Am I Going Through Perimenopause?!

Summary

Podcast Summary: "Am I Going Through Perimenopause?!" - Let's Be Honest with Kristin Cavallari

Title: Let's Be Honest with Kristin Cavallari
Host: Kristin Cavallari
Guest: Dr. Lee Howard
Episode: Am I Going Through Perimenopause?!
Release Date: May 6, 2025

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Overview

In this insightful episode of "Let's Be Honest with Kristin Cavallari," Kristin engages in a candid conversation with Dr. Lee Howard, a board-certified general surgeon who transitioned from traditional medicine to a holistic health approach. The discussion delves deep into perimenopause, exploring its symptoms, impact on daily life, and effective strategies to manage this significant life transition. Additionally, the episode touches upon the crucial role of gut health in overall wellness and offers practical advice for young mothers navigating their health amidst busy lifestyles.

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1. Introduction to Dr. Lee Howard’s Practice

Kristin Cavallari:
"[03:35] I got board certified on November 14, 2010… I wasn't helping my patients… reflexively went to surgery for everything."

Dr. Lee Howard:
"[03:22] Thank you for being here… It was perfect."

Dr. Lee Howard introduces himself as a general surgeon who chose to leave traditional surgery-based practice to focus on holistic health solutions, emphasizing the importance of diet and gut health in patient care.

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2. Allergies and Gut Health

Kristin Cavallari:
"[01:10] Allergies at the core are an immune response… prioritize some gut health. Get rid of gluten."

Dr. Howard discusses the link between gut health and allergies, highlighting gluten as a significant trigger for gut imbalance. Kristin advocates for a Paleo diet, probiotics, and bone broth to restore gut health and boost immunity.

Notable Quote:
"Gluten is a major trigger of gut imbalance just because of the effect that gluten and some of the other proteins and wheat has directly on the lining of our intestines." — Kristin Cavallari [01:22]

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3. Transition from Traditional Medicine to Holistic Approaches

Kristin Cavallari:
"[03:35] After practicing for three months… I wasn't helping my patients… started to have questions about my health."

Kristin shares her personal journey of transitioning from a traditional surgical practice to a holistic approach, driven by her own health challenges and the realization that dietary interventions could significantly impact patient well-being.

Notable Quote:
"When you stop treating your body like a garbage dump, you can start to see real improvements." — Kristin Cavallari [06:56]

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4. Perimenopause Discussion

Kristin Cavallari:
"[39:13] Perimenopause shows up in mid-30s to early 40s… up to 90% of women have symptoms of perimenopause."

The core of the episode focuses on perimenopause, its onset, symptoms, and the lack of adequate support from traditional medical practices. Kristin emphasizes the importance of recognizing symptoms early and seeking appropriate hormonal treatments.

Notable Quote:
"Up to 90% of women have symptoms of perimenopause." — Kristin Cavallari [39:13]

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5. Symptoms and Effects of Perimenopause

Kristin Cavallari:
"[44:53] Symptoms like hot flashes, dryness, mood disturbances, weight gain… affect relationships and daily life."

Dr. Howard and Kristin explore the various symptoms of perimenopause, including mood swings, weight fluctuations, sleep disturbances, and their broader impact on personal relationships and family dynamics.

Notable Quote:
"Perimenopause is the beginning of your body winding down from being reproductive." — Kristin Cavallari [44:53]

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6. Supplements and Dietary Recommendations

Kristin Cavallari:
"[20:29] Vitamin D levels in the upper 20% can reduce a woman's risk of breast cancer by more than 80%."

The discussion highlights essential supplements like vitamin D, magnesium, and creatine, emphasizing their pivotal roles in hormonal balance, muscle maintenance, and overall health during perimenopause. Kristin also touches upon genetic factors like the MTHFR gene mutations affecting detoxification processes.

Notable Quote:
"Vitamin D… can reduce a woman's risk of breast cancer by more than 80%." — Kristin Cavallari [20:29]

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7. Exercise and Sleep Importance

Kristin Cavallari:
"[29:00] Incorporate short, consistent exercises… prioritize sleep to maintain muscle mass and overall health."

Kristin advocates for regular, moderate exercise and prioritizing sleep as critical components in managing perimenopause and aging. She suggests integrating small, consistent physical activities into daily routines and emphasizes the significant benefits of resistance training and adequate protein intake.

Notable Quote:
"Resistance training, creatine, and protein become very, very big." — Kristin Cavallari [51:36]

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8. Advice for Young Moms

Kristin Cavallari:
"[29:00] Integrate small, consistent exercises and prioritize your own sleep and nutrition amidst busy parenting schedules."

Addressing young mothers, Kristin offers practical advice on maintaining personal health while managing the demands of motherhood. She emphasizes the importance of integrating physical activity into daily routines and ensuring sufficient rest and proper nutrition.

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9. Aging and Hormone Replacement Therapy (HRT)

Kristin Cavallari:
"[53:02] Advocates for hormone replacement therapy… maintain muscle mass with resistance training, creatine, and high protein diet."

Kristin discusses the benefits of hormone replacement therapy (HRT) post-menopause, highlighting its role in mitigating muscle loss, maintaining bone density, and preventing cognitive decline. She underscores the importance of a high-protein diet and regular exercise in conjunction with HRT.

Notable Quote:
"Hormone replacement therapy, exercise, creatine being the big cornerstones of that, and a high protein diet." — Kristin Cavallari [53:36]

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10. Practical Tips and Final Advice

Kristin Cavallari:
"[52:54] Eat plenty of protein, supplement with creatine, do some type of movement, exercise daily, and sleep as much as you can."

In her concluding remarks, Kristin distills the conversation into actionable steps for listeners, particularly women navigating perimenopause. She reiterates the importance of nutrition, supplementation, physical activity, and adequate rest in managing the symptoms and maintaining overall health.

Notable Quote:
"Sleep more, manage stress, and get your hormones checked." — Kristin Cavallari [53:02]

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Conclusion

This episode of "Let's Be Honest with Kristin Cavallari" offers a comprehensive exploration of perimenopause, blending personal anecdotes with professional insights from Dr. Lee Howard. Listeners gain valuable knowledge on recognizing perimenopause symptoms, the interplay between gut health and immunity, and effective strategies to manage hormonal changes. Kristin’s holistic approach underscores the importance of proactive health management, empowering women to navigate this life stage with confidence and well-informed strategies.

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For More Information:

• Dr. Lee Howard’s Website: compasshp.com
• Social Media: Facebook, TikTok, Instagram, YouTube (@rlehoward)

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Notable Quotes with Timestamps:

• "Gluten is a major trigger of gut imbalance just because of the effect that gluten and some of the other proteins and wheat has directly on the lining of our intestines." — Kristin Cavallari [01:22]
• "Up to 90% of women have symptoms of perimenopause." — Kristin Cavallari [39:13]
• "Perimenopause is the beginning of your body winding down from being reproductive." — Kristin Cavallari [44:53]
• "Vitamin D… can reduce a woman's risk of breast cancer by more than 80%." — Kristin Cavallari [20:29]
• "Resistance training, creatine, and protein become very, very big." — Kristin Cavallari [51:36]
• "Hormone replacement therapy, exercise, creatine being the big cornerstones of that, and a high protein diet." — Kristin Cavallari [53:36]

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This summary encapsulates the essential discussions, insights, and advice shared during the episode, providing a clear and comprehensive overview for those who have not listened to the podcast.

Transcript

[Kristin Cavallari]

The following podcast is a Dear Media production.

