69: The Hidden Hormone Hierarchy – Unlocking True Balance & Vitality with Dr. Christian Jenski

Make up the core of everything that we do in just about every patient. And then everything else around that. The 20% is kind of individualized. So without further ado, the hormone hierarchy is a pyramid, the way that I visualize it. And at the peak of that pyramid is, or the apex is the HPA axis. So this stress loop as we describe it, some people say adrenals, but I don't want to mislead and think that this is an inherent adrenal problem. It's dysfunction in the loop, chronic stress, loss of resilience, flattened curves, you know, a suppressed or exaggerated car, things that we're going to talk about. And then in the middle is the thyroid, which is just kind of like the engine that runs it. The thyroid's affecting metabolism and weight and energy and mood and mindset and all these other things. And then at the bottom is sex hormones.

Welcome back. Once again, we are super excited to talk more about hormone optimization therapy. Hopefully you saw our first episode. One thing of note, we do have on our website a whole blog series on hormone optimization. Um, if you have more desire to learn more, we also have a lot of resources on our book reading list and the website. So hopefully these episodes will give you a really good sound foundation to start with that you can listen to at the comfort of your own, at least your own comfort. So with that, if this information is helpful, please, like, share, subscribe. This information is for educational purposes only. We cannot diagnose or treat anything. And with that. So we're going to talk about next. Dr. Jensky, disclaimers aside, disclaimers aside, dive.

Into the hormone hierarchy you love. I do.

When you talk about, you get, you get a little twinkle in your eye. You get a twinkle in your eye. So I want you to start.

It was like one of the first new concepts that I learned about in functional medicine. And by new, I mean a new way of looking at something that we were previously taught. And to me, similar to when I was learning functional cardiology, it was kind of like so many aha moments, like so many light bulbs just going off because it just made sense. And finally, maybe for the first time, and as an Xer doc, I wasn't really treating hormone emergencies.

I think you're, you're a rehabilitating, rehabilitated ER doc, because I don't think you'll ever be a truly being exact if.

You'Re getting a hormone emergency, it's usually something really bizarre like multiple endocrine neoplasm or pheochromocytoma. Or something like that. Like, cool stuff to see. Maybe you'll see it once in your career, but not the everyday stuff. I saw a couple of extreme thyroid cases, myxidema, coma, thyrotoxicosis, that's about it. So when learning about this, it was like, this makes sense. And then seeing how much it influences the body, it's like, why is this not the center of what we do? What kind of is this? And the gut collectively make up of, make up the core of everything that we do in just about every patient. And then everything else around that. The 20% is kind of individualized. So without further ado, the hormone hierarchy is a pyramid, the way that I visualize it. And at the peak of that pyramid is, or the apex is the HPA axis. So this stress loop as we describe it, some people say adrenals, but I don't want to mislead and think that this is an inherent adrenal problem. It's dysfunction in the loop, chronic stress, loss of resilience, flattened curves, you know, a suppressed or exaggerated car, things that we're going to talk about. And then in the middle is the thyroid, which is just kind of like the engine that runs it. The thyroid's affecting metabolism and weight and energy and mood and mindset and all these other things. And then at the bottom is sex hormones. And in there is also insulin receptors as a hormone and metabolism. So I think collectively that hierarchy, the way that we look at it is because at the top it's influencing everything below it, and in the middle it's influencing anything below it. And then there's also this kind of bottom up feed where if sex hormones are abnormal, they're going to also influence insulin resistance or thyroid function or adrenal. So there's this just kind of way in which you and I and anyone trained in this way looks at a patient. And when we talk to them, we're almost seeing how that hierarchy might be off. And when they're saying certain things, certain buzzwords, or when we're getting data points, objective data, we're starting to see how this looks good. But this is often as we put those pieces together, a lot of times things will autocorrect, which is always kind of cool. But this is how I address every single patient when I'm talking to them about hormones. It's like, let's start at the top and work our way down. It doesn't mean that you can't work concurrently on these organ systems, but to try to separate one in a vacuum doesn't Always work so well. I mean, how would you kind of.

