120: Hormones, Holistic Health, and Women's Empowerment with Dr. Taz Bhatia

Well, people, I have something really special for you today. I know I say that a lot, but today we have a woman who is my friend, one of my idols, a trailblazer. She is a doctor who ditched cookie cutter medicine for total body transformation. She blends ancient healing with cutting edge science. She's an integrative medicine expert, a best selling author, and. And her mission is to empower women to decode their health and reignite their vitality through personalized, holistic medicine. She is one of the leading voices in the hormone space. And this is a conversation that we are all having right now and we should have. And we need to talk about hormone through the ages, hormones through the ages. And she is here today to do that.

So.

So with that, let's welcome Dr. Taz. So, Dr. Taz, welcome.

Thank you. I'm excited to be with you again.

Yeah, I'm so excited. And you've been on a little bit of a whirlwind tour.

I have. We've been talking a lot about hormones and about this book, the Hormone Shift, and how I really, truly want it to be just a handbook for women and girls of all ages.

Yeah. And I think that these conversations, and I heard you speak recently in New York at the Global Women's Club and you really do address hormones at all ages because it's really a necessary conversation to have. And I feel like so many people at their various stage are blindsided by where they are and the symptoms that they're having and the issues that they're facing. And really most doctors do not have answers for them.

I know it's sort of this very, you know, narrow view when it comes to women and their hormones. It's usually like, let's get your periods regular using birth control. Let's get you pregnant using ivf. Right. And then now as you're translate transitioning into perimenopause and menopause, then like it's HRT for everybody. So it seems like they're just like three conversations that are happening without any nuances, without like any depth or personalization of the conversation. You know, and I, a part of. It's our model. Right. You and I have debated that, like there's X amount of time in an exam room to make decisions. Part of it's our education, but it's not serving anybody well, you know, and people are just repeating the same patterns with like different packaging. I feel like as they move through the decades of life and that's something that, you know, I just want to shed a light on and bring a lot more awareness to is that, you know, the same person who has irregular periods in their teens is the same person that starts to have a lot of PCOS and endometriosis when they go into their 20s, is the same person that is having issues with, like, fertility and mood disorders as they go into their 30s, is the same person whose perimenopause and menopause experience can be horrific or worse. Like, they end up with the diagnoses. Right. Whether it's autoimmune disease or cancer or what have you. So that continues continuum is something that we don't talk about enough. And I just came, you know, I was just doing this very informal talk on, you know, breast cancer and breast cancer prevention because we're coming up here on the tail end of, you know, breast Cancer Awareness month. And I always go through the research, and I was trying to, like, in real time, like, well, let's see what research there is around, you know, inflammation and women's hormones or insulin resistance and women's hormones or toxins and women's hormones. And it is literally like a blip. It's like minimal to none, you know, so we just have so much work to do in this field and so grateful for a lot of the work that you're doing, too, so that we can continue to kind of like, chip away at this thing.

Yeah. So, you know, this kind of thinking that you have is. Is very outside of the box.

Right.

So why is this important to you? How did it become important to you? How did you even recognize how our system is failing?

