← The Dylan Gemelli Podcast
The Dylan Gemelli Podcast
Episode #106 Featuring Dr. Mariza Snyder! The science of menopause and hormonal decline, Stigmas of testosterone and progesterone, Embracing menopause, Estrogen facts and more!
00:56:16
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- [00:18]
A
With over 20 years in the supplement industry, I have seen and heard it all. Empty promises, tricky marketing, wasted money, leaving so much left to be desired and creating feelings of resentment. Thank you. Thankfully, I'm positive by nature and stay on the lookout for the next breakthrough product. And then I found Tonem, a science driven wellness company built on over a decade of research into natural solutions for metabolic and brain health. Tonem understands that it takes a mind and body connection to obtain full health alignment. With their featured products, Modis and Neuro, they address both aspects of this connection. First, Modus, an all natural supplement designed to support fat loss, metabolic function and energy. Then Neuro, a cognitive performance supplement designed to support focus, memory and long term brilliance. Tonem has brought back my trust in the supplement industry with natural evidence based ingredients that support long term outcomes. So because of this, I want to share them with the world. Use my code Dylan for an extra 10% off and start to treat your mind and body today with Tom. All right everybody, welcome back to the Dylan Gemelli podcast. So as I always say, I am super blessed that I have amazing guests that are willing to come in and see me and talk to me in person and I'm extremely thankful. And today's guest has a plethora of information and when I saw her talking about her new book, I said, okay, I gotta have her, gotta get her on here. And, and it wasn't just because of the book, it was because of the content and the stuff that I was seeing that she was putting out, the impact that it was having. And I look for people that give out heartfelt information, not people that are just giving out info to give it out to draw for whatever they've got going on. But people that I can see actually care and you can see the intricacies on what they do. And that's why I invited my guest here today because I want to spotlight what she does. Now, just briefly here because I can't do justice on a short bio, but we're going to get into everything. She is a powerhouse advocate for midlife women, leveraging 17 plus years as a practitioner, an author, a speaker and she has a top rated podcast, it's called Energize. And also a new book which we're going to talk about amongst the many books that I just found out that she wrote. But she has so many skill sets. Her new book is called the Perimenopause Revolution. So my friends, welcome Dr. Maritza Snyder.
- [02:47]
B
Thank you. I'm so happy to be here.
- [02:49]
A
Thank you for making the trip down to see me, especially during all of this busy time with your book, that you've been all over the place, rightfully. So let's talk about all of these things that you're doing that I brought up because I feel like you are trailblazing for menopausal women's health, but all women's health, and really for men, too. I mean, we can look at it from multitudes of ways, but I think the impact that you're making is very prevalent. It's noteworthy. And so I kind of want to get into everything that you're doing right now.
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B
Awesome. I love it. Let's do that.
- [03:18]
A
Well, let. Let's do this first. Before we get into anything. I don't do all the backstory stuff and everything, but I do want to know what your driving force and factor is into the work that you do, because it is impactful and you're so passionate about it. Why the kind of menopausal route in. In that realm, so to speak?
- [03:38]
B
Yeah. I love this question. It was my mama, my mom. You had me when she was 19 years old. So she's a young mom. And if you look at her today, you would say she's in her 40s. This woman is gorgeous. She's retiring this year, and she plays competitive tennis. She is training for a marathon, the LA Marathon, right now. This woman is a force of nature. And that's how I always had seen my mom my whole life. She was a single mom raising us. And she was superwoman. Like, she was superwoman in high heels. I could hear her. She had this walk, this, like, this walk. And she was always physically active when we were growing up. She also wears, like, these little power suits, you know, like, it was very much that vibe, you know, like the 80s mom or the 90s, like working mom, you know, just trying to get in the room where it's happening. That was my mama. And I really. I get to stand on her shoulders. Like, she. She opened the door for me. She allowed me to see what was possible for me as she was trying to get in the room. And she. This invincible woman. I remember she. My sister was having some pretty big struggle. She's in her. And again, moms often won't tell you what's going on. You know, they. They kind of keep it to themselves. And she was struggling in the beginning of her 40s. We weren't talking about perimenopause then. You know, menopause was just your period. Stop that. Was it. Maybe some hot flashes, maybe some Night sweats and that was it. But my mom was struggling with weight, she was struggling with energy issues, she was struggling with mental energy, she was struggling with mood, particularly the rage. And it's finally when she got into her late 40s, she had been dealing with a lot of these things kind of under the surface, not telling people, just kind of powering through the way that we tell women to power through. But in her late 40s, I want to say, was 48 years old. I'll never forget I got a call at 11 o' clock at night. And when your mom was calling you at 11 o' clock at night twice, like it's not good.
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A
No.
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B
And she was in. She was really struggling with her mental health. She was really, she was really scared about, about what was going on. And she had been to OB gyn, she had been to primary doctors and just kept being told that it wasn't menopause, maybe some antidepressants, and just keep, keep it moving until she got to a point where she did not know what to do. And I just watched this woman who was bulletproof become a shell of her former self. And when I started taking care of her, I took over her care immediately. And what I realized is that not only had the medical system, the healthcare system really failed her at every turn. Every went for support, they kept gaslighting her, they kept dismissing her and just sent her on her way. This is a woman who was silently suffering and just trying to survive this season. And as a result, like, it affected her work, it affected her relationships, it affected every aspect of her life. And when I took it, took over her care, you know, we had, I mean, over 90 days, it was like a massive turnaround and transformation. And I thought, you know, how many millions of women are suffering like this? I also thought, I'm like, is this coming for me? Is this gonna happen to me when I get into perimenopause? And I'll be honest with you, perimenopause blindsided me. Was. And it looked very similar in the beginning to my mom's perimenopausal journey. But I just knew this was when I was 30 years old. I was like, I have got to be a part of the solution, not a part of the, of the problem. And that is when I literally pivoted my practice into supporting women. I mostly had women in perimenopause and menopause, but I was like, we. This has gotta be a focal. Because this is a biological initiation. Things are shifting profoundly in this transition. And Women are being ignored. The reason why, you know, we, in a way we failed women is that we only consider those hormones, reproductive hormones. Yeah, we only thought of those hormones like I, my physical is coming up in a month and they're gonna, they're gonna ask about my mammogram, they're gonna make sure I had a pap smear, they're gonna, you know, colonoscopy is always on, is on the list now too, now that I'm in my mid-40s.
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A
Fun.