I mean, it's all. Everything you said the adrenal thyroid pancreas is at the top. If you have insulin resistance, which 80% of Americans have, that's gonna impact everything else. If you have thyroid hormone resistance or some degree of subclinical hypothyroidism or hyperthyroidism, it's gonna affect everything downstream. And then if your cortisol is off, you know, which then plays into the whole stress aspect. It's gonna affect everything downstream. The gut, though, is a really big, important part that I feel like a lot of. You know, unfortunately, there's influencers that are out there that put information out there. I don't really see them talking about the gut in relationship to estrogen. Yeah, Sex hormones, you know, detoxification. I mean, people know the C COM T gene, which is a detox gene, but if that is sub functional, you have a cortisol spike. Cortisol just kind of hangs. Right. So why don't you talk briefly about that? Because that's something that you're passionate about, Comti and all that kind of jazz. Yeah, because that's something that. Not we learned it, we knew about it. But when I have patients talking with me or I see what people are looking at in the blogosphere, whatnot, I don't really see that being discussed.

If you're talking about methylation. SNPs. SNP stands for single nucleotide polymorphism. I call them typos. It's easier to understand. So there's genes that code for enzymes that do something. And if you have a typo in one of those, then the enzyme doesn't work as well. And in this case, they slow down. And so C O M T or compt, like you said, stands for catechol methyltransferase. It's basically how we break catecholamines down. So dopamine, adrenaline, and noradrenaline. And so when you get worked up, you get stressed out. A lot of people immediately go to, oh, it must be cortisol. Actually, adrenaline is released and noradrenaline is released. That's the gas. That's the stress response. That's that sympathetic response. It's cortisol that is released in response to that. That acts as the brakes. So cortisol is actually protective until it becomes too much and it's dysfunctional or low because the body's been dysfunctional for too long. So when you release these catecholamines, they serve a purpose and it's life preserving in certain situations and contexts. However, if you have a comt snip or typo or more than one, what's happening, they're not being broken down. So you stay worked up, you can't decompress. It's kind of a worried warrior is the mentality that he talk about or you just kind of stay at that revved up state. It's like a bell curve with dopamine where it just kind of tips off the side and then you get stuck and you get stuck in fight flight and sometimes freeze, which is worse and, and you wind up more sympathetic, less parasympathetic. That's gonna affect hormones, that's gonna affect gut. The comt gene is also how we methylate estrogen as a byproduct. And so estrogen itself is broken down into estrone, estrone down those three pathways we alluded to previously, the two the 16 and the four hydroxy. The 16 gets converted into estriol, which is protective, hits beta receptors, all good. A little bit of 16 goes a long way, protects bone, not as bad as we thought. But you don't want too much or too little. The two hydroxy or the broccoli pathway that we want still needs to be methylated to be as safe as safe can be. And that's C O M T and then it's methylated and then it's excreted through the stool. And then the 4 hydroxy which you don't want any of, also needs to be methylated. And if you have a comt snp, what I often see is that that methylation is not happening well. And unfortunately preferentially the 2 hydroxy becomes methylated. So you make the 4 IT stockpiles, it's not being neutralized, maybe it's being reduced by glutathione. Tick, tick, tick, it becomes a problem. So C O M T is really, really important for these reasons. Detoxification of estrogen, making sure that person's stress response is maintained. But in addition it's, it makes that person a little bit methyl sensitive. And if they're not methylating, well, you can't just throw massive doses of methylation support at them. The last layer I'll talk about when you were alluding to the gut and detoxification is that there's a complete branch of the microbiome called the estrablum which is designed to help get rid of estrogen metabolites that have been detoxified. And we often see on these stool tests, estrogen being recycled, the part that's been neutralized is kind of cleaved off. And then we see it recycled back through the liver to be done twice. That's when we see upregulation of something called beta glucuronidase. And when we see beta glucuronidase high, we know that that's a problem, that that person is now kicking their estrogen back to the liver to do that job again, obviously you don't want to do that. And that increases the stimulation of the estrogenic tissue and maybe problems down the road.

That's. Well, that's. I was actually getting ready to write down beta glucuronidase and ask you about that, because there's multiple patients I've seen who had hormone issues who did the poop test, which we do on typically on the first or second visit. And it's like, because they're here for hormones, but we look at the gut and then there are. Beta glucuronidase is sky high. They have elevated inflammatory markers, they're having some issues with fat malabsorption. And all of a sudden, just fixing those few things, they feel. And this is where I. This is where I think taking care of hormones in young women. This right here. I feel like so many young women fix the hormones by these few things, and all of a sudden the cycles have gotten better, the acne's better.

