Female Hormones: What Disrupts, Detoxes & Balances Them – Anna Cabeca, D.O. : 975

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You're listening to the Human Upgrade with Dave Asprey.

Today we're going to be talking about one of my favorite topics of all time, hormones. And in this case, we're going to be talking about hormones. And one of my other favorite things of all time, which is women, because it turns out women make up 51% of our species because Mother Nature just rolls that way. So we might as well talk about hormones. Also, from an anti aging perspective, women are underrepresented in the number of studies that look at hormones. The vast majority of research just in the overall body of research, not counting the last 10 or so years, but just the overall body is on young white males because they're the ones who were in college and they were free guinea pigs. So we're still making up for that by doing studies of fasting on women and looking at women's hormones. And it isn't just for obgyns. It's overall for longevity, for anti aging. So what you're going to learn today is we're talking about hormones. We're going to talk about women with someone who only has three board certifications in such things as a medical doctor, and her name is Anna Kabeca. She's a friend and, and has just written a book with one of the best titles I've seen as an author in a long time called Menupause, which is elegant and it's very in alignment with the stuff I talk about. Although I understand she has a kale fetish that we're going to try and cure her of during, during this episode. But other than that, like, I'd say there's a lot of agreement and it's really interesting stuff. And because of that and for other reasons, like, she just knows a lot, she's going to be at the biohacking conference in Beverly Hills September 15th through 19th. So go to biohackingconference.com and sign up. And you're going to love what we're doing in Beverly Hills. There's just going to be so much, so much info here, including about hormones and women's hormones and aging and food and what food does to these things, which is, which is really cool. So your different certifications, I mentioned three of them. What are they in?

So obgyn. So I trained at Emory and OB GYN and then Anti Aging and Regenerative Medicine and Integrative Medicine was my most recent board about six, seven Years ago.

Awesome. So you kind of know what you're talking about. Okay.

I'm still learning. I'm still learning.

I'm going to ask a question that I've never actually asked, but it's one that's like something you'd ask at a bar. Okay. You can study anything you want in medicine. Okay. And. Okay. Some people choose to be, like, proctologists. You could have been anything, but you're a butt doctor. Like, why would you choose that? Of all the things you could do. And, like, I respect that. We really need that. It's important. But, like, what draws you there? But you're an ob GYN and a bunch of other stuff. So what drew you to those specialties to make you go so deep on all these things? Like, I mean, you really know a lot about nutrition. You know a lot about these things. So why. Why those?

Well, you know, that's a great question. Actually, I haven't been asked that. So one of the things is that as a young age, I realized when my mom was undergoing heart surgery and I was. She was 52, I was 16 years old, and I realized that the research they were basing her surgery on was done only on. As a young age, I realized when my mom was undergoing heart surgery and I was. She was 52, I was 16 years old, and I realized that the research they were basing her surgery on was done only on men. And that made me a really strong women's health advocate. So I really started digging into women's health and. And I started doing research in women's health as I entered college. And then I realized, gosh, you know, as a practicing obgyn, my doctor's bag was empty when it came to my own health problems and so many of my patients. And so I went on to continue to study and study and study and fill up my doctor's bag with a wide variety of, let's say, tricks and tools and strategies to help women. So, yeah, and when I was a young woman, and it's just occurred to me because I was listening to your podcast with the Navy divers and the. The deep sea divers, and I was that I did diving medicine research before I went to med school. And I'll never, you know, I. I went to a gynecologist when my first gynecologist, and it was like, a very creepy experience. So I was like, women should not have to go through this. So that's why I did ob GYN too.

It's like a bedside manner thing.

I think it's A bedside manner thing. And it's not typical. Now, I think gynecologist, they're really good. Male and female gynecologist. And it is that, like, it really seeded in me. Like, talk to your patients first. Get to know them, look in their eyes. Right. Just the basics, you know, warm your hands under hot water if you've got cold, creepy hands. And I think that was also after the exam, like, you know, talk about what you found or didn't find and that everything looks great and normal and healthy, and you're normal and healthy no matter what. I mean, like, that's a really important piece that should be part of the exam. So. So really just seated bedside manner and what's a good one and what's a not. What's not a good one? And I think too many women, I think too many, too many women have had an experience where they just felt like a number going through an office versus heard and really valued during a physician's visit, whether it's an obgyn, gynecologic, pap smear exam, which again, it's a very vulnerable position, especially for your initially to go through that.

Thank you for educating me. That's something I don't know anything about, given that I'm a guy.

But I think you should have the experience, and maybe your audience will agree, of being naked on a table with your legs in stirrups.

I should have that experience. All right, I'm adding it to my bucket list right now, and I'll get right on that.

Okay, there you go.

Now, let's talk about what's in your book, which is not that having read it, we have a lot of things that disrupt hormones. And one of the things I like about your approach to this, it's similar to the biohacking approach, which is, look, stop doing the things that make you weak. First, I'm going to work on having strong and having the right hormones. Meanwhile, you're doing something that's adding to your burden. So maybe stop doing the bad stuff before you start doing more good stuff so you have capacity to do good stuff. So talk to me about what's disrupting hormones in the world, women that you see in your practice.

