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[00:01:03.920 --> 00:01:09.840] You're listening to The Michael Shermer Show.
[00:01:16.240 --> 00:01:17.840] Hey, everybody, it's Michael Shermer.
[00:01:17.920 --> 00:01:20.320] It's time for another episode of The Michael Shermer Show.
[00:01:20.320 --> 00:01:22.160] Guess who's on the show today?
[00:01:22.160 --> 00:01:25.120] Returning champion Amy Alcon.
[00:01:25.120 --> 00:01:27.760] She was on before for her, well, I'll introduce.
[00:01:27.840 --> 00:01:29.360] Let me give her a proper introduction here.
[00:01:29.360 --> 00:01:38.800] She's an independent investigative science writer specializing in applied science that is using scientific evidence to solve real-world problems.
[00:01:39.040 --> 00:01:40.240] See why I like that.
[00:01:40.240 --> 00:01:54.160] Alcon critically evaluates and synthesizes research across disciplines and then translates it into everyday language, empowering regular people, that's us, to make scientifically informed decisions for the best of their health and well-being.
[00:01:54.160 --> 00:02:02.840] For 25 years, she wrote the award-winning science-based nationally syndicated advice column, distributed by creators, and is the author of five books.
[00:02:02.840 --> 00:02:12.120] Most recently, before the new one I'll just introduce in a moment, for which she was on the show before, is called Unfuckology: How to Live with Guts and Confidence.
[00:02:12.120 --> 00:02:13.880] At least I think that's how it's pronounced.
[00:02:14.120 --> 00:02:22.760] Actually, Amy, I cite that book in my next book, and the copy editor corrected and said, You have to put an asterisk where the U is.
[00:02:23.400 --> 00:02:24.600] I hate that.
[00:02:24.600 --> 00:02:26.040] It is not my choice.
[00:02:26.040 --> 00:02:29.320] No fig leaves, but bookstores require that, or they won't sell it.
[00:02:29.320 --> 00:02:30.120] So I defer to that.
[00:02:30.360 --> 00:02:30.600] Really?
[00:02:30.600 --> 00:02:31.160] Is that right?
[00:02:31.160 --> 00:02:32.920] Yeah, the god of sales.
[00:02:32.920 --> 00:02:33.800] Oh, my gosh.
[00:02:34.440 --> 00:02:34.840] I know.
[00:02:34.840 --> 00:02:35.720] This is so stupid.
[00:02:35.720 --> 00:02:38.040] Hi, we all know what the word is.
[00:02:39.320 --> 00:02:49.720] Well, anyway, here's the new book: it's called Going Menopostal: What You and Your Doctor Need to Know About the Real Science of Menopause and Perimenopause.
[00:02:49.720 --> 00:02:56.360] I forgot to mention that you've written for the New York Times, Time Magazine, The Washington Post, The Independent in the UK, McLean's.
[00:02:56.680 --> 00:03:01.320] You've been on Today, Good Morning America, CNN, Nightline, Anderson Cooper, coast to coast.
[00:03:01.320 --> 00:03:02.760] Oh, you did coast to coast AM?
[00:03:02.760 --> 00:03:03.800] All right, that's cool.
[00:03:03.800 --> 00:03:05.400] You get those calls at two in the morning.
[00:03:05.400 --> 00:03:06.120] That's always big fun.
[00:03:06.520 --> 00:03:08.360] Actually, I didn't write the story for the New York Times.
[00:03:08.360 --> 00:03:09.800] Someone wrote one about me.
[00:03:09.800 --> 00:03:15.080] So I don't write that many news article-type pieces.
[00:03:15.080 --> 00:03:16.440] Oh, well, that's pretty cool, though.
[00:03:16.440 --> 00:03:19.160] Anyway, well, Amy, I've known you a long time.
[00:03:19.160 --> 00:03:26.840] I never thought we would be discussing that part of your body because I don't know you that well.
[00:03:26.840 --> 00:03:29.480] So, what's going on down there?
[00:03:29.480 --> 00:03:37.720] Well, it's actually going on throughout all of medicine, and it's that we have most of our medical care, and this is according to the U.S.
[00:03:37.720 --> 00:03:42.360] National Academy of Medicine, not some random Twitter person.
[00:03:42.360 --> 00:03:47.440] Most of our medical care is not based on adequate evidence, more than half.
[00:03:47.440 --> 00:03:51.200] I mean, that adequate, that's not like rigorous, it's adequate.
[00:03:51.200 --> 00:03:57.760] And you see this, if you know this science, you see this in every area of your treatment, and I do.
[00:03:57.760 --> 00:04:05.040] And that was how I came to write this book because I was sitting here in Venice, California, in my very temperate office.
[00:04:05.040 --> 00:04:06.480] It's the most temperate place in the world.
[00:04:06.480 --> 00:04:14.320] It's like 55 degrees year-round, breeze blowing, and all of a sudden, oh my God, I'm locked in a trunk in the Everglades.
[00:04:15.280 --> 00:04:17.760] Every pore of my body is just pouring sweat.
[00:04:17.760 --> 00:04:18.560] It's horrible.
[00:04:18.560 --> 00:04:22.320] And I think, oh my God, I think this is a hot flash.
[00:04:22.320 --> 00:04:23.680] So horrible.
[00:04:23.680 --> 00:04:30.320] And so, and I think, you know, what I want to do is to go to my doctor, my gynecologist, and say, I'm uncomfortable.
[00:04:30.320 --> 00:04:31.600] What do I do?
[00:04:31.600 --> 00:04:33.040] But I know better.
[00:04:33.040 --> 00:04:38.480] I was coached, this very generous guy, he co-wrote this seminal book in epidemiology.
[00:04:38.480 --> 00:04:40.720] I can't speak, a modern epidemiology.
[00:04:40.720 --> 00:04:48.320] His name is Sandra Greenland, just generously coached me in how to read and critically evaluate science since about 2007.
[00:04:48.640 --> 00:04:56.640] And so, because of him, and because he sent me all these articles about fraud and abuse and errors in medicine, I was very attuned to that.
[00:04:56.640 --> 00:05:09.120] And so, I went through and started this deep dive into the research, and I saw there was this huge, horrible gap between the practice standards and the science.
[00:05:09.120 --> 00:05:18.480] And every area of medicine, again, is like this, but perimenopause and menopause medical care is the most patient-betraying area of medicine.
[00:05:19.120 --> 00:05:20.000] How can that be?
[00:05:20.000 --> 00:05:26.640] I mean, this is, we've known about this for a long time, and there must be at least a century's worth of serious medical research on it.
[00:05:26.640 --> 00:05:28.800] How can there be this still this huge gap?
[00:05:28.800 --> 00:05:30.040] You're exactly right.
[00:05:29.600 --> 00:05:33.240] Here's the scandal of gynecology departments.
[00:05:33.560 --> 00:05:37.960] In gynecology departments, they are all what I call baby doctors.
[00:05:37.960 --> 00:05:40.520] So they're maternity specialists.
[00:05:40.520 --> 00:05:45.240] They are highly trained in delivering babies, and they're also reproductive specialists.
[00:05:45.240 --> 00:05:48.760] So they specialize in fertility and these problems.
[00:05:48.760 --> 00:05:51.880] People have polycystic ovary disease.
[00:05:51.880 --> 00:05:59.800] Nobody gets training in menopause, or some now are starting to, but the training they have, it's really kind of a joke.
[00:05:59.800 --> 00:06:03.800] They take an online course at the menopause society.
[00:06:03.800 --> 00:06:06.120] You know, that's like passing traffic school.
[00:06:06.120 --> 00:06:08.200] You know, it's not deep knowledge.
[00:06:08.200 --> 00:06:18.840] You're not having some person in clinical rotation who's a seasoned old, crusty expert kick your ass, you know, and you're not reading the science because here's another revelation.
[00:06:18.840 --> 00:06:28.680] There are three big myths of our medical care, and one of them is that doctors read scientific evidence and evaluate you and treat you based on the evidence.
[00:06:28.680 --> 00:06:29.720] They don't.
[00:06:29.720 --> 00:06:33.720] Doctors are not trained to read evidence in med school.
[00:06:33.720 --> 00:06:52.840] They can't critically evaluate it and they don't, frankly, have time to read it, you know, at an HMO like mine, Kaiser Permanente, where doctors have 20 minutes to see you, chop, chop, chop, one patient after the next, medical record keeping requirements, you know, and I'll have doctors email me at seven o'clock quite frequently, so it's not like they're doing nothing.
[00:06:52.840 --> 00:06:54.200] So I can sympathize.
[00:06:54.200 --> 00:07:02.520] I would read it, but I'm a psychoscientific mole rat who sits here dawn till dusk, you know, rejoicing over working.
[00:07:02.520 --> 00:07:07.480] And people want families and things, so I can't expect that of them.
[00:07:07.800 --> 00:07:08.200] Wow.
[00:07:08.200 --> 00:07:09.480] Yeah, I used to be with Kaiser.
[00:07:09.480 --> 00:07:12.120] If you got 20 minutes, that was pretty generous, actually.
[00:07:12.120 --> 00:07:14.480] Mine were usually like eight minutes.
[00:07:14.120 --> 00:07:15.760] Yeah.
[00:07:16.080 --> 00:07:23.920] So, you know, since you're steeped in the literature of evolutionary psychology, let's just kind of back up and do a big picture look here.
[00:07:23.920 --> 00:07:26.160] Why do women go through menopause at all?
[00:07:26.160 --> 00:07:28.480] Why can't you just give birth for, you know, your whole life?
[00:07:28.480 --> 00:07:33.760] Wouldn't evolution select for you having 50 babies in the course of 100 years or so?
[00:07:33.920 --> 00:07:38.880] Well, no, because as you get older, you get less and less, progressively less healthy.
[00:07:38.880 --> 00:07:41.200] Aging causes unhealth, basically.
[00:07:41.200 --> 00:07:42.960] You erode, we erode.
[00:07:42.960 --> 00:07:53.920] And part of what I do in this book is give you the ways of eating and exercise that are the most powerful and efficient for really not eroding and for being healthy throughout your lifespan.
[00:07:53.920 --> 00:07:56.240] So you're you, you're just a little more wrinkled.
[00:07:56.240 --> 00:08:09.680] But with evolutionary psychology, you know, there's no strong proof of this, but we can speculate, you know, there's the grandmother hypothesis that we needed to have people who weren't having children to care for the children that exist.
[00:08:09.680 --> 00:08:15.680] And, but really, you know, you see that as we age, you're going to be much less healthy.
[00:08:15.680 --> 00:08:19.360] Like women need to, if they're going to have children, they want to freeze their eggs.
[00:08:19.360 --> 00:08:23.600] I think it's that they need to do it before 35, certainly, and ideally well before.
[00:08:23.600 --> 00:08:26.320] And the same thing, man, you have old sperm.
[00:08:26.320 --> 00:08:27.680] Your sperm gets old.
[00:08:27.680 --> 00:08:34.240] So you've got to do that too, you know, when you're young, in your 20s, you know, if you want to have kids at a later date.
[00:08:34.240 --> 00:08:35.520] And so that's part of it.
[00:08:35.520 --> 00:08:42.960] You know, just that we're not, for whatever reason, these reasons probably were not adapted to, you know, be like 80 and pushing a stroller.
[00:08:42.960 --> 00:08:44.880] And oh my God, God forbid.
[00:08:45.520 --> 00:08:49.280] Yeah, also with limited resources in our ancestral environment.
[00:08:49.920 --> 00:09:02.600] Once you've given birth and then become a grandmother, probably there's not much more benefits you could provide versus those resources being allocated to the upcoming next generation of women.
[00:09:02.600 --> 00:09:07.480] So essentially, natural selection said, we're just going to let your body rot.
[00:09:07.480 --> 00:09:08.680] You're done.
[00:09:08.680 --> 00:09:09.880] Thank you very much.
[00:09:09.880 --> 00:09:11.240] Now go away.
[00:09:11.560 --> 00:09:12.920] But we're learning more and more.
[00:09:12.920 --> 00:09:16.760] You know, mitochondria, they've been called the energy furnaces of cells.
[00:09:16.840 --> 00:09:17.880] They're much more.
[00:09:17.880 --> 00:09:32.120] I don't want to go into it because it's a complex area, but keeping our mitochondria healthy through eating a diet that is not high in sugar or flour, that is not inflammatory, doing exercise, certain kinds of exercise.
[00:09:32.120 --> 00:09:38.520] And by the way, every bit of advice a medical provider gives you, pretty much, it just reminded me of that is wrong.
[00:09:38.520 --> 00:09:45.160] Osteoporosis, Kaiser Permanente, on their website, they talk about walking for healthy bones.
[00:09:45.160 --> 00:09:51.560] Oh my God, unless you're carrying an elephant, you're not putting enough weight on your bones to tell them they're needed.
[00:09:51.560 --> 00:09:53.080] And what you do, it's really muscles.
[00:09:53.080 --> 00:09:55.480] What you do for muscles, you do for bones.
[00:09:55.480 --> 00:09:57.480] So you need to challenge your muscles.
[00:09:57.480 --> 00:10:00.680] And by challenging them, you create tiny tears in them.
[00:10:00.680 --> 00:10:03.640] And the repair is building strong, healthy muscles.
[00:10:03.640 --> 00:10:15.320] And by the way, all that stuff on bone mineral density, this is about, it's designed, these tests, these scanners, they're designed to prescribe you drugs you don't need as a healthy woman.
[00:10:15.320 --> 00:10:22.360] Osteoporosis was given to, it was diagnosed in just a few elderly women with something called kyphosis, where they were bent over.
[00:10:22.360 --> 00:10:27.640] And the biggest cause of broken bones is falling when you're 79.
[00:10:27.640 --> 00:10:33.400] You know, not that your bones are just suddenly so holy that you collapse into a bucket.
[00:10:33.400 --> 00:10:33.800] Right.
[00:10:33.800 --> 00:10:40.040] Yeah, I've heard that line: that the most dangerous thing an 80-plus person can do every day is take a shower.
[00:10:40.520 --> 00:10:41.480] RBD.
[00:10:41.480 --> 00:10:45.200] I've got like garden clogs, purple gardening clogs in the middle of my living room.
[00:10:45.200 --> 00:10:48.400] Hi, death trap Amy, dummy.
[00:10:48.720 --> 00:10:49.920] Too funny.
[00:10:44.840 --> 00:10:50.080] Yeah.
[00:10:51.040 --> 00:11:00.960] So, for those of us that missed the sex ed class in eighth grade, can you explain what women's bodies go through each month and then what stops or what changes when you hit menopause?
[00:11:01.200 --> 00:11:01.360] Sure.
[00:11:01.520 --> 00:11:02.560] So, there are two parts.
[00:11:02.720 --> 00:11:03.760] I'm going to keep it brief.
[00:11:03.760 --> 00:11:10.400] There are basically two parts of our menstrual cycle: there's the estrogen part at the top, and the bottom is the progesterone phase.
[00:11:10.400 --> 00:11:16.480] These are both hormones, and they work together, their counterparts in the menstrual cycle.
[00:11:16.480 --> 00:11:21.200] And so, estrogen is the hormone that leads up to ovulation.
[00:11:21.200 --> 00:11:25.600] That's when there's a little sac with an egg in it, and it ruptures.
[00:11:25.600 --> 00:11:28.160] It's supposed to rupture, and then the egg is released.
[00:11:28.160 --> 00:11:29.040] And this is so cool.
[00:11:29.040 --> 00:11:31.120] I always thought the fallopian tubes were connected.
[00:11:31.120 --> 00:11:33.280] They're not, they're like little baseball mitts.
[00:11:34.240 --> 00:11:38.480] They sweep over, they grab the egg and they send it down to the uterus.
[00:11:38.480 --> 00:11:44.400] Where if some sperm meets up with it, you know, get fertilized, it implants into the uterine wall.
[00:11:44.400 --> 00:11:49.040] And nine months later, you know, you have a screaming being on your hands.
[00:11:49.200 --> 00:11:55.280] Or two or three if you have, you know, late pregnancies, which happens more, they have like triplets or something.
[00:11:55.280 --> 00:12:02.400] But anyway, so what happens, what goes wrong in perimenopause is that you often don't ovulate.
[00:12:02.400 --> 00:12:14.640] You know, so there's a whole signaling thing that's going on, but in perimenopause, that's a transition years to menopause, like three to ten years, in which some women, me especially, have horrible, horrible symptoms.
[00:12:15.040 --> 00:12:24.640] And during this time, what happens is you'll have a normal period, the same as all other periods, doesn't seem any different, but your egg will not rupture.
[00:12:24.640 --> 00:12:37.880] This is called an ovulation, so you're not ovulating, and this is very bad because what happens is when that egg ruptures, there's like this yellow litter left over from the sac is all the mess on the floor, and it becomes progesterone.
[00:12:37.880 --> 00:12:40.920] It's the corpus luteum, it's yellow, waxy stuff.
[00:12:40.920 --> 00:12:47.000] And you need progesterone for a certain amount of days in your cycle, like 10 to 12, I think it is.
[00:12:47.560 --> 00:12:55.880] And in order for you to have sufficient progesterone to protect your endometrium so you don't get sick, your endometrium is a uterine lining.
[00:12:55.880 --> 00:13:01.720] And what happens is in perimenopause, now doctors see perimenopause as menopause-like.
[00:13:01.720 --> 00:13:06.440] They think that estrogen is just in decline, petering out, but it's not.
[00:13:06.440 --> 00:13:13.720] This is why science is so important to be injected into our medical care, because what happens is that estrogen spikes and dives.
[00:13:13.720 --> 00:13:16.200] It goes sometimes three times higher.
[00:13:16.200 --> 00:13:20.040] And this makes you, estrogen is proliferative and inflammatory.
[00:13:20.040 --> 00:13:21.960] And in proper amounts, it's great.
[00:13:21.960 --> 00:13:23.320] With progesterone, it's great.
[00:13:23.320 --> 00:13:23.880] You need it.
[00:13:23.880 --> 00:13:26.760] It's an important home for every cell in our body.
[00:13:26.760 --> 00:13:34.120] But when it's spiking and you have no progesterone, this is a recipe for hell, especially for some of us.
[00:13:34.120 --> 00:13:51.800] And the reason the book is going menopostal that reflects my rage that after I fought three battles with Kaiser to get the progesterone I need, the amount I need and get it covered, instead of giving the cancer risk increasing drug that was on their formulary alone, is so terrible.
[00:13:51.800 --> 00:13:54.920] You know, that I, what was I saying here?
[00:13:54.920 --> 00:13:56.280] I lost my train of thought.
[00:13:56.280 --> 00:13:59.480] I, oh, it's about my rage that they wouldn't give this to other women.
[00:13:59.480 --> 00:14:02.840] And then also my rate, the symptoms.
[00:14:02.840 --> 00:14:04.680] I am, I'm a nice person.
[00:14:04.680 --> 00:14:05.480] I like people.
[00:14:05.480 --> 00:14:08.440] I'm at the hardware store in perimenopause.
[00:14:08.440 --> 00:14:15.200] And some man, like my dad, I'm from the Midwest, my dad, my grandpa, fixing stuff in the basement, whatever, behind me in line.
[00:14:15.200 --> 00:14:19.200] Like, I would like this man just because he, that breed that I know.
[00:14:14.840 --> 00:14:20.960] Oh, my God, the guy is humming.
[00:14:21.280 --> 00:14:25.680] I, I mean, seriously, I wanted to, I'm like looking around, I want a heavy object.
[00:14:25.680 --> 00:14:28.400] I want to bludgeon this man to death so he shuts up.
[00:14:28.400 --> 00:14:31.120] And then you're so ashamed because this is horrible.
[00:14:31.120 --> 00:14:34.560] You're saying like, calm the hell down, Alcon.
[00:14:34.560 --> 00:14:36.720] But this was from the lack of progesterone.
[00:14:36.720 --> 00:14:42.560] And you feel like you're basically like on rims on the highway in a police chase, which we have a lot of here in California.
[00:14:42.560 --> 00:14:43.600] It is terrible.
[00:14:43.600 --> 00:14:44.720] And there are many other symptoms.
[00:14:44.720 --> 00:14:50.720] So hot flashes, nausea, I mean, insomnia, and then you have brain fog.
[00:14:50.720 --> 00:14:52.000] It's just terrible.
[00:14:52.000 --> 00:15:00.080] So your doctor, all these baby doctors not knowing anything about this, they can't diagnose you and they can't treat you.
[00:15:00.400 --> 00:15:02.320] They'll dismiss what's wrong with you.
[00:15:02.320 --> 00:15:03.920] They won't connect all these things.
[00:15:03.920 --> 00:15:08.080] You have mysterious, mysterious, just like dysfunction of your whole body.
[00:15:08.080 --> 00:15:09.600] You think you're falling apart.
[00:15:09.600 --> 00:15:16.400] And as you know, Michael, uncertainty is the most disturbing feeling to humans, especially medical uncertainty.
[00:15:16.400 --> 00:15:25.120] And so women will try to seek out these diagnoses of like fibromyalgia and other things, you know, that and get treated for diseases they don't have.
[00:15:25.120 --> 00:15:26.800] It's terrible.
[00:15:27.280 --> 00:15:42.320] Just again, I just can't believe it after all this medical research and you know half the population is female and they go to and they go to Kaiser and they have OBGBYNs and so forth.
[00:15:42.320 --> 00:15:43.360] How could they not know this?
[00:15:43.360 --> 00:15:49.040] I mean, if you walked into your doc and told that story, they should go, oh, well, I'll tell you exactly what's going on.
[00:15:49.200 --> 00:15:50.000] I know.
[00:15:50.000 --> 00:15:52.160] And my gynecologist, he's a good guy.
[00:15:52.640 --> 00:15:53.600] I do have a man.
[00:15:53.600 --> 00:15:55.200] It's not like those people with cancer.
[00:15:55.200 --> 00:15:58.880] Okay, unless you've had a glioma, I am not seeing you as a doctor.
[00:15:58.880 --> 00:15:59.680] You know, he's great.
[00:15:59.800 --> 00:16:01.400] So he treated me with respect.
[00:16:01.400 --> 00:16:05.240] And he and his boss, they listened to me.
[00:16:05.240 --> 00:16:06.760] I sent them a slew of studies.
[00:16:06.760 --> 00:16:08.120] I'm really annoying.
[00:16:08.120 --> 00:16:09.720] And they had finally a meeting with me.
[00:16:09.800 --> 00:16:10.680] You're one of those.
[00:16:10.680 --> 00:16:11.400] I am.
[00:16:11.400 --> 00:16:13.320] Well, you're not going to give me unscience.
[00:16:13.320 --> 00:16:14.360] You're not going to harm me.
[00:16:14.360 --> 00:16:15.880] And this is actually going out.
[00:16:15.880 --> 00:16:21.160] The head of gynecology now, it's Kaiser West LA, is so ignorant of menopause science.
[00:16:21.160 --> 00:16:23.560] She's denying me care that I need.
[00:16:23.560 --> 00:16:28.200] I have, for I have, I'm a rapid metabolizer of steroids.
[00:16:28.200 --> 00:16:35.400] I got something done called pharmacogenetics, which looks at your genetic profile as far as how you metabolize drugs.
[00:16:35.400 --> 00:16:36.520] It's very helpful.
[00:16:36.520 --> 00:16:44.360] So I have that and other things that show, oh, look, I'm not getting, I have tests showing I don't even get half the estrogen I take.
[00:16:44.360 --> 00:16:45.320] So I need more.
[00:16:45.320 --> 00:16:46.440] I need a double dose.
[00:16:46.440 --> 00:16:48.120] For someone else, that would be a lot.
[00:16:48.120 --> 00:16:51.000] For me, it is not what she calls a super physiologic dose.
[00:16:51.000 --> 00:16:55.320] Now, this woman tells me that I need to taper off estrogen at 60.
[00:16:55.320 --> 00:17:01.640] Okay, this is research circa 2002 that was debunked in 2004.
[00:17:01.640 --> 00:17:04.280] This is 2025, I recall.
[00:17:04.280 --> 00:17:05.240] Yes, I do.
[00:17:05.880 --> 00:17:12.840] We get a little forgetful of menopause, the norepinephrine and dopamine tank, and I have ADHD and they're already like, you know, hello down there.
[00:17:13.080 --> 00:17:16.680] Anyway, so, and she tells me she reads the science.
[00:17:17.080 --> 00:17:18.760] Yeah, no, you don't.
[00:17:18.760 --> 00:17:34.120] And I sent her this huge document with the study by this guy back who shows women who have, who take estrogen late into life, you know, that they don't have breast cancer, that they have protected cardiology, cardiovascular systems, all this protection.
[00:17:34.200 --> 00:17:40.760] We found that estrogen is protective if, only if you take it right after menopause is a healthy woman.
[00:17:40.760 --> 00:17:43.480] If you're not healthy, you're broken, estrogen won't break you further.
[00:17:43.480 --> 00:17:45.440] It's really pretty terrible.
[00:17:46.080 --> 00:17:46.640] Yeah.
[00:17:44.520 --> 00:17:51.600] You know, I just think there's so much literature to read, and doctors are busy.
[00:17:51.760 --> 00:17:53.280] They just don't keep up.
[00:17:53.280 --> 00:17:53.680] They should.
[00:17:53.680 --> 00:17:54.800] They know they should.
[00:17:54.800 --> 00:17:55.520] They just can't.
[00:17:55.520 --> 00:17:59.920] I've tell the story about, you know, my mom went through 10 years of brain tumors.
[00:17:59.920 --> 00:18:01.360] She had meningioma brain tumors.
[00:18:01.520 --> 00:18:01.920] Oh, my God.
[00:18:02.160 --> 00:18:04.080] Women get more than men.
[00:18:04.080 --> 00:18:07.360] And then, so she had five craniometries.
[00:18:07.360 --> 00:18:09.760] This goes on and on for a whole decade.
[00:18:09.760 --> 00:18:14.640] But in the middle of all this, she got all of a sudden there's a tumor in one of her lungs.
[00:18:14.720 --> 00:18:22.880] I thought, come on, what are the chances she got two completely different kinds of tumors that maybe some cells in the brain migrated to her lungs or something like this?
[00:18:22.880 --> 00:18:27.920] So, and she was being treated by these top oncologists at USC.
[00:18:27.920 --> 00:18:31.040] And, you know, they go, nope, nope, that's not possible.
[00:18:31.040 --> 00:18:35.280] The meningioma tumors cannot do what you just think they can do.
[00:18:35.280 --> 00:18:39.040] Anyway, that night, I had, I went to a dinner party at Carol Taverse's house.
[00:18:39.040 --> 00:18:39.360] I love it.
[00:18:39.520 --> 00:18:40.880] Apart from where you have, yeah.
[00:18:41.200 --> 00:18:45.840] And there at the dinner was a guy named Avram Blooming, who is an oncologist.
[00:18:45.840 --> 00:18:47.600] I quote both of them in my book.
[00:18:47.600 --> 00:18:48.000] Yeah.
[00:18:48.000 --> 00:18:48.560] Oh, right.
[00:18:48.560 --> 00:18:49.520] Yes, right.
[00:18:49.520 --> 00:18:51.760] So I'm telling Avram this story.
[00:18:51.760 --> 00:18:57.680] He goes, No, there was just a paper out like a year ago showing that that can happen and I'll send it to you.
[00:18:57.680 --> 00:18:58.560] So he sends it to me.
[00:18:58.560 --> 00:19:00.080] I send it to the USC doc.
[00:19:00.240 --> 00:19:01.760] He's like, huh, never saw that.
[00:19:01.760 --> 00:19:03.040] I'm like, isn't this terrible?
[00:19:03.040 --> 00:19:03.760] This is okay.
[00:19:03.760 --> 00:19:06.320] Everyone needs to know this is all of medicine.
[00:19:06.320 --> 00:19:12.160] And the problem is, if you're me and you're really a pain in the ass too, you can deal with this because you read the research.
[00:19:12.160 --> 00:19:15.440] But doctors, remember, they are not trained to read the research.
[00:19:15.440 --> 00:19:16.960] They don't know how.
[00:19:16.960 --> 00:19:18.240] And they don't have time.
[00:19:18.640 --> 00:19:22.480] And when you don't know how to read the research, you also don't know how to look it up.
[00:19:22.480 --> 00:19:26.400] You know, you don't know how to use PubMed, these Google Scholar, and all these things.
[00:19:26.400 --> 00:19:31.720] And you need to read enough in an area to know who are the key researchers who are doing really good work.
[00:19:32.040 --> 00:19:35.800] And, you know, who does the methodological crap?
[00:19:36.200 --> 00:19:43.960] You know, and no things like you don't look at studies from China and go, okay, you have to look for a body of work from everybody else because there's so much fraud.
[00:19:43.960 --> 00:19:47.400] And these doctors have not a clue, not a clue in the world.
[00:19:47.400 --> 00:19:53.800] You know, like this one where she's telling me to taper off estrogen, she's telling me this is harmful.
[00:19:54.120 --> 00:19:58.280] It's called iatrogenesis, medical care that intends to help, that harms.
[00:19:58.280 --> 00:20:06.280] So you need to continue taking estrogen through 79, like I was saying, when you're old, when you're going to fall, in order for your bones to be protected.
[00:20:06.280 --> 00:20:14.280] And if you stop at 60, not only do you reverse the advances that you had in your bones, you are unprotected for all those years.
[00:20:14.280 --> 00:20:17.160] Your cardiovascular system is unprotected.
[00:20:17.160 --> 00:20:27.000] Right after menopause, if you don't take estrogen, your estrogen receptors in your endothelium, this is the one cell layer, the lining of your arteries, they go away.
[00:20:27.000 --> 00:20:32.520] So you lose this vital protection, and one in five women will die of cardiovascular disease.
[00:20:32.520 --> 00:20:33.000] It's huge.
[00:20:33.000 --> 00:20:34.600] And soon, one in three.
[00:20:34.920 --> 00:20:40.120] So all these women really need real science driving their care.
[00:20:40.120 --> 00:20:47.640] And instead, they're getting this, like the head of Kaiser Gynecology West Alike is ignorant, tells me she knows science.
[00:20:47.640 --> 00:20:51.080] And oh, she told me also she's choosing the drugs in the formulary.
[00:20:51.080 --> 00:20:53.480] Hello, why don't we have my dog choose them?
[00:20:53.480 --> 00:20:55.560] Because it's now the same crab shoot.
[00:20:55.560 --> 00:20:56.520] It's terrible.
[00:20:56.520 --> 00:20:58.440] It's really terrible.
[00:20:58.440 --> 00:21:00.120] Amy, you're so funny.
[00:21:00.120 --> 00:21:01.560] I love your books and your writing.
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[00:21:32.480 --> 00:21:34.880] Well, I know you got a great sense of humor.
[00:21:34.880 --> 00:21:42.960] You opened this book with a story about your best friend forever dumped you by email on a Sunday.
[00:21:43.200 --> 00:21:45.440] She said, I think we should go our separate ways.
[00:21:45.440 --> 00:21:46.480] There was no explanation.
[00:21:46.480 --> 00:21:47.840] There was just the act.
[00:21:47.840 --> 00:21:52.560] Like I was some stranger she'd once had exchanged sharp words with in a grocery store.
[00:21:52.560 --> 00:21:54.080] I never heard from her again.
[00:21:54.080 --> 00:22:00.160] Getting dumped by a friend is worse than getting dumped by a man because you kind of expect that could happen.
[00:22:00.160 --> 00:22:01.840] There's also a predictable set of reasons.
[00:22:01.840 --> 00:22:03.040] A man ends it with you.
[00:22:03.040 --> 00:22:04.160] The sex got boring.
[00:22:04.160 --> 00:22:04.880] You got boring.
[00:22:04.880 --> 00:22:06.080] He's in love with your sister.
[00:22:06.080 --> 00:22:08.400] He's in love with your sister's husband.
[00:22:08.720 --> 00:22:09.680] Anyway, did you?
[00:22:09.760 --> 00:22:12.400] So you've never figured out what was the upshot of that?
[00:22:12.880 --> 00:22:23.120] And I would wake up, you know, at three in the morning, and part of it was perimenopause, but just, why did, why, why, you know, and because again, uncertainty is so disturbing.
[00:22:23.120 --> 00:22:26.720] It was just like, look, I hate your red hair or whatever.
[00:22:26.720 --> 00:22:30.320] You know, anything, any kind of explanation, I really would have been helped by.
[00:22:30.320 --> 00:22:31.280] And it really is terrible.
[00:22:31.280 --> 00:22:35.440] Women feel so acutely this loss of female friendship.
[00:22:35.440 --> 00:22:37.920] And, you know, I just don't want to go through that ever again.
[00:22:37.920 --> 00:22:43.040] I mean, I take, of course, like risks and have people in my life because I'm not going to not do that.
[00:22:43.040 --> 00:22:45.120] But that was really painful.
[00:22:45.120 --> 00:22:45.520] Yeah.
[00:22:45.840 --> 00:22:46.240] All right.
[00:22:46.240 --> 00:22:48.640] So symptoms began for you at age 52.
[00:22:48.640 --> 00:22:51.680] What's the range for women on average when it begins?
[00:22:51.680 --> 00:22:52.640] It really varies.
[00:22:52.640 --> 00:22:56.800] Someone early early perimenopause is 35.
[00:22:56.800 --> 00:23:02.440] And I write about that because there are nuances with each area of menopause.
[00:23:02.600 --> 00:23:07.960] But most women, mid-40s to like 50, I think 51 is the average age.
[00:23:08.360 --> 00:23:10.200] But really, things are very varied.
[00:23:10.200 --> 00:23:11.240] And the same thing goes.
[00:23:11.240 --> 00:23:12.920] Here's another bit of unscience.
[00:23:12.920 --> 00:23:15.720] The menstrual cycle that we've been told is 28 days.
[00:23:15.720 --> 00:23:17.000] No, it's not.
[00:23:17.000 --> 00:23:19.480] No, it can be 50 or 20.
[00:23:19.480 --> 00:23:28.200] And those fertility apps that go by a 28-day menstrual cycle, they're telling women like what days they should, you know, have sex to get pregnant.
[00:23:28.200 --> 00:23:31.320] Women who are desperate to have a baby, oh my God, they're wrong.
[00:23:31.320 --> 00:23:33.080] It's really egregious.
[00:23:33.080 --> 00:23:37.080] So just when I say every area, I mean every area.
[00:23:37.080 --> 00:23:37.880] Amazing.
[00:23:37.880 --> 00:23:39.800] Again, more bad science.
[00:23:39.800 --> 00:23:42.840] Okay, so there's a broad range there.
[00:23:42.840 --> 00:23:48.280] And then what kind of range is there for the intensity of the symptoms?
[00:23:48.280 --> 00:23:50.040] You know, there's a huge range.
[00:23:50.040 --> 00:23:53.400] Some women do not have symptoms really at all.
[00:23:53.400 --> 00:23:56.680] They barely experience it, if at all.
[00:23:56.680 --> 00:23:59.800] And they're lucky because they're not having this suffering.
[00:23:59.800 --> 00:24:08.200] But here's the thing: what we've seen is that progesterone, like estrogen, is a protective drug to take.
[00:24:08.200 --> 00:24:22.280] And so those women, you know, it's very likely that their progesterone is low or non-existent, that they're having these anovulatory cycles, you know, even though they're not being so disturbed by them, or they're having too short progesterone phase cycles.
[00:24:22.280 --> 00:24:38.120] And I want to say also, I should credit this, the research on progesterone and perimenopause comes from this incredible researcher, Gerilyn Pryor, this fierce woman, grew up in Alaska with no running water or electricity, childhood missionaries.
[00:24:38.120 --> 00:24:43.720] And in this fierce, harsh environment, it created the scientist who fights for things.
[00:24:43.720 --> 00:24:45.680] And you were asking, why don't we know this stuff?
[00:24:46.000 --> 00:25:07.840] Now, she is, you know, the work that she puts out, it's good science, but it is contrary to the beliefs in science about perimenopause and midroxyprogesterone acetate, the drug they give the synthetic that was on Kaiser's formulary that increases breast cancer risk, cardiovascular risk, you know, risk of Alzheimer's and just brain harm.
[00:25:07.840 --> 00:25:14.960] You know, and so she fought to have perimenopause recognized for the unique hormonal state it is with the ups and downs of estrogen.
[00:25:14.960 --> 00:25:17.840] This comes from her work and others that she cites.
[00:25:17.840 --> 00:25:26.960] And then also to have progesterone recognized, it is the most healthy, least side effect-laden drug, less, fewer side effects than aspirin.
[00:25:26.960 --> 00:25:30.160] And really, you know, in perimenopause for me, it was the body's volume.
[00:25:30.160 --> 00:25:31.280] It was wonderful.
[00:25:31.280 --> 00:25:33.760] And it gave me my sleep back, which is really important.
[00:25:33.760 --> 00:25:42.000] That's the fail-safe I tell women in the book because I tell, I say, look, I've written this book in ordinary language so it can be understood by everyone.
[00:25:42.000 --> 00:25:42.960] There's my router over there.
[00:25:42.960 --> 00:25:45.760] It says, write every page in this book for Pamela D.
[00:25:45.920 --> 00:25:47.680] She's my favorite bus driver.
[00:25:48.000 --> 00:25:50.320] She's smart, but she doesn't read science.
[00:25:50.320 --> 00:25:52.320] You know, so it needs to be accessible.
[00:25:52.320 --> 00:25:59.520] And so that way women can bring the science to their doctors, but that's not enough because the doctor, here, give me evidence-based care.
[00:25:59.600 --> 00:26:02.000] The doctor can say, well, no, no.
[00:26:02.240 --> 00:26:13.600] But prior, Gerilyn Pryor, what she did is she created this quantitative basal temperature taking where you measure your temperature every morning for a month and ideally for a few months.
[00:26:13.680 --> 00:26:16.000] You have some extra additional data.
[00:26:16.000 --> 00:26:26.480] And using the there, it's explained in my book, but you use what your temperature is to determine whether or not you have progesterone and adequate progesterone for adequate gaze.
[00:26:26.480 --> 00:26:32.120] And if you don't, you can go to your doctor and say, and I'm not saying that you should lie, but sleep.
[00:26:29.760 --> 00:26:36.040] Sleep, we don't like you can't say, I don't get to sleep if you're a doctor.
[00:26:36.280 --> 00:26:37.960] So that's very persuasive.
[00:26:38.200 --> 00:26:40.680] And say, look, you know, here's the data.
[00:26:40.680 --> 00:26:43.880] This is legit medical data from my body.
[00:26:43.880 --> 00:26:44.680] I've measured this.
[00:26:44.680 --> 00:26:47.240] It takes a digital thermometer, 999.
[00:26:47.240 --> 00:26:47.720] That's all.
[00:26:47.720 --> 00:26:50.200] Write it down in the mornings every day.
[00:26:50.200 --> 00:26:57.960] And you can say, I'm not making adequate progesterone and show them a little chart, you know, and then say, I need this.
[00:26:57.960 --> 00:27:04.040] And then what you need to do is to get the amount that they give in France, which they don't give in the U.S.
[00:27:04.200 --> 00:27:06.120] for no reason whatsoever.
[00:27:06.280 --> 00:27:07.800] They tried to deny me the amount.
[00:27:07.800 --> 00:27:12.120] It's 300 milligrams of what's called oral micronized progesterone.
[00:27:12.120 --> 00:27:21.000] And this is a really safe form of progesterone to take, not unlike midroxy progesterone acetate, the synthetic, but it is in peanut oil.
[00:27:21.000 --> 00:27:29.720] And the only, you know, there are a few reasons you can't take it if you have liver ascites, which is fluid buildup, or really low blood pressure.
[00:27:29.720 --> 00:27:37.160] But basically, it's extremely healthy and health-promoting and protective of your cardiovascular system, your bones.
[00:27:37.160 --> 00:27:38.520] It works with estrogen.
[00:27:38.520 --> 00:27:44.440] They work together to, you know, foster and maintain strong bones, strong, healthy bones.
