What Is Leaky Gut? | Does Gut Health Affect My Hormones? | Frequently Asked Health Questions

Hi, it's Dr. Donny, and today I want to answer some of the questions that you have been submitting to me and take this chance to just dive in and really explain some of these frequently asked questions. We're going to cover everything from some hormone questions, questions about the digestion and about stress, and just helping you understand your body better and how to know what your body needs in order to be as healthy can be, even when you're exposed to various stresses, emotional and physical stresses. So let's get started. So first off, I wanted to start by answering the question about how digestion, what's happening in our digestion, could it be related to what we experience in terms of hormones? Recently, I've been covering a lot about how stress affects our hormones. And I'm so glad that some of you are making the connection that actually the digestion and the hormones can influence each other. Same thing actually, as how the digestion can influence the nervous system in what we call the gut brain axis, and how the digestion can also affect the immune system. Because actually a huge part of our immune system, I think it's 80% of our immune system, is located in our gut. So of course our digestion affects our immune system, it affects our nervous system, and also our gut health can affect our hormones. This is especially the case with, I always look for certain conditions where there's research where we've been able to demonstrate this, because then we can really see, oh, here's an example connection. Once we understand an example connection, then we can start to extrapolate and start to theorize and think about how it might affect other similar conditions. So when you think about it, our digestion is where we process our food and access our nutrients. So that's kind of the simplest way to look at the digestion. In fact, maybe let's talk through a bit like exactly what happens. So we put our food in our mouth. Even before you put your food in your mouth, you start thinking about food. And that actually tells our nervous system to go into parasympathetic mode, which is where we can digest. It starts to turn on the production of enzymes. So we make enzymes in our mouth as well as hydrochloric acid in our stomach. And our pancreas starts making enzymes. And of course the liver makes bile. It sits in the gallbladder waiting to get the message that it should secrete the bile into our intestines to digest our fats. So there's this whole concerted effort to help us digest our food, starting in the mouth so when you chew your food, you already starting to digest your food. So that's why it's important. That's why you'll hear a lot of times people emphasize chewing your food. In fact, sometimes it helps me to just set down my fork or spoon so, you know, between bites, like take a bite, put down your fork or spoon. So then you're chewing a little bit more, you're enjoying your food, you're being more mindful about your eating, and you're allowing your digestive enzymes to start working. And you're being more careful about swallowing, which also helps because now the food has to go down the esophagus, through the sphincter there between the esophagus and the stomach, and land in your stomach to do the next part of the digestion process. When people get reflux, it's that the food and the stomach acid are coming back up through that sphincter and that's irritating to the esophagus and all the way up. If that's the severity of the, what we call GERD or gastrointestinal reflux or gastroesophageal reflux, I should say G, E, R, D. And so when you think about that sphincter, you want to make sure it allows the food to get into your stomach, but you want to also signal to the sphincter to close to keep the food in your stomach instead of refluxing. And some of the things that signal for it to close is the protein in your meal. That's why I always encourage you to include some protein. It doesn't have to be a lot of protein. Even a little bit of protein will signal the sphincter to close so that your food stays in your stomach where it can get digested by the stomach acid. Stomach acid is important, but it can also be, for some people, too little stomach acid. More often we assume that people have too much stomach acid, but actually I think it's more often that we have too little stomach acid. And when you don't have enough stomach acid, the food doesn't get well digested. The stomach acid also tells the sphincter to close. So if you don't have enough stomach acid sometimes, then it will stay open and you end up with reflux of whatever acid is there, you see? So it's important to rethink that whole process. And we want to encourage right by knowing and understanding our physiology, then we can encourage our body to do what we, we know we want it to do, which is going to feel best to Us. So we want to eat our food. Chew carefully, swallow carefully, take deep breaths. Because when you take a deep breath, not only are you signaling your vagal nerve and the parasympathetic nervous system, but you're also encouraging your diaphragm to push your stomach down underneath of it. When people have a hiatal hernia, it's because the stomach is stuck in their diaphragm. So when you take a nice deep breath, you're encouraging your stomach to go under your diaphragm and the food to go through the sphincter, through the space where the esophagus goes, through the diaphragm and into the stomach where it can get digested. This is where also it starts to activate the hormones that help us absorb our nutrients, like B12. We want this process to work smoothly, help us digest our food. Then the food goes from the stomach to the small intestine. The small intestine is really where the, the final parts of digestion happen, that pancreatic enzymes, the biles, digesting the fats. And what happens is the digested nutrients, right? So all of our food gets digested down to essentially glucose, which comes from all the carbohydrates, amino acids, which comes from the protein fats, which get broken down to tiny, tiny little fat molecules, and then all of our water, nutrients, electrolytes. So all of this to get into our bodies right now, it's just inside of our intestines. To get into our bodies, it has to go through the cells that are lining the walls of the intestines to get through those cells to get into our bodies on the other side, right? To be able to get into our circulation. And so that's how we get our food digested and our nutrients through. But what I like to emphasize is that the final part of digestion is done by those cells lining the intestines. And if those cells are not as healthy as they should be, then the food isn't going to get fully digested. And this is where some of the digestive issues can develop.