Yeah. So I think this brings up a really good point. When I'm working with a hormone for a hormone, you know, woman for hormone replacement therapy and working on her hormones, I want to detox her body and open up her receptor sites and empower her body to produce more of her natural hormones first or as part of the process so in my, my book, it's really about sometimes doing less versus doing more and thinking about some of the endocrine disruptors that are really affecting us. So that's why we organic as much as possible. Right. Free range, you know, grass fed, grass finished. And to think about what we eat, ate, and was exposed to because the pesticides, herbicides, we know, the glyphosate, we know the antibiotics and, and many of the animal in meats in general are these animals have been injected with hormones as well. So that is a toxic burden to our bodies. We want to really address that, clean up what we're eating. So it's really, really the best that we can eat and then support our body in naturally removing excess hormones and, you know, endocrine disruptors, the hormone disruptors as well as possible.

One of my favorite hormone disruptors is something called zearalenone, which is a toxin made from mold, but it's actually sold as Xeronol. And they add it on purpose to cows. And it's a synthetic xenoestrogen a thousand times stronger than natural estrogen. And of course it makes the cows super fat on 30% less calories. By the way, guys, calories in, calories out is bs. If that drug is possible, then calories in, calories out just got broken. And well, that blah of thermodynamics might not be how it works anyway. So if people are getting meat that was injected with an estrogen a thousand times stronger than their own estrogen, what happens when they eat it?

Yeah, and I write about that specific toxin hormone disruptor in my first book, the Hormone Fix. And I was shocked really when I, when I read about how what our standards are in the US and what European standards are is like a micro amount compared to what we are allowing. And it's in corn, it's in grains, and so it's in what our animals are fed too.

Where did you learn about all these endocrine disruptors? Because I don't think they teach that in normal medical school, do they?

No, I didn't learn it in med school. I learned it as part of my own journey too, with dealing with early, early menopause at age 39 and premature ovarian failure and infertility issues. And you know, Dave, I don't know if you know this, but I failed the highest doses of fertility treatments and that was devastating to me. We had, you know, a trauma in our family where we lost our son. And then my husband and I at the time, we tried to desperately have another child. So between trauma, stress, ptsd, it created this early, early menopause and infertility. And so that's what led me on my own healing journey around the world, looking for answers. And as a result of that, that's when I naturally restored my menstrual cycle and became pregnant at 41 years old, naturally with the child I was told I would never be able to have. So it made me start looking and thinking, well, okay, so you know, there's a lot more to this. How do we empower our bodies to heal itself? And what, besides stress being a huge hormone disruptor, what were other things? I mean, I struggled with obesity. I was well over £240 at one point. I definitely had dairy sensitivity and mold toxicity issues. Things like, I never, never studied any of that stuff. So I started teasing away, teasing it apart layer by layer, right. Like peeling an onion. And then I started helping my patients with the same thing. What's the cause of your breast cancer? You talked about, you know, the, the animal, livestock, and how these toxins can affect their fertility. It also increases their tumors, right. And their cancers and, you know, affects their thyroids and it doesn't in women and men too. And it affects their fertility and their desire and their mindset and their peace. Right, Those, their moods and. And so he started working with clients and empower, improving detoxification and testing for toxins. Like, what about heavy metals, what about mold toxins? What about endocrine disruptors in the environment like the parabens, the phthalates, and I don't know, the list is long. So what do we do to clear those to get your body to do what it's supposed to do. And then one of the biggest areas that I found very interesting was des diethylstilvestrone and how that was used between 1948 to 1971. And it was actually advertised in newspapers. All pregnant women, if you want to have a healthy baby, you should take this because it will decrease your risk of miscarriage and preterm birth. And it is it. Then, you know, there were eight year old girls showing up with vaginal cancers and then and boys with undescended testes. And, and I knew that my mom had received that in her pregnancy with my older brother because she'd had two miscarriages and he'd had undescended testes. So it's starting to piece these things together. And the French did three third generation studies that looked at not just in the children of moms who were exposed to ds, but Their children had increased infertility issues, had hormonal imbalance issues, had, you know, reproductive genital tract, like abnormally formed uteruses, as well as gender identity confusion is how the French term it, through the third generation. So studies are continuing to go. So it's not, it's so critical to remove these endocrine disruptors from our system and especially when we're working with women, because we are more susceptible. Guys, you've got 10 times as much testosterone, a lot more hormone. That's protective. Women were more vulnerable to these hormone disruptors.

Wow. I actually almost had one of my accounts banned because I said, guys, as the author of a book on fertility, which I wrote like 10 years ago, because similar situations with my wife is that, you know, infertility and like, what are we going to do about it? So that was what made the book. And I just said, look, I think it's unethical to inject anything into a pregnant woman until you have exceptionally large multigenerational safety studies. Because there's so much that happens in that first trimester and the second trimester that we just don't have any knowledge of that you should just practice the highest level of care for that. So someone went on Twitter and got a Twitter mob to go to another one of my platforms and then complain on that platform, because that's considered bullying if you try to organize a mob on a platform, but if you organize it on one platform to go to another. And I'm like, that's so weird, right? Because I feel like that's genuinely heartfelt and scientifically valid advice. Do you agree that we ought to have a higher standard of care for pregnant women? Not a lower standard of care? You agree that we ought to have a higher standard of care for pregnant women, not a lower standard of care?

