← Let's Be Honest with Kristin Cavallari
Let's Be Honest with Kristin Cavallari
Are Your Supplements Useless? The Truth About Gut Health & Antibiotics with Dr. Ryan Monahan
00:56:37
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The following podcast is a Dr. Media production.
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This is, let's be honest with Kristen 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.
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Got all my little bags out here with me with all my supplements.
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I, like, I really.
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I'm committed to the bit.
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Yeah. It's a lifestyle, you know?
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It is.
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You have to.
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Can you ever sort of, like, get
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off of taking supplements?
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For sure, yeah. I mean, a lot of my patients do. They just don't like doing it, you know, so.
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So, like, once you get your levels all set, then you can kind of.
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I don't think those tests will ever show perfect findings that they're not really even meant to, like, achieve perfection. It's like, where do you need support now? Because your physiology is ever shifting.
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Oh, okay.
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So it's like, where should we focus our attention right now and then next time and the time after that? So I think it's more about, like, how you feel. Do you feel like you want to feel? And if so, let's take a break, and if something happens in a year or two or three, come back.
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Oh, interesting. And kind of like, in my head, I've been like, this is my life now. We test my body every six months. This is what I'm doing.
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I think that's the best way to do it. That's what I do for myself. I run those labs every six months. But not everybody wants to live their life that way.
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Right. Right.
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So if you're into it, keep doing it, and if you want to space it out more, you can.
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Okay, maybe that's the move. Just like taking a little supplement break.
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For sure. Supplement fatigue is very real.
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What supplements do you take every day?
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Too many to list. I counted once recently, I take, like, 72 supplements.
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Whoa.
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Yeah, recently. But I'm always doing different protocols, you know? Like, right now, I'm on a few different protocols. So I'm not just taking that for maintenance. I'm actually trying to work on things.
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Got it. Okay. So what would be like, a maintenance program? Let's say, like, you do all the tests and I'm gonna.
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Well, actually.
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Okay, let's start with this. Let's talk about. So. Well, welcome back to the podcast, Dr. Monahan.
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Thank you very much.
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This is your second time coming on the pod. For anyone listening, I would highly recommend going and listening to the first one because we talk about so many great things, and this will Be like an extension of the first one. But on the first one, we talk about when people come to see you, you run a ton of different tests on them. So explain to everybody, if they haven't heard it before, what tests you run on all of your patients.
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I run advanced functional labs, which are very different than kind of the conventional blood work people get when they go to their primary care physician. That's more like a CBC and metabolic panel that's looking for disease. And in functional medicine, we're more preventative and kind of a longevity medicine. So we're trying to see what are the places that need support now to prevent disease from developing down the road. So the things I like to run include like a stool test to look at gut function. A adrenal testing is really big in functional medicine. Work on your stress response in the body hormone panels. Organic acid testing is a very unique test to functional medicine. And that looks at like, it's like 25 tests in one. It's like detoxification, nutrient levels, inflammation markers, toxic burden issues, mitochondria, neurotransmitters. Such a long list of stuff. So kind of all the things we like to see. So it ends up being, I don't know, like a thousand markers. It's a lot of stuff.
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Yeah.
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Yeah.
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So. So you. I mean, we have such a good picture into my body, where it's been, where it currently is, and how this conversation came up. Why I wanted to have you back on the podcast was because I was pretty vocal last spring about redoing my boobs. And we had tested everything in my body, I think, a couple months before, and then we tested everything a couple months after. And what we saw was pretty alarming and specifically from taking antibiotics. So I just felt like it would be important to have a conversation about antibiotics. And I wanna preface this conversation with the fact that obviously we fully understand that there is a time and place for antibiotics. Sometimes we need them. They can be life saving.
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This was an elective surgery.
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So I think for me, I just. I've always known that antibiotics are not good for you, but seeing it firsthand like that on my labs was pretty alarming. And I just think a lot of people will sometimes take things without asking questions or wondering if it's doing anything harmful to their bodies. So in your doctor terms, can you explain what we did see on my labs specifically from the antibiotics?
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Yeah, I mean, just to start, you're absolutely right. Antibiotics are critical and life saving and totally warranted in certain circumstances, but they are typically over Prescribed, and there is growing antibiotic resistance globally. So I think we need to be targeted in where we use antibiotics. Not to say don't use them ever, but just, like, don't overuse them, don't prescribe them in places that they're not gonna work. Like viral issues, common cold, influenza, bronchitis, some sore throats. And then, you know, you can treat other things without antibiotics that are commonly treated with antibiotics. So I see patients for things like UTIs, yeast infections, ear infections, digestive issues, skin issues. Like those are commonly treated with antibiotics, but you can treat them with natural stuff.
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Oh, I didn't even know that. Half of that stuff was, like, yeast infections are with an antibiotic sometimes. Oh, I didn't even know that.
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Yeah, I mean, antifungals would be better, but yeah, so there's just this kind of overuse in places where they're either not effective or not necessary, if you kind of know different ways to approach those. So, yeah, with your labs, there is definitely damage to the microbiome, as you'd expect. When you take antibiotics, you really damage the microbiome.
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And.
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And your microbiome is, like, foundational for health. You know, that's where you produce neurotransmitters, 95% of your serotonin, 50% of your dopamine, vitamins, like B vitamins, K vitamins. Of course, you absorb nutrients from your gut, from food. It's really influential for your immune system. So you want to protect your microbiome and not take antibiotics if you don't have to. And again, time and place for those. But, yeah, it definitely damaged your microbiome. And then typically, what you see is a rebound growth of fungal or yeast or candida issues. And we saw that. Right. So that's something to keep in mind. If you have to take antibiotics, and some people do, there's, you know, precautions you can take, like a Saccharomyces boulardii supplement that can help prevent the rebound growth of yeast. It can help mitigate some of the negative effects of antibiotics as well. And then there's another probiotic strain, L Rhamnosis gg, that can be helpful. But then you want to focus on diet more than anything. Right? So, like, lots of fiber, rich cellulose, rich vegetables, fermented foods like kimchi and sauerkraut. All of that will help a lot.
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So my microbiome or. Well, do you say mitochondria Mic.
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Well, yeah, your mitochondria is a different thing. Yeah, that's okay. That was why cellular energy Right, Yeah, yeah, yeah, yeah. And. And my antibiotics can influence mitochondria. That's absolutely true, but yeah, very direct impact on the microbiome pretty much every time. Actually, there's a. Interesting study that just came out three weeks ago from Sweden that found it takes up to eight years to reproduce. Regrow your microbiome after one course of antibiotics.
