2752: The Menopause Solution with Dr. Lauren Fitzgerald

Summary

Mind Pump Ep. 2752: The Menopause Solution with Dr. Lauren Fitzgerald

Date: December 18, 2025
Hosts: Sal Di Stefano, Adam Schafer, Justin Andrews, Doug Egge
Guest: Dr. Lauren Fitzgerald (@DrLaurenFitz)

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Episode Overview

This episode features Dr. Lauren Fitzgerald—one of the nation’s leading authorities on hormone optimization—taking a deep dive into menopause, perimenopause, and the real solutions for women seeking relief from hormonal changes. The conversation exposes common medical myths, clarifies the difference between bioidentical and synthetic hormones, addresses the stigma around hormone replacement therapy (HRT), and highlights strategies for individualized, science-based treatment. The hosts and Dr. Fitzgerald emphasize quality of life, debunking fears, and empowering listeners to take control of their hormonal health.
(Episode skips advertisements and non-content material; see below for detailed segments and quotes.)

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Key Discussion Points and Insights

1. FDA Lifts Black Box Warning for HRT (03:10–05:40)

• Background: The FDA has removed the longstanding black box warning on estrogen-based HRT, which initially stemmed from interpretations of the 2002 Women's Health Initiative study linking hormones to increased cancer risk.
• Dr. Fitzgerald contextualizes the origin and effects:

  “We have a generation of women that basically missed out on hormone replacement therapy because of misinterpretation of this data... Estrogen got the black box—‘It’s going to lead to cancer’—so now every woman is scared to death.” (03:34 – Dr. Fitzgerald)

• Cause: The risk was associated with synthetic progestins, not bioidentical progesterone or estrogen.
• Industry influences: Dr. Fitzgerald stresses the pharmaceutical motivations behind promoting patentable, non-bioidentical hormones.

2. Understanding Hormone Terms and Misconceptions (05:40–08:00)

• Bioidentical vs. Synthetic:

  “Bioidentical is what our body makes. Non-bioidentical, also known as synthetic, doesn’t match what the body makes.” (06:29 – Dr. Fitzgerald)

• Profit motive: Synthetics are manipulated for extended patents and profits, confusing both patients and providers.

3. Perimenopause and Divorce Correlations (09:08–10:51)

• Behavioral symptoms: Mood swings, irritability, and relationship strain during perimenopause are common and often misattributed.
• Marital impact:

  “All SW marriages could be saved if both are hormonally optimized.” (09:51 – Dr. Fitzgerald)

• Timing: Perimenopause usually begins in the 40s but can start in the mid-30s.

4. Individualized Hormone Replacement Therapy (HRT) Approaches (11:05–14:08)

• Progesterone’s effects: Improved sleep, mood stability, anxiety reduction, PMS, and lighter periods when properly dosed.

  “The dose of progesterone that is right for you is the one that helps you sleep well, takes away the moodiness... makes your period minimal to nothing.” (12:26 – Dr. Fitzgerald)

• Dosing: Varies widely (average 200–400mg), with PCOS patients possibly requiring much more.

5. Thyroid Health in Midlife Women (15:19–22:34)

• Thyroid is often neglected: Symptoms are frequently dismissed as “normal,” and common tests (TSH alone) are inadequate.

  “I've yet to meet a woman at midlife that doesn't have thyroid symptoms.” (16:11 – Dr. Fitzgerald)

• Approach: Dr. Fitzgerald uses free T3 as a key indicator, aiming for what would be labeled as “high” on standard labs, where most patients feel their best.

  “Your free T3 will probably be labeled high between 5 and 7. That’s typically where people feel their best.” (20:48 – Dr. Fitzgerald)

• Benefits: Increased energy, improved metabolism, better body composition, and reversal of insulin resistance.

6. Synergistic Effects of Hormones (23:09–27:10)

• Testosterone in women:

  “Testosterone in women is one of the most well-studied hormones... It literally changes your life as a woman.” (25:19 – Dr. Fitzgerald)

• Benefits: Enhanced sexual health, increased libido, better orgasms, improved vaginal lubrication, muscle mass, fat loss, motivation, and mood.
• DHEA: Used for anti-inflammatory effects and in managing autoimmunity.
• HRT is always comprehensive: Multiple hormones are balanced, not just one in isolation.

7. Overcoming Medical & Social Barriers (27:24–31:17)

• Resistance from other healthcare providers: Primary care often contests HRT protocols, but Dr. Fitzgerald sets clear expectations early with patients.
• Thyroid suppression fears: Suppressing TSH to zero is safe in the context of HRT, despite primary care misconceptions.
• Patient buy-in: Committing for at least a year is crucial due to the gradual nature of hormone optimization.

8. HRT Side Effects and Adaptation (34:13–36:36)

• Early side effects: Some women feel worse before better; time and tailored adjustment are necessary.
• Testosterone delivery: Dr. Fitzgerald prefers intravaginal/topical creams over injections for better physiological mimicry and sexual benefits.

  “It most closely mimics what our body was doing when we were hormonally optimized.” (34:57 – Dr. Fitzgerald)

9. Myths & Realities About Breast Cancer, HRT, and Men’s Health (37:13–40:16)

• Breast cancer fears:

  “Bioidentical hormones not only do not cause breast cancer, but they’re protective against breast cancer. Really.” (37:43 – Dr. Fitzgerald)

• Cancer and HRT: HRT is not advised during active breast cancer, but post-recovery it’s safe.
• Testosterone & prostate cancer in men: Risks only seem increased if testosterone is extremely low; otherwise, optimization may be protective.

10. Metabolic and Mental Health Effects (41:13–48:41)

• Lipids and insulin resistance: HRT typically lowers triglycerides and LDL, improves HDL over time, and enhances insulin sensitivity.
• SSRIs vs. HRT: Many women medicated for anxiety or depression would do better with hormone optimization.

  “The amount of people on some sort of psychiatric drug…would be significantly decreased…if we just addressed hormones, diet, and lifestyle.” (60:15 – Dr. Fitzgerald)

11. Weight Loss Medications and Future Trends (42:44–46:51)

• GLP-1 drugs (Ozempic, semaglutide, tirzepatide, retitrutide): Useful tools for weight loss and inflammation when used correctly, but reverse dieting and strength training are critical for preserving muscle.
• Bodybuilding community and experimentation: Advanced users often split dosages for optimal effects—sometimes ahead of official medical guidance.

12. Role of Lifestyle, Environmental Factors, and Medical Culture (49:15–56:08)

• Upward trend in hormone-related disorders: Attributed to environmental toxins, processed foods, and lifestyle changes, making HRT more necessity than luxury for modern women (and men).
• Generational decline in hormone levels: Sons now commonly have lower testosterone than their fathers, likely due to increased exposure to endocrine disruptors.

13. Integrating Hormone Therapy with Coaching, Training, and Mental Health (57:13–60:50)

• Calls for synergy: Combining HRT with coaching, fitness, nutrition, and even psychiatric care can provide holistic benefits.

  “If psychiatrists really understood that their patients don’t need all of these...pharmaceutical drugs...they really just need hormones, it would take a huge portion of pharma out of business.” (59:40 – Dr. Fitzgerald)

14. Patient Experience & Advocacy (41:35–61:57)

• Dr. Fitzgerald’s practice: Focuses on deep care, thoroughness, and transparency; patients are seen monthly, with annual commitment, ensuring changes have time to take effect.

  “We just really care…It’s not just a business, it’s a mission.” (41:44 – Dr. Fitzgerald)

• Community appreciation: Mind Pump listeners consistently return positive reviews after working with Dr. Fitzgerald.

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Notable Quotes & Memorable Moments

• On HRT fear:
  “Bioidentical hormones not only do not cause breast cancer, but they’re protective against breast cancer. Really.” (37:43 – Dr. Fitzgerald)

• On personal impact:
  “You don’t know how much better you’re gonna feel until you try it.” (51:59 – Dr. Fitzgerald)

• On SSRIs:
  “Do you understand how many people don’t need to be on SSRIs, they just need hormones optimized?” (58:11 – Dr. Fitzgerald)

• On societal change:
  “Men’s testosterone levels have been dropping for something like 50 years. This is well documented.” (52:59 – Sal Di Stefano)

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Essential Segment Timestamps

• 03:10 – FDA lifts black box on HRT; origins of the myth
• 05:40 – Bioidentical vs. synthetic hormones explained
• 09:08 – How perimenopause affects relationships, divorce rates
• 11:18 – Progesterone’s impact on symptoms and dosing
• 15:19 – The critical (and neglected) role of thyroid for women
• 23:27 – Testosterone & DHEA for women; synergies in HRT
• 27:24 – How Dr. Fitzgerald handles primary-care pushback
• 34:13 – Communicating realistic expectations and initial side effects
• 36:02 – Testosterone delivery methods and sexual benefits
• 37:43 – Deconstructing myths about hormones and cancer
• 41:13 – HRT’s effects on lipids and metabolic health
• 42:44 – Weight loss drugs: benefits, best practices, community hacks
• 49:15/56:08 – The environmental & lifestyle roots of low hormone epidemics
• 57:13 – Integrating HRT with health coaching, training, psychiatry
• 58:11 – The massive overuse of SSRIs in place of HRT

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Tone, Style, and Takeaways

This episode is conversational, candid, and lively—with a heavy emphasis on practical empowerment. Dr. Fitzgerald and the hosts blend cutting-edge science with straight talk, myth-busting, and a bit of humor, all directed at helping listeners and practitioners optimize hormonal health, especially for women navigating menopause.

