Incredible Menopause Weight Loss Testimonial! | Empowering Midlife Wellness

This has been an exciting year with much more attention being paid to midlife women's hormonal health. Finally perimenopause/menopause is getting a voice, and the use of MHT (menopausal hormone therapy) is becoming widely accepted. Once we have decided to take menopausal hormone therapy, there are multiple options of products and routes of administration. Today I'll be discussing the different options for bioidentical menopausal hormone therapy, and the pros and cons of each. It's also important to understand why the doses are vastly different for the various different products, and why it's important to have your blood drawn to make sure that you are reaching optimal levels, because absorption is highly variable between patients. In the end, reaching the appropriate blood levels is much more important than the route of administration, which is really just a matter of personal choice and lifestyle. While the vital hormone testosterone continues to be controversial, in my practice we consider "optimal" for female testosterone to be in the upper range of what is physiologic for women (restoring levels to the high end of what they were when we were younger). Multiple studies have shown that these levels safely provide benefits for sexual wellness as well as muscle and bone conservation, sleep and mood. We recognize that long-term very high levels of testosterone put patients at risk of not only nuisance symptoms, but also irreversible masculinizing effects, which is why we never dose at that level, and why we have developed a novel dosing protocol which has proven to be safe and effective. Unfortunately, the practice of "Supra-physiologic dosing" continues elsewhere in the community, and is at the root of many people's misunderstanding about the safety of testosterone . We set ourselves apart from others who put their patients at risk with levels that are too high, and we pay the utmost attention to making sure we keep hormone levels optimal, without elevating risk.

Vitamin D is the subject of a lot of controversy right now after the Endocrine Society made new recommendations in June 2024 suggesting that routine screening for vitamin D was not necessary, and routine supplementation was not beneficial for the average person. Today I'm looking into how they came up with this recommendation and what hundreds of studies have shown over the years, to put this recommendation in context. Everyone agrees that vitamin D is critical for life and no one is suggesting that we don't need it, but questions remain around whether we need to take a supplement or if we can find it naturally, and if so, whether we need to measure blood levels and what the optimal blood level should be.

Creatine is a naturally occurring peptide consistent of 3 amino acids, and has been widely studied for its numerous benefits and low side effect profile. In fact creatine is the most studied supplement in the world. Well known to improve muscle mass and sports performance, creatine is particularly relevant in midlife when losing muscle and bone accelerate, and gaining muscle can be more challenging. As well as the numerous health benefits related to muscle and bone, creatine also has important implications for brain health including improving memory, dementia risk and recovery from brain injury. In short, creatine is one supplement that I recommend for just about everyone!

Most of us have heard a lot about insulin resistance but many of us still don't understand why it should be considered a disease in and of itself, separate from diabetes. Insulin resistance affects more than 50% of our patients and causes weight gain around the middle, as well as increasing heart disease, Alzheimer's disease and of course, diabetes and its related complications. My hope is that with a better understanding of how this process works we can each get more involved in doing the things that are necessary to cure insulin resistance. This can almost always be cured with nutrition and exercise alone, without medications. Once we truly understand how the process works, we can become internally motivated with a clear reason WHY to stick to our healthy nutrition and exercise program.

Today I'm back with my partner, Dr. Leah Antoniewicz, discussing Nitric oxide. This fascinating molecule is made of one nitrogen and one oxygen atom (NO), and reduction in nitric oxide has been shown to be associated with an increase in multiple diseases as we age. Today, I'll be talking to you about the science of how nitric oxide works, as well as how to naturally increase it and some things to avoid that might be decreasing it.

Our understanding of the vital importance of the gut biome has skyrocketed in the past 10 years, yet we are still just beginning to learn all of the incredible functions of these healthy bacteria. Today I'll be reviewing the role of healthy gut bacteria in the prevention of multiple disease processes, including the most common diseases that affect American women- obesity, insulin resistance, diabetes and cardiovascular disease. I will particularly be talking about a really interesting key bacteria called Akkermansia, and a growing body of research suggesting its importance in weight maintenance and insulin sensitivity, amongst other things. Since learning about this, I have started taking the Pendulum brand Akkermansia product myself (I'll explain why I prefer this brand in the video though I have no affiliation with the company), and recommend it to many of our patients. I think after listening to this, you will consider it too!

Iron is a vital micronutrient that is sub-optimal in more than 50% of women. This is frequently missed because it masks as many other things, and most doctors don't check the labs that are necessary to evaluate this completely. Today I'll be talking about where we find iron in our diet, how to diagnose low iron and how to address it by evaluating our input, absorption, and ruling out any sources of blood loss. I'll also tell you about my own story with low iron, how I corrected it, and how both my patients and I feel so much better when our iron is optimized!

We all know that alcohol is a toxin with numerous effects on our health - from weight gain, to sleep and mood disruption as well as causing multiple cancers, diabetes, heart disease, gut dysbiosis, liver damage and dementia - even at "socially acceptable levels." Many of us drink in moderation and don't consider it to be a "problem"- but today I'm discussing an interesting way of reframing your relationship with alcohol and being very clear about where it might be causing problems in your life. I came across an amazing community called "One Year No Beer" (link and tag on social) and joined their 28 day alcohol free challenge. This challenge is supported with emails, videos and connecting with others on the same journey, and invites you to experience how you feel without alcohol for a prolonged period. Like me- a break from drinking makes most people realize that we are being held back by alcohol, and without it many things improve! My personal goal is to be someone who drinks "as much as I like as often as I like"- which will amount to very little, and not very often.

The most common killer of both men and women is heart attack, so understanding how to reduce our risk could not be more important. Since the 1980's, studies have consistently shown that menopausal hormone therapy (particularly estrogen) reduces the risk of heart disease in women. The now infamous Women's Health Initiative study surprised the medical community in 2002 by suggesting that hormone therapy increased the risk of heart attack in a small subset of women. After 22 years of gathering more data, multiple large studies have now confirmed what we previously understood, which is that estrogen has a highly beneficial effect for the heart if it's started in the first 10 years after menopause, and benefit seems to be negligible if it's started later (but not harmful). We no longer recommend taking the lowest dose for the shortest time, but rather suggest starting menopausal hormone therapy as early as possible and continuing it long term. For the great majority of patients the benefits far outweigh any potential risks.

Many people have strong opinions about compounding pharmacies, although few people know what they really are, how they are regulated and what the difference is between one type of compounding pharmacy and another. There is a perception that compounded drugs are not FDA approved, not regulated or somehow not safe or reliable. Today I'm going to explain what these pharmacies are, why we might choose to use them (or not) and why the perception that compounding is inferior or not safe is quite inaccurate.