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Okay, so that, That's a long time. That's the part that just infuriates me. Right. Like, I just think that we should be having these conversations, which again, is exactly why you're here. But I think about that, you know, because even what we saw on my test was from one round of antibiotics. And if you look at the course of someone's life, most people are taking antibiotics at least a few times. I mean, I, I used to get strep throat a lot in my early 20s. I would always take an antibiotic for that. And so.
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Yeah.
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What damage are those making on your body long term? Like, if you have to take antibiotics five times in your life, let's say, what are we looking at exactly?
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Almost nobody's gonna go through life and not take an antibiotic. And most people are gonna take a lot of them. And I even work with patients sometimes, like they have recurring UTIs and their doctor put them on. Take an antibiotic every time you have sex. Right. Oh, my God. So you're just like permanently on an antibiotic. What's going on? Right. That's so counterproductive. Cause as you decimate your microbiome, you're more prone to those types of inf. Happening. So it's like you really get stuck in this vicious cycle. So.
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Yeah, like, what happens in, you know, if you take them five times now you're 40 years old. Like, what could we be looking at?
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That's why we have a lot of health issues.
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It is right from antibiotics.
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Well, destroying the microbiome is associated with a lot of bad things, like, you know, body mass index issues, triglyglyceride issues, if you can say it, just all these health issues. Right. Because the microbiome is so influential to every aspect of your body. So, yeah, I think it's a huge part of why there's kind of a chronic sickness disease epidemic going on, you know, just overuse of antibiotics. So, yeah, it's a really tricky situation because they're here and we can use them and they're really helpful and life saving, like I said, but should be more selective and then, and then just know that. I think people have the impression if you kind of have to take an antibiotic. Okay, I'll go pick up a bottle of probiotics and I'll be good. And that study I just mentioned does not show that.
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Right.
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You may never get your microbiome back. Like, I think of some of these strains, you have 500 to 1,000 strains in your gut. It's. If you kill them with antibiotics, some will come back, some may never come back in your whole life. And so I like to think of them almost like endangered species. Right. So, like, if you kill some, they're gone for good. It doesn't mean you can just bring them back if you want to. So.
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So even if, like, we were to test everything and you're like, okay, here's this protocol for you now, we potentially could still not bring some of those back, even with supplements.
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Absolutely, absolutely.
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Oh, my God.
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Yeah, yeah. It's no guarantee. And that's why I'm saying, you know, people should just be aware that when you take an antibiotic, it's doing some potentially permanent damage to the microbiome.
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Wow. And so when we talk about the microbiome, is that the same thing as saying there's no good bacteria in your gut, or is that different?
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Yeah, that's exactly right. So the microbiome is your commensal flora, your good bacteria.
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Exactly right. Okay. And so with antibiotics, so what are alternatives that people can be doing? I know you just said that you could take a couple of things if you have to take an antibiotic.
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Yeah.
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So, but what are some other things that can sort of act as an antibiotic if you don't necessarily have to take an antibiotic?
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That's a great question. And so that's what I work on with patients, and it's like a case by case basis type of thing. But, you know, some of the common things that I mentioned, like an ear infection, especially in children, and it's like, really good not to give kids antibiotics right away and just get them started with a deficient microbiome. Day one. So ear infections are really common and they get antibiotics prescribed all the time. So I give a very natural blend of olive oil, mullein, and garlic, and you can put drops in the ear.
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What's mulan?
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It's a herb. It's an herb.
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I've never heard of that.
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Yeah. And so that can, you know, do that two or three times a day for a day or two or three until it's gone. And that works pretty well. And you've avoided an antibiotic there. And that happens all the Time, So that's common. And then for, you know, recurring UTIs, I give like Chinese herbal formulas that are really good for that. Bao Zentong is the name of one. So it kind of depends on what you're treating. Right. It's not like a one. It's not like, here's the one thing that replaces an antibiotic always. You know, there are natural antimicrobial herbs, anti parasitic herbs, antifungal herbs, and those will be used in place of an antibiotic, an antiparasitic, or an antifungal medication. There are places where the medications are better because they're stronger if something's really in need of that. But a lot of these lesser concerns that are something you want to fix but aren't like an emergency or life saving event, you can use gentler things.
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What about, is it called colloidal silver? Am I saying that right?
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Yeah, Colloidal silver is great. You can use that in so many different ways. Orally, topically.
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We've put it in eyes.
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I know, yeah.
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Eyes, ears.
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I've done that for patients with like styes in their eye or, you know, pink eye. Pink eye.
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It's cleared pink eye in my kids.
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It's pretty amazing.
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It really is.
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It really kind of works.
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Yeah. So that maybe it's not like one size fits all, but that is kind of universal for a few things.
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That is. Yeah. If you had to like say what is kind of an equivalent to an antibiotic that has like antibiotic properties to it and you can use it in a similar way. It's not as powerful, but that also means it's not as detrimental to your microbiome.
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Right. Do you ever have to be worried because it is silver and that's, that's a real thing.
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Yeah. I mean, if you go online, you can find problems with everything. Right. So silver is one of them. I think there's reports of people turning like blue or silver or something. Yeah. I mean, it's like one in a million type thing. But then people find that and they're like, oh, it's terrible for you, so.
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Right, yeah.
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If you don't feel comfortable using something, don't use it.
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Yeah, yeah.
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I think people just have to know there are other options that exist because I think a lot of people have the idea or are told even, it's this drug or nothing. It's this surgery or nothing. And that's not always the case.
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Exactly.
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Okay, and then the flip side of antibiotics is probiotics. And I think there's this misconception with probiotic also is that everyone should be taking a probiotic. You know, marketing is like, everyone should
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be on these probiotics and.
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And that's not the case. So explain why not everyone is a candidate for probiotics.