You know, I was at Da Vinci 50 in Boston and one of the speakers from Harvard was talking about research and I asked him, I said, well, first I said, longevity starts in the womb. Why aren't we doing three gen, third generation, at least animal studies before a drug is brought to the market? And he said, really, we should. Well, that's as far as it went, but the FDA should have at least three third gen animal studies. That doesn't take a lot of time. And I feel very compelled because I have four daughters. So I, you know, I'm very careful. And moms, like, we're careful. If we eat sushi during pregnancy, how many cans of tuna can we eat, right? So we have to be really careful with what we're putting in our body. And we want it to be clean and amazing and that shouldn't stop once we're done pregnancy. But we're especially conscious of that and the things that we're not aware of or we think it's safe because it's in the market. But like the chemicals in our cosmetics, the chemicals in our body care products, those are the. Many of them are known endocrine disruptors. I always tell women we worry about the lines around our face and eyes and lips. We got to worry about what's happening in our. And I always say the most important anatomy of our body and that's clitoris to anus. Because when there's problems there, it affects our quality of our lives for sure.

So what happens if you put endocrine disruptors right on your.

We just save you here. The pelvic floor is so vascular and it, you know, tremendous amount of nerve supply, blood supply, and it just goes right into your system. So what we see with. With like, we know now we want to use organic tampons. We want to use a cervical cup if possible, or we don't want to bleach and use chemicals on our underwear, you know, or anything that's going into or onto our vaginal areas, the vulva, vulvar area or vaginal area. You want to keep that clean because it's so vascular and it gets absorbed and that adds to dryness. It adds to decreased glandular production. It can cause clogged pores. Pores are cyst formations like the Bartholin gland cyst or decrease in your body's ability to secrete its own natural moisture and again, rapidly aging. And that's very uncomfortable as well as changes the ph so that you're more susceptible to infections.

Okay. So you basically don't want to put it there. Okay. We're going to get into like estrogen and hormone balancing and perimenopause and nutrition in a minute. But I've got like a triple board certified OB GYN here. Okay. Best kind of lube that's not going to mess with hormones in the manner of the woman.

Oh, my gosh. Well, I like to go straight to nature, so I like to mix some fractionated MCT oil or coconut oil and aloe vera gel, like a beautiful organic aloe vera gel. Add a drop of essential oil just to add a beautiful essence and mix that up for me. That's the best lube you've got out there. And then I would use Jalva too, if I needed To Got it.

Okay, so aloe vera and what about those silicon like the ones that are not water based. Is silicon bad for your. By the way, I'm dying here because the Upgrade collective is like listing all of the slang terms for vagina during this episode and I'm like laughing my butt off. So thank you guys for keeping me amused. So I'm just going to pick one of these things. Hoo hay. So what happens if you put silicon on your hoo ha.

Well, I mean it should not, you know, again, silicon is. Should not be easily absorbed into your system, but it still can be disrupt.

Microbiome or anything, but at least not your hormones are going to be okay with that stuff.

Your hormones will be okay, but it will affect your PH in the vaginal bacteria. So we know that for me, and especially in creating Java, I wanted something that's smell, smells good, tastes good and was clean. Is not going to disrupt your. Your vaginal microbiome.

Smells good, tastes good. Okay, now another question. We're just getting super personal. I love having a live audience with us because this comes from live audience. Okay, if you wanted to shave your vaginal region, what is the best shaving cream to use to not disrupt your hormones?

Oh my gosh. You know, I would just say a good clean soap and water. Don't use a shaving cream.

All right, let's get into eating some greens. By the way, thanks for answering all the questions that probably lots of people have wanted to hear a real qualified medical opinion about that. I certainly didn't think I was going to ask when I decided to do an interview. But hey, I appreciate you going there. Now let's talk about estrogen because we just talked about how these plant based estrogens are actually really bad for you, at least fungus based ones. And there are a lot of people who are afraid of taking estrogen because of horse urine derived estrogen that's not the same as human estrogen. From like if the 70s had a problem and they kind of think that that's what current estrogen is. So what is the Just kind of give me what's the deal with estrogen in women as they age? Good, bad. How do you know when you need more, when you need less?

