71: Are Your Hormones Broken? – The Shocking Truth About Stress, Sleep & Gut Health with Dr. Christian Jenski

I address stress, I address sleep. I try to work on that because I think that's pretty powerful. If you're establishing a circadian rhythm, a lot of things will kind of fall in line, at least to some extent. Detoxification is really important. What does that look like? It's either cleaning up that person's lifestyle because it needs it. So is that drinking filtered water, is that purifying air, is that changing out products, or is it cleaning up their diet? Or is it all the above? Or if they're doing all those things already, am I layering in some support that maybe they weren't aware? Fine tuning some things a little bit and then gut. I think the biggest things for anybody with a hormone issue is get their gut right, work on detox, which is also essentially gut, and then start the process up because everybody's got it. Managing stress and optimizing sleep.

Welcome back. Once again, we're gonna be ending up our three podcast session on hormone optimization. And this time we're gonna last time we'll talk about, you know, what are we doing? How do you practically apply some of the stuff we've been talking about in future directions? Again, this is not meant to diagnose or treat any medical condition. If this information is helpful, please, like share and subscribe. That's how we get this information out there and we'll just kind of hop on into it. So if you have questions, please post them below because we'll do it once we collect questions and these go out on the YouTube, we usually answer them and then post them on the the podcast. Hopefully you're watching both of those, or if you want to stick with one. The podcast, once we put the podcast, is where everything's compiled together. Our sessions plus the Q and A sessions with that Christian. Someone comes to your plastic looking for hormonal help. What? This is supposed to be practical, this last one, practical. So what should someone be looking for or what do you do? Someone comes in, you've already kind of mentioned, you might just be repeating yourself about what you do.

Yeah, yeah. Repetition is great. I tell all my patients that repetition is intentionally built into what we do for the sole purpose of making it less overwhelming and also educating. Because you come in, it's a new way of seeing medicine. And it might be drinking from a fire hose. It often is. And so that repetition is actually helpful. So if we're saying stuff that we said in the previous episodes, great, because it's just gonna hammer it home. So most people come in with some degree of chief Complaint or chief complaints, plural. And so based on their history and their intake information and then this in depth 2 hour initial interview, I'm kind of gauging how dysfunctional their hormones might be. They might already have a diagnosis, they might not. And I am already feeling out that they probably do. And then I work towards that. I previously mentioned, one of the things that I get on every single patient is an adrenal stress profile, which is a four point salivary cortisol curve. And I also get something called a cortisol awakening response and a salivary dha and it's all part of the same thing. And basically what that's telling me is how functional or dysfunctional that HPA or hypothalamic pituitary adrenal axis is. So that's called the stress loop. And the car or car cortisol awakening response kind of gives me an idea of light coming through their eyes, hitting a part of the brain called the suprachiasmatic nucleus to tell it to release crh, to tell the pituitary to release acth, to tell the adrenal to release cortisol. Basically light waking you up in the morning and telling the body it's daytime, release cortisol, it should come down, continue to go down. By bedtime, all should be right. But what I typically see is a suppressed or over exaggerated cortisol awakening response. I see a curve that's wonky, elevated, it's flat, losing its shape when really bad low, and then I see DHEA all over the place. So the stress loop is something that I always get on a patient because I need that to help me guide other therapies like their gut, like the other hormones in their cascade, whether it be thyroid or sex hormones, how that's affecting their glucose, how that's affecting their weight, how that's affecting their mood. So that is absolutely important. If the person has any thyroid condition, I'm going to assess that. If they don't have a diagnosis, but I suspect it, I'm going to assess that. So that's typically a full panel for me. That's TSH, total and free T4, total and free T3, as well as TBG, which is a binding protein, as well as reverse T3 as well as autoimmune markers. I also take it a step further and look at their nutrition. Iodine, zinc, selenium, copper, vitamin D, vitamin A, tyrosine, the nutrients, B vitamins, mag, the nutrients that go along with thyroid support. Because, say the thyroid's off just a little. Am I going to put them on medicine right off the bat? No, I'm going to give them some nutritional support, work on other things. And then last but not least, depending on where they're at and what they need, I might look at a sex hormone panel. If it's a female that has predominant sex hormone issues, I'm going to expand out and either get a 28 day salivary rhythm kit or I'm going to get salivary hormones if they're already on hormone replacement therapy or an estrogen detox kit if I think that needs to be worked on. So I get some foundational, although fairly expansive right at the baseline studies that are evaluating that hierarchy. Everybody's getting a cardiometabolic assessment. So that's also factoring that in. I'm addressing their mood by talking to them. And based on their history, I'm looking at everyone's gut as well. So I see the hormone hierarchy, I see their gut, I have the cardiometabolic labs and then I get to work on putting together a plan.