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It's so true. I think over the last decade or so, probiotics really blew up as this kind of one size fits all cure for gut problems. And people have in their head like, I'll just take a probiotic and I'll be better. And that's definitely not the case. So I run stool testing on every patient I work with and we see all sorts of problems. And most of the issues people are having health wise and especially gut wise are pathogenic infections and overgrowth. So like parasitic, bacterial, fungal, yeast, things like that. So most of the time I'm starting patients with kill and clear protocols to get out all the bad guys. And most of the time that's enough. That's actually what people really need. And probiotics are pro life, right? So they're gonna help with the building of the healthy microbiome, but they're not so much gonna clear out the bad guys. You want anti things, antifungals, antiparasitics, antimicrobials. So yeah, clearing out the bad stuff is usually what's needed oftentimes. And so that stool test includes a microbiome analysis. Oftentimes people's microbiomes are okay. That's not really the problem. There are people who have deficient microbiomes. And then you'd want to go strongly with diet. Vegetables, fermented foods, things like that, a lot of fiber rich foods and Then taking out all the bad stuff, inflammatory foods, sugar based things, things that break down to sugar, all of that. And then the testing also shows specific strains like Akkermansia or Lactobacillus or Bifidobacterium. And if you see deficiencies there, you can just give that probiotic. And I do see those come back you. And if there's like a macro deficiency to the microbiome, then I lean more on the diet side with the vegetables, fermented foods, and taking out inflammatory foods.
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Got it. So if you have an overgrowth, like we can use me as an example. When I first came to you, I had sibo, so small intestinal bacteria overgrowth. And so if I was taking a probiotic, would that make it worse?
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It can, exactly, yeah. So it can exacerbate symptoms. It may or may not make the actual SIBO worse, but it'll flare up your symptoms and you'll like, bloating is the number one symptom of sibo, Right. So it'll probably make you feel more bloated. So it's not that the probiotic is bad inherently, it's that you're just using the wrong tool for the job when you want to use antimicrobials and clear out that bacteria not proliferate life with a probiotic.
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Right. So I think a lot of people, in an ideal world, we would all be taking these tests and we would have a clear picture of what's going on in our body. But obviously that's just not feasible for everybody. How can you tell in your life if you are a good candidate to take a probiotic or not? Or maybe the better question is what are ways to tell that you're not a good candidate?
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That's a tough one. In general, there's not too much. If you get a high quality probiotic, there's not too much drawback to taking it. And if you take it and you
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say, okay, even if you have yeast, let's say, yeah, yeah, I mean, I
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mean, even in some schools of thought you can use probiotics to treat overgrowths and pathogens. Like that's, you know, Saccharomyces boulardii is this probiotic yeast and it combats yeast. It's kind of this weird situation where you're using yeast to fight yeast, but it actually works. Right? So, yeah, again, no problem taking a probiotic just to give it a, give it a go. But don't have the assumption this is going to. It's a cure all. It's Going to fix all your problems. And if you notice things get worse, that probably means you have overgrowths and infections and pathogens that need to be treated first. So. Yeah, I mean, short of that, it is, it is test, don't gas and see if, see what you need specifically. Yeah, if you can.
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But like bloating potentially.
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Oh, yeah, yeah, yeah.
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All of those kind of symptoms could
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be just having done this with thousands of patients. What I, what I most often see are pathogens, infections and overgrowth causing the problem. So I don't think a probiotic will really resolve issues in those situations. You know, you should go the other side. The anti life, like antimicrobials, things like that. Okay, yeah.
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How do we get sibo or yeast overgrowth? Where are these all coming from? Because it feels like everyone has some form of an overgrowth of something.
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So true. I mean, antibiotics are part of the problem.
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Right.
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Because when you dust decimate your healthy microbiome, the healthy bacteria, they're gone and there's room for invaders to come in like pathogens and infections and yeast and sibo and all that stuff. That's a part of it. It's such a big question. So like, how do I even categorize it? That's, that's, that's like, that's putting everyone, starting everyone off on the wrong foot. Just decimating a healthy microbiome. Yeah. But then stress plays a role, especially with sibo, kind of. It turns out one of the underlying factors of sibo is motility issues. That means slow transit in the intestine. So if you have slow transit in the intestine, that can often be due to stress, like vagal nerve things. And a lot of people have stress and that's such like a catch all thing and people kind of dismiss it. It's just like, of course that's life. But it really is compounding many factors in health. And we do run like adrenal stress testing and we can work on the HPA axis and modulate stress and its impact in the body. And then you can use like motility agents to correct motility in the gut. But that's a big part of it. Food supply matters too. You know, if you're eating low quality, poor source food, you're probably more prone to getting some kind of foodborne pathogen. There's so many.
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Is that like a parasite?
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You can get a parasite? Yeah, yeah. Very, very, very common.
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Yeah, yeah. And parasites just wreak havoc on your body.
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They really can, I mean, not just the gut, they can ruin Systemic health things you wouldn't even think were related. You know, cognitive issues, behavioral issues, immune issues, skin issues, sleep issues, fertility issues, weight issues. Like all this stuff. Right. And the weird thing, I was gonna say the cool thing. It's not cool. The weird thing about parasites, you can have a parasite and have zero gut symptoms. You could have all those systemic ones I just listed. You could have, you know, brain fog and fatigue and no gut symptoms.
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Whoa.
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We run a stool test, find the parasite, clear it, the brain fog and fatigue is gone.
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Whoa.
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So it's really hard to determine on your own. Like, you would never say it must be a parasite if you didn't have any gut symptoms.
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Do you think that everyone should just
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be doing a parasite cleanse like, once or twice a year? And I will say, I mean, and I know I pay attention to the health stuff, but I feel like more and more people are talking about that.
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Yeah. I do think people should be working on their gut a lot more than they are in more advanced ways than I take a probiotic. And that's kind of where most people land when it comes to parasite cleanses. There's this whole spectrum, Right. And I think people use the word parasite as this catch all for any gut problem or almost any health problem. Like, I think I have a parasite, you know, and like, maybe it could be bacterial, it could be yeast, it could be fungal, it could be a lot of other stuff.
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Yeah.
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So figuring out what it is is critical to getting the right treatment. And then what I've seen in the marketplace for parasite cleanses, there's like really low quality ones that are not worth your money. There's better ones, but even the best ones, if they're using high quality stuff, they're probably doing it in a very, like, direct to consumer way where it's very safe, low dosages, short duration. So it's more like a gentle gut reset. And you might see a little improvement in your symptoms, but you're probably not truly clearing a parasite with that. Like, when I go to clear parasites based on lab work, it's like two, three, four months of like kind of heavy duty stuff.
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Yeah.
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And we retest to make sure it's gone, and we look at your symptoms and make sure you're better. So, you know, even the best parasite cleanses that I've looked into, they're probably not clearing parasites fully.
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Gosh, it's so crazy. Yeah. I mean, and we've cleared parasites for me and my boys. And yeah, it's an aggressive protocol for like three to Four months.
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So.
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And then even sometimes that doesn't work and it comes back totally.