[Dr. Lee Howard]

This is, let's Be Honest with Kristin Cavallari, a podcast all about getting real and open on everything from sex, relationships, reality tv, wellness, family, and so much more. And just a fair warning, there will probably be some oversharing. Cause I got all the power.

[Kristin Cavallari]

Yep.

[Dr. Lee Howard]

Welcome in to let's Be honest. I hope everybody is doing amazing. I have a very special guest today. Today I have Dr. Howard. Hi.

[Kristin Cavallari]

Hi, Kristen. Thank you for having me.

[Dr. Lee Howard]

Thank you for being here. This is actually a great day to have a doctor in my house because I have one of my boys homesick. He has had crazy allergies, and he had pink eye a couple weeks ago. So anyways, I went. I had to pick him up from school this morning, and I was like, perfect. Dr. Howard's coming over.

[Kristin Cavallari]

Coming over to see us? Yeah. Yeah. Well, we had a curbside visit here. Right. We're able to kind of do a little. Little doctoring before we got started.

[Dr. Lee Howard]

It was perfect. Well, I wasn't actually gonna ask you about this on the podcast, but I do think it's interesting because it is allergy season, and you essentially said allergies sort of are what they are. But you did give me a couple pointers that I can do with Cam. So would you wanna say them here, too?

[Kristin Cavallari]

Yeah, absolutely. I think allergies at the core are an immune response. And so if we think about where the immune response and the immune system can be centrally located, I would say a lot of it's in the gut. So as we talked about, let's prioritize some gut health. If there are concerns about sibo or, you know, other growth. And you think a probiotic be a good option. That's always something to consider. But I mentioned specifically, let's get rid of gluten.

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

Because gluten is. I believe that gluten is a major trigger of gut imbalance just because of the effect that gluten and some of the other proteins and wheat has directly on the lining of our intestines. And so if you think about what could weaken that barrier and then allow these pollens and allergens into our system, I believe it plays a pivotal role. Right. So restoring gut health would be kind of removing that stimulus, getting rid of gluten, kind of going paleo, really. Right. And prioritizing things like that. If somebody had really poor gut health, we may even go to the point of supplementing with bone broth a couple times a day with the probiotics to rebuild their gut Health, but gut health becomes important. I also want to kind of help with immune boosting, which would be in the form of vitamin D. So ideally, the vitamin D would allow for more of our natural immunity rather than this reactive immunity kind of thing that's going on with the reacting to the things in our environment. And then I think, especially when we're dealing with little ones that are kind of in Tennessee here, it's definitely probably the worst time to have allergies. And if we're dealing with little ones, knowing that this can affect their sleep, if their adenoids and their sinuses are constantly swollen, it's going to affect their hearing. So it can affect their performance in school and their development even. Right. Because we know that hearing and cognition are linked together. So if we are dealing with a youngster that's got this, what we want to do is make sure that they can ideally be as dependent on as few medications or as few therapies as possible. But we also don't want to not allow them to develop normally and have normal hearing, normal speech and those kinds of things. So. So you have to balance out. Will allergy shots be a good option for this client, given that the disruption of the allergies may be so substantial that it could affect them long term?

[Dr. Lee Howard]

Wow. Okay. Yeah, I know. I just. I feel so bad. Well, and that's the thing. It is affecting school. Because he's missing now.

[Kristin Cavallari]

Yeah, exactly.

[Dr. Lee Howard]

It just kills me even just seeing him. Okay, but let's back up. I want to catch my listeners up to speed on who you are. So you are a board certified general surgeon, but you walked away from tradition medicine, so tell us why.

[Kristin Cavallari]

Yeah, I got board certified on November 14, I think, of 2010. It was just a few months after I completed my residency. And I'd always thought that in that moment I would find a significant degree of happiness and elation at accomplishing that goal. And instead, after practicing for three months, I just felt like I was not only not doing anything for myself professionally, but I wasn't really, really helping my clients or helping my patients at that time, because we just reflexively went to surgery kind of for whatever it was. And I at the same time started to have some changes in my body. I was 34, bordering on 35. We know that men and women start to change pretty fast at that point. And, and I was no, you know, no exception to that rule. So once I started to have some questions about my health and I thought, okay, well, if I go to my regular doctor, what are they going to tell me. And I knew what that was going to be. I'm not a depressed guy, you know, I don't need to think about taking some sort of mood stabilizing medication. It was more organic, I thought. And I knew that if I was going to go there and get that answer, and I didn't want that answer, there were probably a lot of other people that didn't want that answer also. So then the journey began to be, okay, well, what would Lee Howard do, knowing what he knows as a doctor, to start to fix these problems? Initially, it really was diet. I started really hardcore diving into paleo, reading some of the early research on paleo dieting philosophy and why that made the most sense, started applying that in my clinic, in my surgical clinic. And instead of doing more endoscopies for people who had GERD and reflux, I was instead taking them off of medications. I found a huge link, at least in my population. And, you know, I didn't do a scientific study on this, but my, the, the link between reflux and food was meat to me, gluten and processed foods, right? And so once I was able to get them to remove processed foods, their bowel movements, their reflux, all those kinds of things that were off before started to correct themselves, weight loss happened, right? So I even tell the story in the office about a guy who was cybersecurity expert. He was an ex military guy, was still in the reserve, very large, physically big man. And we were having kind of a discussion about what was going on with him. And he thought he needed an EGD and a colonoscopy because he had bad reflux, his blood pressure was up, he was having some bloody stools, and his bowel movements weren't normal other than that. And it was to him, it was a very clear sign that he needed to get these tests because he was looking for the answer from that. And as I told him, I said, I'm not going to find the answer on doing this. I've done 10,000 colonoscopies, 5,000 EGDs, I'm not going to find anything. The answer is you have to stop treating your body like a garbage dump. And when you do that, and this guy physically got angry with me for saying that, and I said, this is not personal, I'm trying to help you. And the reality is that you were thinking that there's something actually wrong with you, and I'm here to tell you that's not the case. He did not want to take my approach, but I brokered A deal with the guy. I said, I tell you what, give me four weeks, right? Like, what do you have to lose by trying my plan for four weeks? And if it's not any better, okay, then we'll figure out something else. So four weeks goes by. He rolls into the suite where we're going to do his EGD and colonoscopy, and I said, hey, man, how's things going? And he hangs his head and he said, you were right.

[Dr. Lee Howard]

Oh my God.

[Kristin Cavallari]

He says, I'm off my medicines, my bowel movements are normal, I've lost £12, I feel great. I'm sleeping through the night. Like, literally it was all food.

[Dr. Lee Howard]

Wow. And just in four weeks.

[Kristin Cavallari]

And just in four weeks, I saw that over and over again. So it doesn't take but a few episodes of that for you to realize, like, okay, I'm probably on a better track doing this than what I was doing.

[Dr. Lee Howard]

That's amazing. So with your practice, when people come and see you, I know everyone's different, but is that what you tell everybody to do is get on a Paleo diet?