This is another common question, by the way, is how does our digestion work? So that's why I've been describing that. And another common question is, what the heck is leaky gut? When I talk a lot about intestinal permeability or leaky gut, and every so often someone says, yes, I've heard of it, but what is it really? Because you're wondering, where is it leaking? What's leaking? Where? It's not diarrhea necessarily. Some people do have diarrhea. But when we're talking about intestinal permeability that we refer to as leaky gut, we're talking about the cells that are lining the intestinal wall of our intestines are like a tube. Then what makes up the tube are little cells all lined up next to each other. In fact, if you measure the extent of our intestines, it's as big as a tennis court. Amazing. We have a whole tennis court of surface area in our intestines, and it's lined with little cells. The job of those cells is to make sure that only digested nutrients get through, or that water and nutrients can get either through the cells or between the cells. But what happens is when we're under stress, whether that's emotional stress, physical stress, stress from toxins like pesticides, stress from foods that are damaging to the intestinal lining like gluten, any of these things can damage those cells lining the intestinal wall. Now, our body's constantly turning over and making new cells, just like on your skin, right? We just constantly are sloughing and making new skin cells. So the intestines are the same. They're constantly making new cells. I'm trying to give you like a cross sectional view with my hands.

So it's a process that's constantly happening. But when the stress is greater than our body's ability to continually make new cells, there can be these little microscopic openings and they can't see it on an endoscopy, even.

If it's severe. They could see it if they do a biopsy. In fact, that's how we are diagnosing celiac diseases, by seeing severe leaky gut with a biopsy. But really, the way we identify leaky gut is by, is by the things it causes. When we have microscopic openings in our intestinal wall, it allows food that's not fully digested to get through. Now the immune system, I mentioned all of this. 80% of our immune system, it's just outside of the walls of the intestines. It's there to protect us in case a bacteria or virus gets through that shouldn't be there, the immune system is going to protect you. But say some food that's not well digested because you're under stress and you're eating quickly, say that food gets through. Now the immune system is going to try to protect you from your food. Even if it's a healthy food, you could be going, oh, but almonds are good for me, and I'm having bananas as a fruit. But if you're not digesting it well, and you have microscopic holes in your intestines, then your immune system could even try to protect you from from foods that you're eating frequently. And that's why when you do a food sensitivity test, it often shows foods that you eat frequently. That tells me it's leaky. That's the definition of leaky gut. Food is leaking through and triggering an immune response. Now, another common question I get is what is a IgA versus IgG food antibody or food sensitivity?