Now, one thing I just want to put out there because I can imagine patients are going to be asking me questions after this comes out. One side note is that I can't speak for you, but the way I practice medicine now is a little different than it was three months ago, a little different than it was six months ago. And so some patients I've worked with for years, if they were to come and do their intake today, it's gonna be a little different than it was nine months ago, a lot different than it was three years ago. Right. So sometimes, you know, we're talking about is how we do things now. But I'm always fine tuning. I'm still practicing, I'm still learning. For me, you know, the autonomic nervous system in patients with POTS and dysautonomia has, you know, come to the foremost forefront. Patients with hypermobility, which is something I really wasn't looking at that much five years ago, six years ago. So this is informational purposes.

We're different.

We're different, we are different people.

So we treat like, just like you would want your treatment plan to be personalized. We are different persons and therefore we practice differently. We have the same similar, not the same, right, because we weren't in the same classes, we have similar training, we have similar certifications, but we have different lives, different experience, different exposures, different patient encounters, different feedback, different skill sets. So everybody's a little bit different. You rely very heavily on history and physical and have the ACUMEN to be able to do that and test less. I also do those things, but I find comfort in testing, and I find that my population likes that as well. So I test more, but that's just me versus you. One's not right versus the other being wrong. If the outcome is that the patient gets better and is educated on how they got there in the first place, then it's good medicine as far as I'm concerned. It doesn't matter how you get there.

It's more style. A year out, they would have had all this stuff done seeing me. But, you know, doing like, the hormones on the front end, unless they're like, amazingly healthy and nothing's going on if your gut's a mess, if I don't, you know, I don't have your nutritional status yet. You're drinking Diet Coke pop. You know your house has mold in it. Of course your hormones are messed up. You know, I'm not going to do anything about it right now because you got issues, right?

You have a lot of room for improvement.

And so that's where just our stylistically. It also depends the patient. You know, if someone comes in, their diet is horrible. Like, I'm not going to do a GI test on them because I want you to eat real food first. Now, if it's someone who, like, I need this data to convince you to eat real food, you know, just like, food, food. We haven't really talked a whole lot about food sensitivity testing. I used to do it all the time. Now it's something I'll do like on visit 3, 4, or 5, typically, because it's like, you need to do an elimination diet if you have an autoimmune issue or if you have lupus, you need to do autoimmune Paleo. Like, of course you're going to react with food. I want to know what it looks like after you clean things up. But some people need that data to convince them. And that's where part of to give.

Up foods that you are telling them to give up, that they don't want to give up, and they're really confused about and you don't want to develop a negative relationship with it. So I'll say, you know what? Let's not gas. Let's just have your body tell us what it doesn't like right now. But what I'm expecting is 40 things to come back positive. And that's gonna scare you. But the reality is it's because your gut's leaky and your immune system's off. But at least we can tease out the three plus or the two plus foods and learn something. Maybe let's not pour some gas on the fire. So there's either approach is right. There's a different way to do it. I see both sides of that coin, which is you can cool things off and work on the low hanging fruit and then get some testing to see why we hit a wall or to round it out versus if you think they can handle it. And I think the reason behind it, the way that I do what I do in hindsight, actually, now that I'm saying it out loud, it's probably because when I was a patient, that's how I wanted it. I wanted all that information. Cause I was so frustrated with not having any. I wanted that control because I was so frustrated, not feeling like I had. Yeah, I know you do. And then when I started to have that North Star, that pointed me in the direction of health. And then I started to have the clinical correlation where I felt it. I just feel like that kind of translated well to me. So I get both sides and I think that's how you have to do it. Right. It has to be personalized.