Key Takeaways:

• Much of the fear around hormone therapy is based on misunderstood science and profit-driven distortions.
• Treatment must be individualized, comprehensive, and monitored over the long term.
• True hormone optimization requires patience and lifestyle commitment, not just medication.
• Integrating HRT into fitness, nutrition, and mental health coaching can be transformative—not just for symptoms, but for total quality of life.

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Guest Info:
Dr. Lauren Fitzgerald

• Instagram: @DrLaurenFitz
• Website: larimarmed.com

Mind Pump Hosts:

• @mindpumpmedia, @mindpumpsal, @mindpumpadam, @mindpumpjustin, @mindpumpdoug

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This summary captures the full arc of the interview and its actionable takeaways, serving as a reference for listeners and newcomers alike.

Transcript

[A]

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[B]

If you want to pump your body and expand your mind, there's only one place to go. Mind Pump Mind Pump. With your hosts Sal Destefano, Adam Schaefer.

[C]

And Justin Andrews, you just found the most downloaded fitness, health and entertainment podcast. This is mind pump. Today's episode the Menopause Solution with Dr. Lauren Fitzgerald. She's actually one of the nation's leading doctors when it comes to helping women through menopause. She's phenomenal with both men and women, but this is her my favorite topic to talk with her about. So we had her on the show and she gave some solutions. By the way, you can find her on Instagram @ Dr. Lauren Fitz. So that's D R L A U R E N F I T Z. You can also find her [e-mail] that's L A R I M A R M E D.com now this episode is brought to you by sponsor ZBiotics. This is a pre alcohol drink so you have it before you have your drinks. It makes a big difference in how you feel. It's there's no product like this, by the way out there. This is a probiotic that's been genetically modified to break down acetaldehyde. Nothing else does this. So if you like to drink a little bit but you don't want to feel like crap, go to zbiotics.com, that's zbiotics.com mindpump25 use the code mindpump25. Get 15% off if it's your first time purchasing. Also brand new program, maps 1540 plus. If you like maps 40 plus, this is the 15 minute version of it. Okay. So 15 minutes a day strength training. Get all the benefits of strength training except it's in a short time, very effective. And this is designed for people in that age group and it's 50% off because it's a brand new program. So if you're Interested, go to 1540/com. That's 1540/com. Use the code 1250 for the discount. All right, real.

[D]

Quick. If you love us like we love you, why not show it by.

[C]

Rocking one of our shirts, hats, mugs.

[D]

Or training gear [e-mail] I'm talking right now. Hit pause, head on over to my pumpstore.com. that's it. Enjoy the rest of the.

[C]

Show. Welcome back to the show, Dr.

[B]

Fitz. Thank you. It's good to be.

[C]

Back. You are a favorite of our fans. Fan favorite. I want to bring something up. I told you a little bit about this off air. Obviously you know about this, but I just read that they finally removed the black box warning on hormone replacement therapy medications for.

[B]

Women. They.

[C]

Did. So let's talk about this for a second. What was the black box warning? Why was it there? Why is it.

[B]

Gone? So the big C word, cancer. Everyone's scared of cancer, right? So, so the Women's Health Initiative that came out in 2002, it was, first of all, it was misinterpreted. And by the time they realized that it had been misinterpreted, it had already gotten out. So we have a generation of women that basically missed out on hormone replacement therapy because this misinterpretation of this data from the Women's Health Initiative basically saying that hormones are linked to cancer. And so estrogen got basically the label of black box. It's going to lead to cancer. So now every woman is scared to death of cancer. And for 20, almost five years, no one has been on hormone replacement therapy, even though there's so many benefits and decreasing risk of all of the bad stuff. So the FDA finally was like, all right, well, we were wrong because there's so much data that shows that it's actually protective and they finally took it away. Now, am I excited about that? No. Because I don't trust the FDA myself. I mean, truly, like, I haven't trusted them in a while. So it's, could this be moving in the right direction for us? Yes. But we're going to have to fight all of these 20 plus years of belief that Estrogen leads to.

[C]

Cancer. What was the misinterpretation? What did the data say that.

[B]

They. That. That there is an increased risk of breast cancer if you take hrt. So what they didn't realize or they didn't decipher was the difference, because actually, in the Women's Health Initiative, they used estrogen, which it's. It's not. Let's define bioidentical versus non bioidentical. Right? So bioidentical is what our body makes. Non bioidentical, also known as synthetic, doesn't match what the body makes. Right. So all of these women were on synthetics, estrogen or non bioidentical, but they were also on progestins. And they didn't realize that the actual progestins are the thing that increase your risk of breast cancer. So even though I'm not a huge fan of synthetic, non bioidentical estrogens, this is not what increases your risk of cancer. It's the progestins. And the progestins are in, like, birth control pills. And I mean, a.

[D]

Lot. I was just gonna ask you. It's so crazy that we've. We've pushed birth control pills for so long and never said. Never say anything, but then freak out if a woman takes a little bit testosterone or estrogen or.

[B]

Something. Correct? Correct. I mean, a true informed consent is not given to probably 99% of women that are started on birth control. I was not sexually active when I was started on birth control pills. No one told me that. Well, if you start taking this, it will increase your risk of cancer, breast cancer specifically, but other types of cancer increase your risk of clot, increase your risk of autoimmunity, increase your risk of all sorts of bad stuff. They just say, this is. It's gonna help your cramps, and that's it. It's a band.

[C]

Aid. Now, progestins, this isn't taking progesterone. These are essentially, they're taking progesterone and tweaking it in a way to create a new chemical that prevents.

[B]

Pregnancy. So let me. The way I like to teach it is you think of the word estrogen as an umbrella term, but under the umbrella, there's non bioidentical, and bioidentical. So in the progestogen world, progestogen is the umbrella term. You've got bioidentical, which is progesterone, and none non bioidentical, which are progestins. So I think they intentionally try and confuse us because big pharma can't make money off of the bioidentical. So they basically take a molecule like progesterone, tweak it just a bit, create a progestin, and now they can make a whole bunch of money. And then they start confusing the people and medical people as well. Like, I mean, I've been a doctor now for 20 years. I graduated.05 MD since, oh, five. And I literally just in the last maybe three or four years, truly understood the difference between bioidentical and non bioidentical. So they start trying to confuse you from day.

[C]

One. And if you use. So they can't make money off of bioidentical because of the way that the. I guess the class classification works with how you patent things. Correct. If it's naturally occurring, I can't patent.

[B]

It.

[C]

Correct. Okay. So in other words, if I make progesterone as a pharma company and it's naturally occurring, or it's identical to naturally occurring, another company could just sell the same thing. But if I tweak it, then I can patent it, and now I am protected against.

[B]

Competition.

[C]

Exactly. Is that the.

[B]

Deal?

[C]

Exactly. Okay. And now some of the tweaks that they put to them can be for, like, what, longer half life? More of this, more of that. This is what they're trying to create when they make these birth.

[B]

Control. So, like, let's take progestins, for example. So progestins, they connect to the progesterone receptor. They actually have a much higher affinity for those receptors. And. And so they will suppress your body's natural ovulation, but they won't give you all of the benefits. Like, let me use a perimenopausal woman, right? So a perimenopausal woman comes in and she's complaining a lot of the standard perimenopausal symptoms. I can't sleep. I want to throat punch my husband for no reason. Like, that's a common one. You laugh, but that is a common one to it. For number two, 100%, the struggle is real. So. So all of these symptoms that can be described as perimenopause come from a initial drop in progesterone. But if you have a woman that's on birth control pills, those progestins which don't match what the body makes are connected to these receptors, and you won't get any of the relief. So this is a common. Like, you come in, you get a birth control pill for your perimenopausal symptoms and they don't feel any better. It makes no sense. But these progestins are linked to increased risk of breast cancer, increased risk of clots, increased risk of all sorts of bad.

[C]

Stuff. Right. Because they don't have the natural checks and.

[B]

Balances.

[C]

Exactly.

[B]

Hormone.

[C]

Exactly. You brought up an interesting symptom of perimenopause, which I did not.

[D]

Know. So let's talk about this.

[B]

Guys. I mean, this is.

[C]

Real. This is very interesting because if you look at the data on divorce rates, there is a.