What it is is that our immune system makes these different antibodies. The antibody that we more often with allergies, like a food allergy, is IgE with name letter E. And that's for when you have an immediate response to a food. So if you have itchy eyes, runny nose, mouth is feeling swollen or itchy immediately after eating something and you react to it, that's probably ige. Or some people will have even an anaphylactic reaction. That's IgE. And you can have that tested in regular blood work or from an allergist. When we're talking about food sensitivity, these are different antibodies. So the immune system could also make iga. We just name it with the letter A. Antibodies which are delayed over a few days or a week after you eat a food or igg can be even delayed over three weeks after you eat a food. These are food reactions that don't cause necessarily an immediate response. A lot of times people don't realize they're having these reactions and you might not even get digestive symptoms. Over 50% of people, their digestion feels fine, but actually the leaky gut is present and it's contributing to symptoms in other areas of the body. Bringing us back to what we were talking at the beginning, which is how the digestion could relate to hormone issues as well as nervous system, immune system, and everywhere else system in your body. So that's why I'm always thinking about intestinal permeability and leaky gut. And this is why I always suggest testing for food sensitivities. Because one, I want to know which foods are stressed to your system. Because essentially if your immune system is trying to protect you from that food, that means that food is a stress for your body at this point in time. But I also from a food sensitivity panel, want to see how severe is the leaky gut. I mean, that's the thing is we all live in a stressful world, so we all probably have some degree of leaky gut. It's really not a matter of do you have it or do you not have it? To me, it's a matter of is it mild, moderate or severe? And so that's what the testing is helping us to identify is, is your food sensitivity, is your leaky gut mild, moderate, severe, and which foods are your highest reactive foods so you know which foods to eliminate from your diet while you work on healing leaky gut? Because optimally, I'd love for you to be able to bring back as many foods as possible to your diet. The point is not to overstress you with a highly restricted diet. The point is, let's work on focusing on healing intestinal permeability or leaky gut, so that you can, in the long run be able to bring those foods back in. And in the meantime, you don't have to avoid every food. We just need to avoid the foods that are the major stresses and preventing you from recovering and feeling better. So there's a way to go about this without, you know, it's always a matter of how do we help our health, how do we bring our bodies back to balance? And sometimes it's tempting to do things that we think is going to help, but it actually could stress us more, right? So you want to always be thinking about if you do anything, if you're avoiding too many foods, that could be a stress. If you're doing too much exercise for your body at this point in time, that could be a stress. So things that you think are healthy could actually be too much or could be a stress to your system. So that's why I always want want you to be checking in with yourself and really thinking through a strategy of how to implement in such a way that you're moving forward and not getting stuck just by trying out new healthy things that aren't actually improving your health in the long run. And so those are some of the common conversations that I have also with patients when I work with people, one on one.

Now you understand leaky gut. The other factor in the digestion to understand is the bacteria, right? We have bacteria living throughout our digestion. Really, essentially, we have bacteria living everywhere in our body, on our skin, in every area that you can think of, even in the bladder, in the uterus and the ovaries, there's healthy bacteria. So we really realize that we need our goal as to how to maintain a healthy balance of bacteria. Again, there's that word, balance, right? It's a balance of bacteria. What are the healthiest bacteria to help your body out? Because now we know that the bacteria can help us help our immune system. They communicate with our nervous system. They communicate with our hormones. So this is another way that the gut is influencing hormones is through the bacteria. So we want to be always thinking about that. And it can be a matter of how to feed your healthy bacteria. So sometimes then it's tempting to eat a bunch of fermented foods or take a bunch of probiotics. But the question I always ask, is that really the best solution for you? Is it really that you need to add more bacteria, or is it possible that you actually have an overgrowth of bacteria? And we need to kind of, I say weed the garden. We need to weed out some of the overgrowing bacteria and just help out the good guys do their best job. And one of the ways that I do that, because here's another common question, is how, you know, first of all, do I take probiotics or do I take fermented foods? And the next question is always, how do I test for my bacteria in my gut? Because to me, when you can test the bacteria, then you have a much better idea of where you're starting from. And whenever we can get some objective measurement, then it can help us really strategize about what's going to be the best plan for you going forward. Where are we starting from? And then we can always retest and see where we can evaluate at a later point and see how effective we're being. To me, that's just so much I want. It helps, I think, too, when you, in your mind, you can see where you're starting from. Where's my point A? Where's my point B? And so then you can work toward it, and then you feel empowered about it versus so many people I talk to are kind of guessing, lots of guessing and feeling lost and feeling like you don't have enough information and feeling like you're not getting anywhere. It's so frustrating. It's frustrating for me, too. So I want. I don't want you to experience that. I want you to be like, okay, let's do a stool test now, when? Right now, the stool test that I'm liking. And there's several available, there's even some you can get online on your own that are measuring the gut bacteria and trying to tell you which food you should eat more of or less of. I find that it's limited value because ultimately this is because I've done thousands of stool analysis and thousands of looking at cases and figuring out how to shift gut bacteria. This is just something I've been doing for years. With patients. So whenever I'm doing something clinically, I'm always evaluating, figuring it out and going, what works best so that I can bring it back to everyone else and say, okay, here's what we're finding. The thing is that yes, you could do a test that's going to tell you, okay, you have a little too many of these bacteria and you have a little too few of these bacteria. So theoretically then, if you eat a little more of these foods and a little less of these foods, you're going to balance it out, right? It kind of makes sense. But the problem is that ultimately a lot of the same foods that overfeed certain bacteria or feed the ones that you want to feed more end up feeding the ones you want to feed less. And so it's very hard to separate it out. It's very hard because those same foods are things like.