[Kristin Cavallari]

I think the Paleo becomes the cornerstone. Yeah. I think the paleo diet is sort of that foundational principle. And then once you get a little more specific about what you like, and let's take females, for example, there's a sizable percentage of women who don't do well with fasting. They, they require a little bit more carbohydrate intake. They don't do well with periods of, of going without food. And so for those females, intermittent fasting is not typically going to work for them and they're going to find themselves hangry, you know, and more likely to make a bad dietary choice than if they would have just at something good in the morning. Right. So taking that philosophy of Paleo, you can take Paleo and then Paleo with intermittent fasting, you can do a high protein sort of version of that with low carbs. And that's kind of where I guide most of my clients, is a low carbohydrate, high protein version of a Paleo diet. And then, and then working in some things for them, like, like for a lot of guys, white rice can make sense. It's typically excluded on a paleo diet. But if you're exercising and you, and you can justify the carb intake by eating a little bit of white rice, we're not talking about a whole, you know, big bowl, but we're talking about small strategic quantities. And, and white rice was one of those things that, you know, we Fudge on and bring that in. And I think dairy is another one of those categories that while typically excluded in the traditional paleo sense, it makes sense to do it in the real world. Dairy becomes strategic. It's not the, the old food pyramid where dairy was its own food group. It's a condiment and we treat it like a condiment. You know, we put small amounts of high quality cheese on broccoli or, you know, small amounts of brie cheese that you use with other types of foods, but it's just not relied on as a main ingredient.

[Dr. Lee Howard]

What do you think about raw milk?

[Kristin Cavallari]

I think it's great.

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

In fact, you know, we were talking about some articles that I brought. There's some research to support that raw milk in schools might actually help our students.

[Dr. Lee Howard]

Oh, wow.

[Kristin Cavallari]

I'll leave that citation with you and you can put it on the show notes. But, but yeah, I mean, anecdotally, if you look around and you say, well, what are the kids who drink raw milk look like? They're typically pretty healthy kids. You know what I mean? So, yeah, it's hard to argue with that outcome, especially when generations of people existed on raw milk before us with really no problem.

[Dr. Lee Howard]

I know. Well, I think we're lucky being in Tennessee because I just get raw milk from a little farm over here.

[Kristin Cavallari]

I mean, yeah, we definitely don't face the restrictions like places like Pennsylvania and some other states do.

[Dr. Lee Howard]

Well, I know in California you can buy it in the grocery store, which I'm really jealous about. Let's take a second to talk about quints. I have been doing a spring clean when it comes to my clothes. I love doing like a little refresh in the spring, getting some new pieces, new staples, new essentials. And Quint has been my go to for that. They have so many great things right now, you guys. And this year I'm treating myself to the luxe upgrades I deserve with Quince's high quality travel essentials at fair prices. Like lightweight European linen styles from just $30, washable silk tops and comfy lounge sets, premium luggage options and stylish tote bags to carry it all. And the best part, all Quince Items are priced 50 to 80% less than similar brands. By partnering directly with top factories, Quince cuts out the cost of the middleman and passes those savings on to us. And Quince only works with factories that use safe, ethical and responsible manufacturing practices and premium fabrics and finishes. I am browsing their website, but I definitely just got this awesome tote carry on bag that's perfect for going everywhere. You can hold all of your essentials on the plane and they have really, really comfy sets that are perfect for traveling in. So guys, for your next trip, treat yourself to the luxe upgrades you deserve from quint. Go to quint.comhonest for 365 day returns plus free shipping on your order. That's Q U I n c e.com honest to get free shipping and 365 day returns. Quints.com honest okay, you guys know I love the brand Element, so let's talk about it. Element is a zero sugar electrolyte drink mix and sparkling electrolyte water born from the growing body of research revealing that optimal health outcomes occur at sodium levels two to three times. Government recommendations Each stick pack delivers a meaningful dose of electrolytes free of sugar, artificial colors or other dodgy ingredients. I love electrolytes. Between working out consistently, the sauna, traveling a lot, or just having an active lifestyle, I find that I definitely need them. I notice when I don't drink electrolytes now because I drink them so often probably. But I love love Element. Their grapefruit flavor is delicious. I also love their chili mango. Trust me, try it you guys, it has this perfect little kick to it. We love that. And right now Element is offering a free sample pack with any purchase. That's eight single serving packets free with any Element order. This is a great way to try all eight flavors including chili, mango or share Element with a friend. Get [e-mail] honestly this deal is only available through my link so you must go to-r I n k l m n t.com honest and you guys, you can try Element totally risk free. If you don't like it, they'll refund your order, no questions asked. And they have a very low return rate and high reorder rate. DrinkElement.com Honest again, element is spelled LMNT. Let's talk about ritual. Seems like everything is connected to your gut microbiome. Well, the fact is we are learning so much about how the gut microbiome is key to our mental health, immunity and of course, digestion. If you're looking for digestive support, ritual has got your back. Or rather your biome with synbiotic plus a 3 in 1 supplement of clinically studied pre, pro and postbiotics to support a balanced gut microbiome with daily use. You guys know I love probiotics. I take it first thing in the morning on an empty stomach and since taking rituals Symbiotic plus, I just Feel so great. I. That's just my own personal opinion. And another thing I love so much is that it's delivered right to my door. Me and a lot of people are probably doing that. I know I say that all the time, but for me to just be able to have one less thing to worry about is the best. Ritual's Symbiotic plus is designed with a delayed release capsule to help reach the colon, not the stomach. Obviously an ideal place for probiotics to survive and grow. One daily pop of mint scented for bloat, gut and regularity. Support vegan friendly and formulated without GMOs, major allergens, animal products, shady fillers or artificial colors, which you guys know I love. So get your gut going. Support a balanced gut microbiome with Rituals Symbiotic Plus. Get 25% off your first [e-mail] Be honest. That's ritual.com Be honest for 25 off your first month. Okay, what else? When clients come to you or patients, I guess I should say, what labs do you run on everybody no matter what?

[Kristin Cavallari]

Yeah, so that's a great question. And you know, and by the way, this is evolving for me, right? Like I think is the more I learn and the more I see in practice and learn kind of what my clients are looking for and what's really working for them. I've changed my approach, but largely speaking, I'm going to get a CBC and a CMP, which is, you know, basic lab stuff where we're looking at hemoglobin, cellular blood counts that just basic stuff. And then a CMP is more kidney function, liver function, electrolytes.

[Dr. Lee Howard]

Is this all blood tests?

[Kristin Cavallari]

These are all blood tests, that's correct, yeah. And we do use urine hormone testing, like a Dutch test for example. But I tend to be strategic about doing that. Not just it's not my go to reflex sort of test.

[Dr. Lee Howard]

Okay.

[Kristin Cavallari]

Why?

[Dr. Lee Howard]

Why not?

[Kristin Cavallari]

I use it in situations where traditional hormone therapy hasn't worked. So let's just say I had a 48 year old female who we tried what we would believe to be a typical approach to help her during that transition. And we got a confusing picture. The results were mixed. We weren't seeing her symptoms resolved. Maybe, maybe we noted some other things popped up, like anxiety, for example, and you start to think, okay, what would be going on underneath all of this? That a urine test which can give you some metabolites and some breakdown things that a typical serum panel won't be able to give you. And so you start to think, well, if that would that information be helpful and would it change our approach? And, and sometimes it is, sometimes it's not. But that's when I tend to go to a more of a urine panel where I'm trying to compare it to serum testing and also when things haven't quite gone the way that we thought they would.

[Dr. Lee Howard]

Okay, interesting.

[Kristin Cavallari]

But going. You know, typical blood tests are vitamin D, hemoglobin, A1C, a basic lipid panel, free T3 and TSH. And I know people get a full thyroid panel and all this stuff and reverse T3 and we do those things, but I'm more selective about when I do them. I'm just not my reflex. In females we do FSH and LH levels, progesterone estradiol free and total testosterone with sex hormone binding globulin and a vitamin D level. And that's kind of our basic starting lipid panel for guys. It's very similar but it includes a PSA because of the prostate. And then we don't get an FSH level, we just get LH or I'm sorry, we don't get lh, we get fsh.