[B]

Spike. Oh, yeah.

[C]

Right. About when women start to go through perimenopause and.

[B]

Menopause.

[C]

Totally. And it's not often talked about. And this is this big hormonal change when suddenly you are. What? You start to just be more irritable? You're angry.

[D]

Whatever. I gotta think that's also exacerbated by. That's also the timing when your kids are probably getting out of the house and you're now having to reconnect to the man you.

[C]

Married. Well, typically it's in their mid to late 30s.

[B]

Right. So most women hit perimenopause in their 40s. It can start as early as mid 30s. But I've talked to plenty of hormone doctors that have been doing this way longer than I have, that all SW marriages could be saved if both are hormonally optimized. And women, you know, are. We're more menopause. But y' all go through hormonal changes too. We like full andropause. It's not quite as definitive as our menopause, but typically divorces happen in their 40s and 50s. And. And if both could just get hormonally optimized, I think a lot.

[D]

Of. Yeah, just imagine. Imagine you have. I mean, how many times do you see this? We know this. Watching friends that have gone through this. Maybe you even experienced it. When you start having kids, you tend to divide and conquer. You lose that connection to your wife. That's okay. But we're building this family. Then the kids often go. And it's like, now we have to focus on us and. Oh, my God. Didn't realize how much we didn't like each other. Hormonal issues are going on. It's just.

[C]

Like. And don't know.

[D]

It. Yeah, yeah, yeah. And then. Exactly. And then it's just like. I would imagine that has a lot to do with. With that.

[C]

Statistic. I wanted to go through the different hormones that tend to be involved with hormone replacement therapy and. What a woman. Okay. So I Want to be clear? It's typically a combination of things, right? We don't typically look at hormone replacement therapies like.

[B]

One.

[C]

Correct. Okay, but when you add one of these, what are the things that people typically experience? And let's start with progesterone. If a woman is now using progesterone, what is that going to. What could that do for her in terms of how she.

[B]

Feels? Changes your life. I mean, truly. So, unfortunately, women that have had a partial hysterectomy, so that means their uterus has been taken out, but their ovaries are left, those women have traditionally not been offered progesterone because when you start estrogen, if you have unopposed estrogen, you can have endometrial cancer. Well, you just took out the uterus, so I don't have to worry about endometrial cancer. So now you have a woman just given estrogen and told, well, you don't need progesterone. Well, what about, do I not want to protect my breasts and my ovaries and my bones and my brain and. I mean, progesterone has protective benefits for so many things. And the insomnia that hits us at midlife is very real. Progesterone is the solution. For most women that have insomnia, there's this. So you. You take your progesterone, it goes through your GI tract, it gets absorbed through the blood, it goes through the liver. First pass metabolite goes to the brain, and gives you all of the benefits of helping you sleep. And with your mood and anxiety.

[C]

100%. Okay? So it's relaxing. So people that I know that will take progesterone, they'll take it an hour before bed, and then it's like, bedtime. They're, like, ready to get some good.

[B]

Sleep. So in my perimenopausal women, I'll let them know the dose of progesterone that is right for you is the one that helps you sleep well, takes away the moodiness. You don't want to randomly throw up, punch your husband for no reason, takes away the anxiety, makes your PMS minimal to nothing, and it makes your period minimal to nothing. So everyone's.

[C]

Different. I was just going to ask that. How do you know the right.

[B]

Dose? Everyone is.

[C]

Different. And does it take time to.

[B]

Adjust? Absolutely. So in my program, I make patients commit to a full year because I know that it's going to take about a full year to find the doses that make you.

[C]

Optimized. Is that because when you first start taking It. You're more sensitive, and so you're like, I got to wait a little bit. Or is it just configuring.

[B]

It? No, not necessarily. I mean, hormones are just slow. And also, I always say hormones are bullets. They're not magic bullets. So if you have a patient that just gets on hormones but is not doing the diet, lifestyle, sleep, exercise, all the things, then there's. You're not going to feel optimized. So it has to be an entire.

[C]

Approach. On average. I don't know if it's okay for you to say this, but on average, what is a typical progesterone dose look like? And again, it varies, everybody. So what you're about to say could be very different.

[B]

From. Yeah, so when patients come to us already on some sort of hormone replacement therapy, it's kind of like a cookie cutter. Everyone is just started on 100 milligrams of progesterone and estradiol patch, and they're still feeling terrible. So, personally, I don't use estradiol in a woman in perimenopause because that's the last hormone for the ovaries to stop making. And so when you give estradiol to a woman that is still making estradiol from her ovaries, she can get the five Bs. So the five Bs of too much estradiol are bleeding, bloating, breast tenderness, blemishes, and.

[C]

Bitchiness. That sounds.

[B]

Awesome. Literally, when I list all of those, and they're like, oh, my gosh, yes. I'm like, so we're gonna take you? Yeah, we're gonna take. So I take my perimenopausal women off of that estradiol patch that they're almost always given, and then I minimum start them at 200 milligrams. But I also, I like to go through. Are they PCOS or not? So if they are perimenopausal and pcos, often they need way more progesterone than a woman without.

[C]

Pcos. Okay. And then typically, where does the dose of progesterone fall after a year for some.

[B]

Women? I mean, I have someone that needs as much as 1200 milligrams. Now, that's not average. The average perimenopausal woman needs somewhere between 2 and.

[C]

400. Okay. So that's on.

[B]

Average.

[C]

Yeah. Okay. So progesterone calms you down, less anxiety, get good sleep, rest. Are there any aesthetic changes from progesterone or is it more of a.

[B]

Feeling? So there are some that can have a little bit of water retention in the initial three to six months. But we know that progestins, not progesterone, but progestins actually can cause weight gain. So it's not just water weight. It actually can cause fat gain as well. Progesterone can't. You can't have a little bit of water retention with progesterone until you adjust.

[D]

Yeah. How much does thyroid play a role in all.

[C]

This? That's a good question. So let's start with the next hormone. Yes, let's go with thyroid. What does thyroid do? What do people feel from.

[D]

That? What do they expect.

[B]

From. So it's funny because this past weekend I taught at a hormone course, and Saturday morning I taught on progesterone. Saturday afternoon, I taught on thyroid. And I'm one that I talk fast. And when I listen to lectures, I listen to them at 2x. And so literally, the person that was the instructor or the person that's over us kept saying, like, slow down. And when I got to thyroid, like, I'm hormonally optimized with thyroid, and I think that that's why I talk fast. It's my favorite hormone, and it's the one that it's almost never utilized by hormone replacement doctors that they will. They will, you know, prescribe the 100 milligrams of progesterone, the estradiol patch, and then send you on your way.

[C]

Right.

[B]

Okay. So thyroid is my favorite because it. I've yet to meet a woman at midlife that doesn't have thyroid symptoms. Right. And what will happen is they'll listen to a doctor like me online and they'll go to their primary care doctor or their ob GYN and be like.

[D]

He. Yeah, you're fine.

[B]

Too. Well, yeah, no, exactly. They'll be like, I have a lot of these symptoms. Can you check my thyroid? And what they do is they just test tsh, Right? So TSH stands for thyroid stimulating hormone. So it's a hormone that our pituitary makes. The way I like to explain it, it's like a text message that goes from your brain to your thyroid gland that says, hey, make more thyroid hormone. Okay. So the TSH has been traditionally the only lab that primary care doctors or gyns or endocrinologists will use to tell you if you have thyroid issues or.

[D]

Not. That is so interesting. That just part where the brain's telling you, because if you're not up regulating it or you're not absorbing it or your body's not like, there could be a whole host of things, I.

[C]

Would imagine, that would change that to their defense. Right. It can be a pretty strong correlate. In other words, if it's low or high, it can give us some.

[B]

Information. It can give us some information on true hypothyroidism. But there are tons of studies that show that the level of symptoms that a patient has does not correlate with.

[D]

Th. What else, Sal? Where else. What else would we measure like that? Where the signal from the brain is what we're going to determine if you're at optimal rates, Wouldn't we normally. What.

[B]

Else?

[D]

Exactly. Everything else we would measure by natural.

[B]

Hormone. But see, this is a fun fact. And I don't think most medical doctors even know this, much less the lay person. So every kind of doctor. So I used to be an anesthesiologist, so I was a member of the asa, the American Society of Anesthesiologists. Right. So each specialty has their own society, and these societies come out with these guidelines every about seven to 10 years. Okay. So these guidelines, you would think would be based on the most recent literature and the highest quality of research. Right. So like a randomized control trial, that's like grade A versus grade D, which is just someone's opinion or just a retrospective look at the literature. So it's not what it is. It's a group of physicians that are, you know, elected, you know, high ups in that society that sit around and decide, well, these are our guidelines. Now, are these people influenced by big Pharma? Absolutely. So it is not the most recent data and the best quality data.

[C]

Right.