All fruits and vegetables. Many of what we call the resistant starches, say like from potato, cooked potato or rice, you know, these starches are fiber. If you think about it as fiber that we get from fruits and vegetables, those are plant sources of fiber. Or even nuts and seeds also have fiber. That's what feeds our bacteria. Our bacteria feeds off of various kinds of fiber. So what I would do, I think is I would just say to yourself, is there some, especially if you're getting, say, gas and bloating, digestive distress or burping, you go, okay, is there something you're eating a lot of? Well, if you eat something a lot and every day, you're probably going to overfeed some bacteria, right? Because they're just going to get overfed. Like if there's some kale loving bacteria and you're eating kale every day, they might get overfed. So what I always encourage people to start with is even just creating variety in your diet. Don't eat the same thing and a lot of the same thing every day. Try to mix it up a bit, have different vegetables and different fruits. And yes, we know that fruits and vegetables are important because our fruits and vegetables contain important nutrients and antioxidants. But more is not necessarily better. Just like we talked about earlier, more exercise is not necessarily better. Well, more. Too many vegetables or fruits are not necessarily better. So especially if your digestion is telling you that it's overwhelmed. Right? So if we overfeed, even on healthy foods, you're going to be more likely to have reflux, bloating, burping, gas, bowel changes and other symptoms of leaky gut. So what you want to do is step back and go, okay, what am I eating too much of? Well, how can I create more variety in my diet and what are my food sensitivities? And then if you're going to do a stool test, I would do a clinical DNA analysis. This would be a test that's a DNA analysis of a single stool sample. What that means is instead of being a culture, a culture means the bacteria have to grow in the lab in order for us to identify them. But a DNA analysis is when we can identify the bacteria and other microbes in the gut based on their DNA. They don't even have to be alive. Still, it's a very sensitive test and a really effective way to see, hey, are there any pathogenic bacteria? How are your healthy bacteria like your Lactobacillus and bifidobacteria? Are there any opportunistic bacteria like bacteria that are okay if there's a little bit, but if they start to overgrow, they start to make toxins and cause leaky gut and be a problem. How about, is there candida? Are there protozoa or parasites? How well are you digesting your food? Is there inflammation? Is there blood? So we can see all of that in these clinical stool analysis panels. For example, there's one called GI MAP from Diagnostic Solutions.