That's where the optimization comes in. And this is exactly what you were talking about earlier. It's like, if you're not paying attention to these things, you can't optimize someone's hormones. And I love that your approach is. Hey, hey, hey, before I do something about your hormones, maybe we just correct this and see if the hormone stuff auto corrects. I use the word autocorrect all the time when I'm talking to patients. Cause the body just does that. I mean, do you not see, like, as you're working on one thing, three other things get better? Yeah, that's not a coincidence. This is kind of how the system works.

I think it's. It's kind of tricky. A little side note sometimes, you know, I've had a couple patients this past week. You know, when can I get off my. This. When can I stop doing that? When can I stop doing all the things we're doing? And your body's natural healing ability is most robust when you're actually. When you're a single egg inside your mom because you can break up and become twins and have to Totally, you know, unique people that are genetically the exact same. And you lose that ability to self heal. Repair goes down. When you're born, you still have an amazing ability to self heal, repair. But you lose that as you, you age. And so when you're 60, yes, we still self heal and self repair. Yes, wounds still heal, but sometimes that needs a little help. When people are younger in their hormonal, you know, chronology, age, they tend to autocorrect a lot better. You know, and sometimes I am using some peptides in some of those younger patients, particularly my hypermobile patients, like BPC 157 for gut support, which, for gut or connective tissue support or even brain support, which I wanted to, you know, I didn't. You know, I'm actually reading this textbook of autonomic medicine right now and it's really interesting. Like I've studied and learned about how important the sympathetic autonomic nervous system is, but we don't. I haven't really heard a lecture on the autonomic nervous system and hormones, but yet we know from autonomic medicine like what you just said. If your sympathetic nervous system gets ramped up, you're gonna release your, your catecholamines and then those are gonna affect your cortisol, which is gonna affect every. It's gonna give you a leaky gut, it's gonna give you a leaky brain.

It's gonna affect your glucose, which is gonna affect your insulin, it's gonna affect your thyroid, it's gonna affect your sex hormones. Yeah.

So I had this little ha. When you were talking. I'm like, maybe the three. I wrote the three sections. The three, the systems of hormone therapy. Maybe we need to put a fourth, which is your autonomic nervous system. Because how many of our patients, you know, have hormone difficulties and don't have a dysfunction in the nervous system? I would probably argue, I don't wanna say a hundred percent, cause I don't wanna be absolutist, but I'm gonna say maybe close to that number. You know, what are your thoughts about that? Like the autonomic nervous system as a part of a hundred percent.

I mean, I don't know how you can involve it. And we know how much it influences everything else that clearly. Like how many dysautonomia patients do you have that don't also have some hormone problems? Like they all have hormone problems. Like I think it just goes hand in hand and, and maybe this demographic pre selects out. But if you understand the physiology and the pathophysiology and how these complex systems are interconnected. You can't overlook something like this. Like it's too important. Like when we're talking about the gut brain axis as the center of health, like that is the autonomic nervous system. At least that's the, the bridge between the two. It's the connector of the two. And all along the way it's doing all its different things. Whether it's heart influence, so cardiometabolic, or its influence on the pancreas and therefore metabolism, or if it's influence on a hormone, either way it's going to be involved. So I think hormones absolutely are involved in that cascade. I mean, do you typically look at, like when you're looking at patients, is your approach. Let me hear them out, let me hear what they're saying, listen to the history and then kind of target these different systems or do you look at top down from everybody? Do you focus on metabolism first? Like, is it individualized? How would you go about like working up a case where you felt like their hierarchy was off and what do you find to be like your kind of strongest ways to, to repair it?