[B]

Wow. So when I found that out, I was like, how is this even legal? Right, Right. But so the Thyroid Society and Endocrinology Society, they have always said the guidelines are to only measure tsh, even though there's tons of high quality research that show that TSH really doesn't correlate to how well the patient feels. It's the free T3, and that's what's happening ins side of the cell. But they say free T3 is not a good test to, to use, even though it's.

[D]

100%. I was just saying something would be.

[B]

Better. Absolutely, absolutely. So when I look at labs, I'll let patients know, like, look, if you go to your primary care doctor, they're only going to look at TSH, maybe free T4, but they will not look at free T3. And this is actually the number that I care about the most because the lower it is, the More likelihood that you're going to say yes to a lot of these low thyroid symptoms. And so I will list them. There's 10 of them. And I'll be like, I want to know how many of these do you relate with? And they'll be like, oh, my gosh, you know, at least half or sometimes it's like all of them. Even though they've just been told your thyroid is.

[C]

Normal. And what are those.

[B]

Symptoms? So weight gain or difficulty losing weight, cold intolerance, which is pretty much only in females. I've yet to meet a man. I mean, it's rare that men will be like, oh, I'm cold all the time. But it's typically a woman thing. Brain fog, difficulty lose or difficulty recalling names, words or numbers. Low energy, dry skin, brittle nails, constipation, depressed mood, overall lethargy. Oh, and hair.

[C]

Loss. So somebody goes on thyroid. You, you put them on thyroid. I'm assuming you're using like armour, which is what, T3.

[B]

T4. So that's a brand name of natural desiccated thyroid. Right. So armor is a brand name. MP Thyroid is a brand name. I like to just use a high quality compounded natural desiccated thyroid. This is actually what the FDA is trying to take away from us right now. So we have a year to fight that, because if they take that away, then we will not have a good natural desiccated thyroid hormone to prescribe. What we have to use synthetic T3 and synthetic.

[C]

T4. And you'll have to figure out whatever the.

[B]

Ratio. Exactly.

[D]

Exactly. Now, is thyroid also like, is it, is it the way people respond to it individually? Similar to, like with testosterone, like, for example, for a male, you know, 400 to 1100, this huge range, some men feel totally fine at 600, other men feel not good at all. And they need to be closer to.

[B]

1100.

[D]

Exactly. And so thyroid is, that's the.

[B]

Whole point in, in optimized health is I'm going to find the dose that makes all of those symptoms go away. So typically. And I'll let them understand, like at the beginning of each new patient consult, I'll be like, look, we're going to look at your labs and we're going to talk about how your normal labs are not optimal labs. And if you let me take over the management of your hormones, you'll find that this time next year, all of them will be labeled abnormal. And that's typically where people feel their best. So, like, when we're talking about thyroid, I'll let them know, look, your free T3 will probably be labeled high between about 5 and 7. Now, here's the thing. Your primary care, they don't TE or they don't check the free T3, but what they will check is your TSH. And your TSH will be suppressed to zero. And I explained. So if you're gonna take exogenous, meaning outside of the body, thyroid hormone, it's gonna go through the GI tract, get absorbed through the blood, go to that center of the brain, the hypothalamus, and the pituitary, and they're gonna be like, hey, we have enough thyroid hormone, so we don't need to send that text message to the thyroid gland TSH to say, make more thyroid. So of course it's gonna be zero. Same way with a woman who's on birth control pills. Their LH and FSH are gonna be zero because it's being suppressed. We don't care about that. And then actually, people that have a history of thyroid cancer, we intentionally suppress the TSH to 0 forever, so we know it's safe. And in fact, one of my most recent patients, she's 38, history of thyroid cancer, she's been working with an endocrinologist forever. Just at her three month appointment, I was able to suppress her TSH to zero. And she was like, I've never felt this great. And the endocrinologist couldn't even do.

[C]

This. So they take thyroid, and you get them in these ranges, they don't feel the lethargy, they feel sharper, they feel amazing. And I've heard thyroid is being referred to as one of the aesthetic hormones. What else happens with them when they take your.

[B]

Body? Composition totally changed. Absolutely. So the underlying root cause of so many problems is insulin resistance. Right. So when you think insulin resistance, you need to think about visceral fat. Right. I wish that we could require everyone to get a DEXA scan so that you can see exactly where you're at with visceral fat. Exactly. Because the more visceral fat you have, the more likelihood that you have insulin resistance and all of the hormonal issues that come along with insulin resistance. Right. So if you have a lot of visceral fat and you're metabolically busted, thyroid hormone is going to be key in helping reverse.

[C]

That. Yeah. So people go on thyroid, they get more energy and they get.

[B]

Leaner.

[C]

Absolutely. I notice. So I take thyroid. I take a little bit of thyroid. I noticed. Yeah, I do. In the morning. I take all. I. I know. I. I know he feels cold. Yeah. No, I taking the. I noticed with thyroid, it made my other hormone replacement therapy work better. Seem to have a synergistic effect with the testosterone. So which, which is quite.

[B]

Interesting. Yeah. When I have male patients, I'll. I'll let them know, like, look, typically men are one of two stereotypes. You're either just wanting me to help you with your testosterone or you're going to let me get all of your hormones optimized. And when I say that, I think it gives them a sense of like, okay, I have some control. Right. And they'll be like, well, yeah, let's do all of the hormones. So typically, if I have a man, that's like, let's do all of them. It's thyroid, testosterone and.

[C]

Dhea.

[B]

Yeah.

[C]

Awesome. Okay, so we talked about progesterone, we talked about thyroid. Let's talk about testosterone for women. What does that look like for women when they start taking testosterone and is there a wide variance with that as.

[B]

Well? It changes everything. Okay, so first of all, can I address the word.

[C]

Overdose?

[B]

Yeah. Okay. Because being a former anesthesiologist, when I hear overdose, that's.

[C]

Death. For anesthesiology, 100%. Absolutely. You overdose any blood anesthesia.

[B]

Legit. Like, I remember my very first day in residency. Dr. Gracowski was teaching me. We had an insulin patient or a type 1 diabetic, and it was a long case and so we had to give him insulin. And I remember she scared the poo out of me because she's like, you can kill a patient if you do this wrong. Because if you give too much insulin, you can literally kill them. Right. So that's an overdose. Right. Or fentanyl. You know, we use fentanyl as anesthesiologists all the time. If you give them too much narcotic and you are not controlling their airway, that overdose can kill them. Right. With our sex hormones, you can't kill someone. So if I overshoot your testosterone, I'm not going to kill you. And in fact, testosterone in women is one of the most well studied hormones. We have, 30 years plus of women that want to be men on really high dose of testosterone. And we know how safe, like insane levels of testosterone. Absolutely. So I know that roughly the range of where all of the women will feel their best, it's totally going to be labeled too high. And if they go to their primary care doctor and get it measured, their primary care doctor is going to scare them, telling them all of the misinformation that, oh, you're going to Get a clot, you're going to get cancer. And all of the dumb stuff that I hear associated with just hormone replacement therapy and especially testosterone in women, but it literally changed your life as a.

[C]

Woman. I mean, what do they.

[B]

Notice? Sexual benefits are literally like again, it changes everything in the bedroom. So when I talk about testosterone, when it is fully optimized in a female, you have sexual and non sexual benefits. Right. So it will increase your libido, it will help easier orgasms and better quality orgasms. It helps improve vaginal lubrication, which obviously helps everything in the bedroom, but also prevents UTIs because dry vaginas lead to UTIs that lead to sepsis, that lead to death. Right. And then the non sexual benefits. I mean your performance in the gym. Yeah, absolutely. I mean literally, I've been on testosterone now for two years and people comment about my arms. This is like new for me. It's literally the, the muscle mass is crazy. Your performance in the gym, it will help decrease both subcutaneous and visceral fat. So if muscle mass is going up, fat mass is going down. Percent body fat goes down. So composition changes. Right. We have testosterone receptors in the brain. So it'll give you better mood, better more motivation, more vigor. I mean you feel like superwoman when your testosterone is.

[C]

Optimized. I like to think of testosterone as like a dope. It's not, but like as a dopamine type hormone, type of drive.

[B]

Motivate.

[C]

Yes. You know, I can do this.

[B]

Thing.

[C]

Yes. Type of deal. And people typically feel really good on.

[B]

It.

[C]

Absolutely. In combination with thyroid, that's your aesthetic combo. That's for visual.

[B]

Changes.

[C]

Correct. Those two make the biggest.

[B]

Ones. Correct. But with women, it's men. I can literally. And all of my patients, I require them to lift weights anyway. But men, if they just got on hormones and didn't lift weights, they could still see body comp changes. We women have to put the work in. If we really want to change our body, it has to be in.

[C]

Combination. Yeah. You mentioned dhea. Now that's over the counter. So why use that? Why would anybody use DHEA in this? Hormone.