Well, some of it was personal and accidental. Some of it is just experience. So, you know, I've shared with you before. Like, I had my own hormone journey and my own hormone experience in my twenties, you know, where, you know, working the er, having disrupted sleep, lots of stress, all that stuff, you know, I developed a lot of symptoms that people couldn't put together and ultimately labeled as me being anxious or depressed or stressed or, you know, all the things we still hear to this day, not me. It's, you know. Right. Even though that was over 20 years ago, you know, so. So that got me into it. And that journey where I had to find out about really how to take care of myself at a time where we didn't have Google and we didn't have the Internet and we didn't have social media and we didn't have all these things, was daunting. And ultimately, what I found was Chinese medicine, you know, the world of nutrition, the world of Ayurveda, like all these systems that were outside of our traditional training that actually had answers. So using some of those mentors, I got better, understood that I had pcos, I had gluten issue, I had a thyroid issue, I had, you know, chronic inflammation. Like all this stuff, right? So I put my own pieces together. And over time, it took a few years, I got better. And in that journey of getting better, all these, like, everyone came out of the woodwork. Like, all these other people were like, well, oh, my gosh. Well, this is happening to me. That's happening to me. And so I finally started my practice back in 09. And at the time, we were just going to be very focused on women's health and very focused on children's health, because that was how Chinese medicine thought. You don't separate the mom from the child. You treat them as like. Like one unit. And, you know, it was going to be a little simple hobby practice. I was going to go there one or two days a week, spend like half a day there, still work the ER. And, you know, that was 2009. Here we are sitting now in 2025, almost 2026. And that journey, you know, was one I never expected. You know, people were, like, sitting on the floor waiting for me to come out of my exam rooms. You know, they were driving in from all over the place once they heard about what I did, which was this, essentially merging these different systems of medicine together to get a better understanding of health and to personalize solutions for everybody. And so as time went on and we built our teams and, you know, we built our clinics, and now we have, you know, like four clinics and a bigger team of, you know, 12 providers. We have a telehealth component. I think collectively we've probably seen, you know, close to 60, 70,000 patients. So we've got a lot of patient experiences now with girls and women of all ages telling us the same story at the end of the day, right, where they have problem X and they're given this one very singular siloed solution which may have solved this one symptom, but ultimately led to yet another thing going wrong and another thing going wrong. And so they. They end up on this roller coaster that seems to really, at the end of the day, be, you know, kind of going nowhere. And so it's based on all of these different patients and their stories, and their experience is based on our collective experience, right? Because as I've written books and done media and talk to people that are not even coming into my clinics, you know, they're having the same, they say the same things, they tell the same story. And so I think the story that we have collectively as women, and I even hate to, to narrow it down to women because I'm, you know, noticing as we started to bring men into the clinic, you know, probably about 10 years ago, very similar, like, you know, their answers are also very one sided. They're just maybe not as complex because they don't have the cyclical changes and all the other things going on. But it's the same story, you know, like not tracking things, not paying attention to these really important determinants of health, not understanding the power of hormones, which are not about reproduction and menopause. They're actually very much more about every other system in the body. And by ignoring that in girls and women, women and boys and men, you know, we are setting ourselves up for a lot of chronic disease and a lot of mental health disorders that probably could have been stopped if somebody dug in, in a, in a deep sort of strategic way.

Yeah. The problem is that they don't even know what they're digging into.

Right.

I mean, you know, and it starts very early and, and I'm more focused on the women because that's what I've spent my last 30 years thinking about. But when, when a woman or a girl or a tween or an adolescent presents with any kind of menstrual abnormality, it starts immediately with the g, the ob GYN and putting them on birth control pills. So and really their training is just to do that in that they've really not been taught to unpack hormones and, and think about what might be leading to imbalance or causing imbalance. And we're really taught to, to kind of mansplain it and muscle it. Right. Like let me just take over your hormonal cycle with these synthetic hormones. And no one's really thinking about it. And even if they were, I don't, I don't know that they have the tools.

Right.

They're just really not trained to do that. So how do we. First of all, what are your concerns with that kind of management? Specifically, what are your concerns about birth control pills? Because you, you had to have in the hormone sh. Shift, you have to address that because it's a huge problem. It's a huge problem in that population. And then it becomes a huge problem for fertility, it becomes a huge problem for chronic disease and it becomes a huge problem for breast cancer. I mean, there's that Danish study of 1.8 million women that directly links duration on hormonal birth control with increased breast cancer risk.

