2502: Hormone Therapy for Aesthetics With Dr. Lauren Fitzgerald

Summary

Mind Pump: Raw Fitness Truth – Episode 2502: Hormone Therapy for Aesthetics With Dr. Lauren Fitzgerald

Hosts: Sal Di Stefano, Adam Schaefer, Justin Andrews
Guest: Dr. Lauren Fitzgerald
Release Date: January 2, 2025
Description: In this pivotal episode, the Mind Pump hosts delve deep into the realm of hormone therapy for aesthetics with renowned expert Dr. Lauren Fitzgerald. They uncover the raw truths about hormone replacement therapy (HRT), debunk myths, and explore science-backed strategies to enhance muscular development, burn body fat, and improve overall health and performance.

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1. Introduction

The episode kicks off with Adam Schaefer and Justin Andrews introducing Dr. Lauren Fitzgerald, highlighting her expertise in hormone health and replacement therapy. They set the stage for an in-depth discussion on how hormone therapy can significantly impact aesthetics and overall well-being.

Adam Schaefer [00:53]: "Today's episode we talk about women's hormone health and hormone replacement therapy for aesthetics. What kind of hormone replacement therapy will make you look better, burn body fat, build muscle, improve sexual and cognitive performance?"

2. Dr. Fitzgerald's Journey from Anesthesiology to Functional Medicine

Dr. Fitzgerald shares her professional evolution, transitioning from a successful anesthesiologist to a functional medicine practitioner focused on hormone health.

Dr. Lauren Fitzgerald [08:43]: "I found myself thinking outside of the box because the whole reason I went into medicine was because I've been into health and fitness since early days."

She recounts her realization that many patients, despite adhering to healthy lifestyles, still struggled with weight, energy, and sleep issues—pointing to hormone deficiencies as the missing link.

3. Understanding Hormone Replacement Therapy (HRT)

Bioidentical vs. Synthetic Hormones

Dr. Fitzgerald emphasizes the superiority of bioidentical hormone replacement therapy (BHRT) over traditional synthetic HRT. She explains that BHRT uses hormones chemically identical to those the human body produces, reducing associated risks.

Dr. Lauren Fitzgerald [06:13]: "Bioidentical just means chemically structured the exact same way of what our sex hormones are made."

She contrasts this with synthetic hormones like Premarin, derived from pregnant horse urine, which do not match the body's natural hormones and carry increased health risks.

Dr. Lauren Fitzgerald [08:22]: "88% of the estrogens in Premarin were from the pregnant horse urine. So it didn't match what our body made."

Safety Profiles and Misconceptions

Addressing common misconceptions, Dr. Fitzgerald clarifies that BHRT is safe and distinct from products that have led to adverse effects.

Dr. Lauren Fitzgerald [06:45]: "When you hear the bad stuff, yeah. A lot of doctors actually don't."

4. Recognizing Symptoms of Hormone Imbalance

Both men and women experience symptoms when hormone levels are imbalanced, though the manifestations differ.

Dr. Lauren Fitzgerald [05:50]: "But those are typically where we start with the midlife patients."

She discusses how low testosterone and thyroid hormones can lead to weight gain, muscle loss, fatigue, and cognitive decline.

5. Personal Experiences with Hormone Therapy

Dr. Fitzgerald narrates her personal hormone journey, detailing how optimizing her own hormone levels led to significant weight loss and improved muscle mass.

Dr. Lauren Fitzgerald [16:20]: "When I saw my testosterone was, like, next to nothing, I'm like, all right, you know, I'm perimenopausal."

Adam Schaefer shares his own transformative experience after starting testosterone replacement therapy, highlighting increased energy and improved well-being.

Adam Schaefer [21:05]: "I went on replacement therapy, and it was like a light switch got turned back on."

6. Hormones and Their Role in Health and Aesthetics

Key Hormones Discussed

• Testosterone: Crucial for muscle building, fat loss, libido, and cognitive function.
• Thyroid Hormones (T3, T4): Essential for metabolism, energy levels, and overall vitality.
• Progesterone: Vital for women's sleep quality, mood stability, and reproductive health.
• DHEA: Supports overall hormonal balance and well-being.

Dr. Lauren Fitzgerald [25:12]: "Most women at midlife need progesterone, thyroid, DHEA, and testosterone."

Impact on Muscle and Fat

Optimizing hormone levels enhances insulin sensitivity, promotes muscle growth, and facilitates fat loss, contributing to a more defined and aesthetically pleasing physique.

Dr. Lauren Fitzgerald [26:55]: "Testosterone and thyroid are the key ingredients to helping... burn body fat... build muscle."

7. Administration Methods for Hormone Therapy

Dr. Fitzgerald discusses various administration methods for hormone therapy, tailoring approaches based on individual needs.

• Creams: Preferred for their ability to mimic natural hormone fluctuations.
• Pellets: Suitable for certain populations, such as those in nursing facilities.
• Injections: An option for patients who prefer this method.

Dr. Lauren Fitzgerald [31:34]: "If you can brush your teeth twice a day, you can put ball cream on twice a day."

8. Diet, Exercise, and Lifestyle Integration

High-Protein Diets and Whole Foods

Dr. Fitzgerald advocates for high-protein, whole-food diets to support hormonal health and muscle maintenance.

Dr. Lauren Fitzgerald [58:57]: "95% of them are like, I eat a lot of protein... All of them are like, I had no idea."

Strength Training Over Cardio

Emphasizing strength training over excessive cardio, she highlights the benefits of muscle mass on metabolism and hormonal balance.

Dr. Lauren Fitzgerald [55:41]: "Gabrielle Lyons says it right. It is the organ of longevity. And you want to build as much of that as you can."

9. Overcoming Limitations in Traditional Medicine

Dr. Fitzgerald critiques the conventional medical approach, which often relies solely on lab "normal ranges" and neglects patient symptoms.

Dr. Lauren Fitzgerald [04:03]: "We all in our 40s... average American... is either overweight, obese... it's a great business model, but it's not interested in helping you get healthy."

She advocates for a symptom-based approach, using labs as a guide rather than the sole determinant of treatment.

Dr. Lauren Fitzgerald [27:23]: "Labs are not as important as symptoms."

10. Hormone Therapy and Longevity

Optimizing hormone levels not only enhances aesthetics but also contributes to longevity by improving bone density, cognitive function, and overall health.

Dr. Lauren Fitzgerald [37:09]: "My dad is like, I'm starting to build muscle again because he still lifts weights three, four times a week."

11. Addressing Misconceptions and Misinformation

The discussion tackles widespread myths, such as the belief that testosterone therapy increases the risk of prostate cancer—a notion disproven by recent data.

Adam Schaefer [39:14]: "There was this dance drug that caused birth defects... You're giving testosterone therapy the same way."

12. Cost and Accessibility of Hormone Therapy

Dr. Fitzgerald frames hormone therapy as an investment in one's health, noting that while it may not be covered by insurance, the long-term benefits far outweigh the costs.

Dr. Lauren Fitzgerald [42:33]: "Your health insurance is not there to optimize you. It's an investment for sure."

13. Conclusion and Future Initiatives

The episode concludes with Dr. Fitzgerald sharing her ongoing projects, including a men's health event in St. Charles, Illinois, aimed at promoting hormonal optimization for better health and aesthetics.

Dr. Lauren Fitzgerald [67:27]: "We are soft. And mentally, I mean, like, yeah, like, we need to become harder. Like, in the good way, harder."

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Notable Quotes with Timestamps

• Dr. Lauren Fitzgerald [06:13]: "Bioidentical just means chemically structured the exact same way of what our sex hormones are made."

• Adam Schaefer [21:05]: "I went on replacement therapy, and it was like a light switch got turned back on."

• Dr. Lauren Fitzgerald [37:09]: "My dad is like, I'm starting to build muscle again because he still lifts weights three, four times a week."

• Dr. Lauren Fitzgerald [58:57]: "95% of them are like, I eat a lot of protein... All of them are like, I had no idea."

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Key Takeaways

1. Bioidentical Hormone Replacement Therapy (BHRT) is Superior: Using hormones identical to those naturally produced by the body minimizes health risks compared to synthetic alternatives.

2. Symptom-Based Treatment Over Lab Norms: Prioritizing patient symptoms ensures more effective and personalized treatment plans.

3. Comprehensive Hormonal Optimization: Balancing multiple hormones, including testosterone, thyroid hormones, progesterone, and DHEA, leads to significant health and aesthetic improvements.

4. Integration of Diet and Strength Training: A high-protein, whole-food diet combined with regular strength training enhances the benefits of hormone therapy.

5. Investment in Health Pays Off: Although not always covered by insurance, the long-term benefits of hormone optimization justify the initial costs.

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Final Thoughts:
This episode sheds light on the transformative potential of hormone therapy for both aesthetic and health purposes. Dr. Lauren Fitzgerald's expertise and personal experiences provide listeners with a comprehensive understanding of how optimal hormone levels can revolutionize their well-being. By debunking myths and presenting science-backed solutions, Mind Pump empowers its audience to make informed decisions about their health.

Transcript

[Sal Destefano]

Marketing is hard, but I'll tell you a little secret. It doesn't have to be. Let me point something out. You're listening to a podcast right now and it's great. You love the host. You seek it out and download it. You listen to it while driving, working out, cooking, even going to the bathroom. Podcasts are a pretty close companion. And this is a podcast ad. Did I get your attention? You can reach great listeners like yourself with podcast advertising from Libsyn Ads. Choose from hundreds of top podcasts offering host endorsements or run a pre produced ad like this one across thousands of shows to reach your target audience audience in their favorite podcasts with Libsyn Ads go to libsyn ads.com that's L I B S Y N ads.com today.

[Adam Schaefer]

If you want to pump your body and.

[Justin Andrews]

Expand your mind, there's only one place to go.

[Sal Destefano]

Mind Mind Pop.

[Justin Andrews]

With your hosts, Sal Destefano, Adam Schaefer.

[Adam Schaefer]

And Justin Andrews, you just found the most downloaded fitness, health and entertainment podcast. This is Mind Pump. Today's episode we talk about women's hormone health and hormone replacement therapy for aesthetics. What kind of hormone replacement therapy will make you look better? Burn body fat, build muscle, improve sexual and cognitive performance? We have one of the world's best on today's podcast, Dr. Lauren Fitzgerald. We love her. She's blunt, she's honest. She's been doing this for a long time. She's a real doctor. You're going to love this episode. Now this episode is brought to you by one of our sponsors, Element. This is an electrolyte powder you add to your water. No artificial sweeteners, no sugar, but it has the right amount of sodium to fuel you through your workouts and give you good performance. And if you go through our link drinklmnt.com mindpump you'll get a free sample pack with any drink mix purchase. Also, the January special is here we have four workout program bundles. The New to Weightlifting Bundle, the Body Transformation Bundle, the New Year Extreme Intensity Bundle, and the body transformation bundle 2.0. Every single one of those workout program bundles is $300 off retail. It's massive sale. If you're interested, go to maps january.com all right, here comes the show. Dr. Lauren, welcome to the show.

[Dr. Lauren Fitzgerald]

Thank you.