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So this can give us a lot of information, especially when we're trying to solve gut health. Now, a stool test really reflects the large intestine. If you're having symptoms in the small intestine, like say up above here, under your rib cage and burping, we may need to do a breath test to Test for bacterial overgrowth, which doesn't identify the exact bacteria. It just identifies whether those bacteria are making methane or hydrogen gases. And then if they are, if you do have high amount of methane or hydrogen gases in the first 60 to 90 minutes after you. After you eat, then that tells us there's bacterial overgrowth in the small intestine or something called sibo, which we can address. And that's the thing is, whenever there's bacterial overgrowth or candida overgrowth, we can address it using herbs and plants. See, that's the thing. Another question is, how do I address it? And the thing is that I am so inspired by nature, and I think it's so amazing that in nature, these plants are creating their own antimicrobials, antibacterial, antifungal, antiviral substances to protect themselves as a plant. And when we take them as a human now, we can access those same antimicrobial actions from a plant. And there's actually many plants that are very safe and can be used with other therapies and very effective at addressing, for example, bacterial overgrowth or candida overgrowth or what have you. So we can use these herbal substances or plant substances to help us to address the overgrowing situation. And then we can use not just a standard probiotic, because a lot of people say to me, well, should I take a probiotic now? Probiotic is usually Lactobacillus ambifidobacteria, because those are the ones that have been standardized and a system for creating those bacteria. So it's very easy to access Lactobacillus and Bifidobacteria. But if you're not low in lactobifido and there's trillions of different bacteria, you want a diversity of bacteria in your gut. So just taking two strains is not necessarily going to fix the issue. It's just going to flood the environment with two types of. So we want to think bigger. We want to go, how do we help all the bacteria, right? Not just those two types. And so a lot of times when I test people, I find that they don't need any more lacto or bifido. And instead we use different kinds of bacteria types, including, for example, bacillus forms of bacteria, which are what I call traffic directors. The studies show they help us to manage the bacteria. So decrease the bacteria that are overgrowing or increase the bacteria that are undergrowing and really sort the population out. And that's a product. The product I like to use is called Megaspore There are others similar, but often I'm suggesting Megaspore because it works so well. Now, anytime we're working on managing gut bacteria, we want to go about it very carefully, because if we go too quick, even with leaky gut healing, if you go too quick or you go too big on your doses, or you add too many things at once, you could feel worse. So it's really important to recognize and pay attention to your body. So I always suggest going slowly. If you feel worse at all with any of this, you have to back off. Sometimes you have to stop, you have to rethink and go, what do I need to do differently? Give your body a break and start again slowly because it doesn't make sense. It's tempting to pounce on these situations and try to get it fixed fast, but it often backfires. So it's better to take it slow and just gradually start shifting the environment and gradually start getting the overgrowing guys to go and gradually supporting the guys who need support to grow, to improve. And now you can gradually shift the environment and then it's just a matter of maintaining it over time. Because what we know is that when there's intestinal permeability and when there's imbalance of the gut bacteria, that increases all different health issues from autoimmunity of any type in the body, so including Hashimoto's, which is a thyroid autoimmunity. So if there's imbalance in your gut health, you're more likely to develop autoimmunity, more likely to develop thyroid issues. It's also true for women with the menstrual cycle. If there's intestinal permeability and imbalanced gut bacteria, there's, we know, increased likelihood of irregular menstrual cycles or even pcos, which is polycystic ovarian syndrome. Polycystic ovarian syndrome is a really broad name for all kinds of different menstrual irregularities. But we know that the digestion and the gut bacteria are influencing ovary function. They also influence insulin function, which is from the pancreas, to help us with our blood sugar balance. So if you're having issues with blood sugar or high glucose or high cholesterol, it comes back to your digestion. We got to help your. Help the leaky gut, help the gut bacteria in order for your insulin to be stabilized and optimized itself. So all of these hormones can be and more, some that I didn't even mention, they're definitely influenced by, by your digestive health, which is why? To me, part of stress recovery has to be to solve your digestive health. And as we heal the digestion, then your body can already be doing some stress recovery on its own. Because we know stress causes leaky gut. We know stress disrupts our gut bacteria, and we know those imbalances cause all kinds of other health issues.

Let's see. So I also wanted to talk about the hormone testosterone now in upcoming podcast. I'm interviewing one of my colleagues who just recently wrote a book about testosterone and men's health. So I'm going to be talking about a lot more with him in an upcoming podcast. But what about testosterone for women? Because a lot of times for women, we talk about estrogen and progesterone. Well, we don't always talk about testosterone. And I want to just say, yes, women make testosterone, too. The ovaries make testosterone. And also there's some testosterone production that comes from the adrenal glands through the dhea. So when you look at these hormone pathways, essentially there's cholesterol, which here we are, we're usually thinking of cholesterol just for the blood vessels, but cholesterol, such as from fat in our diet, we get cholesterol. Cholesterol is made into these other sex hormones. So it goes into pregnenolone, something called pregnenolone. And then from there we can go into testosterone and progesterone and estrogen. So they're all actually interrelated with each other. And how does our body decide which pathway it's going to emphasize and what it's going to make? What we are learning from the ovaries is that when ovaries are kind of functioning healthy and we're optimized in terms of our stress and our cortisol and our digestion, then the ovaries are going to make a healthy amount of all these hormones. But when things are out of balance in our body and we're under a lot of stress of different types, and when the ovaries in particular have stress or oxidative stress, that's when things get out of balance. And sometimes women experience too much testosterone production, which is common with pcos. You get high testosterone, or what it is, is the testosterone also can. All of these hormones have to then get metabolized out of the body. And when testosterone gets metabolized.