[Dr. Lee Howard]

And then from there you write up a whole protocol for.

[Kristin Cavallari]

That's right, we meet back and let's kind of see what this beginning step tells us. Right. Is sort of just initially open the hood up and take a look underneath. And with that we can start to put together what is our clients experience, client is experiencing. And then what do these tests tell us? What do we know based off of where this data can send us? Do we need more data? Are we pretty conclusive about what we're dealing with and what can we move forward with? And if that's more testing or, or treatment or a combination of the two.

[Dr. Lee Howard]

What if you can't do some of these tests? Are there certain supplements that you give everybody? Like is, are most people deficient in vitamin D or magnesium? Like what are the universal supplements that everyone could take?

[Kristin Cavallari]

That's a great question. And you know, so many times people ask me, you know, do I need to. For example, MTHFR has gotten a lot of buzz recently, right. In the methylation cascade. And, and for good purposes, data says up to 70 of us or so can have a breakdown in that gene family.

[Dr. Lee Howard]

Which means explain what that is because I, I know, I feel like in the health world it's taking off, but mainstream, I don't think.

[Kristin Cavallari]

You don't think people got it? Okay, well that's, that's good. I mean, because this is a great Opportunity for a lot of people to I think, take a small intervention that they can make that will make a big outcome in their health. So MTHFR stands for the long word methyl tetrahydrofoline reductase, but it enzyme that really participates in the breakdown and labeling of toxins in our body that then allows our body to process those toxins and move them through a pathway of excretion. And, and there's several steps to this. But the gene family, that MTHFR gene family, which has, I think, about two dozen different genes in it, and the ones that we commonly check are what's called a C677T mutation and an A1298 mutation. Those are the two most common mutations that we can attribute clinical outcomes to or clinical disease states too. And the, the C677T mutation is probably, it's definitely most impactful, specifically from the element of detox. So it's believed that if you have a single gene mutation in that pair, then your detox capacity is impaired by about 30 to 40%. If you have both genes are bad, then you're probably reduced up to about 70%. And, and that can be catastrophic. I mean, we're talking about alcohol, you're talking about caffeine drugs, sedatives that we give people in the operating room. You know, for a long time I didn't, I didn't know this, right? Like, I would have people that I was getting ready to do surgery on, they say, you know, doc, I'm really sensitive to anesthesia. And in the medical world, you're like, oh boy, this is. Oh, no, one of those problem patients, right? Like everything's a problem. Like it's.

[Dr. Lee Howard]

Oh, right.

[Kristin Cavallari]

You know, I'm always nauseated or whatever. You know what I mean? And so. And we falsely. I falsely attributed what they were truthfully telling me to something that was not based in real science. And it is.

[Dr. Lee Howard]

Oh my gosh.

[Kristin Cavallari]

And now What? You know, 15 years later, I see the pattern. I'm like, okay, these people are also sensitive caffeine, they're sensitive to alcohol, they're sensitive to every. Like hormone replacement therapy. As a general rule, it's going to be a lower dose. I mean, it, it spans across a spectrum, right? And so, yeah, anyway, that's kind of. The MTHFR would be. Take a methylation supplement, right? I think that's a great one because most, a lot of people have breakdowns in that cascade. So taking something with methyl folate or methyl B12 would be advisable I think vitamin D is huge, especially for the females who are listening to us. There are studies out there that show that vitamin D, and I like to keep that in the upper 20% of that range, which is typically around 80 to 100, that that level of vitamin D can reduce a woman's risk of breast cancer by more than 80%.

[Dr. Lee Howard]

I remember you telling me that when I.

[Kristin Cavallari]

Huge, Right. I don't know of a single other therapy in the world that can reduce a woman's risk of breast cancer by that much. I mean, even if it was half of that, yeah, it's still a huge number. And just by taking vitamin D, so. So I try to push vitamin D levels up a little bit. And I'm not like some of the other docs out there. If it's 120, I'm pretty cool with that. I don't. I don't really get so worried If I'm above 100, even 130, on the vitamin D levels, because I've never just seen toxicity.

[Dr. Lee Howard]

Right.

[Kristin Cavallari]

And then I think the third thing would be, is what you kind of hit on, which was, especially as we get older, sleep just becomes not only harder to get, it becomes more important to prioritize. And so getting something like magnesium or taking some sort of sleep cocktail before bed, strategic sleep planning becomes necessary as we age.

[Dr. Lee Howard]

Oh, okay. And yeah, magnesium is good for sleep.

[Kristin Cavallari]

Absolutely.

[Dr. Lee Howard]

But there's so many different kinds of magnesium. Right?

[Kristin Cavallari]

That's right. The magnesium chelates are the ones that are typically. So they are the ones that end in, say, like Mag glycinate or magnesium 3 and 8. Those tend to be very good. Systemic absorption of magnesium, glycinate and threonate are probably the best for sleep.

[Dr. Lee Howard]

Okay.

[Kristin Cavallari]

If you're dealing with some bowel issues and you want to promote, like, relief of constipation, mag citrate and mag oxide tend to work the best.

[Dr. Lee Howard]

Okay, great. That's. I love that information. Okay, let's talk about kids. We're both parents. Should we be looking at kids health the same way that we look at ours? And what I mean by that is, I'll just give you an example. Obviously, when my kids were little, I could control everything that was going in their bodies. And now that they're in middle school and they're off in the real world, I can only control what I can control. And they eat like shit a lot of the times. And so I guess my question is, if they're eating like shit 30% of the time, is that okay? Because I think about when I was a kid and I did eat crap a lot of times.

[Kristin Cavallari]

Yeah, we did. Right.

[Dr. Lee Howard]

Food is different today. It is.

[Kristin Cavallari]

That's right.

[Dr. Lee Howard]

So I guess how bad is it if they're eating crap 30% of the time?

[Kristin Cavallari]

I think a lot of times it depends on the kid. And because I do believe that genetics and environment can make a difference. Right. There's always an argument of nature over nurture and which one kind of plays the biggest role. But if you're feeding your child healthy foods 70% of the time, and they are in your watch, getting the right amounts of protein, some healthy fats, and overall not consuming too many calories, especially from Sugar, then that 30 to 40% disruption is probably not gonna be so significant for most children that are active and otherwise healthy. But if you took a child who had asthma, for example, and maybe struggling with maybe obesity because they're not as active, and then they had that 30 to 40%, that could be catastrophic for that kid. But thankfully, I think there's a greater awareness. And as you said, like, we ate bad. It was the rise of fast food. And, you know, you've probably done the same thing. I take my kids to the grocery store, man, I'm like, I don't remember. There was not half of this stuff wasn't even around when I was a kid. We didn't have that. I know, and I'm glad we didn't, because I probably would have been a different kid. But the point is that we ate bad. We did those things. And as you said, though, it's not the same stuff. Just like the flu vaccine now ain't the flu vaccine from the 80s, and neither is the MMR vaccine. Like, it's just those things. We can't assume that just because our parents ate that way that we should do the same thing. Even though it looks on the surface to be the same, it's a lot of times it's not.

[Dr. Lee Howard]

Right. Even GMOs, when were GMOs introduced into the food system?

[Kristin Cavallari]

As we started doing Roundup Ready soybeans. Yeah, right. We started kind of getting things that could tolerate Roundup spraying, and that led to the whole, you know, breeding and cross breeding of fruits and foods and stuff.

[Dr. Lee Howard]

Yeah. You know, what about supplements for kids? Are there supplements? Same thing that you would just recommend for every kid?