So what do you, what do you think? The lowest hanging fruit. We're trying to optimize someone's hormones.

Yeah.

And this is general just, you know, what's the lowest hanging fruit? That if you're not doing that, you really need to do this. It should be two or three things if you want your hormones to be balanced. Like the optimization to include everything we've been discussing.

I mean, obviously working on stress I think has gotta be what, one of the top three. And for me that kind of goes hand in hand with sleep. If you're stressed, you're not sleeping, or at least not getting quality sleep. So I address stress, I address sleep, I try to work on that because I think that's pretty powerful. If you're establishing a circadian rhythm, a lot of things will kind of fall in line, at least to some extent. Detoxification is really important. What does that look like? It's either cleaning up that person's lifestyle because it needs it. So is that drinking filtered water, is that purifying air, is that changing out products or is it cleaning up their diet or is it all the above? Or if they're doing all those things already, am I layering in some support that maybe they weren't aware? Fine tuning some things a little bit. And then gut. I think the biggest things for anybody with a hormone issue is get their gut Right. Work on detox, which is also essentially gut, and then start the process up. Cause everybody's got it. Managing stress and optimizing sleep. When you're doing those things, I think a lot of things will kind of fall in line from a gut standpoint. I think the major issue is trying to introduce them to some foods that they might not understand or are potentially detoxifying. Like, I feel like it should be common knowledge that cruciferous vegetables are detoxifying foods, but it's not. Like how many times I'm telling somebody, eat more broccoli. But I love broccoli. Great, eat more of it because it's going to help you. Right. Like, it's almost like someone told them, don't eat too much broccoli. Like eat more cruciferous vegetables. Eat more of these things. Oh, I love putting fresh herbs. I love using rosemary. Great. Rosemary blocks the enzymes that convert estrone into the bad pathway. Use more rosemary. Like, there's these cool moments where you can just tell people about things that they're already doing, just do more of. And that's a little bit empowering from a dietary standpoint. I mean, what would you consider to be the.

That that's pretty much all the things, you know, gut stress and sleep, which you've already mentioned detoxification. And then, you know, with. Since we're seeing us replacing nutrient deficiencies because everybody's deficient in something and optimizing those. It's, you know, it. Sometimes it takes, you know, it was during the pandemic, I remember seeing patients come see me. I had one patient. It was like, I still see the chart where I've been tracking their vitamin D levels since. Since 2012, and it normalized in 2019. So I kind of joked with the Miles prepping you for the pandemic, you know, but, you know, some people takes a long time to get their D level status, you know, and that has to do with inflammation and your body weight and stuff. But.

And genetics.

Genetics, yeah.

Sometimes receptors on your kidneys, if you have high affinity receptors. And sometimes chronic infections that are just churning through your day. If you have a VDR receptor, snap, which is a methylation gene, like all those things. I mean, my d levels were 16 when we started. 16. And I started taking D and I was like, I'm going to fix this. 10,000 IU. 25. 25,000 IU a day, 45. Like, I was taking huge amounts of D and I could barely get above 60. But I also have a VDR receptor, SNP a homozygous one. So I don't really convert sunlight into D. I don't utilize it appropriately. So I got to really take super physiologic levels to keep my levels where they need to be. What nutrient deficiencies, since you brought it up, do you. You talked about D a little bit. But what nutrient deficiencies do you see most common or which ones do you find to be most impactful when you actually are like here, just take this. And it's something as benign as X.

You know, thiamine B1. Particularly with patients with dysautonomia and neurological issues. There is amazing literature on low level wet and dry beriberary populations. We have stuff from Japan 1900s where people would get B1 deficiencies because they ate lots of rice and the stress of going out working in the sun would give them these low level basically better dry bear bear reactions. And can you overdose on thiamine? No. Rubber flavin? A little bit. I'm folic acid and B12. You know how many times you check someone you know if 40 to 60% of Americans have. Well have 25 have her heterozygous and I forget the number is for homozygous but core of people will have at least one but just will have a single B vimin deficiency so in your serum. So it's like people are gonna have B Vimin deficiencies on testing if they're not supplementing. You know if your B12 is like 300 is that optimal? You want it over 500 for optimizing neurologic.