[00:27:44.440 --> 00:27:46.360] So all of this is just vital.
[00:27:46.360 --> 00:27:48.840] And you're not able to get this from your doctor.
[00:27:48.840 --> 00:27:50.120] You go to the baby doctor.
[00:27:50.120 --> 00:27:50.680] They don't know.
[00:27:50.680 --> 00:27:52.520] They're basically faking it off a sheet.
[00:27:52.680 --> 00:27:54.200] You know, they've got some practice standards.
[00:27:54.200 --> 00:27:55.480] Oh, here's what we do.
[00:27:55.480 --> 00:27:57.960] Or they heard something or their colleague does something.
[00:27:57.960 --> 00:27:59.400] That's not science.
[00:27:59.560 --> 00:28:07.480] And the reason why they give 100 or 200 milligrams here, it should be, oh, well, we, because it was tested against this and that, and it's better.
[00:28:07.480 --> 00:28:09.320] We see that it has better effects.
[00:28:09.320 --> 00:28:10.280] They haven't done that.
[00:28:10.280 --> 00:28:17.200] They just say, they actually said to me initially that, oh, well, that's the amount they give in France.
[00:28:14.840 --> 00:28:20.160] And I said, you hear all these French studies, but that's French studies.
[00:28:20.160 --> 00:28:20.960] I'm sorry.
[00:28:21.600 --> 00:28:24.640] Are they Martians or they just dress better and eat better food?
[00:28:24.640 --> 00:28:26.160] You know, come on.
[00:28:27.760 --> 00:28:42.000] Yeah, but again, I mean, with baby boomers, you know, coming coming online here for these kinds of issues, you would think a place like Kaiser would have like the menopause expert person that sees patients all day because there's so many now.
[00:28:42.000 --> 00:28:42.960] Well, they have one.
[00:28:42.960 --> 00:28:47.280] They have a girl, a woman who got went through the menopause society's training.
[00:28:47.280 --> 00:28:48.240] But you know what?
[00:28:48.240 --> 00:28:52.720] I mean, when I talk to them, I can identify all the stuff they don't know.
[00:28:52.720 --> 00:28:56.640] It's amazing because that's different from what I do.
[00:28:56.640 --> 00:28:58.640] Like I said, I'm a psycho.
[00:28:58.640 --> 00:29:00.480] I had studies piled all over my floor.
[00:29:00.560 --> 00:29:01.600] There's a shot of that.
[00:29:01.600 --> 00:29:04.560] It looks like, you know, like mountains, like moguls.
[00:29:05.120 --> 00:29:09.520] You know, I read for eight years, deep dive, and I'm terrified of getting things wrong.
[00:29:09.520 --> 00:29:13.680] And I send things to researchers and say, oh, I did this with Carol Tavis and blumming.
[00:29:13.840 --> 00:29:15.760] Hand me my ass, like kick my ass.
[00:29:15.760 --> 00:29:17.120] And Carol knows me.
[00:29:17.120 --> 00:29:27.200] You know, and so you do it in a way where you show them that you're grateful for the most harsh criticism because I can't bear to have errors in this book because I could hurt somebody.
[00:29:27.200 --> 00:29:33.200] And so it's that's kind of thinking, whereas everybody else, like these doctors, they want, I mean, can't blame this as normal life.
[00:29:33.200 --> 00:29:38.080] They want to go home and have a family and go on a date or whatever and have a life, you know.
[00:29:38.080 --> 00:29:41.280] And for the last couple of years, I didn't go anywhere.
[00:29:41.280 --> 00:29:43.120] Thanksgiving, Christmas, people invite me places.
[00:29:43.200 --> 00:29:44.320] I'm sorry I have to stay home.
[00:29:44.320 --> 00:29:46.480] The book monster, I called it.
[00:29:46.800 --> 00:30:00.920] And so, you know, when they have one expert and she really doesn't know things, I love when they say stuff to me like, there's something called sex hormone binding globulin, which I have elevated levels of because I eat a carnivore diet.
[00:30:00.920 --> 00:30:11.720] And if you don't have high insulin, which is good, you know, healthy insulin, very healthy, then your SHBG, it's called, it goes sky high and it binds with steroids.
[00:30:11.720 --> 00:30:16.680] So it binds with testosterone and estradiol and sells them right out of your system.
[00:30:16.680 --> 00:30:25.960] And so I'm asking for a double dose of what would be a high dose for someone else, but for me, sufficient since I'm getting less than half the estrogen I take.
[00:30:25.960 --> 00:30:29.960] And she says to me, oh, but estrogen raises your SHBG.
[00:30:30.280 --> 00:30:35.320] Well, yes, oral estrogen does, but I'm not taking oral estrogen.
[00:30:35.320 --> 00:30:36.920] I'm taking transdermal.
[00:30:36.920 --> 00:30:42.200] And you know that because I'm asking for double patch, you know, and you see my records.
[00:30:42.200 --> 00:30:45.160] And so that raises it in the most minimal way.
[00:30:45.160 --> 00:30:47.000] And it probably is going to suppress it.
[00:30:47.000 --> 00:30:51.320] And so this is the kind of thing like, hi, I mean, I'm a weirdo wholly infants.
[00:30:51.320 --> 00:30:52.120] I used to have a pink car.
[00:30:52.120 --> 00:30:53.160] I have a tiny little dog.
[00:30:53.160 --> 00:30:54.360] I wear clothes.
[00:30:54.360 --> 00:30:55.480] I'm a crackpot.
[00:30:55.480 --> 00:30:58.680] I shouldn't be the medical genius in all of these situations.
[00:30:58.680 --> 00:31:06.680] And in every situation, I had a eye surgery for my, thanks, mom, this genetic disease called, I'm going to say it politely, Fuchs dystrophy.
[00:31:06.680 --> 00:31:08.680] You can better believe I say it the other way.
[00:31:08.680 --> 00:31:14.360] And, you know, so I had to have a transplant, the endothelium, the one cell layer over your cornea.
[00:31:14.360 --> 00:31:16.280] I had to get a transplant in that.
[00:31:16.280 --> 00:31:18.600] And this doctor made me really sick.
[00:31:18.600 --> 00:31:21.240] She gave me an overdose of steroids.
[00:31:21.240 --> 00:31:29.720] She gave, they all give all these doctors, these people who have serious eye surgeries, they give you antibiotics and steroids that have bath preservatives.
[00:31:29.720 --> 00:31:33.480] They begin destroying the cornea in a matter of days.
[00:31:33.480 --> 00:31:35.160] I mean, it's crazy.
[00:31:35.480 --> 00:31:39.720] And so, okay, so she gives me afloat, I can't say it, right?
[00:31:40.040 --> 00:31:41.000] Afloxacin.
[00:31:41.000 --> 00:31:43.720] Okay, that's what it is, with a bath preservative.
[00:31:43.720 --> 00:31:48.080] But wait, there's moxaflaxacin that's like not expensive.
[00:31:44.840 --> 00:31:51.360] It's a generic word, you know, and it doesn't have the preservative.
[00:31:51.600 --> 00:31:54.800] How about we switch me to the drug that doesn't destroy the cornea?
[00:31:54.800 --> 00:31:56.240] Okay, cool.
[00:31:56.240 --> 00:32:08.960] I mean, like, why should I, you know, I was working on a book till I like fell in the car and fell on the gurney, so I didn't have time to read, you know, she's a surgeon, so she seems good, you know, that the cutting stuff sticking in X-Acto in your eye.
[00:32:08.960 --> 00:32:10.800] Yeah, I can't, you know, know that.
[00:32:11.360 --> 00:32:14.880] Her colleagues said she was good, and so I have to hope and believe that's true.
[00:32:14.880 --> 00:32:23.200] But on the medicine stuff, so these doctors, they focus on the X-Acto part, they know nothing about the drugs they prescribe, like nothing, nothing.
[00:32:23.200 --> 00:32:25.440] I mean, it's terrible, terrible, terrible.
[00:32:25.440 --> 00:32:26.480] Every area is like this.
[00:32:26.480 --> 00:32:37.440] And so if you can't do a deep dive into the research, or someone hasn't covered it, like I cover this area, Gary Tobbs, Nina Teisholt, other people cover the low carb area.
[00:32:37.440 --> 00:32:40.480] But really, you need this for every area of medicine.
[00:32:40.480 --> 00:32:47.920] You know, I have a book on osteoporosis that I have mostly written to debunk all the crap and tell you what actually keeps you healthy.
[00:32:47.920 --> 00:32:50.960] But, you know, that took me a long time.
[00:32:50.960 --> 00:33:02.640] And like hematology, you know, oncology, your specific kind of cancer, like you said, you know, with the lung, the cancer taking over the lung, doctors, oh no, it's not connected.
[00:33:02.640 --> 00:33:04.480] And then you just go to a dinner party.
[00:33:04.480 --> 00:33:10.480] I mean, how random, how horrible that if you had stayed home, like, what would the outcome have been?
[00:33:10.480 --> 00:33:11.760] I mean, that's, that's terrible.
[00:33:11.920 --> 00:33:12.720] Yes, exactly.
[00:33:12.720 --> 00:33:13.360] Yeah.
[00:33:13.360 --> 00:33:28.160] Well, yeah, I mean, this is just crazy that a science writer like Gary Tobbs, I mean, before Gary Tobbs brought so much attention to sugar and carbs and all that stuff, and he's the one that points out that doctors have no training in nutrition.
[00:33:28.160 --> 00:33:30.280] They don't take any courses in med school.
[00:33:30.280 --> 00:33:34.520] And this is like the biggest predictor of obesity, diabetes.
[00:33:29.680 --> 00:33:36.280] We have all these problems.
[00:33:36.520 --> 00:33:40.040] And the doctors for decades have been going, I wonder what it is.
[00:33:40.680 --> 00:33:41.720] It's so terrible.
[00:33:41.720 --> 00:33:49.000] And the lipid hypothesis, the idea that cholesterol cause or lipids cause heart disease, it is not proven.
[00:33:49.000 --> 00:33:54.520] It looks more and more like it's high blood sugar, insulin resistance, and what's called inflammaging.
[00:33:54.520 --> 00:34:18.600] And that's when you keep having the chronic inflammation, chronic low-grade inflammation, and then you basically have a broken immune system where you're in, you, you know, because it's on fire all the time, low-grade fire, you end up not having the immune resources when you need them if you have an infection or a disease that needs to have some, you know, immune warriors come out and deal with it.
[00:34:18.600 --> 00:34:20.440] And so you want to not have that.
[00:34:20.440 --> 00:34:29.240] And so I personally, I've gone really SWAT team on inflammation, especially because I got so sick from the steroid overdose this doctor gave me.
[00:34:29.240 --> 00:34:30.760] I mean, crazy, crazy.
[00:34:30.760 --> 00:34:35.560] Well, but on a separate question to that, what are the steroids supposed to do?
[00:34:36.520 --> 00:34:38.600] So what they, oh, sorry, I talked over you.
[00:34:38.600 --> 00:34:39.480] What did you say?
[00:34:39.480 --> 00:34:43.160] Yeah, are they supposed to, steroids are supposed to enhance healing or something?
[00:34:43.160 --> 00:34:48.200] They're supposed to prevent the rejection of your transplant.
[00:34:48.200 --> 00:34:48.680] Oh, I see.
[00:34:48.840 --> 00:34:50.120] But see, here's the thing.
[00:34:50.600 --> 00:34:53.960] The transplant I had is called D-MAC Decimets.
[00:34:54.360 --> 00:34:54.920] Sorry.
[00:34:54.920 --> 00:34:58.120] Okay, I'm going to not go there because I can't remember it right now.
[00:34:58.120 --> 00:35:13.720] But basically, it has an 0.6, it's either 0.6 or 0.7 percent chance of rejection, you know, and so because it's not vascularized, you don't have blood vessels in there in that in the endothelium or your cornea.
[00:35:13.720 --> 00:35:18.640] So, um, it doesn't even pay for them to do matching before they give you a transplant.
[00:35:14.760 --> 00:35:21.360] You just hope you get a young person's endothelium.
[00:35:21.680 --> 00:35:23.040] And I mean, and how miraculous!
[00:35:23.040 --> 00:35:27.040] And it's why I'm an organ donor because this is amazing that I'm allowed to see people.
[00:35:27.280 --> 00:35:31.200] Some young motor, some young man in a motorcycle, yeah, I thought that too.
[00:35:31.840 --> 00:35:35.040] Yeah, donor cycle, donor cycle, donor cycle, yeah.
[00:35:35.040 --> 00:35:50.880] And so, you know, um, so the steroids, but the thing is, I'm looking at this now because the steroids, so she, the, the, clinical habit, it won't be too long on this, but the they prescribe the standard in the field is four drops after the transplant.
[00:35:50.880 --> 00:36:04.400] Well, this is not based on oh, we researched this and three didn't do so well, it's just clinical habit, nobody compared anything, and they don't look at well, there's this one woman, Marianne O'Price, who's a clinician and researcher.
[00:36:04.400 --> 00:36:07.120] She looks at, oh, well, what about this steroid or that steroid?
[00:36:07.120 --> 00:36:09.680] But there's only a tiny bit of research in that.
[00:36:09.680 --> 00:36:14.720] What I want to know is what can you use instead of steroids because they have horrible systemic effects.
[00:36:14.720 --> 00:36:23.040] So, my doctor told me when I said she said steroids, and I said, Oh, because I know about steroids and inflammation, all this other stuff that's related.
[00:36:23.040 --> 00:36:28.880] And I said, Oh, well, you know, I'm worried because the bone destruction, all these other destruction from steroids in the body.
[00:36:28.880 --> 00:36:31.680] And she said, Oh, they don't have systemic effects, they stay in the eye.
[00:36:31.680 --> 00:36:33.280] I thought, like, that's unlikely.
[00:36:33.280 --> 00:36:34.400] Sure enough, I look it up.
[00:36:34.400 --> 00:36:36.080] Yeah, no, they don't.
[00:36:36.080 --> 00:36:38.880] I had horrible systemic effects, just terrible.
[00:36:38.880 --> 00:36:41.200] And I ended up, I had her switch me.
[00:36:41.360 --> 00:36:45.840] Doctors do not like this when you tell them the reasons why the drug they gave you was like horrible.
[00:36:45.840 --> 00:36:51.600] And I had her switch me to another steroid that has less systemic effects, but it still made me sick, you know.
[00:36:51.600 --> 00:36:56.000] And, you know, so these are not, it's not good to give patients.
[00:36:56.000 --> 00:36:58.600] Oh, so what she does, so they give four in the field.
[00:36:58.600 --> 00:37:01.640] She figures if four is good, eight is better.
[00:37:01.880 --> 00:37:03.240] It's not how steroids work.
[00:36:59.840 --> 00:37:03.880] This is horrible.
[00:37:04.120 --> 00:37:14.840] When you give steroids to a metabolically healthy patient like me, you can probably see, look at my arms, like I exercise, I eat a low inflammatory diet, you know, you know, that what is that?
[00:37:14.840 --> 00:37:16.200] What is a low inflammatory diet?
[00:37:16.520 --> 00:37:21.080] Oh, so I, oh, so well, let me just finish telling this because I get lost enough in stories.
[00:37:21.080 --> 00:37:24.680] But so what she did is she suppressed healthy inflammation in me.
[00:37:24.680 --> 00:37:26.360] And this was also a red flag.
[00:37:26.360 --> 00:37:30.600] I asked her when she talked about steroids, I said, well, what about, you know, healthy inflammation?
[00:37:30.600 --> 00:37:32.840] She said, oh, no, we want to suppress inflammation.
[00:37:32.840 --> 00:37:37.000] And I felt like, you, you know, missing some boats here, lady.
[00:37:37.240 --> 00:37:42.600] So, but I usually, you know, it was because I hadn't read because I was so busy on the book until like the moment.
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[00:38:12.920 --> 00:38:18.040] Before that I really didn't remember about the drugs and then I took them and got sick.
[00:38:18.040 --> 00:38:20.120] So you were saying, oh, low inflammation.
[00:38:20.120 --> 00:38:27.400] So what you want to do is to keep down omega-6 fatty acids and prioritize omega-3.
[00:38:27.400 --> 00:38:35.000] So I eat fish and you want to not eat, you know, these are basically inflammatory foods that have very high omega-6.
[00:38:35.240 --> 00:38:39.880] I don't eat the oils, and there are all sorts of fights about them.
[00:38:39.880 --> 00:38:45.280] But basically, they do, they're inflammatory in a way.
[00:38:45.520 --> 00:38:46.320] Other foods are not.
[00:38:44.680 --> 00:38:49.920] I eat butter, ghee, RG, I can never say that right.
[00:38:50.720 --> 00:39:07.360] And I eat a carnivore diet, and I fill in with some supplements for the few vegetables, you know, the nutrients I miss from vegetables, B1, manganese, or a couple of methyl, I forget how which folate is, it's folate, the kind that's better.
[00:39:07.840 --> 00:39:16.320] And then, so I only eat a few things: I eat herring, I eat salmon, I eat beef, I eat the ghee, and then butter.
[00:39:16.320 --> 00:39:17.200] And what else do I eat?
[00:39:17.200 --> 00:39:17.760] Eggs.
[00:39:17.760 --> 00:39:19.360] Oh, big secret on eggs.
[00:39:19.360 --> 00:39:20.640] Here's a big tip.
[00:39:20.640 --> 00:39:27.200] So you see these people like Vital Farms, scumbags, advertising, and I can prove this so it's not libel slander.
[00:39:27.200 --> 00:39:28.960] Well, actually, it'd be slander.
[00:39:29.760 --> 00:39:32.560] They advertise pasture-raised eggs.
[00:39:32.560 --> 00:39:36.320] So people think, oh, good, I won't, you know, have inflammatory food.
[00:39:36.320 --> 00:39:41.600] Well, that's crap because their pasture-raised eggs also get fed soy and corn.
[00:39:41.600 --> 00:39:42.640] It's really terrible.
[00:39:42.640 --> 00:39:48.640] And so, if you look, I think it's like eating maybe two eggs, like eating a tablespoon of canola oil or something.
[00:39:48.800 --> 00:39:52.080] I can't remember what it was, but it's really unhealthy.
[00:39:52.080 --> 00:39:56.400] Supermarket eggs, oh my god, they're the worst, inflammatory, terrible.
[00:39:56.400 --> 00:40:05.040] And so, I started getting, you know, they're hard to find eggs with that are raised, pasture-raised that are not fed corn and soy.
[00:40:05.040 --> 00:40:06.400] And they're hard to find.
[00:40:06.400 --> 00:40:18.400] And oh my God, because I was sick and everything, I live near Erewhon in Venice, which is a store where they charge rich people like undoubtedly amounts of money to show them, like, you're really, you are rich because you can burn money in a fire and it doesn't matter.
[00:40:18.760 --> 00:40:20.800] And so, and so oh my god, I'm from Michigan.
[00:40:20.800 --> 00:40:23.280] Like, the idea that I would spend, it was so horrible.
[00:40:23.280 --> 00:40:24.320] They didn't have eggs.
[00:40:24.800 --> 00:40:26.480] I bought, I had to buy six.
[00:40:26.480 --> 00:40:30.920] They didn't have a dozen, $10.99 for a six eggs, yeah.
[00:40:29.920 --> 00:40:33.000] And it was like $22 for a dozen eggs.
[00:40:33.160 --> 00:40:38.840] And I went to the counter and I was like, I want to disassociate myself from being, you know, being a person who paid this much for eggs.
[00:40:38.840 --> 00:40:43.960] And I said, like, I just have an eye issue, and like, I'm, you know, I'm, don't do this.
[00:40:43.960 --> 00:40:44.600] This is horrible.
[00:40:44.600 --> 00:40:50.280] This is like worst thing I've ever bought because, like, this is insane.
[00:40:50.280 --> 00:40:53.480] You know, anyway, so now I get the ones when they're in at whole foods.
[00:40:53.480 --> 00:40:57.240] Um, this one kind called Chino Valley, soy-free, corn-free.
[00:40:57.240 --> 00:41:00.040] There's happy hens, but basically, they're really hard to find.
[00:41:00.040 --> 00:41:01.240] They're always out of them.
[00:41:01.240 --> 00:41:07.800] And I was at one point where I was going to order 58 from a farm in Michigan, but you have to call like a Tuesday at 7 p.m.
[00:41:07.880 --> 00:41:10.200] on the dot or you don't get them.
[00:41:10.200 --> 00:41:13.240] What do they massage the hens before they give the eggs?
[00:41:13.240 --> 00:41:16.600] No, they just feed them like the fruit that isn't soy and corn.
[00:41:16.840 --> 00:41:17.960] It's so crazy.
[00:41:17.960 --> 00:41:21.400] And so, the reason I eat like this is because I'm 61.
[00:41:21.400 --> 00:41:30.040] And at 61, as you age, you get much less robust in terms of your immune system and all the stuff in your body, you know, and so bones, everything.
[00:41:30.040 --> 00:41:41.560] And so, I want to give my body the least amount of stress to overcome in terms of healing and everything, make my immune system as robust as possible, you know, be as strong as possible.
[00:41:41.560 --> 00:41:46.280] Um, and so did you change your diet when you went through menopause?
[00:41:46.280 --> 00:41:49.000] Oh, no, I actually, no, it was just in the middle.
[00:41:49.000 --> 00:41:49.960] I've eaten low carb.
[00:41:49.960 --> 00:41:51.960] Gary Todd's a good friend of mine.
[00:41:51.960 --> 00:42:03.400] Um, and so I've known him forever and ever since he wrote the soft science of dietary salt for no, I think it was, was that, yeah, well, it was for nature in like 1998, um, and then through with low carb stuff.
[00:42:03.400 --> 00:42:07.240] And so, in 2009, that was when I went low carb.
[00:42:07.240 --> 00:42:13.880] And then, um, it was like February of last year that I started eating carnivore, and I just meant to do it, you know, for a little while.
[00:42:13.880 --> 00:42:16.800] Um, I was fixing my testosterone level.
[00:42:17.200 --> 00:42:19.760] And as a woman, you cannot take testosterone.
[00:42:14.840 --> 00:42:20.960] This is, oh, that's another thing.
[00:42:21.120 --> 00:42:25.200] The doctor, their menopause expert, menopause expert, told me.
[00:42:25.440 --> 00:42:28.160] She said, oh, you know, you should take testosterone.
[00:42:28.160 --> 00:42:30.880] And I said, well, no, it's not safe.
[00:42:30.880 --> 00:42:32.400] And she said, yes, it is.
[00:42:32.960 --> 00:42:37.280] No, it's not because I read the research and I know how.
[00:42:37.280 --> 00:42:48.880] And I see that there just isn't enough longitudinal, like over years of time, study of whether it's safe for the cardiovascular system and, you know, perk breast cancer.
[00:42:48.880 --> 00:42:50.160] So I'm not going to take it.
[00:42:50.160 --> 00:42:53.760] And that's why there's no FDA-approved testosterone for women.
[00:42:53.760 --> 00:42:55.920] And to take the men's kind, it's not safe.
[00:42:55.920 --> 00:42:57.520] They're huge doses.
[00:42:57.520 --> 00:43:01.920] You know, and the safest kind, the best delivery form is a pellet implanted under the skin.
[00:43:01.920 --> 00:43:08.240] And that doesn't exist for women, except in some like they're like providers that sell it in their own thing.
[00:43:08.240 --> 00:43:09.920] You don't know what you're getting.
[00:43:09.920 --> 00:43:20.800] And so what I ended up doing, and I don't recommend this for everyone because, and I didn't put it in the book, because what your medical, your whole individual health metric is matters.
[00:43:20.800 --> 00:43:31.280] But I take DHEA, which is another hormone that you can get as a supplement, to try to correct that.
[00:43:31.280 --> 00:43:36.400] And it did, and then it didn't because I started eating carnivore and then it was uncorrected some more.
[00:43:36.720 --> 00:43:42.080] But I want to tell people also: supplements, this world, it's the wild, wild west.
[00:43:42.080 --> 00:43:43.120] There can be anything.
[00:43:43.120 --> 00:43:49.840] You can have like small children, like tiny little, like, okay, I'm fantasizing here, but in your, in your, like, your vitamin capsule.
[00:43:49.840 --> 00:43:50.560] Nobody knows.
[00:43:50.560 --> 00:43:52.240] And so, Consumer Lab is great.
[00:43:52.240 --> 00:43:52.800] I'm a member.
[00:43:52.800 --> 00:43:53.600] It's a member site.
[00:43:53.600 --> 00:43:55.920] It costs maybe like 50 bucks or something.
[00:43:55.920 --> 00:44:01.480] But they tell you, you know, what's in them, if they have the amount of the stuff, if they have arsenic and everything.
[00:44:01.720 --> 00:44:09.320] And so I use that to buy supplements and also to be frugal about it because you see that, you know, like I've lunged GNC and Swanson.
[00:44:09.320 --> 00:44:10.600] These are really good brands.
[00:44:10.600 --> 00:44:14.280] And I wouldn't think so because I had them growing up, Tail 12 Mall, the GNC store.
[00:44:14.280 --> 00:44:18.840] It seems, you know, sort of, you know, like it wouldn't be good, but they are.
[00:44:20.680 --> 00:44:29.000] All right, let's go through the different bodily systems that change during menopause and what you recommend women do to deal with that.
[00:44:29.000 --> 00:44:30.840] Okay, so bones, so interesting.
[00:44:30.840 --> 00:44:34.200] So this is, there's this whole scam.
[00:44:34.760 --> 00:44:39.640] Fox, the Merck came up with this drug called Fosimax that my mother took.
[00:44:39.640 --> 00:44:42.040] It's called a bisphosphonate.
[00:44:42.040 --> 00:44:53.160] And it was just for, you know, would have been just taken by these very, you know, elderly women with very fragile bones, you know, to protect them.
[00:44:53.160 --> 00:44:55.960] But they wanted, you know, a bigger customer base than that.
[00:44:55.960 --> 00:44:58.680] So they came up, this is so horrible.
[00:44:58.920 --> 00:45:08.680] They funded all this research, which found things that, you know, prescribed, that led to the prescription of bisphosphonates.
[00:45:08.680 --> 00:45:14.840] They got these scanners or these huge, the scanners for your bones were enormous and very expensive.
[00:45:14.840 --> 00:45:24.200] And they funded smaller ones going into doctor's offices, medical facilities, because the scanners would diagnose you as needing a drug.
[00:45:24.200 --> 00:45:37.480] Now, osteoporosis, porous bones, this is based on, you know, what they thought about bones, you know, like from centuries ago in France, you know, this idea of porous bones.
[00:45:38.120 --> 00:45:41.960] This is merely a risk for bone breakage.
[00:45:41.960 --> 00:45:49.440] It doesn't mean if you have porous bones, if you have a low bone, it's called bone density score, that doesn't mean you'll break bones.
[00:45:49.440 --> 00:45:51.840] And if you have a high one, it doesn't mean you won't.
[00:45:51.840 --> 00:45:58.240] Because what it doesn't measure, these scanners don't measure bone quality, they measure bone quantity, how much bone stuff you have in there.
[00:45:58.240 --> 00:45:59.360] And guess what?
[00:45:59.360 --> 00:46:09.440] Those drugs, the bisphosphonates, that supposedly are preventing bone breakage, what they do is they stop the removal of old crappy bone.
[00:46:09.440 --> 00:46:15.120] So you've got bone that's way past its prime and would get removed by these cells called osteoclasts.
[00:46:15.120 --> 00:46:27.840] I remember these osteoclast cutters, C cutters, and osteoblast builders, B builders, you know, and so you're not, and you don't build as fast as you cut, especially in menopause and older age.
[00:46:27.840 --> 00:46:35.760] And so by keeping crappy old bone around, basically, bisphosphonates, they make your bones more brittle and breakable.
[00:46:35.760 --> 00:46:39.040] They cause microcracks in your bones.
[00:46:39.040 --> 00:46:43.600] And so, like, within three years, that's the amount of time it takes to destroy your bone.
[00:46:43.600 --> 00:46:46.000] That's cool, really cool research, by the way, microcracks.
[00:46:46.000 --> 00:46:53.520] Richie Abel in England, he used a particle beam scanner in Germany that's the size of a football field to see this nano on the nano level.
[00:46:53.520 --> 00:46:55.520] And this is the kind of research I read.
[00:46:55.520 --> 00:46:57.840] And talking to him, I don't usually talk to many people.
[00:46:57.840 --> 00:47:01.040] I read their research because I don't care what you have to say or if you're impressive.
[00:47:01.040 --> 00:47:04.880] You know, you can be like the guy who's like doing science in the janitor's closet.
[00:47:04.880 --> 00:47:07.280] If it's good science, you know, I'm there.
[00:47:07.280 --> 00:47:13.200] But, you know, he was really, I mean, it's really important research because microcrests, you're cracking your bones.
[00:47:13.200 --> 00:47:20.240] What the bisphosphonates don't do is produce what you need, strong, quality, resilient bones.
[00:47:20.240 --> 00:47:22.800] You know, this is this is really vital for healthy bones.
[00:47:22.800 --> 00:47:27.840] And the way you do that, and doctors, I'm telling you to walk Kaiser on their website, I hate them.
[00:47:27.840 --> 00:47:29.440] I mean, I love Kaiser for a lot of reasons.
[00:47:29.440 --> 00:47:32.040] I have some, I have one doctor, my psychiatrist.
[00:47:32.040 --> 00:47:34.440] He is the only evidence-based doctor I have.
[00:47:34.440 --> 00:47:35.320] I can trust him.
[00:47:29.760 --> 00:47:36.280] He's fantastic.
[00:47:36.840 --> 00:47:42.520] He gives pharmacogenetic testing to patients to see: okay, should I give you this antidepressant or that?
[00:47:42.520 --> 00:47:44.040] Or how much of a drug do you need?
[00:47:44.040 --> 00:47:48.120] This is responsible medicine, individualized, responsible medicine.
[00:47:48.120 --> 00:47:56.920] Anyway, so with osteoporosis, what you need to do, especially in perimenopause when you can still build bone well, is to do this weight-bearing exercise.
[00:47:56.920 --> 00:47:58.600] This is what I recommend in the book.
[00:47:58.600 --> 00:48:02.040] And what I did, nutrition research, by the way, it's just shit.
[00:48:02.040 --> 00:48:02.760] Oops, sorry.
[00:48:03.000 --> 00:48:03.640] I love to say it.
[00:48:03.880 --> 00:48:04.920] Oh, you can do it.
[00:48:04.920 --> 00:48:05.480] Sorry.
[00:48:07.080 --> 00:48:08.120] So it's just crap.
[00:48:08.120 --> 00:48:11.400] What they do is they ask you, so what did you have to eat all last month?
[00:48:11.400 --> 00:48:12.360] Like, hi, Dr.
[00:48:12.360 --> 00:48:13.080] House.
[00:48:13.080 --> 00:48:13.960] People lie.
[00:48:13.960 --> 00:48:14.600] I mean, really?
[00:48:14.600 --> 00:48:15.240] And you don't remember.
[00:48:17.080 --> 00:48:19.240] I'm also going to forget the things that make me look bad.
[00:48:19.240 --> 00:48:21.960] Like I had a donut and then I had another donut and I had, yeah.
[00:48:21.960 --> 00:48:22.600] Okay.
[00:48:22.600 --> 00:48:31.080] So, you know, with both the nutrition and the exercise, I reverse engineered from what we want in our cell.
[00:48:31.080 --> 00:48:33.320] What do we want to have happen in our cell?
[00:48:33.320 --> 00:48:40.200] And so with the exercise, what you want to do is what's called slow-speed weightlifting.
[00:48:40.360 --> 00:48:46.280] I exercise, I don't know if you can see, I don't want to brag too much about my muscles, but I'm not like a Hercules here.
[00:48:46.280 --> 00:48:49.720] I lift like a Barbie-sized weight graveyard on my floor.
[00:48:49.720 --> 00:49:05.480] But what I do is the slow-speed weight training where you lift, you do like 10 reps with a weight heavy for you very slowly, like five up, five seconds down, and you do that until you can't do another with good form.
[00:49:05.800 --> 00:49:16.320] And what that does, it creates those tiny tears in your muscles, and you really, you have to be like screaming in pain at the end, you know, and so, and there's some dispute as to whether you need to go to actual failure.
[00:49:16.560 --> 00:49:22.880] There's a guy named Scheinfeld, Brad Scheinfeld, who's like, Yeah, his research says don't really.
[00:49:23.200 --> 00:49:25.680] But it's good to push yourself as much as you can go.
[00:49:25.680 --> 00:49:28.000] And then Steele and Fisher say, Yes, you have to do that.
[00:49:28.480 --> 00:49:29.280] These others.
[00:49:29.280 --> 00:49:31.680] So, this is really important stuff.
[00:49:31.680 --> 00:49:35.280] If you do this, bones and muscles are metabolically active.
[00:49:35.280 --> 00:49:37.120] What you do for muscle, you do for bones.
[00:49:37.120 --> 00:49:39.120] This is how you prevent osteoporosis.
[00:49:39.120 --> 00:49:42.640] Also, not being a jerk like me and leaving stuff all over your floor.
[00:49:43.840 --> 00:49:49.200] And the drugs, they're simply terrible and not a solution.
[00:49:49.200 --> 00:49:54.960] And, you know, the idea that you should treat bone mineral density is just crap.
[00:49:54.960 --> 00:49:57.440] You know, it's not bone strength, not bone quality.
[00:49:57.440 --> 00:50:06.080] And so, some women, elderly women, there's some women who are so terribly frail that they may need these drugs or these other drugs like reloxafene.
[00:50:06.320 --> 00:50:08.640] They're all evil and horrible.
[00:50:08.640 --> 00:50:13.440] They're all, you know, there's a piper to pay with every drug, with these drugs, especially.
[00:50:13.440 --> 00:50:20.960] And then in Japan, they give high doses of vitamin K, which is healthy and helps bones.
[00:50:20.960 --> 00:50:28.080] But, you know, once again, oh, that's French research, you know, and so we're not told that.
[00:50:28.080 --> 00:50:34.000] I mean, so you could have the microcracks in your bones or you could have real help, but that's Japanese.
[00:50:34.000 --> 00:50:35.040] You know, crazy.
[00:50:35.360 --> 00:50:36.960] All right, cardiovascular.
[00:50:36.960 --> 00:50:39.120] I presume some cardiovascular activity.
[00:50:39.840 --> 00:50:41.440] What was the question initially about each of these?
[00:50:41.520 --> 00:50:42.880] Well, we were going through different systems.
[00:50:42.880 --> 00:50:45.440] So, bones, well, if you want to do boobs, you could do that too.
[00:50:45.440 --> 00:50:46.480] Okay, bones, boobs.
[00:50:46.480 --> 00:50:48.960] Okay, so spoiled my tea.
[00:50:48.960 --> 00:50:49.840] Oh, it's okay.
[00:50:50.240 --> 00:50:51.680] At least it didn't fall on electronics.
[00:50:51.680 --> 00:50:52.720] That's always the question.
[00:50:52.720 --> 00:50:53.520] Then I'm fine.
[00:50:53.520 --> 00:50:54.400] Just tea.
[00:50:54.800 --> 00:51:06.280] So with your cardiovascular system, so men get cardiovascular disease much sooner, and women don't because we have estrogen in our bodies that's relatively high, you know, compared to men, not relatively as high.
[00:51:06.600 --> 00:51:15.160] And so what happens in menopause, again, when you lose the estrogen, if you're not taking estradiol, then and estrogen is the general term.
[00:51:15.160 --> 00:51:17.960] Estradiol is the kind in your body.
[00:51:18.440 --> 00:51:24.280] And I should remember to talk about bio-identical hormones and FDA-approved drugs and everything.
[00:51:24.280 --> 00:51:33.800] But so your estrogen receptors in your cardiovascular endothelium go away, so you're not protected anymore from cardiovascular disease the way you were.
[00:51:33.800 --> 00:51:38.360] And like I said, one in three women will die of cardiovascular disease, you know, pretty soon.
[00:51:38.360 --> 00:51:39.800] It's one in five now.
[00:51:39.800 --> 00:51:43.080] And there's a whole slew of cardiometabolic diseases.
[00:51:43.080 --> 00:51:51.560] And it looks like that these diseases are caused by eating carbohydrates, sugar, and starch, and starchy vegetables.
[00:51:51.560 --> 00:51:53.240] Don't ever drink orange juice.
[00:51:53.240 --> 00:51:55.000] It's like the worst thing you could drink.
[00:51:55.000 --> 00:51:56.200] I just have a sugar.
[00:51:57.160 --> 00:51:58.200] I would have ice cream.
[00:51:58.200 --> 00:52:00.920] You know, I eat dessert very occasionally.
[00:52:01.720 --> 00:52:06.200] You know, like a scientist, like I party chocolate chip cookies, like analyze them.
[00:52:06.200 --> 00:52:09.240] Were they made by a vegan out of that gross stuff?
[00:52:10.120 --> 00:52:11.960] Like it is like a big analysis.
[00:52:11.960 --> 00:52:15.000] But so you need to prevent that.
[00:52:15.320 --> 00:52:26.200] The evidence suggests that it is eating sugar, flour, starchy carbohydrates that provokes the insulin resistance that puts on fat and causes these diseases.
[00:52:26.200 --> 00:52:30.120] And, you know, you want to keep your blood sugar, your blood pressure down.
[00:52:30.920 --> 00:52:38.440] There's a cluster of metabolic risks, high blood pressure, high blood sugar, a large waist circumference.
[00:52:38.760 --> 00:52:41.240] That's visceral fat that packs around your organs.
[00:52:41.240 --> 00:52:42.840] It's not like muffin top fat.
[00:52:42.840 --> 00:52:47.920] It's this dangerous fat that's metabolically active and kills you, working to kill you.
[00:52:47.920 --> 00:52:48.960] And then what are the others?
[00:52:44.840 --> 00:52:52.080] If you have high triglycerides, low is healthy.
[00:52:52.400 --> 00:52:55.360] And if you have low HDL, high HDL is healthy.
[00:52:55.360 --> 00:53:02.400] So if you have three out of five of those, and you're a white person, you have a risk of metabolic disease.
[00:53:02.400 --> 00:53:05.760] And here's what is so horrible that I cover in this book.
[00:53:05.760 --> 00:53:09.840] Women of color and people of color, I mean, we're mostly all the same, all of us.
[00:53:09.840 --> 00:53:13.440] If you have a liver, I have a liver, but there are some differences.
[00:53:13.440 --> 00:53:23.760] And so black women tend to have, I think it's like 20% higher, 70% higher HDL and 20% lower triglycerides on average.
[00:53:23.760 --> 00:53:26.400] So you can miss heart disease in a black woman.
[00:53:26.400 --> 00:53:31.120] And these metabolic standards, the standard is two if you're black.
[00:53:31.120 --> 00:53:32.800] So doctors don't know that.
[00:53:32.800 --> 00:53:34.320] You don't even know about the cluster of five.
[00:53:34.320 --> 00:53:35.600] This is by Reven at Harvard.
[00:53:35.600 --> 00:53:37.360] It was called Syndrome X.
[00:53:37.360 --> 00:53:38.400] But so it's important.
[00:53:38.400 --> 00:53:45.680] This is stuff I present so patients can diagnose themselves because we can't wait for doctors and medicine to catch up to the evidence.
[00:53:45.680 --> 00:53:47.040] So we have to do that ourselves.
[00:53:47.040 --> 00:53:48.880] So that's our cardiovascular system.
[00:53:48.880 --> 00:53:52.560] And you need to exercise and eat in these ways, these targeted ways.
[00:53:52.560 --> 00:53:53.840] I call it the trifecta.
[00:53:53.840 --> 00:53:59.920] Now, not everyone's going to be willing to take estrogen and progesterone, and not everyone will, you know, want to.
[00:54:00.720 --> 00:54:16.560] But so if you can do that, that is if you're healthy and you take it initiated at menopause and then exercise this way and then eat a low carbohydrate, you know, balanced, like it's, what is it called?
[00:54:16.560 --> 00:54:20.720] A well, well-created, I forget, but the guys at VertiHealth talk about this.
[00:54:20.720 --> 00:54:22.640] You can look them up, Volik and Finney.
[00:54:22.640 --> 00:54:24.080] They're very good about this.
[00:54:24.080 -->