[B]

Therapy? Yeah, DHEA has some great benefits too. It's a great anti inflammatory. So we're all in our 40s and this is the, the, the decade where people start to complain about the aches and pains of getting older. Right. That typically when you get that in optimal range, it will typically take that away because it's such a strong anti inflammatory and in fact there's a lot of autoimmune patients that will aim for even higher levels of dhea, because it helps suppress the inflammation that comes along with.

[C]

It. I think. You know, when I think hormone replacement therapy, I think the word. The important word in this is therapy, because you're looking at a combination of hormones. You're looking at how the person's symptoms resolve, how they feel, and then you're looking at the hormones in relation to each.

[B]

Other.

[C]

Correct. Because, you know, I noticed for myself because of my testosterone replacement therapy, taking a little DHEA makes me feel better. And I don't think it's because I was low in dhea, but rather its relationship to my current levels of testosterone. And so you're looking at all these things when you're working with a.

[B]

Patient.

[C]

Absolutely. Are women generally harder to.

[B]

Treat? Oh.

[C]

Yes.

[B]

Okay. I mean, there's some days I'm like, I wish I could just treat men. Y' all are so much easier. Yeah.

[D]

Exactly. Two levers.

[C]

Really. Yep. Well.

[D]

How. How often do you have to. So we've obviously, we've all personally, I think, personally have sent a lot of family, friends your way and that you've helped out. If any of them ever come back to me, like, questioning or concerned, it's always because they're still speaking to their other practitioners, and they're always like, you know, Dr. Lauren's telling me this, but then I'm my doctor saying, this is crazy, and this is this, and I'm just like, oh, my God. I'm like. I'm like, stop it. Like, go. I sent you to her to listen to her. Like, you. You got to ignore that because this is why you're with her. It's like, it hasn't worked for years. Seeing your regular physician, how often are you having that.

[B]

Conversation? I've. I've become more intentional at that initial appointment to let them know. If you're going to let me take over the management of your hormones, these are going to be the areas that your primary care doctor is going to put you in an awkward position. And with all due respect, your primary care doctor is a specialty. He specializes in primary care and not in hormones. If he did, you wouldn't be in front of me. Right. So let me manage your hormones. Let them manage your primary care needs. And so, like, specifically thyroid. That's probably the one.

[D]

Thing. Number.

[B]

One. It's so annoying. So I will let them know your TSH will be 0.0. That is almost 100% of patients. That's where they feel their best. It's completely safe but this will freak out your primary care doctor tell you that you have hyperthyroidism, and then you'll be like, no, I'm taking thyroid. Oh, well, then you're being overdosed. No, you're not. You're being optimized. But they, unfortunately, they're not trained in hormones. Like, that's not their specialty. So they're associating the bad side effects of graves, which is an autoimmune hyperthyroid state, with being given the high dose of.

[C]

Thyroid. Yeah, so because in graves, that's when you see TSH at zero. Right, but that's a symptom of this. This autoimmune.

[B]

Issue. Exactly. So when you take a person's thyroid out that has GRAVES disease, you still get the bad side effects of thyroid that can lead to cardiac issues and all of the bad things. So they assume that because I'm giving them levels that will suppress their TSH to the same as if it were graves, that it's the same outcome. And there's not a single study that shows that.

[C]

That. Do you work with growth hormone? What about growth hormone.

[B]

Therapy? Yeah, growth hormone is. So. It's a great hormone. It typically is done in our brain by the time we're 50s. So it, like replacing growth hormone is typically something that I only do with patients that are in their 50s and beyond. If. If I'm working with someone in their 30s or 40s and I want to induce their own natural growth hormone production, I'll use some peptides, like tesamorelin or something like.

[C]

That. Yeah. How much is, though has. Have peptides now been played a role in your.

[B]

Practice? It's definitely becoming more of a role. I mean, they. The way I like to explain it, hormones are bullets. Peptides or bbs, both can do a lot of great. But let's get your hormones optimized first before we play around with.

[D]

Peptides. Yeah, that's a cool way to give that. I've always tried to explain it because people are always asking me, like, what I think about peptides. And like. Because obviously it's popular right now. Everybody's seen it on the Internet and yep, everybody knows that I have access to it. So they're like sitting. What do I need to do is like, listen, let's first get the diet and work me out first. And let's go get your blood work. Let's see where your hormones are, and then I can tell you what peptides it take. They are awesome, but, like, it's not the big.

[B]

Rocks. No, no, do do the other.

[D]

Stuff first and then, then it makes a big.

[B]

Deal. Absolutely. Yeah.

[C]

Absolutely. Is it an issue if somebody has, let's say, unhealthy lifestyle, they don't eat great, they're, they're not exercising, so they're sedentary, overweight, and they want to get on hormone replacement therapy. Is that not a good idea to put the push hormones up to a level when the person is inflamed and unhealthy, or is that just.

[B]

Suboptimal? It's just suboptimal. I mean, oftentimes getting them started on hormones will push them to be motivated.

[C]

Absolutely. Because they feel.

[B]

Better. Absolutely.

[C]

Yeah. And that's a big part of your practice too, is encouraging. Let me ask you this as a doctor. Yes, I'm gonna guess. But I can imagine getting someone to take their hormones is probably a lot easier than getting someone to consistently exercise and eat right all day, every.

[B]

Day. Y' all know.

[C]

That. Yeah.

[B]

So. Yes. But I also, I mean, we don't take health insurance, so it's a cash pay. And I.

[C]

Make. Oh, you got a little bit of a.

[B]

Bias. 100%. And I make them pay for the full year because I know specifically women just being in the health and fitness world for so long, I know that they're not gonna feel amazing by three months in and maybe not even six months in. So I need them to buy in for the full year because nothing happens fast with hormones.

[D]

Right. It's so good you do that. Cause that's the other conversation that I've had. Is that like, yeah, I've been doing everything she's saying. It's like, it's been three months, like, keep going, keep going. It takes time to reverse a lot of.

[B]

This. I literally have only had one patient at the 9 month appointment because I see them every 3 months. Right. I've only had one patient at the 9month appointment that was not feeling amazing. And I think other things are going on with her, but that's neither here nor.

[C]

There. So I'm so, so this is so great because you're speaking coach talk now because as a trainer, what's really important when you work with someone that you forecast accurately and let them know here's what to expect. Because when they have different expectations, then it's hard to kind of back to. So you're telling them like, look, it's going to take us a year totally to figure this.

[B]

Out. I mean, these were back from my beachbody coaching.

[C]

Days. All.

[B]

Right. I mean, all jokes aside, though, literally, I Mean, I did, you know, health coach for quite a while. And so my experience with that, I just know how we want instant gratification and we're so easy to quit if we don't see changes in the first three months. So I'm like, nope, you're bought in for the full year. So. And they also know that I will fire them. So, I mean, I, I'm very clear about that from day one. Like, if you don't do what I ask you to do, I will fire you because I don't want your bad outcome to make me look.

[C]

Bad. Right, right. Any initial side effects from hormone replacement therapy that you communicate like, hey, when you start on progesterone, you might feel lethargic at first or when you start.

[B]

Testosterone. Oh, yeah. Oh, yeah. And. And some people feel worse before they feel.

[D]

Better. That's. That's part of that three months. I feel, I don't feel better. I feel like I'm worse than I was. I was like, yeah, that's. You're changing, you're transitioning right now from exactly what's going on right now. Stay the.

[B]

Course. This is where women are more challenging than you.

[C]

Men. Now let's talk about the way that you. Because you are a huge proponent of how you advocate for testosterone to be applied. So let's talk about that. Because the traditional way of using testosterone is a once a week intramuscular injection. You like to use creams intra vaginal or.

[B]

Vaginal?

[C]

Absolutely. Why is.

[B]

That? So it most closely mimics what our body was doing when we were hormonally optimized. So when you're 19 or 20 years old, your testosterone peaks and troughs every 24 hours. So that's why I like. And it's easier for, I mean, I can get really high levels with that cream. So I, I give patients the options. Right. There's multiple ways that I can give you testosterone pellets. I'm. Pellets are my least favorite.

[C]

Because. Because of the exact.

[B]

Slow. You feel great in that first month. And then month two, month three, month four, you're feeling not so great. So I want you to feel great every day. Right. And when I first started testosterone, I was doing the once a week IM injection. So I, I can speak from my own personal experience. But then also now seeing so many patients taking them from the injections to daily cream, and I let them know, like, if you are not feeling great by, you know, three, six months in, we can always go back to injections. And that never.

[C]

Happens. Is. Are There in. This is probably speculative, but are there receptors on the vagina that would make it so that when you use it vaginally that there's more.

[B]

Sexual.

[C]

Absolutely.

[B]

Benefits. It happens all the.

[C]

Time. So it increases sensitivity now to the areas that you're.

[B]

Interesting. Yes. I mean, women that are looking for a help in libido that, like, I've been on testosterone. My libido is crap. Like, just wait, I got you.