By DHT to other androgens, then sometimes there's a backup in that step in the process. And that's where women will have more hirsutism or hair growth in areas that they don't usually have hair growth or hair loss, where they usually wouldn't want to have hair loss. So this we call hirsutism, and it's related to the testosterone levels and the testosterone metabolism. And so that's an important place where testosterone becomes a topic for women. And all of this we can measure. One of my favorite ways, or what I suggest, is to measure these hormones in urine. Because, yes, you can measure estrogen, progesterone, testosterone in blood, but the ranges that we get in a blood test is really wide and sometimes it doesn't get. It can be helpful, but maybe not as helpful as we need. Then we do a urine test like the precision analytical Dutch urine test can show us estrogen, all three types of estrogen. E1, E2, E3, estrogen detoxification. Because estrogen goes through the liver to get detoxified, and it helps us to see how well is your liver detoxifying estrogens. Do we need to support the detoxification of estrogen in your body? There's phase one, phase two, phase three of detoxification. We can start to get a sense of that from the urine hormone panel. We can also see progesterone levels. Say if you're a menstruating woman and you're having a lot of PMS or irregular cycles, then we measure progesterone in the urine at about day 20 of your cycle. Or say you have perimenopause and you're like, what is going on with my cycle? I don't know. I'm getting periods either too frequently or too far apart. And all this bleeding and all these hot flashes and what the heck is happening in my body? We can do this urine test so we can see better. Where is your progesterone? Is it too low? Do we need to. Can we encourage your ovaries to make more progesterone? What's happening with your estrogen? How is it detoxifying? And we can see testosterone and how it's detoxifying. This can be very helpful. Again, especially if you have irregular cycles and also if you are perimenopausal or. Or even postmenopausal. Because what happens postmenopausal is the ovaries really decrease their function of all these hormones. They still make a teeny, teeny bit, which is an important distinction, because if, say, you have a hysterectomy where the ovaries are completely removed, women notice more symptoms than if they have ovaries that are postmenopausal. Because the postmenopausal ovaries are still doing a little bit of functioning. They're still giving a little bit of hormone release. And so this is why, if women have their ovaries removed, sometimes we have even more symptoms to help them recover from that. But also why in postmenopausal women still do have the potential to make a little bit of testosterone also from the adrenal glands. And the adrenal glands, of course, are our stress responding hormones, is how we usually think about them. But the adrenals actually do other things too. The adrenals also manage our electrolyte balance on our blood pressure, and they also have this ability to make some testosterone. So women postmenopausally become more dependent on their adrenals to help them out with testosterone. And still sometimes a lot of women postmenopausally have symptoms of low estrogen, low progesterone and low testosterone. And that could show up as sometimes testosterone. I mean, it affects energy levels and mood, but it also affects libido. And so sometimes when women have decreasing libido, they often think of testosterone, which is correct. And sometimes by supporting testosterone, it can have an improvement in libido. But there's a lot of other things involved in even libido, including blood flow, because as we age, we also have decreased nitric oxide production. And nitric oxide is a substance that helps dilate our blood vessels. So if we want some dilation to get blood flow happening, especially related to sexual activity and libido, and if we don't have that nitric oxide production, we're going to notice a difference. And so that's another area that we can focus on when we're helping with libido and other menopausal symptoms is how can we support nitric oxide pathways, which there's always, as always for me, there's genetics related to that. There's other influences on that. And there's more I could say about how to support nitric oxide. I guess one thing is to know that nitric oxide has another metabolic pathway. It goes down and depending on your genetics, it could get stuck there. One of the first things I'll do whenever I think that someone might be having.