Prompt 2: Key Takeaways

Now please extract the key takeaways from the transcript content I provided.

Extract the most important key takeaways from this part of the conversation. Use a single sentence statement (the key takeaway) rather than milquetoast descriptions like "the hosts discuss...". 

Limit the key takeaways to a maximum of 3. The key takeaways should be insightful and knowledge-additive. 

IMPORTANT: Return ONLY valid JSON, no explanations or markdown. Ensure:
- All strings are properly quoted and escaped
- No trailing commas
- All braces and brackets are balanced
Format: {"key_takeaways": ["takeaway 1", "takeaway 2"]}

Prompt 3: Segments

Now identify 2-4 distinct topical segments from this part of the conversation.

For each segment, identify:
- Descriptive title (3-6 words)  
- START timestamp when this topic begins (HH:MM:SS format)
- Double check that the timestamp is accurate - a timestamp will NEVER be greater than the total length of the audio
- Most important Key takeaway from that segment. Key takeaway must be specific and knowledge-additive.
- Brief summary of the discussion

IMPORTANT: The timestamp should mark when the topic/segment STARTS, not a range. Look for topic transitions and conversation shifts.

Return ONLY valid JSON. Ensure all strings are properly quoted, no trailing commas:
{
  "segments": [
    {
      "segment_title": "Topic Discussion", 
      "timestamp": "01:15:30",
      "key_takeaway": "main point from this segment",
      "segment_summary": "brief description of what was discussed"
    }
  ]
}

Timestamp format: HH:MM:SS (e.g., 00:05:30, 01:22:45) marking the START of each segment.

Prompt 4: Media Mentions

Now scan the transcript content I provided for ACTUAL mentions of specific media titles:

Find explicit mentions of:
- Books (with specific titles)
- Movies (with specific titles)  
- TV Shows (with specific titles)
- Music/Songs (with specific titles)

DO NOT include:
- Websites, URLs, or web services
- Other podcasts or podcast names

IMPORTANT: 
- Only include items explicitly mentioned by name. Do not invent titles.
- Valid categories are: "Book", "Movie", "TV Show", "Music"
- Include the exact phrase where each item was mentioned
- Find the nearest proximate timestamp where it appears in the conversation
- THE TIMESTAMP OF THE MEDIA MENTION IS IMPORTANT - DO NOT INVENT TIMESTAMPS AND DO NOT MISATTRIBUTE TIMESTAMPS
- Double check that the timestamp is accurate - a timestamp will NEVER be greater than the total length of the audio
- Timestamps are given as ranges, e.g. 01:13:42.520 --> 01:13:46.720. Use the EARLIER of the 2 timestamps in the range.

Return ONLY valid JSON. Ensure all strings are properly quoted and escaped, no trailing commas:
{
  "media_mentions": [
    {
      "title": "Exact Title as Mentioned",
      "category": "Book",
      "author_artist": "N/A",
      "context": "Brief context of why it was mentioned",
      "context_phrase": "The exact sentence or phrase where it was mentioned",
      "timestamp": "estimated time like 01:15:30"
    }
  ]
}

If no media is mentioned, return: {"media_mentions": []}

Prompt 5: Context Setup

You are an expert data extractor tasked with analyzing a podcast transcript. 
I will provide you with part 2 of 2 from a podcast transcript. 
I will then ask you to extract different types of information from this content in subsequent messages. Please confirm you have received and understood the transcript content.