[Adam Schaefer]

It's great having you on. You've said a couple times we all work together in a forum with a group of people that we're using GLP1. We've talked to you a few times aside from that and you've said There's a statement that you've made, and I've heard you say it several times. I'd like to start with that, which is that, like, why wouldn't you go on hormone therapy once you're past a certain age? Like, it's like everyone should, except for maybe a very small percentage of people. Let's start there. Why do you believe that? What does it provide are the risks? Like, what's the deal with that?

[Dr. Lauren Fitzgerald]

So I think after, when I opened my functional medicine practice in 2020, I had really highly motivated patients. I don't take health insurance, so they're motivated because they're paying cash. Right? And I had so many patients that despite doing all of the right things, were still struggling with stuff like weight and energy and sleep and all of the things. And I got to a place where I was like, I think you need hormones. And now, after the last year of doing all my BHRT training, I realized this is the missing link for most people. And I think it's because if we were living a hundred Years ago, in 1924, I don't think we would have the same issue. But our bodies are hit by so many different endocrine disrupting agents, like our food, the stuff that we put on our skin, what we wash our hair with, the stuff we cook with, the clothing that we even put in our. On our body. Our body is not supposed to hit, you know, get so many toxic agents. And I think that this is why the, the hormone deficiency is really the key missing element for a lot of people.

[Adam Schaefer]

Well, so what do you notice? What are you looking at when you're taking someone's labs? Because I know just from working with people like you that, you know, someone will get their gp, will do their labs and be like, well, you're within normal range. Is, is that just not a range you should look at? Like, like, let's talk about that.

[Dr. Lauren Fitzgerald]

So normal does not meet October. Like, literally, the normal ranges are based on a small group of people that the average. So do any of y'all want to be average?

[Unknown]

No.

[Dr. Lauren Fitzgerald]

No. Especially not the American average. Right? I mean, we're all in our 40s, right? The average American 40 year old is either overweight, obese, has at least diabetes, probably some hypertension, maybe some autoimmunity, already is on two or three different prescription drugs and it's only going to get worse, right? So I have no desire to be normal. I want to be optimal. And oftentimes optimal ranges are too high on lab values.

[Adam Schaefer]

And what do you see when you start to change those, and again, you're working with a group of people who you're getting them to exercise and eat. Right. It's not like you're just doing that.

[Dr. Lauren Fitzgerald]

Absolutely.

[Adam Schaefer]

But when you add the. When you start to work with the hormones, what are the things that you start to notice? And are most of these people in that age group of like, 40 plus?

[Dr. Lauren Fitzgerald]

So I think that I have patients in their 20s because they've got hormone deficiencies. That's crazy, for sure. Like PCOS females, they need thyroid and progesterone. And so getting that diagnosed early can help them avoid a lot of the infertility, a lot of the weight, a lot of the, you know, stereotypical phenotypes that you see with PCOS patients. Right. But the average patient that's finally is like, hey, I think I need some help with my hormones. Typically is someone in their 40s and beyond. But now, knowing what I know, I really think there's like, maybe 1% of people that shouldn't be on BHRT. And I, when I referred to BHRT, I want to make sure the audience knows I'm talking about bioidentical hormone replacement therapy, because, well, so HRT is the generic umbrella term. So back in the day before the whi, the Women's Health Initiative, that kind of screwed everything over about 20 years ago, most women that were on HRT were on Premarin, which is a synthetic sex hormone from pregnant horse urine. So hence the word primarin. Pregnant horse urine. Right. And so most of the estrogens that are in that particular hormone don't match the sex hormones that our body makes. So bioidentical just means chemically structured the exact same way of what our sex hormones are made. So I do not do anything that's synthetic that doesn't match what the body makes versus the estrogens in Premarin or that's just one of the examples. Doesn't match what the body makes. And those are the ones that are linked to all the different risks that come along with.

[Adam Schaefer]

Really?

[Dr. Lauren Fitzgerald]

When you hear the bad stuff. Yeah.

[Adam Schaefer]

Is that just because they flip the molecule like, oh, it's just the same breakdown, but it's, you know, the carbons on this side versus this side or whatever.

[Dr. Lauren Fitzgerald]

Absolutely, absolutely. It literally comes down to the chemical structure.

[Adam Schaefer]

Wow. And so it does attach to the estrogen receptor.

[Dr. Lauren Fitzgerald]

Absolutely.

[Adam Schaefer]

But some of the other downstream effects aren't the same.

[Dr. Lauren Fitzgerald]

For sure. For sure. So, like, I hate it because when you hear someone say, you know, bioidentical hormone replacement therapy. They assume that it's linked to the risk of, like, increased clotting. Well, actually, those risks are only linked to non bioidentical sex hormones, specifically, like, primary.

[Adam Schaefer]

Interesting.

[Unknown]

I didn't know that.

[Dr. Lauren Fitzgerald]

Yeah, a lot of doctors actually don't. I mean, I've been since 2005, and it wasn't until the recent past that I really understood the difference between bioidentical versus non bioidentical. And I've heard a lot of people, medical doctors say, oh, that's just a scam word. That's just a way for people to make money. No, it's legit. Like, estradiol is a sex hormone that our ovaries make and you guys make too. Actually, this is. That's another thing we've got to get away from. Estradiol is female and testosterone as male. Like, we all make both. It's just y'all make more testosterone than us. Right. But both sex hormones are very important. But estradiol matches what our body makes. And the estrogens found in, like, Premarin do not. And those are the ones that are linked to all the bad stuff.

[Adam Schaefer]

Yeah. And by the way, low testosterone symptoms or low estrogen symptoms. This, this. The symptoms are the same in men and women. We just have different references.

[Dr. Lauren Fitzgerald]

Right.

[Adam Schaefer]

Different amounts. There was a drug that was. It was a long time ago that they were giving to pregnant women, and I think it was for nausea. And they. It was a mirror image of the actual chemical that they were supposed to use. So it was the same chemical, but.

[Dr. Lauren Fitzgerald]

It was flipped and it was teratogenic.

[Adam Schaefer]

And it caused birth defects. Yes. So they're like, it's the same thing, but instead of it, it was just a mirror image of the chemical. And then children were born with crab hands or lobster hands or I think what they called it. So that's a real thing. Wow. So with bioidentical, that's kind of what's happening.

[Dr. Lauren Fitzgerald]

Exactly. It's just adding a little bit, basically changing the chemical structure. The thing is, big pharma cannot patent are hormones that our body naturally makes. So it's money. I mean, at the end of the day, wow. Do you understand how much money was made by Premarin?

[Adam Schaefer]

Tons.

[Dr. Lauren Fitzgerald]

Tons. Because they can patent that because it doesn't match what our body makes. I think 88% of the estrogens in Premarin were from the pregnant horse urine. So it didn't match what our body made.

[Adam Schaefer]

Oh. So let's go back. So You've been an MD since 2000.

[Unknown]

I know. I was just gonna, I want you to, because I don't think that you got here the day you got out of school. So catch the audience up.

[Dr. Lauren Fitzgerald]

Yes.

[Unknown]

On your journey of becoming an md, what you did right after all that. Yeah. Catch us up here.

[Dr. Lauren Fitzgerald]

Yeah, yeah. So I knew I wanted to be a doctor. I actually graduated high school early, so I went to University of Texas as a young, naive 17 year old. And I knew that I had a long journey because I knew college was going to take four years and med school was going to take four, and then residency would take four or five. So I decided in my third year of med school that I wanted to be an anesthesiologist. So it's a super competitive area to go into because it makes a lot of. So I got in, did my residency, and I'm a full fledged anesthesiologist by 29. Right. And I was good at what I did. Like, I, I, I still am connected with all the OR people that I used to work with, but I found myself, it was about 34 or 35, so I'd only been an anesthesiologist for five or six years. And I, I found myself thinking like, okay, this, it was this one particular day actually that the surgeon that I was with was this old crotchety guy. The OR nurse was an old crotchety guy. It just happened to be guys. But there's unhappy old women too in the or, for the record. But it happened like all four people that were in the OR that day were just like unhappy, miserable people. And I was like, is this really what I want to do the rest of my life? And that's when I kind of started thinking outside of the box. Because the whole reason I went into medicine was because I've been into health and fitness like since early days. I started teaching aerobics at 16. I was one of those group fitness people y'all talk about. But I also started lifting weights at 16, for the record. So I've always lifted. But I've also, you know, been into the health and fitness thing. And I just remember like my, my patients on my OR table thinking like, man, if I could have only gotten to them, you know, 10 years ago, maybe they wouldn't even need the surgery. And that's the state of our world right now. It's so much is self induced from lifestyle that is completely reversible.

[Adam Schaefer]

So you were in there and you were just, you're just like, I'm not happy I got here. I'm Doing this, by the way, anesthesia is very tough. I know. I used to train as anesthesiologists. Like, you guys are very, very important. If things go wrong there, it goes real wrong.

[Dr. Lauren Fitzgerald]

Absolutely.

[Adam Schaefer]

So you're in there. You're. You're making great money. You' doing great. You did it.

[Dr. Lauren Fitzgerald]

Yes.

[Adam Schaefer]

And you're like this. I'm unhappy.

[Dr. Lauren Fitzgerald]

So.

[Adam Schaefer]

So what do you do? You leave.

[Dr. Lauren Fitzgerald]

So I did. And y'all are 100% okay with making fun of me for this, because I've heard your What. What prompted you to start your business, but I. I did Beachbody coaching.

[Adam Schaefer]

You went from anesthesia anesthesia to beachbody coaching?

[Dr. Lauren Fitzgerald]

I can't remember.

[Unknown]

Beachbody was crushing it back then.

[Adam Schaefer]

Multi billion dollar commitment, you know, half a million dollars a year. Like you are anesthesia.

[Dr. Lauren Fitzgerald]

So I. I always knew. I. Well, I always knew that it wasn't going, but I realized the opportunity because I had this YouTube channel, which you can't if you go and look at Club Fitz Fitness. I've taken down all the dance fitness videos, but it was pretty popular. I have like 320,000 subscribers on my YouTube channel. Like, legit. Like, your girl can dance.

[Unknown]

I'm just saying, we are for sure getting some B roll.

[Dr. Lauren Fitzgerald]

I will give you that.

[Adam Schaefer]

For sure.

[Dr. Lauren Fitzgerald]

It was. So I started it in 2011 when I was living in Japan, and I started teaching this dance fitness class just out of necessity because there was nothing there when I was living on this military base. And I called it hip and I co taught it with a girl, so she would do Zumba, I would do hip hop. And my class was so sad when we, you know, military. You only live in a place for three years. And so I was about to move back and my class was really sad. So I was like, well, military people live all over the world, and you can access YouTube all over. So we just started recording and it went viral. I mean, I would upload a video and in the first 24 hours, 100,000 views. No way. Yes.

[Adam Schaefer]

This is 2011.

[Dr. Lauren Fitzgerald]

2011. I was one of the OGs, by the way.

[Unknown]

Those type of views back then is huge.