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B
But when we think about preventative care for women, it is bikini medicine. Even today. It's, it's, it's ovaries, it's uterus, it's the cervix, it's the boobs and, and done. You know, and we don't think about these hormones being whole body hormones, that they're affecting every single system of the body. But most importantly, the silence shifts. We're talking about bone loss, metabolic changes, body composition, the brain is shifting. All of this is happening. Mental health concerns, cognitive issues like, and again, not every woman, it's gonna be very unique to every single woman. But this is, it's a reckoning. It is a full body recalibration. And the fact that we are minimizing it to this is a reproductive transition and oh, your periods are over is doing no one any favors hormonally.
- [08:18]
A
Cuz I know a lot of women still, even though it's more acceptable and understood now, they still have a fear of testosterone and nobody really talks about progesterone like they should. And the balance of testosterone, progesterone, estrogen, which I'm sure we're gonna thoroughly there. But then when you talked about bone loss and muscle loss can be fatal and people don't realize that like they think that when, when you say something like that, that you're fear mongering. No, that can kill you.
- [08:44]
B
Well, and that is, I think that's the other issue that I see playing out is there's a lot of narrative around this being a fear mongering conversation. Because I think again, if all you ever thought, well, that menopause is natural and just grit through it, you know, push through it.
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A
Yeah.
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B
And it is just a loss of a period or hot flashes, night sweats, may sleep issues, maybe some, you know, genital urinary symptoms and that's it. It's not doing us any favors when we know that women, you know, in terms of quality of life, it's significantly more diminished than men in the second half of our lives. And I mean the, the stats are there. We know that more women than men are going to get Alzheimer's and dementia. We know more women than men are going to die of a mostly preventable heart attack. We know more women than men are going to have migraines and are going to have, you know, even osteopenia. They're going to fracture a bone like these. These are real stats. And the, what I call kind of the, the window of opportunity, because it's a window of vulnerability, is perimenopause and even into early menopause. But I think it's not fear mongering, it's just letting women know, you know, how you're not feeling good right now. Things are massively shifting. These are signals the body is telling you, hey, I need a new level of support. And we've got to be mindful at looking at these silent shifts. No one feels blood pressure creep up, no one feels fasting insulin go into pre diabetes. We don't feel these things. But ultimately they are devastating down the road, especially in our 60s and beyond.
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A
You brought up something I think is of so importance. I have always been Mr. Plan Ahead because I coach steroid users and bodybuilders and I've dealt with supplements and I've always, always, always stressed doing blood work early.
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B
Yes.
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A
Do it often.
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B
Yes.
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A
And don't think because you're too young that you don't need to check certain things. You may not need to check it as often, but you should still in your early 30s in my view. Start testing heart signs, cardiovascular signs, see if there's anything there, you know, that you were passed down. You never know.
- [10:41]
B
Yeah, I know. I had a best friend, 38 years old, not in perimenopause yet. I would call her in late reproductive, you know, so hormones are shifting. The are like, you know, I'm thinking about not doing this job anymore. And she's worn down. She's a mom of two. I could tell, you know, weight gain. And I made her run an advanced cardiovascular panel and sure enough, her lipoprotein little A was, was extremely high. And. Right. This is a genetic, you know, and so, but she didn't know. And we're talking about, we're catching this in her 30s. Yeah, thankfully. And I wish we would have caught it even sooner because she was literally, she was pre diabetic. Um, her, she was a severe insulin resistance. I mean every, she had metabolic dysfunction. But more important, the, the thing that I was most worried about was that lipoprotein little A yeah. And if we had enough, I mean, luckily we're making all of these lifestyle modifications. We are on top of it now. But I. I think about all the years that we, you know, if we had known even sooner, how many interventions would have been a lot easier to implement.
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A
Anybody listening? The LP is a genetic condition. You're not going to control it with diet. You're not going to control it with any of the other things. Statins will increase your lp. All of these things need to be known. And that is something that you can. You can spot it early.
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B
Yeah.
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A
If you take cardiac IQ tests, you need to be checking apob, lp, particle sizes, all of that. And that's one of the things that I would stress to people. You could find that in your 20s.
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B
Absolutely.
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A
I had a 330LP and was able to get it down in the 90s.
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B
Yeah. She. It was a 220. Yeah.
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A
That's extremely high. And that's a great way to get, like, silent plaque buildup that you never know is coming. I walked in and got a calcium score and was blown away because I don't know how the hell it could have been so high. And there was the culprit. So it's good that you did that and found it early enough, because if you don't, then one day you wake up and you have a 70% blockage and you wonder what the hell happened.
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B
Exactly. And even earlier than you think.
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A
Yeah.
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B
Yeah, even earlier than you think.
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A
Let's go down the stages.
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B
Yeah, let's go down the stage.
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A
Okay, so first, maybe let's give some telltale signs. And I understand that there is no magic answer on when this starts.
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B
No, there is no magic. It doesn't announce itself one day. There isn't a lab like a fasting insulin or an APOB to kind of let you know what's going on. It is a clinical diagnosis based on symptoms, based on your age and menstrual cycle changes.
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A
Is there anything that could put you into it early and. Or what is the average when it would start?
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B
That's a great question. So the average. Let's reverse engineer menopause really quickly. I feel like everyone knows menopause, Right. That defining moment when you have it. And even that definition needs to be redefined. But the defining moment where you haven't had a period for 12 consecutive months, the average age is 51.6 for women here in. Mostly globally, but here in the US anywhere, natural menopause can fall anywhere between 45 and 55 years old. And so if we reverse engineer that, you know, and I have a lot of colleagues who go into menopause in their late 40s, not their, not their early 50s or mid-50s. And so if perimenopause is the 4 to 10 plus year transition leading into menopause, then we're talking about as early as your mid-80s for some women. And the only way we really know, besides starting to pay attention to those that clinical diagnosis of symptoms and the things that I mentioned is asking your mom. Now, unfortunately, a lot of moms didn't know, you know, didn't know when they were in perimenopause. Um, some of them remember when they went into menopause, some of them don't, and many. I can't tell you how many times I've had a patient, patient tell me my mom doesn't know because she had a hysterectomy in her 40s or in her 30s. And so just note that that would be one of the ways that you would know is ask your mom. And that's kind of a proxy of when you'll go into menopause and when you'll be in perimenopause. So you asked what would potentially kind of bring you into perimenopause and menopause earlier? Two really big ones are going to be smoking and alcohol. So excessive alcohol drinking or pretty consistent alcohol drinking. We don't know if stress is a major player here, but when I think about, you know, kind of reproductive longevity and ovarian longevity, I think of mitochondrial longevity. Ultimately they're, they go in hand in hand. You cannot 3D print human beings without mitochondria. Really important. And so excessive stress is a big one. Not having children could potentially put you in because again, if, if you, when you have a baby or when you're pregnant in postpartum, you don't have a cycle for quite some time depending on when you started your period, that could elongate you into menop. But I would say chronic stress, chronic metabolic dysfunction, excessive smoking and drinking. These are things that could set you back and have you start perimenopause and menopause earlier. Also epigenetic driven stress and trauma. So we know that, you know, women of Latin descent, African American women, we do see them going into perimenopause earlier and we do see them having more exacerbated symptoms even earlier and that they're in perimenopause longer.