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And that's where you have to start thinking about things holistically. And it like Sibo. I get a lot of people saying, I have sibo. What do I do? I'm like, well, sibo is one part of a bigger problem. And a lot of that comes back to, like I said, like nervous system regulation. And that's just a whole ball of yarn.
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That's a.
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It's a lot.
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Yeah. Yeah.
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Well, okay, so talking about, like what you can go and buy at, you know, your local grocery store to kill a parasite, let's talk about supplements in general, because not all supplements are created equal. And another shocking find for me on my results was my glutathione and my vitamin C were essentially non existent. And at the time I was taking these liposomal pouches sometimes twice a day from a brand that I thought was really effective, really great quality. And that was shocking to me because to me, it's a waste of time, money, energy. I mean, it was a complete waste. And so how can we tell what supplements out there are actually good quality and are going to do something for us? It's such a saturated market, how can
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we even know where to begin?
- [24:59]
C
You're exactly right. It's such a saturated market. There's a million supplements out there. You can put a supplement out with virtually no oversight or regulation. And there are, I mean, there's nothing more important if you're going to use supplements than making sure you're using the highest quality, the best version of that thing.
- [25:15]
A
How do we know what that is?
- [25:17]
C
Okay, so let's talk about that. There's a study I like to reference that looked at, they went into the marketplace and they just bought random supplements from common sellers. They tested all of them and their conclusion was 80% of those supplements had 0% of the ingredients. None.
- [25:32]
A
What?
- [25:33]
C
And then everything else was like a lower dosage or it had contaminants like metals or chemicals and all these fillers. Right. So like most supplements are fake.
- [25:43]
A
Wow.
- [25:44]
C
And then there's another study. So, okay, so what can you do? There's this website that I have a subscription to called Consumer Lab. It's like a paid thing, but it's worth the money, especially for what I do to follow on what supplements are good and not good. So they test very large amounts of supplements all the time and they send out an email, email, like every week or two. Here's what we've tested, here's what We've found. Yeah. And so I'm watching that all the time. But yeah, the last email I opened from them, they had randomly bought 13 vitamin E supplements off Amazon and they tested them. Five of the 13 had zero vitamin E. No way. So like you go on Amazon, you buy your supplement, you think you're doing something good for yourself and you're taking filler. Yeah, it's like filler powder. There's nothing in there.
- [26:27]
A
That is crazy.
- [26:27]
C
It gives supplements a bad name because then people like, I tried that didn't work. Supplements are bogus. They don't work. And like, it's true if you're taking a fake supplement that has nothing in it. Right?
- [26:36]
B
Yeah.
- [26:37]
C
So like there's probably a dozen or two dozen brands that I think are really high quality and good. So I use those with my patients and myself. You have to make sure you're buying really high quality brands from reputable sources. So I use fullscript. That's where I buy my supplements and send patient supplements. They only carry the best of the best. So if you get it off there, you know it's gonna be good.
- [26:56]
A
Okay, and can anyone join that website? Yeah. Oh, okay. So anyone can just go on and order supplements?
- [27:01]
C
Yeah, I think you need to sign up with a practitioner. Of course you can sign up with me if you want, but you can sign up with anyone. I think you do have to be in a practitioner's account.
- [27:08]
A
I was gonna say, I don't think anyone can just go and start ordering supplements.
- [27:11]
C
It's not like Amazon, where. Yeah, just go. I think you're right. I think you do have to go under a practitioner.
- [27:15]
A
Well, that's why people need contact you and make an appointment.
- [27:18]
C
You can sign up for it for free anytime. You know, you don't even have to be a patient. But that's great because they're all direct from manufacturer. They only carry the good stuff. They're very selective on what they allow into their catalog. So if it's in there, it's good still. They have 13 to 17,000 supplements. So how do you know what 10 or 20 are good for you? That's where the testing comes in. And then you can also buy supplements direct from manufacturers, websites if you know good, good companies. So like, just to name a few that I like, designs for health, Pure encapsulations, Thorn orthomolecular metagenics. Seeking health is good. Apex Energetics is good. There's, you know, probably 10 or 20 others that are really good. But yeah, just if you're going to buy supplements, Spend the money. Like, don't look for the cheapest one from the most random third party store, Walgreens. Exactly.
- [28:05]
A
Don't be buying supplements.
- [28:06]
C
That was one of the place they tested. It was, Yeah. I wasn't gonna list the places.
- [28:10]
A
I'll say it. Anytime I'm in there, I'm looking at those supplements. I can just tell these don't look like they're actually gonna do anything.
- [28:16]
C
I know, and so it's a bummer for me. Cause kind of the central piece of what I do in treatment is I use supplements, but I use it in a really methodical, thorough, therapeutic way. We test, we use the best version, we use the right dosages, we do it for the right amount of time. So it's discouraging for patients to buy what ends up being potentially a fake supplement with nothing in it and feeling like that didn't work for them.
- [28:38]
B
Yeah.
- [28:38]
A
And then as far as reading the labels on supplements, I'm even just thinking about the pouches that I was taking because I read the labels, I looked at the website. I mean, to me it looked like a great company and it wasn't doing anything. So how can you know, is it. Are we looking at dosage? Are we looking like, what specifically should we be looking at?
- [28:59]
C
Absolutely. This is a really good question. And I know the company you're talking about. Like, I've never seen third party party testing for that company, so I can't say. That's where like a consumer lab comes in and you start to learn. Like, oh, this company always tests well.
- [29:11]
A
Could you even like Google third party testing for possibly. I wonder.
- [29:15]
C
I've never done that. I mean, their whole business model is cataloging this stuff. So. Yeah, it's possible you might be able to.
- [29:22]
A
Yeah.
- [29:23]
C
But I guess in the world of functional medicine, it's like our bread and butter to know what works best, you know? And so, you know, colleagues were always talking about like, and there's new supplements coming out all the time, right?
- [29:33]
A
All the time.
- [29:33]
C
So it's like you have to do your research. You have to use and see what helps patients and what doesn't. And then you monitor lab results. Like, did that work? Was that like with you? Right. You were taking that glutathione and we saw your glutathione marker was like, it's not doing anything. It was not good. Right? Yeah. So with glutathione, just to be fair, there's a few things to consider. It should always be liposomal. Yours was. That's Good. It could have been a low quality product. Maybe, maybe not. I don't know. Like I said, there could be absorption issues. Glutathione is not well absorbed for everybody. So I often use precursor amino acids for glutathione support, which I'm taking right now. Yeah, cysteine, glycine, things like that. Then your body builds its own glutathione, and that's probably a more productive process than taking the liposomal glutathione.