Right. You know, there's so many things that you bring up there, and one of them is like the biggest concern about just jumping to put young girls or even women on birth control to manage their hormones is that the first problem is you're not identifying the reason why they might be having a hormonal imbalance to begin with. Right. So, and I do think it's important to understand that because that in turn will prevent them from, you know, masking something that probably needs to be managed. I think the second piece of this is that birth control itself creates a terrain or an environment in the body that is nutritionally deficient, that is more susceptible to environmental toxins because it's putting a heavier load on the liver, which is our primary detox organ. It is shifting the microbiome. And when we look at studies around pcos and autoimmune disease and cancer and breast cancer, you see very clearly that the research itself can connect a change in the microbiome, inflammation, nutrient deficiency, to an increased cancer risk. Right. So, for example, the birth control will deplete the body of things like B vitamins. You know, it will deplete the body of vitamin C. We even suspect that it depletes the body of some of the fat soluble vitamins like vitamin D and vitamin E. And in the depletion of those key nutrients, there's this fallout effect. And that fallout effect is a couple of different things. First of all, it is a fallout in energy and mood and some of the mental health stuff that we're seeing, right? Because for healthy serotonin and healthy dopamine production, we know we need the right amount of B vitamins, we know we need the right amount of magnesium, we know we need some of the fat soluble vitamins as well. So we see in other ways and in other systems of the body what happens when we go on systemic birth control. Secondly, we know that markers like your sex hormone binding globulin go up when somebody's on birth control. That's because the liver's working a little bit harder. It's binding up more hormone that's being secreted. But in that work, it has to do for that job of birth control metabolism and birth control management, it is now not able to filter out the load of environmental chemicals coming at us. And so our toxic load is going up, which in turn is impacting everything from, again, what our gut is going to do to our mental health, to our disease burden. So when we look at some of that. And I haven't looked at the literature on this. I don't know if you have. But when we look at a lot of that, we can tie birth control and chronic use of birth control definitely to breast cancer, but I think we can actually tie it to infertility and a lot of the mental health stuff that we're seeing as well. So here we are medicating everybody, and that's kind of like where I started is birth control from, you know, 14 or 15 to about, like, 26 or 27. Then it's IVF from like, 28 to about 35, 36, and then it's HRT after that. So, again, we're not understanding the interconnectedness of all of this. That, you know, instead of going straight to birth control, can we balance the gut. Can we look and see if we can work with the family to say, all right, there is an inflammatory component to not having a regular cycle? Can we find what the drivers of this inflammation is or are so that we can help you over a course, you know, 90 days, four months, maybe six months at the most, work on decreasing some of those things so that the first answer is not birth control. So I think that's number one. Number two is, okay, if we do have to make the decision to put you on birth control for whatever reasons, there should be a limited. It should be timestamped, right? So right now, like, I meet women. I'm sure you do, too. Oh, I've been on birth control for 20 years. You know, I've been on birth control since I was, you know, you know, whatever age, you know, and so there should be a timestamp on birth control, which is essentially buying you time to work on all this other stuff. Like, that's the way I would like to see it done. Like, and, you know, in this toolbox, in this expansive toolbox, you know, you know, our clinics are called Whole Plus. And the idea is that is bringing all these different systems of medicine together to really have this holistic approach. You know, we're not calling things good or bad. We're saying that there is a right time for everything. But this whole idea that you need to be on this forever and you need to be on things or can be on things without any monitoring, I think is very, very limited. So let's say you do have to go on birth control. Like, you know, just approaching it through gut and food modulation and inflammation balancing and blood sugar balancing is not enough. That's not taking care of it. And you do have to go on birth control. Well, then we need to monitor all the other stuff that goes with birth control. Right. Like, where are your nutrients, how's your liver health going? You know, is there anything else we need to be thinking of in a supportive way while you're on this birth control pill? So that's kind of the shifting that. That needs to happen for sure.

Yeah. I love thinking about it.

With guardrails. Yeah.

Right.

Like, I don't think any of us are saying throw out every single pharmaceutical. No one should ever be on a pharmaceutical for anything but that. Most of these pharmaceuticals, and we can run down the list, but most of these pharmaceuticals that people are on for decades were never, ever, ever intended for that. And so I'm reminded of the H2 blockers, the proton pump inhibitors, which were approved for. I can't remember if it was one to two weeks or two to four weeks. Yes. But that's all that they were approved for. And the average person is on them for four years.

Yeah, years.

And so many people wind up in my office. Because that alone will increase your cancer risk. Because when you take away the acidity to the stomach, a place that is supposed to be acidic, and you increase your bacterial load, you increase your infectious.

Load.

You decrease your nutrient load because you're no longer digesting your food adequately. And so you miss out on a. Absorbing nutrients, like this has huge implications that are being completely ignored for the purposes of just continuing to utilize whatever the system has thrown at us.

Right, right.

And antidepressants are the same way. People are not supposed to be on antidepressant drugs for more than six months.

Right.

They were only ever supposed to be a bridge, a transient medication, and yet it's. It's all gotten away from us.