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A
Would you say that people that tend to go in there early have like, higher levels of inflammation, lower Mitochondrial health. Yes, things like that.
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B
Yeah. And so a lot of women, again, we can, we are quick even as, as patients, as women, to gaslight ourselves, to second guess ourselves, because it's, oh, is it motherhood? Is it burnout? Is it stress? You know, is this can't be perimenopause? Like, what is this? And I will tell you that as I am running labs, especially if I have a timeline of labs like you just alluded to, starting as early as your early 30s or at least your disease. I can tell when your highly sensitive CRP goes up, when your lipids begin to go up, when your fasting insulin begins to go up. So I can identify perimenopause sometimes just based on labs alone. Again, it's a composite of many things that I'm looking at in alignment with symptoms. And so, yeah, we, I will see that as you move into perimenopause, hormones are beginning to erratically shift. And again, life is lifing. Right. Stress is still happening. You were, you're carrying a lot that I will begin to see. Labs move out of range. And I have diagnosed perimenopause through labs, but not the labs that you think of. Not. I wasn't through hormone labs. It was looking at metabolic labs and inflammation labs.
- [16:47]
A
Okay. Is there any sort of diet that you could be doing for many years, example, like low fat or high carbohydrate or something that could trigger, throw you into it early or anything like that?
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B
We don't have any evidence on that at the moment, so I won't speak to that. What I will say is that we know that a majority of adults are already struggling with insulin resistance and metabolic dysfunction before perimenopause. You know, by the time A woman is 45 years old, she's more likely to be obese or overweight than men. We know that often we. About 90% of women by the time they're 45 years old are going to have one or more labs, metabolic labs, out of range. And so, you know, a lot of women are coming in with polycystic ovarian syndrome, which I feel is a metabolically driven, you know, infertility, potentially infertility issue or reproductive issue. And so if you've got these issues coming in, you know, you again, a fasting insulin that's headed into prediabetes, or your lipids are going out of range, or you have liver enzymes that are out of range, like all these types of things that are going on, I will see an exacerbation of symptoms. Of my patients in perimenopause. So, yeah, if you're coming in metabolically, you know, busted, it was call it, you know, it's, it's. You're gonna see bigger body composition changes, you're going to see more mood and brain changes, you're going to see more belly fat. And so you start to see these exacerbation of the most common symptoms of perimenopause, mainly because we're coming into this season already struggling with some issues.
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A
So when you start to get into this perimenopause state, what are some early, just telltale signs that could warn you? Like, okay, it's coming.
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B
Yeah, absolutely. So if we are looking at early perimenopause, and I would say on average for my patients, it's usually 41, 42, 43. And they come in and they're like, I don't feel like myself anymore. I can't, I can't pretend like this is something else at this point. And they may notice some cycle changes, usually in the luteal cycle. So after ovulation, we know that we need to ovulate in order to make progesterone. Progesterone is the progestation hormone. And in that cycle, if she shows up to the party or is at least, you know, robust, we feel pretty good. You know, you know, maybe some PMS symptoms, you know, those last couple of days before your cycle, before your menstruation hits. But for the most part, we feel pretty good. It's. It's when we're not ovulating, we're having those. An ovulatory cycles or ovulation just isn't the way it used to be. It's not as robust. It's not. Again with the mitochondria aren't doing their due diligence. They didn't show up to the party either. And so we'll notice maybe you feel great in the follicular phase, but the luteal phase is feeling even harder than it used to. So you'll notice more mood changes, you'll notice more PMS symptoms, but instead of two days, we're talking five, six days more rage, more irritability more bloating and water retention and inflammation in that last week, or maybe even the whole luteal phase. So that's some of the symptoms that women will experience. Also, instead of 29 days of their cycle or 28 days or 27, maybe now it's 25, or it swings all the way to like 37. So we're starting to see some swings in the cycle. That's an indicator, but more so. What I hear more than anything is that I, I don't feel like myself in relation to things feeling harder. Things that used to be effortless are now requiring more mental effort. Now they're, they don't have the same stress tolerance that they used to have. Things are hitting them harder than they used to be. They're not remembering what they were going to say in a presentation or, you know, they're not feeling as motivated or as confident. So it's, it's, it's almost, it feels a bit like an identity crisis in a way that you're like, this is the woman I've always been. These are the things that I'm fully capable of. But now I don't have the same bandwidth to do what I know I know how to do. And it's that grappling with yourself about why can't I do this anymore? Why is everything requiring so much more of me? This is usually what early perimenopause can feel like for women.
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A
So, and some people don't understand that, that, that mind body connection. So if you get off really bad hor suddenly you lose your sharpness, you start to get brain fog, you can't focus, you're probably way more irritable. And just sometimes I wonder, do women kind of go through this? They, they react a certain way and don't even realize they're doing it?
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B
Absolutely. Yeah, yeah, yeah. I mean, I think again when you lose that stress tolerance, it's not just estrogen, testosterone and progesterone that are shifting.
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A
Yeah.
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B
Cortisol is often deregulating. Melatonin, it's beginning to decline as well along with progesterone, again because of that bi directional relationship with insulin and estrogen. You know, our energy capacity again, even on a physical level is shifting as well. We're seeing our bodies change without permission. You know, the workout recovery is not the same. You're like, I used to be the woman who could do this big workout and now I feel like I can't function for the rest of the day. So all of this is up for review. But it's a lot of the, I would say the mental shift, I always call it that neuro, neurochemical transition that really can destabilize women along with the physical changes that are happening as well. So those are often the early signs that I see that again in the beginning we can easily brush off as I'm just not going to bed early. Enough. I'm not honoring my, you know, circadian rhythm. I'm not optimizing my sleep consistently. I, I just my, I have too much work going on. It's, it's really easy to ride those things off. And again, a lot of women that I meet, patients, including myself, you know, I didn't come into perimenopause with the cleanest bill of health. I have a, I have Hashimoto's thyroiditis. And the, you know, I've had burnout before. I've had deregulation of my stress response system. And so initially when I started going through perimenopause, I thought it was, it was the first thing I pointed to. I was like, oh, it must be my thyroid. It must be. Oh, it must be, it must be burnout. It must, you know, it's all these other things and it's kind of like when you finally kind of cross those off, because it can be a yes. And you're like, okay, you know, send me a sign, make it impossible for me to miss. And for me, it was the rage. And I knew it because I knew my mom's rage.