- [30:14]
A
Okay, But I mean, I was also taking vitamin C. Is that also not easily absorbed?
- [30:20]
C
Well, vitamin C is water soluble, so to be fair on testing, vitamin C often will show up deficient because we have patients stop taking supplements before the testing. And since it's water soluble, you clear it out, but.
- [30:31]
A
Oh, that's interesting.
- [30:32]
C
Yeah, it's potential. You know, you'd still support it when you see it deficient on a test.
- [30:36]
A
So vitamin C is probably one that just across the board, everyone can take.
- [30:39]
B
Like, you can't.
- [30:40]
C
The only drawback to taking too much vitamin C is diarrhea.
- [30:43]
A
That's what I thought. Yeah.
- [30:44]
C
Yeah.
- [30:44]
A
Don't people do like, vitamin C flushes?
- [30:46]
C
Yeah, you can do high dose, high dose vitamin C. Well, it's great for antiviral stuff. Oh, like really high dose, though. And like intravenous.
- [30:54]
A
Oh, okay.
- [30:55]
C
You can do it orally and you do it to tolerance until you have like diarrhea, basically. And then so you're maxing out your vitamin C, observing the effects until diarrhea, then you've taken enough.
- [31:04]
A
Yeah.
- [31:05]
C
And you do that for as long as you want. That's kind of like an old school naturopathic thing.
- [31:08]
A
Yeah, I remember, I think a few years ago I wanted to do that. I couldn't tell you why I wanted to. I never ended up doing it, but I've always been kind of fascinated by that.
- [31:20]
B
Okay, guys, let's take a second to talk about Ladder. If you told me that there was an app that could potentially replace my trainer, I would have laughed. But honestly, Ladder is the closest thing that I've found. You get a new plan every week from a real coach.
- [31:37]
A
It talks you through every rep. And
- [31:39]
B
for me, this is huge when I travel, because when I'm traveling, I want to do a workout that is really effective, but where I don't have to think about it. And I have someone just telling me what to do. And Ladder is an expert strength training plan, not a content library. These aren't influencer workouts or challenges. It's real progressive programming. Designed by certified coaches, it costs less than $1 a day and Ladder now includes nutritional tracking at no extra cost. It really is like having a personal trainer right there in your headphones.
- [32:10]
A
It is so great.
- [32:12]
B
And this is coming from someone who loves working out and I definitely strength train.
- [32:16]
A
I mean that's all I do.
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B
So remove the guesswork with ladder and get a real coach in your ear telling you exactly what to do for every workout. No thinking, everything planned for you and if you have an iPhone, head to ladder, dot fit, slash honest and take a quick quiz to find your perfect ladder plan. Use my link and get a free 7 day trial with no credit card and get $10 off your first month if you join. Happy working out. Let's talk about K18 hair K18 is a biotech powered hair care brand on a mission to unlock your fullest expression without hair damage. Their viral formulas are built around patented technology that targets damage from Bleach, Color Chemical Services and Heat Heat Triple Bright is their newest innovation. Have you ever been blonde? Because I obviously am. And when you're blonde you really do deal with brassiness, damage and dryness. I've been a blonde basically my whole life and it definitely takes a lot of work to maintain, but I am so excited. My newest obsession is K18's triple bright oxidation Defense Purple Shampoo. It's a breakthrough for a brighter, longer lasting blonde. Powered by K18 triple action technology. One wash removes up to three months of brass from hard water. And it doesn't just neutralize brass, it stops those orangey yellow tones from ever coming back so your blonde will always look fresh from the salon. Perfect. And the best part? It works in as little as 60 seconds. So trust there are brighter days ahead for all the busy blondes out there. Soft, strong, bouncy Blonde One Wash removes up to three months of brass from hard water. Breakthrough Triple Action Blonde Shampoo for a brighter, longer lasting blonde. Music to my ears. Shop at Sephora or get 10 off your first purchase at k18hair.com with code Kristen. That's code Kristen K R I S T I N@k18hair.com let's chat. Cook Unity now that we are approaching summer, I always change up what I'm eating. I like to eat really fresh clean stuff right about this time of year.
- [34:31]
A
Just getting ready to be in a
- [34:32]
B
bikini and I like everything to still of course taste really good. But it's also travel basketball season which means my time is very, very limited right now to be able to be in the kitchen cooking and meal planning
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A
and doing all the things.
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B
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- [35:20]
A
So I love it because no matter
- [35:21]
B
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- [36:02]
A
All of the good doctors that I've ever known, and you included, you guys all like your vitamin D levels higher than recommended. Explain why that is.
- [36:12]
C
Yes, absolutely true. Conventional standards are like, if you're above 20 or 30, you're good. In functional medicine, we like it a little more optimized. We use reference ranges in general that are more optimized, whereas the conventional ranges are more like, it's acceptable if you're in this broad range. Right. So we're like, how do we hone you into like, optimal range for health? And so with vitamin D, we like it in kind of the 60 to 100 range, which is you're just going to get more of the health benefits of vitamin D. So vitamin D is great for immune function, lowering inflammation, supports heart health and bone health, prevents cancer mortality and autoimmune issues. So many great things from vitamin D. And then the toxicity is more up towards like 150 to 200. Right. So being in the 60 to 100 range is kind of a sweet spot for optimized vitamin D. And you see more of the health benefits from it there.
- [36:58]
A
Okay, great. And vitamin D, in addition to obviously a supplement, you can get from a lot of different foods.
- [37:04]
C
Yeah, but food is actually kind of a lower source of vitamin D. Yeah. On like tears, I would go supplement sunlight. Yeah. And then food. Yeah. So fatty, oily fish, eggs, beef liver, best sources of vitamin D. But you're just getting a little like, frankly. And then you get a good amount from sun. But I work with people near the equator. They're eating fish, they're eating eggs, and they're like, I'm in the sun all the time, and they're still below 60.
- [37:27]
A
Oh, really?
- [37:28]
C
I just don't see patients above 60 unless they're taking a supplement.
- [37:30]
A
Okay, well, that's good to know. Well, another thing talking about when you want your levels higher is cholesterol.
- [37:37]
C
Oh, my gosh. Yeah.
- [37:38]
A
So same thing. All holistic doctors that I've never known, they say that high cholesterol is actually okay, well. And I've been seeing more and more people are saying, like, oh, it's maybe not as bad as we thought to have high cholesterol. So talk to me about that and what you think about that.