[Dr. Lauren Fitzgerald]

Huge. Never paid a lick of advertising or whatever. It was just all organic. I didn't make a single dime, though, because it was all music that was copyrighted. But I just did it because I knew that there were a lot of people that didn't feel comfortable going to a gym. And if you can find something to just get you moving and I mean, who doesn't like good music and dancing, right? I mean, I don't know if y'all like dancing, but I think that there's a dancer inside of it. Yeah, totally.

[Adam Schaefer]

Adam does too, but we don't let him. It's so bad.

[Dr. Lauren Fitzgerald]

Probably smart.

[Unknown]

I believe it's good.

[Adam Schaefer]

So you're doing that. You're making these videos. Videos. And. And you're like, I got. But you also have to make a living. So what do you do?

[Dr. Lauren Fitzgerald]

Absolutely. So. So I realized I've got this large YouTube following and this opportunity with Beachbody that kind of aligns with, like, you can't get healthy unless you change your diet, you exercise, and. And, you know, a community that supports. And while, I mean, I've always been very transparent, I don't like all of the Beachbody products or all of their programs, but it did offer something that was very tangible. And I'm not gonna lie, I made a lot of money from it. So I literally bought my current business, Laura Marmed, and renovated it. $100,000 worth of renovations, all from money that I made from Beachbody.

[Adam Schaefer]

Wow.

[Dr. Lauren Fitzgerald]

Legit. So I'm not throwing shade. It's not my favorite workout programs. There's a few that I like, but I'm a mind pump girl now.

[Adam Schaefer]

So you're doing that, you're crushing, and then you decide to get back into medicine.

[Dr. Lauren Fitzgerald]

Correct, Correct. So there was this one day, it was January 2019. The reason I remember this is because it manifested basically a year later in January of 2020. So I'm at this place that I just left getting red light therapy and cryotherapy. And I was like, man, if only there'd be a place that offered all of the things that I do, right? The biohacking kind of stuff, but also the aesthetics, like Botox. Because, yes, I'm about to turn 45, and I've been doing Botox since my late 30s. But I had this vision, like, why couldn't I just do that? Like, I'm an md. I kept my medical license, and then the whole idea of doing functional medicine. I don't have to go back and do a four year residency. Like, I can go do a lot of training to basically be ready to offer for functional medicine. So a year later, I had an opportunity to buy an established business in this tiny community outside of Chicago called St. Charles. And it was just a day spa. All he did was like, facials and massages. And they wanted to sell the business. And so they already had basically patients. And I turned it into a med spa. And so now we offer, I mean, I do functional medicine. I have an IV lounge. You know, I moved from California where IV lounges are everywhere, and it was nowhere where I was at. So I was like, okay, this is opportunity. I have a red light bed, infrared sauna, all of the things. So that was 2020. And so I decided to buy the business January of 2020. And then Covid happened right after.

[Adam Schaefer]

Literally right after.

[Dr. Lauren Fitzgerald]

Literally.

[Adam Schaefer]

Wow.

[Dr. Lauren Fitzgerald]

So I'm here against all odds.

[Unknown]

Wow.

[Adam Schaefer]

So how did. So when you're doing. When you're going through the functional medicine training, is any of it, like, countering your previous training and knowledge? Are you having moments of like, oh, my God, totally.

[Dr. Lauren Fitzgerald]

Totally. There's so many things that you're not taught in med school, and I didn't even realize this.

[Adam Schaefer]

This.

[Dr. Lauren Fitzgerald]

Most med schools are mostly funded by pharma.

[Adam Schaefer]

Yeah.

[Dr. Lauren Fitzgerald]

Which. How is that not a conflict of interest? So in med school and residency, all you're learning to do is treat with pharmaceuticals, procedures, and surgeries. It's a great business model, but it's not interested in helping you get healthy.

[Adam Schaefer]

No.

[Dr. Lauren Fitzgerald]

And so functional medicine was kind of a give the patient that's motivated, that doesn't want to be on those hypertensive medicines their whole life or diabetic their whole life, give them an opportunity to reverse that stuff. Because we all know not everyone's motivated. A lot of people just want a pill, that's fine. But when you have someone that's motivated but doesn't know what to do, like, it's a perfect. Because I am an md, I can. Because a lot of people, you know, are functional medicine that are not MDs, so they can't prescribe or deprescribe, you know, prescription drugs. So. So having that experience in, you know, the allopathic world, and then now with functional medicine, it was. It was a perfect, you know, marriage, if you will.

[Adam Schaefer]

I feel like it's just. It gives you more of a complete picture, because there's a ton of value in traditional Western medicine, but it's not the complete picture. And there's a ton of value in functional medicine, but it's also not the complete picture. So you have the opportunity to go through both worlds and apply both. And is this serving you well? Are you able use both with your patients and say, okay, we're doing this, doing that. So let me ask you this. It's probably really easy for me to ask you this, like, how you're different from traditional Western medicine doctors, but how are you different from traditional functional medicine doctors?

[Dr. Lauren Fitzgerald]

In that case, I think it's because I do all of the things and I practice what I preach. I mean, I definitely, I lift heavy. I require my patients. I let them know at the first appointment that they will be fired if they don't do all of the things. I don't want to have to fire them. And I explain to them, if you don't do it the way I want you to, the healthy way, I don't want your lack of results to, you know, reflect my. Yeah, exactly. So I, I have the fitness background, I have the MD background, and I have the functional medicine background. And I also have my own journey. I mean, I'm about to turn 45, and, like, I've been very open with my journey. When I turned 42, that was when I really, I just gotten back from a really cool trip to Bali, and I was looking at all my pictures flying back, and I just, like, was not happy with what I was seeing. And this happens to a lot of women at midlife, that despite doing all of the things, eating right and exercising and doing all the things, I was carrying an extra about 20, 25 pounds. So I used semaclotide, and I, I, I microdosed it. I started increasing my step count, and I, I showed everyone. I lost about 20, 25 pounds. And I've maintained that weight loss. Last year, this time, I literally realized, okay, I'm 100% perimenopausal. I had lost about five pounds of, of muscle on DEXA scan despite, you know, I shouldn't have. I, I was eating high protein and lifting heavy. And then when I saw my testosterone was, like, next to nothing, I'm like, all right, you know, I'm perimenopausal. So I've shared my experiences with my audience as well, and my patients. I think trust me more because you've done it. Yep. I'm my own guinea pig.

[Adam Schaefer]

So what does that feel like? Because I've had people tell. And this is looking into my past as an early trainer. I cringe at how I didn't believe people sometimes, and I feel really bad for it because I would have clients, oftentimes women in their early 40s, sometimes late 30s, but usually early 40s. And they would say things like, I haven't changed anything, Sal. I don't know what's going on. I never stored body fat in my midsection. I suddenly have a belly. And, you know, early trainer Sal, stupid version of me was like, well, you're just not tracking properly. You're just not doing it right. Whatever. What does it feel like when things like, does it feel like that? Like it's just out of nowhere and what's happening.

[Dr. Lauren Fitzgerald]

Absolutely. It's not fair. It's not fair at all. But it happens to men, too. I mean, I think it's a little bit more apparent with females, but I mean, I was the same way. I remember because I've been a group fitness instruct for so long. I mean, I would hear the women say, and I would literally in my head, think they're lying to themselves. They're really just eating too much and not really moving. And the reality is, no, hormones do play a role. They really do.

[Adam Schaefer]

Yeah.

[Unknown]

And a lot of play a massive role. I mean, I don't know what it's like to be a woman and go through that, but I know what it's like to be a man and have your testosterone on the floor and you're still doing all the things, dieting, working on sleep, strength training and not see progress. That's what's. So it's like, well, unbelievably frustrating to feel like you're checking all the major boxes and to wake up and be like, why am I not seeing any positive results?

[Adam Schaefer]

Well, my own personal experience with it was really crazy because years ago we get approached by people all the time, companies that want to work with us, and we had gotten approached by a company that did hormone replacement therapy, particularly for men. And they said, hey, you guys, we'd love to work with you. And we're like, nah, whatever. And they said, we'll give you free blood tests. And so Adam's like, I'm going to go get it done. This is when Adam had stopped bodybuilding. And he's like, I probably need to get on testosterone. I've been trying to get mine up for the last year. I feel like garbage. And he's like, do you want to come with me? So I'm like, sure now at the time. Now I'm, I've been. I've been consistent with workout since I was 16, right? Very consistent with diet, very consistent with supplements. The crazy thing for me was my libido was okay, right? And so because my libido was okay, I didn't think my testosterone had any issues. But there were lots of other symptoms. But I went with them just for fun, got my results and I was like, I was destroyed. I was crushed. Probably due to, you know, anabolic use in my early 20s. Probably had that effect on me. But I'm looking at this. My testosterone was low. And I remember I was like, in disbelief. Then I went on replacement therapy, and it was like a light switch got turned back on. I was like, oh, my God, it was deficient. It's like being deficient in anything. Deficient in a nutrient. Like, you're going to have these crazy symptoms. So this. So when start. Let's go back to when you do the semaglutide. You're doing everything right. You've been consistent, your body fat. So you start microdosing semaglutide.

[Dr. Lauren Fitzgerald]

Correct? Correct. And this is kind of how I do it with my patients. Not everyone responds to microdosing. And everyone's going to ask what's officially microdosing? It's different. Different for everyone, honestly. But truly, like, tiny doses of. Of semaglutide or tirzepatide really only work in someone that's already metabolically healthier than the average person. So I know a lot of people are interested in microdosing, but the average American needs actual real dosing. But oftentimes they don't need as high dosing as the. The standard increasing. Like a lot of these weight loss mills, they don't even look at the patient. I, I make sure that you're losing about one pound of weight per week, and I don't increase the dose until. Unless you're doing all of the things and you have hit a right. Because I don't want them to lose weight too fast and I don't want them to lose muscle.

[Adam Schaefer]

Did you get appetite suppression from the microdose?

[Dr. Lauren Fitzgerald]

Oh, big time. I mean, listening to you guys talk about it like it was, it's 100%. You can't really explain it until you actually are there. But I mean, the food noise that I'd heard people talk about, I didn't even think I had food noise, but I definitely had food noise.

[Adam Schaefer]

Did you notice any effects on muscle with that dose or so?

[Dr. Lauren Fitzgerald]

I've always been good about getting DEXA scans, and when I did it, I wanted to make sure and show my audience that follows me online, you can do this and not lose muscle. So I was getting DEXA scans and I actually gained muscle while I was on it. So.

[Adam Schaefer]

Okay, so let's talk about that for a second. Dr. 1 Because there's this, and I want to be clear, I don't think GLP1s are for everybody. I think they can be abused. There's a right way to do them, wrong way to do them, but nonetheless, there's this myth out there that they cause muscle loss. The fact is the data actually shows a muscle preservation effect, and there's even some data suggesting it's pro muscle or pro muscle function. Let's talk about that for a second.

[Dr. Lauren Fitzgerald]

Correct. It really irritates me when these people with large social media followings continue that narrative. That's a false narrative. If it is done properly, you can actually spare muscle. But the problem is the average person is not doing it right. And so this is why they get that reputation. Right? And so that's why, you know, I always tell people, look, you're going to pay a little bit more to do it with me, but you're going to do it the right way. Because a lot of these places, I mean, they will just keep upping the dose. And of course you're going to lose muscle. Good job for losing 30 pounds in 30 days. But 15 of that is muscle. And it's really hard to gain that.