Even though 400 is normal.

Actually on the. I think the labcore is like 3 80. I had one patient know it might.

Be lower than 350. Yes. Be 250 to 1100.

Yeah, that's.

So if they're 275 it's.

It's normal. Yeah, for me it needs to be over 500. And if I see. And one caveat, sometimes people come back and like oh my gosh, you did my B12 level and it's over 2000. I'm gonna stop all my B's. You can use B12 like a drug for mitochondrial function. You can use thymine for a drug for mitochondrial functioning. When you're using multiple for thymine, for example. Actually there's some interesting research and Italy using high doses for Parkinson's and dysautonomia.

Benfotiamine or just regular.

Well, benfotamine or allithymine. Allithymine is the more absorbable Benfophotamine is the water soluble version of thiamine. But thiamine in general, you know, depends on what's available. This was actually with thiamine hydrochloride, which is not as, not as bioavailable. But you know, people doing, you know, 4 to 5 grams.

So you can use supraphysiologic dosing for.

As a medication, therapeutic B1 and B12.

B12.

B6 is tricky because if you get too much, you get neuropathy. Yes. Because pyridoxy hydrochloride actually blocks at high doses can block your body's formation of P5P. So you can actually induce, have high blood levels of B6 but induce a physiologic B6 deficiency and you get the neuropathy. So I'm kind of in the process of transitioning all my.

To P5P.

Yeah, yeah. From everybody people. And you don't ever do so like just B's. D Magnesium. I mean mag. I mean, I mean magnesium. It's like, it's like it's its own drug. You know, people have migraine. You know, I have some patients with really bad migraines. Let's do some IV magnesium. You know, dysautonomia. I used to think the, the magic between our, the IVs we do here for our dysautonomia patients was the vitamin C. Because I was all, because I'm all into the hypermobility, right. Then I started reading some of. I read this actually a book from Cleveland Clinic about kids with dysautonomia. I'm like, maybe it's not the C, maybe it's the mag and the B's, you know, the thiamine. Right. So mag is the other one. Those are the nutrients. If you're deficient in something, fix it.

When you're stressed, you renally waste magnesium. When your cortisol's high, you're just peeing mag out. So you, you know it's gonna be low if you're stressed. So take more mag. If your insulin receptors, if you want em to work, you need magnesium. So all of this ties together. And what he had mentioned was essentially that, you know, I see these nutrient deficiencies all the time. They're incredibly common. So sometimes just correcting those corrects the problem. And like it seems like an easy fix. And it seems like this isn't useful information, but it's profound. And the key is using the right formulary, not all mags are created equally. And, and you also want to measure Levels and you also want to clinically correlate. So you want to make sure that you're doing this under the guidance of a practitioner. But you know, it's not going to hurt you to attempt to improve your nutrition. Right. Like it's, it's only going to help your cause.

And so let's, let's, let's make a little ship because then this is supposed to be things people can take home and apply sugar, insulin, you know, it's something we've, we've talked about it a lot in other, other episodes, but I feel like, you know, talk about a little bit about that because it's something we haven't discussed a whole lot. Yeah, insulin resistance, sugar levels, diet. You know, we did talk about insulin and how it affects with people's hormones. But a low hanging fruit, a simple thing people can start now is, is improving the sugar which will affect your insulin and a positive impact on hormones. So why don't you kind of give us the skinny on that briefly?