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A
I see. Okay, what about sleep cycles? Like circadian rhythm thrown off? Anything like that? Is that an issue?
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B
Yeah, oh, absolutely. 66% of women in perimenopause or in midlife, even, even more like from 40 to 60, are going to have sleep issues.
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A
And that just exacerbates the problem even further because the sleep, lack of sleep just makes everything, everything worse.
- [23:19]
B
Sleep or make or break you? Yeah, especially in this, in this season. You know, I, you know, it's, it's, we're talking about a second puberty, except that women are meant to, they're, we're just supposed to smile through, running households, taking care of kids, running careers, being leaders, you know, and just all the things. And it's, it's this, it's this major upheaval. And so, yeah, in your sleep goes there, that motivation to get up at 6 o' clock in the morning to go work out in the gym, like, that's gone. You know, it's not one thing. People always ask me what's going on with the belly fat and the body composition changes. And it's not just estrogen, you know, kind of repositioning fat or messing with insulin sensitivity. It's the fact that you're deregulated at night and you can't get to bed and that wind down just wrecked your sleep, you know, and you wake up just feeling like hot garbage. You don't have you have the capacity to do the non negotiables, to survive, to get your kids off to school, to do the work, but you don't have room for anything else.
- [24:15]
A
Yeah.
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B
So a lot of the lifestyles begin to slip. You're noticing that you can't lift the way that you used to in your 30s. You can't train the way that you used to in your 30s. And so you pivot. Maybe you're spending more time on the cardio machines now. You know, maybe you're, now maybe you're doing a Zumba class or you're doing more Pilates. You know, you're. And so you're actually losing more muscle in the process. So it's not one thing. I find it can really. There's a lot of things that spiral out of control a bit.
- [24:42]
A
So what is, what is the actual reason or cause of when you start to not have your cycle anymore? Why do these hormonal changes occur? What is it about the cycle itself stopping that causes all of this to go haywire?
- [24:56]
B
I love this question. It's eggs, okay? You, how many eggs do you got? You know, it's egg supply. And so we don't have an ability to keep these ovaries going. Right. They have, they have an expiration date. You know, we are born with a, about a million eggs, give or take. By the time we get to puberty, we're down to half, 300,000. And then we start cycling every single month rhythmically, you know, and so, and you have to understand that even with puberty, it takes four to six years to really come online again. That although, you know, your period's one day in time, I think we really have to have extra grace for our girls who are navigating, you know, the teenage years because their brain is massively remodeling. Everything is massively remodeling in puberty. Finally, you know, by the time we're in our 20s, we're, we're running, this is running pretty, pretty, hopefully in lockstep. And, you know, estrogen is showing up consistently throughout the entire cycle. Let's be honest. Progesterone is showing up in, after ovulation, is showing up in the luteal phase of the cycle. Testosterone is in the first phase of the cycle and the follicular phase of the cycle. And the body, all of the receptor sites that are receiving these chemical messengers, they are expecting them rhythmically every single month. So we know when that estradiol peak's gonna happen on day 11, day 12, right. So many things are gonna happen. One, ovulation is gonna be initiated to begin with, right. And that moves, you know, our species forward. But we're suppressing like we have tumor suppressor genes that activate, we are optimizing brain capacity and function. Like there's so many things that are happening because these hormones are doing their job every single month. But every month we are priming eggs. That one egg gets chosen and we release it in hope that we are going to propagate the species of the human race. And we start moving through them. By the time we're about 35 years old, give or take, we have about 10,000 eggs left. The ovaries know it, the brain knows it, although they pretend like they don't, aren't communicating really well. And so we're talking in our mid to late 30s. If it isn't perimenopause for many of us, we're in our late reproductive years, right. And so we will start to have an ovulatory cycles. We will, as I mentioned, we will start to notice that progesterone is declining. And for in today's world, it seem to be happening sooner and sooner, earlier and earlier due to stress and, and, and the toxic world that we live in. There's nothing about this modern day world that lends to optimized hormones. Let's be honest, they're already fighting to keep rhythmically cycling every month. And yeah, now we're running out of eggs. The ovaries know it. And so then there becomes this miscommunication. It's like trying to play telephone with a five year old or a four year old. You know, you're just going to get a garbled message. That HPO axis, the hypothalamic pituitary ovarian axis, that relationship begins to get a little wonky. Oh, by the time we're in our, let's say early 40s, where early perimenopause for most of us was really showing up, are even, we're down even more eggs, we're down to like maybe 5 to 7,000 eggs. And so that's really what's come happening. And as a result, that miscommunication between the pituitary hormones, follicular stimulating hormone, luteinizing hormone, bodying the ovaries to keep moving eggs, you know, and the ovaries are like maybe, maybe one month and then it pops to the next month. That's right. We have more twins in our 40s and late 30s than any other time. But then as a Result, that miscommunication happens with estradiol and progesterone.
- [28:17]
A
Right?
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B
And then that becomes erratic. Initially it's progesterone, it's erratic, it's declining erratically, but a bit more of a steady decline than estrogen. Estrogen can be more, we can be more estrogenic in the beginning, so more estrogen dominant type symptoms. But then ultimately towards late perimenopause, where we're skipping at least a period every 60 days, give or take, we now are in an estrogen decline. And so that's when we really start to see what I call the eye of the storm. This is where the hot flashes and the night sweats and the vaginal dryness and the low libido, the depression, the anxiety. This is where we start to see the greatest amount of bone loss. This is where we start to see pretty big, we will see muscle loss. This is where we really begin to see the major changes because this is when estrogen is beginning to significantly decline. And by the time we're in menopause, we have less than a thousand eggs, give or take, and we're done at that point. We're not.