- [37:55]
C
I think people should be running more advanced lipid panels before being concerned with cholesterol. I think the standard lipid panels are a little old school, and you can get more information these days on how risky it is for you in particular. Okay, so cholesterol is. There's, like, this hyper fixation on it for a lot of individuals. Even people who come to see me are like, the only thing they care about is getting the cholesterol to the reference range. And I'm like, okay, but cholesterol is this downstream indicator of all these upstream imbalances. So I'm more interested in why is the cholesterol out of range? If it's out of range, and how do we fix that? Like, how do we get into the root causes behind that? Because it's usually a lot of things going wrong and your cholesterol's responding to help. Actually, 80% of your cholesterol is internally produced. So if you have high levels and you're concerned about that and you want to treat that, let's dig into your physiology and look for metabolic dysfunction that we can fix. If you do that, lower systemic inflammation. You see cholesterol levels get better. And so, yeah, if you do have. I mean, there are markers that indicate high risk if you're. If you have elevation. So it's not to say, you know, any cholesterol marker is useless. That's not true. There are very helpful cholesterol markers, but it gives more context to get those advanced lipid markers.
- [39:08]
A
Okay, okay, got it. And what are is it. What do they put you on?
- [39:13]
C
Oh, statins.
- [39:14]
A
Statins. Those are really bad for you, right?
- [39:16]
C
Well, they're associated. They have risk. Yeah. They're associated with diabetes, cognitive issues, muscle mass, and Function issues, mitochondrial issues, and they just changed the age at which to start recommending them. A few weeks ago, the American Heart association dropped the age from 40 to 30. So more and more people are going to be recommended statins. Right. It's just becoming very easy to be in that pool of people that will be recommended a statin. So that's an option. You will be recommended a statin. Statistically, you probably will be at some point. So if you want to take that, it'll be available to you. But if you're more interested in getting to the root of the problem and fixing those upstream imbalances that are leading cholesterol to be elevated, that's a good idea, because you won't only move your cholesterol into the reference range. You'll prevent all these other diseases from developing and then maybe don't have to take a statin that has some risk associated.
- [40:03]
A
Right. I mean, I think that's the thing with pharmaceuticals is it's like people think they're these magic pills and it's just going to fix everything. And there's always risk to it.
- [40:12]
C
Yeah. And 75% of people who have heart attacks had normal or low LDLs. And statins are kind of pushing down LDL, the bad cholesterol. Right. And so you can't just have this mindset of like, oh, my LDL was high. I'll take the statin to push it down, and now I'm safe because like I said, 75% of people who have heart attacks had normal or low ldl.
- [40:31]
A
That's crazy. Another thing that I want to talk to you about is peptides.
- [40:36]
C
Oh, my goodness.
- [40:36]
A
Unless you've been living under a rock, then you know that peptides are everywhere right now. So funny to me, because literally, it feels like every year there's a new health trend, you know? And here we are with the peptides. I had asked you about them just on a call that we had, but I want to talk to you about it here, because I think there's a lot of confusion around peptides. And I think, again, people are injecting themselves with peptides. They're not monitoring their bodies at all. Half the time they don't even know what they're injecting into their bodies. So let's start with, do we even need to be taking peptides to begin with?
- [41:09]
C
Need to be? No. No. It's not like this secret compound nutrient that was missing for all of millennia and we finally discovered it, saving everybody's lives. Yeah. No, you don't need to be taking peptides. And then I think when you. Well, some people do. Okay, so let's talk about peptides. Like for instance, the first, you know, insulin, that's a pept peptide that was synthesized in 1922. That kind of kick started things and we produce insulin. But if you're a type 1 diabetic, you have to have insulin.
- [41:35]
A
Oh, okay.
- [41:36]
C
What a great peptide. Right?
- [41:37]
A
Oh, I didn't realize that's a peptide. Okay, right, yeah.
- [41:39]
C
And so that's. So I get asked about peptides literally every single day. And so the first thing I say back is which peptide do you mean? Because if you say insulin in your type 1 diabetic, I'm like, fantastic.
- [41:48]
A
You need it, you need it.
- [41:49]
C
Guess what else is a peptide? Glutathione.
- [41:51]
A
It is absolutely oh so interesting.
- [41:54]
C
So like that's made in your body. We use that as supplementations. You can inject it, you know, et cetera. And then there's like kind of the newer kids on the block and I use some of those in my practice, but I just view them as like tools in the toolkit. Not, not the magic potion that cures all ills. So like BPC157 for gut issues. TB500 for tissue repair stuff. Copper GHK for skin stuff.
- [42:16]
A
Well, they say that one it can tighten your skin.
- [42:18]
C
Yeah.
- [42:19]
A
Is that true?
- [42:20]
C
I. I've given it and taken it.
- [42:21]
A
Does it work?
- [42:22]
C
So the that's what I want to say is like these are not wondered drugs or compounds that just magically fix things overnight. I think where that impression is coming from. Well, with tissue pair I should back up. Tissue repair can be pretty magical. But with like, I think that impression is coming from like the GLP1s that are. You're seeing huge shifts very quickly in people in terms of weight. And so I think often people are asking about GLP1s when they mean peptides. So that's why I like to define what do you mean by a peptide? Because there are lots of that I think are good and work and are helpful. But again like I use some of them, I've taken some of them. They are a tool in the toolbox. They're not like the end all be all. They're like one supplement out of 10 or 15 or 20. I'll include. Okay. And those are low risk. But you also don't see the like giant, you know, return immediately like a GLP one which have risk. Like those have risk and you see a big effect. And that's the allure Right. That's what draws people in. But those kind of started out and those have been around for a bit too.
- [43:26]
A
GLP1s have.
- [43:27]
C
Yeah. Oh, well, they were originally used for diabetics, insulin resistant, cardiometabolic, high risk folks and.
- [43:34]
A
Right. And then with Ozempic it just got this craze all of a sudden.
- [43:38]
C
Yeah, exactly. So things kind of shifted, I think, in 2017 with some of the laws and developments. But what's really shifted is people have started using them not for those things. I just listed the severe stuff, but cosmetically, a few pounds, 5, 10, 15, 20 pounds. Ye market has exploded and I think that's where the conversation is right now is like, is that what they should be used for? Are there safer, more root focused approaches to getting to metabolic dysfunction, of which 93% of Americans have, and other physiological imbalances in the body that are causing you to have a few extra pounds that you could lose if we fix those things?
