Why Progesterone Drops at 35 and How to Know If You're in Perimenopause with Zora Benhamou

A 2018 study found that 88% of the population is metabolically unwell. But more recent studies estimate the number is closer to 92%!  My guest today is Dr. Ritamarie Loscalzo, founder of the Institute of Nutritional Endocrinology. She has 30+ years of clinical experience and sees imbalanced blood sugar and disordered insulin regulation as the underlying cause of so many people's problems.  Her bottom line is that to get fuel into your mitochondria, good insulin and blood sugar control is a non-negotiable. Most people think of insulin resistance as the diagnosis you get from your doctor, but by that point, there's already been retinopathies (damage to retinas), neuropathies (damage to peripheral nerves), damage to kidneys, and damage to blood vessel linings.  Dr. Loscalzo focuses on "pre-insulin resistance," catching the breakdown decades before diagnosis, when you can actually prevent it. This episode was initially released in November 2022   

Today's podcast guest is Dr. Amie Hornaman, most well-known as The Thyroid Fixer. She was a figure competitor and powerlifter who gained 25 pounds eating chicken, broccoli, and asparagus while hitting the gym twice a day. Biologically, it didn't make sense.  It took seven doctors before she got diagnosed with Hashimoto's, and the sixth one made her cry in her car, praying that something was wrong because, as she told me, "if something was wrong, we could fix it." The seventh doctor gave her Synthroid, and after five months, there was zero change. Not one pound lost, no energy gained, hair still falling out. In this episode, she explains that nearly all diagnoses of hypothyroidism are Hashimoto's, the autoimmune form, where your body attacks your thyroid gland. The conventional standard of care is to check only TSH (thyroid-stimulating hormone), even though TSH doesn't identify an autoimmune disease. This episode is especially important if you've been struggling with thyroid symptoms and haven't been checked for thyroid autoimmunity. (This episode was originally released in Dec 2022)

Today's podcast guest, Dr. Sonya Jensen, is a first-generation immigrant who grew up navigating two very different cultures and the rules imposed on her about how she should look, who she should be friends with, and how she should perform in school. Around age 13, she developed anorexia as a way of gaining control of her own life.    Ultimately, her experiences with anorexia, processing childhood trauma, and working with patients led her to put the pieces together between emotions, trauma, and physical health. In this episode, we discuss the deep work she does with women, where she focuses on the well-researched links between emotions and physical health. In this podcast, Dr. Jensen and I discuss: A 66,000-woman study over 16 years found every single woman with a fibroid had childhood abuse, whether physical, sexual, or emotional (this is when Dr. Jensen started piecing together trauma and physical health) When progesterone is low, GABA is low - so you may feel anxious - when estrogen is low, dopamine and serotonin are low, so you're not accessing joy as quickly Constant production of the stress hormone cortisol creates more pronounced estrogen dominance; one woman manifests tender breasts or cysts, another manifests fibroids, but all have low progesterone Fibroids can become worse by pseudo-estrogen from environmental toxins (pesticides, phthalates, plastics)...if your body can't detoxify them, they recirculate and create estrogen dominance Dr. Jensen was previously against bioidentical hormones, but she then realized women go into midlife very depleted, and physiological dosing helps them feel like themselves again Progesterone dosing is nuanced: One of Dr. Jensen's patients went into psychosis on progesterone because her OB-GYN doubled the dose - not everyone can be on the same dose or same kind of hormone Holocaust studies show infants born to survivors have adrenal insufficiency; their ability to adapt to stress isn't as optimal due to generational trauma If mom was stressed during pregnancy, her preteen will have more anxiety, if mom had really low cortisol, the child's nervous system regulation isn't as efficient Women who use hormones along with lifestyle changes and emotional work thrive on minimal doses, and some can even take breaks; women who only do hormones hit plateaus and cycle back  