[C]

Girl. Put it on here. The reason why I'm saying that is because I actually saw some places promoting, like libido enhancing creams that had some testosterone in them, but also had tadalafil, I think was. Which is, I believe, a PDE5 inhibitor. And there was. It was vaginal. I'm like, wait, testosterone on the. Like, I wonder if there's an increased improvement in sensitivity because you're applying.

[B]

It. Absolutely, Absolutely. I will tell my women that are still menstruating, literally put it on your finger and literally stick it up your hoo. Ha. Like a tampon. If you're bleeding, then put it on your labia. But literally, I mean, it's life changing in the.

[D]

Bedroom. Isn't the Tadafil or whatever, Isn't that like.

[B]

Viagra?

[C]

Yep. Yeah, that.

[D]

Is. Okay. So basically they're putting testosterone and.

[B]

Viagra on which just the mechanism of action. Exactly. Increases blood flow. So. So blood flow down there is effective for both men and.

[C]

Women. Yeah. Interesting. What are some of the. So what are some of the big myths you still have to overcome or conversations? I feel like people are so much more aware now around hormone replacement.

[B]

Therapy.

[C]

True. Where it's not so taboo, but what are the big myths out there that when you go do these conferences and you're talking about this, what are the things that people want you to speak.

[B]

About? The breast cancer thing always comes up. I mean, because you hear hormones and you automatically think breast cancer. Because we've been brainwashed over the last 20, 25 years that hormones cause breast cancer. So I always have to break that down. And the literature is very clear that bioidentical hormones not only do not cause breast cancer, but they're protective against breast.

[C]

Cancer.

[B]

Really? Absolutely. Think about it. The women in their menstruating years don't get breast cancer for the most part. It's typically women that are postmenopausal. Right. If the natural hormones that our body was making would increase your risk of breast cancer, we would see it way more in menstruating.

[D]

Women. So it's similar, wouldn't you say? It's similar with men and testosterone. That's still the stigma around men taking testosterone increased cancer risk. And it's just like, no, if you're an unhealthy, low testosterone male, you're at a higher risk than someone who's at optimized.

[C]

Hormones. Well, I also think there's my, you know, there's. It may come from here as well, where when you. If you had breast cancer or you're treating breast cancer, they block suck.

[B]

Estrogen. Oh.

[C]

Yeah. At the receptor. Because in that situation, hormones can drive cancer growth once you have.

[D]

Cancer. Yeah. But won't anything grow? Drive that? Yes, grow it once. It's like at that point. So you can make that.

[B]

Case. So. So here's the thing. I will not take a patient who's in the middle of breast cancer, but after she's over that, she a hundred percent is safe to do hormones. The book that I always recommend, it's called Estrogen Matters. It is written by an oncologist and wife is a breast cancer survivor. And so he dispels all of these myths that, oh, you have a history of breast cancer. You can't do hrt. That's just a lie. And he goes through it. It's a great book, and it's written for someone that's not medical. So I always send patients to that, because that's the biggest fear. I mean, even one of my own staff, she has a history of breast cancer, and I cannot for the life of me convince her that these hormones are not going to increase because it's.

[C]

Scary. Yeah, well, some. When you have cancer, some of them are hormone sensitive. This is while you have the.

[B]

Tumor.

[C]

Right. So for men, I'll just use a man example. For men, if the man has prostate cancer, taking testosterone may speed up.

[B]

Its growth, but only if their total testosterone is less than.

[C]

250. Got.

[B]

It.

[C]

Okay.

[B]

Okay. So would I take on someone as a patient in the middle of cancer? If it was my dad, I would 100% start him on testosterone. But if it's someone that consumed me and this is. Unfortunately, this is the life that we live in. Yeah. They'll teach us. If it's you and your own, you can do this. But if it's. If it's just a, you know, a patient that's not connected to you that can come back and sue you, then don't do.

[D]

It. Back up for me there. So if you. If you had to start a testicular cancer and you were lower than 250 and it was your dad, we're saying we're not. So you're not getting in trouble here. You would still.

[B]

Take.

[C]

Absolutely.

[B]

Wow.

[D]

Absolutely.

[B]

Wow.

[D]

Yeah. Okay.

[C]

Interesting. What do you see when. With hormone replacement therapy and other measurements, like blood lipid levels, you know, signs of insulin resistance, stuff like that. What do you. Do you see any.

[B]

Changes? Yeah, absolutely. We check lipid panel once a year. The two numbers that I care most about are your good cholesterol, your hdl, and your triglycerides. The triglycerides are almost always decreased in that first year. We see a pattern of. In the first year, typically a drop in hdl, and then it bounces back in year two. But overall, LDL is almost always decreased. And more importantly, the lp, which they say it's just genetic and there's nothing you can do. There was a drug that I think just went through phase three trials in the recent past. I'm sure it's super expensive, that can apparently lower lp, but guess what? Testosterone can just lower lp. So one of my patients dropped her lp in just one year from 300 to.

[C]

200.

[B]

Wow.

[C]

Yeah. Wow. And what about insulin.

[B]

Sensitivity? Oh, thyroid and testosterone.

[C]

Baby.

[B]

Yeah. I mean.

[C]

Yes. And you see a big change.

[B]

There? Absolutely, absolutely. Their homa IR and their fasting insulin almost always do decrease in the first.

[C]

Year. That's right. Tell me a little bit about your practice, because people, we get, you know, people go to you who've listened to the show, and they just come back and they just love you. And I think they love you. You do a good.

[B]

Job. Thank.

[C]

You. But I think they love you because, you guys, they seem to feel like they're really cared about. So tell. Tell us a little bit about your practice and what do you do that's different? Like, what's going.

[B]

On? I mean, I don't. I don't know what we do that's different. We just really care. I mean, I really, like, I'm in my purpose, and I've got amazing staff that really care. We all understand that it's not just a business, it's a mission. And we have the tools to help people literally change their lives. And so, I mean, you know, I. When you come in, whether it's to be hormone patient or maybe a weight loss patient or maybe just do functional medicine, there's always this initial evaluation. We'll look at labs, we'll talk about your options. But just like with my weight loss program, we see you once a month. I don't want you to become that, you know, ozempic face. Ozempic butt person that loses 30 pounds in 30 days and you've lost 15 pounds of muscle. Like, I'm not gonna do that. So would it. Would I make more money if I didn't see them once a month? Absolutely. And just recently, one of my staff members was like, can we. Do we have to see them once a month? Yes, we.

[D]

Do. Talk to me a little bit about. Because obviously GLP1s are huge.

[B]

Now.

[D]

Huge. Give me some ideas, like, how patients are you seeing on it? What are you. What are you noticing? What are the.

[B]

Challenges? Like, I. I think they are incredible tools when used appropriately. And I have a lot of my patients that have reached their ideal body weight and they come off of it and they're like, can I just get back on a small dose for the inflammatory benefits? So I will literally have patients that cycle on and off a very small dose of GLP1s. Six months on, three months off, six months on, six months.

[C]

Off. Do you, like. Do you have a preference over semaglutide versus.

[B]

Tirzepatide? I. I mean, you know, iPhone 14 versus iPhone.

[C]

15.

[B]

Yeah. Right. I mean, they're both great, but iPhone 15 does it better than 14, you know, and then Retitrue Tide, which has the three mechanisms of action, is even.

[C]

Better. Are we using that already or is that still ish?

[D]

Okay. Okay. Yeah, soon to.

[B]

Be.

[D]

Yes. That's the one that is crazy. That one just.

[C]

The. That's the one that the.

[D]

Body. I can't wrap my brain around the science on how it's possible to. To gain muscle and lose body at the same.

[B]

Time. It is happening with raditry.

[C]

Diet. That's the one that's taken the bodybuilding world by.

[B]

Storm.

[D]

Exactly. Has anybody reported, like, any changes in addictive.

[B]

Behavior? Oh, 100%. I mean, it is. It's going to be used off label in so many different patients. I mean, I think last time I was here, I might have told y' all about my patient that had the addiction to the nicotine gum. And she literally. She wasn't a smoker. She just started it because she heard nicotine gum was good on a podcast and literally had this, like, crazy addiction. She was losing, like, a lot of money every month because she was so addicted to it. And semaglutide broken. She was like, I don't care if I don't lose weight. This was 100% worth every single penny that I paid for it. Yeah, I know those. Those areas in the brain.

[D]

Now. Talk about the challenges, though, because we. I Mean this. We obviously take a lot of live callers. We have written a program for GLP1. So we ran a group that you've talked to. The thing that I see, probably the most common is someone like who's been on a GLP1 for like a year. And let's say they had like a 100 pound plus goal and they did really good and they get like to 50 by just crushing the appetite and then they get to a point where they're like 1100 calories or something like that and they've been at this hard plateau forever and they're up walking, they're doing all the things. Are you seeing that a lot? And do you typically lower the dose, reverse diet? What are kind of your.