Yeah. So estrogen always, I think has gotten the bad rap over the years, right? It has gotten the bad rap because we formulated back in 1950s synthetic, well, a combination of pregnant mare urine. Right. That's the Premarin formula that first came to market. And so it was this, it was a combination of, you know, like, I don't know, Maybe there's like 100 different types of estrogen that's in that formula. And we women were given it unopposed, unopposed with any progesterone. And so what happened was women were showing up with estrogen related cancers, specifically uterine cancer. So then they said, okay, well we need to give you a progesterone. Well, progesterone is bioidentical. Let's make a progestin, something that looks like progesterone but not really, but it'll thin out the endometrium and oppose estrogen so you don't get uterine cancer. So that was the Provera part of Prempro, that was the number one sold drug in for hormone replacement for many decades. And, and then they said okay, well let's, let's really talk about estrogen. You know, let's talk about this drug. Wyeth Arist was the manufacturer. And actually I had worked with Wyeth Arist in their drug metabolism department as a young 20 something year old. Again before med school I was doing research and then computerized their drug metabolism department with them. So it was very interesting to kind of get the insight on some of the research also. And so why there said okay, well let's look at it for prevention of heart disease. So they started the HERS trial and the HERS trial was very interesting. Look at it looked at using estrogen and progestin, so this combination. And it actually they were surprised by their results because I think some of their original data was ignored, but they were surprised by the results because it was actually increasing coronary vascular events, so heart attacks and strokes. And so then they said, okay, well it's not going to be preventive for heart disease, but maybe it'll prevent osteoporosis, maybe it'll prevent Alzheimer's and dementia. So then the Women's Health Initiative study came out in early 2000 and there they looked at Prempro again and they also looked at estrogen only. And they showed very quickly. 2002 warnings came out to all of us in OB GYN, first page front page news and said hormone replacement is bad. It increases your risk of breast cancer and this is dangerous. Well I went to the original research and I started looking and there were so many flaws with the study. And I don't know if you've talked about this, but it's really profound. And cause first of all, if we look at the science, I mean we look at oral estrogen, oral estrogens increase your inflammatory markers, increases all your inflammatory markers. Most specifically, we look at hscrp. So we know that increases that important marker and it increases your risk of strokes because it's increasing inflammation, increasing your risk of blood clotting. So oral estrogens really over 50, definitely over 55 or if there's any signs of heart disease and diabetes are not a good idea because we know that increases inflammation. We want to do everything to decrease inflammation. And then we teased out the estrogen only arm and now, you know, revisiting the studies, the estrogen only arm never showed any increased risk of breast cancer. So even with that, but the progestin arm did. So progestins are different than progesterone. Big thing. And sadly in the literature, even reading an article that was published recently looking at hormones and breast cancer, they still use the word progesterone when they're talking about progestins. Two they look, they're different molecules, they don't look the same. And progestins have negative cardiovascular effects as well. Increases swelling, water retention, increases blood pressure, increases your adverse lipid profile. So it, it affects your cholesterol. And so so these and increases your risk of breast cancer. So those progestins do, but bioidentical progesterone does not. There was a huge study done in France by Dr. Fournier and when I say it was 2010, 2008 and that initial 50,000 person study showed, looked at the different types of progesterone versus progestins, there are three different types of progestins. So it showed that the progesterone had no increased risk of breast cancer, but the progestins did significantly three to four times as much. So that was profound. I mean that was really profound. But despite that research, we didn't go back and look at using bioidentical progesterone because the patent, there was a patent for prometrium with peanut oil and that pattern was running out. And biogenical progesterone can be compounded. In fact, you know, it's used in cosmetics over the counter. My balance cream, I use progesterone and pregnenolone over the counter without prescription. And so and transdermally hormones are safer than if we use them orally. So I think this whole concept of, you know, being anti estrogen is really misogynistic conversation. So I believe estrogen is good. It is what makes women women. It helps support TH1 immunity, it helps support your collagen production, it helps with fascia. So like as we get older and we start to lose estrogen and progestin. We feel stiffer, we have more pains and less flexibility. That's, that's one thing. And estrogen starts to decline really. And you know, like our peak hormones are in our 20s for both men and women. And for men and women, we start to lose DHEA in our 20s. And then for women in our mid-30s, we really start to see that steeper decline of progesterone, our body's natural production of progesterone. But it's even a faster rapid decline when we're under periods of stress, chronic everyday stress and post traumatic stress. So we see a more rapid decline in progesterone, which is so interesting because it's really taken me on this whole, you know, fascinating journey looking at progesterone as, I mean it's a neuroendocrine hormone, it's brain protective, it's a neuropeptide too. And it's anti aging and it helps with fascia and helps with, you know, hormone health and sexual health. And it's something that women should be able to have access to. And unfortunately, many physicians still think if you don't have a uterus, you don't need bioidentical progesterone, you don't need progesterone because you're not going to get uterine cancer. And that was the only reason the progestins came to existence initially. But with or without a uterus, bioidentical progesterone is game changing for my clients.

You know, there was a guy on the show and you guys are going to have to excuse me. It's been almost a thousand episodes and I'm out of aniracetam, which increases memory IO right now. So I'm not recalling his name, name off the top of my mind. He was in his late 70s or 80 and it spent his entire career recommending progesterone cream, bioidentical progesterone cream to people for almost anything like, oh, you have a migraine, progesterone cream, sore neck, progesterone cream and men and women, it was just finding profound effects because of something it was doing with cell biology and mitochondrial something and it was fascinating. And I've definitely tried some progesterone. Like if you have weird muscle tension, it does something. But it seems like you might probably be throwing some stuff out of balance if you over treat with progesterone topically. Right?

Yeah, yeah, you definitely can have too much progesterone. You can if you're on too much, just like with anything, too much methylated folate, right. You can hit over, you can get over the curve, and you can have more mood issues. You can have, you know, I think that's really one of the big ones is moodiness. You can have weight gain, and that's two of the main reasons. Water retention with too much progesterone is another one. So a little bit goes a long way. And you never want to suppress your body's own ability to produce its own hormones naturally. So everyday, continuous progesterone also is not a good idea. And I still see many clients on that. You've got to cycle on, cycle off, or at least take a break on a weekly, like one or two days a week or three to five days a month off your progesterone.

So women in their 30s, you're saying, should maybe consider taking progesterone because that's when it starts to decline and. No. Did I get that wrong?