We have our basic intake, which is two hours and the paperwork they fill out. Yeah, I, you know, this is where I struggle with where some of the functional medicine is going, where it's lab heavy. Like my training was clinic heavy. Like you should be able to get, I can get 8% of diagnosis by your story. So I start with the patient's story, you know, and so that's where I start with like spending that time learning their story. And then it's like, where are my knowledge gaps? Do the testing and figure things out and really is, you know, they're the. Yes, all start in the gut. Get your gut better. You know, there's the triangle of health I look at, which is gut stress and sleep. Work on stress, trauma. If your sleep is disturbed, I mean your, that's when your hormones kind of recharge and you have your, if you're a male, you have your testosterone burst in the morning and your female as well, like working on that, work on your environment. You mentioned neuroendocrine disruptors. Those. That for me is like ground level. Everybody gets that. Nutritional stats, where do you have B bomb deficiencies, fatty acid deficiencies, increased inflammatory markers, autoimmune markers. That's like, everybody gets that. That's not like, you know, I'm not an all IM specialist, I'm not a hormone specialist or a gut specialist. I'm a uber generalist. And so it's like we're doing all that in the intake and then specialist. Yeah, I'm gonna start using that, man. You said that. You've said that a couple times. I've seen the starts put that. I'm like, I'm a human specialist. I like that. That's. That's more clever. It's more clever. I know I'm gonna steal that one. It's more clever. That's right off the quote. Dr. Jinsky says, Human specialist. I like that better than Uber. Cause that's not very. Human's a better word. But the point is that, you know, and then it's like, where you at? If you have really bad dysautonomia, then we really need to hone on that nervous system and figure out which kind of dysautonomia is going on. If you're younger and you have like this PCOS stuff, then you're, we're going down this neuroendocrine disruptor toxin chemical route and we're going down this metabolic syndrome route, which in those cases, things like metformin, things like low dose naltrexone can be like game changers to get people moving in the right direction. Goal's not for them to be on stuff forever, but it can be a game changer to kind of calm things down while working on their gut health. That was the long thing. The quick thing is I individualize it. I've got these paradigms that I think about. You know, it's like we've got functional medicine, integrative medicine. I've got Corewitz's 16 point scale in my head. I've got the Triangle of health, I've got Dr. King's lipid therapy in my head.

Computer, your brain, all these things. I do not. But I get an adrenal stress profile and a GI kit on every new patient, regardless of their symptoms, regardless of their story. And I can guarantee you that I have not had one that was normal to date. Everyone is off to some extent, not optimized. Now, some are pretty good, but that's rare. Most are not. And to me, I tell the patient, everybody gets these two kits. Why? Because when these two systems are buttoned up, a lot of stuff just gets better. And then we figure out what's left or we do it concurrently. But every gut is off to some extent, everyone's ASP is off to some extent. That then informs me about globally what's going on with their system because of how many things those affect and maybe even that collectively is a surrogate marker for their autonomic nervous system. Right. Combined with maybe vital signs and symptoms and other things. But, like, the reality is, like, get some information, get some appropriate testing, see where it is, and then you start to kind of recognize these patterns. Like, how would you go about informing somebody who's like, really interested in what we're talking about? And maybe they're not a functional provider yet, maybe they're dabbling in it. How would you go about. They learn about stuff like this, like what to do, how to test for it, things of that nature.

If they are a provider, I would just say sign for the IFM and start getting your training. You know, go to the places, you know, that we went to train. You know, it might take you five or six years to get your training, but if you're a provider, a licensed practitioner, that's ifm.

A4M things.

Exactly. Yeah. Yeah. I mean, we. I did ifm first in a4M. You did.

I did that as well.

We did aihm.

I did a hm with ifm, with.

Afm and then a4 afterwards. And they have different perspectives, which I think super, super complimentary. Now everybody's, you know, you are unicorn, which I'm glad you're. You're with us here. Not everybody has the time, the resources is going to do that. If it's a patient, I'm going to tell them to go to our website. I mean, we've. I've been working on stuff there since 2016. So we have. Going on nine years. Nine years. We have over 300. We have like tons of stuff. So. And it's geared towards patients. You know, it's geared towards people like, learning and taking charge of their health. So I would recommend patients go there. The strange thing is I've talked with a lot of nurse practitioners and PAs as we interview people for coming and joining us, and many of them are like, oh, I love your stuff. I read it. I learned so much from it. And I'm like, well, that's kind of cool. Yeah, I know, but it's. I'm like, no, I'm like, is that right? It's too technical. You know, so. And then we have our pod, like this, this podcast. Like, you know, people want to learn about hormones and more about mold. Yeah. That's one of the reasons we're doing this is in one of. And this is not to be selfish, but, like, I want people to be prepared when they come here to rock and roll. Yeah. If someone already realizes they have gut issues and Some mold problems because they've listened to us talk about it and they've read some blogs on it, and they. Or you realize they probably have nutrient deficiencies. They already know about the lab testing. When they come and see us, it's not gonna be. You know, I feel like a lot of what I do is try to convince people, like, go down this pathway so they've already had a chance to read this stuff. There's individuals, it's way easier. And sometimes they come ready. Like, I know what you're gonna do. I've seen the reviews. I know you're gonna draw a lot of blood.