[Adam Schaefer]

Which will happen with any severe calorie restriction. No stress, strength training, not hitting your protein. That's the body pares it down totally.

[Dr. Lauren Fitzgerald]

Whether you're on semaglutide or not, exactly.

[Adam Schaefer]

You notice a difference in you or your patients between semaglutide and tirzepatide.

[Dr. Lauren Fitzgerald]

So, yes, I mean, the. It's iPhone 14 versus iPhone 15. Of course, this is great, but this is even better, right? The way that I sell it is, look, semaglutide. I've seen it work for 95% of my patients and it's cheaper. But if. If you have a money tree in the backyard and you don't care, then cool, go with tirzepatite. Cause it is better because it has two mechanisms of action instead of one.

[Adam Schaefer]

Okay, I heard. Now this is anecdote, everybody. But I've heard people say that semaglutide, because you hear this anecdote. And there's some studies going on right now talking about how GLP1s also affect other hedonistic behaviors. Like, people are like, I'm not smoking as much. I'm not drinking as much. Are you noticing that with patients?

[Dr. Lauren Fitzgerald]

Oh, 100. 100. There is one woman who did my weight loss program and had this nicotine gum addiction. She didn't even smoke. She just started taking nicotine gum because she heard someone talk about it on podcast and literally. Yeah, no. And she was literally addicted. The amount of money she was spending on nicotine gum is crazy. It broke her. It, like, completely broke her habit. She was like, if anything, this was totally worth it for me because I've tried so many times. To stop this habit and I couldn't. Yeah.

[Adam Schaefer]

Are you noticing a difference between semaglutide and tirzepatite in that respect? No, not really. What about retatren, am I saying right?

[Dr. Lauren Fitzgerald]

You're so close.

[Adam Schaefer]

Have you worked with that one?

[Dr. Lauren Fitzgerald]

I have not.

[Unknown]

Is it officially out yet?

[Adam Schaefer]

I don't know if it's out or if it's gray market. I read, I've seen sneak studies like, holy cow, what has happened here?

[Dr. Lauren Fitzgerald]

Yeah, I, I haven't used it because it can't be compounded and I only use a high quality compounding pharmacy.

[Adam Schaefer]

Right, right. So now let's go back to hormones. What are the most common ones that you start with with people? Is it thyroid and testosterone? Progesterone.

[Dr. Lauren Fitzgerald]

Absolutely. So, so for my fe, midlife and and beyond, most of them need progesterone, thyroid, DHEA and testosterone. My men typically need all of those except for progesterone. So a lot of times when people think TRT like, yes, testosterone replacement therapy is important, but your other, your other hormones are important as well. So I, I make sure that all of their hormones get optimized. But those are typically where we start with the midlife patients.

[Adam Schaefer]

And which ones are the provide the most aesthetic benefit. Is it testosterone and thyroid?

[Dr. Lauren Fitzgerald]

Oh, 100%. So insulin resistant is at the root of most people's problems. Right. Most people are not getting DEXA scan, so they can't see how much visceral fat they have. But literally, if everyone could get a, a DEXA scan and see their visceral fat and aim to decrease that, that would decrease all of their metabolic markers. They would be a lot healthier. And testosterone and thyroid are the key ingredients to helping especially motivated patients like, like, or people that follow you guys that are actually working out and doing all of the things.

[Adam Schaefer]

Yeah, you tend to see insulin sensitivity improve with testosterone levels because of the muscle building aspect of it, for sure. And then progesterone, what does that provide to women?

[Dr. Lauren Fitzgerald]

Oh, man. So my first symptom of perimenopause that I was completely in denial about was terrible sleep. Because I was telling you guys a couple years ago our business was financially struggling and so I just assumed that my bad sleep was the stress of all of the things that were going on at work and whatnot. But really, insomnia is one of the first symptoms that a lot of women experience in perimenopause. And it's because the hormone inhibin and the hormone progesterone are two of the first hormones that start to decrease in. In that stage of life from the ovaries.

[Adam Schaefer]

And is it also enzylytic? I know some women will take progesterone, find their anxiety.

[Dr. Lauren Fitzgerald]

Absolutely. I'd never experienced. I've always been a very chill person, never experienced anxiety. And. And last year, when I was 43, I never experienced panic attacks, but almost. So I was dealing with anxiety as well. So the mood up and down is very real. And that's from progesterone.

[Unknown]

Now, what were your labs saying when you were first eating? Did your labs look, quote, unquote, normal and then you still went in and did stuff, or were there things that were off the chart right out the gates?

[Dr. Lauren Fitzgerald]

That's a great question. So labs are not near as important as symptoms. And up until the 1970s, actually, testosterone and thyroid were completely treated by your symptoms. Like, there were no lab values.

[Unknown]

Oh, interesting.

[Dr. Lauren Fitzgerald]

Yeah. And it's crazy because I have lots of patients that have endocrinologists that literally will tell them, I don't care if you felt better on a higher dose of natural desiccated thyroid, I'm going to treat your numbers. So we've gotten back ass words. No, ass. Backwards. That's the word as far as how we treat people. Right. So labs, they are important, but not near as important as a lot of people think. For me, my testosterone was super low, and that was the biggest thing that I could tell. Like, this explains my weight or my muscle loss in the last year. But they actually tell us to not even measure progesterone and estradiol in a perimenopausal woman, because it's all over the place in perimenopause. And perimenopause can last 10 years. So, like, my labs, I. I'll show this on my Instagram stories. My labs from last November, they actually showed zero estradiol, But I'm still menstruating. I'm irregularly menstruating. But if I would have done my labs even two or three days later, it could have shown estradiol of 100 or even 500. So. So the actual values of the estradiol and progesterone in a perimenopausal woman don't really matter. It's really symptoms.

[Adam Schaefer]

Now, why are they going off of labs and not symptoms? It's interesting to me. Are they afraid of 100%?

[Dr. Lauren Fitzgerald]

100%? A lot of primary care doctors and gynecologists will not treat with testosterone just because it's a controlled substance. And I think you Just don't know what you don't know. But the safety profile of testosterone especially, I mean, we have have decades of data that show the safety profile specifically because there's a huge population of biological females that think that they're men that have taken high, high, high dose testosterone. And we know the safety profile. It's very safe.

[Adam Schaefer]

Yeah. So it's actually one of the safest hormones you can.

[Unknown]

That's why it's so weird that a GP won't do that. We've known this for a long time.

[Adam Schaefer]

You give 10 times of your normal dose of any hormone, you could kill yourself or cause problems. Testosterone won't. You get some symptoms, but you ain't going to kill yourself with it. It's very interesting.

[Dr. Lauren Fitzgerald]

No, the safety profile is so, I mean, there are no risk of high dose testosterone.

[Adam Schaefer]

Wow.

[Dr. Lauren Fitzgerald]

Now as females can have some of the unwanted side effects.

[Adam Schaefer]

Yeah.

[Dr. Lauren Fitzgerald]

You're going to grow a beard right here, citizen. Some acne and some hair shedding. But that's not necessarily in all females. It's in like 20 to 30% of females.

[Adam Schaefer]

Well, what's interesting to me too about this is we know that there are different, like there's differences between individuals and let's say androgen receptor density or estrogen receptor density. And so a certain amount of testosterone in one person is going to feel great because they have more receptors versus another person.

[Dr. Lauren Fitzgerald]

And, and there's no way to measure how many receptors they have. So this is literally where you have to talk to the patient and know like their symptoms. So most men feel best when their free testosterone is somewhere between 30 and 50. Right. You might feel amazing at 30, but you might feel great at at 60. Right. So I'm not gonna treat the number, I'm gonna, I know what you're supposed to feel like when all of your hormones are optimized. So I'm not scared of going higher on these hormones because I understand the safety profile of them.

[Adam Schaefer]

Now you recommend to women when they take testosterone because there's different methods of administration. There's creams, there's pellets, there's injections. You recommend creams to women applied intravaginally.

[Dr. Lauren Fitzgerald]

Correct.

[Adam Schaefer]

Now why is that?

[Dr. Lauren Fitzgerald]

So at the first initial appointment, I always tell patients, look, I'm gonna go over your labs and ultimately the end goal of your labs are gonna be looking like what they looked like when you were hormonally optimized. It's when you're like 19 or 20 years old. Right. And so oftentimes the end results are gonna be labeled too high. Right, right. So testosterone ebbs and flows in a 19 year old. Peaks and troughs every 24 hours. It's a nice sine wave. Right. And so this is why pellets are my lace. I offer pellets and I think pellets are great for a certain patient population. So maybe someone that's in a nursing home that's not going to do a intramuscular injection or, you know, applying their cream to their balls or their vagina. But to the average person who can take vitamin D every day, you can put, you know, cream on your balls or cream in your vagina every day. Right, right. So it most closely mimics what your body was doing when you were hormonally optimized at 19 or 20.

[Adam Schaefer]

And so you. Do you like creams for men too?

[Dr. Lauren Fitzgerald]

I do, I do. You can get great levels.

[Adam Schaefer]

Can you really?

[Dr. Lauren Fitzgerald]

Oh, 100%. If, if you are applying it to an area of the balls that doesn't have hair. And I always tell my patients, you got to, if you have hairy balls, you're going to have to shave it because that's the way that you get the best. And then you do it twice a day. So literally, if you can brush your teeth twice a day, you can put ball cream on twice a day.

[Adam Schaefer]

Yeah, Just don't, just don't go hugging anybody naked.

[Dr. Lauren Fitzgerald]

Correct.

[Adam Schaefer]

No. Did you know there was some, there was some, Wasn't there some reports of like, parents, they don't wash their hands playing with their kids?

[Dr. Lauren Fitzgerald]

Oh, yeah, well, that's always part of my, my, when I'm talking to them because I give them options. For my telemedicine patients, I can't do a pellet. But for my, my, you know, everyone, I always offer intramuscular injection, subcutaneous injection or cream. I let them know which is my favorite and then let them choose. So I do have some patients that are like, I'd rather just do a shot. That's fine.

[Adam Schaefer]

Wait a minute. How do you do sub Q with testosterone? Isn't it in an oil?

[Dr. Lauren Fitzgerald]

You dose it a little bit more frequently, but yeah, a lot of people.

[Adam Schaefer]

Are doing sub Q. Wow. Does that leave a little knot in your.

[Dr. Lauren Fitzgerald]

I mean, I don't know because I did an intramuscular for the first five months and I definitely, it worked. But I feel so much better on daily cream. You can just dose it. What's the difference for you?

[Adam Schaefer]

You don't feel the too high, too low type of deal?

[Dr. Lauren Fitzgerald]

Yeah, no, I feel the best and I Feel a lot of the sexual benefits from. From it. A lot of people don't get the sexual benefits from the munch, the intramuscular injection, so.

[Unknown]

Oh, interesting.

[Adam Schaefer]

Oh, libido, huh?