Yeah. Well, I mean, the first thing you want to do if you're in your 30s, 40s, and you're feeling that decline, you want to empower your body to make its own progesterone naturally and keep as much circulating. So things that drop your progesterone is stress cortisol. Cortisol is a biggie. So supporting. And as our ovarian function starts to decline, our adrenals take over, right? Our adrenals are going to take over. So supporting our adrenal glands with adaptogens, that's number one, detoxifying. So our body, you know, uses our natural hormones even more efficiently, even better. Right? And then if we need to cycle with some progesterone, we can definitely do it. But I would use like. That's why one of the reasons I created my product, mighty baka plus 30, it's because that adaptogenic blend really helps your body naturally produce more DHEA and progesterone and detoxifies at the same time. So that's key. But then above that, the. Everything you do in like 40 years of Zen, how critical that is, because you're decreasing cortisol stress reduction. That is huge. Because if we're making cortisol, we're taking what we need to make progesterone away. So we call that the cortisol steel, you know, and so. Or progesterone steel. And so we're losing that natural hormone from our body and it creates infertility, it creates worse PMS symptoms. So to give you an example, a 36 year old client who I'd seen in my medical practice, Cindy. And she was a mom of four and ran all the books for her husband's business. And did you know she was the organizer on target, really, running the family home, office, etc. And she came to me and she goes, you know, I just don't feel like myself. I'm pissed off. I hate my husband two weeks of the month. And I always say, if you only hate your husband two weeks of the month, it's most likely your hormones. Not necessarily completely your husband's fault. And then, you know, but moody, anxious. She feels like I lost my edge. I'm so disorganized. My house is a mess. And, you know, sometimes I. I miss picking up one of the kids on carpool. Like, what's happening to me? Am I getting early Alzheimer's? I'm like, okay, relax. And so that's where really created the, like, what I now call a keto green detox, but a modified elimination diet, detoxification, support liver function, support gut health. And I run labs and tell her to follow this regimen and come back for your lab results. And she comes back in just a few weeks later, and she's like, Dr. Anna, I feel better than I have in years. And she goes, I have no more pms. I didn't even know when my last period was coming. I'm initiating sex. That's a real biggie. And also she goes, my daughter Sophia climbed into my lap and said, mama, you're smiling again. And that's without adding progesterone. So I would have made a mistake if, number one, I put her on Prozac or if I prescribed her birth control pills, which is very commonly done to manage those symptoms that Zendi presented with. And so that. And I would have impaired her own body's ability to make her own hormones. So several years later, yes, I added progesterone, but I didn't need to at that time. And so my order of hierarchy is that it's to support your natural production of hormones, Detoxification, bringing joy into your life, doing everything you can to decrease cortisol and increase oxytocin. And then on a hierarchy, I would supplement with probably DHEA and progesterone and then testosterone and estrogen.

I love that concise and complete answer. And if you're listening, going, oh, blah, blah, I just heard a bunch of gins and orons. It's not the same for everyone. Just like fasting isn't the same for everyone. And even with menopause, your book like, here's five different diets. You got to try each one in order to figure out which of these things is messing with you. And that perspective of maybe you should detox first so your natural stuff can work. And then let's give you some precursors and reduce your stress by bringing in joy and all that kind of stuff. That's real medicine. And then, oh, it's not working. Then let's start with some low dose hormones and things like that. And I'm looking at the comments from people in Upgrade Collective and there's a lot of women doing hormone replacement who are exceptionally happy. Like, you know, I got my, got my sex drive back. One of them is a self described cougar. Congratulations. And just people at all different ages are saying, you know, know, okay, yeah, this stuff is really important. But it sounds like you really have to go get your labs done and work with a functional medicine doctor to hit that level. But it's pretty pricey. So the affordable way to start this would be do the stuff that's in Menupause. Or you know, frankly, you could try Carnivore, go on the bulletproof diet, don't do Carnivore or full keto for a long period of time. It'll trash you. But I mean, you can try something for two weeks or four weeks or something and be like, oh my God, I feel so much better. Well, there you go, you stopped doing whatever was messing with you. But there's structured approaches to that. And that's what's in menopause is like, let's just try pausing this and see if it's actually toxic and you don't know it. So I like that. And then you go to the next level of precursors. But you've mentioned dhea, which is one of two primary precursors, but pregnenolone is the other one. Why does pregnenolone get no love?

I do not know. I love pregnenolone. I put pregnenolone with progesterone in my balance cream for that reason.

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You're listening to the human upgrade with Dave Asprey. Why does pregnenolone get no love?

I do not know. I love pregnenolone. I put pregnenolone with progesterone in my balance cream for that reason. Pregnenolone is a beautiful, a beautiful hormone. I mean, it is the, like mother hormone, right? Progesterone comes from it. We, you know, downstream. All our reproductive hormones come from it. So that's, that's just a beautiful hormone. I don't know. So just because we haven't found a synthetic equivalent to ring to pharma, it's.

Not famous because big pharma hasn't trashed it yet. Give them time. All right. There. I'm sure they're listening right now.

I do want to touch on the power of ketosis in this hormonal transition. Because like what you said, I mean, the quickest way that I can get people feeling better, I always say it's, you know, I love the reproductive hormones. I'm a hormone specialist. I likely will put you on hormones at some time. And, but first and foremost, like the most powerful hormones in our body are insulin and cortisol. Right? They are. I was like to consider the hormone our body circuit, hundreds of hormones circulating. Like if you were to compare it to a university setting, they're all our students. Each hormone has its own role, right? Its own purpose, its own mission. Like a student does in university. And then your university professors would be insulin and cortisol. And they are game changers when they are on, when they're working appropriately, you know, there's order in the student body. But when they're not showing up to class and they're drunk at the head of the class and they're off the wall, what? Right, left. You know, there's chaos. And then the dean of the university would be oxytocin, the most powerful hormone of our body. And in that hierarchy, oxytocin, insulin, cortisol, are reproductive hormones we have to think about in that way. So to get well quickly, we work on oxytocin as much as possible, the most alkalinizing hormone in our body. We reduce cortisol, the most catabolic and acidifying hormone in our body, and we create insulin sensitivity. And that is where ketosis is really critically important, because as we get into ketosis, we become more insulin sensitive. And what I didn't understand until I went through my own brain fog and then discovered what I call my keto green way is when. And the brain fog listed lifted, I had already dialed in my hormones, right? Progesterone, estrogen, dha, testosterone, dial in.