Yeah, that's the best. That's the best. And, like, I think these. These videos and the podcasts collectively, all this information, it's been a game changer for that because I've been seeing, you know, I've been seeing new intakes every week since the fall, and I can't tell you how many people are like, oh, yeah, yeah, I know. I listened to your podcast or I saw you on T shirts, and I'm like, you know what? And they're like, I know that this is going to be hard. I know that you're going to order a lot of stuff. I know that I'm going to have to make a lot of changes. I'm ready. You're the person that I think is going to be able to help.

That's working.

It's awesome, though. Like, they come in. It's almost like they come in and we already have a relationship and a rapport because they feel like they already know me a little bit, because we are these people, and this isn't fake. This is who we are, and this is what we do. We're talking about this because this is literally how I talk to patients. This is literally how you talk to patients. The whole point is, for that reason, like, we're trying to educate and inform and maybe convey that we have an ability that some other practitioners might not or that we feel really confident in our ability to do these things. But it's also the dialogue that I'm having on a daily basis. And I think it's really helpful because the whole goal is education. Not just, you know, repair and fix someone. Like, they're not broken. They don't need to be fixed. They just need to be taught. Taught what to do, how to live, how to be healthy.

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One of my underlying beliefs is that 80% of the stuff people can do at home, 80% of the foundational stuff, they can't do their own blood testing and lab interpretation. But changing your diet and cleaning it up and work on your gut, removing the hormonal disruptors in your environment, working on stress and sleep.

Advice of drafting.

Yeah, it's like all that stuff, like, you know, you know, in my family, we've. I've got three different kids. You know, I've got Anna, which we talk about a lot. Who's the kid who, like, literally, we had driven her to Canada to do special therapy, and we've done hyperbaric with her. She's the one who needs, like, functional medicine, precision, personalized medicine. Plus all stuff.

Plus the future of medicine.

Plus the future of medicine. Yeah. Plus stuff that. Who knows what's, you know, just. We just started exosomes on her, you know, a couple weeks ago, and she's like, her vision continues to improve. I mean, she's never done this before. I'm not sure when this is coming out, but. What's this? May. So the first week in May of 20, 24, 25. I'm sorry. She was able to swim in the pool half an hour by herself without a life preserver. Without a life preserver.

Holy cow.

And get out of the pool by herself. And when she was getting ready to get out, she's like, dad, my legs are shaking. I'm like, I got you, girl. And get out by herself. She could not do that last year.

That's amazing.

Three years ago, she was frightened to take her life preserver off for like a second.

Oh, my gosh.

Six years ago, she would just sit in the pool and Float and just literally float like a buoy. And it's just like, yeah, yeah, it got hurt. And now we've done all cool things, NMS and stimulation stuff and tasis therapy and spending hundreds of thousands, you know, crazy, crazy, crazy. And I got my son Khalil, who came to us with horrible asthma and eczema. He's hypermobile as well, has a little adhd, which, you know, you know how it is. And he's been solely. We've gotten him cleaned up solely with diet and environment. And so I've got my family. Both his extremes, you know, and so it's one of those things, like, for him, it's been like, he didn't take any supplements, he doesn't do squat, and he's like, asthma, eczema, are resolved, you know? And so I feel like to the average person, that 80% seemed like a reasonable number for them to be able to get better if they're doing this. The basics, if they're perfecting the basics. And this conversation here, our website, the.

Blogs, provides so much of that. It's a combination of what you shouldn't do and what you should do. And the what you shouldn't do is adding by subtracting, right? I shouldn't eat these things. I shouldn't use these products. I shouldn't store my food in this. I shouldn't drink this unfiltered water. And then what you should do, eat these things, purify your air, use natural pro. Like, it's just a combination of teaching the person where they're askew and how to nudge them back. And I think for anybody, and this isn't always realistic, obviously for anybody, lifestyle is always the priority. But getting to that point takes time. And adding supplements and medications and other things as necessary will get you there. But, you know, then the goal is peel back the stuff. What's the least amount of crap that I need to take on a daily basis to hold this space? That's the ultimate goal. And so I think it's awesome.