- [29:07]
A
Yeah, yeah. So there's more complexity here. So for men, there's always a testosterone, estrogen balance and when a man's estrogen gets too low, there's a lot of problems. And, and I've seen that time and time again because there's the, the concern is always for the elevated estrogen. So gynecomastia, holding water, high blood pressure, loss of libido, and then it, it'll cause depression. But low estrogen has a lot of similar symptoms and there's a balance issue there. So with women, it's like a trifecta. Right? So testosterone, progesterone, estrogen. Can you explain the roles of each? Especially progesterone, Because I think that's the one that more people don't know enough about. But also the importance of testosterone levels for women as well, especially the ones that have this, you know, and, and I get it that there's almost a stigma on, on, you know, we're, we're
- [29:56]
B
trying to tackle that.
- [29:57]
A
Well, yeah, and I'm trying to. I went through it on the men's side with the estrogen thing, and there's a greater understanding there amongst bodybuilders and people that deal with it, but not mainstream people. And with women. One of the things I see that bothers me that I wish I had a bigger voice in was explaining the role, the importance, even though it's not a lot. It's still. That little bit makes a big difference.
- [30:20]
B
Yeah, let's talk about. I mean, absolutely. Let's talk about the balance. Right. When we think about, you know, women and men are very different. You guys are running on 24, very simple, very easy, you know, and we're running on this monthly cycle, you know, that a lot of things can throw that off as well. And so, you know, progesterone and estrogen, I mean, these are. They are initiators for one another. You know, in order for estrogen to really show up, we need progesterone on the back end.
- [30:46]
A
Right.
- [30:46]
B
And they are, they are really helping to support one another. You know, when I think about progesterone, I mean, the number one job, and this is kind of where we. We kind of put progesterone in its little, like we kind of put in this little box. Is that progesterone, as I mentioned earlier, is that progestation hormone? And so this is the hormone that shows up. It's got receptor sites all over the body for some reason. We think it's only on the uterus. And, you know, that's the reason why progesterone is prescribed for women with a uterus. Yeah, but if you don't have a uterus, you don't need progesterone. And I'm like, what about the brain, you know, immune system and the gut microbiome and the ligaments and tendons and muscle and even metabolism, progesterone is involved. I don't know. Why do they think that it's just the uterus? It's mind blowing to me. So. But we do know that it's, it's a major player in maintaining that pregnancy. Yeah, if we get pregnant, right. Every single month, the body's like, did we, did we get pregnant? And if we don't, then everything begins to decline. And we have. We have menstruation. So progesterone is that. That beautiful hormone that helps us to maintain pregnancy. But also, we know that it is. It's a neurotransmitter known as allopregnanol. I'm sure you guys have talked about this on the show. And it, it activates GABA A receptors to help kind of calm the system, but it's doing even so much more. I mean, we know that it's helping with neurogenesis. We know that it's helping to reduce inflammation in the brain. If anything, progesterone is helping to modulate inflammation across the entire body. So Those are the things I think about when I think about progesterone. But it helps for sleep, it helps for calming and it's, it's no wonder when we start to see a decline in the luteal phase in early perimenopause that women are experiencing a lot of these more neuro neurological based symptoms. It's gonna be progesterone that's not showing up again the way that it used to with estrogen. Estrogen is throughout the entire cycle, but in the follicular phase it's playing the big role of basically prepping the uterus for implantation of that, that egg, but also initiating ovulation. That's the really big role. But it's doing so much more than that. I mean estrogen is driving energy metabolism. Again, there's this direct relationship between mitochondrial capacity and energy and ovarian capacity and function. And so estrogen is a very big part of that relationship. It is the CEO regulator of the brain. And not just in terms of energy metabolism, but helping to initiate and regulate neurotransmitters like dopamine and serotonin. It's helping to ensure that we have, our brain is actually getting cleared of inflammation. It's helping to manage insulin sensitivity in the brain. It is helping to keep, I mean I think about collagen and you know, our, you know, the health of our joints, the health of our muscle and tissue. Everything you think about when it comes to a woman's body, estrogen is pretty much involved all the way down to our gut microbiome. I know you've talked to Cynthia about this.
- [33:37]
A
Oh yeah.
- [33:37]
B
At great, great length. You know, when estrogen begins to decline, we see diversity drop.
- [33:42]
A
And that's the thing. And, and when we talk about dominant hormones for each sex that you need to understand how big of a vital role they play. Yeah.
- [33:50]
B
And testosterone.
- [33:52]
A
Yes. And I want you to touch on that, please.
- [33:54]
B
And it's your build you up hormone. I mean it is confidence, motivation. You know, I always joke that Everybody Loves Day 11, Day 12 US. I even, even me, I, I felt, you know, when I didn't understand what was going on with the cycle, I was like, why can't I feel like this day, this week, second week of follicular phase all the time. You know, I would hit day 26, day 27, I would try to, you know, do a PR, you know, personal. No, there was no, that was, and I would be so angry. I'm like, why can't I push the way that I was pushing two Weeks ago. So, and that's testosterone is showing up at the party right then as well. And so that's when you feel the most vibrant, the most confident, the most self assured. You want to go out, you want to, you want to create more intimacy and connection. Like this is where we feel the most alive. And that's because testosterone entered the party as well. And, and when we start to lose testosterone, you know, the only thing that we can even, well, we can't even off label, prescribe testosterone to women. Right. It's not FDA approved. When we think about it. The only, only way that we can even get approval for it is that, you know, it, it's a, it's a libido issue. It's not that, you know, we're not looking at confidence, we're not looking at motivation, we're not looking at drive, we're not looking at workout recovery. These aren't things that we are considering for testosterone therapy, but these are the things that make some of the biggest difference in women when they start testosterone.
- [35:14]
A
Yeah, I mean, like I'm, I've been doing this for two decades. I'm the biggest TRT advocate on the planet if you need it. And I have found over the years, because I was like really male dominant in my coaching for too long and I find that so many women need it. So many women and they don't even know, no, don't test it. And, and then if you bring it up to them, it's like, no, I don't want to do that.
- [35:37]
B
Well, we won't, we won't test it. Yeah, you know, we, we're not really prescribing it. Women have to. I find so many people, so many women I know are, are fighting, try to get it and the dosage is messy.
- [35:48]
A
That's another problem altogether. Lack of education and understanding on how to actually take care of the women because they haven't done it enough.
- [35:55]
B
Yeah, I know that there's a big fight. I mean, there's a big push right now for the fda. It's going to be a minute. But I think, you know, with the advocacy that's happening right now for women to get testosterone therapy, I'm hoping within the next five years we'll have a solution.
- [36:10]
A
I hope so. I just switched to Kaisertrex, which is the oral form of it. And so I'm hoping that that has the same. But you know, the Kaisertrex is nice because it doesn't crush your luteinizing hormone or your follicle stimulating hormone. It's not supposed to have the effects on estrogen. So it's really nice that.