My guest today, Dr. Wendie Trubow, went to France in 2019 for the trip of a lifetime.  But when she came home, her hair started falling out, she gained weight, and had a rash all over her face. She tested her thyroid (perfect), hormones (perfect), and gut (great). Ultimately, she realized that when Notre Dame burned, it released 500 tons of lead into the air and soil, and she had slogged through that dust for a week. Testing showed that her lead levels were incredibly high. Her biggest insight was that all the modern medical issues she treated as a functional MD—obesity, diabetes, cancer, insomnia, endocrine dysfunction, gut dysfunction—could be tracked back to toxic exposures, creating a state of inflammation.  Dr. Trubow believes your particular "soup" (genetics, lifestyle, early childhood, antibiotic use, diet, sleep, stress, relationships, self-talk, movement) determines how inflammation manifests in you. Wendie's story is really incredible, and I think you'll love this podcast. This episode was first released in Jan 2023  In this podcast, Dr. Trubow and I discuss: How toxins are related to stubborn weight: they get stored in fatty tissue when you exceed your body's ability to excrete them Studies show that levels of persistent organic pollutants ("forever chemicals") in the bloodstream during weight loss predict weight regain! Alcohol is an acute toxin that takes priority in the liver—your body stops all other detox behavior (hormone processing, pesticide excretion) to focus exclusively on processing alcohol  By the time most women leave the house, they've put over 200 chemicals on their bodies, from shampoo, conditioner, face products, makeup, moisturizers, and perfumes Your bed is a hidden toxin if it contains flame retardants—these are endocrine disruptors, mess up your thyroid and female hormones, and raise your risk of estrogen-dependent cancers Never ask "What-if?" questions…ruminating about uncontrollable situations sends your body into fight-flight-freeze and shuts down detox New cars contain over 300 chemicals, and even new clothes are sprayed with chemicals—wash clothes before you wear them, and shop consciously It's more expensive to react to disease than prevent it…if you could avoid cancer by spending $10 extra a day, it would be the right financial move; cancer costs most people over $100,000 per year to treat  

Today, I'm excited to introduce you to Zora Benhamou, a gerontologist who studies aging and has some unique ideas about menopause, based on research and her gerontology background. In this episode, we discuss her take on menopause, including the fact that it's technically a one-day event! 12 consecutive months without a period lead to your "meno birth date." But perimenopause - the stage just before menopause - lasts 5 to 7 years on average (10-15 years for some women!), and that's where the most difficult symptoms can happen. The biggest menopause myth is that it's a concern for older women, that it's something you don't need to worry about until you're 50.  But research shows women start losing progesterone around age 35, the calming, relaxing hormone that makes you feel good. The reality is that women should ideally begin thinking about menopause decades earlier, in their 40s and 50s.  

Dr. Shivani Gupta comes from a family of people with diabetes, generation by generation, where she's seen the after-effects of suffering with chronic metabolic disease.  Her new book, The Inflammation Code (launching, distills 20 years of studying Ayurveda into simple pillars you can apply to prevent the level of inflammation and disease we see today. When people tell her, "I have brain fog, I'm tired, my sleep is off, my digestion's off, I have stubborn weight gain…I guess this is just aging," her reply is, "No, it's not aging, it's inflammaging." We had a really excellent, in-depth conversation that covered a lot of ground, from black pepper and the blood-brain-barrier to our detox experiences in India. I hope you enjoy the podcast! In this podcast, Dr. Gupta and I discuss: Her study of Ayurveda, a 5,000-year-old system from India that taught us the circadian clock, modern science discovered what Ayurveda taught 5,000 years ago about living in rhythm with nature The three doshas or constitutions of Vata (air/ether), Pitta (fire/water), and Kapha (earth/water)—understanding your constitution helps customize your self-care practices and diet The circadian clock in Ayurveda teaches that 10:00 to 2:00 PM is Pitta (fire) time, when you're most focused and energetic, and meant to eat your biggest meal 10:00 PM to 2:00 AM is the most important time to be asleep, when Pitta fire cleans and clears inflammation, the lymphatic system, and the glymphatic system (lymphatic system of the brain) Vata people are always in motion and prefer jobs where they don't sit still—they're endurance athletes who can run through the day on coffee, green juice, and crackers (but their homework is three square meals) Pitta people are fiery, passionate leaders who tend to crave hot, oily, spicy fried food…but that's the one thing they shouldn't eat because their digestive fire is already like a bonfire! Kapha people are sturdy, strong, and very grounded, but can struggle with sluggish metabolism, low mood or depression, getting stuck, or not wanting to create change Black pepper increases curcumin absorption by 2,000%—scientists at MD Anderson Cancer Center discovered this, which is why traditional Indian cooking always uses turmeric with black pepper What it feels like to experience a Panchakarma detox in India: "massage that feels like abuse" with paper thongs—Dr. Gupta says, "I can't believe you're allowed to do this to me and I'm paying for it" (both she and I had this experience!) Mental inflammation is the stress we create when forcing ourselves to be healthy; if you force workouts, force protein, force intermittent fasting, the stress alone causes the inflammation you're trying to prevent