I'm old. Do a little shout out here real quick. I was on vacation for two weeks in Italy with my wife three weeks ago. So we. We're in Italy. It's beautiful in Rome. Everything's gorgeous. Eating the amazing food there. My eyes start getting itchy and watery. On day 11, I wake up. My eyes are puffy red. I'm stuffy, I'm getting headaches. There's people on our trip that are having flares of their allergies. Then we're in the Coliseum, they're like, oh, we have to clean this up. I'm like, oh, that's interesting. So I just. I don't know what led me to start investigating on vacation. The PM2.5 air quality in Italy. Right. Horrible. The PM 2.5 is like 35 to 40. While we're there to put that in perspective, the World Health Organization says it should be less than five. Then I started. Then I got these maps and starting these maps, and I was like, oh, this is the area in Lombardi where Covid was just real, literally knocking people. Like, when you hear how bad it was in Italy, it was in that section. And then I started talking to people on the trip and. Oh, well, why don't you. We start talking to people. I'm. I'm also Debbie Downer on these kind of trips. And so I started pulling people's water supplies up on the environmental working group. A guy in Dallas, you know, someone else living on Lake. Lake Erie. And the water supplies are all runoff water. I mean, just the air. The water quality is horrible. Then looking at the air quality in Dallas, it's not so good. And so all of a sudden, and we talk about all these in our Detox blog series. We talk about looking at clean water, clean food, clearing, clearing water, and as well as reminders that, like, on vacation, I went to a nice place to have food, and I was having issues from the air quality, and I was meeting people that came from America who had some health issues. And the water they're drinking is. They're toxic. Yeah. And so the point of all. We'll get back on track here. But the point is that the basics matter, you know, Perfect. The basics. Like professional soccer player. They. Yeah, there's. There's cool guys and do cool tricks, but the ones that actually make it. And are they perfect. The basics. And get really, really good at that. I. All our resources are just to help people. Perfect. It's cool. Get as close as they can to that with the basics. Yeah.

You gotta make it automatic. Like things that you do on a daily basis without thinking. And that's just how you should just maintain the lifestyle. I think we're wrapping up. What are the most common. And I know it's probably all of them, but what are the most common hormone issues or disruptions that you see? Like, what do you see more of versus just kind of a little bit of everything.

I see a little bit everything. You see people, you know, women still cycling, 30s for before they go into the perimenopause. With low progesterone and low testosterone and then obviously menopause, just everything's low. I will occasionally see some who have elevated estrone levels are really high. Usually my patients that are overweight.

Yeah. Are there trends that you see that are concerning, that are like becoming more increasingly common, like low T across the board or infertility in women across the board or emerging hypothyroidism? I mean, it's just, I mean the.

Trends I'm seeing is men getting low testosterone younger and younger and younger. I mean that's well the one trend that's like, because again, women are made to like change up the month. They're made to do this miracle of holding a child in their womb. Like it's literally a tumor. It's a foreign object that they, it's.

Sure they're all going to love you. They're going, yeah, you're canceled.

I'm canceling. I know, but it's literally, it's not you. And yet your body somehow figures out to hold it and protect it for nine months. And that requires fluctuating hormones. So that's why women hormones are kind of tricky. You know, men are just kind of, you know, the Volkswagen, you know, they just kind of hum. But to see that decline more and more and more. Like I, you know, you've seen guys late 20s and early 30s. You know, I'm in a professional group of entrepreneurs who routinely hear young, like athletic, good looking professionals like, oh yeah, my testosterone is 200, like it's 300. I'm like, yeah, yeah, like 40. Like literally the normative testosterone in the 1950s and 60s for a 65 year old man was about 500. Now people are like in their 20s, like 500. I'm like, yeah, congratulations. Like grandpa had your levels like in the 50s, you know, and I feel like that's probably the one in fertility issues. You want to talk about hormonal trends? I'm seeing like worse and worse. I mean obviously more pcos, more pre diabetes and all that. All the typical stuff. Cancer's younger and in women the cancers tend to be hormonal related. You know, what's in the water. It's really interesting NHANES data. NHANES is a national. I forget what it stands for. It's the government EPA check in. They basically just test the water, the food, the air and tell us what's in it and then that's all they do.

But it's, it's good data and longitudinal studies, basically.

Exactly, yeah. It tells us. And so Right now the average American has between like 10 or 13 toxic chemicals in urine testing right now 10 years ago it was 6 to 8 and 10 years before that it was like 3 to 5. So that's just an NHANES trend that we're just getting more toxic, you know. Is that behind, you know. Yes, a lot of the stuff we're dealing with low T women with pcos, you know here's a trend I'm seeing. I'm sorry now that, now I'm thinking about. I got lots of trends I'm saying yeah, that's a trend I got to think about for a second.

That's the point.