[Dr. Lauren Fitzgerald]

Yeah, yeah, interesting. But what you said earlier, I do want to address. I think a lot of men assume, well, I've got a strong libido. I've got great testosterone. No, that's not always true. You can have a good libido and have terrible testosterone. Testosterone is important for so many other things.

[Adam Schaefer]

Low libido is one of the first symptoms of low testosterone. But for some men. For some, yeah, because it can also be driven by like, libido is driven by dopamine. Can be driven by lots of different things.

[Dr. Lauren Fitzgerald]

Absolutely.

[Adam Schaefer]

So I thought my test, these guys, I mean, Adam's like, oh, your testosterone be fine. Because, you know, these guys know me, right? And it was, it was in the floor.

[Dr. Lauren Fitzgerald]

Oh, yeah.

[Adam Schaefer]

And I couldn't, I couldn't believe it. Now, that's not to say didn't get better. Although that first three, four month period, my wife wanted to shoot me.

[Dr. Lauren Fitzgerald]

I can imagine. I can imagine.

[Adam Schaefer]

But it does. It did start to kind of balance out a little bit. Do you have preferences when it comes to thyroid prescription? Because I know, like, my wife was actually going through that and they're recommending her. Like the ones that's derived from pig.

[Dr. Lauren Fitzgerald]

Absolutely, absolutely that. So we have been replacing people's thyroid with that kind of natural desiccated thyroid since 1890.

[Adam Schaefer]

Yeah.

[Dr. Lauren Fitzgerald]

Like, literally it's been forever. And again, we weren't even testing our thyroid labs until 1970s. So, yes, this is 100%. So many of my functional medicine patients came to me and were on, on basically Synthroid. So it's levothyroxine, it's synthetic T4. And yet they were told they were normal based on their labs, but they had all of the symptoms of a subpar thyroid. I would take them off a Synthroid, put them on natural desiccated thyroid, which has T1, T2, T3 and T4. And all of a sudden they're starting to feel amazing. I literally, one of my weight loss patients, she is a type 1 diabetic and she has hypothyroidism. And so I told her, I'm like, look, your endocrinologist is managing these two things. Ask if you can switch from Levo to natural desiccated. So I surprised she let her. Definitely started feeling better. And then I told her, I'm like, off the record, if you want to double up the dose and see how you feel. Do that. And she was like, oh, my gosh, I feel amazing. She literally told her endocrinologist that. But the endocrinologist would only treat the labs instead of listening to the patient saying, but I doubled up on the dose and I felt amazing.

[Adam Schaefer]

Yeah, it's so frustrating because you gotta, you have to have that insider knowledge.

[Dr. Lauren Fitzgerald]

Exactly.

[Adam Schaefer]

Ask for that.

[Dr. Lauren Fitzgerald]

Exactly. And here's the thing. Thing. We know that thyroid cancer patients, we suppress their tsh, which stands for thyroid stimulating hormone. It's the hormone that our pituitary gland is supposed to send to our thyroid gland to say, hey, thyroid, make more thyroid. But if we're taking enough exogenous thyroid in natural desiccated thyroid, our brain is going to be like, yo, we're good. We don't need any more thyroid. So of course TSH is going to be zero. Yeah, absolutely. It's not dangerous. We know that these thyroid cancer patients live at TSH of 0 their whole life lives. So we know it's. It's not dangerous. But. But, yeah, but here's the thing. The endocrine society recommendations are very highly influenced by big pharma. I mean, do you realize, like, how many of the recommendations, like, if everyone just started to get deficient, their hormone deficiencies and their micronutrient deficiencies replaced, like, people would feel so much better and they wouldn't need all of the pharmaceuticals that are making these computers. But he's so wealthy now.

[Adam Schaefer]

What hap. Because I know that context matters when you're looking at, like, context of the health of the human body. For example, if you stimulate MTOR in the context of cancer, you're going to make the cancer grow. Right. But otherwise it builds muscle, improves recovery, improves athletic performance. What happens if you take someone who's inflamed, unhealthy, obese, and then you put them on hormone replacement therapy? Is it not a good idea or is it different? You have to be careful.

[Dr. Lauren Fitzgerald]

You don't have to be careful. For a lot of them, it's their, their starting point because they've tried to do it the, you know, okay, you know, change the lifestyle. But now all of a sudden there's. You're starting to give them a little bit more pep.

[Adam Schaefer]

I mean, thyroid, so it actually helps motivate them. That makes sense.

[Dr. Lauren Fitzgerald]

A lot, A lot. But are you gonna get optimized if you just take hormones and sit on your ass? No. I mean, and we're all about, like, let's get people fully optimized. So it has to be combined with diet, lifestyle, sleep management, all of the kind of things.

[Unknown]

This is why she. You said you'd fire your clients if they're not lifting 100%, right? Yeah, absolutely.

[Dr. Lauren Fitzgerald]

Now.

[Adam Schaefer]

Okay, so it improves. What about longevity? What does the data show on longevity?

[Dr. Lauren Fitzgerald]

So let me tell you, my parents are super healthy. I'm really. Thank you, Jesus. They're really healthy. They've always set the example of what diet and lifestyle looks like. So my mom is 69 and my dad is 70, and I literally started them on BHRT. And I'm pissed because if I would have known, I would have started them 20 years ago. So it's never too late. But literally when I was talking about they were my first two patients to start hormones on, and my dad was like, but, you know, Lauren, we're really healthy. I'm like, I realize that y'all are healthier than 99% of people your age, but you're not fully optimized. And here we are, they've been on it for six months. And my dad is like, I'm starting to build muscle again because he still lifts weights three, four times a week. So. Yeah. And he's like, I can start to see muscle again.

[Adam Schaefer]

So from a longevity standpoint though, does the data. Because someone might be like, well, these hormone changes are natural, and if we just force the body to have all these extra hormones, it's not gonna make you live longer. Yeah, you're gonna feel better and younger, all that stuff. But what does the data show on longevity?

[Dr. Lauren Fitzgerald]

I hate that argument. It's so dumb. Well, it's natural to not brush your teeth. Are you gonna not brush your teeth? I mean, come on. Yeah, absolutely. I mean, we used to not live past our 50s, so we're living into our 70s, 80s, 90s. No, it's not natural. But I don't want to be natural because I know what the average person that looks in their 70s and 80s looks like. I'm not about that. I want to be optimized. I want to be like my great grandmother. She was a full blooded German woman. She was literally mowing her own lawn at 98.

[Adam Schaefer]

Oh, that's.

[Unknown]

That's awesome.

[Dr. Lauren Fitzgerald]

Absolutely. That's what I strive to be like.

[Adam Schaefer]

Now, you did said that there is a very small percentage of people you would not do hormone replacement therapy. Are these people who had like previous hormone sensitive cancers or what? Who are we talking about?

[Dr. Lauren Fitzgerald]

So. So this is where, if they were my loved ones, I would still start them. But we live in such A legal society that. Yeah. And, and we're, we're trained. Like, you have to understand, like, if you are gonna take on that patient, you have to basically have a solid consent form because you are taking on the risk. But I. There is not a single patient that I think wouldn't benefit from hormones even with a history of hormone sensitive cancers.

[Unknown]

Wow.

[Adam Schaefer]

Wow.

[Dr. Lauren Fitzgerald]

If they are actively fighting cancer, that would be the only time that I wouldn't take them off.

[Adam Schaefer]

Yeah, that's different. Right. Like you have breast cancer. Well, we can't give you estrogen or anything like that. Or you have.

[Dr. Lauren Fitzgerald]

Not at this moment.

[Adam Schaefer]

Testicular prostate cancer. Canc.

[Dr. Lauren Fitzgerald]

Not at this moment, but in the Future, they are 100% cancer.

[Adam Schaefer]

Speaking of which, for a while, for a long time there, there was this like conversation around testosterone that it could cause prostate cancer because the prostate is sensitive to testosterone. Well, lo and behold, the data comes back and shows that low testosterone is a risk for prostate cancer, not high testosterone.

[Dr. Lauren Fitzgerald]

Correct. And low estradiol. So all these people that are taking AIs blocking the estradiol. Like I want not prescribe AIs to my men, my patients.

[Adam Schaefer]

That's anastrozole. That's correct. So those are the ones. So I've heard people say that. Don't touch those.

[Dr. Lauren Fitzgerald]

Do not.

[Adam Schaefer]

What if. Okay, so if somebody's on synthetic testosterone, at the higher range, they feel better. At the higher range, they're going to have higher than normal range of.

[Dr. Lauren Fitzgerald]

And it gives you the same protective benefits that it gives us. Like it gives you cardiovascular protective benefits, decreases your likelihood of developing osteoporosis, dementia. Like there's so many benefits of the downstream metabolites, the DHT and the estradiol. So I would never prescribe a AI for my male patients. And that's a common theme that I'm seeing from a lot of these testosterone mills.

[Adam Schaefer]

They typically give it to them with their.

[Dr. Lauren Fitzgerald]

Absolutely. Absolutely no.

[Adam Schaefer]

So when would you. Or do you. What about. What if they have estrogenic side effects?

[Dr. Lauren Fitzgerald]

Never. The. Literally talking to my colleagues that have been doing BHRT way longer than I have, I literally. Keith Nichols, he's very well known. He's got a good following and does a lot of teaching. He said in his 20 plus years, he's seen two men with gynecomastia and it's because they already had a predisposition. He's. It is such a, it's such a feared thing that he's like, I almost never see it. And so it's in, in WorldLink Medical. That's where I did all my BHRT training. We are taught stay away from AIs. The, the risk that come along with it are not worth it.

[Adam Schaefer]

Make you feel like garbage.

[Dr. Lauren Fitzgerald]

Absolutely. And it's a pharmaceutical, you know, I mean literally like if we can just get back to replacing people's hormones and their micronutrients that they're deficient in, they're gonna feel so much better.

[Adam Schaefer]

What about like finasteride, dutasteride, the DHT to reduce those for things.

[Dr. Lauren Fitzgerald]

DHT has so many good side effects and benefits.

[Adam Schaefer]

Let's talk about, about that.

[Dr. Lauren Fitzgerald]

So, so the sexual benefits, it's more androgenic than testosterone. So you need it, you want the downstream metabolites of DHT and estradiol. And that's why when people are blocking them, I'm like, you don't understand. Like you, you're, you're blocking yourself from so many great benefits. The, the, the brain fog, the. There's some anti cancer benefits, there's sexual benefits. I mean there's, look, testosterone. If you happen to have some of the bad side effects of some hair loss loss. I believe that it's, it's worth all of the benefits to not block the DHT and the estradiol and have all of the benefits of all the hormones, the testosterone, dhe, DHT and estradiol.

[Adam Schaefer]

There's also peptides now that people use on their scalp and for that kind of stuff to kind of prevent that kind of stuff. Blocking thd. It always sounded so extreme to me to block that. So you're also like, no, absolutely.

[Dr. Lauren Fitzgerald]

I mean God created us perfectly and he put those enzymes and those metabolites there for a reason. Reason.