- [36:25]
B
Yeah, I'd be curious how that works. Yeah. But I mean, I have so many friends and colleagues and even patients of mine that are on testosterone therapy and feel amazing. It's like, like this light comes on, but more so again. And not that estrogen can't do this as well, but with testosterone, particularly, especially with women where they are so used to the confidence and the motivation. Like, again, it's that identity shift. You're like, I was always motivated, I was always ready to do the thing, and all of a sudden it's all flat. Yeah. And then you look at the levels and they're pretty much ground zero.
- [36:57]
A
Perimenopause, we've got this like 12 month buildup of not having a cycle. And so that's the perimenopause. Perimenopause phase in a year, right?
- [37:05]
B
No, 10.
- [37:06]
A
Oh, it's 10 years. 10 years.
- [37:08]
B
We're talking about a freaking career. I mean, who you are at the beginning of Perry and who you are the end, like, you're talking about a completely different person.
- [37:16]
A
Okay. So you got a decade in.
- [37:18]
B
We're talking about a decade. So yeah, like I said, those, those late reproductive years are usually late 30s, mid to late 30s. Progesterone is already declining. You're starting to notice some symptoms. Like again, maybe you. The be your ability to push in the gym and the recovery isn't there. A little bit more irritability, a little bit more PMS symptoms. And this is the time where we're often just saying, oh, no, it's this. It's this now and then 4142. That's full early Perry. Cycles are changing at this point. You are like, I don't recognize myself anymore. Something isn't right. And it's none of these other things that is early peri. Again, you're still cycling regularly. And if you, if you look at the cdc, they will say that perimenopause is technically late perimenopause. Because the only way that we really recognize perimenopause until this last decade or so was that you were skipping periods more than 60 days. That's not until late. So there's this whole, you're. You're still cycling regularly. This is where women are told, it's not perimenopause. You are too young. It's just, da, da, da, go relax, eat less, exercise more. And isn't. They're already doing all of that, you know, Something isn't right. Or here's some. Here's an antidepressant, maybe some birth control and, like, send you off on your. In your, you know, back in your life. That's early, usually. And this is where we really miss the boat. Then there's, you know, there's a little middle. I'm in Middle Perry. I'm kind of not in early anymore. I'm 46. I'm heading into Lake Perry. I'll probably be there by. By 47, 48, because I'm not. I'm still not skipping periods. I'm still regulated. Cycling. How we define late perimenopause is you're skipping periods more than two months. You are having, you know, often crime scene periods at this point, too. Like, one month, it's not there. The next month, you're bleeding through everything. And this is where the hot flashes, the night sweats, and this can go on for three to four years. Now. This is where this more severe depression, anxiety. This is where we see higher rates of divorce. This is where women really start to feel a seismic shift.
- [39:14]
A
So I was a real dick all the times that I was told, oh, you just don't understand. You just don't get it. And I said, I don't like that excuse. So I was a real jerk for.
- [39:22]
B
Yeah, this is. Yeah, this is. This is the really hard time again, you know, if. Hopefully. And that's why I. I love these conversations, because what if we could have caught her at 42, 43, when we just kept saying, oh, no, just keep pushing through. Like, what if we would have caught my mama then? You know, I caught my. We got. I caught my mom when we all caught my mom, which was 48. Crime scene periods, you know, hot flashes, night sweats, severe depression, anxiety, like, was, like, untethered. Did not know who she was anymore and didn't think she was going at that point. For so many women, they don't. They're like, is everything going to implode? Like, am I going to get through this without losing my job or losing my marriage? For so many women, it can feel that intense. We're talking another, you know, three years in that transition. And then you're in the perpetual waiting room where you maybe don't have a period for six months and then it comes back, and then maybe you don't have a period for three months, and then it comes back, and so you're just kind of waiting for menopause. But at that point, all of the hormones at this point are low for the most part you have. Testosterone can be relatively stable for some women. You know, 50% of women, give or take, but progesterone, testosterone or estrogen have left. They have left. And I think a lot of women think this is, this is the, where we've really miseducated as a lot of women think that now that the hormones are stable or that they're gone, you know, everything's gonna level out. But because we've lost these hormones, you know, we are seeing an exact. We see the bone loss, the muscle loss, we start to see the cardiovascular risk go up. We start to see more brain inflammation again, it's these silent shifts due to the fact that we've lost these hormones or that they are erratically going away for years that puts us at greater risk for the silent shifts, the big diseases. So, yeah, no, maybe you're not as irritable as you used to be. Maybe the hot flashes have kind of dissipated. Maybe some of the, your period is now gone, so you're not having the crime scene periods. But what about the bone loss? What about the lipids that are now out of range? What about the climbing blood pressure? These are the things that I want women on, on their radar. What about the, you know, the potential sarcopenia that's starting to develop up? This is why I think we have to be having this conversation. And it's not fear mongering, it's just a deep understanding that there are major shifts that are happening during this transition, that if we know and we take intervention in this time, we, we can future proof our health. But if we keep, you know, following the dialogue of, oh, this is only natural and this is what's meant to happen, well, we're going to see a lot of the statistics that we see playing out right now today.
- [41:54]
A
Yeah. One of the things I talk about especially lately is implementing creatine use not just for the muscle, which that's the obvious, but then the right up here. And I think that a lot of people are now catching on to the creatine benefits for the mental side. But then a couple other things that I have been working on or talking about. One is higher protein intake to, to build the muscle. And that's really for anybody anyway, but especially during this time period of importance. And then I think the other things that we were kind of talking about, you got your mitochondrial decline. So I'm looking for ways to improve mitochondrial health. NAD levels are dropping. These are dropping naturally for men and women anyway.
- [42:34]
B
That's happening.
- [42:34]
A
Yeah.
- [42:35]
B
And then it's and then it's accelerating.
- [42:37]
A
Absolutely. All of these things are naturally going to decline. So you've got to catch onto it early, be preventative diet wise. Are there better diet structures as you enter those stage? Like, like higher protein, higher fat, lower carb, higher carb, like whatever. Or is it kind of variant among individuals? And then what are the most important vitamins somebody needs to be making sure they may even be getting extra of? Is it vitamin D, vitamin K? Like what are essentials that we need to really wrap our head around? Like this is going to help, this is going to mitigate a lot of this that I'm going through.