[Kristin Cavallari]

There are, yes. I think I'm still a big proponent of vitamin D because I think that, you know, they're the most susceptible to the viral illnesses that are out there in school and older Research indicates that having your vitamin D level up not only helps prevent cancer, like breast cancer, but it also helps prevent some of these seasonal flus and things that we get, colds and stuff. So, so it will help keep them, you know, from getting sick. I think that if they are starting to exercise like little boys and little girls, getting like 13, 14 years old, giving them a couple grams of creatine is probably not a bad idea.

[Dr. Lee Howard]

Okay.

[Kristin Cavallari]

I think that's probably a good thing for the little ones as their brains are developing. If you are talking about smaller children, like maybe around the two year old age group, using a good fatty acid profile. Now, whether or not that's some moms now are more advanced. Right. They're giving their children eggs and kind of cooking with beef tallow and doing some really unique things. So I believe that that's a great approach to get those healthy fats and high protein, good quality proteins in the, in the younger kids. But they need those fats for brain development. Right. Our brain and nervous system is largely made up of fat. And so having a good amount of healthy fats is important for the kids. And so if that means you need to supplement, supplement with like an EPA DHA fish oil formula, fine. But it, but I would try to get good meats, good fats, good butter, olive oil, you know, use those types of opportunities to get those extra good calories in, especially when it can come from healthy fat.

[Dr. Lee Howard]

So butter does count as a good fat?

[Kristin Cavallari]

I do. Especially if it's grass fed butter. Yeah, I would definitely say that it kind of goes back to the whole, the milk, the raw milk thing. Right. Sort of the same type of fat and protein that is.

[Dr. Lee Howard]

Okay, so the raw milk is considered a good fat.

[Kristin Cavallari]

Well, it's got, that's right, that's the.

[Dr. Lee Howard]

Cream and stuff that's in there.

[Kristin Cavallari]

Right. It's going to have that same fatty acid profile that would be found. It's just the butter's just devoid of the milk solids. That's the only difference.

[Dr. Lee Howard]

Right. We power through butter in my house and say how much butter we go through.

[Kristin Cavallari]

That's right.

[Dr. Lee Howard]

So you said a minute ago as we age, sleep becomes really the most important thing. What about for kids though? How important is sleep for kids?

[Kristin Cavallari]

Well, probably more important than it is for us.

[Dr. Lee Howard]

Okay.

[Kristin Cavallari]

Because they require more of it, you know, and, and so it's just that as we get older, as adults, it's. We don't require as much sleep, but it's harder to come by.

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

You know, because we're just Pulled in more directions.

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

And the little ones, you know, thank God, largely, if you just get out of the room and close the door.

[Dr. Lee Howard]

You know, until they're 12 years old.

[Kristin Cavallari]

And then they get a phone.

[Dr. Lee Howard]

Last night at 11, I said, Go to bed.

[Kristin Cavallari]

Yeah. A parents worst nightmare. Right. The screen. And. And so, yeah, I've also got a couple articles that I can leave with you about how screen time does affect things like insomnia and depression rates in kids. And so I have started to. And, you know, and look, I'm not some gestapo parent that's like every night marching up there to seize my children's phone. But I have tried to, because they're getting big now. My boys are 14 and 16. Right. And it's time for me to encourage them to make the right choice and show them what that right choice looks like. So what I've tried to do is, like, after 8:00, we need to be limiting screen time. Like, phones need to be put down, ringers and notifications are turned off, and it's time to start winding down and get your body ready for bed. And so, yes, those hours before bed, whatever hour, one or one or two hours before bed, become critical in getting good sleep. That sleep hygiene is really important. So, you know, I used to read to them. They don't really want that anymore, of course. So that's not. That's out. But. But still a similar thing of even. I feel like even turning the. Getting the phone away and just going to the TV is probably better.

[Dr. Lee Howard]

I agree.

[Kristin Cavallari]

Because at least it's a few feet away. Right. You know, and I can kind of, like, the distance makes me feel better.

[Dr. Lee Howard]

Same, you know, same with me. I am kind of a freak about this, but, like, I have all these little red lights that I put in everyone's bedrooms. I turn those on at night. Camden actually showed me you can make your whole phone screen red by. It's a program you have to do. I actually talked about on my podcast, like a week ago. But you can just click your little button three times and it turns it red.

[Kristin Cavallari]

Yep.

[Dr. Lee Howard]

So. Because that helps with the natural melatonin, right?

[Kristin Cavallari]

That's right. That's right. You get rid of the blue light, you'll stimulate your normal melatonin. There's a couple other ways to do that. Right. Like getting out in the morning first thing in the morning, early morning, sunlight grounding. Getting that sort of first sunlight of the morning, because it sort of sets you up for like a melatonin release 16 or so hours later. So you're priming your clock to think, okay, it's morning time and that means in about 16 hours from now, I got to start to wind down. Right. That'd be our natural sort of rhythm. So getting that early morning sunlight is important. Right.

[Dr. Lee Howard]

I didn't realize that's what it was doing.

[Kristin Cavallari]

Yeah, it's kind of programming. Yes. Like time to. Time to get up and it's going to be time to turn down later on.

[Dr. Lee Howard]

That's very cool. I love that. Okay, great. Yeah, Sleep is very important. Let's talk about young moms. And you know, if you are a young mom, I've been a young mom, it's very busy. You know, there is no time for anything but your little kids. But a young mom's health is still very important. What are ways that young moms can be prioritizing their health?

[Kristin Cavallari]

It becomes more of a, I think you bringing awareness to it and having other moms be aware of it is the biggest factor. Because when you, whether you're 48 or 28 and you're dealing with a 16 year old or a, you know, 16 day old, the, the time demands and the way that you're going to sort of like sacrifice your own health for your children is maybe a little bit different, but overall, still the same thing. So I tell women sometimes I'm like, look, if you're at home all day and you don't feel like you're going to get outside and go do an hour workout every time you walk in the laundry room, do 10 air squats.

[Dr. Lee Howard]

Oh.

[Kristin Cavallari]

So find something that you do routinely that you can almost mindlessly work in some kind of workout. So what if we said every time you walk by this table, you're going to do 10 mountain climbers on this table, just lean over, pull your knees up 10 times. And what we, what research is showing it recently is like just a couple weeks ago there was a study that came out of Japan where they would do like three minutes of fast walking, three minutes of slow walking. And I think they did that pattern like six times or five times. And it was almost as much cardiac benefit as running for like 30 minutes.

[Dr. Lee Howard]

Oh, wow.

[Kristin Cavallari]

So what we are seeing is that short burst of moderate exercise are really good at stabilizing blood sugar, which, and probably I would say going to go for maintaining muscle mass too. Right. And then not pushing you into a cortisol response. So so many young women like to do high intensity cardiac activity. Right. Because they, they equate input like, I'm going to work my butt off, which means I'm gonna burn a bunch of calories and I'm gonna be skinny. Yeah. And that is. As you get older, that equation starts to not work anymore. And. And. And that can even change rapidly after childbirth. So intensity of exercise doesn't necessarily guarantee results. Consistency will. Okay, so. So even doing small amounts consistently will pay dividends. And the thing. I think the biggest mistake made when it comes to exercise is believing that. And I. There's a couple ways we could say this. Believing that it had to be perfect or believing that taking our kids with us was dangerous, or taking our kids with us was boring to them, or it was gonna, you know, not stimulate them. It's the exact opposite. Them watching us do that and us bringing them that environment would have been more powerful than what we. You know, than what we attributed.