You still had brain fog after that.

I still had brain fog.

This is really important for listeners. Yes, you can fix your hormones and stuff. Still have a foggy brain. All right, what did you do about it?

So that getting into ketosis and adding in the alkalinizing factor, it was like the fog lifted. I had my memory back, my visual memory back, my auditory memory back. I mean, it was profound. And plus, I experienced what they say in the Bible, the peace that surpasses all understanding. Like nothing in my external environment changed, but I was at peace. And there was that contentment, there was that order, right? And as a result of being a, you know, a crazy busy single mom burnout from her medical practice and feeling that peace, that was amazing. My kids then were at peace too, without doing anything different to in our again, in our environment or the way I parented, they were better humans too. And I think that's really important. Then looking at the research, recognize that as our hormones are shifting the brain's ability to use glucose for fuel, so muscle needs to use glucose, our brain needs to use glucose, but that ability is estrogen dependent. Gluconeogenesis in the brain is estrogen dependent. So as our body's hormone levels are declining, that ability is also declining. It's like our brain is starving for fuel. But shifting to ketones is not hormone dependent. And that lights up our brain. And that's the gift of getting into ketosis. That is the gift of cutting out carbs in a healthy way. And of course, cycling back in carbs periodically too. So that. That is the gift. And that's why I say it's not just a good idea in perimenopause and menopause. To get keto green, but I consider it mandatory. And you get there not just from healthy fats. Right. In my plans, it's, you know, intermittent fasting, no snacking. We have to stop that stuff so that we can empower insulin.

Fasting is useful and snacking is garbage. So with the kit that for menupause, your book, you have your girlfriend, doctor, which is your URL, keto pH, urine test strips. So these are cool because you can pee on them and then they tell you like, are you in ketosis? You wanted to turn lightly pink if you're a regular keto. But talk to me about how you use the ph with urine. When should you collect urine? What should the PH look like? And what does it matter?

Yeah, so it, it matters a lot really. Research has shown that the more alkaline your urine PH is, greater than seven, you will be less likely to have metabolic syndrome type diseases like diabetes, hypertension, heart disease, as well as inflammatory diseases like cancer and bone loss. And also it's very interesting because we know about uric acid. High levels of uric acid is associated with an acidic ph. The higher your urine alkalinity ph, the more you're clearing uric acid. So that's another key thing. Yeah. And you can use your saliva on the, for the ph pad.

So, okay, so, so ph, where do I want my ph? Because you just hold the strip up to the thing and it tells you the, the color here and yeah, you.

Want it green and you, so you want it seven or greater. So seven being neutral, the lower the number, the more acidic and the higher the number, the more alkaline.

My saliva is 7.5. What does that mean?

Awesome. That's great.

Oh my God.

Means you're good. You don't, you don't have to have your kill today.

Will my saliva match my pee?

It can. It really depends on what you drank recently. Doesn't necessarily. The urine is susceptible to what's happening also in your kidneys, right?

Yeah.

So again, cortisol increases hydrogen ion secretion across the renal tubules. So that's going to decrease your urine ph, make it more acidic. So this is where I discovered this. And I remember being blown away by this because it was trying to understand these high fat diets like the Inuits and in Alaska, the high fat diets, but yet they didn't have bone loss, they didn't have cardiovascular disease. What was going on? And so what were, what were they getting as far as an alkalinizer? And then I realized that they would do they do fishbone broth, right? Bone broth is rich in minerals. Those are your alkalinizers. So that would balance that ketogenic effect of the high fats that create that acidity long term. So the bone broth is really beneficial. That was mind blowing for me. But I first recognized when I went strict keto when I was very cranky, irritable. I felt like I hit a wall. I just didn't feel good on it. And that's when I went back to checking my urine pH. And it was as acidic as the pH paper read, so likely I was peeing out straight acid at that point. And that's where I started adding the greens, the alkalinizers, the beet greens, the herbs, the spices. I mean, herbs and spices are very alkalinizing. So adding those in with keeping carbohydrates low for me below 40 grams of total carbohydrates was critical to staying ketosis. And then I realized that those days that I did gratitude journaling in the morning or, or I went for a walk on the beach, I was more alkaline each day. And that's where I learned the renal physiology of cortisol. And so that was. I mean, that's mind blowing. So not only does your urine PH tell you about your nutritional status, you can be eating amazingly good, but have stress or PTSD and be acidic. So you have to again, increase oxytocin.

So stress makes you acid, even if it's from PTSD and you don't know about it. A lot of people with PTSD have no clue. I didn't know when I had PTSD at all. I'm like, I'm just always like this. I don't have any trauma. There's nothing to be traumatized about. It's. Oh, it's.