Yeah, I mean, what, half of the country is overweight and diabetic and Then up to 88% at this point in time are metabolically inflexible. So that means 12%, maybe less proper weight and metabolically flexible. And this is a trend that's also being seen in the pediatric population, maybe not to the same statistics. So it's kind of crazy. So we see dysglycemia or hyperglycemia a lot. We see insulin resistance a lot. We see elevated A1Cs, we see leptin resistance, dysfunctional adipose tissue and therefore low adiponectin. So you know, if you're not familiar with some of these markers, mean I'm going to explain, these are the things that should be tested by your provider. There is a paucity of fasting insulins being tested on individuals and the gold standards in hemoglobin A1c, which is A, a marker of your average estimated daily glucose over the course of three to four months. It's a glycosylated hemoglobin. A hemoglobin or red blood cell lasts about 120 days. And so if you have high glucose, they kind of stick to the hemoglobin called glycosylation. And we see an elevation in this number over time. And so say you get an A1C that says you're pre diabetic, you automatically assume or someone tells you that you have insulin resistance, but yet you don't get a fasting glucose and you don't get a fasting insulin checked. How do they know you have proper insulin resistance? They don't. So if you get a fasting glucose and you get a fasting insulin, you now have a mark of yes. This is corroborating evidence that this looks like insulin resistance because the glucose is high and the insulin is high. Or what if your glucose is normal and your insulin is normal or even optimal and your A1C is still elevated, then it's clearly not classic metabolic dysfunction. Hormones are playing a role, like cortisol or your gut microbiome is playing a role. So there are other parameters at play. It's not as simple as this is just mainstream IR and you gotta get on metformin or some other drug, so you gotta look upstream. A1C is downstream. You look at fasting glucose, look at fasting insulin. Upstream of that is leptin and adiponectin. Leptin should be low, adiponectin should be high. These are what influence higher up in our hormone cascades, the posterior pituitary that sends down messages that you're full or you're not full and influences things like cravings. So ghrelin and cholecystokinin and all these other markers that are influenced by GLP1s that are all the rage now are being influenced by these same pathways. So I see excess glucose, I see insulin resistance across the board. I just had a patient today for a first follow up. The guy is fit as a fiddle. He eats incredibly well, he's managing his stress, although he hasn't done his ASP yet. So I don't really know that for sure. His A1C is 5.5, but his insulin is 3, which is optimal. His glucose is 82, which is optimal. His leptin is low, his adiponectin is normal. This is related to biotoxins. In his case, he's a SIRS patient. And so this is a little bit esoteric, but it shows you that you can't always assume anything when you're just looking at an A1C. So I look at it that way. I'm looking at metabolism through a cardiometabolic lens where I'll also look at lipids and other markers, uric acid, ggtp, inflammatory markers, gut and short chain fatty acid production like butyrate plays a role. But all of that is important when you're trying to balance hormones. As far as I'm concerned.

There's a couple of caveats to that. This is also where some of the power of with women, if you do it Appropriately. Which we're not gonna talk about here, like fasting during your cycles. Yeah. But how the diet and fasting can be. Have a massive impact through insulin tending. You tend to do fasting better on the first part of your cycle. You tend to need more carbs in the progesterone last part of your cycle. Not space for that discussion here. But for women, particularly fasting or Paleo diet or these different things can have a massive impact on their insulin metabolic syndrome, which can feed into hormones, which one of my friends and colleagues, Cynthia Thurlow, wrote a whole entire book about, basically how fasting can have a positive impact on women's hormones. So it's a pretty big thing.

By improving insulin sensitivity.

Yes.

And glucose.

Yes. Yes.

And leptin and upstream signaling. Right?

Yeah. And all the fancy words you said. Yes.

And autophagy. And decreased inflammation and immune modulation. Again, the ties. Right, Ties of fasting.

