, I should say, is evolving. But one of the things that is coming out slowly is that chronic use of birth control pills actually triggers inflammation. So that's one thing for everyone to keep in mind. I think the second that has been established is that birth control usage actually depletes key nutrients. Some of those nutrients include things like folate, vitamin B6, vitamin B2, zinc, magnesium. Now, why is this relevant? Those are the exact same nutrients that your neurotransmitters need for you to feel good, whether it's serotonin, dopamine, you know, epinephrine, all of these different things. So the loss of nutrients, which is usually not discussed when somebody's going into starting or taking birth control, and the potential inflammatory response, specifically it's an increase in one inflammation marker called tumor necrosis factor alpha. Right. So that combination is kind of a setup up to overall chronic inflammation that leads to some of the diseases that we see today. Right. Because once you set forth that sort of depleted inflammatory state in the body, then you're going to be vulnerable to weight gain, you're going to be vulnerable to depression and anxiety. All of these are diseases of inflammation, by the way. You're going to be vulnerable to changes in your cardiovascular health. Right. So lipids may change, you know, your blood sugar can change as well. So your insulin and your A1Cs can be affected. So the implication of long term usage of birth control on a woman's health is something that I don't think we take seriously, you know, and we don't do enough front education. Now. People need birth control, right? We're not saying, you know, nobody needs birth control. But I think that's something that we need to think about. The other part of the story that we need to look at with birth control is that we're not getting into each person's individual capacity to handle hormones, right? So some of the birth control options are like a progestin only option, right? Progestin is a very difficult hormone to metabolize, especially in a certain population with certain genetics. And so for folks that are put on that, you know, they don't do well on that. And in some ways there's some studies, and I'm not trying to fear monger here, but there are a lot of studies talking about birth control usage and increased cancer risk. So the question to ask is, as breast cancer has not really changed over, despite all the screenings and everything like that, the incidence of breast cancer diagnostics has not really dramatically changed or reduced. Right. Over the last 15 to 20 years. Is birth control a part of that conversation? And then the most interesting part is I had on my show a guest who was talking just about how birth control changes the brain. You may be attracted to different people on the pill versus off the pill. It literally changes your brain because it's changing the hormone like sort of of construct there. So, you know, again, another area where we could say not enough advocacy around girls health or women's health, right? And we need the research to continue to support some better decision making. But even with the research that is out there currently, we are still not being proactive. You know, if I had my way, every girl going on the birth control pill should also go on some nutrient supported at the same time and something to help them mitigate inflammation while understanding what in their lifestyle might be driving future inflammation and then tracking something like TNF alpha maybe every year or two, just to see where their loads of inflammation are, right? Because a lot of inflammation can be nipped in the bud, you know. So I'm not saying don't do anything, it's just be a little bit more educated before you jump.
- [47:06]
Dr. Darshan Shah
And what about birth control alternatives that people can use instead?
- [47:10]
Dr. Taz Bhatia
There are so many different birth control alternatives today, right? There's everything from natural cycling, which some people do and pay attention to. You know, there's the non hormonal IUDs which some people do and actually do really well with that. There are a lot of barrier forms, whereas whether it's the NuvaRing or some of the other things that are out there. So there are a lot of different options if they want to look at that. You know, again, it's a conversation to have with a provider that's going to look at the whole picture.
- [47:37]
Dr. Darshan Shah
Yeah, exactly. So I think as parents though, it's really important, important to have these conversations with daughters about, you know, Newering IUDs versus birth control and what are the long term implications of each of those choices.
- [47:51]
Dr. Taz Bhatia
Right, exactly.
- [47:51]
Dr. Darshan Shah
I think a lot of people go to their primary care provider, you know, it's an embarrassing conversation to begin with. No one wants to be on birth control, you know, kind of a thing. And then it's just like, here's a prescription, see you later.
- [48:02]
Dr. Taz Bhatia
Right.
- [48:03]
Dr. Darshan Shah
And to your point, like there's no consideration given to the genetics and the which form of birth control is gonna be the best form for the particular individual too. So definitely needs to be a deeper conversation for sure. Because to your earlier point, which is hormone health conversations need to start at adolescence, not waiting until perimenopause is there or infertility issues come around.
- [48:26]
Dr. Taz Bhatia
Right, Right. Definitely. I mean, I think you talk a lot about the health span, not just the lifespan. Right. The health span should include a conversation that actually starts, starts in your early teen years around hormones, honestly, because you're laying down a lot of what you're going to look like at 30, 40 and 50 in those early years. We just don't realize it, you know.
- [48:50]
Dr. Darshan Shah
Thank you so much for listening to the podcast today. Please remember to subscribe if you like this episode and give us a good review and share a link with your friends. It really helps us support all of our efforts. I also want to remind you that the information shared on this podcast is for educational purposes only and is not intended to replace professional medical advice, diagnosis or treatment. Please consult with your healthcare provider or physician before making any decisions or taking any action based on what you hear today, especially if you have any underlying
- [49:20]
health conditions or on any medications.
- [49:22]
Your doctor knows your personal health situation the best. It is always important important to seek their guidance.