Three hours of sleep a night is fine.

Who's that?

Who's that?

It should be fine if we could just figure out a hack sleep. But in the meantime, six and a half is the best I've. I've been able to do and still feel great. Um, okay, what about just taking some potassium bicarbonate and sodium bicarbonate, I. E. Baking soda. Because there's a couple studies I talked about in Superhuman that say that just baking soda, think of something like 20 grams a day. It was a meaningful amount, had a lifespan extending. I think it was about 15% from memory effect. So, I mean, you just have some baking soda and be alkaline and be done with it. You've got a bicarbonate Buffer in your system. So who the heck cares all this stupid kale?

You know, it's. You know, that's a really good point. And it's a balance of things. No, you don't want to do in general. Like with menopause, you don't want to do the same thing all the time. You got to change things up. And again, empower your body to stay in balance. So with the concept of when you're drinking something alkaline. Alkaline water, Mineral water, right? The minerals are key. That. That's why now the keto world, they talk about mineral salts, right? Because we want to give those minerals back to your body. But what's really important is when timing that when we eat, we need the acid in our stomach to digest our food. That is not the time to drink a tall glass of water or anything. We're diluting our digestive enzymes. Do not drink with our meals, right? No more than 4 to 6 ounces of a good glass of wine or, or just, you know, just something. So the. We don't want to dilute our digestive enzymes. So that is not the time to drink water or any alkalinizer. But in between our meals, once our body theoretically has digested our food, that's when you do want to hydrate. And that's great to have mineral water. I do a scoop of Mighty Maca mid afternoon. Typically I actually have it here to drink. My energy starts to drop. So got to drink some Mighty Maca plus there.

You made me drink some of your Mighty Maca plus because you sent it to me. And guys, I read the ingredient list and right there on the ingredient list there was kale. And right away it activated my PTSD around kale. And I was like, man, I told Anna that I was going to drink Mighty Maca, but then it had kale. And so I was going back and forth and I took a deep breath and I did a lot of eft tapping. And then I spun around a few times and actually had some tequila so I could make sure that I would be safe from the kale. And then I took it and I got drunk from Mighty Maca. Does it have alcohol in it?

And it has, right? You're so funny. It is so good for you. Didn't it give you clean energy? I mean, it gave you clean energy.

I did notice the difference from it. I'm totally teasing about the kale. I'm still going to get you to take kale and spinach out of your. Like people should actually do that. To their kidneys list.

But that's a good way to take it in. It's good.

It's a trace amount, so it doesn't matter. And there are studies that show if you have small amounts of those things, that you get some gut bacteria that are better at digesting them. So I actually don't really care if most people have, you know, a gram of it, which is probably all that's in there, or less, but it's about 30 different herbs in it. And yeah, I. I drank all the stuff that you gave me, and I think it did make a difference.

Yeah. Thank you. Well, what we've seen in clinical research with it, we've seen an improvement in DHEAs in the blood by 70 to 200% in two to three months. That's huge. I've done every adrenal protocol known to man. And my DHEAS was in the teens and 30s for a long time until I started doing this on a regular basis. And. And so that was what I noticed. My DHEAS went into the two hundreds, so really amazing. And now it runs. I'm 56. And now it runs this month, next week, actually, so I'm 56. Thank you. And my DHEA runs in the 150s. And so that's like a good. I like to try to keep it up around 200 for women, 150 to 250 is great to have your DHEAS level and so get empowering your body to make enough. DHEAS is really powerful. So I think it's the combination of ingredients because it's maca, which is adaptogenic turmeric, kercetin, resveratrol, cat's claw, herb, all of these that also work on your inflammatory pathways and are also genetic adaptogens. So this can help support your body in. Especially in times of stress and great hormonal fluctuation, which perimenopause and menopause is okay.

In menupause, you have five different diets for people to try. And this is if I just really simplify it. You can do elimination diets. I did elimination diets for two years straight in my 20s to try and figure out what's messing with me. And there's these really old protocols. You can only eat one food every four days, and it's like pages of notes. It's not necessary. And then you go to one end of the extreme or like, I don't know, try the bulletproof thing. Don't eat any of the stuff that's likely to cause a problem for two weeks and see what happens and then kind of randomly add the stuff back in and see when you feel like crap after me. Oh, that ought to be a good sign, right? A more structured approach is what you have in Menupause. We're saying, okay, here's five different diets that allow you to cut out the likely culprits so you have more variety while you're doing those five things than you would if you're doing what I'm saying, which is like two weeks. Just kind of have some coffee and some butter and live with it. There's a bunch of other stuff you can have, you know what I'm saying? So walk me through the five buckets. Like what are the things that you, what are the things that you, you consider matter?

Yeah, yeah. So it was, this came from in my first book was the Hormone Fix and Then keto green 16 and then clients have been doing this, this Keto Green plan now since 2015 online with me. And there were certain things I would have to pause when they hit a plateau or if I wasn't getting the results that I was expecting. And so the first one, I call it my Keto Green Extreme plan. And I pause like, you know, it's really autoimmune paleo compliant. So I paused the nightshades. So your eggplants and your tomatoes and your peppers and, and that's the first one. And that's really good. Especially if you have an autoimmune disease, if you have Ms. Or Hashimoto's, that's a great place to start. And in general the order that I put the plans in are great place just you know, great way to go through it. And each of the plans are only six days because two 72 hour cycles. So in three days are gut mucosal lining regenerates. So that gives you a good, in a short time a good kind of cleansing or, or experience without that food sensitivity likely that's in there. All the plans are dairy free, grain free and so, so that's key or dairy free, gluten free for sure. And the second plan is plant based, it's a keto green plant based detox because number one there are a lot of plant based eaters out there that are eating way too many carbs and it really affects their hormones. So.