Do you know when that. I was curious, like, when did that shift occur to where, like, these medications were supposed to be for a finite amount of time? And it went to like, okay, you're on it now for 10 years, 15 years at a time. I don't.

In my opinion, it happens like, late 80s, early 90s, when individual physicians were rewarded for how many scripts they wrote. So think about the. Think about the whole OxyContin timeline.

Yeah.

And I know for a fact that, you know, because that. That happened when I was a surgical resident. So those OxyContin reps were front and center in front of all of the surgical residents because we were. We were prime pickings for them.

Right.

And they used to come to the surgery lounge and sit with us and tell us that this is the best thing for post operative pain and that we should write it for all of our post operative patients, whether they had a lumpectomy or a whipple, like didn't matter. We were supposed to use this. And let me tell you, like as a surgical resident, I don't know what I was making at the time. $26,000 a year maybe. And like on call every other night.

Yeah.

So what did the reps do? They took us out to dinner.

Yeah.

I mean, we could barely afford to eat.

Yeah.

And what we could afford was eating in the hospital cafeteria, which, you know, for someone who did five years of residency and a year of fellowship, like you retire quickly of the hospital, of the hospital cafeteria food. And so, you know, they were taking us out to these beautiful, beautiful restaurants.

Yeah.

And it was kind of ridiculous. Money was spent on us and we were nothing compared to the doctors that they wined and dined and traveled with and paid for them to come to this conference and come to that conference. And I, it definitely clouded people's visions. I, and I know that they have since put policy in place so that that's not happening anymore. So doctors aren't paid to use a drug.

Right.

But I also think that to some extent the damage was done. I know, like you just, you get into the habit of this is what you do. And if you're, if your person isn't complaining, you, you tend to not change it.

Yeah. And I think culturally too, as physicians, like the education is. When I was coming through, there was no education around. Medications are only supposed to be prescribed for X amount of time. I didn't get any of that education whatsoever. You know, so I think it was use this. Right. It was very like, you know, you know, linear. So yeah, we have just so much, you know, it seems daunting sometimes that there's just so much to do and so much unwinding to do and re education to do. But I think the exciting part is that there's a hunger. Right. There's a hunger out there. People want the information. You know, Gen Z is driving it. They're on Tick tock. They're on, you know, social media. They're talking about these things. It's no longer like hush hush, you're the weird one in the room. So that's the exciting part, that there is a lot of movement.

Well, it depends. It depends who you are and what you're talking about.

Right? That's true. Absolutely.

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Back to our show. All I, I see my colleagues enjoying like a tremendous amount of success and I'm really happy for them. Like, don't get me wrong, but it is. Is a million times harder when what you're talking about is so disruptive.

Yeah.

Like me trying to change the breast cancer screening paradigm is. It is hard. And people.

Sure.

Horrible things about me. Horrible things.

Yeah.

And it's okay because I know that I'm on the right side of history and I know that I have God with me and that I was specifically put on this journey by God. So I'm okay with it. But it is hard.

Yeah. And I, it's hard to change that journey. Right. Like, I was called a quack from day one. I was teaching the residents at our local university and they were rotating through our clinics and all of a sudden, out of nowhere, I was told to stop coming. And I got a letter in the mail from the dean saying to please withdraw my title of associate professor, blah, blah, blah, blah, blah. And I was just like, what happened? And I don't think to this day I still know what happened. I think what happened is some random doctor had some patient that maybe had a complaint and then was totally against, you know, holistic Integrative functional medicine, all these different things and just went on a rampage, you know, and probably had more power, influence with whoever was making decisions. But it left such a bad taste in your. It leads back. You just feel bad because you're like, you feel bad. I'm passionate, trying to like do this and you're gonna, you know, point fingers at me and call me all kinds of names, you know, so whatever. That was years ago, decade. It was over a decade ago. I think that that happened. But. But I. It's hard, it's hard to fight this fight and go against the system that's so entrenched. Right. And so self rewarding and self motivating and so like married to these very singular studies that at the end of the day are also influenced by an outcome or. Absolutely. Things like that. Absolutely. Really hard. But I still feel hopeful because I know back in 2009 what the temperature was like then. And I do feel like we're in a different place now and we're fighting big stuff. Right? You're fighting big, entrenched, you know, big stuff. So, you know, some of that unfortunately, hopefully we'll all come out of it okay. But. But some of that unfortunately becomes a part of this battle for sure.