Transcript section:
 so horrible that I cover in this book.
[00:53:05.760 --> 00:53:09.840] Women of color and people of color, I mean, we're mostly all the same, all of us.
[00:53:09.840 --> 00:53:13.440] If you have a liver, I have a liver, but there are some differences.
[00:53:13.440 --> 00:53:23.760] And so black women tend to have, I think it's like 20% higher, 70% higher HDL and 20% lower triglycerides on average.
[00:53:23.760 --> 00:53:26.400] So you can miss heart disease in a black woman.
[00:53:26.400 --> 00:53:31.120] And these metabolic standards, the standard is two if you're black.
[00:53:31.120 --> 00:53:32.800] So doctors don't know that.
[00:53:32.800 --> 00:53:34.320] You don't even know about the cluster of five.
[00:53:34.320 --> 00:53:35.600] This is by Reven at Harvard.
[00:53:35.600 --> 00:53:37.360] It was called Syndrome X.
[00:53:37.360 --> 00:53:38.400] But so it's important.
[00:53:38.400 --> 00:53:45.680] This is stuff I present so patients can diagnose themselves because we can't wait for doctors and medicine to catch up to the evidence.
[00:53:45.680 --> 00:53:47.040] So we have to do that ourselves.
[00:53:47.040 --> 00:53:48.880] So that's our cardiovascular system.
[00:53:48.880 --> 00:53:52.560] And you need to exercise and eat in these ways, these targeted ways.
[00:53:52.560 --> 00:53:53.840] I call it the trifecta.
[00:53:53.840 --> 00:53:59.920] Now, not everyone's going to be willing to take estrogen and progesterone, and not everyone will, you know, want to.
[00:54:00.720 --> 00:54:16.560] But so if you can do that, that is if you're healthy and you take it initiated at menopause and then exercise this way and then eat a low carbohydrate, you know, balanced, like it's, what is it called?
[00:54:16.560 --> 00:54:20.720] A well, well-created, I forget, but the guys at VertiHealth talk about this.
[00:54:20.720 --> 00:54:22.640] You can look them up, Volik and Finney.
[00:54:22.640 --> 00:54:24.080] They're very good about this.
[00:54:24.080 --> 00:54:33.720] And I tell people who are wealthy, because I think it's like $300 or $400, like if you have diabetes and something's wrong with you, that it's good to use them because they can deal with that.
[00:54:33.880 --> 00:54:38.520] You can't just say, oh, I'm going to eat low carb like I did because I'm metabolically healthy.
[00:54:38.840 --> 00:54:39.960] You can have some risks.
[00:54:39.960 --> 00:54:41.560] So, wait, what are we on next?
[00:54:43.080 --> 00:54:47.240] Well, just on the, but your cardiovascular exercise is good anyway.
[00:54:47.800 --> 00:54:51.800] You should be doing that even before menopause, but then, you know, adding that.
[00:54:51.800 --> 00:54:55.480] Oh, and also, being sedentary causes inflammation.
[00:54:56.200 --> 00:54:59.640] And so, one day, one day of sedentary stuff.
[00:54:59.640 --> 00:55:03.640] And so, what I do is I run 20 minutes.
[00:55:03.640 --> 00:55:09.240] And also, here's something: I learned this because of my horrible problems I had.
[00:55:09.240 --> 00:55:11.080] It's called adrenal insufficiency.
[00:55:11.080 --> 00:55:13.640] I had tachycardia and bradycardia in the same day.
[00:55:13.720 --> 00:55:17.240] It's really high, dangerously high, dangerously low heartbeat.
[00:55:17.560 --> 00:55:19.640] 177 while sitting on my couch.
[00:55:19.640 --> 00:55:20.520] It's amazing.
[00:55:20.760 --> 00:55:21.960] 177.
[00:55:21.960 --> 00:55:23.080] And then 45.
[00:55:23.080 --> 00:55:25.560] I mean, this is really dangerous.
[00:55:25.560 --> 00:55:33.080] And so I use that to get a different drug out of my, get the lodopredinol out of my irritated eye surgeon.
[00:55:33.480 --> 00:55:36.760] You know, so I mean, but, and it still continues.
[00:55:36.760 --> 00:55:42.200] I see this like incredibly insane, you know, like the heartbeats per minute.
[00:55:42.200 --> 00:55:43.480] And so I'm correcting that.
[00:55:43.480 --> 00:55:58.520] But I learned that, sorry, long story, too long, that what you need to do to help potentiate, it's called your adrenocorticotropic hormone in your pituitary, is to get first morning light in your retinas.
[00:55:58.520 --> 00:56:01.080] So I run for 10 minutes out my porch.
[00:56:01.080 --> 00:56:06.120] You know, if it's cloudy, you know, I'm here in Venice, we have marine layer, then I'll do 15.
[00:56:06.440 --> 00:56:11.640] And that's really important because circadian rhythm fosters the health of that whole system.
[00:56:11.640 --> 00:56:15.600] It's called the hypothalamic pituitary adrenal axis.
[00:56:15.600 --> 00:56:22.080] The hypothalamus notices, like, okay, you cold, you hot, you thirsty, tells the pituitary, hey, yo, send out a message.
[00:56:22.080 --> 00:56:22.640] And it messes.
[00:56:22.880 --> 00:56:25.600] Cheap Caribbean vacations.
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[00:56:28.320 --> 00:56:34.160] Vacation planning should feel like a breeze, not a deep dive into countless travel sites searching for the best deal.
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[00:56:40.240 --> 00:56:46.640] Go to cheapcaribbean.com and try the Budget Beach Finder and see how stress-free vacation planning should be.
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[00:56:52.560 --> 00:56:55.600] Messages your adrenal glands or whatever, like, okay, do this.
[00:56:56.160 --> 00:57:00.640] Make the person, okay, you're thirsty, drink, you know, here, we're going to elevate your cortisol.
[00:57:00.640 --> 00:57:02.160] Cortisol is not unhealthy.
[00:57:02.160 --> 00:57:13.760] It's only if you have, you know, chronic elevated cortisol for, you know, no reason, you know, but you need it, you know, like for many things, many health metrics.
[00:57:13.760 --> 00:57:16.880] And so mine was sort of broken because of this.
[00:57:17.200 --> 00:57:18.240] And I'm working on it.
[00:57:18.240 --> 00:57:20.560] That first money light is very important.
[00:57:20.560 --> 00:57:21.920] It also helps you sleep.
[00:57:21.920 --> 00:57:24.000] You know, people need to foster sleep.
[00:57:24.000 --> 00:57:25.360] That's very important.
[00:57:26.000 --> 00:57:27.600] All right, breast cancer.
[00:57:27.600 --> 00:57:33.840] Okay, so here's the thing: estrogen and progesterone are not carcinogens.
[00:57:33.840 --> 00:57:40.000] However, this very interesting work, I was really, this chapter was really the most horrible chapter in the book to write.
[00:57:40.160 --> 00:57:43.920] This is where I quote some of Avram Bluming Carol Tabas' work.
[00:57:44.400 --> 00:57:47.600] You know, he's the breast cancer, he's an oncologist.
[00:57:48.240 --> 00:57:53.000] And the problem is the research in this area is so heterogeneous.
[00:57:53.000 --> 00:57:56.320] Where it's like, oh, they tested this drug on this group of women.
[00:57:56.320 --> 00:57:59.200] Oh, and then they tested this drug for this amount of time.
[00:57:59.200 --> 00:58:03.080] So, what I say in this chapter is, I'm really sorry.
[00:57:59.680 --> 00:58:09.480] You know, I want to tell you definitively: will taking hormones give you breast cancer?
[00:58:09.480 --> 00:58:12.360] You know, and the answer is we can't say definitively.
[00:58:12.360 --> 00:58:18.200] However, here's where I'm where I, you know, work things out for myself and don't do exactly what I do because you're not me.
[00:58:18.200 --> 00:58:21.320] You need to look at your individual health and risks.
[00:58:21.320 --> 00:58:31.160] And so, what I said is, you know, I have a family, I have dense, we have dense boobs in my family, and so that is it makes it hard for them to see mammograms.
[00:58:31.160 --> 00:58:35.240] And, you know, so I have some risks, but I get regular mammograms, and you can have false positives.
[00:58:35.240 --> 00:58:37.000] That's another whole problem area.
[00:58:37.000 --> 00:58:41.880] But so, women who have breast cancer will die, most of them will die of heart disease.
[00:58:41.880 --> 00:58:45.160] And 90% of breast cancer now is survivable.
[00:58:45.160 --> 00:58:46.440] Now, you don't want this, it's horrible.
[00:58:46.440 --> 00:58:47.400] You have to go through chemo.
[00:58:47.400 --> 00:58:48.440] I mean, it's a terrible thing.
[00:58:48.440 --> 00:58:49.800] I'm terrified of it.
[00:58:49.960 --> 00:58:58.040] But we're terrified of the wrong thing because, you know, like it's like nobody's like looking through their shirt, like, oh, can you see my aorta through this top?
[00:58:58.040 --> 00:58:59.640] You know, boobs are a big part of us.
[00:58:59.640 --> 00:59:05.640] So that's why we're more afraid of breast cancer than the thing that really kills us, which is cardiovascular disease.
[00:59:05.640 --> 00:59:07.480] And so I made that calculation.
[00:59:07.480 --> 00:59:10.040] But in looking at this, I was desperate.
[00:59:10.040 --> 00:59:15.320] Let me, please, I've got to find something out to tell women and what I found out.
[00:59:15.320 --> 00:59:19.400] Because I look for the stuff that says, you know, oh, this is a bad idea too.
[00:59:19.400 --> 00:59:20.840] You know, you look for the adverse effects.
[00:59:20.840 --> 00:59:22.520] You look for the disconfirming stuff.
[00:59:22.840 --> 00:59:29.160] I'm always looking to like kill my darlings, like this stuff I believe I want, you know, to be true.
[00:59:29.160 --> 00:59:31.000] So that I take an extra hard look at.
[00:59:31.000 --> 00:59:49.120] And so, Carol Sartorius and Catherine Horwitz, these pioneer, Horwiss pioneer in doing receptor research, they found that though estrogen and progesterone are not carcinogens, if you have some in you already, they can pick it up and run with it.
[00:59:44.840 --> 00:59:50.560] So, that's what I say in the book.
[00:59:50.880 --> 00:59:54.800] And so, you know, but we can look at boobs through mammograms.
[00:59:54.800 --> 00:59:58.400] And also, you know, there just was some research crap.
[00:59:58.400 --> 00:59:59.040] I forget.
[00:59:59.040 --> 01:00:04.640] So, you know, if you have dense breasts, you need an ultrasound, but they just came up with some new way.
[01:00:04.960 --> 01:00:06.400] I wish I could remember what it is.
[01:00:06.400 --> 01:00:11.200] I just saw that I have to read the paper to look at breasts of dense breasts.
[01:00:11.200 --> 01:00:12.560] That's that's important.
[01:00:12.800 --> 01:00:18.480] But again, false positives, women can get treated for breast cancer that would never, never develop into anything.
[01:00:18.480 --> 01:00:21.360] It's just teeny, a couple teeny cells, you know.
[01:00:21.360 --> 01:00:27.520] And so, you know, this is an unfortunate thing that I can't definitively tell you something in this chapter.
[01:00:27.520 --> 01:00:32.080] But this is what I call it's not being, it's not giving you a maze ball science.
[01:00:32.080 --> 01:00:35.200] Worry about the people who tell you, oh my God, it's incredible.
[01:00:35.200 --> 01:00:36.160] It's going to cure cancer.
[01:00:36.160 --> 01:00:37.760] You're going to white teeth your whole life.
[01:00:37.760 --> 01:00:40.080] And, you know, you live in a mansion.
[01:00:40.080 --> 01:00:41.520] You know, no, no, no, no.
[01:00:41.520 --> 01:00:43.680] Look for the people who say, like, I don't know.
[01:00:43.680 --> 01:00:44.800] I wish I could tell you.
[01:00:45.040 --> 01:00:46.000] This really sucks.
[01:00:46.000 --> 01:00:46.480] I can't.
[01:00:46.480 --> 01:00:47.760] I'm so sorry.
[01:00:47.760 --> 01:01:00.880] Because that's somebody who's being careful, you know, about what they're telling you and cares to tell the truth as opposed to tell you something that's going to, you know, make you excited and tell people, 60 people to buy their book.
[01:01:01.520 --> 01:01:02.960] White teeth your life.
[01:01:02.960 --> 01:01:03.680] That's such a great thing.
[01:01:03.760 --> 01:01:04.480] You know, we try.
[01:01:04.480 --> 01:01:06.480] I drink so much coffee, it's an issue.
[01:01:07.040 --> 01:01:08.160] This is great.
[01:01:08.160 --> 01:01:10.560] Yeah, I had Eric Topol on the show.
[01:01:10.560 --> 01:01:13.680] We just recorded it actually earlier today.
[01:01:13.680 --> 01:01:20.000] He was talking about, you know, all women over whatever the age is get a mammogram.
[01:01:20.320 --> 01:01:21.920] And 80%, what do you say?
[01:01:22.000 --> 01:01:31.640] 88% of women will never get breast cancer, but 60% of women will have a false positive test because they do it every year for decades.
[01:01:31.640 --> 01:01:36.120] And that even though the false positive rate is low, but there's so many tests.
[01:01:29.680 --> 01:01:37.160] It's terrifying, too.
[01:01:37.320 --> 01:01:38.440] I love Kaiser.
[01:01:38.440 --> 01:01:39.480] This happened once.
[01:01:39.480 --> 01:01:43.320] So I get some kind of, there's some kind of, uh-oh, there's a little thing we see.
[01:01:43.320 --> 01:01:45.800] They call me on Friday afternoon, leave that message.
[01:01:46.280 --> 01:01:47.240] We'll see you next week.
[01:01:47.400 --> 01:01:47.960] Yeah, thanks.
[01:01:48.280 --> 01:01:49.240] What is wrong with you?
[01:01:49.240 --> 01:01:49.720] That's so hard.
[01:01:49.800 --> 01:01:52.040] And like all weekend, I'm afraid.
[01:01:52.040 --> 01:01:54.440] You know, and I went in, I got, they gave me a biopsy.
[01:01:54.440 --> 01:01:56.280] It was nothing, but biopsy is not nothing.
[01:01:56.280 --> 01:01:59.960] They're, you know, digging into your with an instrument and everything.
[01:01:59.960 --> 01:02:02.280] It's all terrifying, you know.
[01:02:02.280 --> 01:02:08.680] And so the problem, too, one of the myths that I detail in the book is that doctors are not trained to assess risk.
[01:02:08.680 --> 01:02:10.440] They cannot properly assess risk.
[01:02:10.440 --> 01:02:18.360] Now, maybe an oncologist, I tell people in the book, look, you know, if you, if you want your risk assessed, maybe an oncologist will be able to do this.
[01:02:18.360 --> 01:02:20.920] And you don't have to be a genius to do this.
[01:02:20.920 --> 01:02:27.000] You know, Gerd Gegerenser, he, I quote him in the book, and he just talks about natural frequencies.
[01:02:27.000 --> 01:02:30.600] We as humans did not evolve with percentages.
[01:02:30.600 --> 01:02:32.440] You know, we're not good at them.
[01:02:32.440 --> 01:02:33.480] So what do you do?
[01:02:33.480 --> 01:02:34.120] Easy.
[01:02:34.120 --> 01:02:36.360] You draw 100 people on a page.
[01:02:36.360 --> 01:02:39.160] You color in the ones who are going to end up sick or dead.
[01:02:39.160 --> 01:02:43.720] You know, and then you factor in the person's individual health and color in a few or erase a few.
[01:02:43.720 --> 01:02:45.560] And then you say, here's, you know, here's your risk.
[01:02:45.560 --> 01:02:52.920] In a meaningful way, we can look at people in a page and say, oh, okay, you know, and understand that, you know, but they don't understand stats.
[01:02:52.920 --> 01:03:05.720] So doctors are often misled by pharmaceutical, like a maizeball stats, like 50% more people, like sometimes it's like, sometimes like one or two, you know, like in out of 7,000 or something like that.
[01:03:05.720 --> 01:03:06.920] It's terrible.
[01:03:06.920 --> 01:03:09.880] I keep saying it's terrible, but all of it is, all of it.
[01:03:09.880 --> 01:03:10.360] Oh, yeah.
[01:03:10.360 --> 01:03:16.640] I use this example of in Bayesian reasoning and the diagnosis problem.
[01:03:14.920 --> 01:03:20.560] A patient is diagnosed with cancer that has a 1% prevalence rate.
[01:03:20.720 --> 01:03:23.440] That is, it happens to one out of 100 people.
[01:03:23.440 --> 01:03:26.480] The test sensitivity for this type of cancer is 90%.
[01:03:26.480 --> 01:03:29.520] That is, the test will be right 90% of the time.
[01:03:29.520 --> 01:03:32.240] The false positive rate of the test is 9%.
[01:03:32.240 --> 01:03:35.280] That is, the test will be wrong 9% of the time.
[01:03:35.280 --> 01:03:38.720] What is the percent likelihood that the patient has cancer?
[01:03:38.720 --> 01:03:46.000] And that almost everybody says it's between 80 and 90%, including medical doctors, when the actual answer is 9%.
[01:03:46.000 --> 01:03:57.200] They have to do the numbers, but basically the flaw in the reasoning is the rate is very low, so it's very unlikely you'll get that cancer.
[01:03:57.200 --> 01:04:08.160] But since everybody's tested for it, let's say, you know, millions of people are tested for it, that 5% false positive rate, or whatever I said it was, a false predator rate of 9%.
[01:04:08.160 --> 01:04:12.640] Yeah, that's the 9% of this huge population.
[01:04:12.880 --> 01:04:14.320] And so that throws people off.
[01:04:15.360 --> 01:04:25.680] The Kahneman Tversky interpretation of that is the representative fallacy that we're used to thinking of people.
[01:04:26.800 --> 01:04:28.960] A person has cancer or they don't.
[01:04:28.960 --> 01:04:31.440] What is this 90% cancer?
[01:04:31.760 --> 01:04:41.440] Well, that's on a huge population of people, but we didn't evolve to think about huge statistical populations and percentages and probabilities and predictions.
[01:04:41.440 --> 01:04:42.800] You either have cancer or you don't.
[01:04:42.800 --> 01:04:46.000] What do you mean 9% is, you know, whatever.
[01:04:46.000 --> 01:04:47.520] No, but this is important thinking.
[01:04:47.520 --> 01:04:52.480] You see, when you're saying that, I just gave up because I need to do that calculation on a page.
[01:04:52.480 --> 01:04:55.520] But, you know, you learn from Gerd Gagerenzer.
[01:04:55.600 --> 01:04:57.360] He can train people in 90 minutes.
[01:04:57.840 --> 01:04:59.280] You know, it's amazing.
[01:04:59.280 --> 01:05:03.640] And so, med schools, the fault here, so I don't bash doctors in the book.
[01:05:03.800 --> 01:05:09.560] I get mad, you know, at them sometimes, but I can't do the whole, if I were you, I would, you know, whatever, like, give up my life.
[01:05:09.880 --> 01:05:11.560] It's not fair, it's not right.
[01:05:11.560 --> 01:05:23.960] The institutions not giving, say, my eye surgeon an expert on steroids, all the eye doctors telling them, look, here's this, here are the standards, and giving them a lecture and saying, here's what they're, and they can call on those people.
[01:05:23.960 --> 01:05:25.320] Like, they shouldn't be prescribing.
[01:05:25.320 --> 01:05:26.520] She knows less about steroids.
[01:05:26.520 --> 01:05:27.480] She's an elite surgeon.
[01:05:27.480 --> 01:05:28.920] I'm lucky to have her.
[01:05:28.920 --> 01:05:33.400] But she knows less about steroids than the average smart person in her waiting room who reads.
[01:05:33.400 --> 01:05:36.120] You know, it's insane that this is medicine.
[01:05:36.120 --> 01:05:39.880] The other thing that they can't do, they're not trained in diagnostic reasoning, a la Dr.
[01:05:39.960 --> 01:05:40.680] House.
[01:05:40.680 --> 01:05:43.560] And so, Michael, you and I both love this kind of thinking.
[01:05:43.560 --> 01:05:44.920] Like, I did this.
[01:05:44.920 --> 01:05:47.480] In fact, that's how I encountered Carol Tavis first.
[01:05:47.560 --> 01:05:53.720] She's a great book: Mistakes Were Made, but not by me with her, Elliot Aronson, and she wrote that book together.
[01:05:53.720 --> 01:05:56.040] And those are the kinds of books I buy and the thinking I do.
[01:05:56.040 --> 01:05:59.640] My favorite class in all of high school is critical thinking, you know.
[01:05:59.640 --> 01:06:07.800] And, but if you don't have that kind of thing, you don't love it, you're not going to be able to just do this on your own since you're not trained to do that.
[01:06:07.800 --> 01:06:12.040] There's a guy named Alan Graver who's trying to get diagnostics into medical schools.
[01:06:12.200 --> 01:06:14.840] Medical schools, they have no incentive to change.
[01:06:14.840 --> 01:06:15.960] Nobody knows.
[01:06:15.960 --> 01:06:28.520] And institutions, Kaiser, they should have people like Sandra Greenland and Gerd Gagerenzer looking at the stats on studies, and then people like me, Nina Teisholz, you know, Gary Tobbs as the mole rats.
[01:06:28.520 --> 01:06:29.800] We're looking at the science.
[01:06:29.800 --> 01:06:32.440] And someone checks the stats.
[01:06:32.440 --> 01:06:34.040] And then we make a determination.
[01:06:34.040 --> 01:06:41.000] And not just having these people who basically, yeah, they have panels, but they're just confirming what's already been thought and done.
[01:06:41.000 --> 01:06:48.320] You know, and I saw that with my own, when you, at Kaiser, if you complain that you're being given an unscientific treatment, they had me present to a panel.
[01:06:44.840 --> 01:06:50.400] This is about menopause and perimenopause.
[01:06:50.560 --> 01:06:53.680] There was not a gynecologist or endocrinologist on there.
[01:06:53.680 --> 01:06:56.880] And basically, it's a panel designed to let you whine.
[01:06:56.880 --> 01:06:58.320] And I presented all the science.
[01:06:58.320 --> 01:06:59.840] They read none of it.
[01:06:59.840 --> 01:07:03.280] And they simply called the gynecologist and said, What's the standard of care?
[01:07:03.280 --> 01:07:04.320] Now, I went all insane.
[01:07:04.400 --> 01:07:07.360] Which gynecologist, I mean, this guy, Seth Kibnik, he's a researcher.
[01:07:07.360 --> 01:07:08.720] I'm like, did they ask you?
[01:07:08.960 --> 01:07:10.080] He never wrote me back.
[01:07:10.080 --> 01:07:14.240] It turned out they called my gynecologist, you know, and he told me this.
[01:07:14.240 --> 01:07:19.280] And he's great because if I explain the science to him on something, he'll treat me according to the evidence.
[01:07:19.280 --> 01:07:27.280] You know, I don't just say, here, give me this, but I explained to him, look, I have high SHBG binding my testosterone and estrogen.
[01:07:27.280 --> 01:07:30.240] And he was the one who suggested, he's gone till August.
[01:07:30.240 --> 01:07:31.600] This is why I have a problem.
[01:07:31.600 --> 01:07:35.680] So he was the one who made the suggestion that I'd use a double patch.
[01:07:35.680 --> 01:07:37.040] This is not usual.
[01:07:37.040 --> 01:07:41.680] Chlimera, the patch I use, is just, it's, you know, you take one, but okay, I need more.
[01:07:41.680 --> 01:07:43.040] You treat the individual patient.
[01:07:43.040 --> 01:07:47.360] You don't say, oh, we're not going to give you that dose because the average person doesn't need it.
[01:07:47.360 --> 01:07:49.840] There's no such thing as the average person.
[01:07:49.840 --> 01:07:50.560] I'm me.
[01:07:50.560 --> 01:07:51.920] I have certain health metrics.
[01:07:51.920 --> 01:07:54.880] I'm weird in some ways compared to other people.
[01:07:54.880 --> 01:08:02.160] And you treat me according to my body and the fact that I'm not getting the estradiol active in my system that I'm taking.
[01:08:02.160 --> 01:08:10.800] So give me more, please, because you're prolonging my hot flashes and you're denying me the protective effects that I need for my endothelium and the rest of me.
[01:08:11.120 --> 01:08:16.440] So the Kaiser docs must, when your name comes up at the computer, they must think, uh-oh.
[01:08:17.080 --> 01:08:18.480] Here she comes.
[01:08:18.800 --> 01:08:22.000] Well, it's because everyone, I have, like, they, I correct all this stuff.
[01:08:22.000 --> 01:08:24.640] I just, ahead of endocrinology, he's very nice to me.
[01:08:24.640 --> 01:08:26.240] He's giving me a test I needed.
[01:08:26.240 --> 01:08:31.000] When, like, the ladies in like in gynecology just wouldn't, she wouldn't test my estrogen.
[01:08:29.840 --> 01:08:36.280] Hi, I'm telling you, I have low, low, I'm getting, you know, not getting the estrogen I'm taking.
[01:08:36.360 --> 01:08:36.840] What do we do?
[01:08:36.840 --> 01:08:43.720] We guess, yeah, you know, so he tested that for me, but then he said the same thing on SHBG: estrogen elevates it.
[01:08:43.720 --> 01:08:46.040] And I said, No, oral estrogen does.
[01:08:46.040 --> 01:08:47.320] I'm taking transderable.
[01:08:47.320 --> 01:08:48.520] Head of endocrinology.
[01:08:48.520 --> 01:08:51.880] I mean, please, can somebody please know more than I do?
[01:08:52.200 --> 01:08:59.960] You know, again, like I'm just sitting here in Venice, my like untidy house with the gardening clogs on the floor, you know, reading a bunch of papers.
[01:08:59.960 --> 01:09:06.280] So, okay, sex, libido, uh, desert vagina, and clitty-clitty dead zone.
[01:09:06.920 --> 01:09:08.120] I'd like to have fun.
[01:09:08.120 --> 01:09:12.280] This is a terrifying subject, so, and I'm vulgar and funny, and so I use that.
[01:09:12.280 --> 01:09:21.480] So, desert vagina, oh my God, the gynecologist, it was called vaginal atrophy, and they thought that that was mean and degrading to women, and they would name it something better.
[01:09:21.800 --> 01:09:30.440] They named the whole down there thing, like bladder, vagina walls, like all of it, um, geniturinary syndrome of menopause.
[01:09:30.440 --> 01:09:32.760] It took me a while to be able to remember that.
[01:09:32.760 --> 01:09:33.480] So, great.
[01:09:33.720 --> 01:09:40.680] You're telling women they have something they can't remember or pronounce, and that sounds frankly terrifying, and it doesn't describe the problem.
[01:09:40.680 --> 01:09:43.640] Desert vagina, that describes the problem.
[01:09:43.640 --> 01:09:53.320] When you don't have estrogen in menopause, all this stuff that it did, like keeping your vaginal walls all moist and nice, that stops.
[01:09:53.320 --> 01:10:00.520] And you can have atrophy of your urethra and your, you know, your bladder, your muscles, everything.
[01:10:00.520 --> 01:10:04.200] It can just like everything is just awful down there.
[01:10:04.200 --> 01:10:15.120] But if you take estradiol, you know, that systemic estradiol, or there's a kind of vaginal estradiol that will help some of it.
[01:10:14.680 --> 01:10:20.960] It will help, like, there's one kind, there's, oh, I'm not going to remember what it's called.
[01:10:21.600 --> 01:10:25.680] It's the keeping you up at night to pee all the time.
[01:10:26.480 --> 01:10:29.040] That really helps that if you're taking estrogen.
[01:10:29.040 --> 01:10:36.400] Now, vaginal estrogen, when you take estrogen, you need to take progesterone to counterbalance it because it's very important.
[01:10:36.400 --> 01:10:39.280] So, estrogen is proliferative in the breasts.
[01:10:39.280 --> 01:10:43.920] Estrogen causes cells to proliferate, to grow, and increase.
[01:10:43.920 --> 01:10:50.640] And progesterone, what it does, it doesn't pair the cells, but what it does is it makes them specialized.
[01:10:50.640 --> 01:10:54.400] So, they're generic cells that can become delinquents, do anything.
[01:10:54.400 --> 01:10:59.200] And what it does is it turns them into, makes them differentiate and turn into breast cells.
[01:10:59.200 --> 01:11:00.880] So, they've got a job to do.
[01:11:00.880 --> 01:11:12.320] And then, in the endometrium, the lining of the uterus, which can develop hyperplasia, which is this, it's overgrowth, cell overgrowth, you know, which can become cancer.
[01:11:12.320 --> 01:11:16.880] That progesterone, it decreases that, it counterbalances that.
[01:11:16.880 --> 01:11:20.480] And so, you need adequate progesterone for this, you know, in this area.
[01:11:20.480 --> 01:11:33.120] And so, my problem with vacation planning should feel like a breeze, not a deep dive into countless travel sites searching for the best deal.
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[01:11:52.000 --> 01:11:58.720] Vaginal estrogen is they will tell you, oh, you don't need to take progesterone because it's local.
[01:11:58.720 --> 01:12:00.360] Okay, no, it's not.
[01:12:00.360 --> 01:12:05.480] There are some you see, especially at first, you see a systemic raise in estrogen.
[01:11:59.840 --> 01:12:06.840] So that doesn't seem to last.
[01:12:07.080 --> 01:12:13.640] However, they'll say, oh, it doesn't seem to cause hyperplasia in your uterus.
[01:12:13.640 --> 01:12:19.320] Well, okay, it's not that it doesn't in many people, but doesn't is not never.
[01:12:19.320 --> 01:12:22.600] And some for some women, there is hyperplasia.
[01:12:22.600 --> 01:12:30.760] So when I talked to these ladies, you know, so you can take, there's vaginal estrogen that's local, and there's one kind that's not, that's systemic.
[01:12:30.760 --> 01:12:37.320] But I was going to take the local kind when I was going through this because my immune system was screwed up from this steroid overdose.
[01:12:37.320 --> 01:12:39.720] I mean, just incredible medical harm.
[01:12:39.720 --> 01:12:45.880] So they were going to prescribe me the estradiol, vaginal estradiol, but oh my God, this is the head of gynecology.
[01:12:45.880 --> 01:12:48.600] She tells me, okay, I'm going to give you two or three times a week.
[01:12:48.600 --> 01:12:51.480] I said, no, that's the maintenance dose.
[01:12:51.480 --> 01:12:56.280] The acute dose is daily for two weeks, and then you taper to two to three times a week.
[01:12:56.280 --> 01:12:58.280] Hi, she's the head of gynecology.
[01:12:58.280 --> 01:12:59.400] She's telling me she's an expert.
[01:12:59.400 --> 01:13:00.200] She knows this area.
[01:13:00.200 --> 01:13:01.160] She reads the science.
[01:13:01.160 --> 01:13:04.280] She doesn't, yeah, you know, no, she doesn't read anything.
[01:13:04.520 --> 01:13:08.680] Or, you know, she picked up like something in 2002 and hasn't looked at it since.
[01:13:08.680 --> 01:13:13.240] So, you know, and I'm telling her, I need crinone or, you know, there are these tablets.
[01:13:13.240 --> 01:13:14.760] So, sorry, that's for pregnancy.
[01:13:14.760 --> 01:13:30.840] But there are these, I decided the tablets, progesterone tablets, I've heard they're called endometrin, that I wanted those too because, you know, because, you know, since it's possible that I could have hyperplasia from this, and, you know, she would not give them to me.
[01:13:30.840 --> 01:13:32.440] It's like, oh, no, it doesn't do this.
[01:13:32.440 --> 01:13:37.640] What, you know, so because the doctors aren't reading the research, there's a possibility for incredible harm.
[01:13:37.640 --> 01:13:39.160] And I'm conservative with drugs.
[01:13:39.160 --> 01:13:40.200] I don't want to take a drug.
[01:13:40.200 --> 01:13:41.800] I don't want to take more than I need.
[01:13:41.800 --> 01:13:47.680] I err on the side of not taking drugs until I really just must take them, like with sleep drugs and perimenopause.
[01:13:44.840 --> 01:13:50.960] My sleep was covered by progesterone and menopause.
[01:13:51.120 --> 01:13:53.280] Oh my God, welcome to crap sleep again.
[01:13:53.280 --> 01:13:59.200] You know, and so I worked my one evidence-based doctor, my psychiatrist, to test different sleep drugs.
[01:13:59.200 --> 01:14:04.320] I didn't want to take ambien and these benzos that you know cause cognitive harm.
[01:14:04.320 --> 01:14:07.360] You know, there's good research suggesting they do.
[01:14:07.360 --> 01:14:14.960] And what I ended up doing was taking a drug called trazodone, which is an anti-anxiety drug off-label for sleep.
[01:14:14.960 --> 01:14:17.600] I never would have taken it but for him, you know.
[01:14:17.600 --> 01:14:25.600] And so, doing this, it was just important to take something because I need my sleep rather than just to suffer and have, you know, brain fog.
[01:14:25.600 --> 01:14:29.200] I forget how I got in this topic, but where were we?
[01:14:29.200 --> 01:14:32.400] Oh, so, okay, so for this, the whole desert vagina thing.
[01:14:32.400 --> 01:14:35.200] So, not all women can take or want to take hormones.
[01:14:35.200 --> 01:14:36.480] You can use these different lubes.
[01:14:36.560 --> 01:14:39.200] Hyaluronic acid is very good.
[01:14:39.520 --> 01:14:46.400] You know, and there are the other lubes that you want to be careful not to get the one that destroys silicone if you're using condoms or toys.
[01:14:46.720 --> 01:14:49.280] You know, so this is a doable thing.
[01:14:49.280 --> 01:14:58.560] But really, I think, you know, for many women, because the bladder involvement and everything, there's more than just the let me moisturize there that can go on.
[01:14:58.560 --> 01:15:04.400] And so, once you start to have this urinary atrophy, bladder atrophy, it's not like you can bring it back.
[01:15:04.400 --> 01:15:07.360] That's why I was so angry at these women for denying me.
[01:15:07.520 --> 01:15:10.880] I wouldn't take it, I had the vaginal estradiol, but I wouldn't take it.
[01:15:10.880 --> 01:15:12.960] I tried this is like me.
[01:15:13.520 --> 01:15:20.160] I didn't read on it, but I like, you can stick some progesterone calves up there, but they don't dissolve the way they do in stomach acid.
[01:15:20.160 --> 01:15:23.520] All this is sorry, TMI, but you know, and so I couldn't do this.
[01:15:23.520 --> 01:15:30.440] So, so I'm just not going to take it because it's not safe since not, since doesn't usually happen, it's not never in terms of hyperplasia.
[01:15:30.440 --> 01:15:31.960] And how dare they?
[01:15:29.920 --> 01:15:34.200] And she said, Oh, super physiologic dose.
[01:15:34.360 --> 01:15:35.080] Guess what, lady?
[01:15:35.080 --> 01:15:38.760] I read the research, they give like 1,200 milligrams of progesterone.
[01:15:38.760 --> 01:15:40.440] I'm taking 300.
[01:15:40.760 --> 01:15:48.520] And I only get that with my high SHPG because I know to correct for it with the one thing I can, which is pregnenolone.
[01:15:48.520 --> 01:15:50.840] I take a huge amount of, it's the mother of all hormones.
[01:15:50.840 --> 01:15:56.360] It's called a supplement called pregnenolone from, is it Swanson or GNC?
[01:15:56.360 --> 01:15:58.040] I think it's, yeah, it's Swanson.
[01:15:58.040 --> 01:16:01.320] Wait, no, no, no, it's not because you need micronized pregnenolone.
[01:16:01.320 --> 01:16:02.600] I forget who I get it from.
[01:16:02.600 --> 01:16:04.680] But anyway, that huge dose.
[01:16:04.680 --> 01:16:11.400] And so the one steroid in me that is at a good level, which is important, protecting you from cancer and everything else, is progesterone.
[01:16:11.400 --> 01:16:13.000] That's at a good place.
[01:16:13.000 --> 01:16:17.000] And when the doctor, one of the doctors mentioned that, I said, oh, that's because I fix it.
[01:16:17.160 --> 01:16:22.440] I fix it with the thing I can fix it with, you know, since no one can control that, you know.
[01:16:22.440 --> 01:16:29.640] And so it's just obnoxious that I'm being denied what I need, you know, to protect myself and adequate symptom relief.
[01:16:29.640 --> 01:16:33.080] This is not, it's against medical ethics for them to do that.
[01:16:33.720 --> 01:16:34.680] Amazing.
[01:16:34.680 --> 01:16:37.640] All right, Amy, let's wrap up here because I got to go pick up my kid.
[01:16:37.640 --> 01:16:41.880] Six questions to ask your doctor before agreeing to a treatment.
[01:16:41.880 --> 01:16:42.360] I've got the question.
[01:16:42.520 --> 01:16:47.640] One, can you lay out your reasoning behind your diagnosis and the treatment you're recommending?
[01:16:47.640 --> 01:16:50.680] Two, could there be other conditions that are causing my symptoms?
[01:16:50.840 --> 01:16:51.560] Confounders.
[01:16:51.560 --> 01:16:52.680] Hey, there's an idea.
[01:16:52.680 --> 01:16:54.680] Three, what are my risks from this treatment?
[01:16:54.680 --> 01:16:58.120] Four, are there safer, less invasive alternatives?
[01:16:58.120 --> 01:17:01.880] Five, what can I expect during the treatment and what sort of recovery?
[01:17:01.880 --> 01:17:05.880] And six, do I need to do this now or could I wait or go without the treatment?
[01:17:05.880 --> 01:17:09.000] And you have eight minutes to answer those questions before you explain.
[01:17:09.000 --> 01:17:09.240] Go ahead.
[01:17:09.640 --> 01:17:14.640] Actually, what I want to talk about, so these are, this is that sixth quote, I printed them up so I can read them.
[01:17:14.040 --> 01:17:17.920] But I'm glad you read them because I needed a vacation from talking.
[01:17:18.640 --> 01:17:28.080] But so these are very important because you need to find out how, you know, how scientific is the conclusion you have, this, whatever they're saying you have.
[01:17:28.080 --> 01:17:37.760] And your doctor, if they don't explain this, don't answer these reasonably, well, okay, either seek out other treatment, you know, or, you know, see that they do.
[01:17:37.760 --> 01:17:39.040] You can ask over and over.
[01:17:39.040 --> 01:17:43.120] And the thing I learned, I'm a mediator, so I do dispute resolution.
[01:17:43.120 --> 01:17:48.960] I do voluntary, I volunteer in the LA City attorney's office when I'm not on the book hiatus.
[01:17:48.960 --> 01:17:54.480] And one of the things I've learned is to not rush, to not be on someone else's timetable.
[01:17:54.480 --> 01:17:58.320] So, you know, you need to have, it's called informed consent.
[01:17:58.320 --> 01:18:07.040] In order to consent to medical care, you need to understand what you're diagnosed with, what the treatment is, why they're treating you this way.
[01:18:07.040 --> 01:18:10.240] And if you're not informed, you cannot consent.
[01:18:10.240 --> 01:18:11.520] And so this is part of it.
[01:18:11.520 --> 01:18:14.560] And so you might need to make three appointments with a doctor.
[01:18:14.560 --> 01:18:17.440] You know, don't be ashamed if you don't understand it.
[01:18:17.440 --> 01:18:18.960] This is complicated stuff.
[01:18:18.960 --> 01:18:20.400] It's scary.
[01:18:20.400 --> 01:18:23.520] And all that matters is that you get to a point where you do.
[01:18:23.520 --> 01:18:28.560] And if a doctor can't explain this clearly, you know, there's a good chance they don't know what they're talking about.
[01:18:28.560 --> 01:18:37.280] Because if you understand something, I see this with, I'll go to a conference, there'll be something that I can, I understand when someone talks about it, but I can't talk about it.
[01:18:37.280 --> 01:18:42.720] You have to understand it on the level where you can explain it to another human being, like my psychiatrist can.
[01:18:42.720 --> 01:18:44.960] He treats, he's a child psychiatrist.
[01:18:44.960 --> 01:18:46.880] I see him for ADHD.
[01:18:46.880 --> 01:18:53.920] And so he can explain to a six-year-old the medication, why they're taking it, how it'll help them, what they're going through.
[01:18:53.920 --> 01:18:58.080] And that's the kind of thing that you need and you deserve from every doctor.
[01:18:58.080 --> 01:19:07.640] And just because so many of them don't have diagnostic ability, can't assess risk, don't know the science, they're basically in lab coats reading practice standards.
[01:19:07.640 --> 01:19:08.760] You know, and not all.
[01:19:08.760 --> 01:19:16.120] There are some who do read the science and go by it, but you know, don't count on it because I really don't see anybody but my psychiatrist.
[01:19:16.120 --> 01:19:21.880] And I was, I got fired by the guy before him, short angry guy, because I asked too many questions.
[01:19:22.520 --> 01:19:23.480] Oh, I'm shocked.
[01:19:23.480 --> 01:19:24.360] I can't believe that.
[01:19:24.360 --> 01:19:25.720] I was all suspicious.
[01:19:25.720 --> 01:19:27.160] And so I was a little aggressive.
[01:19:27.160 --> 01:19:30.120] And so I, you know, like, you guys don't, and you don't know, I hate you.
[01:19:30.120 --> 01:19:31.080] You don't know anything.
[01:19:31.080 --> 01:19:32.840] So the first appointment was good.
[01:19:32.840 --> 01:19:35.320] I was sort of impressed by him, but then I was still angry.
[01:19:35.320 --> 01:19:40.120] And then I sent him studies by Randy Nessie, who's the co-founder of evolutionary medicine.
[01:19:40.120 --> 01:19:41.160] I love his work.
[01:19:41.160 --> 01:19:42.120] It's incredible.
[01:19:42.120 --> 01:19:43.080] And said, here's this guy.
[01:19:43.080 --> 01:19:45.160] And he said, oh, I know his work really well.
[01:19:45.480 --> 01:19:47.000] I was blown away.
[01:19:47.000 --> 01:19:54.040] And this guy, during my sleep, lame little sleep test thing, drugs had just come out called orexin receptor antagonists.
[01:19:54.040 --> 01:19:56.680] And I asked him about them and he said, I don't know anything about them.
[01:19:56.680 --> 01:19:57.960] Oh my God, I love you.
[01:19:57.960 --> 01:20:03.960] Doctors who say, I don't know like that, you know, they're the doctors that you can trust on some level, at least.
[01:20:03.960 --> 01:20:07.080] And so he does know now because he read about them.
[01:20:07.080 --> 01:20:14.760] But, you know, otherwise, if they're not explaining what they don't know, yeah, there's a problem.
[01:20:14.760 --> 01:20:24.440] So, with all of this, you know, you deserve to understand what you're being treated, why you're being treated a certain way, and it needs to go in accord with your values.
[01:20:24.440 --> 01:20:31.800] This is called shared decision-making: that a doctor needs to consider who you are, what matters to you in deciding your care.
[01:20:31.800 --> 01:20:34.920] Like, if a woman doesn't want to take estrogen, you don't push her.
[01:20:34.920 --> 01:20:39.960] You can ask her if she wants to understand why that might be problematic or whatever, you know.
[01:20:39.960 --> 01:20:40.760] But that's all.
[01:20:40.920 --> 01:20:43.880] You need to do it in a way where you're not bullying people.
[01:20:43.880 --> 01:20:47.120] You know who needs to read this book, Amy, besides women?
[01:20:47.120 --> 01:20:48.080] Doctors.
[01:20:48.400 --> 01:20:48.960] I know.
[01:20:48.960 --> 01:20:50.800] Well, this book also, this is what I tell people.
[01:20:50.880 --> 01:20:55.600] It's so funny because here I am on your podcast and you're joking about like, okay, it's a vagina land.
[01:20:55.840 --> 01:21:07.600] You know, but the thing is that this book takes on the problems in medicine and how they need to be fixed at the medical, school, and institution level, you know, and also, you know, yeah.
[01:21:07.600 --> 01:21:10.720] And so this is this is more than just a book on menopause.
[01:21:10.720 --> 01:21:22.000] And I had to write that chapter because I found when people who really trust my work, like my copy editor's wife, she's read me for a million years and knows the science I put in and the thinking, she said, I don't want to believe you.
[01:21:22.000 --> 01:21:23.360] Oh, she's actually the head of this.
[01:21:23.360 --> 01:21:24.560] She's at the lead of that chapter.
[01:21:24.560 --> 01:21:29.200] I don't want to believe you, you know, because if I do, my doctor doesn't know anything.
[01:21:29.200 --> 01:21:30.480] And this is terrifying.
[01:21:30.480 --> 01:21:32.880] Like, you know, how do I, what do I do?
[01:21:32.880 --> 01:21:45.600] Because if you're not me and can't read the research, like in this incredible, nerdy, deep dive way, you don't have time, whatever, you know, you go to the doctor and you're just sort of like, you're, you're a victim to anything you get told.
[01:21:45.920 --> 01:21:50.240] Well, of course, you don't want to encourage people to do their own research who don't know how to do that.
[01:21:50.640 --> 01:21:51.120] Exactly.
[01:21:51.120 --> 01:21:52.240] Don't do your own research.
[01:21:52.240 --> 01:21:57.200] If you don't know how to read studies, if you don't know, you know, does the study have a control group?
[01:21:57.200 --> 01:22:00.000] You know, what's things like that.
[01:22:00.000 --> 01:22:04.160] You know, why you need to look at a body of research to see if the effect is the same.
[01:22:04.160 --> 01:22:12.400] When I talked about heterogeneous breast cancer research, you know, it's like on different forms and for different amounts of time and different ages of women.
[01:22:12.400 --> 01:22:15.120] You can't say anything conclusive from that.
[01:22:15.120 --> 01:22:24.640] And if you don't know that, this do-your-own research thing, my God, yeah, read WebMD and then, like, you know, decide you're going to take this drug that could cause you all sorts of problems.
[01:22:24.640 --> 01:22:25.840] All right, Amy, I got to run.
[01:22:25.840 --> 01:22:26.560] Thank you so much.
[01:22:26.560 --> 01:22:27.120] Great book.
[01:22:27.120 --> 01:22:28.080] Really important work.
[01:22:28.080 --> 01:22:28.680] Really important work.
[01:22:28.640 --> 01:22:29.080] Thank you.
[01:22:28.880 --> 01:22:29.560] Thank you.
[01:22:29.720 --> 01:22:33.480] Again, I'm just astonished at how much ignorance is still out there about this.
[01:22:28.960 --> 01:22:35.320] So thank God or whoever for you.
[01:22:29.120 --> 01:22:29.600] Thank you.
[01:22:36.600 --> 01:22:38.200] Yeah, and it's always great talking to you.
[01:22:38.280 --> 01:22:39.240] Ask great questions.
[01:22:39.240 --> 01:22:40.360] And it's fun.
[01:22:47.080 --> 01:22:52.200] If you want to feel more connected to humanity and a little less alone, listen to Beautiful Anonymous.
[01:22:52.200 --> 01:22:56.440] Each week, I take a phone call from one random anonymous human being.
[01:22:56.440 --> 01:22:59.000] There's over 400 episodes in our back catalog.
[01:22:59.160 --> 01:23:03.320] You get to feel connected to all these different people all over the world.
[01:23:03.320 --> 01:23:10.440] Recent episodes include one where a lady survived a murder attempt by her own son, but then the week before that, we just talked about Star Trek.
[01:23:10.440 --> 01:23:11.160] It can be anything.
[01:23:11.160 --> 01:23:12.280] It's unpredictable.
[01:23:12.280 --> 01:23:13.000] It's raw.
[01:23:13.000 --> 01:23:13.800] It's real.
[01:23:13.800 --> 01:23:16.920] Get Beautiful Anonymous wherever you listen to podcasts.