[Adam Schaefer]

Now what about the cost of, of doing something like this? Okay, I want to go on hormone replacement. Is it expensive or because they're generic, they could be not so bad.

[Dr. Lauren Fitzgerald]

So I always explain to, to people, your, your health insurance is like your home insurance. If you get hit by a hurricane, you're really glad you have home insurance. Right. Your health insurance is not there to optimize you. So your, your home insurance is not going to pay for your new floors and your redecor. You are optimizing yourself and that's an investment. Investment. And ultimately the sooner that you can invest in yourself, the better. Well, the cheaper your health care is going to be when you're older as well. So it's, it's an investment for sure. And, and there's, I mean, you know, I've spent a lot of money on my training. So you're paying for, you know, the expertise and, you know, so typically health insurance does not cover it.

[Unknown]

The roi, though, on every other aspect of your life is so high. I try to explain that to people like you. The healthy, fit, stronger, optimized version of.

[Adam Schaefer]

You, cheaper in every.

[Unknown]

Is a better partner. Is a better business person, better at work. Is it just like ye, all that stuff? You know, it's hard to measure that and put a dollar amount to that. But if you've experienced it and you know what it's like, it's, it's beyond worth it. It's crazy.

[Dr. Lauren Fitzgerald]

Marriages that are saved once both are being hormonally optimized. I mean, I've heard so many, so many stories from my colleagues that have been doing it a lot longer. I mean, think about the woman at midlife who is just all of the sudden like, you know, you, you never know which side you're going to get of her. Like if, if you could get her mood leveled out and if you could get the man. I mean, it's not just libido. I mean, it's energy, it's, it's, it's motivation, it's confidence. I mean, a man that doesn't have enough testosterone. You're deficient in so much more than just libido. Right? So imagine if you are the best version of you and your spouse becomes the best version. You're only going to better your marriage.

[Unknown]

I watched, I watched it happen with Katrina and I, I mean, I felt so bad for her. Not just like you said, libido, but I'm, I'm more motivated to help her around the house. Totally help her with our son, do things like that. Like those types of things are also affected.

[Dr. Lauren Fitzgerald]

Absolutely.

[Unknown]

It's a no brainer.

[Adam Schaefer]

A lot of people don't realize either that because testosterone is known as this aggression hormone, which by the way, the aggression that you get from normal high levels of testosterone is a motivated aggression. It's not aggression like the bad guy. Low testosterone causes irritability. A lot of people don't know that. So they think like the asshole who's just super irritable might be low testosterone because they tend to feel better when they're on it.

[Dr. Lauren Fitzgerald]

But what happens to them? Here's your prescription for an ssri. And then that decreases their testosterone even more.

[Adam Schaefer]

Do they really?

[Dr. Lauren Fitzgerald]

Oh, 100%.

[Adam Schaefer]

Oh, wow.

[Dr. Lauren Fitzgerald]

Statins do too. Do you understand how many people are on an SSRI and a statin? I mean, it's.

[Adam Schaefer]

By the way, the margins on those drugs are so much higher because they're patented. Testosterone is not patented. So the margins are. It's not a huge.

[Dr. Lauren Fitzgerald]

Exactly. That's why these big pharmaceutical companies are worried about people basically getting healthy.

[Adam Schaefer]

That's interesting.

[Dr. Lauren Fitzgerald]

They don't want us to get healthy.

[Adam Schaefer]

Now, are you seeing a huge uptick? Because this is kind of more commonly known in the news, right, where you see that testosterone levels have been dropping in men now for decades. We're starting to see that. But is it becoming more well known that women don't have to deal with or have solutions to? You know, they kind of suffered in silence before going through perimenopause. Are you seeing a higher interest in women saying, okay, I can do something about this?

[Dr. Lauren Fitzgerald]

There's definitely a movement. Without a doubt.

[Adam Schaefer]

For sure.

[Dr. Lauren Fitzgerald]

Um, there, there was this guy who is a, a big YouTuber and he posted my little blurb on testosterone because I always say the same thing when I'm talking to a female patient. I'm like, I saved testosterone for the, the last because it's my favorite hormone. And I always let them know, look, when your testosterone is optimized, you've got a strong libido, you're able to easily orgasm, you're able to have multiple orgasms, you've got good vaginal lubrication, you can increase muscle mass, you can decrease visceral fat, you can improve your present body fat, you have better mood, better energy, more vigor. Why would you not want all of that? Right? And so, yeah, no, for sure. Everyone's like, you should have started there. I'm sold. But he took that clip. And then there was a man in the comments that was like this, none of these are necessary for a female. And I mean, can you imagine? I was just like, what's wrong with that? I know, I know.

[Unknown]

So it's single, dude.

[Dr. Lauren Fitzgerald]

Yeah, 100%. Must be, must be. But, but no, I think that there's definitely a movement of like, no, this is. You don't just have to put your big girl panties on and you know, suck it up, buttercup. Like there are options.

[Unknown]

So I have, I have, I want to ask, I want you to kind of like step us through here because you came to mind the other day when I was talking to my, my niece and my sister in law, both over a overweight, the younger ones mid-30s. Right now my sister in law is late or mid-50s. And the, the norm that they like, the average, they fall in the category. The average, you know, female that wants to get in shape. That's got a couple extra pounds. They go right away to cut calories, you know, cut out the junk food, goes right to the salads. And then sign up to the boot camp classes and they start or get on the treadmill start. And I can't stress how important it is that they. They balance out their hormones. First they get healthy, then they stress strength training. So walk through someone like that who's about to make a shift, like, okay, they're motivated the order of operation for you, like getting blood work done, like, what does it look like? What should they make sure that it looks like? And what are the most likely things they're probably going to have to do? And then what does that step that person through?

[Dr. Lauren Fitzgerald]

That's a great question. So they, they all always need to start with labs for sure, so that you understand the baseline. And I use labs as a teaching tool. Tool. But also let them know that this is just going to guide. But ultimately I'm going to treat their, their symptoms and side effects. Right. I, I did learn when I first started all my BHRT training, if you have a woman that's midlife and 30s is still, you know, partially midlife, because a lot of women can start going through perimenopause at 35. So, yeah, you can start seeing those midlife symptoms as it relates to mid 30.

[Adam Schaefer]

Right. Quarter women, like by 37 are already going for.

[Dr. Lauren Fitzgerald]

Yeah, it's crazy. So if you have a woman at midlife that is struggling with her weight and you can only do BHRT or GLP1s, get her hor. Right. And then. Absolutely. But we do know they're synergistic. There was a study that looked at a group that only did BHRT, a group that only did GLP1s, and then a group that was together, and that group had a 30 better outcome. So as far as weight loss.

[Adam Schaefer]

Well, GLP1 is a hormone.

[Dr. Lauren Fitzgerald]

It's a peptide. Yeah, yeah, It's a peptide that our GI tract mates.

[Adam Schaefer]

Okay. Okay.

[Dr. Lauren Fitzgerald]

Right. So it's just a matter of how many amino acids that makes it a.

[Adam Schaefer]

Hormone or a peptide.

[Dr. Lauren Fitzgerald]

Correct. Okay, correct. But almost. Yeah.

[Adam Schaefer]

So you'll start them there first.

[Dr. Lauren Fitzgerald]

I, if, if they can only do one or the other, I will get their hormones. Right. There's this one pharmacist that works for World Link. She literally lost over 100 pounds just getting her hormones. Right. So it, it can be done. And especially when you have a patient that's like, all right. And oftentimes the motivation that comes from getting A little bit more thyroid and a little bit more testosterone on board leads them to. Exactly, exactly. So. So hormones would be. If they could only do one or the other, but if. If they could do better, both. Absolutely.

[Unknown]

Well, what are some things, too, like when they get their labs, because this is the other thing you. I wish I remember what levels you were talking about, but you were talking about your own. Your own blood work, and that what the GP would tell you is in the normal level. And what you've found in your practice is like, I operate so much better at these higher levels.

[Dr. Lauren Fitzgerald]

Thyroid. Thyroid. So I always use my labs from last year versus the end of the summer. So my tsh, which is typically the only thing your primary care doctor is gonna measure when you say, hey, Doc, I think I have a thyroid issue. You know, I'm having low energy, struggling with my weight, maybe some brain fog, maybe cold. All the time, we call it cold intolerance. Some dry skin, brittle nails, constipation. That's all of the ways that, you know, low thyroid can manifest. So the doc goes, oh, yeah, I'll check it. They only check tsh, and they say, oh, your thyroid's normal. So I used my labs from last year to show that my TSH was completely normal, but my free T3 was 2.6. Now your free T3 is really all I care about, because that's what's available at the cellular level.

[Adam Schaefer]

That's the active one.

[Dr. Lauren Fitzgerald]

Absolutely. So I can guarantee if I see someone's free T3 is on the low side, I know that they're going to say yes to almost all of those.

[Unknown]

Symptoms, and they need to ask for that separately, don't they?

[Dr. Lauren Fitzgerald]

But here's the thing, though. If they ask for it, the doctor's not going to know what to do with it. That's the problem, because the Endocrine Society suggests their recommendations to only use tsh. So this is why so many people are being failed. I mean, thyroid is amazing. I know what I felt like when my free T3 was 2.6, and now mine's on the high side. I am around about 8.

[Adam Schaefer]

You know, people know thyroid affects your cognitive function, your iq. You'll see IQ go up or down.

[Dr. Lauren Fitzgerald]

Yes.

[Adam Schaefer]

Based off of your thyroid. So it's not just, I'm getting fatter. It's literally, you're dumber because your thyroid isn't being optimal.

[Unknown]

Imagine how, like, how tough this is when you.

[Dr. Lauren Fitzgerald]

When you.

[Unknown]

You hear, oh, I should go get my blood work. I listen to that podcast, Mind Pump. You Go to your gp, gives me your blood, they come back. Yeah, they don't even look at it. And then the level they are looking at is in the normal range. Meanwhile, this is very common for you to see that someone could be in that normal range, yet would feel so much better if it was a little better.

[Dr. Lauren Fitzgerald]

Absolutely. I always tell my new patients and I use my before and after. I'm like, I will not fight with your primary care or your gynecologist over this. Because what's going to happen is if they measure your tsh, when your thyroid is optimized, it's probably going to be zero or close to zero. And it's going to freak them out and they're going to say you have hyperthyroidism, you have Graves disease. No, you don't. You have optimized thyroid. Thyroid. And I'm not gonna fight with them, I'm not gonna send them literature that backs up what I do like. So you basically, if you wanna follow them, keep doing that.

[Adam Schaefer]

So let's pause there, doctor. So it's called a negative feedback loop with hormones, right? Correct. So if I take testosterone, my body will, will see the testosterone and will stop producing its own, right?

[Dr. Lauren Fitzgerald]

Correct.

[Adam Schaefer]

If you're taking thyroid to optimize your thyroid, your body's like, oh, you have plenty of thyroid. We can stop producing TSH because TSH signals thyroid production.

[Dr. Lauren Fitzgerald]

Exactly.

[Adam Schaefer]

So it is gonna be zero because you're taking thyroid.

[Dr. Lauren Fitzgerald]

Exactly.