Yeah.

Yeah.

I mean, I. What continues to astound me is how married people are to mammogram.

Yes.

Like it is so flawed. We've known for decades how flawed it is. We know that it missed. It will miss up to 40% of cancers in women with dense breasts. And yet people are like willing to lay down their life for that, for that test. And I used to think, well, you know, there's nothing else and people are desperate. It.

Right.

They're scared and they're desperate and there's nothing else. But that's not true anymore. There are other things.

Yeah, yeah.

We have great options now and you know, things like the ARIA test, which is an at home breast cancer screening tool which just uses your tears. Like it couldn't be any easier for people. It's 100% accessible for people. It has a 93% sensitivity for breast cancer which compared to the mammogram, which in dense breasts has a 60% sensitivity.

Yeah.

And yet people are totally unwilling to even learn, consider, entertain, that there's anything other than mammogram. Like they're so married to it.

Well, do you think it's people or do you think it's doctors? Because I think we have to separate.

Like, I think it's both.

Okay.

I think there's this whole. Well, first of all, we've been so conditioned to believe that mammograms save lives that it rings in the ears of. Of consumers as much as it does doctors.

Right.

Doctors are a little bit of a lost cause. And I. I always go back to that Upton Sinclair quote that it is impossible to teach a man something when his livelihood depends on him not knowing it. Right. So for doctors, it's really hard, especially if you're a breast imager, because if you've spe your career doing mammogram, it's nearly impossible for you to hear that mammogram is not the thing.

Right, right, right.

So that is very hard. But it's also the women who mammogram saved my life, or mammograms saved my mother's life or my sister's life, or my mom died of breast cancer, and I'm screening even though the mom screened and died of breast cancer. Like, people prove their point all the time and double down.

Yeah.

Olivia Munn, she's someone who, I guess mammogram missed her breast cancer, and she's out there telling people to get mammogram. Why?

Why?

You of all people should know it doesn't work.

I know, right? Yeah. So it's.

It's frustrating, but whatever it is, what it is is. Right. Like, I'm gonna win this battle. It's definitely David versus Goliath, but we know who wins in David versus Goliath.

And I think they're more David's, too, which I think is. That feels different to me than 2009, 2010. Yeah. I feel like they're more sure. For sure, you know, so. So we'll see. We'll all keep chipping away, But I'm arguing for all women, all girls, to check their hormones, to understand what their hormone patterns are, to, like, get a handle on it, you know, and to act to make that a part. You know, we talk about these wellness visits, and we talk about, like, you know, screening and prevention. Well, this should be a part of prevention. You know, it's not the only part of prevention, but should absolutely be a part of prevention as well.

Well, there's this whole prevailing thought that there's no point in checking premenopausal hormones. Right.

That you.

You. They don't mean anything or you can't measure them or blah, blah, blah. So can you address that and talk about that a little bit?

I do hear that, and I hear it all the time, even hear it within our practice, that, you know. Well, we can't check hormones because this is happening or that's happening, and there's no point or validity of testing them. Here is the thing. Your hormones at any stage of the cycle are reflective of your hormone pattern. And so when you are testing them, if you can be cons, if you're menstruating and you can be consistent with testing them around the same time every month, well, you've got a pattern right there. Just like your oura ring has a pattern, just like your glucose monitor has a pattern, right? So if every single time you test it, you know, during the first half of the cycle, or you go and always test it in the second half of the cycle, you have a way to interpret those hormones. And given where you are in the cycle, we can interpret them, we can get a sense of what's going on. Now let's say you can't track them, your periods are irregular, you're skipping around all over the place. You're not clear. One of the things that we've been able to establish clinically is that there are some absolutes, there are some numbers above which estrogen should not get to and below which estrogen should not get to. And the same with progesterone and the same with some of the other ones. And on top of that, if we could think a little bit more broadly and not only just check estradiol and progesterone, but actually also check some of the derivatives, right. Some of the metabolites like an estrone or a pregnenolone or a 17 hydroxy progesterone, a lot of those I have in the book. If we could like check just a few more markers, then we would have a sense of what the hormones are doing throughout the month, not just at the static point, you know, when we go to draw them. So that's another reason why it is possible. And you know, just being consistent and looking at it just like you would look at other data is a way to understand where you're landing. And so for, we do this for people in the practice all the time and we will find that they are always estrogen dominant it, or they are always low progesterone or they are always high androgens. Right? These are hormone patterns we want to get under and start to work on so that no matter where you are in the cycle, you're kind of covered. So I think in those ways, you know, you use hormones. Now, if we're going to get super academic about it and be like, well, I didn't check it, you Know, at the exact same time on the same day that I did last month, then you're, like, overthinking it a little bit, just like you're overthinking the oura ring or the glucose monitor or any of these, these, you know, tools that we have today. We are looking for trends and patterns that educate us. And I think it's really important to understand that differentiator because people get really parked on, you know, well, is this number right? This number is reflective of you at this particular time. When you amass a set of data over a period of time, we know what's happening with you, you know, so I think that's the way I want people to think about their hormones.