Prompt 6: Key Takeaways

Now please extract the key takeaways from the transcript content I provided.

Extract the most important key takeaways from this part of the conversation. Use a single sentence statement (the key takeaway) rather than milquetoast descriptions like "the hosts discuss...". 

Limit the key takeaways to a maximum of 3. The key takeaways should be insightful and knowledge-additive. 

IMPORTANT: Return ONLY valid JSON, no explanations or markdown. Ensure:
- All strings are properly quoted and escaped
- No trailing commas
- All braces and brackets are balanced
Format: {"key_takeaways": ["takeaway 1", "takeaway 2"]}

Prompt 7: Segments

Now identify 2-4 distinct topical segments from this part of the conversation.

For each segment, identify:
- Descriptive title (3-6 words)  
- START timestamp when this topic begins (HH:MM:SS format)
- Double check that the timestamp is accurate - a timestamp will NEVER be greater than the total length of the audio
- Most important Key takeaway from that segment. Key takeaway must be specific and knowledge-additive.
- Brief summary of the discussion

IMPORTANT: The timestamp should mark when the topic/segment STARTS, not a range. Look for topic transitions and conversation shifts.

Return ONLY valid JSON. Ensure all strings are properly quoted, no trailing commas:
{
  "segments": [
    {
      "segment_title": "Topic Discussion", 
      "timestamp": "01:15:30",
      "key_takeaway": "main point from this segment",
      "segment_summary": "brief description of what was discussed"
    }
  ]
}

Timestamp format: HH:MM:SS (e.g., 00:05:30, 01:22:45) marking the START of each segment.

Prompt 8: Media Mentions

Now scan the transcript content I provided for ACTUAL mentions of specific media titles:

Find explicit mentions of:
- Books (with specific titles)
- Movies (with specific titles)  
- TV Shows (with specific titles)
- Music/Songs (with specific titles)

DO NOT include:
- Websites, URLs, or web services
- Other podcasts or podcast names

IMPORTANT: 
- Only include items explicitly mentioned by name. Do not invent titles.
- Valid categories are: "Book", "Movie", "TV Show", "Music"
- Include the exact phrase where each item was mentioned
- Find the nearest proximate timestamp where it appears in the conversation
- THE TIMESTAMP OF THE MEDIA MENTION IS IMPORTANT - DO NOT INVENT TIMESTAMPS AND DO NOT MISATTRIBUTE TIMESTAMPS
- Double check that the timestamp is accurate - a timestamp will NEVER be greater than the total length of the audio
- Timestamps are given as ranges, e.g. 01:13:42.520 --> 01:13:46.720. Use the EARLIER of the 2 timestamps in the range.

Return ONLY valid JSON. Ensure all strings are properly quoted and escaped, no trailing commas:
{
  "media_mentions": [
    {
      "title": "Exact Title as Mentioned",
      "category": "Book",
      "author_artist": "N/A",
      "context": "Brief context of why it was mentioned",
      "context_phrase": "The exact sentence or phrase where it was mentioned",
      "timestamp": "estimated time like 01:15:30"
    }
  ]
}