[B]

Strategies? I was about to say I, I will send them to people like y' all to help them reverse diet. But also just, just splitting the dose has helped a lot too. So some of our patients are twice a week, some of them are even three times a week and just taking the dose but dividing.

[D]

It. Oh.

[B]

Interesting. Yeah. And that's started to.

[C]

Move. So instead of taking a once a week, it's more frequent, half dose. And what is that producing? Just.

[D]

Less. It's starting to less of a crushing appetite and just more subtle. I didn't even think about.

[B]

That.

[C]

Yeah. So what's funny about that, by the way? I don't know if you're already doing this, you're so busy, so I don't think so. But if you ever read the bodybuilding forums, these are the.

[B]

Causes. I definitely don't do that for the.

[C]

Record. Let me just establish that. But if you ever want to.

[D]

Say that I do that.

[C]

Every. If you ever want to like go into and observe a group of people who are willing to experiment on.

[B]

Themselves, it's the bodybuilding world. I do know.

[C]

That. And they're the ones that have done all this stuff. And that's how they use reditutride. They use red. They don't use one dose, they use like three or four small. And that's what they're saying. Those were.

[D]

Two. What do we call.

[B]

Them?

[D]

Firmino?

[C]

Yeah. No.

[B]

Cosmonauts. Oh, yeah. Oh.

[C]

Yeah. So that's what they.

[D]

Typically. Hey, we're pushing the science forward.

[C]

Dude.

[B]

Yeah, I am grateful for.

[C]

That. A few. A few deaths here and there. No big deal. Let's see what happens. That's great. So. So tell us about. I. I love that you're doing these speaking, by the way. You're a great.

[B]

Speaker. Thank.

[C]

You. Yeah, you And I both spoke at the. The Peptide.

[B]

Congress.

[C]

Right. And when I was done, and.

[B]

I have to thank you guys, because Dr. Seeds would have never known who I am if. If it weren't for you guys putting me on your.

[C]

Podcast. Well, I gotta tell you, so I had this ego boost, and then I was like, what? So I come off stage, and people like, you were the best speaker. So I'm like, wow, that's so awesome. And then the next day, people were. People were coming up to me. Dr. Fitz was the best. I was like, oh, wow, that's.

[B]

Great. So tell.

[C]

Me. Tell me about these speaking engagement. Why are they inviting you on? Is this my speech? I don't even know. The interest must be just exploding right now around.

[D]

This. Well, I think. I think she's commute. I mean, every time you've been with us, you've communicated. You communicate it really, really well. And I think there's a lot of women that are being told by their general practitioners, you know, yet they know in their heart that they don't feel right, and they're trying all the things totally. And they're getting told you're fine or you're good, and it just doesn't make sense. And I think you do a really good job of. Of communicating that, and I just don't think there's a lot of resources for people like.

[B]

That. When I was preparing to come on your show this time last year, I've been listening to you guys for a long time, so I knew all of the great people that y' all had on board, but you'd never really addressed this thing. And so I was like, I know that you have so many people that listen, that need to hear this message because normal isn't optimal, and your normal labs, you're feeling like crap. Fire that doctor and find someone that will listen to.

[C]

You. Do you? Do you. This might be controversial, but do you think most women should be on hormone replacement therapy once they get into 100% menopause? What about the whole, like. I'm sure you hear this argument, like, well, it's natural. You're supposed to go into.

[B]

Menopause. I mean, that's fine. Like, you can do that. But I choose. I know my quality of life is when I'm hormonally optimized. So that's the beautiful thing about hormones is that if you get on it and you're like, this is not worth it for me. You can stop them at any given time, whether it's a year from now, five years from now, 10 years from now, I'm 45 and I will be on this until the last day on earth because I understand it protects me from all of the things. And I feel.

[D]

Amazing. I don't remember the doctor who my mother in law was very close friends to, but she's been advocating, this is 30 years she's been advocating for this. And I always thought it was interesting when I first met Katrina that her mom was so adamant about when you were in your 20s and early 30s to get your blood work done, see where optimals are, because you're, you're soon going to be on hormones and you're going to want to be able to look back and be like, this is what my optimal is. And she like, that's. And she helps coach life coach people. And almost every single first thing she does with every woman she life coaches is send them to go get their.

[C]

Hormones. This is what it. So that's how I explain it because I have, I, I have a lot of cousins. We're around the same age. There's like nine of us that grew up together, so includes my brother. And so it's a bunch of dudes that grew up. And, you know, I'm the guy on all the, you know, hormone replacement.

[B]

Therapy.

[C]

Yep. And so they're asking me, you.

[B]

Look younger than all of.

[C]

Them. Well, so seriously, I also have four kids and I was divorced, so I got that work, but we'll talk. And it's like, you know, I'm like, look, you still get older. So it's not like I'm like, you know, I'm a 20 year old. I could still tell that I'm.

[B]

46.

[C]

Right. But it's definitely very different. Well, anyway, finally one of my cousins who's my age went on some testosterone and he's like, dude, he goes, I didn't know how bad I was.

[B]

Feeling.

[C]

Yep. You know, because, you know, he's a black belt in Jiu Jitsu, he trains and we're talking all the time and he's always like, well, natural is better. I'm like, listen, dude, it's not, you're not doing crazy stuff. This is optimizing you. I said, you work out, you try to watch your diet. Do you like doing your Jiu Jitsu? Do you like working out? And I'm like, you'll enjoy it more. And so he gets back on. He's like, dude, I didn't realize how low my tolerance for exercise stress was. He's like, I would go to Jiu Jitsu and I'd roll and I'd try to go easy, but I just feel beat up, you know, I was just feeling beat up from everything. He's like, man, I feel like I could train again. And I feel good. And he's on, like, a low. He's, like, super conservative. He's, like, scared to go on higher. He's not like, me, where I'm like, what's the most I can take? But he's coming back and he's like, dude, this feels so different. So now everybody else is starting to kind of get convinced, like, and I'm a big believer. Like, you know, as you get.

[B]

Older, but you also have to remember it's not natural for us to eat processed food. It's not natural for us to breathe, you know, the chemtrails that we're exposed to. Did y' all watch that documentary, by the.

[C]

Way? No. I love.

[B]

That. Dude, you've got.

[C]

To. I don't know. I collected.

[B]

More. Doctor. I'm a full fledged conspiracy theorist, thank you very much. But. But, I mean, it's not natural, all of the things that we're exposed to. So. So if you want to go through it just, you know, naturally, just to say you did it, here's your, you know, gold star. But I ain't doing that. Yeah, I know. It's.

[D]

Quality. I'm trying to convince my best friend is like, he. I can't get him to. I'm literally about to, like, finance it. Just so I'm like, I'm gonna finance it for like a.

[B]

Year. What's stopping him.

[D]

Though? I mean, it's. It cost a little bit, because I know, I know. Even just. Just the steps of. Go get my blood work. Just the step and him feeling like, like, I'm okay. And I know. I'm like, no, you're not. I'm on the outside going like, no, no, you're.

[C]

Not. I.

[D]

Know. You know what I'm saying? I grew up with you, you know, and again, you be. You just. You get so adapted, the body is so resilient that you start to fool yourself of like, yeah, I'm fine. I'm normal. And then you get on that nice little dose and it's like, oh.

[B]

Well, it's the same thing when I was talking. So my parents were on my very first two patients and got on FaceTime with them. And my mom has always just done blindly what I tell her to my dad. He has to hear it from Peter Atia before he believes it. Right? Let's just be real so my mom is, you know, yes, let's do it. Whatever you say. And my dad's like, tell me why I need this. I'm pretty. You know, I feel like I'm pretty good. Like you are, but you're not optimized. I don't know, dad. Give me six months, and if you don't feel any difference in six months, you can go off of it. Okay. And sure enough, he was like, well, I'm starting to see muscle again. I'm like, yeah, you don't know how much better you're gonna feel until you try it and what's to hurt? Like, worst case scenario, you invest and you do it for a year. And you're like, no, it doesn't. Didn't do anything. Okay.

[C]

Cool. The way.

[D]

I. Next time dad says that, you tell him. You say, hey, I've been on mind pump twice, Peter. Never been on.

[B]

There.

[C]

Totally. The way I look at it, there's a couple things. First off, we know that men's testosterone levels have been dropping for something like 50 years. This is well.

[B]

Documented. Very well.

[C]

Documented. So this is not, like, this is not controversial in any way. It's for sure going down. Fertility in general is going down. Women are more hormonally imbalanced, natural women than ever. Why? There's a lot of reasons, possibly why. Probably a combination of things. Nonetheless, hormone optimization is becoming less of a. Like. Like that's cool. And more of a. Might be more necessary for a lot of people because of the things that are happening to us through our unnatural environment, exposure to things like xenoestrogens and microbiome being thrown off and our lifestyles and all that stuff. So.