I also think a lot of that, that thinking and that approach is born out of the fact that we really are under trained in this area. We are largely under trained. Even the gynecologists are largely under trained. We think of the gynecologists as hormone experts, but in fact, they are surgeons.

Right?

They are surgeons. They're not hormone experts. They're not.

And.

And the endocrinologists aren't either, because the endocrinologists may get more training around adrenal hormones, around thyroid hormones, but they do not get adequate training around sex hormones.

No, they don't. Men and women like testosterone. Not around, not around any of it whatsoever. And that's something that has to change and. Or they at least need to be open to working with somebody who does. Does deal. Breathe. Live hormones day in and day out, for sure.

Yeah.

Yeah. So when I heard you give your talk in New York, you really gave a beautiful, beautiful summary about hormones through the ages and more specifically, what we should be thinking about, looking at, paying attention to as we go from stage.

To stage to stage. Can you.

I know you probably don't have time to do all of that, Right. Can you just give us a little insight?

Yeah, absolutely. And I do talk about it in the book, but again, going back to the central idea of the continuum, right, that our hormones are on a continuum, that they're a vital sign, and we want to be tracking them all the way through the journey of our lives. Honestly, you know, one of the things I talked about when we were together was that there are basically five hormone shifts that I think every woman should know. And the first one begins in puberty, although the foundation for it is being set, believe it or not, in the preconception, perinatal, and even early childhood era. I mean, there was some fascinating research that just kind of Blew my mind talking about, you know, the prenatal environment. If it's exposed to cortisol, excessive amounts of cortisol, they are seeing changes in infant behavior. They're able to link those two things together. But here's the thing that was really shocking. They can even link it to the increase in androgens, which for me, on my end in the exam room, I'm seeing all this PCOS and all this, like, endometriosis, all these very high androgen, high estrogen conditions, but they're tying it all the way back to what that prenatal or preconception environment look like. So this idea of the continuum, that article actually is in the journal called placenta. It's a 2022 article. But this idea that the continuum is this powerful. Powerful, right. It weaves through in such a strong way. So puberty. I've called those guys the rock stars, and it was partly tongue in cheek. I have teenagers, but the whole idea was like, they're all over the place. They're up, they're down, they're happy, they're sad, they're, you know, you know, up all night, sleeping all day, what. However you want to think about them. But that idea of the rock star, where they think they are invincible, nothing can bother them. But oftentimes, their entry into the hormone world is complete chaos. Right? A lot of them are skipping their periods. A lot of them have very painful periods. You know, seeing a lot more of the sort of early endometrial, pelvic congestion type stuff in our teenagers. And so for that age group, I really wanted them to come into their hormone conversation being like, okay, I need to understand what's going on. I need to start charting how I feel against my cycle. Because so many people don't even do that as adults. They don't even know they're supposed to do that. So first, correlating those two things I think is very important. The second is if we can gift that age group an understanding of how food and their gut. Gut really impacts their hormones, we're going to keep them healthier for such a longer period of time than even our own generation. Right? So understanding, like, little things like, are you going to the bathroom consistently every day? Do you have bloating? Do you have reflux? You know, what time of the month do those things happen? You know, are you eating foods that are diverse and have fiber and an array of different, you know, nutrients and probiotics? All of those are going to lead to a healthy gut. Gut, which at the End of the day, we know there's a gut hormone pathway will lead to healthy hormone levels. So for me, that was like the big thing with them is can we educate them on gut health, can we educate them on nutrition? And can we get them to understand that at least 80% of the time we want them having deep, consistent sleep. So moving on from them, like going into the next stage, which is a.