If no media is mentioned, return: {"media_mentions": []}

Full Transcript

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[00:01:03.920 --> 00:01:09.840] You're listening to The Michael Shermer Show.
[00:01:16.240 --> 00:01:17.840] Hey, everybody, it's Michael Shermer.
[00:01:17.920 --> 00:01:20.320] It's time for another episode of The Michael Shermer Show.
[00:01:20.320 --> 00:01:22.160] Guess who's on the show today?
[00:01:22.160 --> 00:01:25.120] Returning champion Amy Alcon.
[00:01:25.120 --> 00:01:27.760] She was on before for her, well, I'll introduce.
[00:01:27.840 --> 00:01:29.360] Let me give her a proper introduction here.
[00:01:29.360 --> 00:01:38.800] She's an independent investigative science writer specializing in applied science that is using scientific evidence to solve real-world problems.
[00:01:39.040 --> 00:01:40.240] See why I like that.
[00:01:40.240 --> 00:01:54.160] Alcon critically evaluates and synthesizes research across disciplines and then translates it into everyday language, empowering regular people, that's us, to make scientifically informed decisions for the best of their health and well-being.
[00:01:54.160 --> 00:02:02.840] For 25 years, she wrote the award-winning science-based nationally syndicated advice column, distributed by creators, and is the author of five books.
[00:02:02.840 --> 00:02:12.120] Most recently, before the new one I'll just introduce in a moment, for which she was on the show before, is called Unfuckology: How to Live with Guts and Confidence.
[00:02:12.120 --> 00:02:13.880] At least I think that's how it's pronounced.
[00:02:14.120 --> 00:02:22.760] Actually, Amy, I cite that book in my next book, and the copy editor corrected and said, You have to put an asterisk where the U is.
[00:02:23.400 --> 00:02:24.600] I hate that.
[00:02:24.600 --> 00:02:26.040] It is not my choice.
[00:02:26.040 --> 00:02:29.320] No fig leaves, but bookstores require that, or they won't sell it.
[00:02:29.320 --> 00:02:30.120] So I defer to that.
[00:02:30.360 --> 00:02:30.600] Really?
[00:02:30.600 --> 00:02:31.160] Is that right?
[00:02:31.160 --> 00:02:32.920] Yeah, the god of sales.
[00:02:32.920 --> 00:02:33.800] Oh, my gosh.
[00:02:34.440 --> 00:02:34.840] I know.
[00:02:34.840 --> 00:02:35.720] This is so stupid.
[00:02:35.720 --> 00:02:38.040] Hi, we all know what the word is.
[00:02:39.320 --> 00:02:49.720] Well, anyway, here's the new book: it's called Going Menopostal: What You and Your Doctor Need to Know About the Real Science of Menopause and Perimenopause.
[00:02:49.720 --> 00:02:56.360] I forgot to mention that you've written for the New York Times, Time Magazine, The Washington Post, The Independent in the UK, McLean's.
[00:02:56.680 --> 00:03:01.320] You've been on Today, Good Morning America, CNN, Nightline, Anderson Cooper, coast to coast.
[00:03:01.320 --> 00:03:02.760] Oh, you did coast to coast AM?
[00:03:02.760 --> 00:03:03.800] All right, that's cool.
[00:03:03.800 --> 00:03:05.400] You get those calls at two in the morning.
[00:03:05.400 --> 00:03:06.120] That's always big fun.
[00:03:06.520 --> 00:03:08.360] Actually, I didn't write the story for the New York Times.
[00:03:08.360 --> 00:03:09.800] Someone wrote one about me.
[00:03:09.800 --> 00:03:15.080] So I don't write that many news article-type pieces.
[00:03:15.080 --> 00:03:16.440] Oh, well, that's pretty cool, though.
[00:03:16.440 --> 00:03:19.160] Anyway, well, Amy, I've known you a long time.
[00:03:19.160 --> 00:03:26.840] I never thought we would be discussing that part of your body because I don't know you that well.
[00:03:26.840 --> 00:03:29.480] So, what's going on down there?
[00:03:29.480 --> 00:03:37.720] Well, it's actually going on throughout all of medicine, and it's that we have most of our medical care, and this is according to the U.S.
[00:03:37.720 --> 00:03:42.360] National Academy of Medicine, not some random Twitter person.
[00:03:42.360 --> 00:03:47.440] Most of our medical care is not based on adequate evidence, more than half.
[00:03:47.440 --> 00:03:51.200] I mean, that adequate, that's not like rigorous, it's adequate.
[00:03:51.200 --> 00:03:57.760] And you see this, if you know this science, you see this in every area of your treatment, and I do.
[00:03:57.760 --> 00:04:05.040] And that was how I came to write this book because I was sitting here in Venice, California, in my very temperate office.
[00:04:05.040 --> 00:04:06.480] It's the most temperate place in the world.
[00:04:06.480 --> 00:04:14.320] It's like 55 degrees year-round, breeze blowing, and all of a sudden, oh my God, I'm locked in a trunk in the Everglades.
[00:04:15.280 --> 00:04:17.760] Every pore of my body is just pouring sweat.
[00:04:17.760 --> 00:04:18.560] It's horrible.
[00:04:18.560 --> 00:04:22.320] And I think, oh my God, I think this is a hot flash.
[00:04:22.320 --> 00:04:23.680] So horrible.
[00:04:23.680 --> 00:04:30.320] And so, and I think, you know, what I want to do is to go to my doctor, my gynecologist, and say, I'm uncomfortable.
[00:04:30.320 --> 00:04:31.600] What do I do?
[00:04:31.600 --> 00:04:33.040] But I know better.
[00:04:33.040 --> 00:04:38.480] I was coached, this very generous guy, he co-wrote this seminal book in epidemiology.
[00:04:38.480 --> 00:04:40.720] I can't speak, a modern epidemiology.
[00:04:40.720 --> 00:04:48.320] His name is Sandra Greenland, just generously coached me in how to read and critically evaluate science since about 2007.
[00:04:48.640 --> 00:04:56.640] And so, because of him, and because he sent me all these articles about fraud and abuse and errors in medicine, I was very attuned to that.
[00:04:56.640 --> 00:05:09.120] And so, I went through and started this deep dive into the research, and I saw there was this huge, horrible gap between the practice standards and the science.
[00:05:09.120 --> 00:05:18.480] And every area of medicine, again, is like this, but perimenopause and menopause medical care is the most patient-betraying area of medicine.
[00:05:19.120 --> 00:05:20.000] How can that be?
[00:05:20.000 --> 00:05:26.640] I mean, this is, we've known about this for a long time, and there must be at least a century's worth of serious medical research on it.
[00:05:26.640 --> 00:05:28.800] How can there be this still this huge gap?
[00:05:28.800 --> 00:05:30.040] You're exactly right.
[00:05:29.600 --> 00:05:33.240] Here's the scandal of gynecology departments.
[00:05:33.560 --> 00:05:37.960] In gynecology departments, they are all what I call baby doctors.
[00:05:37.960 --> 00:05:40.520] So they're maternity specialists.
[00:05:40.520 --> 00:05:45.240] They are highly trained in delivering babies, and they're also reproductive specialists.
[00:05:45.240 --> 00:05:48.760] So they specialize in fertility and these problems.
[00:05:48.760 --> 00:05:51.880] People have polycystic ovary disease.
[00:05:51.880 --> 00:05:59.800] Nobody gets training in menopause, or some now are starting to, but the training they have, it's really kind of a joke.
[00:05:59.800 --> 00:06:03.800] They take an online course at the menopause society.
[00:06:03.800 --> 00:06:06.120] You know, that's like passing traffic school.
[00:06:06.120 --> 00:06:08.200] You know, it's not deep knowledge.
[00:06:08.200 --> 00:06:18.840] You're not having some person in clinical rotation who's a seasoned old, crusty expert kick your ass, you know, and you're not reading the science because here's another revelation.
[00:06:18.840 --> 00:06:28.680] There are three big myths of our medical care, and one of them is that doctors read scientific evidence and evaluate you and treat you based on the evidence.
[00:06:28.680 --> 00:06:29.720] They don't.
[00:06:29.720 --> 00:06:33.720] Doctors are not trained to read evidence in med school.
[00:06:33.720 --> 00:06:52.840] They can't critically evaluate it and they don't, frankly, have time to read it, you know, at an HMO like mine, Kaiser Permanente, where doctors have 20 minutes to see you, chop, chop, chop, one patient after the next, medical record keeping requirements, you know, and I'll have doctors email me at seven o'clock quite frequently, so it's not like they're doing nothing.
[00:06:52.840 --> 00:06:54.200] So I can sympathize.
[00:06:54.200 --> 00:07:02.520] I would read it, but I'm a psychoscientific mole rat who sits here dawn till dusk, you know, rejoicing over working.
[00:07:02.520 --> 00:07:07.480] And people want families and things, so I can't expect that of them.
[00:07:07.800 --> 00:07:08.200] Wow.
[00:07:08.200 --> 00:07:09.480] Yeah, I used to be with Kaiser.
[00:07:09.480 --> 00:07:12.120] If you got 20 minutes, that was pretty generous, actually.
[00:07:12.120 --> 00:07:14.480] Mine were usually like eight minutes.
[00:07:14.120 --> 00:07:15.760] Yeah.
[00:07:16.080 --> 00:07:23.920] So, you know, since you're steeped in the literature of evolutionary psychology, let's just kind of back up and do a big picture look here.
[00:07:23.920 --> 00:07:26.160] Why do women go through menopause at all?
[00:07:26.160 --> 00:07:28.480] Why can't you just give birth for, you know, your whole life?
[00:07:28.480 --> 00:07:33.760] Wouldn't evolution select for you having 50 babies in the course of 100 years or so?
[00:07:33.920 --> 00:07:38.880] Well, no, because as you get older, you get less and less, progressively less healthy.
[00:07:38.880 --> 00:07:41.200] Aging causes unhealth, basically.
[00:07:41.200 --> 00:07:42.960] You erode, we erode.
[00:07:42.960 --> 00:07:53.920] And part of what I do in this book is give you the ways of eating and exercise that are the most powerful and efficient for really not eroding and for being healthy throughout your lifespan.
[00:07:53.920 --> 00:07:56.240] So you're you, you're just a little more wrinkled.
[00:07:56.240 --> 00:08:09.680] But with evolutionary psychology, you know, there's no strong proof of this, but we can speculate, you know, there's the grandmother hypothesis that we needed to have people who weren't having children to care for the children that exist.
[00:08:09.680 --> 00:08:15.680] And, but really, you know, you see that as we age, you're going to be much less healthy.
[00:08:15.680 --> 00:08:19.360] Like women need to, if they're going to have children, they want to freeze their eggs.
[00:08:19.360 --> 00:08:23.600] I think it's that they need to do it before 35, certainly, and ideally well before.
[00:08:23.600 --> 00:08:26.320] And the same thing, man, you have old sperm.
[00:08:26.320 --> 00:08:27.680] Your sperm gets old.
[00:08:27.680 --> 00:08:34.240] So you've got to do that too, you know, when you're young, in your 20s, you know, if you want to have kids at a later date.
[00:08:34.240 --> 00:08:35.520] And so that's part of it.
[00:08:35.520 --> 00:08:42.960] You know, just that we're not, for whatever reason, these reasons probably were not adapted to, you know, be like 80 and pushing a stroller.
[00:08:42.960 --> 00:08:44.880] And oh my God, God forbid.
[00:08:45.520 --> 00:08:49.280] Yeah, also with limited resources in our ancestral environment.
[00:08:49.920 --> 00:09:02.600] Once you've given birth and then become a grandmother, probably there's not much more benefits you could provide versus those resources being allocated to the upcoming next generation of women.
[00:09:02.600 --> 00:09:07.480] So essentially, natural selection said, we're just going to let your body rot.
[00:09:07.480 --> 00:09:08.680] You're done.
[00:09:08.680 --> 00:09:09.880] Thank you very much.
[00:09:09.880 --> 00:09:11.240] Now go away.
[00:09:11.560 --> 00:09:12.920] But we're learning more and more.
[00:09:12.920 --> 00:09:16.760] You know, mitochondria, they've been called the energy furnaces of cells.
[00:09:16.840 --> 00:09:17.880] They're much more.
[00:09:17.880 --> 00:09:32.120] I don't want to go into it because it's a complex area, but keeping our mitochondria healthy through eating a diet that is not high in sugar or flour, that is not inflammatory, doing exercise, certain kinds of exercise.
[00:09:32.120 --> 00:09:38.520] And by the way, every bit of advice a medical provider gives you, pretty much, it just reminded me of that is wrong.
[00:09:38.520 --> 00:09:45.160] Osteoporosis, Kaiser Permanente, on their website, they talk about walking for healthy bones.
[00:09:45.160 --> 00:09:51.560] Oh my God, unless you're carrying an elephant, you're not putting enough weight on your bones to tell them they're needed.
[00:09:51.560 --> 00:09:53.080] And what you do, it's really muscles.
[00:09:53.080 --> 00:09:55.480] What you do for muscles, you do for bones.
[00:09:55.480 --> 00:09:57.480] So you need to challenge your muscles.
[00:09:57.480 --> 00:10:00.680] And by challenging them, you create tiny tears in them.
[00:10:00.680 --> 00:10:03.640] And the repair is building strong, healthy muscles.
[00:10:03.640 --> 00:10:15.320] And by the way, all that stuff on bone mineral density, this is about, it's designed, these tests, these scanners, they're designed to prescribe you drugs you don't need as a healthy woman.
[00:10:15.320 --> 00:10:22.360] Osteoporosis was given to, it was diagnosed in just a few elderly women with something called kyphosis, where they were bent over.
[00:10:22.360 --> 00:10:27.640] And the biggest cause of broken bones is falling when you're 79.
[00:10:27.640 --> 00:10:33.400] You know, not that your bones are just suddenly so holy that you collapse into a bucket.
[00:10:33.400 --> 00:10:33.800] Right.
[00:10:33.800 --> 00:10:40.040] Yeah, I've heard that line: that the most dangerous thing an 80-plus person can do every day is take a shower.
[00:10:40.520 --> 00:10:41.480] RBD.
[00:10:41.480 --> 00:10:45.200] I've got like garden clogs, purple gardening clogs in the middle of my living room.
[00:10:45.200 --> 00:10:48.400] Hi, death trap Amy, dummy.
[00:10:48.720 --> 00:10:49.920] Too funny.
[00:10:44.840 --> 00:10:50.080] Yeah.
[00:10:51.040 --> 00:11:00.960] So, for those of us that missed the sex ed class in eighth grade, can you explain what women's bodies go through each month and then what stops or what changes when you hit menopause?
[00:11:01.200 --> 00:11:01.360] Sure.
[00:11:01.520 --> 00:11:02.560] So, there are two parts.
[00:11:02.720 --> 00:11:03.760] I'm going to keep it brief.
[00:11:03.760 --> 00:11:10.400] There are basically two parts of our menstrual cycle: there's the estrogen part at the top, and the bottom is the progesterone phase.
[00:11:10.400 --> 00:11:16.480] These are both hormones, and they work together, their counterparts in the menstrual cycle.
[00:11:16.480 --> 00:11:21.200] And so, estrogen is the hormone that leads up to ovulation.
[00:11:21.200 --> 00:11:25.600] That's when there's a little sac with an egg in it, and it ruptures.
[00:11:25.600 --> 00:11:28.160] It's supposed to rupture, and then the egg is released.
[00:11:28.160 --> 00:11:29.040] And this is so cool.
[00:11:29.040 --> 00:11:31.120] I always thought the fallopian tubes were connected.
[00:11:31.120 --> 00:11:33.280] They're not, they're like little baseball mitts.
[00:11:34.240 --> 00:11:38.480] They sweep over, they grab the egg and they send it down to the uterus.
[00:11:38.480 --> 00:11:44.400] Where if some sperm meets up with it, you know, get fertilized, it implants into the uterine wall.
[00:11:44.400 --> 00:11:49.040] And nine months later, you know, you have a screaming being on your hands.
[00:11:49.200 --> 00:11:55.280] Or two or three if you have, you know, late pregnancies, which happens more, they have like triplets or something.
[00:11:55.280 --> 00:12:02.400] But anyway, so what happens, what goes wrong in perimenopause is that you often don't ovulate.
[00:12:02.400 --> 00:12:14.640] You know, so there's a whole signaling thing that's going on, but in perimenopause, that's a transition years to menopause, like three to ten years, in which some women, me especially, have horrible, horrible symptoms.
[00:12:15.040 --> 00:12:24.640] And during this time, what happens is you'll have a normal period, the same as all other periods, doesn't seem any different, but your egg will not rupture.
[00:12:24.640 --> 00:12:37.880] This is called an ovulation, so you're not ovulating, and this is very bad because what happens is when that egg ruptures, there's like this yellow litter left over from the sac is all the mess on the floor, and it becomes progesterone.
[00:12:37.880 --> 00:12:40.920] It's the corpus luteum, it's yellow, waxy stuff.
[00:12:40.920 --> 00:12:47.000] And you need progesterone for a certain amount of days in your cycle, like 10 to 12, I think it is.
[00:12:47.560 --> 00:12:55.880] And in order for you to have sufficient progesterone to protect your endometrium so you don't get sick, your endometrium is a uterine lining.
[00:12:55.880 --> 00:13:01.720] And what happens is in perimenopause, now doctors see perimenopause as menopause-like.
[00:13:01.720 --> 00:13:06.440] They think that estrogen is just in decline, petering out, but it's not.
[00:13:06.440 --> 00:13:13.720] This is why science is so important to be injected into our medical care, because what happens is that estrogen spikes and dives.
[00:13:13.720 --> 00:13:16.200] It goes sometimes three times higher.
[00:13:16.200 --> 00:13:20.040] And this makes you, estrogen is proliferative and inflammatory.
[00:13:20.040 --> 00:13:21.960] And in proper amounts, it's great.
[00:13:21.960 --> 00:13:23.320] With progesterone, it's great.
[00:13:23.320 --> 00:13:23.880] You need it.
[00:13:23.880 --> 00:13:26.760] It's an important home for every cell in our body.
[00:13:26.760 --> 00:13:34.120] But when it's spiking and you have no progesterone, this is a recipe for hell, especially for some of us.
[00:13:34.120 --> 00:13:51.800] And the reason the book is going menopostal that reflects my rage that after I fought three battles with Kaiser to get the progesterone I need, the amount I need and get it covered, instead of giving the cancer risk increasing drug that was on their formulary alone, is so terrible.
[00:13:51.800 --> 00:13:54.920] You know, that I, what was I saying here?
[00:13:54.920 --> 00:13:56.280] I lost my train of thought.
[00:13:56.280 --> 00:13:59.480] I, oh, it's about my rage that they wouldn't give this to other women.
[00:13:59.480 --> 00:14:02.840] And then also my rate, the symptoms.
[00:14:02.840 --> 00:14:04.680] I am, I'm a nice person.
[00:14:04.680 --> 00:14:05.480] I like people.
[00:14:05.480 --> 00:14:08.440] I'm at the hardware store in perimenopause.
[00:14:08.440 --> 00:14:15.200] And some man, like my dad, I'm from the Midwest, my dad, my grandpa, fixing stuff in the basement, whatever, behind me in line.
[00:14:15.200 --> 00:14:19.200] Like, I would like this man just because he, that breed that I know.
[00:14:14.840 --> 00:14:20.960] Oh, my God, the guy is humming.
[00:14:21.280 --> 00:14:25.680] I, I mean, seriously, I wanted to, I'm like looking around, I want a heavy object.
[00:14:25.680 --> 00:14:28.400] I want to bludgeon this man to death so he shuts up.
[00:14:28.400 --> 00:14:31.120] And then you're so ashamed because this is horrible.
[00:14:31.120 --> 00:14:34.560] You're saying like, calm the hell down, Alcon.
[00:14:34.560 --> 00:14:36.720] But this was from the lack of progesterone.
[00:14:36.720 --> 00:14:42.560] And you feel like you're basically like on rims on the highway in a police chase, which we have a lot of here in California.
[00:14:42.560 --> 00:14:43.600] It is terrible.
[00:14:43.600 --> 00:14:44.720] And there are many other symptoms.
[00:14:44.720 --> 00:14:50.720] So hot flashes, nausea, I mean, insomnia, and then you have brain fog.
[00:14:50.720 --> 00:14:52.000] It's just terrible.
[00:14:52.000 --> 00:15:00.080] So your doctor, all these baby doctors not knowing anything about this, they can't diagnose you and they can't treat you.
[00:15:00.400 --> 00:15:02.320] They'll dismiss what's wrong with you.
[00:15:02.320 --> 00:15:03.920] They won't connect all these things.
[00:15:03.920 --> 00:15:08.080] You have mysterious, mysterious, just like dysfunction of your whole body.
[00:15:08.080 --> 00:15:09.600] You think you're falling apart.
[00:15:09.600 --> 00:15:16.400] And as you know, Michael, uncertainty is the most disturbing feeling to humans, especially medical uncertainty.
[00:15:16.400 --> 00:15:25.120] And so women will try to seek out these diagnoses of like fibromyalgia and other things, you know, that and get treated for diseases they don't have.
[00:15:25.120 --> 00:15:26.800] It's terrible.
[00:15:27.280 --> 00:15:42.320] Just again, I just can't believe it after all this medical research and you know half the population is female and they go to and they go to Kaiser and they have OBGBYNs and so forth.
[00:15:42.320 --> 00:15:43.360] How could they not know this?
[00:15:43.360 --> 00:15:49.040] I mean, if you walked into your doc and told that story, they should go, oh, well, I'll tell you exactly what's going on.
[00:15:49.200 --> 00:15:50.000] I know.
[00:15:50.000 --> 00:15:52.160] And my gynecologist, he's a good guy.
[00:15:52.640 --> 00:15:53.600] I do have a man.
[00:15:53.600 --> 00:15:55.200] It's not like those people with cancer.
[00:15:55.200 --> 00:15:58.880] Okay, unless you've had a glioma, I am not seeing you as a doctor.
[00:15:58.880 --> 00:15:59.680] You know, he's great.
[00:15:59.800 --> 00:16:01.400] So he treated me with respect.
[00:16:01.400 --> 00:16:05.240] And he and his boss, they listened to me.
[00:16:05.240 --> 00:16:06.760] I sent them a slew of studies.
[00:16:06.760 --> 00:16:08.120] I'm really annoying.
[00:16:08.120 --> 00:16:09.720] And they had finally a meeting with me.
[00:16:09.800 --> 00:16:10.680] You're one of those.
[00:16:10.680 --> 00:16:11.400] I am.
[00:16:11.400 --> 00:16:13.320] Well, you're not going to give me unscience.
[00:16:13.320 --> 00:16:14.360] You're not going to harm me.
[00:16:14.360 --> 00:16:15.880] And this is actually going out.
[00:16:15.880 --> 00:16:21.160] The head of gynecology now, it's Kaiser West LA, is so ignorant of menopause science.
[00:16:21.160 --> 00:16:23.560] She's denying me care that I need.
[00:16:23.560 --> 00:16:28.200] I have, for I have, I'm a rapid metabolizer of steroids.
[00:16:28.200 --> 00:16:35.400] I got something done called pharmacogenetics, which looks at your genetic profile as far as how you metabolize drugs.
[00:16:35.400 --> 00:16:36.520] It's very helpful.
[00:16:36.520 --> 00:16:44.360] So I have that and other things that show, oh, look, I'm not getting, I have tests showing I don't even get half the estrogen I take.
[00:16:44.360 --> 00:16:45.320] So I need more.
[00:16:45.320 --> 00:16:46.440] I need a double dose.
[00:16:46.440 --> 00:16:48.120] For someone else, that would be a lot.
[00:16:48.120 --> 00:16:51.000] For me, it is not what she calls a super physiologic dose.
[00:16:51.000 --> 00:16:55.320] Now, this woman tells me that I need to taper off estrogen at 60.
[00:16:55.320 --> 00:17:01.640] Okay, this is research circa 2002 that was debunked in 2004.
[00:17:01.640 --> 00:17:04.280] This is 2025, I recall.
[00:17:04.280 --> 00:17:05.240] Yes, I do.
[00:17:05.880 --> 00:17:12.840] We get a little forgetful of menopause, the norepinephrine and dopamine tank, and I have ADHD and they're already like, you know, hello down there.
[00:17:13.080 --> 00:17:16.680] Anyway, so, and she tells me she reads the science.
[00:17:17.080 --> 00:17:18.760] Yeah, no, you don't.
[00:17:18.760 --> 00:17:34.120] And I sent her this huge document with the study by this guy back who shows women who have, who take estrogen late into life, you know, that they don't have breast cancer, that they have protected cardiology, cardiovascular systems, all this protection.
[00:17:34.200 --> 00:17:40.760] We found that estrogen is protective if, only if you take it right after menopause is a healthy woman.
[00:17:40.760 --> 00:17:43.480] If you're not healthy, you're broken, estrogen won't break you further.
[00:17:43.480 --> 00:17:45.440] It's really pretty terrible.
[00:17:46.080 --> 00:17:46.640] Yeah.
[00:17:44.520 --> 00:17:51.600] You know, I just think there's so much literature to read, and doctors are busy.
[00:17:51.760 --> 00:17:53.280] They just don't keep up.
[00:17:53.280 --> 00:17:53.680] They should.
[00:17:53.680 --> 00:17:54.800] They know they should.
[00:17:54.800 --> 00:17:55.520] They just can't.
[00:17:55.520 --> 00:17:59.920] I've tell the story about, you know, my mom went through 10 years of brain tumors.
[00:17:59.920 --> 00:18:01.360] She had meningioma brain tumors.
[00:18:01.520 --> 00:18:01.920] Oh, my God.
[00:18:02.160 --> 00:18:04.080] Women get more than men.
[00:18:04.080 --> 00:18:07.360] And then, so she had five craniometries.
[00:18:07.360 --> 00:18:09.760] This goes on and on for a whole decade.
[00:18:09.760 --> 00:18:14.640] But in the middle of all this, she got all of a sudden there's a tumor in one of her lungs.
[00:18:14.720 --> 00:18:22.880] I thought, come on, what are the chances she got two completely different kinds of tumors that maybe some cells in the brain migrated to her lungs or something like this?
[00:18:22.880 --> 00:18:27.920] So, and she was being treated by these top oncologists at USC.
[00:18:27.920 --> 00:18:31.040] And, you know, they go, nope, nope, that's not possible.
[00:18:31.040 --> 00:18:35.280] The meningioma tumors cannot do what you just think they can do.
[00:18:35.280 --> 00:18:39.040] Anyway, that night, I had, I went to a dinner party at Carol Taverse's house.
[00:18:39.040 --> 00:18:39.360] I love it.
[00:18:39.520 --> 00:18:40.880] Apart from where you have, yeah.
[00:18:41.200 --> 00:18:45.840] And there at the dinner was a guy named Avram Blooming, who is an oncologist.
[00:18:45.840 --> 00:18:47.600] I quote both of them in my book.
[00:18:47.600 --> 00:18:48.000] Yeah.
[00:18:48.000 --> 00:18:48.560] Oh, right.
[00:18:48.560 --> 00:18:49.520] Yes, right.
[00:18:49.520 --> 00:18:51.760] So I'm telling Avram this story.
[00:18:51.760 --> 00:18:57.680] He goes, No, there was just a paper out like a year ago showing that that can happen and I'll send it to you.
[00:18:57.680 --> 00:18:58.560] So he sends it to me.
[00:18:58.560 --> 00:19:00.080] I send it to the USC doc.
[00:19:00.240 --> 00:19:01.760] He's like, huh, never saw that.
[00:19:01.760 --> 00:19:03.040] I'm like, isn't this terrible?
[00:19:03.040 --> 00:19:03.760] This is okay.
[00:19:03.760 --> 00:19:06.320] Everyone needs to know this is all of medicine.
[00:19:06.320 --> 00:19:12.160] And the problem is, if you're me and you're really a pain in the ass too, you can deal with this because you read the research.
[00:19:12.160 --> 00:19:15.440] But doctors, remember, they are not trained to read the research.
[00:19:15.440 --> 00:19:16.960] They don't know how.
[00:19:16.960 --> 00:19:18.240] And they don't have time.
[00:19:18.640 --> 00:19:22.480] And when you don't know how to read the research, you also don't know how to look it up.
[00:19:22.480 --> 00:19:26.400] You know, you don't know how to use PubMed, these Google Scholar, and all these things.
[00:19:26.400 --> 00:19:31.720] And you need to read enough in an area to know who are the key researchers who are doing really good work.
[00:19:32.040 --> 00:19:35.800] And, you know, who does the methodological crap?
[00:19:36.200 --> 00:19:43.960] You know, and no things like you don't look at studies from China and go, okay, you have to look for a body of work from everybody else because there's so much fraud.
[00:19:43.960 --> 00:19:47.400] And these doctors have not a clue, not a clue in the world.
[00:19:47.400 --> 00:19:53.800] You know, like this one where she's telling me to taper off estrogen, she's telling me this is harmful.
[00:19:54.120 --> 00:19:58.280] It's called iatrogenesis, medical care that intends to help, that harms.
[00:19:58.280 --> 00:20:06.280] So you need to continue taking estrogen through 79, like I was saying, when you're old, when you're going to fall, in order for your bones to be protected.
[00:20:06.280 --> 00:20:14.280] And if you stop at 60, not only do you reverse the advances that you had in your bones, you are unprotected for all those years.
[00:20:14.280 --> 00:20:17.160] Your cardiovascular system is unprotected.
[00:20:17.160 --> 00:20:27.000] Right after menopause, if you don't take estrogen, your estrogen receptors in your endothelium, this is the one cell layer, the lining of your arteries, they go away.
[00:20:27.000 --> 00:20:32.520] So you lose this vital protection, and one in five women will die of cardiovascular disease.
[00:20:32.520 --> 00:20:33.000] It's huge.
[00:20:33.000 --> 00:20:34.600] And soon, one in three.
[00:20:34.920 --> 00:20:40.120] So all these women really need real science driving their care.
[00:20:40.120 --> 00:20:47.640] And instead, they're getting this, like the head of Kaiser Gynecology West Alike is ignorant, tells me she knows science.
[00:20:47.640 --> 00:20:51.080] And oh, she told me also she's choosing the drugs in the formulary.
[00:20:51.080 --> 00:20:53.480] Hello, why don't we have my dog choose them?
[00:20:53.480 --> 00:20:55.560] Because it's now the same crab shoot.
[00:20:55.560 --> 00:20:56.520] It's terrible.
[00:20:56.520 --> 00:20:58.440] It's really terrible.
[00:20:58.440 --> 00:21:00.120] Amy, you're so funny.
[00:21:00.120 --> 00:21:01.560] I love your books and your writing.
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[00:21:32.480 --> 00:21:34.880] Well, I know you got a great sense of humor.
[00:21:34.880 --> 00:21:42.960] You opened this book with a story about your best friend forever dumped you by email on a Sunday.
[00:21:43.200 --> 00:21:45.440] She said, I think we should go our separate ways.
[00:21:45.440 --> 00:21:46.480] There was no explanation.
[00:21:46.480 --> 00:21:47.840] There was just the act.
[00:21:47.840 --> 00:21:52.560] Like I was some stranger she'd once had exchanged sharp words with in a grocery store.
[00:21:52.560 --> 00:21:54.080] I never heard from her again.
[00:21:54.080 --> 00:22:00.160] Getting dumped by a friend is worse than getting dumped by a man because you kind of expect that could happen.
[00:22:00.160 --> 00:22:01.840] There's also a predictable set of reasons.
[00:22:01.840 --> 00:22:03.040] A man ends it with you.
[00:22:03.040 --> 00:22:04.160] The sex got boring.
[00:22:04.160 --> 00:22:04.880] You got boring.
[00:22:04.880 --> 00:22:06.080] He's in love with your sister.
[00:22:06.080 --> 00:22:08.400] He's in love with your sister's husband.
[00:22:08.720 --> 00:22:09.680] Anyway, did you?
[00:22:09.760 --> 00:22:12.400] So you've never figured out what was the upshot of that?
[00:22:12.880 --> 00:22:23.120] And I would wake up, you know, at three in the morning, and part of it was perimenopause, but just, why did, why, why, you know, and because again, uncertainty is so disturbing.
[00:22:23.120 --> 00:22:26.720] It was just like, look, I hate your red hair or whatever.
[00:22:26.720 --> 00:22:30.320] You know, anything, any kind of explanation, I really would have been helped by.
[00:22:30.320 --> 00:22:31.280] And it really is terrible.
[00:22:31.280 --> 00:22:35.440] Women feel so acutely this loss of female friendship.
[00:22:35.440 --> 00:22:37.920] And, you know, I just don't want to go through that ever again.
[00:22:37.920 --> 00:22:43.040] I mean, I take, of course, like risks and have people in my life because I'm not going to not do that.
[00:22:43.040 --> 00:22:45.120] But that was really painful.
[00:22:45.120 --> 00:22:45.520] Yeah.
[00:22:45.840 --> 00:22:46.240] All right.
[00:22:46.240 --> 00:22:48.640] So symptoms began for you at age 52.
[00:22:48.640 --> 00:22:51.680] What's the range for women on average when it begins?
[00:22:51.680 --> 00:22:52.640] It really varies.
[00:22:52.640 --> 00:22:56.800] Someone early early perimenopause is 35.
[00:22:56.800 --> 00:23:02.440] And I write about that because there are nuances with each area of menopause.
[00:23:02.600 --> 00:23:07.960] But most women, mid-40s to like 50, I think 51 is the average age.
[00:23:08.360 --> 00:23:10.200] But really, things are very varied.
[00:23:10.200 --> 00:23:11.240] And the same thing goes.
[00:23:11.240 --> 00:23:12.920] Here's another bit of unscience.
[00:23:12.920 --> 00:23:15.720] The menstrual cycle that we've been told is 28 days.
[00:23:15.720 --> 00:23:17.000] No, it's not.
[00:23:17.000 --> 00:23:19.480] No, it can be 50 or 20.
[00:23:19.480 --> 00:23:28.200] And those fertility apps that go by a 28-day menstrual cycle, they're telling women like what days they should, you know, have sex to get pregnant.
[00:23:28.200 --> 00:23:31.320] Women who are desperate to have a baby, oh my God, they're wrong.
[00:23:31.320 --> 00:23:33.080] It's really egregious.
[00:23:33.080 --> 00:23:37.080] So just when I say every area, I mean every area.
[00:23:37.080 --> 00:23:37.880] Amazing.
[00:23:37.880 --> 00:23:39.800] Again, more bad science.
[00:23:39.800 --> 00:23:42.840] Okay, so there's a broad range there.
[00:23:42.840 --> 00:23:48.280] And then what kind of range is there for the intensity of the symptoms?
[00:23:48.280 --> 00:23:50.040] You know, there's a huge range.
[00:23:50.040 --> 00:23:53.400] Some women do not have symptoms really at all.
[00:23:53.400 --> 00:23:56.680] They barely experience it, if at all.
[00:23:56.680 --> 00:23:59.800] And they're lucky because they're not having this suffering.
[00:23:59.800 --> 00:24:08.200] But here's the thing: what we've seen is that progesterone, like estrogen, is a protective drug to take.
[00:24:08.200 --> 00:24:22.280] And so those women, you know, it's very likely that their progesterone is low or non-existent, that they're having these anovulatory cycles, you know, even though they're not being so disturbed by them, or they're having too short progesterone phase cycles.
[00:24:22.280 --> 00:24:38.120] And I want to say also, I should credit this, the research on progesterone and perimenopause comes from this incredible researcher, Gerilyn Pryor, this fierce woman, grew up in Alaska with no running water or electricity, childhood missionaries.
[00:24:38.120 --> 00:24:43.720] And in this fierce, harsh environment, it created the scientist who fights for things.
[00:24:43.720 --> 00:24:45.680] And you were asking, why don't we know this stuff?
[00:24:46.000 --> 00:25:07.840] Now, she is, you know, the work that she puts out, it's good science, but it is contrary to the beliefs in science about perimenopause and midroxyprogesterone acetate, the drug they give the synthetic that was on Kaiser's formulary that increases breast cancer risk, cardiovascular risk, you know, risk of Alzheimer's and just brain harm.
[00:25:07.840 --> 00:25:14.960] You know, and so she fought to have perimenopause recognized for the unique hormonal state it is with the ups and downs of estrogen.
[00:25:14.960 --> 00:25:17.840] This comes from her work and others that she cites.
[00:25:17.840 --> 00:25:26.960] And then also to have progesterone recognized, it is the most healthy, least side effect-laden drug, less, fewer side effects than aspirin.
[00:25:26.960 --> 00:25:30.160] And really, you know, in perimenopause for me, it was the body's volume.
[00:25:30.160 --> 00:25:31.280] It was wonderful.
[00:25:31.280 --> 00:25:33.760] And it gave me my sleep back, which is really important.
[00:25:33.760 --> 00:25:42.000] That's the fail-safe I tell women in the book because I tell, I say, look, I've written this book in ordinary language so it can be understood by everyone.
[00:25:42.000 --> 00:25:42.960] There's my router over there.
[00:25:42.960 --> 00:25:45.760] It says, write every page in this book for Pamela D.
[00:25:45.920 --> 00:25:47.680] She's my favorite bus driver.
[00:25:48.000 --> 00:25:50.320] She's smart, but she doesn't read science.
[00:25:50.320 --> 00:25:52.320] You know, so it needs to be accessible.
[00:25:52.320 --> 00:25:59.520] And so that way women can bring the science to their doctors, but that's not enough because the doctor, here, give me evidence-based care.
[00:25:59.600 --> 00:26:02.000] The doctor can say, well, no, no.
[00:26:02.240 --> 00:26:13.600] But prior, Gerilyn Pryor, what she did is she created this quantitative basal temperature taking where you measure your temperature every morning for a month and ideally for a few months.
[00:26:13.680 --> 00:26:16.000] You have some extra additional data.
[00:26:16.000 --> 00:26:26.480] And using the there, it's explained in my book, but you use what your temperature is to determine whether or not you have progesterone and adequate progesterone for adequate gaze.
[00:26:26.480 --> 00:26:32.120] And if you don't, you can go to your doctor and say, and I'm not saying that you should lie, but sleep.
[00:26:29.760 --> 00:26:36.040] Sleep, we don't like you can't say, I don't get to sleep if you're a doctor.
[00:26:36.280 --> 00:26:37.960] So that's very persuasive.
[00:26:38.200 --> 00:26:40.680] And say, look, you know, here's the data.
[00:26:40.680 --> 00:26:43.880] This is legit medical data from my body.
[00:26:43.880 --> 00:26:44.680] I've measured this.
[00:26:44.680 --> 00:26:47.240] It takes a digital thermometer, 999.
[00:26:47.240 --> 00:26:47.720] That's all.
[00:26:47.720 --> 00:26:50.200] Write it down in the mornings every day.
[00:26:50.200 --> 00:26:57.960] And you can say, I'm not making adequate progesterone and show them a little chart, you know, and then say, I need this.
[00:26:57.960 --> 00:27:04.040] And then what you need to do is to get the amount that they give in France, which they don't give in the U.S.
[00:27:04.200 --> 00:27:06.120] for no reason whatsoever.
[00:27:06.280 --> 00:27:07.800] They tried to deny me the amount.
[00:27:07.800 --> 00:27:12.120] It's 300 milligrams of what's called oral micronized progesterone.
[00:27:12.120 --> 00:27:21.000] And this is a really safe form of progesterone to take, not unlike midroxy progesterone acetate, the synthetic, but it is in peanut oil.
[00:27:21.000 --> 00:27:29.720] And the only, you know, there are a few reasons you can't take it if you have liver ascites, which is fluid buildup, or really low blood pressure.
[00:27:29.720 --> 00:27:37.160] But basically, it's extremely healthy and health-promoting and protective of your cardiovascular system, your bones.
[00:27:37.160 --> 00:27:38.520] It works with estrogen.
[00:27:38.520 --> 00:27:44.440] They work together to, you know, foster and maintain strong bones, strong, healthy bones.
[00:27:44.440 --> 00:27:46.360] So all of this is just vital.
[00:27:46.360 --> 00:27:48.840] And you're not able to get this from your doctor.
[00:27:48.840 --> 00:27:50.120] You go to the baby doctor.
[00:27:50.120 --> 00:27:50.680] They don't know.
[00:27:50.680 --> 00:27:52.520] They're basically faking it off a sheet.
[00:27:52.680 --> 00:27:54.200] You know, they've got some practice standards.
[00:27:54.200 --> 00:27:55.480] Oh, here's what we do.
[00:27:55.480 --> 00:27:57.960] Or they heard something or their colleague does something.
[00:27:57.960 --> 00:27:59.400] That's not science.
[00:27:59.560 --> 00:28:07.480] And the reason why they give 100 or 200 milligrams here, it should be, oh, well, we, because it was tested against this and that, and it's better.
[00:28:07.480 --> 00:28:09.320] We see that it has better effects.
[00:28:09.320 --> 00:28:10.280] They haven't done that.
[00:28:10.280 --> 00:28:17.200] They just say, they actually said to me initially that, oh, well, that's the amount they give in France.
[00:28:14.840 --> 00:28:20.160] And I said, you hear all these French studies, but that's French studies.
[00:28:20.160 --> 00:28:20.960] I'm sorry.
[00:28:21.600 --> 00:28:24.640] Are they Martians or they just dress better and eat better food?
[00:28:24.640 --> 00:28:26.160] You know, come on.
[00:28:27.760 --> 00:28:42.000] Yeah, but again, I mean, with baby boomers, you know, coming coming online here for these kinds of issues, you would think a place like Kaiser would have like the menopause expert person that sees patients all day because there's so many now.