- [44:16]
A
Right.
- [44:17]
C
So for me, that's my approach, that's what I do. So I'm going to recommend that. Right. And I think if you're going to do a GLP1, you should just be aware of some of the risks involved, you know, which are what? Gut issues.
- [44:27]
A
Let's talk about that.
- [44:28]
C
Thyroid issues, kidney issues, gallbladder issues, sibo, chronic constipation, gastroparesis, bowel blockages, obstructions. I mean, there's other ones too. Right. So it's not that everyone will have those things, but if you sign up for that compound, you're signing up for that potential risk. Right. And I have worked with patients who have had those. They've come to me after a GLP1 or on a GLP1 and they've like. I had a patient who had. Had to have their gallbladder removed.
- [44:53]
A
Really?
- [44:53]
C
Yeah, because of it.
- [44:54]
A
So how long were they on a GLP one for?
- [44:56]
C
Oh, I can't remember now. But then I've also had patients who have been on them and not seen the weight loss they're looking for. And then we put them on like an adrenal protocol and they lose the weight, you know, in a month or two. And that's not gonna happen for everybody, but it just goes to speak to getting at the underlying physiological imbalances can often resolve it. And then diet, lifestyle, all that has to be there too.
- [45:18]
A
Yeah. So you sort of look at peptides as a supportive tool in the overall health regime?
- [45:26]
C
The ones that I use, yes, because they're safe and not a lot of risk and Gentle, Right. So that's my approach. I don't like to use things with a lot of risk personally, but that's not true. So you have to just think about what your personal philosophy is on how you want to take care of your health. There's a lot of drugs out there that come with risk and are very powerful. And so if that's what you're looking for, that's widely available. But I like to let people know you can approach these things in safer, lower risk ways and address true imbalances in the body that will help you stay healthy for the long term without any of the risk.
- [46:01]
A
Well, in talking about supplements with peptides, how do you know that you're getting a good quality peptide?
- [46:06]
C
I mean, things are moving really fast right now with that, you know, like gray market things in the FDA and all that's changing and compounding pharmacies. So I don't know where that's all gonna land. I'm also not a peptide specialist.
- [46:17]
A
Just to put that out there.
- [46:18]
C
I use. I use a few here and there.
- [46:20]
A
Which ones do you take?
- [46:21]
C
Bpc? Well, do I take or give to patients?
- [46:24]
A
Okay, well, both, I guess.
- [46:25]
C
I've taken. Well, actually, I haven't taken. I haven't given anything that I haven't taken. Okay, so that's like BPC157 for the gut. I've tried that and given it to some patients.
- [46:35]
A
And that really works. Like, that really is helping your gut for some people.
- [46:38]
C
I mean, I didn't notice any difference when I took it, but for some people, they do. And so that's where you have to kind of try things out and see. Right. If there's low risk, it's okay. Probably give it a go. And. And because I have so many patients ask me about peptides all the time, they're like really eager to try stuff. And I'm like, okay, well, we can include one of these. That makes sense for your. What we're working on. And then the copper GHK for skin. It does other things too. You know, tissue repair is like a big part of peptides.
- [47:03]
A
And I actually, I did a couple after my boobs as well for recovery. BPC and TB500 maybe. I can't even remember tissue repair stuff, which is probably not smart. But I do trust this guy in Nashville who does this. And so he gave me two. And I mean, but honestly, I don't think I noticed a difference exactly.
- [47:21]
C
Right. So I don't think those are problematic if, you know, from, from what I've Seen. There's still a lot of time will tell with these, though. Like, there's a lot of new stuff, a lot of these are new. And there's even more coming down the pipeline. And I think with new medical advancements, it's like, wait and see, observe, give it many years, see how it works for people. What are the drawbacks? So, yeah, I don't have all the answers on peptides. I use them sparingly. I'm not an expert on them, but.
- [47:47]
A
But maybe people could dabble and see how they feel on them.
- [47:49]
C
There are some that are really safe to dabble in. Okay.
- [47:53]
A
But maybe GLP ones we need to be a little more reserved with.
- [47:57]
C
Those seem to have the most risk, especially for those using them, purely cosmetically, to lose a few pounds, I'd say you're signing up for some risk. And there are just. The takeaway should be there are ways to address your underlying physiology that will actually fix the metabolic dysfunction, causing you to have extra weight. That won't only help you lose weight, it'll help you be healthy. And on the GLP1, okay, 80% of people are off those within two years. Once you get off of it, you'll gain 65% of that weight back. And along the way, 40% of what you lost was muscle. So then you have to think about body composition versus weight loss. Just because the number on the scale is going down doesn't mean that's healthy. If you're losing muscle and bone, that's metabolic tissue that keeps you healthy now and keeps you healthy as you age. So if you're on a GLP1, you should think about what am I doing to fix underlying physiology for once I get off of it. How am I strength training and supporting protein intake for muscle and tube, avoid muscle loss. Am I testing my nutrient levels? Am I looking at my hormones? Like, you have to think about that stuff?
- [48:55]
A
Is that because you're just not hungry at all on them? So you're just quite literally not eating? Yeah, it's so crazy.
- [49:00]
C
Well, it slows motility, which ironically is something we're trying to improve all the time. So taking GLP1 is counterproductive to something I'm trying to fix in my patients all the time. It sets it back. That's why you can have SIBO from it. So, yeah, it slows motility and it just decreases appetite and hunger. And then you're taken, taking in less nutrients. I run nutrient levels on every patient I work with. 0% have ever come back with all the nutrients. They need. So the thing that I see with the GLP1 is higher risk for nutrient deficiencies. And then nutrients are the resources your body uses to stay healthy.
- [49:31]
A
Okay. And we talked about this on the last podcast. But just for anyone at home, again, who can't do all of these tests, what are supplements that they could be taking every day that are just great for support overall?
- [49:41]
C
For sure, it will vary, but generally speaking, like a multivitamin, really high quality multi packs are what I use. I like those a lot. Vitamin D. I've never seen anybody. I mean, 65% of Americans are insufficient in vitamin D. So there's a good chance you need more B vitamins. Kind of can't go wrong. They support energy detox, hormones, neurotransmitters. They're used in every process of the body all the time. They're water soluble. Magnesium's a good one.
- [50:08]
A
Before bed, for sure.
- [50:10]
C
I take high doses before bed. Just load up. I take some throughout the day as well. But yeah, magnesium glycinate's a good one. It's like vitamin C in the sense that you can kind of take it until you have diarrhea and then you're taking too much and you want to back down.