Yeah. Young ladies and cycling younger. In the mid-1800s the average age of starting your cycle was about 16. When I was in high school I was told it was like 13 and 14. When I was in residency I was 12. Now in African American young ladies 9 is actually considered normative. And I heard, I was talking with one patient that just went to an endocrinology Warner Friends endocrinologist and she was saying they're talking about you know, six to seven. They're starting to see that now. That's, I'm like yeah, it's so, so what is doing that?

Yeah, that's an environment that's toxic, disrupting chemicals.

It's all that and this is. And again most of that people can do on their own if they get the right information. And so you know we talked about, we actually, I think this was actually useful. This, this on little side journey detoxification hormones, doesn't matter your age, you know phthalates, I mean I post, I do these on social, I do these little things all the time. Phthalates, you know I did a thing, I talked about the kid them, the dyes, food dyes. You know that's a big controversy right now cuz we're actually starting to take them out of our food. Those things are petroleum distillates that are neuroendocrine disruptors. In young kids they make em a little wonky. In young ladies they mess the hormones.

Up like when I trained and this was not super long ago but it was long enough where the data might even be different now. But there was a statistic that was talked to us about PCOS females they did a study that showed 40% of them had detectable BPA levels. So almost half of women in this study with PCOS had detectable levels of BPA which has been outlawed but replaced by BPS which will be outlawed and replaced by BPZ or whatever. It's like phthalates, parabens, PCBs, these PFOAs, all these things, they're not just affecting you daily, they're affecting you transgenerationally because they got into grandma, who got into your mom, who got into your eggs, and are going to affect your offspring. We don't know. They're called forever chemicals for a reason. So do what you can to avoid them. They're kind of inevitable, but do what you can to avoid them. Don't be flippant about it. Filter your water, purify your air, eat clean, use clean products. But then you got to work on your body, meaning detox pathways. Like, you got to open them up. That's liver, gut, kidneys, that's sweat. Everybody's breathing, so that's fine. But sweat with exercise, sweat with sauna, get your gut working, support your liver, make sure your kidneys are working. And then these things can kind of get pushed out and your body can have less of a toxic burden. You have less of these overstimulation of these receptors. I mean, we see the rising tide of breast cancer in 20 and 30 year olds. And these, they're throwing their hands up saying, we don't know why, but we're looking into it. We just gave you like 10 reasons why. Right? Like, it's obvious to me. It's obvious to you. Like, do I have definitive proof? No. But why not do something that's benign? As benign as eating more cruciferous vegetables, eating more fiber, eating flaxseeds, maybe taking a supplement, working on your gut, managing your stress, detoxifying your environment? All of that is pretty basic and can transform your health.

And if you're waiting for the calvary, I. E. The government surgeon, generally, I'm in states. Yeah. Yes. Because it took 50 years and 7,000 research articles for them. The surgeon general say smoking calls. Yeah. Cancer. So good luck. Yeah. So, you know, people say it's controversial. I'm like, it's controversial till it's not. Yeah. And then it's like old news.

Yeah.

And so you don't want to wait the 20, 30 years for it to be old news. You want to get on the front end.

So ahead of the curve.

Yeah. And that's what we do. We're, you know, the. Like I like to say we're the compressed air at the tip of the spear, which means we. I don't know about you. I change what I do every two to three months. I mean, I'm literally changing the way I think about the autonomic nervous system by this textbook I'm reading right now there's actually five parts of the nervous system and then in the myenteric nervous system which you mentioned actually its own separate system it does communicate with the sympatho adrenal system as well as the parasympathetic and the sympathonoradrenergic system which actually are other systems that are intricately connected. So who knows what I'll be thinking I'll be talking about. Yeah in two, three months after I read it's only like 800 page textbooks.

Great.

I know, I know, I know I got. Got a lot of. Yeah and nothing else better to do.

I don't get that kind of time.

I don't either man. You make it. I got time machine. It's always I'm like Hermione Granger. Remember that little time thing?

Sometimes I feel like you have she's.

Never seen it yet Hermione has a little time. What was that thing called in Harry Potter? She turned it and went back and she should know but she was like did like two years of school in one year and was falling asleep all the time. I've got one of those hidden.

Yeah, I bet you you do.

On that note we'll end there before we digress too much. Thanks a lot like share and subscribe all the good stuff and next we will be talking about in the next section Practical Application and future directions of hormones. Take care. I'll talk to you soon.