[00:28:42.000 --> 00:28:42.960] Well, they have one.
[00:28:42.960 --> 00:28:47.280] They have a girl, a woman who got went through the menopause society's training.
[00:28:47.280 --> 00:28:48.240] But you know what?
[00:28:48.240 --> 00:28:52.720] I mean, when I talk to them, I can identify all the stuff they don't know.
[00:28:52.720 --> 00:28:56.640] It's amazing because that's different from what I do.
[00:28:56.640 --> 00:28:58.640] Like I said, I'm a psycho.
[00:28:58.640 --> 00:29:00.480] I had studies piled all over my floor.
[00:29:00.560 --> 00:29:01.600] There's a shot of that.
[00:29:01.600 --> 00:29:04.560] It looks like, you know, like mountains, like moguls.
[00:29:05.120 --> 00:29:09.520] You know, I read for eight years, deep dive, and I'm terrified of getting things wrong.
[00:29:09.520 --> 00:29:13.680] And I send things to researchers and say, oh, I did this with Carol Tavis and blumming.
[00:29:13.840 --> 00:29:15.760] Hand me my ass, like kick my ass.
[00:29:15.760 --> 00:29:17.120] And Carol knows me.
[00:29:17.120 --> 00:29:27.200] You know, and so you do it in a way where you show them that you're grateful for the most harsh criticism because I can't bear to have errors in this book because I could hurt somebody.
[00:29:27.200 --> 00:29:33.200] And so it's that's kind of thinking, whereas everybody else, like these doctors, they want, I mean, can't blame this as normal life.
[00:29:33.200 --> 00:29:38.080] They want to go home and have a family and go on a date or whatever and have a life, you know.
[00:29:38.080 --> 00:29:41.280] And for the last couple of years, I didn't go anywhere.
[00:29:41.280 --> 00:29:43.120] Thanksgiving, Christmas, people invite me places.
[00:29:43.200 --> 00:29:44.320] I'm sorry I have to stay home.
[00:29:44.320 --> 00:29:46.480] The book monster, I called it.
[00:29:46.800 --> 00:30:00.920] And so, you know, when they have one expert and she really doesn't know things, I love when they say stuff to me like, there's something called sex hormone binding globulin, which I have elevated levels of because I eat a carnivore diet.
[00:30:00.920 --> 00:30:11.720] And if you don't have high insulin, which is good, you know, healthy insulin, very healthy, then your SHBG, it's called, it goes sky high and it binds with steroids.
[00:30:11.720 --> 00:30:16.680] So it binds with testosterone and estradiol and sells them right out of your system.
[00:30:16.680 --> 00:30:25.960] And so I'm asking for a double dose of what would be a high dose for someone else, but for me, sufficient since I'm getting less than half the estrogen I take.
[00:30:25.960 --> 00:30:29.960] And she says to me, oh, but estrogen raises your SHBG.
[00:30:30.280 --> 00:30:35.320] Well, yes, oral estrogen does, but I'm not taking oral estrogen.
[00:30:35.320 --> 00:30:36.920] I'm taking transdermal.
[00:30:36.920 --> 00:30:42.200] And you know that because I'm asking for double patch, you know, and you see my records.
[00:30:42.200 --> 00:30:45.160] And so that raises it in the most minimal way.
[00:30:45.160 --> 00:30:47.000] And it probably is going to suppress it.
[00:30:47.000 --> 00:30:51.320] And so this is the kind of thing like, hi, I mean, I'm a weirdo wholly infants.
[00:30:51.320 --> 00:30:52.120] I used to have a pink car.
[00:30:52.120 --> 00:30:53.160] I have a tiny little dog.
[00:30:53.160 --> 00:30:54.360] I wear clothes.
[00:30:54.360 --> 00:30:55.480] I'm a crackpot.
[00:30:55.480 --> 00:30:58.680] I shouldn't be the medical genius in all of these situations.
[00:30:58.680 --> 00:31:06.680] And in every situation, I had a eye surgery for my, thanks, mom, this genetic disease called, I'm going to say it politely, Fuchs dystrophy.
[00:31:06.680 --> 00:31:08.680] You can better believe I say it the other way.
[00:31:08.680 --> 00:31:14.360] And, you know, so I had to have a transplant, the endothelium, the one cell layer over your cornea.
[00:31:14.360 --> 00:31:16.280] I had to get a transplant in that.
[00:31:16.280 --> 00:31:18.600] And this doctor made me really sick.
[00:31:18.600 --> 00:31:21.240] She gave me an overdose of steroids.
[00:31:21.240 --> 00:31:29.720] She gave, they all give all these doctors, these people who have serious eye surgeries, they give you antibiotics and steroids that have bath preservatives.
[00:31:29.720 --> 00:31:33.480] They begin destroying the cornea in a matter of days.
[00:31:33.480 --> 00:31:35.160] I mean, it's crazy.
[00:31:35.480 --> 00:31:39.720] And so, okay, so she gives me afloat, I can't say it, right?
[00:31:40.040 --> 00:31:41.000] Afloxacin.
[00:31:41.000 --> 00:31:43.720] Okay, that's what it is, with a bath preservative.
[00:31:43.720 --> 00:31:48.080] But wait, there's moxaflaxacin that's like not expensive.
[00:31:44.840 --> 00:31:51.360] It's a generic word, you know, and it doesn't have the preservative.
[00:31:51.600 --> 00:31:54.800] How about we switch me to the drug that doesn't destroy the cornea?
[00:31:54.800 --> 00:31:56.240] Okay, cool.
[00:31:56.240 --> 00:32:08.960] I mean, like, why should I, you know, I was working on a book till I like fell in the car and fell on the gurney, so I didn't have time to read, you know, she's a surgeon, so she seems good, you know, that the cutting stuff sticking in X-Acto in your eye.
[00:32:08.960 --> 00:32:10.800] Yeah, I can't, you know, know that.
[00:32:11.360 --> 00:32:14.880] Her colleagues said she was good, and so I have to hope and believe that's true.
[00:32:14.880 --> 00:32:23.200] But on the medicine stuff, so these doctors, they focus on the X-Acto part, they know nothing about the drugs they prescribe, like nothing, nothing.
[00:32:23.200 --> 00:32:25.440] I mean, it's terrible, terrible, terrible.
[00:32:25.440 --> 00:32:26.480] Every area is like this.
[00:32:26.480 --> 00:32:37.440] And so if you can't do a deep dive into the research, or someone hasn't covered it, like I cover this area, Gary Tobbs, Nina Teisholt, other people cover the low carb area.
[00:32:37.440 --> 00:32:40.480] But really, you need this for every area of medicine.
[00:32:40.480 --> 00:32:47.920] You know, I have a book on osteoporosis that I have mostly written to debunk all the crap and tell you what actually keeps you healthy.
[00:32:47.920 --> 00:32:50.960] But, you know, that took me a long time.
[00:32:50.960 --> 00:33:02.640] And like hematology, you know, oncology, your specific kind of cancer, like you said, you know, with the lung, the cancer taking over the lung, doctors, oh no, it's not connected.
[00:33:02.640 --> 00:33:04.480] And then you just go to a dinner party.
[00:33:04.480 --> 00:33:10.480] I mean, how random, how horrible that if you had stayed home, like, what would the outcome have been?
[00:33:10.480 --> 00:33:11.760] I mean, that's, that's terrible.
[00:33:11.920 --> 00:33:12.720] Yes, exactly.
[00:33:12.720 --> 00:33:13.360] Yeah.
[00:33:13.360 --> 00:33:28.160] Well, yeah, I mean, this is just crazy that a science writer like Gary Tobbs, I mean, before Gary Tobbs brought so much attention to sugar and carbs and all that stuff, and he's the one that points out that doctors have no training in nutrition.
[00:33:28.160 --> 00:33:30.280] They don't take any courses in med school.
[00:33:30.280 --> 00:33:34.520] And this is like the biggest predictor of obesity, diabetes.
[00:33:29.680 --> 00:33:36.280] We have all these problems.
[00:33:36.520 --> 00:33:40.040] And the doctors for decades have been going, I wonder what it is.
[00:33:40.680 --> 00:33:41.720] It's so terrible.
[00:33:41.720 --> 00:33:49.000] And the lipid hypothesis, the idea that cholesterol cause or lipids cause heart disease, it is not proven.
[00:33:49.000 --> 00:33:54.520] It looks more and more like it's high blood sugar, insulin resistance, and what's called inflammaging.
[00:33:54.520 --> 00:34:18.600] And that's when you keep having the chronic inflammation, chronic low-grade inflammation, and then you basically have a broken immune system where you're in, you, you know, because it's on fire all the time, low-grade fire, you end up not having the immune resources when you need them if you have an infection or a disease that needs to have some, you know, immune warriors come out and deal with it.
[00:34:18.600 --> 00:34:20.440] And so you want to not have that.
[00:34:20.440 --> 00:34:29.240] And so I personally, I've gone really SWAT team on inflammation, especially because I got so sick from the steroid overdose this doctor gave me.
[00:34:29.240 --> 00:34:30.760] I mean, crazy, crazy.
[00:34:30.760 --> 00:34:35.560] Well, but on a separate question to that, what are the steroids supposed to do?
[00:34:36.520 --> 00:34:38.600] So what they, oh, sorry, I talked over you.
[00:34:38.600 --> 00:34:39.480] What did you say?
[00:34:39.480 --> 00:34:43.160] Yeah, are they supposed to, steroids are supposed to enhance healing or something?
[00:34:43.160 --> 00:34:48.200] They're supposed to prevent the rejection of your transplant.
[00:34:48.200 --> 00:34:48.680] Oh, I see.
[00:34:48.840 --> 00:34:50.120] But see, here's the thing.
[00:34:50.600 --> 00:34:53.960] The transplant I had is called D-MAC Decimets.
[00:34:54.360 --> 00:34:54.920] Sorry.
[00:34:54.920 --> 00:34:58.120] Okay, I'm going to not go there because I can't remember it right now.
[00:34:58.120 --> 00:35:13.720] But basically, it has an 0.6, it's either 0.6 or 0.7 percent chance of rejection, you know, and so because it's not vascularized, you don't have blood vessels in there in that in the endothelium or your cornea.
[00:35:13.720 --> 00:35:18.640] So, um, it doesn't even pay for them to do matching before they give you a transplant.
[00:35:14.760 --> 00:35:21.360] You just hope you get a young person's endothelium.
[00:35:21.680 --> 00:35:23.040] And I mean, and how miraculous!
[00:35:23.040 --> 00:35:27.040] And it's why I'm an organ donor because this is amazing that I'm allowed to see people.
[00:35:27.280 --> 00:35:31.200] Some young motor, some young man in a motorcycle, yeah, I thought that too.
[00:35:31.840 --> 00:35:35.040] Yeah, donor cycle, donor cycle, donor cycle, yeah.
[00:35:35.040 --> 00:35:50.880] And so, you know, um, so the steroids, but the thing is, I'm looking at this now because the steroids, so she, the, the, clinical habit, it won't be too long on this, but the they prescribe the standard in the field is four drops after the transplant.
[00:35:50.880 --> 00:36:04.400] Well, this is not based on oh, we researched this and three didn't do so well, it's just clinical habit, nobody compared anything, and they don't look at well, there's this one woman, Marianne O'Price, who's a clinician and researcher.
[00:36:04.400 --> 00:36:07.120] She looks at, oh, well, what about this steroid or that steroid?
[00:36:07.120 --> 00:36:09.680] But there's only a tiny bit of research in that.
[00:36:09.680 --> 00:36:14.720] What I want to know is what can you use instead of steroids because they have horrible systemic effects.
[00:36:14.720 --> 00:36:23.040] So, my doctor told me when I said she said steroids, and I said, Oh, because I know about steroids and inflammation, all this other stuff that's related.
[00:36:23.040 --> 00:36:28.880] And I said, Oh, well, you know, I'm worried because the bone destruction, all these other destruction from steroids in the body.
[00:36:28.880 --> 00:36:31.680] And she said, Oh, they don't have systemic effects, they stay in the eye.
[00:36:31.680 --> 00:36:33.280] I thought, like, that's unlikely.
[00:36:33.280 --> 00:36:34.400] Sure enough, I look it up.
[00:36:34.400 --> 00:36:36.080] Yeah, no, they don't.
[00:36:36.080 --> 00:36:38.880] I had horrible systemic effects, just terrible.
[00:36:38.880 --> 00:36:41.200] And I ended up, I had her switch me.
[00:36:41.360 --> 00:36:45.840] Doctors do not like this when you tell them the reasons why the drug they gave you was like horrible.
[00:36:45.840 --> 00:36:51.600] And I had her switch me to another steroid that has less systemic effects, but it still made me sick, you know.
[00:36:51.600 --> 00:36:56.000] And, you know, so these are not, it's not good to give patients.
[00:36:56.000 --> 00:36:58.600] Oh, so what she does, so they give four in the field.
[00:36:58.600 --> 00:37:01.640] She figures if four is good, eight is better.
[00:37:01.880 --> 00:37:03.240] It's not how steroids work.
[00:36:59.840 --> 00:37:03.880] This is horrible.
[00:37:04.120 --> 00:37:14.840] When you give steroids to a metabolically healthy patient like me, you can probably see, look at my arms, like I exercise, I eat a low inflammatory diet, you know, you know, that what is that?
[00:37:14.840 --> 00:37:16.200] What is a low inflammatory diet?
[00:37:16.520 --> 00:37:21.080] Oh, so I, oh, so well, let me just finish telling this because I get lost enough in stories.
[00:37:21.080 --> 00:37:24.680] But so what she did is she suppressed healthy inflammation in me.
[00:37:24.680 --> 00:37:26.360] And this was also a red flag.
[00:37:26.360 --> 00:37:30.600] I asked her when she talked about steroids, I said, well, what about, you know, healthy inflammation?
[00:37:30.600 --> 00:37:32.840] She said, oh, no, we want to suppress inflammation.
[00:37:32.840 --> 00:37:37.000] And I felt like, you, you know, missing some boats here, lady.
[00:37:37.240 --> 00:37:42.600] So, but I usually, you know, it was because I hadn't read because I was so busy on the book until like the moment.
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[00:38:12.920 --> 00:38:18.040] Before that I really didn't remember about the drugs and then I took them and got sick.
[00:38:18.040 --> 00:38:20.120] So you were saying, oh, low inflammation.
[00:38:20.120 --> 00:38:27.400] So what you want to do is to keep down omega-6 fatty acids and prioritize omega-3.
[00:38:27.400 --> 00:38:35.000] So I eat fish and you want to not eat, you know, these are basically inflammatory foods that have very high omega-6.
[00:38:35.240 --> 00:38:39.880] I don't eat the oils, and there are all sorts of fights about them.
[00:38:39.880 --> 00:38:45.280] But basically, they do, they're inflammatory in a way.
[00:38:45.520 --> 00:38:46.320] Other foods are not.
[00:38:44.680 --> 00:38:49.920] I eat butter, ghee, RG, I can never say that right.
[00:38:50.720 --> 00:39:07.360] And I eat a carnivore diet, and I fill in with some supplements for the few vegetables, you know, the nutrients I miss from vegetables, B1, manganese, or a couple of methyl, I forget how which folate is, it's folate, the kind that's better.
[00:39:07.840 --> 00:39:16.320] And then, so I only eat a few things: I eat herring, I eat salmon, I eat beef, I eat the ghee, and then butter.
[00:39:16.320 --> 00:39:17.200] And what else do I eat?
[00:39:17.200 --> 00:39:17.760] Eggs.
[00:39:17.760 --> 00:39:19.360] Oh, big secret on eggs.
[00:39:19.360 --> 00:39:20.640] Here's a big tip.
[00:39:20.640 --> 00:39:27.200] So you see these people like Vital Farms, scumbags, advertising, and I can prove this so it's not libel slander.
[00:39:27.200 --> 00:39:28.960] Well, actually, it'd be slander.
[00:39:29.760 --> 00:39:32.560] They advertise pasture-raised eggs.
[00:39:32.560 --> 00:39:36.320] So people think, oh, good, I won't, you know, have inflammatory food.
[00:39:36.320 --> 00:39:41.600] Well, that's crap because their pasture-raised eggs also get fed soy and corn.
[00:39:41.600 --> 00:39:42.640] It's really terrible.
[00:39:42.640 --> 00:39:48.640] And so, if you look, I think it's like eating maybe two eggs, like eating a tablespoon of canola oil or something.
[00:39:48.800 --> 00:39:52.080] I can't remember what it was, but it's really unhealthy.
[00:39:52.080 --> 00:39:56.400] Supermarket eggs, oh my god, they're the worst, inflammatory, terrible.
[00:39:56.400 --> 00:40:05.040] And so, I started getting, you know, they're hard to find eggs with that are raised, pasture-raised that are not fed corn and soy.
[00:40:05.040 --> 00:40:06.400] And they're hard to find.
[00:40:06.400 --> 00:40:18.400] And oh my God, because I was sick and everything, I live near Erewhon in Venice, which is a store where they charge rich people like undoubtedly amounts of money to show them, like, you're really, you are rich because you can burn money in a fire and it doesn't matter.
[00:40:18.760 --> 00:40:20.800] And so, and so oh my god, I'm from Michigan.
[00:40:20.800 --> 00:40:23.280] Like, the idea that I would spend, it was so horrible.
[00:40:23.280 --> 00:40:24.320] They didn't have eggs.
[00:40:24.800 --> 00:40:26.480] I bought, I had to buy six.
[00:40:26.480 --> 00:40:30.920] They didn't have a dozen, $10.99 for a six eggs, yeah.
[00:40:29.920 --> 00:40:33.000] And it was like $22 for a dozen eggs.
[00:40:33.160 --> 00:40:38.840] And I went to the counter and I was like, I want to disassociate myself from being, you know, being a person who paid this much for eggs.
[00:40:38.840 --> 00:40:43.960] And I said, like, I just have an eye issue, and like, I'm, you know, I'm, don't do this.
[00:40:43.960 --> 00:40:44.600] This is horrible.
[00:40:44.600 --> 00:40:50.280] This is like worst thing I've ever bought because, like, this is insane.
[00:40:50.280 --> 00:40:53.480] You know, anyway, so now I get the ones when they're in at whole foods.
[00:40:53.480 --> 00:40:57.240] Um, this one kind called Chino Valley, soy-free, corn-free.
[00:40:57.240 --> 00:41:00.040] There's happy hens, but basically, they're really hard to find.
[00:41:00.040 --> 00:41:01.240] They're always out of them.
[00:41:01.240 --> 00:41:07.800] And I was at one point where I was going to order 58 from a farm in Michigan, but you have to call like a Tuesday at 7 p.m.
[00:41:07.880 --> 00:41:10.200] on the dot or you don't get them.
[00:41:10.200 --> 00:41:13.240] What do they massage the hens before they give the eggs?
[00:41:13.240 --> 00:41:16.600] No, they just feed them like the fruit that isn't soy and corn.
[00:41:16.840 --> 00:41:17.960] It's so crazy.
[00:41:17.960 --> 00:41:21.400] And so, the reason I eat like this is because I'm 61.
[00:41:21.400 --> 00:41:30.040] And at 61, as you age, you get much less robust in terms of your immune system and all the stuff in your body, you know, and so bones, everything.
[00:41:30.040 --> 00:41:41.560] And so, I want to give my body the least amount of stress to overcome in terms of healing and everything, make my immune system as robust as possible, you know, be as strong as possible.
[00:41:41.560 --> 00:41:46.280] Um, and so did you change your diet when you went through menopause?
[00:41:46.280 --> 00:41:49.000] Oh, no, I actually, no, it was just in the middle.
[00:41:49.000 --> 00:41:49.960] I've eaten low carb.
[00:41:49.960 --> 00:41:51.960] Gary Todd's a good friend of mine.
[00:41:51.960 --> 00:42:03.400] Um, and so I've known him forever and ever since he wrote the soft science of dietary salt for no, I think it was, was that, yeah, well, it was for nature in like 1998, um, and then through with low carb stuff.
[00:42:03.400 --> 00:42:07.240] And so, in 2009, that was when I went low carb.
[00:42:07.240 --> 00:42:13.880] And then, um, it was like February of last year that I started eating carnivore, and I just meant to do it, you know, for a little while.
[00:42:13.880 --> 00:42:16.800] Um, I was fixing my testosterone level.
[00:42:17.200 --> 00:42:19.760] And as a woman, you cannot take testosterone.
[00:42:14.840 --> 00:42:20.960] This is, oh, that's another thing.
[00:42:21.120 --> 00:42:25.200] The doctor, their menopause expert, menopause expert, told me.
[00:42:25.440 --> 00:42:28.160] She said, oh, you know, you should take testosterone.
[00:42:28.160 --> 00:42:30.880] And I said, well, no, it's not safe.
[00:42:30.880 --> 00:42:32.400] And she said, yes, it is.
[00:42:32.960 --> 00:42:37.280] No, it's not because I read the research and I know how.
[00:42:37.280 --> 00:42:48.880] And I see that there just isn't enough longitudinal, like over years of time, study of whether it's safe for the cardiovascular system and, you know, perk breast cancer.
[00:42:48.880 --> 00:42:50.160] So I'm not going to take it.
[00:42:50.160 --> 00:42:53.760] And that's why there's no FDA-approved testosterone for women.
[00:42:53.760 --> 00:42:55.920] And to take the men's kind, it's not safe.
[00:42:55.920 --> 00:42:57.520] They're huge doses.
[00:42:57.520 --> 00:43:01.920] You know, and the safest kind, the best delivery form is a pellet implanted under the skin.
[00:43:01.920 --> 00:43:08.240] And that doesn't exist for women, except in some like they're like providers that sell it in their own thing.
[00:43:08.240 --> 00:43:09.920] You don't know what you're getting.
[00:43:09.920 --> 00:43:20.800] And so what I ended up doing, and I don't recommend this for everyone because, and I didn't put it in the book, because what your medical, your whole individual health metric is matters.
[00:43:20.800 --> 00:43:31.280] But I take DHEA, which is another hormone that you can get as a supplement, to try to correct that.
[00:43:31.280 --> 00:43:36.400] And it did, and then it didn't because I started eating carnivore and then it was uncorrected some more.
[00:43:36.720 --> 00:43:42.080] But I want to tell people also: supplements, this world, it's the wild, wild west.
[00:43:42.080 --> 00:43:43.120] There can be anything.
[00:43:43.120 --> 00:43:49.840] You can have like small children, like tiny little, like, okay, I'm fantasizing here, but in your, in your, like, your vitamin capsule.
[00:43:49.840 --> 00:43:50.560] Nobody knows.
[00:43:50.560 --> 00:43:52.240] And so, Consumer Lab is great.
[00:43:52.240 --> 00:43:52.800] I'm a member.
[00:43:52.800 --> 00:43:53.600] It's a member site.
[00:43:53.600 --> 00:43:55.920] It costs maybe like 50 bucks or something.
[00:43:55.920 --> 00:44:01.480] But they tell you, you know, what's in them, if they have the amount of the stuff, if they have arsenic and everything.
[00:44:01.720 --> 00:44:09.320] And so I use that to buy supplements and also to be frugal about it because you see that, you know, like I've lunged GNC and Swanson.
[00:44:09.320 --> 00:44:10.600] These are really good brands.
[00:44:10.600 --> 00:44:14.280] And I wouldn't think so because I had them growing up, Tail 12 Mall, the GNC store.
[00:44:14.280 --> 00:44:18.840] It seems, you know, sort of, you know, like it wouldn't be good, but they are.
[00:44:20.680 --> 00:44:29.000] All right, let's go through the different bodily systems that change during menopause and what you recommend women do to deal with that.
[00:44:29.000 --> 00:44:30.840] Okay, so bones, so interesting.
[00:44:30.840 --> 00:44:34.200] So this is, there's this whole scam.
[00:44:34.760 --> 00:44:39.640] Fox, the Merck came up with this drug called Fosimax that my mother took.
[00:44:39.640 --> 00:44:42.040] It's called a bisphosphonate.
[00:44:42.040 --> 00:44:53.160] And it was just for, you know, would have been just taken by these very, you know, elderly women with very fragile bones, you know, to protect them.
[00:44:53.160 --> 00:44:55.960] But they wanted, you know, a bigger customer base than that.
[00:44:55.960 --> 00:44:58.680] So they came up, this is so horrible.
[00:44:58.920 --> 00:45:08.680] They funded all this research, which found things that, you know, prescribed, that led to the prescription of bisphosphonates.
[00:45:08.680 --> 00:45:14.840] They got these scanners or these huge, the scanners for your bones were enormous and very expensive.
[00:45:14.840 --> 00:45:24.200] And they funded smaller ones going into doctor's offices, medical facilities, because the scanners would diagnose you as needing a drug.
[00:45:24.200 --> 00:45:37.480] Now, osteoporosis, porous bones, this is based on, you know, what they thought about bones, you know, like from centuries ago in France, you know, this idea of porous bones.
[00:45:38.120 --> 00:45:41.960] This is merely a risk for bone breakage.
[00:45:41.960 --> 00:45:49.440] It doesn't mean if you have porous bones, if you have a low bone, it's called bone density score, that doesn't mean you'll break bones.
[00:45:49.440 --> 00:45:51.840] And if you have a high one, it doesn't mean you won't.
[00:45:51.840 --> 00:45:58.240] Because what it doesn't measure, these scanners don't measure bone quality, they measure bone quantity, how much bone stuff you have in there.
[00:45:58.240 --> 00:45:59.360] And guess what?
[00:45:59.360 --> 00:46:09.440] Those drugs, the bisphosphonates, that supposedly are preventing bone breakage, what they do is they stop the removal of old crappy bone.
[00:46:09.440 --> 00:46:15.120] So you've got bone that's way past its prime and would get removed by these cells called osteoclasts.
[00:46:15.120 --> 00:46:27.840] I remember these osteoclast cutters, C cutters, and osteoblast builders, B builders, you know, and so you're not, and you don't build as fast as you cut, especially in menopause and older age.
[00:46:27.840 --> 00:46:35.760] And so by keeping crappy old bone around, basically, bisphosphonates, they make your bones more brittle and breakable.
[00:46:35.760 --> 00:46:39.040] They cause microcracks in your bones.
[00:46:39.040 --> 00:46:43.600] And so, like, within three years, that's the amount of time it takes to destroy your bone.
[00:46:43.600 --> 00:46:46.000] That's cool, really cool research, by the way, microcracks.
[00:46:46.000 --> 00:46:53.520] Richie Abel in England, he used a particle beam scanner in Germany that's the size of a football field to see this nano on the nano level.
[00:46:53.520 --> 00:46:55.520] And this is the kind of research I read.
[00:46:55.520 --> 00:46:57.840] And talking to him, I don't usually talk to many people.
[00:46:57.840 --> 00:47:01.040] I read their research because I don't care what you have to say or if you're impressive.
[00:47:01.040 --> 00:47:04.880] You know, you can be like the guy who's like doing science in the janitor's closet.
[00:47:04.880 --> 00:47:07.280] If it's good science, you know, I'm there.
[00:47:07.280 --> 00:47:13.200] But, you know, he was really, I mean, it's really important research because microcrests, you're cracking your bones.
[00:47:13.200 --> 00:47:20.240] What the bisphosphonates don't do is produce what you need, strong, quality, resilient bones.
[00:47:20.240 --> 00:47:22.800] You know, this is this is really vital for healthy bones.
[00:47:22.800 --> 00:47:27.840] And the way you do that, and doctors, I'm telling you to walk Kaiser on their website, I hate them.
[00:47:27.840 --> 00:47:29.440] I mean, I love Kaiser for a lot of reasons.
[00:47:29.440 --> 00:47:32.040] I have some, I have one doctor, my psychiatrist.
[00:47:32.040 --> 00:47:34.440] He is the only evidence-based doctor I have.
[00:47:34.440 --> 00:47:35.320] I can trust him.
[00:47:29.760 --> 00:47:36.280] He's fantastic.
[00:47:36.840 --> 00:47:42.520] He gives pharmacogenetic testing to patients to see: okay, should I give you this antidepressant or that?
[00:47:42.520 --> 00:47:44.040] Or how much of a drug do you need?
[00:47:44.040 --> 00:47:48.120] This is responsible medicine, individualized, responsible medicine.
[00:47:48.120 --> 00:47:56.920] Anyway, so with osteoporosis, what you need to do, especially in perimenopause when you can still build bone well, is to do this weight-bearing exercise.
[00:47:56.920 --> 00:47:58.600] This is what I recommend in the book.
[00:47:58.600 --> 00:48:02.040] And what I did, nutrition research, by the way, it's just shit.
[00:48:02.040 --> 00:48:02.760] Oops, sorry.
[00:48:03.000 --> 00:48:03.640] I love to say it.
[00:48:03.880 --> 00:48:04.920] Oh, you can do it.
[00:48:04.920 --> 00:48:05.480] Sorry.
[00:48:07.080 --> 00:48:08.120] So it's just crap.
[00:48:08.120 --> 00:48:11.400] What they do is they ask you, so what did you have to eat all last month?
[00:48:11.400 --> 00:48:12.360] Like, hi, Dr.
[00:48:12.360 --> 00:48:13.080] House.
[00:48:13.080 --> 00:48:13.960] People lie.
[00:48:13.960 --> 00:48:14.600] I mean, really?
[00:48:14.600 --> 00:48:15.240] And you don't remember.
[00:48:17.080 --> 00:48:19.240] I'm also going to forget the things that make me look bad.
[00:48:19.240 --> 00:48:21.960] Like I had a donut and then I had another donut and I had, yeah.
[00:48:21.960 --> 00:48:22.600] Okay.
[00:48:22.600 --> 00:48:31.080] So, you know, with both the nutrition and the exercise, I reverse engineered from what we want in our cell.
[00:48:31.080 --> 00:48:33.320] What do we want to have happen in our cell?
[00:48:33.320 --> 00:48:40.200] And so with the exercise, what you want to do is what's called slow-speed weightlifting.
[00:48:40.360 --> 00:48:46.280] I exercise, I don't know if you can see, I don't want to brag too much about my muscles, but I'm not like a Hercules here.
[00:48:46.280 --> 00:48:49.720] I lift like a Barbie-sized weight graveyard on my floor.
[00:48:49.720 --> 00:49:05.480] But what I do is the slow-speed weight training where you lift, you do like 10 reps with a weight heavy for you very slowly, like five up, five seconds down, and you do that until you can't do another with good form.
[00:49:05.800 --> 00:49:16.320] And what that does, it creates those tiny tears in your muscles, and you really, you have to be like screaming in pain at the end, you know, and so, and there's some dispute as to whether you need to go to actual failure.
[00:49:16.560 --> 00:49:22.880] There's a guy named Scheinfeld, Brad Scheinfeld, who's like, Yeah, his research says don't really.
[00:49:23.200 --> 00:49:25.680] But it's good to push yourself as much as you can go.
[00:49:25.680 --> 00:49:28.000] And then Steele and Fisher say, Yes, you have to do that.
[00:49:28.480 --> 00:49:29.280] These others.
[00:49:29.280 --> 00:49:31.680] So, this is really important stuff.
[00:49:31.680 --> 00:49:35.280] If you do this, bones and muscles are metabolically active.
[00:49:35.280 --> 00:49:37.120] What you do for muscle, you do for bones.
[00:49:37.120 --> 00:49:39.120] This is how you prevent osteoporosis.
[00:49:39.120 --> 00:49:42.640] Also, not being a jerk like me and leaving stuff all over your floor.
[00:49:43.840 --> 00:49:49.200] And the drugs, they're simply terrible and not a solution.
[00:49:49.200 --> 00:49:54.960] And, you know, the idea that you should treat bone mineral density is just crap.
[00:49:54.960 --> 00:49:57.440] You know, it's not bone strength, not bone quality.
[00:49:57.440 --> 00:50:06.080] And so, some women, elderly women, there's some women who are so terribly frail that they may need these drugs or these other drugs like reloxafene.
[00:50:06.320 --> 00:50:08.640] They're all evil and horrible.
[00:50:08.640 --> 00:50:13.440] They're all, you know, there's a piper to pay with every drug, with these drugs, especially.
[00:50:13.440 --> 00:50:20.960] And then in Japan, they give high doses of vitamin K, which is healthy and helps bones.
[00:50:20.960 --> 00:50:28.080] But, you know, once again, oh, that's French research, you know, and so we're not told that.
[00:50:28.080 --> 00:50:34.000] I mean, so you could have the microcracks in your bones or you could have real help, but that's Japanese.
[00:50:34.000 --> 00:50:35.040] You know, crazy.
[00:50:35.360 --> 00:50:36.960] All right, cardiovascular.
[00:50:36.960 --> 00:50:39.120] I presume some cardiovascular activity.
[00:50:39.840 --> 00:50:41.440] What was the question initially about each of these?
[00:50:41.520 --> 00:50:42.880] Well, we were going through different systems.
[00:50:42.880 --> 00:50:45.440] So, bones, well, if you want to do boobs, you could do that too.
[00:50:45.440 --> 00:50:46.480] Okay, bones, boobs.
[00:50:46.480 --> 00:50:48.960] Okay, so spoiled my tea.
[00:50:48.960 --> 00:50:49.840] Oh, it's okay.
[00:50:50.240 --> 00:50:51.680] At least it didn't fall on electronics.
[00:50:51.680 --> 00:50:52.720] That's always the question.
[00:50:52.720 --> 00:50:53.520] Then I'm fine.
[00:50:53.520 --> 00:50:54.400] Just tea.
[00:50:54.800 --> 00:51:06.280] So with your cardiovascular system, so men get cardiovascular disease much sooner, and women don't because we have estrogen in our bodies that's relatively high, you know, compared to men, not relatively as high.
[00:51:06.600 --> 00:51:15.160] And so what happens in menopause, again, when you lose the estrogen, if you're not taking estradiol, then and estrogen is the general term.
[00:51:15.160 --> 00:51:17.960] Estradiol is the kind in your body.
[00:51:18.440 --> 00:51:24.280] And I should remember to talk about bio-identical hormones and FDA-approved drugs and everything.
[00:51:24.280 --> 00:51:33.800] But so your estrogen receptors in your cardiovascular endothelium go away, so you're not protected anymore from cardiovascular disease the way you were.
[00:51:33.800 --> 00:51:38.360] And like I said, one in three women will die of cardiovascular disease, you know, pretty soon.
[00:51:38.360 --> 00:51:39.800] It's one in five now.
[00:51:39.800 --> 00:51:43.080] And there's a whole slew of cardiometabolic diseases.
[00:51:43.080 --> 00:51:51.560] And it looks like that these diseases are caused by eating carbohydrates, sugar, and starch, and starchy vegetables.
[00:51:51.560 --> 00:51:53.240] Don't ever drink orange juice.
[00:51:53.240 --> 00:51:55.000] It's like the worst thing you could drink.
[00:51:55.000 --> 00:51:56.200] I just have a sugar.
[00:51:57.160 --> 00:51:58.200] I would have ice cream.
[00:51:58.200 --> 00:52:00.920] You know, I eat dessert very occasionally.
[00:52:01.720 --> 00:52:06.200] You know, like a scientist, like I party chocolate chip cookies, like analyze them.
[00:52:06.200 --> 00:52:09.240] Were they made by a vegan out of that gross stuff?
[00:52:10.120 --> 00:52:11.960] Like it is like a big analysis.
[00:52:11.960 --> 00:52:15.000] But so you need to prevent that.
[00:52:15.320 --> 00:52:26.200] The evidence suggests that it is eating sugar, flour, starchy carbohydrates that provokes the insulin resistance that puts on fat and causes these diseases.
[00:52:26.200 --> 00:52:30.120] And, you know, you want to keep your blood sugar, your blood pressure down.
[00:52:30.920 --> 00:52:38.440] There's a cluster of metabolic risks, high blood pressure, high blood sugar, a large waist circumference.
[00:52:38.760 --> 00:52:41.240] That's visceral fat that packs around your organs.
[00:52:41.240 --> 00:52:42.840] It's not like muffin top fat.
[00:52:42.840 --> 00:52:47.920] It's this dangerous fat that's metabolically active and kills you, working to kill you.
[00:52:47.920 --> 00:52:48.960] And then what are the others?
[00:52:44.840 --> 00:52:52.080] If you have high triglycerides, low is healthy.
[00:52:52.400 --> 00:52:55.360] And if you have low HDL, high HDL is healthy.
[00:52:55.360 --> 00:53:02.400] So if you have three out of five of those, and you're a white person, you have a risk of metabolic disease.
[00:53:02.400 --> 00:53:05.760] And here's what is so horrible that I cover in this book.
[00:53:05.760 --> 00:53:09.840] Women of color and people of color, I mean, we're mostly all the same, all of us.
[00:53:09.840 --> 00:53:13.440] If you have a liver, I have a liver, but there are some differences.
[00:53:13.440 --> 00:53:23.760] And so black women tend to have, I think it's like 20% higher, 70% higher HDL and 20% lower triglycerides on average.
[00:53:23.760 --> 00:53:26.400] So you can miss heart disease in a black woman.
[00:53:26.400 --> 00:53:31.120] And these metabolic standards, the standard is two if you're black.
[00:53:31.120 --> 00:53:32.800] So doctors don't know that.
[00:53:32.800 --> 00:53:34.320] You don't even know about the cluster of five.
[00:53:34.320 --> 00:53:35.600] This is by Reven at Harvard.
[00:53:35.600 --> 00:53:37.360] It was called Syndrome X.
[00:53:37.360 --> 00:53:38.400] But so it's important.
[00:53:38.400 --> 00:53:45.680] This is stuff I present so patients can diagnose themselves because we can't wait for doctors and medicine to catch up to the evidence.
[00:53:45.680 --> 00:53:47.040] So we have to do that ourselves.
[00:53:47.040 --> 00:53:48.880] So that's our cardiovascular system.
[00:53:48.880 --> 00:53:52.560] And you need to exercise and eat in these ways, these targeted ways.
[00:53:52.560 --> 00:53:53.840] I call it the trifecta.
[00:53:53.840 --> 00:53:59.920] Now, not everyone's going to be willing to take estrogen and progesterone, and not everyone will, you know, want to.
[00:54:00.720 --> 00:54:16.560] But so if you can do that, that is if you're healthy and you take it initiated at menopause and then exercise this way and then eat a low carbohydrate, you know, balanced, like it's, what is it called?
[00:54:16.560 --> 00:54:20.720] A well, well-created, I forget, but the guys at VertiHealth talk about this.
[00:54:20.720 --> 00:54:22.640] You can look them up, Volik and Finney.
[00:54:22.640 --> 00:54:24.080] They're very good about this.
[00:54:24.080 --> 00:54:33.720] And I tell people who are wealthy, because I think it's like $300 or $400, like if you have diabetes and something's wrong with you, that it's good to use them because they can deal with that.
[00:54:33.880 --> 00:54:38.520] You can't just say, oh, I'm going to eat low carb like I did because I'm metabolically healthy.
[00:54:38.840 --> 00:54:39.960] You can have some risks.
[00:54:39.960 --> 00:54:41.560] So, wait, what are we on next?
[00:54:43.080 --> 00:54:47.240] Well, just on the, but your cardiovascular exercise is good anyway.
[00:54:47.800 --> 00:54:51.800] You should be doing that even before menopause, but then, you know, adding that.
[00:54:51.800 --> 00:54:55.480] Oh, and also, being sedentary causes inflammation.
[00:54:56.200 --> 00:54:59.640] And so, one day, one day of sedentary stuff.
[00:54:59.640 --> 00:55:03.640] And so, what I do is I run 20 minutes.
[00:55:03.640 --> 00:55:09.240] And also, here's something: I learned this because of my horrible problems I had.
[00:55:09.240 --> 00:55:11.080] It's called adrenal insufficiency.
[00:55:11.080 --> 00:55:13.640] I had tachycardia and bradycardia in the same day.
[00:55:13.720 --> 00:55:17.240] It's really high, dangerously high, dangerously low heartbeat.
[00:55:17.560 --> 00:55:19.640] 177 while sitting on my couch.
[00:55:19.640 --> 00:55:20.520] It's amazing.
[00:55:20.760 --> 00:55:21.960] 177.
[00:55:21.960 --> 00:55:23.080] And then 45.
[00:55:23.080 --> 00:55:25.560] I mean, this is really dangerous.
[00:55:25.560 --> 00:55:33.080] And so I use that to get a different drug out of my, get the lodopredinol out of my irritated eye surgeon.
[00:55:33.480 --> 00:55:36.760] You know, so I mean, but, and it still continues.
[00:55:36.760 --> 00:55:42.200] I see this like incredibly insane, you know, like the heartbeats per minute.
[00:55:42.200 --> 00:55:43.480] And so I'm correcting that.
[00:55:43.480 --> 00:55:58.520] But I learned that, sorry, long story, too long, that what you need to do to help potentiate, it's called your adrenocorticotropic hormone in your pituitary, is to get first morning light in your retinas.
[00:55:58.520 --> 00:56:01.080] So I run for 10 minutes out my porch.
[00:56:01.080 --> 00:56:06.120] You know, if it's cloudy, you know, I'm here in Venice, we have marine layer, then I'll do 15.
[00:56:06.440 --> 00:56:11.640] And that's really important because circadian rhythm fosters the health of that whole system.
[00:56:11.640 --> 00:56:15.600] It's called the hypothalamic pituitary adrenal axis.
[00:56:15.600 --> 00:56:22.080] The hypothalamus notices, like, okay, you cold, you hot, you thirsty, tells the pituitary, hey, yo, send out a message.
[00:56:22.080 --> 00:56:22.640] And it messes.
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[00:56:52.560 --> 00:56:55.600] Messages your adrenal glands or whatever, like, okay, do this.
[00:56:56.160 --> 00:57:00.640] Make the person, okay, you're thirsty, drink, you know, here, we're going to elevate your cortisol.
[00:57:00.640 --> 00:57:02.160] Cortisol is not unhealthy.