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

So I think I would have brought them with me even if it was a walk. Walk up the hill, you know, do air squats, roll a yoga mat out there on the thing on the. On the porch, and just do some basic groundwork. But leave them there with you on the ground. Get them involved. That's the main thing.

[Dr. Lee Howard]

I agree. I've always, for the most part, worked out at home. And when my kids were little. Yeah. I mean, they would be with me, you know, goofing off, putting ankle weights on, and, like, doing silly stuff. And now they're actually. Well, sailor's a little young, but the boys are into working out, and especially once they start playing sports and stuff. Camden's like, I want to hit the weight. I'm like, this is great. I love it.

[Kristin Cavallari]

That's right. That's right. And so you will set the tone, you know, for your children to determine kind of where their health and fitness level is going to be.

[Dr. Lee Howard]

Exactly. If we had to prioritize three things for young moms to do, what would you say are the most important things?

[Kristin Cavallari]

Eat plenty of protein, supplement with creatine. I would put those in the same category. Do some type of movement. Exercise daily and sleep as much as you can.

[Dr. Lee Howard]

Sleep as much as you can.

[Kristin Cavallari]

Yeah. Sleep with your babies.

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

You know, when they take a nap, you take a nap. That would be it. Yeah. Eat good, take some creatine, move daily and sleep as much as you can.

[Dr. Lee Howard]

Okay. And so remind us again. Creatine. Creatine. I think I've been saying it wrong.

[Kristin Cavallari]

Creatine. Creatine.

[Dr. Lee Howard]

Okay, whatever. I started taking it maybe six months ago. I've noticed a huge difference.

[Kristin Cavallari]

It's amazing. And I think the benefits Long term we're going to see that the benefits for women are greater than for men. Right? Really? Yeah. Well, I think cognition really.

[Dr. Lee Howard]

Oh, wow.

[Kristin Cavallari]

So some. There's. I don't, I don't, I'm not going to have the resource here, but a couple weeks ago there was an article that I read and it was not really like a scientific article. It's more of an assessment of the literature, if you will. They were just talking about how the literature seems to point to the fact that females age in terms of their cellular aging, they lose creatine levels faster. So would there then be a bigger role for supplementation in females when it comes to, you know, helping cellular anti aging and creatine? And the outcomes seem to point to that, that there's something about creatine in women. Like even now a lot of people are recommending 10 grams rather than 5 grams, which seems like a whopping dose. But I don't really know that there's a top level of absorption or benefit. And at the end of the day, if it just turns into urine, what you don't need, what would be the harm? I think, I think it does. And you know, I don't know that I would up it in one dose. I would probably split dose it, right. Like do 5 grams and in two different doses. But I think that we're going to see some emerging literature that's going to be highly supportive of specifically females using creatine, maybe even in higher doses as they age.

[Dr. Lee Howard]

Cool. I'm excited.

[Kristin Cavallari]

Good stuff.

[Dr. Lee Howard]

A brand that I absolutely love and always get excited to talk to you guys about is Primal Kitchen. Let's talk about real food for a hot minute. We all know we should be eating more real whole foods, but guys, who has time to make homemade sauces and dressings from scratch all the time? I wish, but it's just not realistic for my life. That's why I love Primal Kitchen condiments. Primal Kitchen has nailed the perfect combo of high quality ingredients plus delicious flavor. So your meals will taste as real and homemade as it gets. They're not just made from real ingredients, they're also made for real food eating. My house loves the buffalo sauce. It does have a little bit of heat, but not too hot and just still really flavorful. Obviously we use it on wings, but it's also great on roasted veggies. And guys, even a drizzle on scrambled eggs in the morning. Try it. They also have an unsweetened ketchup made with real organic California grown tomatoes. No high fructose corn syrup, cane sugar or artificial sweeteners. And Primal Kitchen Mayo is a must have. It's made with six simple ingredients like organic cage free eggs and avocado oil. So if you're all about real food but need a little help making it exciting, you need to try Primal Kitchen condiments and sauces made with real ingredients we love. They're your secret weapon for making easy dinners of just protein and veggies. Taste amazing. Head to PrimeLKitchen.com Honest to save 20% off your next online order with Code Honest at checkout. That's P R I m a l kitchen.com honest and code honest. Primal Kitchen products are also available in stores nationwide. So visit primalkitchen.com honest to find a location near you Here's a newer brand that I want to talk to you guys about and that's fatty 15. Obviously, you know, getting in my late 30s now I'm 38. Aging is sort of at the forefront of my mind. My friends and I talk about it and there are just things that come with aging. You know, sometimes poor sleep, lack of energy, stiff joints. You know what I'm saying? It is important for me to stay youthful. You know, I want to feel and obviously look good as much as possible. And let's talk about how much time, money and energy that we spend on health and wellness products and supplements to look and feel younger. I mean, I know that we all pretty much do it. What would it mean to you to know there was a product out there that could help you and your loved ones, parents, etc, potentially stay healthier, live longer and slow aging? Well, I'm so excited to share with you guys C15 from Fatty 15, the first essential fatty acid to be discovered in more than 90 years. It's an incredible scientific breakthrough to support our long term health and wellness and you guessed it, aging and longevity. Okay, based on over 100 studies, we know now that C15 strengthens our cells and is a key longevity enhancing nutrient which helps to slow biological aging at the cellular level. The bottle is great. It is this awesome reusable glass bamboo jar and refills are shipped right to your door. Again, just another thing I love. One less thing to worry about. Fatty15 is on a mission to optimize your C15 levels to help you live healthier longer. You can get an additional 15% off their 90 day subscription starter kit by going to fatty15.comhonest and using code Honest at checkout.

[Kristin Cavallari]

Out.

[Dr. Lee Howard]

Let's talk about built rewards attention renters. If you haven't heard of Built? You're about to thank me. Earn your favorite airline miles and hotel points through Built just by paying your rent on time. All right, let me explain. There's no cost to join, and just by paying rent, you unlock flexible points that can be transferred to your favorite hotels and airlines, a future rent payment, your next Lyft ride, and more. When you pay rent through bilt, you unlock two powerful benefits. First, you earn one of the industry's most valuable points on rent every month. No matter where you live or who your landlord is, your rent now works for you. Second, you gain access to exclusive neighborhood benefits in your city. Built neighborhood benefits are things like extra points on dining out, complimentary post workout shakes, free mats or towels at your favorite fitness studios, and unique experiences that only Built members can access. And when you're ready to travel, Built points can be converted to your favorite miles and hotel points around the world, meaning your rent can literally take you places. So if you're not earning points on rent, my question is, what are you waiting for? Start paying rent through Built and take advantage of your neighborhood benefits by going to join built.com honest. That's J-O-I-N B I L T.com honest. Make sure to use my URL so they know that I sent you. Again, that is join built.com honest to sign up for Built today. Okay, well, speaking of aging, let's talk about aging because as you get older, you know, I'm 38 now. It's always at the forefront of my mind. It's the topic of conversation with all my friends. It just sort of is what it is and not just for appearance, but also just how we feel as well. So I want to talk about some preventable challenges that we face with aging.