An effect on their nitric oxide is we'll use something called hydroxyl B12. It's a type of vitamin D, B12. Normally with B12 we're thinking about methyl B12, but in this situation we're thinking of hydroxyl B12, because hydroxyl B12 helps reset this metabolism in the nitric oxide pathway. And so we usually start with a low dose, like maybe a half a. It's a chewable or one a day, and see if you have an improvement in. Sometimes it's in mental clarity. Like if you have a lot of brain fog, the nitric oxide gets blood flow to your brain and your. All of a sudden you're like, oh, wow, I feel much clearer. And so we do the hydroxyl B12 trial first to see if it's just that there's a clog in that metabolic process. Then we can also, instead of using there's support for nitric oxide, like you can use arginine as a amino acid to support nitric oxide. But sometimes, again, things can get stuck in that pathway. So sometimes it's better to use citrulline, which is further down the pathway, in order to help with nitric oxide production. And so those are some ideas and there's much more. But I want you to know that for women who are going through perimenopause and menopausal symptoms, that there's options that you. There's so much you can do. I mean, yes, you can use testosterone replacement. The thing about testosterone to know is that it's a scheduled drug, so it requires prescription and very fine tuning on the dosing. And so it's just one of those things that sometimes we like to try other things first before going to a prescription form of testosterone. But I always feel like, hey, might as well try herbal approaches first. Might as well try nitric oxide processes first. Might as well. Because there are also herbs that can improve testosterone production. Might as well help your adrenals. So they're doing their best job for you. See if your ovaries, if they're still some possibility that your ovaries could make some testosterone for you. We take these steps before we go to, all right, let's just replace the testosterone. But it is an important thing to consider for women as well as for men.

I also wanted to cover the question of, first of all, is it possible to recover from trauma or even betrayal? Because whenever I'm talking about stress, you know, we think about, you know, what am I supposed to do about this stress? And I also get asked, how do I test for cortisol? Because I talk about cortisol and adrenaline so much. So I suggest, whenever you want to test for cortisol, we want to test at different times a day. Yes, you can do a blood test for cortisol. It's going to show you your cortisol at just the time you have your blood drawn. But if we measure cortisol in saliva or urine, when you wake up in the morning and the midway through the day, in the evening and the bedtime, we have a much better sense of what your cortisol and adrenaline. Well, adrenaline, we measure just once a day in the urine, and then we can see what is your cortisol doing through the day and what is your adrenaline level, which is adrenaline is norepinephrine and epinephrine. But we can measure them in the urine. And these tests can give us so much better information about what's happening in your body. Because it's tempting to assume when we've been under stress stress, it's tempting to assume that cortisol is high. Most people say that to me, like, of course I've been stressed. Probably my cortisol is high. Do I really need to do a test? And I say, yeah, I suggest doing a test because many times in the studies that I've done shows me that it's not easy to guess. You could be wrong, and then the treatment's wrong and then you're not feeling better. So it's not worth it to risk that it's better to test and see, hey, where is your cortisol too high? And at what time of day is your adrenaline high or low? Then we can really dial in your stress recovery. So whether you've been through a betrayal or grief or work stress, or hormonal shifts in your body or digestive stress, whatever the kinds of stress that you've experienced, by understanding how stress has affected you at this point in time, this is, to me, the essential stress test. How has stress affected you? What is your cortisol, adrenaline, neurotransmitters? How has it affected you? Because then we can dial in a really strategic plan to help you rebalance. And this is the thing is it's not just a quick fix or a temporary or band aid. It's that we're actually helping your cortisol levels, neurotransmitter levels, digestion, gut, bacteria. We're actually helping to get them back to optimal because then it's just about maintaining that over time. You can learn how to maintain those healthier levels over time. But I really want you to know that it's possible to recover, including from stress and betrayal. When you're just going through it, it's so intense and it feels sometimes hopeless. Like, how could I ever recover from what I've been through or what I'm experiencing? And I get it And I get it from my own experience, and I get it from. From hearing from and what I've learned from patients who shared with me that it can be so overwhelming when you feel like everything's falling apart and you don't know where your center is or how you're ever going to get back there. So I want to just help you to know that it's possible. And then it's. Some of it is starting to get this information. So we know exactly what your body needs, what's out of balance, and what needs to be rebalanced. But also it's a matter of helping you to know yourself and to really gain this awareness for yourself, to feel empowered that your body can heal, that with the right information and the right support, your body can heal and recover even from the most painful emotional stresses. There's so many tools, and I try to interview guests on my podcast to really share with you from different perspectives about neurofeedback, about meditation, about other forms and approaches to really help us to recover from stress. Because that's the thing. I totally acknowledge that stress happens to us and that we as humans are affected by it. And the more we can help strategize and individualize about how it affected you and what do we need to do to help you recover. That's. That's my passion. That's what I love to think about and help people to do. Some of you have been asking how I've been doing with my health, because I have shared recently about how I've been working through some diagnostic processes on my own and what I've learned from it.