The A1C is interesting. I saw a patient this past week, just went to her primary doctor, had a physical, and part of her physical did not include an A1C. It boggles my mind that the standard of care still is that people are not getting screening A1Cs. It looks at the area under the curve is what's called in the diabetes world. So if you imagine. If you imagine you're fasting, it's a flat line. Let's just say it's fasting at 70 and you eat it, goes up with the meal and it comes back down. Should be normalized in 2 hours. You do that 3 times a day. The A1C, if you kind of shave that in, A1C represents the area into the curve. And so if you have. You have a normal fasting sugar with an elevated A1C, let's say you're fasting. Insulin is normal. Your A1C can be a reflection as well of that area into the curve. And all of a sudden the question is, what are you eating? Yeah. Because if you're eating these meals and you're jacking that area up and it takes you a while to come back down, you might do this. This thing. And your pancreas is struggling. And so the A1C has so many nuances to it. It's such a powerful tool that, you know, it's. It's crazy. I remember when I was doing my training in 96, it had just come out, and the endocrinologist I was doing some stuff with was like, we got this new fancy thing. It's an A1C. I was so impressed. 96, my friend. That's like 29, almost 30 years ago now and still not standard of care. It's a blind spot in our healthcare, man. It's one of the, you know, the things you're waiting for the government to tell us what the right thing to do.

It's kind of insane. Vitamin D is. Is the same way my dad's primary care doctor won't check his vitamin D level. I requested it. He sent me three papers as to why he shouldn't check it. And I was just like, I'm gonna fight this guy.

That's where style, my style is a doctor is if a patient comes to me, it's just. It's easiest to order it. And I learn. I learn. And, you know, but it's just, you know. Anyway, there are a couple of things you said. Leptin resistance. Yeah. Checking a leptin, someone has weight loss issues, hormonal problems. If their leptin is high and they have leptin resistance, they can store energy in their tissue as fat. They can't get it back out. Yeah. And all of a sudden you're eating sticks, leaves, and twigs, doing all the right stuff, and you're not losing weight, and your leptin's up. You have leptin resistance. Do you have sers? Do you have mold? Do you have biotoxin issue? Not going to pathway this. We've already. We've already talked about this for seven episodes.

But. Yeah, but that's a clue to chase biotoxins sometimes.

It's a clue. Yeah. And then GLP1. I'm gonna. I've done a lot of social things on this. GLP1s are. So this is actually a little interesting thing I saw in my training recently. GLP1s, you know, when you work out that you eat. They go up with me as you buy it, naturally makes them. When you do these shots of GLP1s, you get these crazy super physiologic doses that are 20 or 30 times higher than what your body does. I don't know if you've heard about microdosing, which is kind of all the rage now. I first heard about it. All my colleagues in the integrated world mention it to me. I'm like, I never heard this before. Even at microdosing, it's still two to three times higher than physiologic dosing. So now it's like, okay, I know that microdosing is more than natural dosing, but mast cell stabilization in the mast cell world, we using it for people with the Sodom domain POTS microdosing, they're having. Some people are stopping reacting with food refoods. Their, their hives are going away because of this muscle stabilization thing that can happen with the low doses of GLP1. So. And again, if your gut's messed up, your gut, this is where your gut makes this. You know, there's probiotics you can take.

Butyrate, right? Short chain fatty acids.

Exactly. Yeah.

So chromancia, Clostridium, butyricum, all these bugs with fun names make lots of these things. If you got them and you feed them, right?

Yeah. And if you're not making them, that's gonna affect your insulin, your sugar. Yeah. Which isn't gonna affect downstream your hormones. And so how is this basic and simple? Now I'm trying to rewind here. Cause I feel like we're getting complicated because diet, lifestyle, fasting, these basic things can address everything we talked about. Yeah. Which goes back to lifestyle. What are some of the lifestyle things? Cause everything we just talked about, oh my gosh. Lifestyle can address like 89% of it. What are some of the lifestyle hangups when you're dealing with someone's coming in, they need their hormones fixed that people just can't get over the get to the starting line that are going to be simple things that have a massive downstream impact.