[D]

Yeah. Well, how. How rare is our business partner? I mean, Doug is like the only dude I know.

[C]

That'S. You know what his natural testosterone levels.

[B]

Are? I heard.

[C]

Y'. All. His totals are like.

[B]

1100. Yeah. That's not.

[C]

Normal. Yeah. Just look at his face. Those are old numbers. Yeah. Oh, they're higher. Easy.

[D]

Guy. Easy.

[C]

Guy.

[B]

But. But he. When he was in his. His teenage years and twenties, he wasn't exposed to a lot of the endocrine disrupting.

[D]

Agents. He's also. I would say, you know, the three of us are obviously the gurus, but he's the better student, right? He's. He. He's better than all of us. I think he. He's. He is better at working on his sleep. He's better consistent with whole foods. I think. I think he's the. One of the best. I think he. At.

[C]

That. But she makes a great point. You know, he wasn't exposed. The amount of chemicals now that you grow up with with totally just in your. Just from the things you touch and the clothes you wear and the stuff you put on your skin is just insane compared to what it.

[B]

Was. I have three families that I'm taking care of where I'm taking care of the mom and dad that are in their 40s or 50s and then their, their adult children and the dad's testosterone is always higher than the, the son's testosterone who's in his.

[D]

20S. That's so.

[C]

Crazy.

[B]

Yeah. Because he's been exposed to all of these endocrine disrupting agents for his entire childhood and.

[C]

Adolescence. Sense the way I try to.

[D]

Look at it, how much is this playing a role in all these weak ass men.

[B]

That. Yeah, we will go there if y' all want.

[D]

To. I mean I, I know what it's like to have very low testosterone and you feel, you don't feel like the, the man you are on optimized.

[B]

Testosterone. Imagine me being a single 45 year old female trying to find a man that. Yeah, see. Uhhuh. The struggle is.

[C]

Real. You know. So I mean there's a couple ways to, to look at this because there's definitely. And I'm just going to call it out, this is what I struggle with. There's definitely. You can go on hormone replacement therapy to really push the limits and you might be a little too focused on aesthetics and that kind of stuff that happens to me. But then there's this other side which is it will improve the quality of your life so you could do the important things more often and better. So more energy to play with my kids. More energy to perform at work. Better sleep. So I feel, feel better. Things that can, you know, I can enjoy these sports and activities that I used to enjoy which bring me joy and allow me to connect with people. And I really, I think that's the main.

[B]

Benefit. Yeah. It's how you show up to the.

[C]

World.

[B]

Yeah. So if you are a better version of you then everyone in your world appreciates that.

[C]

100%. We really appreciate when you come and speak to our groups, they love hearing you talk. How do you enjoy doing that? Because these are, these are all like just coaching.

[B]

Clubs. Yeah. No, I love doing.

[C]

That.

[D]

That. Yeah. What do you think of the muscle mommy.

[B]

Group? It's.

[C]

Awesome.

[D]

Yeah.

[B]

Yeah. But I will have to say I'm, I'm not as good about getting on school versus the Facebook group last.

[C]

Summer.

[B]

Yeah. I Need to be better about that. But I've been juggling a.

[D]

Lot. Well, you know, for your like, own self, business wise. I tell you what, I'm blown away by.

[B]

School.

[D]

Yeah. So that's my, that was my first introduction to it. And the UI is incredible and the things that you can do. So I don't know how much you've dove around and we can talk off air about all the business stuff you can do with it. Very, very.

[C]

Cool. Have you thought about. Because you're very, very smart, especially even in business. Have you thought about combining what you do with trainers and coaches and gyms? I just don't. I could see the synergy just so much where, I mean, we've talked about having our trainers and coaches work with doctors and stuff. Have you thought of.

[B]

That? Absolutely. Absolutely. I mean, I've thought about, you know, the three of you guys, you know, doing something with me because I mean, what y' all bring to the table versus what I bring to the table is what most people need. You know, I've also talked about it with one of my best friends who has been in the fitness world forever. You know, she's the health coach, nutrition, whatever. And yeah, it's. I think it's the missing element for a lot of.

[C]

People. So do I, because I even have a friend who's a psychiatrist and we've talked about this and she's actually learning about hormone replacement therapy, therapy for her.

[B]

Practice. Oh.

[C]

Yeah. Because of all of the people that she sees and she's like, you know, a lot of some of these.

[D]

Issues. What I'm telling you about, my mother in law who's the life coach, that's like, they come to her and oh, the husband this, that, and then, and she's just like, go get your hormones, take care of first and then we'll work on all the other. Because you're just battling uphill. I can teach you all the tools on how to communicate with your husband and this and that, but if you're hormonally out of.

[B]

Whack.

[D]

Exactly. You're just, you're, you're fighting an uphill.

[B]

Battle. Do you understand how many people don't need to be on SSRIs, they just need hormones.

[D]

Optimized.

[B]

Right. I mean, when I give the patient even hope that maybe they don't need to be on that SSRI the rest of their life, they're like, are you kidding me? I've been on this for 20.

[C]

Years. So I know personally, I know people personally who've done this. And here you have. So the symptoms were anxiety, worry, you know, mood was kind of up and down. Dr. Puts you on an SSRI, which comes with the side effects, by the.

[B]

Way. Nobody talks about this erectile.

[C]

Dysfunction. Well, it was a woman. It was sexual.

[B]

Dysfunction. Oh.

[C]

Yeah. Libido shot by the. Yeah. And so these are people, these are friends of ours. And it's like you feel numer or numb down there. So issues with orgasm, sexual fun, weight gain. Those are the side effects of this, you know, kind of numbing agent, which kind of. Okay, so the anxiety got a little better, moods got a little better, but also sexual dysfunction. Also weight gain on the hormones, Mood is better. No anxiety, sleeping better, except I'm leaner, not gaining body fat, and my sexual, you know, how I respond and how I feel sexually has improved. So it's like the best. The best versus, you know, you got all these crazy side.

[B]

Effects.

[C]

Correct. Yeah, I think there's a lot of women because again, you look at the data on women prescribed SSRIs and enziolytics, it's right around the.

[B]

Time.

[C]

Absolutely. When perimenopause and menopause.

[B]

Hit. Oh, that's the standard. If they go to their primary care doctor, they'll be put on birth control pills and an.

[C]

Ssri. They're doing terrible hormone.

[B]

Replacement. Terrible, terrible. Yeah, no, it's. I, I think that if psychiatrists really understood that their patients don't need all of these, you know, terrible drugs that are, you know, pharmaceutical drugs that these patients think they need to be on for life, they really just need hormones. It would, it would take a huge portion of pharma out of business.

[C]

At the very least, because I think there's a role in some of this stuff. But at the very least, you, you could lower doses to opt hormones. But put it differently, a hormonally optimized person probably needs less of everything else, even if they did need something.

[B]

Else. Yeah. I think the amount of the percent of people that are on some sort of a psychiatric drug, whether it's an SSR or whatnot, would be significantly decreased to like 10% if, maybe even less than 10% if we just addressed hormones, diet and.

[C]

Lifestyle. Does that happen with you? We get these clients and then they go on hormones and they start.

[B]

Coming off stuff all the time. All the time. I will let them know. I don't want to even talk about it until the six month appointment. And then at the six month appointment, we can talk about you doing this with whoever is prescribing that, because Technically, since I didn't prescribe it, I'm not supposed to deprescribe.

[C]

It. Right, Right. So you work with.

[B]

Them.

[C]

Yep. Well, Dr. Fitz, you're always so.

[B]

Awesome. Thank.

[C]

You. We love you being on the show. You're always such a great, such a gift to our.

[B]

Community. Thank.

[C]

You. And I'm sure your books are totally slammed and you can't. I mean, are you.

[B]

Just. I'm booked out till.

[C]

March. Are you trying to.

[B]

Grow?

[C]

Yeah. How do you do.

[B]

That? I go back and forth if I want to open a location in a warmer place because Chicago is really cold in the winter, but I have two other medical providers and I'm about to hire a third. And then if I want to open a second location, I go back and forth. But will we take over one.

[D]

Of the spaces right next to.

[B]

Me? I mean, maybe so. I mean, the weather here is much better. I will say that it's snowing in Chicago today, and I sent a picture to one of my friends. I'm like, don't hate me because I'm not wearing a.

[C]

Jacket. Awesome. Well, thank you so much for coming.

[B]

On. I want to thank you guys, though, because the amount of patients that have come to me because y' all put me on your podcast last year, I. I will never be able to say thank you enough. I truly am grateful for.

[C]

That. It's. It's an honor because you are servicing people that we care about, so the fact that they're going to somebody who knows what they're doing is good, cares about them. That, for us, is the.

[B]

Best. Thank you. I appreciate you.

[E]

Guys. 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 [e-mail] 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.

[B]

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