[Kristin Cavallari]

Yeah, I would say the first one is going to be that most women, it really gets their attention is when perimenopause shows up, right? So kind of mid-30s, maybe even late-30s, early-40s, depending on some factors. You know, like there's, I've noticed in some women that if they have a child late, let's say at 38 or 39, they'll tend to kind of start to have some pretty significant hormone shifts after that. Not, not every time, but that if I have a 38 year old woman who has a baby and she comes in six months later and she knows her body's off, it's not surprising that they felt great before the delivery. And then afterwards things really change. Right? So, so, but, but this, this perimenopause part shows up and, you know, up to 90% of women. And another study that we have. I'll leave with you. Is that up to 90% of women have symptoms of perimenopause. And the fact is, is that we as doctors are not trained to identify the symptoms, to sort of put together what the client is telling us and what the labs look like and then make a plan to help that person, because there's really not a. There's not a treatment plan, if you will, for perimenopause. Right. And so it disturbs the mood, it causes anxiety, weight gain, sleep disturbances, and. And all of those things start to show up. And if you go to your regular doctor, unfortunately, we're just not equipped to kind of help you. And so you end up getting a label. Maybe it's an antidepressant type drug. Yeah. How many women do you know at like, 38 years old end up on an antidepressant? And when you see them when they're 58, they're still on the antidepressant.

[Dr. Lee Howard]

You know, I actually. I can think of a few friends in my life right now that just told me they're on anxiety medication. And now I'm like, wait, maybe it's.

[Kristin Cavallari]

This is a lot of it, right? This is so much. And in real life, this is how it plays out, right? The husband and the wife come in. The wife sits here. The husband sits here. And she. He looks at me and goes, yeah. And she goes, oh, my gosh, I'm so sorry. I don't know why I'm yelling at everybody. I feel so bad. I don't know what's wrong with me. Like, this is not normal. I don't want to feel like this.

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

And he's going, doc, you got to help us. And that's so common. That's so common to see that probably, like, literally twice a month, that's what's going to play out in my office. And so that is the first time where women are really, like, sort of smacked with it. And it's also about that same time that their husbands start to lose testosterone. Right. Like I was telling you, I was 34. My body started to get off. Initially, I approached that with diet, but by five years into that, I was already thinking and seeking out testosterone replacement. So I was 39 when I got on TRT. And so men and women's bodies both start to pivot at this point. And of course, now to get this picture, you got a husband and wife who are both 40 years of old. They got, let's say three kids in the house, 2, 6 and 8. Right now they're both having problems. So now they start. You see what I mean? This starts to go south fast. Right? Yeah. So anyway, that, that. But perimenopause is what really starts to get young moms. And that perimenopause can be accelerated in certain circumstances, particularly if there's a late last pregnancy. And. And usually what will happen is it will be mood disturbances, weight gain, low libido, poor sleep, feeling sad, feeling blue, especially in the week or so leading up to your period. Like, that's a pretty clear like. Like I feel off in that 10 days or so before my cycle. That's a pretty clear indicator that things.

[Dr. Lee Howard]

Are starting to change and consistently, like for a few months. Right. Because, I mean, I feel like. I mean, I'm sitting here thinking, like, I've had moments like that, but it's not consistent.

[Kristin Cavallari]

Yeah, that's right. Usually you're going to see a consistent pattern. You're going to notice that, okay, this was the week before my side. And it's usually. Honestly, you're not gonna be surprised by this, but the husband will tell the wife, like, he'll be like, I don't know, you seem a little bit irritated. Like, I don't know why. Like I did something last week and you didn't yell at me and this week I did the same thing. And you like, you know, really dropped the hammer on me. And so it does. There are. Your loved ones will typically pick up on that. Or the people in your house.

[Dr. Lee Howard]

My poor kids.

[Kristin Cavallari]

Yo. I know, I know. When it happened to us. Here's the thing. I wasn't even as smart to know what was going on then. You know what I mean? So Kelly had Parker at 38.

[Dr. Lee Howard]

Oh.

[Kristin Cavallari]

And boom. Like, the hammer dropped.

[Dr. Lee Howard]

Interesting.

[Kristin Cavallari]

And. And I felt powerless. Kristen. I mean, it was so. Yeah. To watch her be like this and. And be like this with us.

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

And then to know that there's not anything I can do about it. I'm not. I don't know what to do, you know, because I hadn't figured it out then.

[Dr. Lee Howard]

So are there things that you can do to minimize.

[Kristin Cavallari]

Absolutely. Absolutely. Yeah. You know, the most common female pattern is estrogen dominant, progesterone deficient. Right. So. And when that refers to a relative imbalance of how those two hormones should work together. And estrogen is kind of like your fun, let's go out adventurous hormone. And progesterone is like your. Let's stay Home, clean house and prioritize things for hormone. Right. They're sort of like, you know, good devil, bad devil in a way. Right. But you gotta have a balance of those two things when that shift in perimenopause starts to occur. And I guess I would like to that my ask of all your female listeners would be, don't think about these as singular events. Think about this as if you're going across the Appalachian Trail. And these are just mile markers along your journey. It's not like the journey just you open one door and, you know, and close another kind of thing. It's. It's a chapter that sort of just never really has a beginning and an end. Right. So it's all of these are steps along a woman's journey and they're going to come at different points for different people. And it's just that perimenopause is the beginning of your body winding down from being reproductive. So we may, if you have a woman who says, well, I had to have progesterone so I could carry my last child, then I would have you consider that they had already started getting into perimenopause. Right. Their progesterone levels were low. So low that they couldn't, their body would not develop a placenta.

[Dr. Lee Howard]

Right.

[Kristin Cavallari]

And so if we didn't give them progesterone, that process would have never occurred. So what we're seeing really is this shift between being reproductive to now not being reproductive and we're not. And that takes like 15 years. Right. The average age of menopause in the US is 51. So if a woman starts perimenopause at 35 and they don't go through formal menopause till 50, that's a 15 year journey.

[Dr. Lee Howard]

I had no idea that it could last that long.

[Kristin Cavallari]

And, you know, we don't, we don't tell our clients. We don't, as doctors, we don't. It's not like we sit down and draw this out and say, okay, here's what's going to happen, sweetie. You know, this is what this is going to look like. We don't do that, that.

[Dr. Lee Howard]

Oh, my gosh. So why do some women go through menopause really early and some really late?

[Kristin Cavallari]

I think genetics has a lot to do with it. Like, you're most likely going to go through menopause close or near when your mom went through. Right. So if you kind of know what your mom did then, and I can tell you that this is very close. Like, I see some young women who go into menopause in their early 40s because their mom was, you know, through menopause and done by 45.

[Dr. Lee Howard]

Wow.

[Kristin Cavallari]

So I saw last week I saw a 29 year old girl, 28, 29, who's already in menopause. Right. So she had trouble conceiving her second child, who's now six months old. So she had to be on progesterone before that. So this is exactly the pattern, I'm telling you. Right. So now you've got a young girl who was on progesterone. She was probably already starting to wind down her reproductive clock. Anyway, she got on progesterone, was able to conceive and carry a second pregnancy to term. But after that she's got no hormones, nothing. Like she hasn't got her period back, she hasn't done anything. So. And she had classic symptoms of menopause. Hot flashes, dryness, all the stuff that we would think of.

[Dr. Lee Howard]

Right, right.

[Kristin Cavallari]

And then of course we replaced those hormones and her symptoms improved. So, so, and that's a 29 year old young woman, right?

[Dr. Lee Howard]

Yeah, that's. I've never heard of anyone that young going through menopause. Does menopause accelerate the aging process?

[Kristin Cavallari]

By far, yeah. And there'll be another citation that I'll leave with you about this. It's it, you've got about five years. Right. The data shows that once menopause starts, and menopause as I'm going to define it, would be when the estrogen starts to leave the body. Perimenopause hormonally is characterized by a deficiency or a loss of progesterone and typically testosterone. So that's why we see menstrual cycles change. They typically get heavier, they may become a little erratic. Like my Cycle was always 28 days, now it's 21, and then it was 32 and then it was 26.