Challenge to say the very kidding.

No kidding. But again, I repetition.

Go to bed, go to bed.

Sometimes they go to bed, but they're like up, right? Like I've been threatening to confiscate all, you know, electronic devices out of rooms.

Because we should have done that. Yeah.

It's hard though, because they're like, you're being the weird parent, you know. So moving on from that age into, you know, what I call the hustlers? The hustlers are folks in their 20s, right, burning the candle at both ends. They're trying to establish themselves. If we think from a chakra standpoint point, this is the grounding phase, right? You're in that sort of solar plexus phase, trying to, you know, find your identity, your purpose in life. And for them, their biggest issue is now cortisol, because oftentimes they're catching up from their early teen years, cortisol levels are starting to go up because they are super stressed, maybe again, going out all the time, those type of things. But that high Cortisol through those 20s ultimately creates something called cortisol steel syndrome where you start depleting your progesterone reserves. And remember, progesterone is the female hormone responsible. You know, kind of shines in the second half of the cycle. But it's also an anti inflammatory hormone. It's actually something that helps calm anxiety down. It helps with consistent sleep, it helps with cognitive health. They even give men progesterone nowadays that are having cognitive delay in dementia. So now progesterone is dropping as you're going through your 20s. So you hit like 26, 27, 28, and you're having all kinds of symptoms. Some of them are mental, right? Some of them are increased anxiety, trouble focusing, trouble sleeping. Again, some of them are more physical, where you're having the earliest signs of sort of this pseudo inflammation or your periods are heavy or shorter. And this is when a lot of these girls are getting the diagnoses of PCOS or endometriosis or things like that. And some of them are just opting out, right? Like they will take a lesser role in a job or you know, there's this trend right now. I want a soft life. They're making these decisions. Whereas I would say, can we balance things out so that you have the energy, the vitality, the chi that we talk about to do the things you want to do? So these guys then move into the next phase, which I call sort of superstars, and now they are starting families, getting more advanced in their career, taking on more responsibility. Usually you have teams at this point, and again, that juggling that lower progesterone levels. They're trying to get pregnant. And this is where we're seeing a lot of women really, really struggle with fertility and, you know, that promise of a family and starting a family, you know, starts to become sort of this chase that drives them all, you know, insane. So instead, can we, at this age range, kind of the. In the superstar phase, help them understand, okay, could we balance your progesterone a little bit better? How are we going to cortisol and kind of get that to where it needs to be? Is there some nutrient supplementation that you need at this particular phase? Because over the last 10, 15 years, you've depleted some key nutrients. You've been running really hard, you know, and could we now start to balance you that way? Now, these women then move into perimenopause. And if they've done the work, perimenopause is not that bad. But one of the biggest things that starts to happen in perimenopause is that as progesterone has been declining, now estrogen is coming, coming up behind it slowly coming down, not dramatically to where you might be having hot flashes and night sweats and all that business, but enough to be where you're suddenly super irritable because you don't have the right amount or the right balance of hormones, or you're starting to get a little bit depressed or sad, or you're starting to first see, you know, the very earliest signs of weight gain, where, you know, as long as you did that workout or watched your calories for a few days, everything would be fine. But now it's not. And the we just kind of very slowly, subtly creeping on as that estrogen level is kind of winding down. So these women are going through perimenopause thinking that they're turning into different people, thinking that they're a former version of themselves, and they'll use language like, I must be getting old. This is what aging feels like. Oh, I'm 40. I'm sure this happens when you're 40. And I kind of just, like, kind of cringe. I'm like, no, don't say that. Because there. There are reasons you're feeling this way, and there are reasons that things are happening this way. So we move into perimenop. We call these women super women, because now we're adding on not just career and family, but kids are getting older, Some of them are turning into teenagers. We have aging parents. And then that's a level of responsibility that's just ramping up in the face of declining hormones. So this is where women maybe first start thinking about some form of hormone replacement therapy of some kind to help them. And they're seeking answers. But frequently they're told, you know, that's really for when you've lost your period. You really don't need anything right now. And then moving on from there is the fifth and kind of most final stage, I would say would be menopause and postmenopause, where your hormones are truly have declined. They're low. Your metabolic pathways and patterns are shifting. You have maybe more insulin resistance. And so the chemistry and the terrain, again, is primed for chronic inflammation and for many of the chronic diseases that we see today. So those are kind of the five shifts. And so for each shift, it's like, if I could get everybody to focus. So for the rocks to shift, if you guys could focus on your gut nutrition for the hustlers, if you could focus on cortisol and how to balance cortisol and dial those cortisol levels down, for the superstars, if they could focus on building progesterone back up. Right. And having a strategy to do that for your super women, if they can understand, you know, that now they really need a lot more optimization. They need the nutrient optimization. They need the diet optimization. You know, they need the gut support. They may still need a little bit of bioidentical progesterone in this phase to help them, and that's okay. And then moving into, you know, like you're superwoman, and then moving into what I'm calling the commanders that are the women going to into menopause. You know, if you need hormone replacement therapy, great, let's personalize it to you, because hormones are at a sweet spot. Too much is not good. Too little is not good. Let's find that sweet spot for you. But sort of package it in this sort of box where the gut and the liver are also doing what they're supposed to do so that a hormone serves you well and doesn't kind of go the wrong way.