A lot of, you know, I have a history of migraines. And one of the things I figured out is that I have something called Ehlers Danlos syndrome, which is Ehlers Danlo is collagen, a genetically determined collagen that's more flexible, which means I have more flexible joints. Sometimes you guys might notice me with my flexible joints. When you have hypermobility or hypermobile joints, it means that you can become injured more easily. What happened in my situation is that just from doing, say, weightlifting and some of my other activities, somehow along the way, I injured my clavicle joint. These are our clavicles here that come across in the sternum. This joint where the clavicles and the sternum come together, that joint can become injured. Now, a lot of people that would only happen if they were, say, playing rugby and they really hit hard on the clavicle bone. But for me, because of my hypermobility, My clavicle joint was injured way more easily, and it caused a cyst to develop. Sometimes people will get a cyst at different joints, say the elbow joint or the knee joint. For me, I got a cyst to develop in that clavicle joint. The doctors, I went to all different kinds of imaging and biopsies and so on, because the doctors, of course, have to be like, what is this? What they ended up finding is that it's essentially like a cyst. And I said to them, because they said they don't really know why or what it is. And I said to them, well, I think it's because of the hypermobility and that I have inflammation at the joint that causes cysts to develop. And my doctors confirmed that way of thinking. And so what I'm doing is a lot of different approaches to help stabilize the joint, decrease inflammation in the joint, and also to think about what are the stresses I'm exposed to, even psychosis stresses, let alone physical stresses that end up showing up in this pattern in my body. And what can I do to shift that? Even things like meditation and mindfulness and so on that shift my energy throughout my body so that it can shift this pattern of stress on my clavicle joint. One of the other things, if some of you might notice, because I often find, since I experienced it, I noticed it in other people. So when I think about healing my joints and hypermobility, I think about collagen, right? Because it's the collagen hypermobility that led to the joint injury. And I think a lot of you also ask me about collagen. Like, what is collagen? How do we help it? Because collagen also shows up in our hair, our skin, our nails, our joints. Collagen also is a source of amino acids. So sometimes when a person has severe leaky gut, especially. But really, anytime you have leaky gut and you're wanting to have a source of protein or amino acids, collagen can be a nice source. In fact, I put it in my protein shake every day because it has amino acids for protein. And what we've seen in studies is when you swallow collagen, it actually can improve your joints, your bones, your hair, and your skin and all the places that collagen. In fact, you realize our whole body is made up collagen, right? So we really want to support our collagen levels. And yes, you can support collagen with nutrients like vitamin C and foods like bone broth that are high in collagen. You can also Take collagen as a powder and you can help your body to maintain your collagen levels because as we age, that's another thing that decreases or it can degrade. So that's why we get wrinkles when we get older. Right? So you want to improve your collagen levels and especially if you have arthritis or hypermobility like me. And so I'll continue to update you on my process of learning about joints and hypermobility.

And I want to remind you that any products that I mentioned that you want to learn more about, you can also find them on my website in my online store. So either go to drdonnie.com or drdonistore.com so D R D O N I S-T O R E.com and you can find collagen, protein and these other products that I've mentioned along the way. All right, well, that was me answering a bunch of your common questions. I hope that's helpful. I love connecting with you. I love hearing from you. So if you have more questions, please submit them and I'll do another FAQ podcast again soon. I hope you have a good day.

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