[Adam Schaefer]

So that's what's supposed to happen.

[Dr. Lauren Fitzgerald]

It's not dangerous at all.

[Adam Schaefer]

Okay.

[Dr. Lauren Fitzgerald]

I will tell you, I am not going back to my free T3 of 2.6. I feel amazing with my free T3 around 8 and my TSH is 0 and I will live like that forever.

[Adam Schaefer]

Now, form of exercise with your patients, which for. I know the answer, but form of exercise produces the best, the best kind of results across the board.

[Dr. Lauren Fitzgerald]

Lifting heavy shit. Yeah, I literally at the gym, so I'm a 5am worker outer and there were these two young girls in their like young 20s and I went up to them, I'm like, keep doing what you're doing. I'm 40, almost 45. And if you keep doing, you will, you will definitely not regret. But I mean it's, it's, you know, so many women weights now.

[Adam Schaefer]

It's great.

[Dr. Lauren Fitzgerald]

I know, it's amazing, right?

[Unknown]

To see a 20 year old lifting.

[Adam Schaefer]

I never saw that before.

[Dr. Lauren Fitzgerald]

No, because they were all cardio bunnies. Yeah, I mean I was, I've always lifted weights in addition to cardio, but I'VE definitely. I do less cardio now. I walk a whole lot.

[Adam Schaefer]

Yeah.

[Unknown]

I mean, I'd say that was what the. The good, smart girl was doing 20 years ago was. She was doing both.

[Dr. Lauren Fitzgerald]

Both. Yes.

[Unknown]

Where now you actually see girls that are like, heavily lifting. Yeah. Lifting weights, which is so, so good.

[Dr. Lauren Fitzgerald]

I know one. Especially in your 20s and 30s, like when you have hormones that help you build muscle, like, man, that is. You know, Gabrielle Lyons says it right. It is the organ of longevity. And you want to build as much of that as you can, because what your life looks like when you're elderly will completely depend on how much muscle mass.

[Unknown]

And it's like I tell. I'm screaming this the rooftop. It's like investing, too. The sooner you start and the more.

[Dr. Lauren Fitzgerald]

You quoted you on that the other day.

[Unknown]

Hey, the easier it is. I think there's such this my around.

[Adam Schaefer]

Muscle memory is real.

[Unknown]

People talk about, oh, it's so hard to build muscle. It's so hard when you get older, all these things, and hard to get in shape when you get older. It's like, not if you've been investing since you were 20. If you've been investing and lifting heavy since you were 20. Even if it wasn't every single day of your life and you had bouts where you were off for six months. If you just kept doing that for decades, holy. Is it easier and better when you get older?

[Dr. Lauren Fitzgerald]

I heard you say that on a podcast a few weeks ago, and I literally quoted you exactly. Because that is such a great analogy.

[Unknown]

It is. And it's. And it's a. It's a. It's a myth that. That is that people continue to spread that it's so difficult when you get older. It's like, no, I'm. I'm having an easier time maintaining a healthy fit, strong physique than I ever had in my Life. In my 20s, I was doing 10 times the amount of volume, intensity, and I looked half as good. It's like, it gets better, you guys. If you just start now and be consistent with it, it'll. It'll pay you back.

[Dr. Lauren Fitzgerald]

But it's also never too late to start. My mom, literally, my dad and I have been trying to get her to lift weights, literally, for the last three or four decades, and she finally started lifting weights at 67. So she's been lifting weights now for two. Two years. My mom looks amazing. And she's like, I wish I would have listened to you earlier.

[Adam Schaefer]

No, it was never too late. There was a study I just quoted on A recent podcast where they were looking at people in their 70s and 80s. Their ability to build muscle is not hampered now. The potential is less because you're in your 70s, 80s, but the rate of muscle growth and the strength that they were gaining was. There was actually, there was no difference between them and the 50 year olds. That was the comparison. So yeah, your body will adapt and respond. The potential, potential, it starts to change as you get older but like you can always build muscle and get stronger.

[Unknown]

Well, let's explain, explain to the audience, especially for the female, what is happening hormonally when they do decide they're going to lift weights. Why, why is the body just seem to organize the hormones in this optimal way or a better way than what it would be doing with them? What's like, what is the difference between the same girl who is, is trying to get healthier but is not lifting weights versus the one that is lifting weights?

[Dr. Lauren Fitzgerald]

I mean, I think it just goes back to like we're supporting the way God created us to live. Like God didn't create us to sit all day and not move and not lift heavy stuff. And like we've just become so sedentary and so get getting back to going to bed when it's dark outside and you know, not eating crap food that's, you know, highly processed and like just, you don't have to complicate it. So I think that getting back to the way that our ancestors lived just helps support our hormones in the way, the way we were designed to work.

[Adam Schaefer]

Well, the insulin sensitivity that comes from extra muscle is, is huge. So that's going to make a big difference. I mean, you mentioned earlier, you know, pcos, like there's a strong connection or correlation between that insulin. Oh yeah, insensitivity.

[Dr. Lauren Fitzgerald]

They need to rename it honestly. I mean they teach us literally assume a woman has is PCOS until proven otherwise.

[Adam Schaefer]

Wow.

[Dr. Lauren Fitzgerald]

So if you look at, and now this is only true for a woman in her menstruating years and perimenopause. So once she's, she's become postmenopausal, her LH and FSH FSH ratio don't matter. But if you look at their FSH and lh, no matter where they're at in their cycle, if the LH is equal to or greater than their fsh, their pcos, and what that means is that they have a luteal phase defect. So follow me on this. I'm not going to get too geeky. So in a, in a female cycle, you've Got four phases. You've got the menstrual phase, the. From day one, you bleed to the last day. Right. And it's followed by your follicular phase, which is mostly your estrogen. Right. Then you ovulate. So you have your ovulatory stage, and then the luteal stage is progesterone. Right. And so if you have a luteal phase defect, you don't have enough progesterone. So this is why the PCOS female has terrible periods or terrible pms, oftentimes, can't get pregnant, oftentimes has history of miscarriage.

[Adam Schaefer]

Don't they sometimes say estrogen dominance? Wouldn't that be the term?

[Dr. Lauren Fitzgerald]

No, we don't use that anymore.

[Adam Schaefer]

I know that, but that's what they would say.

[Dr. Lauren Fitzgerald]

Correct, Correct. But they're just not making enough progesterone.

[Adam Schaefer]

That's right. That's right.

[Dr. Lauren Fitzgerald]

So my PCOS patients oftentimes need a lot of progesterone and literally, like, it will change their life.

[Adam Schaefer]

Does progesterone help with insulin sensitivity, or is it the insulin sensitivity that helps progesterone, or is it both?

[Dr. Lauren Fitzgerald]

No, it's mainly thyroid and testosterone that help with your insulin sensitivity, so.

[Adam Schaefer]

And then build that muscle and that'll get that for sure. Yeah, that makes a big difference.

[Dr. Lauren Fitzgerald]

I wish we could require everyone to get DEXA scan so they could stay on top of their. Their muscle mass, their visceral fat.

[Adam Schaefer]

Are you looking at bone density for your female patients as well?

[Dr. Lauren Fitzgerald]

For sure, for sure. And literally, one of my staff members who's 25 already has osteopenia and that.

[Adam Schaefer]

Crazy.

[Dr. Lauren Fitzgerald]

Crazy. But it's reversible with hormones.

[Adam Schaefer]

Super.

[Dr. Lauren Fitzgerald]

Literally.

[Adam Schaefer]

Especially with strength training combination.

[Unknown]

Is that just because of how sedentary we become and how if you have.

[Adam Schaefer]

Weak muscles, you'll have weak bones?

[Dr. Lauren Fitzgerald]

I think it's. It's a combination of that and then just the fake food that we eat. I mean, the Franken food that's highly processed, like the analogy that I use. If you brought your car, your car, dude, if it's supposed to have diesel and you put regular gas in it, what happens?

[Unknown]

Yeah, right.

[Dr. Lauren Fitzgerald]

Was our body designed to be fueled on all of this fake crap? No, but.

[Adam Schaefer]

So talk about diet. What are one of the first things that you recommend for diet? Is it high protein? Is it whole natural foods protein?

[Dr. Lauren Fitzgerald]

Yeah, absolutely.

[Adam Schaefer]

So you're not afraid of protein? This was something that the medical community was kind of weird about for a little while.

[Dr. Lauren Fitzgerald]

No. Isn't that crazy?

[Adam Schaefer]

Yeah.

[Dr. Lauren Fitzgerald]

I mean, our ancestors literally like ate meat, eggs and dairy all the time, and yet everyone's scared. Especially here in California.

[Adam Schaefer]

Yeah. Yeah.

[Unknown]

And talk about how, how grossly under eating protein most people are, man.

[Dr. Lauren Fitzgerald]

I, I will literally, I make my patients track it for a week because I cannot tell you. I would say 95% of them, when they tell me, yeah, I eat a lot of protein, I'm like, track it for a week and come back to me. And all of them are like, I had no idea.

[Adam Schaefer]

40 grams, 50 grams a day.

[Unknown]

Yeah. What's wild about that statement to me is I had the same experience too. Just as all the years of training people. People is that these are the people that say they eat high. Right?

[Dr. Lauren Fitzgerald]

Totally.

[Unknown]

I mean, they, I mean, I can't tell you how many times I had some. Oh, yeah, I eat lots of me. I eat lots of protein. Really? Let's track, let's see. And it's like, I had cheese.

[Dr. Lauren Fitzgerald]

Yeah, yeah, exactly.

[Adam Schaefer]

That's literally what I've clients tell me that, oh my God, I have cheese on my salad.

[Unknown]

Well, and I think, you know, that's where it comes from. Like, if you're someone who's just like, oh, yeah, every day I eat meat. Or every, every, even every meal, you could say I eat a protein. It's still not enough. Not enough for most people. You're four ounces of, of meat. Three times a day is not enough for even the tiniest woman, protein wise. And so huge, huge component.

[Adam Schaefer]

How long does it take when you're working with someone? Typically, I know it's different from person to person, but when you first start with hormone replacement, there's a process of figuring out what the right levels are. Right. So you got to kind of start here. And then how long does that typically take? Like, do you give someone a number? Like, okay, within six months we'll start to figure this out.

[Dr. Lauren Fitzgerald]

So I actually, my hormone management program, it's a year because I tell them it's going to take a year to get your hormones off. Optimize. It's kind of like the hostess at a restaurant that tells you the wait time is an hour, but they know in their head it might only be 45 minutes. So it doesn't take a year for everyone. But I like to make sure that they understand nothing happens fast with hormones. And I have some people, so I have a hormone phone. So all my BHRT patients, a hormone phone. I carry two phones now. So my hormone phone, I love it because I will get text messages from patients like, like one had Sex with her husband for the first time in like three years.

[Adam Schaefer]

Oh my gosh.

[Dr. Lauren Fitzgerald]

Yeah, literally. I mean, like life changing and then some. So everyone's different. Everyone is their own unique snowflake when it comes to hormones and how long it's going to take. But this is why you can't go with just, just one of these kind of, you know, these hormone programs that are just kind of cut and dry. Exactly, exactly. Like you want to work with a professional that is talking to you.