[Dr. Lee Howard]

Am I going through perimenopause?

[Kristin Cavallari]

Starts to sound familiar, right? Like, yeah, right. Why was this? Why was it not on time like it always is? So we start to see these patterns and, and then it all adds up when you start to look at it. Right. So, so anyway, perimenopause is progesterone and testosterone. And then once we get to estrogen starting to leave the body, that's when we know like menopause is infinitely close. Right. Like it's really starting to be upon us. And so within that last loss of estrogen, you've got about five years to replace the hormones to counteract and really, I guess Mitigate any long term damage. A lot of women lose a substantial amount of muscle mass in the first five years after menopause. And the data shows that if you act soon enough, hormone replacement therapy, exercise, creatine being the big cornerstones of that, and a high protein diet. So it's not complicated. Right. But if you act, you can stop that loss of muscle mass.

[Dr. Lee Howard]

Great.

[Kristin Cavallari]

So HRT and those four little things that I just mentioned, you know, eating protein, taking creatine, exercising, eating high protein diet, and those things will stop that process from happening.

[Dr. Lee Howard]

Right.

[Kristin Cavallari]

So it's not as complicated or as far fetched as people would have thought in the past. Yeah.

[Dr. Lee Howard]

What? I know that you are a fan of nad and NAD is great for anti aging. Is that something that you can do as well?

[Kristin Cavallari]

It is, but you know, and I would, I would say that that's not even, you know, how do you put it?

[Dr. Lee Howard]

It has nothing to do with.

[Kristin Cavallari]

Yeah, yeah. We could all benefit from it. Right.

[Dr. Lee Howard]

Like whether you're not going to change when you go through menopause.

[Kristin Cavallari]

That's exactly right. Yeah. It's not gonna. Yeah. Depending on the day, it may not even make you feel better. You know what I mean? Like, so how. Depending on what's going on. But. But yeah, nad. I'm a real big proponent of nad and a great anti aging measure. Probably not necessarily going to affect the timing of your menopause.

[Dr. Lee Howard]

Okay. I really do feel like maybe I am going through perimenopause and I never. It was not even on my radar really, until we just, just had this conversation.

[Kristin Cavallari]

The signs are subtle and they don't always cause problems. Right. So. And the healthier an individual is, the less likely they are to get that disturbance. Right.

[Dr. Lee Howard]

Wow. Okay. This is blowing my mind, but I'm glad we had this conversation. Okay. And then I have a really silly question for you. You know eye twitching when your eye twitches? Okay, so mine has been twitching for months and I thought it was stress for my podcast tour, but that's been over for a month and a half now. And it's still twitching. Not as much, but it's still twitching. So can you just answer once and for all, what causes eye twitching? Do I need to eat a banana? Like what?

[Kristin Cavallari]

I would say that this is a. And by the way, I don't have a lot of qualifications in studying eye twitching. Okay. So let me qualify my statements from like my perspective. But I think of eye twitching probably like I would like a diaphragm or a hiccup. It's a nervous system kind of glitch.

[Dr. Lee Howard]

Okay.

[Kristin Cavallari]

And. And our nervous system can glitch for a lot of reasons. It can be from stress. It could be from lack of sleep. It could be from an electrolyte of perimenopause.

[Dr. Lee Howard]

Oh, my God.

[Kristin Cavallari]

Yeah. Think about it. Like, why else would a woman feel anxious? That's a central nervous system thing. Right. You may be. You know, I'll let you take the inventory once we're done today. And you can go in and, like, write on the whiteboard and start checking off some boxes and say, well, here's where I am, doc. But, yeah, I would say that eye twitching is like a little nervous system malfunction. Is it usually from an underlying electrolyte imbalance? Probably not. You know, it's probably not a deficiency of sodium, potassium, or magnesium or something like that. It's probably more. And I agree with what your initial assessment was, is this is probably my nervous system, like, a little bit on overdrive, you know, and then. And then there's the sort of things that, you know, we've always watched, like our dogs and stuff, when they lay down and they get calm and they twitch a little bit. Well, what if it's the same thing as that? What if it's not necessarily a sympathetic response, one of stress, but what if it was a relaxation? What if it was your body saying, like. Because if you noticed it at night, like, what if you guys were hanging out here on the couch and you're kind of, like, relaxing, Lights are down. You know, you got your little red lights on, everybody's sort of chilled out, and your eyes start twitching. Well, maybe that's Kristen's body winding down. Right. So. So I believe it could probably go both ways. It could be a system on overdrive or a system coming down off of overdrive.

[Dr. Lee Howard]

Interesting. Okay, now I'm gonna have to really start paying even closer.

[Kristin Cavallari]

See what you find out. Yeah, and see if taking magnesium makes a difference. Right. Because that's the central nervous system relaxant.

[Dr. Lee Howard]

Got it. Maybe help that I'm convinced I'm going through perimenopause.

[Kristin Cavallari]

Yeah, that's gonna. That's gonna be the topic for the next few days.

[Dr. Lee Howard]

It is what it is. Okay, well, this has been amazing. Is there any other advice that you would want to give my listeners? Primarily women, obviously?

[Kristin Cavallari]

Yeah, I do. I think there's so much of what we have been taught about aging, specifically around don't eat a lot of protein, don't weight train, don't take hormones. I think that those Three pieces if you can, as a female, as you age, start to think about, how can I work on exercise to maintain my muscle mass? Because just as dollars in your retirement account fund your retirement muscle mass on your bones funds your aging. It is key to maintaining your blood sugar, to preventing Alzheimer's, to preventing a fall. So you've got to maintain your muscle mass. And the earlier you start, the better. So resistance training, creatine and protein become very, very big. And then that's one big thing. I would always prioritize. Sleep. Sleep, even if you don't think you need it. Sleep more, manage stress. And then the last thing would be, get your hormones checked, find someone. And when you start thinking, like, gosh, this is not me. Right. Like I was. I'm not the guy or the girl, rather, who yells at her husband just because he left his plate right there. You know what I mean? And when you start noticing those things, you say, well, that's not me. I think something's going on. You're probably right. Trust your gut. And if the labs are normal, that's an even more sign that you're probably onto something. Right?

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

And then you don't need to believe the. The. The practitioner who just says, hey, Kristen, your labs are normal. I think, you know, there's nothing going on here.

[Dr. Lee Howard]

Yeah.

[Kristin Cavallari]

I think I would always ask a deeper question. So, yeah, get your hormones checked. There's a lot of data out there. There was a big paper that came out in the Journal of Menopause last year on May 1, 2024, that showed tremendous benefits in women past the age of 65 taking hormone replacement therapy. So. So basically what we can see is that, you know, between like, 35 and 75 or 85, there are tremendous benefits for pretty much every woman in taking hormone replacement therapy. So those would be my three recommendations.

[Dr. Lee Howard]

Great. Those are great. I love that. Thank you so much for being here. Thank you.

[Kristin Cavallari]

It's great to be here.

[Dr. Lee Howard]

And then tell everyone where they can find you.

[Kristin Cavallari]

Yeah. So we have. Our website is compasshp.com, compass Human Performance. And then I'm on Facebook, TikTok, Instagram, YouTube, rlehoward.

[Dr. Lee Howard]

Amazing. And if you guys are in Tennessee, you can go see him. Thank you so much.

[Kristin Cavallari]

Thank you for having us. Great. Great to be here.

[Dr. Lee Howard]

Yeah, yeah.