- [43:11]
B
Absolutely. I love this question. Again, we talked about mitochondrial function and I think everything cellular energy is the epicenter of all of it. You want your brain to work, you want to be able to pay attention and focus, you want to have capacity to pick up your grandkids. Like that's what we're talking about here. And so I always think about what is a proxy for cellular energy. It's going to be blood sugar. So how do we make sure that we're balancing blood sugar? And a majority of us coming into this time in our lives, blood sugar is probably not ideal or optimal and many of us don't know. We don't know that it's variable, it's jumping all over the place. We don't know that our fasting blood glucose is maybe 95 milligrams per deciliter. But these are just not things we know. So I would say, you know, I always want to keep it simple, I want to keep it accessible. But we have to be thinking about balancing and optimizing blood sugar throughout the day from the beginning of the morning to the end of the day. So protein is always first and especially in the morning. I want to make sure that you one protein so that you are not hangry at 11am and making some decisions that maybe you're going to regret that we, yeah, we start with protein, but also we start with fiber. I want to make sure mitochondria really thrive when your microbiome is thriving. So I don't want forget about the fiber piece as well and then some good healthy fats. And I think that can be depending on how you tolerate fats. Look at your lipids, kind of pay attention to that. Some people do better with saturated fats, some people do better with more plant based fats. Like kind of figure out, look at your numbers. Yeah, this is where it can be more bio individual. But protein forward again you have to get rid of the ultra processed foods. Yeah. You have to get rid of the added sugar. And it's so sneaky.
- [44:49]
A
I know.
- [44:49]
B
You know, so it's, it's really paying attention to those things as well and being very honest with yourself about where is it in your creamer for your coffee? Are you having a little probiotic drink? And it's got 8 grams of sugar in that little. And you think you're doing a good thing but you're, you know, you're messing with your blood sugar. Read labels, read labels and ingredients. Yeah, yeah. So those are the things that I, so I talk about this in the book. Is how you build metabolically healthy meals. Focusing on how do we build muscle, are we balancing blood sugar, how are we protecting our gut microbiome? And, and how are we ensuring that you are, that you feel energized? Yes, that's gonna be important. And in reducing inflammation, those are gonna be kind of, I always talk about just protein, healthy fats and fiber. And then you have to get rid of the rest. But even alcohol is up for review. Like you gotta renegotiate that, that relationship. Cause that's gonna be messing with you.
- [45:40]
A
Yeah.
- [45:41]
B
Also I, I'm a big proponent of early time restricted eating.
- [45:44]
A
Okay.
- [45:45]
B
So meaning I, I look at blood sugar numbers all the time on continuous glucosamide.
- [45:49]
A
We're gonna say CGMs all day. Yeah.
- [45:51]
B
I, weeks just to know.
- [45:54]
A
Yeah.
- [45:55]
B
Like how, how you're living, how, how, how you're operating. You know, is that, is it the meetings that are stressing you out that are driving blood sugar? Is it the, you know, that little late night snack right before bed? Is that messing with your fasting and blood sugar in the morning? I, this kind of data is so important, even just two weeks to kind of take a look. But in all the research I've looked at all the data points, you know, we can keep it pretty nice in the morning and it, it starts to creep by the end of the day. And so it makes a big difference what time you eat dinner.
- [46:23]
A
Dinner.
- [46:23]
B
And I always say, you know, and I've looked at this on so many patients over the years. You know, a patient can have salmon, I'm talking salmon salad and you know, maybe you know, some roasted broccoli. Like they could have that dinner at 6:00 or 5:30. And blood sugar looks great. Yeah. Have that Same dinner at 8pm Blood sugar is going to start to shift and so the earlier we can eat and then kitchen's closed. Yeah. Like it is closed. It was closed when I was a kid. Like there was no going back in the kitchen. And then you don't eat until the morning and you start with a, what I call kind of a metabolically boosting breakfast. I'm just having a good metabolically boosting morning routine that sets the tone for the rest of the day. If you start your day with a latte and a croissant, you're not getting off that blood sugar roller coaster. I don't care if you eat only salmon and broccoli for the rest of the day, you're not recovering from that blood sugar.
- [47:12]
A
Absolutely not.
- [47:13]
B
That's going to be important. So. And if, if, if indeed, like you are so hungry after 8 o' clock at night that you don't know what to do. And then it's going to be a very protein focused little snack back so that you're not stressing your system out. I don't want you to stress out because you're so starving you can't get to sleep. So you know, there's always little swaps and things that you can do. So that is where I land on basically on in terms of meals and
- [47:36]
A
then for people listening when you got a plate, take your protein first, eat your fat second, eat your carbs last. And that will help to blunt the glucose spike too. If you absolutely eat in order and
- [47:48]
B
always do not eat naked carbs. Carbs, yes, please. Gone are the days that we could just eat grapes, you know, by themselves. Like if I, My son, my 5 year old, he can do that, I gotta pair that with something, you know, so it's just being really mindful about how we're pairing it and find ways to, you know, I, I eat about a tablespoon of seeds, either flax seeds or chia seeds every single day.
- [48:07]
A
Yeah.
- [48:08]
B
And in the book I'm so practical about how do we go from only 5 or 10 grams of fiber a day, how do we get to closer to 25, 30 grams? You know, how do you move up, up or how do you go from only 65 grams of protein to let's get you to about 90 to 100 to maybe 110. Like I always say, we're aiming for a hundred grams, but I get like, we gotta, we gotta work our way up there. And so I have it all. This whole book is all about practical ways to do this.
- [48:34]
A
I love that because sometimes the numbers can look crazy. Then if you see, this is what I have to do to myself a lot is look in the mirror and Say stuff out loud so I realize, okay, okay, all right, Okay.
- [48:47]
B
I love being my own hype man.
- [48:48]
A
You have to.
- [48:49]
B
You gotta be your own hype man.
- [48:50]
A
You have to. That's how you stay accountable, too, is you look in the mirror and you, you can't. I mean, if you can sit and lie to yourself, then I, I don't know. I can't. That's when I'm the most honest, is when I look directly at myself and go, all right, dude. You know, and that, and that's what I'm saying. With a lot of these foods, especially when you look at numbers on protein, it can look daunting until you sit there and like, for me, I go, okay, well, I just had 12 ounces of salmon, 78 grams of protein. Like that. Right. And you can digest it. I know there's been these. I won't even get into it. But anyway, you can do it. And you can prioritize certain hacks throughout the day to do it properly. Eating real food. I don't like to depend on protein powders or anything. They're there for a purpose. You need a little bit of extra sweet, but like you said, naked carbs. I love fruit, but I pair it with full fat yogurt. When I eat it, it's always together. And I, I'm in control. And I like data. I think that what you said is perfect. We need data. You can't just play guesswork the whole time.