So two biggest ones are typically the cost of completely detoxifying your home. So they know what to do. But like, I don't really feel like changing out all my pants. I don't really feel like buying all this Tupperware. I don't really, I can't afford to get a whole house filter. I don't want. So there's always a financial hang up. And so you just, you work with them to make small changes to the best of their ability and then diet. Because unfortunately, and this is where it kind of goes back to us being, you know, medical feminists. It's like, you know, a lot of my patients are females and they talk to me about their struggles with home life, which is to say that they're here to work on their health, but they're the one preparing meals. And if they prepare a meal that is beneficial for them, the rest of the team doesn't think it's delicious and is mad. So now this woman is preparing two or three or four separate meals and then she just winds up giving up on, I can't be a short order cook. I'm just gonna eat what everybody eats. So the dietary changes are also often difficult for that reason for logistical reason, because the rest of the family isn't also not eating gluten or not eating dairy or eating more vegetables. I don't want that. Give me my pizza. And there she is in the corner eating her salad like a bird and feels left out. And so support is a problem. Dietary changes are a problem. The cost of things are a problem. But honestly, small changes make huge differences. If you, if you just kind of tease out. I go for the things that I think are the big hitters. Usually it's diet and then movement, getting that person moving. Because I think when people move, they don't realize how distressing it is. When people move, they don't realize how good it's for their microbiome. When people move, whatever they exercise, they don't realize that they're driving that brain drive neurotrophic factor. So they're repairing and healing their brain. And they tend to sleep better and they might even cut a little bit of weight, which is always gonna be helpful for stabilizing glucose, insulin, and hormones. So getting somebody to move. Sometimes pain is an obstacle, or physical aspect is an obstacle. But I have a patient today who's got chronic back pain. And I said, you know what if you walk and it hurts? Let's not walk. Let's do aquatic aerobics, let's do chair yoga. She's like, that sounds cool. And so she's gonna look up some videos on cherry yoga and do it at home. Like, there's always a way. Like if you're willing, there's a way. You don't give up, you just work on it and you kind of build on that. I mean, what are some of the obstacles that you come across?

Big obstacle is the family stuff. You mentioned where it drives me crazy and mom's gonna take care of everybody else first standard. That's part of, you know, and what that means is they make a meal for everybody else but themselves. And so really having support at home, support their kids. And ultimately, you know, kids are kids, you know, they can. If they only what is put in front of them, they'll get hungry and eat it later, you know, and so. Yeah, yeah, yeah. I mean, the only reasons your family's done so well is because you've had buy in. The reason my family's done so well is because we have a buy in. I feel like that's one of the bigger stumbling blocks with my patients is they're doing this alone. And because the whole gaslighting, it's all in your head. You're not really that sick. I mean, look, you're doing all this stuff. It's like, yeah, I'm. Yeah, like crashing it in every day. It's like, you know, get a little help here and, you know, unfortunately not getting that. So that's a big. That's a hard one that women have to navigate. That's. I don't have a magic answer for that. On the stress side, this is something actually interesting happened this past weekend with us and our family. I have my little aura ring here that tracks my, my heart rate and blood pressure and stuff. And. And this goes to you, like, doing things that relax you, low your core is all kind of a massive impact. We were kind of lazy bums and didn't go to church this past Sunday. We started up the family and hung out for an hour and talked and just, you know, had some family time, then went out and did some yard work, yada, yada, yada. I was looking my ring at the end of the day and it was like, you're amazing. You had, you know, one hour of restoration time today. This was absolutely amazing. Keep up the good work. You never. I usually have, like five minutes and I'm like, looking at my ring. There was that hour, like, just sitting down as a family having family time. I remember the feeling. I felt good. We're talking, we're hanging out. My son was talking. It was just. It was like, you get that feeling, like. But that feeling correlated with low heart rate variability, like family time. And it's like, sometimes the things for cortisol and stress don't have to be fancy. Adaptogenic herbs and things that actually work the best. Stress reduction, outdoor time, meaningful relationships, having time with family. You know, all these things are like, that's the easy. That's like the easy. The not easy, easy stuff, right? The camera, massive impact. So we could talk forever. But on that note, we. We're gonna skip out for today. Um, we will be doing a question answer session later. So all these things typically go out on YouTube first and then we collect questions and we post it on the podcast. So please put your questions below and then we'll have a later session where we answer those. Hopefully this was helpful. If you have things you'd like us to talk about, you put them in social. Drop us a message, because we're looking for you. Things we can talk about and help. Not with just with our patients we see in the office, but also with those who follow us. So please drop us a line, let us know. That way we can put out quality information that can help you and your family. Otherwise, take care, be well, and we'll talk to you soon.

See you next time.