Dr. Gabrielle Lyon argues we've been focusing on the wrong idea for 50 years…the problem isn't that we're over-fat, it's that we're under-muscled.  Skeletal muscle makes up 40% or more of your body and is an underrecognized endocrine organ that secretes myokines (signaling molecules) when contracted, impacting the brain, liver, pancreas, and truly every body system. Yet skeletal muscle wasn't even considered an organ system until about 25 years ago! The diseases we think of as obesity-related—type 2 diabetes, Alzheimer's, cardiovascular disease—are actually diseases of skeletal muscle first, decades before symptoms appear. When Dr. Lyon asked a PCOS expert what body fat percentage contributes to infertility, the answer shocked her: "It has nothing to do with body fat percentage—it has everything to do with the fat infiltrated into the muscle, the intermuscular adipose tissue (IMAT)." The new US Dietary Guidelines (which Dr. Lyon witnessed being announced on stage) recommend 1.2 to 1.6 grams of protein per kg for the first time in history, a tremendous change based on randomized controlled trials instead of epidemiology. Her mentor, Dr. Donald Layman, wrote the protein portion of the guidelines, and 90% of those guidelines are reflected in her new book, Forever Strong Playbook, released on January 27th of this year.  

Over 30 million women in the US deal with some form of pelvic floor dysfunction…nearly 1 in 4 women.  In this episode, I speak with Jana Danielson, founder of Lead Pilates and creator of the Cooch Ball (and no, that's not a typo!), who reveals shocking realities about the urinary incontinence product industry.  Even though they'll top $24 billion in profit this year, 9 out of 10 people could fix incontinence if they learned to breathe correctly and stopped being such literal "tight asses" (her words, not mine). Listen to the podcast to hear all of Jana's insights.   In this podcast, Jana and I discuss:   Why over 30 million US women deal with pelvic floor dysfunction—nearly 1 in 4 women—and the urinary incontinence product industry will top $24 billion this year The pelvic floor can be too tight (hypertonic) or too loose (hypotonic)—too tight causes one set of symptoms, while too loose causes another About 90% of erectile dysfunction is actually a fitness/movement issue, not medical…when pelvic floor muscles get too tight, blood flow to the penis cannot happen There are four grades of prolapse; some grades can be completely reversed, while others require surgery. Jana explains the anatomical and energetic underpinnings of prolapse The diaphragm is the "roof" and the pelvic floor is the "floor" of your core—doing 10-12 diaphragmatic breaths daily will wake up the pelvic floor tissues, like giving it CPR The pudendal nerve's Latin root means "ashamed"—it's the main sensory and motor nerve from your brain to your genitals/pelvic floor in both men and women You can do all the fancy medical spa pelvic floor contractions, but without proper breathing, your results won't last—you have to create the environment for the solution to work When you inhale into your diaphragm, the pelvic floor is in its restful/descension phase—when you exhale, it's in its lift phase, a key distinction for pelvic floor health Posture plays a considerable role in pelvic floor health: mechanically holding weight in an optimal position takes unnecessary stress off your pelvic floor If you chug water rapidly, your body will excrete more of it. Sip tiny amounts throughout the day so cells absorb hydration properly and your bladder functions optimally  

In this episode, I am speaking with Dr. Loretta Breuning, who is the founder of the Inner Mammal Institute. She's the author of many personal development books, including the one that I have read of hers, which I highly recommend, and found fascinating, called Habits of a Happy Brain.

Periodontist Dr. Al Danenberg was diagnosed with incurable bone marrow cancer (multiple myeloma) in September 2018 and given 3 to 6 months to live. His oncologist wanted to start chemotherapy the next day, but Dr. Al rejected chemo and instead focused on natural methods to help his body heal.  While Dr. Danenberg has since passed on, he survived most of his remaining years with an outstanding quality of life, shocking his oncologist and maintaining such good health that his gut microbiome diversity was in the 97th percentile. In this episode, filmed in March 2023, Dr. Al discusses his diagnosis and why he believed his cancer stemmed from toxic exposures in dental school in the late 1960s and early 1970s. He emphasizes that all cancers are diseases of lifestyle, and that there are very few wild animals with cancer and very few primal societies with gum disease, tooth decay, chronic diseases, or cancer. Dr. Al also explores a few somewhat shocking oral health ideas, including why dental plaque is actually healthy! He backs this surprising claim with three critical roles plaque plays in the mouth: it acts as a gatekeeper, allowing minerals from saliva to remineralize teeth; it contains chemical buffers that keep pH at ~5.5 to prevent decay; and it produces hydrogen peroxide that kills pathogenic bacteria trying to invade. I know you'll enjoy this episode with the late Dr. Al Danenberg.