But more plant based. Why plant based?

Well, because there sometimes it's really good to just pause eating all meat and support gut microbiome. The gut microbial diversity is associated with more plant diversity and that creates Resilience plus constipation is a really big issue as we get older and for so many Americans. So plant based high fiber week is game changing for that. Really, really supportive. And it's all low carbohydrate too, so getting enough protein and, and fat as a vegetarian is also a challenge.

Well, just getting, getting building blocks without toxins as a vegan is the problem. Yes, go eat a more toxic diet to detox. Like you're, you're just saying because you're concerned meat, all meat or just like industrial meat is going to disrupt the microbiome.

No, I mean industrial meat. But this is for six days. This is for a change.

And it's a long time without a grass fed ribeye.

I agree with you. I agree with you. Maybe you can do three days. Okay, we'll start for the weaker of the species. We'll let you do it for three days.

Oh, as long as I don't have to wax anything, I think I can own that.

There you go.

So, but reality, six days isn't that big of a deal any. And if people feel really good afterwards, what keeps them from falling into the vegan trap? That caught me for almost two years, like, oh, I went vegan for a week, I felt good. So now I was vegan for two weeks. So now I'm raw vegan, I'm even more vegan. And eventually like you punch yourself in the face hundreds of times thinking it was good for you as you're getting autoimmunity and you're losing bone density and you've got phytic acid and oxalates and all that stuff. So at the end of a six day pause, what do you do?

Well, you can, the seventh day, you can feast or fast. I mean, that really gives you that flexibility. And that's what's really beautiful about the plans too. But also recognizing there are seasons for a reason, we won't do the same bicep curl every day, right? We have to change things up. And it's really important for our gut microbiome. So since the realization that it's not just about our genes, about the gut microbiome, we really are paying a lot more attention in science on what makes a strong, resilient, healthy gut microbiome to support our immune system and our hormones. Right. We have the estrobolone for estrogen detoxification, we don't have a healthy gut, we become very estrogen dominant and toxic with unhealthy estrogens. So that's where, that's where the rub is, so you really want to make sure, you know, you have great healthy bowel movements every day. And that leads us into the third plan, which is the other extreme completely. It's a carnivore plan. So completely pause carbohydrates in general. And it's all meat based, nose to tail to show people the right way. If you're doing carnivore, there's the right way to do it. We ate glands like my mom, you know, again, I'm first generation American. My mom cooked liver, she cooked chicken hearts. We had a wide range of, you know, organ meats, etcetera, as part of our diet. But then like, I didn't, I didn't cook that for a long time, you know, it just wasn't part of my American way. But now I'm like, okay, making an effort at least on a monthly basis that we've got something that's, there's some organ meat in there somewhere.

Here's, here was the question from the Upgrade Collective. Do you need a prescription for progesterone cream?

So it is ideal to work with a physician when you are doing any hormone replacement, including progesterone and pregnenolone. There are progesterone creams over the counter that are low dose and part of a cosmetic formula. For instance, my balance cream is one of them that's available without prescription and it does use usp, you know, micronized progesterone and pregnenolone in that formula along with some tripeptide and essential oils. So that was really important for me to give access to people that didn't have physicians that could prescribe their, their hormones. And especially because when I closed my practice, my patients were like, Dr. Anna, no one will write your creams, your, you know, vaginal creams, your hormone creams. And they just didn't feel comfortable. And so it was important to be able to give good, clean, safe options to people. And again, you know, don't use anything without cleaning up your system to begin with.

So, so you can get it. And you've got a product with topical progesterone on your website and is, is it thegirlfriend doctor.com or is it Anna? What's the right one?

So the girlfriend, doctor.com, but Dr. Anna.com d r a n n a dot com.

Okay, got it. SO-R-A-N n a dot com is where you can get that. And if you wanted a higher dose than the FDA will allow on an over the counter, there's this weird thing you do use twice as much. Like why they get to regulate dose, I do not know. So anyway, you get to pick your dose just by using more or you using less. Okay, a couple more quick questions from the collective. Biggest one. Do you do telemedicine or telehealth? Is that something you're set up for or do they have to go to Dallas to see you?

I do physician to physician consults at this time because I only came to Dallas temporarily, so I'm not licensed in Texas yet, but I'm working on it.

Oh, I didn't know you weren't practicing. Okay, so you talk to their doctor. So what do they do? They reach out to you on your website and then get an appointment for their doctor and you and whatever.

Exactly.

Okay, good deal. Are you gonna get licensed in Texas?

It's in process. It's in process.

Process. Awesome. Well, thank you for sharing your knowledge, listening to my crazy theories, and thanks for walking us through the book. And the book is called Menu Pause. I really do agree with this idea of look, stop doing some stuff that's likely causing harm for five days and switch it out and see if you're noticing differences. You might see different things, things for each diet. You may have to add them all up together, but there's something good that'll happen if you give it a try. So thank you very much.

Thank you. Thanks everyone.

You're listening to the Human Upgrade with Dave Asprey.

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