[Unknown]

Which was, I imagine, though, I would imagine though most people start, start to see at least positive changes pretty quick. If you take any, if they're deficient in anything and you start tweaking, even if it's not the perfect optimal amount, they're already heading in a better direction. What they were heading.

[Dr. Lauren Fitzgerald]

I, I have seen zero patients that haven't told me that they're improved in some way at the first three month follow up.

[Adam Schaefer]

Yes.

[Dr. Lauren Fitzgerald]

So everyone has some sort of progress just three months in.

[Adam Schaefer]

Are you a start low, go slow, or how do you typically approach it? Like, let's start in the lower dose and start bumping up. Or does it depend on the hormone?

[Dr. Lauren Fitzgerald]

Well, with thyroid, so I have a little spiel that I talk. Because thyroid is like n, which is caffeine. Right. And I want them to experience how you feel when you have a triple espresso. But I can't start at that dose because they might be a little jittery, you know. So I'll start them at my single espresso dose for a few weeks, then I'll bump them up to my double espresso dose. And then in the second month they're at my triple espresso dose. And that tends to work for a large majority of people. And I will get their labs done at the three month mark to see where they're at. And then their numbers might correlate with optimization or they, they might say optimal numbers, but they still maybe have some afternoon fatigue or whatever, you know, so the numbers help. But ultimately I'm treating the symptoms.

[Adam Schaefer]

You had said, by the way, and this needs to be talked about. I think that when you take thyroid medication in the morning, take it with distilled water.

[Dr. Lauren Fitzgerald]

Correct? Correct.

[Adam Schaefer]

Don't take it with electrolytes, don't take it with. Now why is that?

[Dr. Lauren Fitzgerald]

So that is the one hormone that if you take it with anything else, it will actually bind to it and you won't absorb the whole dose. So I always tell my patients, have a cup of distilled water or reverse oh yeah, yeah, yeah.

[Adam Schaefer]

Electrolytes will bind.

[Dr. Lauren Fitzgerald]

You don't want minerals or electrolytes in it. So, so basically you have your cup of distilled water and take it first thing in the morning and then look at your clock and don't have anything for at least 30 minutes.

[Adam Schaefer]

Then you take it with another hormone.

[Dr. Lauren Fitzgerald]

No, has to be taken also solo.

[Adam Schaefer]

I didn't know that. So you can also bind with DHEA or something like that.

[Dr. Lauren Fitzgerald]

Correct, Correct. So I have my patients take DHEA in the same, the same time. Basically. Vitamin D3 and everyone should be on vitamin D3. K2. Are y'all all on D3?

[Adam Schaefer]

Yeah. Okay, why do you have the K2?

[Dr. Lauren Fitzgerald]

Well, so D3 needs adequate K2 and magnesium in the system to work. I actually don't put K2 with mine because I eat plenty of K2 rich foods, but a lot of people don't. So that's why you oftentimes see it together. So D3, K2 or D3 by itself, it needs to be taken with a food that has fat because both of those are fat soluble vitamins. So we saw a whole lot of people start taking vitamin D once Covid happened and literally their levels were zero. And I'm like, you're taking on an empty stomach, aren't you? How'd you know that it's fat soluble? Because you didn't read the back of the bottle. It says take with food, so you have to take it with food that has fat. And I like my patients for their vitamin D levels to be hundred or higher.

[Adam Schaefer]

Really? Wow, that's way high for what they would say you would need. What do they recommend? Like 40?

[Dr. Lauren Fitzgerald]

Again, normal is not optimal. I know normal is not optimal.

[Adam Schaefer]

Okay.

[Dr. Lauren Fitzgerald]

Vitamin, it's a hormone. It supports your immune system, it supports your body.

[Adam Schaefer]

Wait, say that again a lot. Know that vitamin D3 is a hormone.

[Dr. Lauren Fitzgerald]

It's a hormone. Absolutely, absolutely. And I don't care where they live in the United States. I have plenty of patients that are in sunny states that still have terrible.

[Adam Schaefer]

Vitamin D. So my dad, who's outside constantly working, constantly working, always outside, he was getting all these weird pain symptoms. His back was hurting, he was feeling stiff, couldn't figure out what the hell was going on. He's like, I'm just getting old, I have arthritis. It's not. His vitamin D levels were low.

[Dr. Lauren Fitzgerald]

Oh yeah.

[Adam Schaefer]

So, and, and, and the reason why they never, my dad never tested it is because he's, he's literally outside all the time now. We're dark skinned, but he's right.

[Dr. Lauren Fitzgerald]

But we lose our ability to convert vitamin D as we get older. So that's why I've just carte blanc told all my patients, you need to take vitamin D, bottom line.

[Adam Schaefer]

Wow.

[Dr. Lauren Fitzgerald]

Awesome. Most people need about 10,000 IUs a day. Some people need 15,000. Yeah, absolutely.

[Unknown]

I'm that way. I mean, I was. I remember when we first did the test, I was taking 5,000 a day consistently and I tested still super low.

[Dr. Lauren Fitzgerald]

I take 20,000 a day.

[Unknown]

Wow.

[Dr. Lauren Fitzgerald]

Wow. Yeah.

[Unknown]

And see, I didn't know I could bump.

[Dr. Lauren Fitzgerald]

I haven't been sick in a long time.

[Unknown]

Wow. I've been. I've been at 10,000. Maybe I'll bump a little because I was low at 5,000.

[Adam Schaefer]

Yeah. You were taking it regularly.

[Unknown]

Ye.

[Adam Schaefer]

Your levels came back.

[Dr. Lauren Fitzgerald]

There was this really smart doctor at this men conference that I went to a few weeks ago and he was actually talking about how he basically has his patients get to 150 or higher.

[Unknown]

Wow. I thought it was dangerous to have too high.

[Adam Schaefer]

If you go way high. Sure.

[Dr. Lauren Fitzgerald]

If you go way high and you have high calcium, that's the only time. And it's very rare that you see that. Oh, yeah. So I will tell you. A lot of people are told by their doctor, oh, that's dangerous. And they don't know what they're talking about. Like, I always tell people, patients ask your doctor to, to basically show you data to back that up and, and they'll realize like, they. I don't have. Right. Like there's this really well known menopause doctor online and she was literally, she's got a huge following and was telling terrible advice, basically that it's wrong and I'm not that person. That's controversial. That's in the comments. Like, you're wrong. But, but I will always tell patients, like, ask for proof, like, show me the data that says that. Because I follow this one chick online that says the opposite. And oftentimes they won't be able. Not oftentimes they won't be able to back that up.

[Adam Schaefer]

Wow. Wow. What is your. Your primary business? Is this still seeing private practice patients?

[Dr. Lauren Fitzgerald]

Yeah.

[Adam Schaefer]

Do you do anything else? Is it. Or is it just primarily that?

[Dr. Lauren Fitzgerald]

It's primarily that, yeah. Lorinmore Med, I have patients that are local and telemedicine. I've got a staff of 17, so I've got estheticians and massage therapists and I've got.

[Adam Schaefer]

So it's all wellness and all.

[Dr. Lauren Fitzgerald]

Absolutely, absolutely.

[Adam Schaefer]

Yeah.

[Dr. Lauren Fitzgerald]

We've got the aesthetic side, so I've Got some, you know, nurse practitioners that do the. The injectables, which, you know, I still got to keep that around, but it's mostly health and wellness now.

[Unknown]

Are you personally still thinking. Because I thought the last time I talked to you were, like, overwhelmed. Are you. Are you actually taking patients?

[Dr. Lauren Fitzgerald]

I am. I am. I'm booked out until March. Praise Jesus.

[Unknown]

Yeah.

[Dr. Lauren Fitzgerald]

Yeah.

[Adam Schaefer]

All right.

[Unknown]

Well, for a while.

[Adam Schaefer]

Well, we love. We love you. We love working with you.

[Dr. Lauren Fitzgerald]

Yeah.

[Adam Schaefer]

I appreciate you coming to the show.

[Dr. Lauren Fitzgerald]

And can we address my shirt, though?

[Adam Schaefer]

I literally made this shirt again.

[Unknown]

Oh, don't worry. It'll be in the comments. It'll make the comments.

[Adam Schaefer]

So what's that all about?

[Dr. Lauren Fitzgerald]

So we are doing a men's event in St. Charles, Illinois, at the end of January, and I got this idea from my friend Amy Stuttle, who owns Victory Men's health out of St. Louis. She had these little koozies at that men's conference that I said, make America hard again. And of course, like, I've always been about to make America healthy again. Before, it was actually a thing like, that's. You know, that's what we all strive for. Right? And when I saw that, I was like, that's amazing. So we're doing this. This conference at the end of January in St. Charles, and I was like, we should do that now. St. Charles, Illinois, it's, like, it's conservative, so it's gonna be rocking the boat. But I thought, you know, the Rosie, the Riveter. So. Do you realize that's my face on her? Like, oh, no.

[Adam Schaefer]

I didn't even know that. Oh, look at that.

[Dr. Lauren Fitzgerald]

Yes.

[Adam Schaefer]

Wow, you got. That's great.

[Dr. Lauren Fitzgerald]

I know. I know. I have a friend that's an artist, Madeline, who I was like, hey, this is the idea that I have. You know, I want something catchy. And, of course, you know, make America hard again. It's not just about making the penis hard again. It's about making muscles hard again. Because we are soft. And mentally, I mean, like, yeah, like, we need to become harder. Like, in the good way, harder. So. So. But, yeah, literally, my. My best friend, who. She's. She's a designer, she had this idea literally two days ago. She was like, we should get a T shirt made for the interview. And I'm like, so that's what I did on Sunday.

[Adam Schaefer]

Two days ago, Adam said, you got to see your shirt.

[Dr. Lauren Fitzgerald]

Y. I literally made it just for you.

[Unknown]

Oh, my God. You're on brand today.

[Dr. Lauren Fitzgerald]

Yes.

[Adam Schaefer]

Problem for Adam. Right.

[Dr. Lauren Fitzgerald]

I will send them to you for sure.

[Adam Schaefer]

Well.

[Unknown]

Do the best. Dr. We appreciate you. Thanks for coming.

[Dr. Lauren Fitzgerald]

I appreciate you all having me.

[Justin Andrews]

Thank you for listening to Mind Pump. If your goal is to build and shape your body, dramatically improve your health and energy and maximize your overall performance, check out our discounted RGB super bundle@mindpump media.com the RGB Super Bundle includes Maps, Anabolic Maps, Performance and Maps Aesthetic nine months of phased expert exercise programming designed by Sal, Adam and Justin to systematically transform the way your body looks, feels and performs with detailed workout blueprints and over 200 videos. The RGB Super Bundle is like having Sal, Adam and Justin as your own personal trainers, but at a fraction of the price. The RGB Super Bundle has a full 30 day money back guarantee and you can get it now plus other valuable free [e-mail] if you enjoy this show, please share the love by leaving us a five star rating and review on itunes and by introducing Mind Pump to your friends and family. We thank you for your support and until next time, this is Mind Pump.