- [49:45]
B
No, especially in this season. We're talking about that midlife season or that perimenopausal season. Data is going to really help us. We can't change. We can't optimize what we're not measuring. If you don't know what your sleep is looking like, you don't know what your steps look like. You don't know what your, Your stress is looking like. I love a whoop, you know, aura. Or even what your blood sugar is looking like throughout the day. How are you going to make changes? It's so easy to tell ourselves that we're, We're. We're eating healthy, we're doing all these right things, but yet we're not seeing the results. And, and this is why it's. I think it's so imperative, particularly in this time of our lives, is that your body is going to change without permission.
- [50:19]
A
Yeah.
- [50:19]
B
And so, and if you're not looking at that, you're not looking at your lab numbers at least annually. If not maybe twice a year or quarterly. If you're not looking at Real time data every day, you just aren't going to be able to optimize. And one of the things that I find particularly for women is that we have been told, women have been told to not trust themselves, to not trust their intuition, to not trust what's going on with their bodies. So we don't listen to our bodies very well. And so sometimes data can really help validate what we're experiencing.
- [50:49]
A
That's right. But you gotta do your own data.
- [50:51]
B
Yeah, you have to do your own data. You have to know your patterns, you have to know your energy patterns, your mood patterns, your sleep patterns. And I, I know again, just like the protein numbers, it can feel a little bit daunting at first. First. But you start to look at your, your info, you start to track your data and it's, it's a quick look, that's it. And then you, you just, you just keep going from there. And so I am a big proponent of tracking data. For me, it's accountability.
- [51:14]
A
Yeah.
- [51:14]
B
You know, just like, okay, I'm on track. Okay. That's it.
- [51:16]
A
And some days are different than others. Right. Okay. We blitz through our time. So I want to talk about your book because I just looked up and I'm like. And I didn't get through half of what I want to talk about. So you've written several books like we talked about, about what makes this one different or so special? Because I know this one is doing extremely well.
- [51:33]
B
Yes. What makes it so special? I mean, it's deeply personal.
- [51:36]
A
Yeah.
- [51:36]
B
As I mentioned, Perimenopause blindsided me. I thought I knew after watching my mama and so many patients. I mean, this has been the group of women that I've been blessed to take care of for 17 years. And I will tell you, it's one thing to support women through a transition like this, it's another thing to go through it. I'm like, whoa. Okay. So I just understanding through the research how important this biological inflection point is and knowing that there's so much that we can do to future proof our health, to be resilient, to feel resilient. And if women just had that information that they could begin to implement, it would change everything. It would change the trajectory of the second half of their life. That is why this book is so important. If anything, this book is more leaning towards longevity, but also helping women to know that they feel seen, they feel heard in their journey. And so that's, that's really what this book is bringing to the table. So part one is Am I in perimenopause? I'm going to help you dissect that really quickly. Part two is okay, these are all the symptoms. What does it mean for my future health outcomes? How do I track this? How do I know what's going on with my body? How do I advocate? And then the pillars, from community to mental health to blood sugar balance, metabolically healthiness, meals, movement building, muscle building, resilience. That is all of what that the pillars are. And then it's a five week plan that puts it all together so that you don't have to second guess what you're doing. You can just implement.
- [52:59]
A
You're giving people hope here and understanding that this doesn't have to be a miserable end of the lifetime.
- [53:04]
B
No, I am, I am not settling up for survival through this period. I want to thrive. I, I do. I have no desire to survive perimenopause.
- [53:12]
A
So when, before we, we stop here, I want to talk a little bit about like when I brought up the creatine. Are there any other essentials yet? No, no, it's okay. We add onto the diet, Frank.
- [53:24]
B
So yes, creatine is definitely one of them.
- [53:26]
A
Yeah, but what, what else would you say? Because okay, so when I brought up like urolith and a very important. Yeah. And then you know, I nmn.
- [53:34]
B
Nmn is the 100 precursor vitamin D. Yeah. Usually at least 4000ius. I cannot. I 98% of women will have subpar vitamin D levels.
- [53:45]
A
3k2 always. Yeah, yep.
- [53:46]
B
Always omegas, big one. I love a good probiotic. I think it's important. I think our gut microbiome can use all the help it can get. I'm a big fan of activated methylated B vitamins. Most women are deficient there some type of magnesium. Whether it's 3 and 8 malate glycinate. I'm a big glycinate girl. That's for sleep. And, and we all need that little sleepy, sleepy mocktail before going to bed. I just take my supplements and then I'm a big fan of antioxidant support support and liver support. So a good turmeric supplement or curcumin polyphenols are going to be a big one. Man. I know. I'm forgetting, you know, my list of supplements. I try to keep it tight for the liver and then so yeah, so milk thistle or a good liver supplement. That's kind of hitting because you can just get a good liver support supplement that's got a lot of the polyphenols and the milk thistle in there and other mitochondrial precursors. Choline, you know, some of the big precursors that I love. Again, urolithin A does such a great job of delivering what we need for mitochondria. I see. Those would be my big heavy hitters. And then I love hrt. I love hormone replacement therapy.
- [54:48]
A
Absolutely. If needed. That can be a lifesaver.
- [54:51]
B
I'm on it.
- [54:51]
A
Yeah, I've been on it for.
- [54:53]
B
My brain loves it. Me too.
- [54:54]
A
Been on it for, I don't know, 10 years now. So I get it. I totally do. So thank you so much for what you do, for the help that you're providing, for sacrifices that you've made to do what you do, because I know it's not easy having a kid and traveling all over and being everywhere and discussing everything, writing books and everything else. So we need more people like you. And your work is greatly appreciated. And I know you're making a massive impact, and hopefully we've gotten you out and out of more people.
- [55:20]
B
Thank you so much for having me.
- [55:22]
A
Yes. Thank you for coming to see me. I appreciate it. So tell everybody where to get the book, where to find you, and we'll put everything in the description.
- [55:29]
B
Yes, the book is doctormesa.com book. I've got insane bonuses because I believe women deserve the best of things and not the least of things. So go and get the book, and then you can find me on the energized podcast as well.
- [55:42]
A
Awesome. Well, make sure to follow. Check. Check out her book, please, and every other piece of content that you have online because it is phenomenal and I've seen plenty, so. All right, everybody, that wraps up another one. Stay tuned for plenty more to come. Dylan Gelli and Dr. Maritza Snider signing off. Sam.