[00:57:02.160 --> 00:57:13.760] It's only if you have, you know, chronic elevated cortisol for, you know, no reason, you know, but you need it, you know, like for many things, many health metrics.
[00:57:13.760 --> 00:57:16.880] And so mine was sort of broken because of this.
[00:57:17.200 --> 00:57:18.240] And I'm working on it.
[00:57:18.240 --> 00:57:20.560] That first money light is very important.
[00:57:20.560 --> 00:57:21.920] It also helps you sleep.
[00:57:21.920 --> 00:57:24.000] You know, people need to foster sleep.
[00:57:24.000 --> 00:57:25.360] That's very important.
[00:57:26.000 --> 00:57:27.600] All right, breast cancer.
[00:57:27.600 --> 00:57:33.840] Okay, so here's the thing: estrogen and progesterone are not carcinogens.
[00:57:33.840 --> 00:57:40.000] However, this very interesting work, I was really, this chapter was really the most horrible chapter in the book to write.
[00:57:40.160 --> 00:57:43.920] This is where I quote some of Avram Bluming Carol Tabas' work.
[00:57:44.400 --> 00:57:47.600] You know, he's the breast cancer, he's an oncologist.
[00:57:48.240 --> 00:57:53.000] And the problem is the research in this area is so heterogeneous.
[00:57:53.000 --> 00:57:56.320] Where it's like, oh, they tested this drug on this group of women.
[00:57:56.320 --> 00:57:59.200] Oh, and then they tested this drug for this amount of time.
[00:57:59.200 --> 00:58:03.080] So, what I say in this chapter is, I'm really sorry.
[00:57:59.680 --> 00:58:09.480] You know, I want to tell you definitively: will taking hormones give you breast cancer?
[00:58:09.480 --> 00:58:12.360] You know, and the answer is we can't say definitively.
[00:58:12.360 --> 00:58:18.200] However, here's where I'm where I, you know, work things out for myself and don't do exactly what I do because you're not me.
[00:58:18.200 --> 00:58:21.320] You need to look at your individual health and risks.
[00:58:21.320 --> 00:58:31.160] And so, what I said is, you know, I have a family, I have dense, we have dense boobs in my family, and so that is it makes it hard for them to see mammograms.
[00:58:31.160 --> 00:58:35.240] And, you know, so I have some risks, but I get regular mammograms, and you can have false positives.
[00:58:35.240 --> 00:58:37.000] That's another whole problem area.
[00:58:37.000 --> 00:58:41.880] But so, women who have breast cancer will die, most of them will die of heart disease.
[00:58:41.880 --> 00:58:45.160] And 90% of breast cancer now is survivable.
[00:58:45.160 --> 00:58:46.440] Now, you don't want this, it's horrible.
[00:58:46.440 --> 00:58:47.400] You have to go through chemo.
[00:58:47.400 --> 00:58:48.440] I mean, it's a terrible thing.
[00:58:48.440 --> 00:58:49.800] I'm terrified of it.
[00:58:49.960 --> 00:58:58.040] But we're terrified of the wrong thing because, you know, like it's like nobody's like looking through their shirt, like, oh, can you see my aorta through this top?
[00:58:58.040 --> 00:58:59.640] You know, boobs are a big part of us.
[00:58:59.640 --> 00:59:05.640] So that's why we're more afraid of breast cancer than the thing that really kills us, which is cardiovascular disease.
[00:59:05.640 --> 00:59:07.480] And so I made that calculation.
[00:59:07.480 --> 00:59:10.040] But in looking at this, I was desperate.
[00:59:10.040 --> 00:59:15.320] Let me, please, I've got to find something out to tell women and what I found out.
[00:59:15.320 --> 00:59:19.400] Because I look for the stuff that says, you know, oh, this is a bad idea too.
[00:59:19.400 --> 00:59:20.840] You know, you look for the adverse effects.
[00:59:20.840 --> 00:59:22.520] You look for the disconfirming stuff.
[00:59:22.840 --> 00:59:29.160] I'm always looking to like kill my darlings, like this stuff I believe I want, you know, to be true.
[00:59:29.160 --> 00:59:31.000] So that I take an extra hard look at.
[00:59:31.000 --> 00:59:49.120] And so, Carol Sartorius and Catherine Horwitz, these pioneer, Horwiss pioneer in doing receptor research, they found that though estrogen and progesterone are not carcinogens, if you have some in you already, they can pick it up and run with it.
[00:59:44.840 --> 00:59:50.560] So, that's what I say in the book.
[00:59:50.880 --> 00:59:54.800] And so, you know, but we can look at boobs through mammograms.
[00:59:54.800 --> 00:59:58.400] And also, you know, there just was some research crap.
[00:59:58.400 --> 00:59:59.040] I forget.
[00:59:59.040 --> 01:00:04.640] So, you know, if you have dense breasts, you need an ultrasound, but they just came up with some new way.
[01:00:04.960 --> 01:00:06.400] I wish I could remember what it is.
[01:00:06.400 --> 01:00:11.200] I just saw that I have to read the paper to look at breasts of dense breasts.
[01:00:11.200 --> 01:00:12.560] That's that's important.
[01:00:12.800 --> 01:00:18.480] But again, false positives, women can get treated for breast cancer that would never, never develop into anything.
[01:00:18.480 --> 01:00:21.360] It's just teeny, a couple teeny cells, you know.
[01:00:21.360 --> 01:00:27.520] And so, you know, this is an unfortunate thing that I can't definitively tell you something in this chapter.
[01:00:27.520 --> 01:00:32.080] But this is what I call it's not being, it's not giving you a maze ball science.
[01:00:32.080 --> 01:00:35.200] Worry about the people who tell you, oh my God, it's incredible.
[01:00:35.200 --> 01:00:36.160] It's going to cure cancer.
[01:00:36.160 --> 01:00:37.760] You're going to white teeth your whole life.
[01:00:37.760 --> 01:00:40.080] And, you know, you live in a mansion.
[01:00:40.080 --> 01:00:41.520] You know, no, no, no, no.
[01:00:41.520 --> 01:00:43.680] Look for the people who say, like, I don't know.
[01:00:43.680 --> 01:00:44.800] I wish I could tell you.
[01:00:45.040 --> 01:00:46.000] This really sucks.
[01:00:46.000 --> 01:00:46.480] I can't.
[01:00:46.480 --> 01:00:47.760] I'm so sorry.
[01:00:47.760 --> 01:01:00.880] Because that's somebody who's being careful, you know, about what they're telling you and cares to tell the truth as opposed to tell you something that's going to, you know, make you excited and tell people, 60 people to buy their book.
[01:01:01.520 --> 01:01:02.960] White teeth your life.
[01:01:02.960 --> 01:01:03.680] That's such a great thing.
[01:01:03.760 --> 01:01:04.480] You know, we try.
[01:01:04.480 --> 01:01:06.480] I drink so much coffee, it's an issue.
[01:01:07.040 --> 01:01:08.160] This is great.
[01:01:08.160 --> 01:01:10.560] Yeah, I had Eric Topol on the show.
[01:01:10.560 --> 01:01:13.680] We just recorded it actually earlier today.
[01:01:13.680 --> 01:01:20.000] He was talking about, you know, all women over whatever the age is get a mammogram.
[01:01:20.320 --> 01:01:21.920] And 80%, what do you say?
[01:01:22.000 --> 01:01:31.640] 88% of women will never get breast cancer, but 60% of women will have a false positive test because they do it every year for decades.
[01:01:31.640 --> 01:01:36.120] And that even though the false positive rate is low, but there's so many tests.
[01:01:29.680 --> 01:01:37.160] It's terrifying, too.
[01:01:37.320 --> 01:01:38.440] I love Kaiser.
[01:01:38.440 --> 01:01:39.480] This happened once.
[01:01:39.480 --> 01:01:43.320] So I get some kind of, there's some kind of, uh-oh, there's a little thing we see.
[01:01:43.320 --> 01:01:45.800] They call me on Friday afternoon, leave that message.
[01:01:46.280 --> 01:01:47.240] We'll see you next week.
[01:01:47.400 --> 01:01:47.960] Yeah, thanks.
[01:01:48.280 --> 01:01:49.240] What is wrong with you?
[01:01:49.240 --> 01:01:49.720] That's so hard.
[01:01:49.800 --> 01:01:52.040] And like all weekend, I'm afraid.
[01:01:52.040 --> 01:01:54.440] You know, and I went in, I got, they gave me a biopsy.
[01:01:54.440 --> 01:01:56.280] It was nothing, but biopsy is not nothing.
[01:01:56.280 --> 01:01:59.960] They're, you know, digging into your with an instrument and everything.
[01:01:59.960 --> 01:02:02.280] It's all terrifying, you know.
[01:02:02.280 --> 01:02:08.680] And so the problem, too, one of the myths that I detail in the book is that doctors are not trained to assess risk.
[01:02:08.680 --> 01:02:10.440] They cannot properly assess risk.
[01:02:10.440 --> 01:02:18.360] Now, maybe an oncologist, I tell people in the book, look, you know, if you, if you want your risk assessed, maybe an oncologist will be able to do this.
[01:02:18.360 --> 01:02:20.920] And you don't have to be a genius to do this.
[01:02:20.920 --> 01:02:27.000] You know, Gerd Gegerenser, he, I quote him in the book, and he just talks about natural frequencies.
[01:02:27.000 --> 01:02:30.600] We as humans did not evolve with percentages.
[01:02:30.600 --> 01:02:32.440] You know, we're not good at them.
[01:02:32.440 --> 01:02:33.480] So what do you do?
[01:02:33.480 --> 01:02:34.120] Easy.
[01:02:34.120 --> 01:02:36.360] You draw 100 people on a page.
[01:02:36.360 --> 01:02:39.160] You color in the ones who are going to end up sick or dead.
[01:02:39.160 --> 01:02:43.720] You know, and then you factor in the person's individual health and color in a few or erase a few.
[01:02:43.720 --> 01:02:45.560] And then you say, here's, you know, here's your risk.
[01:02:45.560 --> 01:02:52.920] In a meaningful way, we can look at people in a page and say, oh, okay, you know, and understand that, you know, but they don't understand stats.
[01:02:52.920 --> 01:03:05.720] So doctors are often misled by pharmaceutical, like a maizeball stats, like 50% more people, like sometimes it's like, sometimes like one or two, you know, like in out of 7,000 or something like that.
[01:03:05.720 --> 01:03:06.920] It's terrible.
[01:03:06.920 --> 01:03:09.880] I keep saying it's terrible, but all of it is, all of it.
[01:03:09.880 --> 01:03:10.360] Oh, yeah.
[01:03:10.360 --> 01:03:16.640] I use this example of in Bayesian reasoning and the diagnosis problem.
[01:03:14.920 --> 01:03:20.560] A patient is diagnosed with cancer that has a 1% prevalence rate.
[01:03:20.720 --> 01:03:23.440] That is, it happens to one out of 100 people.
[01:03:23.440 --> 01:03:26.480] The test sensitivity for this type of cancer is 90%.
[01:03:26.480 --> 01:03:29.520] That is, the test will be right 90% of the time.
[01:03:29.520 --> 01:03:32.240] The false positive rate of the test is 9%.
[01:03:32.240 --> 01:03:35.280] That is, the test will be wrong 9% of the time.
[01:03:35.280 --> 01:03:38.720] What is the percent likelihood that the patient has cancer?
[01:03:38.720 --> 01:03:46.000] And that almost everybody says it's between 80 and 90%, including medical doctors, when the actual answer is 9%.
[01:03:46.000 --> 01:03:57.200] They have to do the numbers, but basically the flaw in the reasoning is the rate is very low, so it's very unlikely you'll get that cancer.
[01:03:57.200 --> 01:04:08.160] But since everybody's tested for it, let's say, you know, millions of people are tested for it, that 5% false positive rate, or whatever I said it was, a false predator rate of 9%.
[01:04:08.160 --> 01:04:12.640] Yeah, that's the 9% of this huge population.
[01:04:12.880 --> 01:04:14.320] And so that throws people off.
[01:04:15.360 --> 01:04:25.680] The Kahneman Tversky interpretation of that is the representative fallacy that we're used to thinking of people.
[01:04:26.800 --> 01:04:28.960] A person has cancer or they don't.
[01:04:28.960 --> 01:04:31.440] What is this 90% cancer?
[01:04:31.760 --> 01:04:41.440] Well, that's on a huge population of people, but we didn't evolve to think about huge statistical populations and percentages and probabilities and predictions.
[01:04:41.440 --> 01:04:42.800] You either have cancer or you don't.
[01:04:42.800 --> 01:04:46.000] What do you mean 9% is, you know, whatever.
[01:04:46.000 --> 01:04:47.520] No, but this is important thinking.
[01:04:47.520 --> 01:04:52.480] You see, when you're saying that, I just gave up because I need to do that calculation on a page.
[01:04:52.480 --> 01:04:55.520] But, you know, you learn from Gerd Gagerenzer.
[01:04:55.600 --> 01:04:57.360] He can train people in 90 minutes.
[01:04:57.840 --> 01:04:59.280] You know, it's amazing.
[01:04:59.280 --> 01:05:03.640] And so, med schools, the fault here, so I don't bash doctors in the book.
[01:05:03.800 --> 01:05:09.560] I get mad, you know, at them sometimes, but I can't do the whole, if I were you, I would, you know, whatever, like, give up my life.
[01:05:09.880 --> 01:05:11.560] It's not fair, it's not right.
[01:05:11.560 --> 01:05:23.960] The institutions not giving, say, my eye surgeon an expert on steroids, all the eye doctors telling them, look, here's this, here are the standards, and giving them a lecture and saying, here's what they're, and they can call on those people.
[01:05:23.960 --> 01:05:25.320] Like, they shouldn't be prescribing.
[01:05:25.320 --> 01:05:26.520] She knows less about steroids.
[01:05:26.520 --> 01:05:27.480] She's an elite surgeon.
[01:05:27.480 --> 01:05:28.920] I'm lucky to have her.
[01:05:28.920 --> 01:05:33.400] But she knows less about steroids than the average smart person in her waiting room who reads.
[01:05:33.400 --> 01:05:36.120] You know, it's insane that this is medicine.
[01:05:36.120 --> 01:05:39.880] The other thing that they can't do, they're not trained in diagnostic reasoning, a la Dr.
[01:05:39.960 --> 01:05:40.680] House.
[01:05:40.680 --> 01:05:43.560] And so, Michael, you and I both love this kind of thinking.
[01:05:43.560 --> 01:05:44.920] Like, I did this.
[01:05:44.920 --> 01:05:47.480] In fact, that's how I encountered Carol Tavis first.
[01:05:47.560 --> 01:05:53.720] She's a great book: Mistakes Were Made, but not by me with her, Elliot Aronson, and she wrote that book together.
[01:05:53.720 --> 01:05:56.040] And those are the kinds of books I buy and the thinking I do.
[01:05:56.040 --> 01:05:59.640] My favorite class in all of high school is critical thinking, you know.
[01:05:59.640 --> 01:06:07.800] And, but if you don't have that kind of thing, you don't love it, you're not going to be able to just do this on your own since you're not trained to do that.
[01:06:07.800 --> 01:06:12.040] There's a guy named Alan Graver who's trying to get diagnostics into medical schools.
[01:06:12.200 --> 01:06:14.840] Medical schools, they have no incentive to change.
[01:06:14.840 --> 01:06:15.960] Nobody knows.
[01:06:15.960 --> 01:06:28.520] And institutions, Kaiser, they should have people like Sandra Greenland and Gerd Gagerenzer looking at the stats on studies, and then people like me, Nina Teisholz, you know, Gary Tobbs as the mole rats.
[01:06:28.520 --> 01:06:29.800] We're looking at the science.
[01:06:29.800 --> 01:06:32.440] And someone checks the stats.
[01:06:32.440 --> 01:06:34.040] And then we make a determination.
[01:06:34.040 --> 01:06:41.000] And not just having these people who basically, yeah, they have panels, but they're just confirming what's already been thought and done.
[01:06:41.000 --> 01:06:48.320] You know, and I saw that with my own, when you, at Kaiser, if you complain that you're being given an unscientific treatment, they had me present to a panel.
[01:06:44.840 --> 01:06:50.400] This is about menopause and perimenopause.
[01:06:50.560 --> 01:06:53.680] There was not a gynecologist or endocrinologist on there.
[01:06:53.680 --> 01:06:56.880] And basically, it's a panel designed to let you whine.
[01:06:56.880 --> 01:06:58.320] And I presented all the science.
[01:06:58.320 --> 01:06:59.840] They read none of it.
[01:06:59.840 --> 01:07:03.280] And they simply called the gynecologist and said, What's the standard of care?
[01:07:03.280 --> 01:07:04.320] Now, I went all insane.
[01:07:04.400 --> 01:07:07.360] Which gynecologist, I mean, this guy, Seth Kibnik, he's a researcher.
[01:07:07.360 --> 01:07:08.720] I'm like, did they ask you?
[01:07:08.960 --> 01:07:10.080] He never wrote me back.
[01:07:10.080 --> 01:07:14.240] It turned out they called my gynecologist, you know, and he told me this.
[01:07:14.240 --> 01:07:19.280] And he's great because if I explain the science to him on something, he'll treat me according to the evidence.
[01:07:19.280 --> 01:07:27.280] You know, I don't just say, here, give me this, but I explained to him, look, I have high SHBG binding my testosterone and estrogen.
[01:07:27.280 --> 01:07:30.240] And he was the one who suggested, he's gone till August.
[01:07:30.240 --> 01:07:31.600] This is why I have a problem.
[01:07:31.600 --> 01:07:35.680] So he was the one who made the suggestion that I'd use a double patch.
[01:07:35.680 --> 01:07:37.040] This is not usual.
[01:07:37.040 --> 01:07:41.680] Chlimera, the patch I use, is just, it's, you know, you take one, but okay, I need more.
[01:07:41.680 --> 01:07:43.040] You treat the individual patient.
[01:07:43.040 --> 01:07:47.360] You don't say, oh, we're not going to give you that dose because the average person doesn't need it.
[01:07:47.360 --> 01:07:49.840] There's no such thing as the average person.
[01:07:49.840 --> 01:07:50.560] I'm me.
[01:07:50.560 --> 01:07:51.920] I have certain health metrics.
[01:07:51.920 --> 01:07:54.880] I'm weird in some ways compared to other people.
[01:07:54.880 --> 01:08:02.160] And you treat me according to my body and the fact that I'm not getting the estradiol active in my system that I'm taking.
[01:08:02.160 --> 01:08:10.800] So give me more, please, because you're prolonging my hot flashes and you're denying me the protective effects that I need for my endothelium and the rest of me.
[01:08:11.120 --> 01:08:16.440] So the Kaiser docs must, when your name comes up at the computer, they must think, uh-oh.
[01:08:17.080 --> 01:08:18.480] Here she comes.
[01:08:18.800 --> 01:08:22.000] Well, it's because everyone, I have, like, they, I correct all this stuff.
[01:08:22.000 --> 01:08:24.640] I just, ahead of endocrinology, he's very nice to me.
[01:08:24.640 --> 01:08:26.240] He's giving me a test I needed.
[01:08:26.240 --> 01:08:31.000] When, like, the ladies in like in gynecology just wouldn't, she wouldn't test my estrogen.
[01:08:29.840 --> 01:08:36.280] Hi, I'm telling you, I have low, low, I'm getting, you know, not getting the estrogen I'm taking.
[01:08:36.360 --> 01:08:36.840] What do we do?
[01:08:36.840 --> 01:08:43.720] We guess, yeah, you know, so he tested that for me, but then he said the same thing on SHBG: estrogen elevates it.
[01:08:43.720 --> 01:08:46.040] And I said, No, oral estrogen does.
[01:08:46.040 --> 01:08:47.320] I'm taking transderable.
[01:08:47.320 --> 01:08:48.520] Head of endocrinology.
[01:08:48.520 --> 01:08:51.880] I mean, please, can somebody please know more than I do?
[01:08:52.200 --> 01:08:59.960] You know, again, like I'm just sitting here in Venice, my like untidy house with the gardening clogs on the floor, you know, reading a bunch of papers.
[01:08:59.960 --> 01:09:06.280] So, okay, sex, libido, uh, desert vagina, and clitty-clitty dead zone.
[01:09:06.920 --> 01:09:08.120] I'd like to have fun.
[01:09:08.120 --> 01:09:12.280] This is a terrifying subject, so, and I'm vulgar and funny, and so I use that.
[01:09:12.280 --> 01:09:21.480] So, desert vagina, oh my God, the gynecologist, it was called vaginal atrophy, and they thought that that was mean and degrading to women, and they would name it something better.
[01:09:21.800 --> 01:09:30.440] They named the whole down there thing, like bladder, vagina walls, like all of it, um, geniturinary syndrome of menopause.
[01:09:30.440 --> 01:09:32.760] It took me a while to be able to remember that.
[01:09:32.760 --> 01:09:33.480] So, great.
[01:09:33.720 --> 01:09:40.680] You're telling women they have something they can't remember or pronounce, and that sounds frankly terrifying, and it doesn't describe the problem.
[01:09:40.680 --> 01:09:43.640] Desert vagina, that describes the problem.
[01:09:43.640 --> 01:09:53.320] When you don't have estrogen in menopause, all this stuff that it did, like keeping your vaginal walls all moist and nice, that stops.
[01:09:53.320 --> 01:10:00.520] And you can have atrophy of your urethra and your, you know, your bladder, your muscles, everything.
[01:10:00.520 --> 01:10:04.200] It can just like everything is just awful down there.
[01:10:04.200 --> 01:10:15.120] But if you take estradiol, you know, that systemic estradiol, or there's a kind of vaginal estradiol that will help some of it.
[01:10:14.680 --> 01:10:20.960] It will help, like, there's one kind, there's, oh, I'm not going to remember what it's called.
[01:10:21.600 --> 01:10:25.680] It's the keeping you up at night to pee all the time.
[01:10:26.480 --> 01:10:29.040] That really helps that if you're taking estrogen.
[01:10:29.040 --> 01:10:36.400] Now, vaginal estrogen, when you take estrogen, you need to take progesterone to counterbalance it because it's very important.
[01:10:36.400 --> 01:10:39.280] So, estrogen is proliferative in the breasts.
[01:10:39.280 --> 01:10:43.920] Estrogen causes cells to proliferate, to grow, and increase.
[01:10:43.920 --> 01:10:50.640] And progesterone, what it does, it doesn't pair the cells, but what it does is it makes them specialized.
[01:10:50.640 --> 01:10:54.400] So, they're generic cells that can become delinquents, do anything.
[01:10:54.400 --> 01:10:59.200] And what it does is it turns them into, makes them differentiate and turn into breast cells.
[01:10:59.200 --> 01:11:00.880] So, they've got a job to do.
[01:11:00.880 --> 01:11:12.320] And then, in the endometrium, the lining of the uterus, which can develop hyperplasia, which is this, it's overgrowth, cell overgrowth, you know, which can become cancer.
[01:11:12.320 --> 01:11:16.880] That progesterone, it decreases that, it counterbalances that.
[01:11:16.880 --> 01:11:20.480] And so, you need adequate progesterone for this, you know, in this area.
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[01:11:52.000 --> 01:11:58.720] Vaginal estrogen is they will tell you, oh, you don't need to take progesterone because it's local.
[01:11:58.720 --> 01:12:00.360] Okay, no, it's not.
[01:12:00.360 --> 01:12:05.480] There are some you see, especially at first, you see a systemic raise in estrogen.
[01:11:59.840 --> 01:12:06.840] So that doesn't seem to last.
[01:12:07.080 --> 01:12:13.640] However, they'll say, oh, it doesn't seem to cause hyperplasia in your uterus.
[01:12:13.640 --> 01:12:19.320] Well, okay, it's not that it doesn't in many people, but doesn't is not never.
[01:12:19.320 --> 01:12:22.600] And some for some women, there is hyperplasia.
[01:12:22.600 --> 01:12:30.760] So when I talked to these ladies, you know, so you can take, there's vaginal estrogen that's local, and there's one kind that's not, that's systemic.
[01:12:30.760 --> 01:12:37.320] But I was going to take the local kind when I was going through this because my immune system was screwed up from this steroid overdose.
[01:12:37.320 --> 01:12:39.720] I mean, just incredible medical harm.
[01:12:39.720 --> 01:12:45.880] So they were going to prescribe me the estradiol, vaginal estradiol, but oh my God, this is the head of gynecology.
[01:12:45.880 --> 01:12:48.600] She tells me, okay, I'm going to give you two or three times a week.
[01:12:48.600 --> 01:12:51.480] I said, no, that's the maintenance dose.
[01:12:51.480 --> 01:12:56.280] The acute dose is daily for two weeks, and then you taper to two to three times a week.
[01:12:56.280 --> 01:12:58.280] Hi, she's the head of gynecology.
[01:12:58.280 --> 01:12:59.400] She's telling me she's an expert.
[01:12:59.400 --> 01:13:00.200] She knows this area.
[01:13:00.200 --> 01:13:01.160] She reads the science.
[01:13:01.160 --> 01:13:04.280] She doesn't, yeah, you know, no, she doesn't read anything.
[01:13:04.520 --> 01:13:08.680] Or, you know, she picked up like something in 2002 and hasn't looked at it since.
[01:13:08.680 --> 01:13:13.240] So, you know, and I'm telling her, I need crinone or, you know, there are these tablets.
[01:13:13.240 --> 01:13:14.760] So, sorry, that's for pregnancy.
[01:13:14.760 --> 01:13:30.840] But there are these, I decided the tablets, progesterone tablets, I've heard they're called endometrin, that I wanted those too because, you know, because, you know, since it's possible that I could have hyperplasia from this, and, you know, she would not give them to me.
[01:13:30.840 --> 01:13:32.440] It's like, oh, no, it doesn't do this.
[01:13:32.440 --> 01:13:37.640] What, you know, so because the doctors aren't reading the research, there's a possibility for incredible harm.
[01:13:37.640 --> 01:13:39.160] And I'm conservative with drugs.
[01:13:39.160 --> 01:13:40.200] I don't want to take a drug.
[01:13:40.200 --> 01:13:41.800] I don't want to take more than I need.
[01:13:41.800 --> 01:13:47.680] I err on the side of not taking drugs until I really just must take them, like with sleep drugs and perimenopause.
[01:13:44.840 --> 01:13:50.960] My sleep was covered by progesterone and menopause.
[01:13:51.120 --> 01:13:53.280] Oh my God, welcome to crap sleep again.
[01:13:53.280 --> 01:13:59.200] You know, and so I worked my one evidence-based doctor, my psychiatrist, to test different sleep drugs.
[01:13:59.200 --> 01:14:04.320] I didn't want to take ambien and these benzos that you know cause cognitive harm.
[01:14:04.320 --> 01:14:07.360] You know, there's good research suggesting they do.
[01:14:07.360 --> 01:14:14.960] And what I ended up doing was taking a drug called trazodone, which is an anti-anxiety drug off-label for sleep.
[01:14:14.960 --> 01:14:17.600] I never would have taken it but for him, you know.
[01:14:17.600 --> 01:14:25.600] And so, doing this, it was just important to take something because I need my sleep rather than just to suffer and have, you know, brain fog.
[01:14:25.600 --> 01:14:29.200] I forget how I got in this topic, but where were we?
[01:14:29.200 --> 01:14:32.400] Oh, so, okay, so for this, the whole desert vagina thing.
[01:14:32.400 --> 01:14:35.200] So, not all women can take or want to take hormones.
[01:14:35.200 --> 01:14:36.480] You can use these different lubes.
[01:14:36.560 --> 01:14:39.200] Hyaluronic acid is very good.
[01:14:39.520 --> 01:14:46.400] You know, and there are the other lubes that you want to be careful not to get the one that destroys silicone if you're using condoms or toys.
[01:14:46.720 --> 01:14:49.280] You know, so this is a doable thing.
[01:14:49.280 --> 01:14:58.560] But really, I think, you know, for many women, because the bladder involvement and everything, there's more than just the let me moisturize there that can go on.
[01:14:58.560 --> 01:15:04.400] And so, once you start to have this urinary atrophy, bladder atrophy, it's not like you can bring it back.
[01:15:04.400 --> 01:15:07.360] That's why I was so angry at these women for denying me.
[01:15:07.520 --> 01:15:10.880] I wouldn't take it, I had the vaginal estradiol, but I wouldn't take it.
[01:15:10.880 --> 01:15:12.960] I tried this is like me.
[01:15:13.520 --> 01:15:20.160] I didn't read on it, but I like, you can stick some progesterone calves up there, but they don't dissolve the way they do in stomach acid.
[01:15:20.160 --> 01:15:23.520] All this is sorry, TMI, but you know, and so I couldn't do this.
[01:15:23.520 --> 01:15:30.440] So, so I'm just not going to take it because it's not safe since not, since doesn't usually happen, it's not never in terms of hyperplasia.
[01:15:30.440 --> 01:15:31.960] And how dare they?
[01:15:29.920 --> 01:15:34.200] And she said, Oh, super physiologic dose.
[01:15:34.360 --> 01:15:35.080] Guess what, lady?
[01:15:35.080 --> 01:15:38.760] I read the research, they give like 1,200 milligrams of progesterone.
[01:15:38.760 --> 01:15:40.440] I'm taking 300.
[01:15:40.760 --> 01:15:48.520] And I only get that with my high SHPG because I know to correct for it with the one thing I can, which is pregnenolone.
[01:15:48.520 --> 01:15:50.840] I take a huge amount of, it's the mother of all hormones.
[01:15:50.840 --> 01:15:56.360] It's called a supplement called pregnenolone from, is it Swanson or GNC?
[01:15:56.360 --> 01:15:58.040] I think it's, yeah, it's Swanson.
[01:15:58.040 --> 01:16:01.320] Wait, no, no, no, it's not because you need micronized pregnenolone.
[01:16:01.320 --> 01:16:02.600] I forget who I get it from.
[01:16:02.600 --> 01:16:04.680] But anyway, that huge dose.
[01:16:04.680 --> 01:16:11.400] And so the one steroid in me that is at a good level, which is important, protecting you from cancer and everything else, is progesterone.
[01:16:11.400 --> 01:16:13.000] That's at a good place.
[01:16:13.000 --> 01:16:17.000] And when the doctor, one of the doctors mentioned that, I said, oh, that's because I fix it.
[01:16:17.160 --> 01:16:22.440] I fix it with the thing I can fix it with, you know, since no one can control that, you know.
[01:16:22.440 --> 01:16:29.640] And so it's just obnoxious that I'm being denied what I need, you know, to protect myself and adequate symptom relief.
[01:16:29.640 --> 01:16:33.080] This is not, it's against medical ethics for them to do that.
[01:16:33.720 --> 01:16:34.680] Amazing.
[01:16:34.680 --> 01:16:37.640] All right, Amy, let's wrap up here because I got to go pick up my kid.
[01:16:37.640 --> 01:16:41.880] Six questions to ask your doctor before agreeing to a treatment.
[01:16:41.880 --> 01:16:42.360] I've got the question.
[01:16:42.520 --> 01:16:47.640] One, can you lay out your reasoning behind your diagnosis and the treatment you're recommending?
[01:16:47.640 --> 01:16:50.680] Two, could there be other conditions that are causing my symptoms?
[01:16:50.840 --> 01:16:51.560] Confounders.
[01:16:51.560 --> 01:16:52.680] Hey, there's an idea.
[01:16:52.680 --> 01:16:54.680] Three, what are my risks from this treatment?
[01:16:54.680 --> 01:16:58.120] Four, are there safer, less invasive alternatives?
[01:16:58.120 --> 01:17:01.880] Five, what can I expect during the treatment and what sort of recovery?
[01:17:01.880 --> 01:17:05.880] And six, do I need to do this now or could I wait or go without the treatment?
[01:17:05.880 --> 01:17:09.000] And you have eight minutes to answer those questions before you explain.
[01:17:09.000 --> 01:17:09.240] Go ahead.
[01:17:09.640 --> 01:17:14.640] Actually, what I want to talk about, so these are, this is that sixth quote, I printed them up so I can read them.
[01:17:14.040 --> 01:17:17.920] But I'm glad you read them because I needed a vacation from talking.
[01:17:18.640 --> 01:17:28.080] But so these are very important because you need to find out how, you know, how scientific is the conclusion you have, this, whatever they're saying you have.
[01:17:28.080 --> 01:17:37.760] And your doctor, if they don't explain this, don't answer these reasonably, well, okay, either seek out other treatment, you know, or, you know, see that they do.
[01:17:37.760 --> 01:17:39.040] You can ask over and over.
[01:17:39.040 --> 01:17:43.120] And the thing I learned, I'm a mediator, so I do dispute resolution.
[01:17:43.120 --> 01:17:48.960] I do voluntary, I volunteer in the LA City attorney's office when I'm not on the book hiatus.
[01:17:48.960 --> 01:17:54.480] And one of the things I've learned is to not rush, to not be on someone else's timetable.
[01:17:54.480 --> 01:17:58.320] So, you know, you need to have, it's called informed consent.
[01:17:58.320 --> 01:18:07.040] In order to consent to medical care, you need to understand what you're diagnosed with, what the treatment is, why they're treating you this way.
[01:18:07.040 --> 01:18:10.240] And if you're not informed, you cannot consent.
[01:18:10.240 --> 01:18:11.520] And so this is part of it.
[01:18:11.520 --> 01:18:14.560] And so you might need to make three appointments with a doctor.
[01:18:14.560 --> 01:18:17.440] You know, don't be ashamed if you don't understand it.
[01:18:17.440 --> 01:18:18.960] This is complicated stuff.
[01:18:18.960 --> 01:18:20.400] It's scary.
[01:18:20.400 --> 01:18:23.520] And all that matters is that you get to a point where you do.
[01:18:23.520 --> 01:18:28.560] And if a doctor can't explain this clearly, you know, there's a good chance they don't know what they're talking about.
[01:18:28.560 --> 01:18:37.280] Because if you understand something, I see this with, I'll go to a conference, there'll be something that I can, I understand when someone talks about it, but I can't talk about it.
[01:18:37.280 --> 01:18:42.720] You have to understand it on the level where you can explain it to another human being, like my psychiatrist can.
[01:18:42.720 --> 01:18:44.960] He treats, he's a child psychiatrist.
[01:18:44.960 --> 01:18:46.880] I see him for ADHD.
[01:18:46.880 --> 01:18:53.920] And so he can explain to a six-year-old the medication, why they're taking it, how it'll help them, what they're going through.
[01:18:53.920 --> 01:18:58.080] And that's the kind of thing that you need and you deserve from every doctor.
[01:18:58.080 --> 01:19:07.640] And just because so many of them don't have diagnostic ability, can't assess risk, don't know the science, they're basically in lab coats reading practice standards.
[01:19:07.640 --> 01:19:08.760] You know, and not all.
[01:19:08.760 --> 01:19:16.120] There are some who do read the science and go by it, but you know, don't count on it because I really don't see anybody but my psychiatrist.
[01:19:16.120 --> 01:19:21.880] And I was, I got fired by the guy before him, short angry guy, because I asked too many questions.
[01:19:22.520 --> 01:19:23.480] Oh, I'm shocked.
[01:19:23.480 --> 01:19:24.360] I can't believe that.
[01:19:24.360 --> 01:19:25.720] I was all suspicious.
[01:19:25.720 --> 01:19:27.160] And so I was a little aggressive.
[01:19:27.160 --> 01:19:30.120] And so I, you know, like, you guys don't, and you don't know, I hate you.
[01:19:30.120 --> 01:19:31.080] You don't know anything.
[01:19:31.080 --> 01:19:32.840] So the first appointment was good.
[01:19:32.840 --> 01:19:35.320] I was sort of impressed by him, but then I was still angry.
[01:19:35.320 --> 01:19:40.120] And then I sent him studies by Randy Nessie, who's the co-founder of evolutionary medicine.
[01:19:40.120 --> 01:19:41.160] I love his work.
[01:19:41.160 --> 01:19:42.120] It's incredible.
[01:19:42.120 --> 01:19:43.080] And said, here's this guy.
[01:19:43.080 --> 01:19:45.160] And he said, oh, I know his work really well.
[01:19:45.480 --> 01:19:47.000] I was blown away.
[01:19:47.000 --> 01:19:54.040] And this guy, during my sleep, lame little sleep test thing, drugs had just come out called orexin receptor antagonists.
[01:19:54.040 --> 01:19:56.680] And I asked him about them and he said, I don't know anything about them.
[01:19:56.680 --> 01:19:57.960] Oh my God, I love you.
[01:19:57.960 --> 01:20:03.960] Doctors who say, I don't know like that, you know, they're the doctors that you can trust on some level, at least.
[01:20:03.960 --> 01:20:07.080] And so he does know now because he read about them.
[01:20:07.080 --> 01:20:14.760] But, you know, otherwise, if they're not explaining what they don't know, yeah, there's a problem.
[01:20:14.760 --> 01:20:24.440] So, with all of this, you know, you deserve to understand what you're being treated, why you're being treated a certain way, and it needs to go in accord with your values.
[01:20:24.440 --> 01:20:31.800] This is called shared decision-making: that a doctor needs to consider who you are, what matters to you in deciding your care.
[01:20:31.800 --> 01:20:34.920] Like, if a woman doesn't want to take estrogen, you don't push her.
[01:20:34.920 --> 01:20:39.960] You can ask her if she wants to understand why that might be problematic or whatever, you know.
[01:20:39.960 --> 01:20:40.760] But that's all.
[01:20:40.920 --> 01:20:43.880] You need to do it in a way where you're not bullying people.
[01:20:43.880 --> 01:20:47.120] You know who needs to read this book, Amy, besides women?
[01:20:47.120 --> 01:20:48.080] Doctors.
[01:20:48.400 --> 01:20:48.960] I know.
[01:20:48.960 --> 01:20:50.800] Well, this book also, this is what I tell people.
[01:20:50.880 --> 01:20:55.600] It's so funny because here I am on your podcast and you're joking about like, okay, it's a vagina land.
[01:20:55.840 --> 01:21:07.600] You know, but the thing is that this book takes on the problems in medicine and how they need to be fixed at the medical, school, and institution level, you know, and also, you know, yeah.
[01:21:07.600 --> 01:21:10.720] And so this is this is more than just a book on menopause.
[01:21:10.720 --> 01:21:22.000] And I had to write that chapter because I found when people who really trust my work, like my copy editor's wife, she's read me for a million years and knows the science I put in and the thinking, she said, I don't want to believe you.
[01:21:22.000 --> 01:21:23.360] Oh, she's actually the head of this.
[01:21:23.360 --> 01:21:24.560] She's at the lead of that chapter.
[01:21:24.560 --> 01:21:29.200] I don't want to believe you, you know, because if I do, my doctor doesn't know anything.
[01:21:29.200 --> 01:21:30.480] And this is terrifying.
[01:21:30.480 --> 01:21:32.880] Like, you know, how do I, what do I do?
[01:21:32.880 --> 01:21:45.600] Because if you're not me and can't read the research, like in this incredible, nerdy, deep dive way, you don't have time, whatever, you know, you go to the doctor and you're just sort of like, you're, you're a victim to anything you get told.
[01:21:45.920 --> 01:21:50.240] Well, of course, you don't want to encourage people to do their own research who don't know how to do that.
[01:21:50.640 --> 01:21:51.120] Exactly.
[01:21:51.120 --> 01:21:52.240] Don't do your own research.
[01:21:52.240 --> 01:21:57.200] If you don't know how to read studies, if you don't know, you know, does the study have a control group?
[01:21:57.200 --> 01:22:00.000] You know, what's things like that.
[01:22:00.000 --> 01:22:04.160] You know, why you need to look at a body of research to see if the effect is the same.
[01:22:04.160 --> 01:22:12.400] When I talked about heterogeneous breast cancer research, you know, it's like on different forms and for different amounts of time and different ages of women.
[01:22:12.400 --> 01:22:15.120] You can't say anything conclusive from that.
[01:22:15.120 --> 01:22:24.640] And if you don't know that, this do-your-own research thing, my God, yeah, read WebMD and then, like, you know, decide you're going to take this drug that could cause you all sorts of problems.
[01:22:24.640 --> 01:22:25.840] All right, Amy, I got to run.
[01:22:25.840 --> 01:22:26.560] Thank you so much.
[01:22:26.560 --> 01:22:27.120] Great book.
[01:22:27.120 --> 01:22:28.080] Really important work.
[01:22:28.080 --> 01:22:28.680] Really important work.
[01:22:28.640 --> 01:22:29.080] Thank you.
[01:22:28.880 --> 01:22:29.560] Thank you.
[01:22:29.720 --> 01:22:33.480] Again, I'm just astonished at how much ignorance is still out there about this.
[01:22:28.960 --> 01:22:35.320] So thank God or whoever for you.
[01:22:29.120 --> 01:22:29.600] Thank you.
[01:22:36.600 --> 01:22:38.200] Yeah, and it's always great talking to you.
[01:22:38.280 --> 01:22:39.240] Ask great questions.
[01:22:39.240 --> 01:22:40.360] And it's fun.
[01:22:47.080 --> 01:22:52.200] If you want to feel more connected to humanity and a little less alone, listen to Beautiful Anonymous.
[01:22:52.200 --> 01:22:56.440] Each week, I take a phone call from one random anonymous human being.
[01:22:56.440 --> 01:22:59.000] There's over 400 episodes in our back catalog.
[01:22:59.160 --> 01:23:03.320] You get to feel connected to all these different people all over the world.
[01:23:03.320 --> 01:23:10.440] Recent episodes include one where a lady survived a murder attempt by her own son, but then the week before that, we just talked about Star Trek.
[01:23:10.440 --> 01:23:11.160] It can be anything.
[01:23:11.160 --> 01:23:12.280] It's unpredictable.
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[01:23:13.800 --> 01:23:16.920] Get Beautiful Anonymous wherever you listen to podcasts.