- [50:22]
A
Oh, I didn't know that.
- [50:23]
C
Yeah. And of course, if you're having constipation issues, it's great to help with that.
- [50:26]
A
Yeah.
- [50:27]
B
Okay.
- [50:27]
A
Yeah. Okay. And then I want to talk about birth control. So I went on birth control at age 15, and I got off at age 24. And I'm really happy I never went back on it. And it's tricky because I'm really thankful that I had it in my late teens and my early 20s. But I know now, you know, more and more people are talking about, again, how there are always gonna be these harmful risks. You know, there's no magical pill. And so I'm curious, what are complications that people can experience from birth control? What are some of the negative side effects that women can experience?
- [51:00]
C
Absolutely. So I think it's important to state birth control is not balancing your hormones. It's suppressing endogenous production. And I have a lot of patients come in thinking they were taking birth control and it was balancing their hormones. And that's not the case. So first you should know that. And then second of all, they do come with risk and side effects potentially. And I don't think from experience that a lot of women who've been put on birth control are told all the side effects, potential side effects. Right. That's a really Long list. So I sat down one day and went through PubMed and found all the research papers I could citing potential side effects to birth control. I listed them on my website. All the citations are there. It came out. Came down to like 88. Right. And they're all the common conditions you hear people have. Right. So like every gut issue you can imagine, abdominal distension, bloating, gas constipation, diarrhea, nausea, whatever it is, thyroid issues, autoimmunity issues, anemia issues, malabsorption issues, nutrient deficiencies, heart issues. It's associated with some cancers. Uterine, cervical, and breast cancers, headaches. I mean, it's just like such a long list. It's like kind of everything you can think of. So what will happen is somebody gets put on a hormonal birth control drug, and then over some period of time, they may start to develop health issues. Right. And those health issues may or may not be related to the birth control. So I work with a lot of patients that want to get off their birth control. We get them off and they see improvements, and we work on the underlying physiology that was really causing the problem in the first place. So, yeah, birth control is. It comes with some risk, and it's just, you know, people should be aware of that.
- [52:34]
A
So, I mean, I think about, you know, I have a daughter and she's only 10, so obviously I've got some time. But I think about when she's older and we have to have this conversation. I'm just. I. I don't really know what to do. So I guess what are the other options? And then I want to know also if the good outweighs the bad. Like, obviously there's a reason why women take birth control, you know, I mean, to prevent pregnancy. And so does that outweigh some of the negative side effects? I don't know. I mean, again, because I was thankful I had it at a point in my life.
- [53:05]
C
So it's a personal decision, and everyone should do what they think is best for them. But I think having information on alternative options is useful. Right. You should at least have those choices to make. So if a patient I'm working with doesn't want to be on birth control, I recommend the Natural Cycles app, which is 93% effective against pregnancy if you use it correctly. I think birth control is up around 98% effective, so pretty similar.
- [53:32]
A
And that's just tracking your cycle and knowing exactly when you're ovulating.
- [53:36]
C
Yeah, it's using your basal body temperature, so when they first developed it, you had to use a basal thermometer, take your temperature every morning, and then you put that into the app, and after some number of months, maybe two or three months, it calibrates to when you're fertile, when you're not fertile. Whoa.
- [53:51]
B
Just based off of your temperature.
- [53:52]
C
Just based on your temperature.
- [53:53]
B
Oh, that's so interesting.
- [53:53]
C
So you don't take anything other than your body temperature.
- [53:55]
A
Oh, that's so interesting.
- [53:56]
C
The cool thing is they recently, somewhat recently linked up with. With OURA rings. So now if you wear an OURA ring, or don't mind getting one, you don't even have to take your temperature. It just syncs from your ring to the app. And then you just have this calendar of like, I won't get pregnant if I have sex today. I will get pregnant if I have sex today.
- [54:12]
A
Whoa.
- [54:12]
C
Yeah. And it's 93% accurate, so that's cool. That's a pretty good statistic.
- [54:17]
A
Yeah. Okay. Are there other options other than that?
- [54:20]
C
Well, I think that's the best one. Yeah. Neem oil is an option. There's some human studies that show 93% of efficacy with that. It can act as kind of a natural spermicide. You inject it, you know, five minutes before sex. But, you know, I've had some patients have issues with that. It has a smell to it they don't like. And stopping everything to, like, go eject this. Yeah. It's not really the vibe for everybody.
- [54:42]
A
Also, good luck trying to explain that to my daughter. I'm like, all right, sailor, here's what you're gonna do.
- [54:46]
C
Yeah. And so, you know, a lot of people don't sign up for that one, but it's there. The Natural cycle app. I like that a lot. But it does also require some thought and effort. But there's zero risk. That's what I like about that. Birth control has some risk. And then birth control is also used off label, not to prevent pregnancy, but for, like, skin issues.
- [55:05]
A
Yeah, right.
- [55:06]
C
Irregular menstrual cycles.
- [55:07]
A
True.
- [55:08]
C
And there you're just suppressing symptoms. Right. Like, by suppressing the hormones. So that's where I'm like, let's fix the underlying problems, not just put you on birth control, which has a lot of side effects, and you're also ignoring those problems. Eventually, you'll go off birth control, and when you do that, those symptoms will flare up again.
- [55:25]
A
Right. And then what about. Cause, like, some of the birth control, I don't know if it's an injection or what it is, but, like, some women I know literally don't have a period for three months or nine months or a year. And what is that doing to a woman's body?
- [55:39]
C
Yeah, it's not good.
- [55:40]
B
Not good.
- [55:41]
A
There's a reason why we have a period every month.
- [55:43]
C
I know. I talk to a lot of women who are younger and maybe not thinking about it in a bigger picture way, and they're like, I love not having a period.
- [55:50]
A
Yeah. I've got friends. Yeah.
- [55:51]
C
Who say that that's not kind of the way nature intended it.
- [55:55]
A
Right. Right. Yeah, exactly. Okay. Amazing. Well, I really appreciate you being here. And tell everyone where they can find you, book appointments with you.
- [56:02]
C
Yeah.
- [56:03]
A
And everything's on Z, which is great. So you don't have to be in California to come and see you.
- [56:06]
C
That's true. Absolutely. Yeah. My website's peaceful mountain medicine.com and then I'm on Instagram at. Dr. Ryan Monahan.
- [56:14]
A
Amazing. Thank you.
- [56:15]
C
Thank you for having me.
- [56:26]
A
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