Yeah.

I agree with you. And it needs to be personalized. And I think that while we're much better off than we were, let's say, even five years ago.

Yeah.

In that we're having the conversations, I think that this stigma of the Women's Health initiative is wearing off.

Yeah.

But now we have two problems. One is that we have two decades of providers who are not or under trained. So they're either not trained in hormones or under trained in hormones. So that's one issue. And the second issue is those that are willing to write them tend to do the same for everyone. Hello, my beautiful listeners.

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Yeah, I've seen that everyone gets a patch and a pill, right? Yes. Across the board. And that's not the right solution either. So it has to be personalized. And what I would advise people to do is use the book really as a guide. I just think it needs to be a guide. There's a place in there with all the different labs you should be testing and hormones, you really need to know. And if you can dive into that and at this day and age, at this juncture, you can test your own hormones if you have to. Right. Like you can go to a lab corps, you can order a saliva test. You know, it's no longer.

Well, there's also those independent labs like Avexia, where you can, you can order your own labs. Yeah, there's, there's function Health.

Right. Yeah.

Where, you know, you basically. And I think it's a pretty reasonable price to have that huge lab panel done twice a year.

Right.

So there are options for self testing. It's just kind of a shame that people have to manage their own care and, and really harden a lot of responsibility.

Yeah, it is. And that's one of the things that just personally, I kind of challenge myself with, of how do we solve this problem? You know, and I certainly don't have all the answers by any means. But one of the things we're doing at whole place, plus it's now we're not just clinics, we're also kind of a digital ecosystem where people could come in and be a member and have some coaching without necessarily having to go through, you know, a huge medical appointment if they're not ready for it.

Right.

Sometimes people aren't ready for all that. So, you know, that's one way of like just coaching people through like, you know, this is something that you need to be thinking about. This is, you know, the direction you would go in. But I think if folks want that very personalized approach, they have to look for doctors like us. Us, like, you know, more of that holistic or functional medicine approach. That's going to take that time. You know, my dream is like, we come up with an ability to, you know, inject ourselves in the medical education system. Right. Or even in the residency education system, where this becomes a natural way of thinking. This is not so out of the box or so, you know, revolutionary. This is just, this is just what you do when it comes to hormones and. Hormones. Yeah, yeah.

And, and if you think about it, I mean, 20 some years ago, it was very, very commonplace to put a woman in menopause on hormones.

Oh, yeah.

I mean, it was kind of a rite of passage.

Right.

And it was really only with the Women's Health Initiative that that practice stopped on a dime and unfortunately continues today. Not because it's no longer acceptable, because I, I think now it is acceptable. And mean, you know, Oprah has the menopause and you know, they're, they're, they're talking about. We don't have to talk about that.

But.

But, you know, it's, it's out there as acceptable. What's unacceptable is that most people who are doing it are not doing it. Right. Not to their fault, but they haven't been trained. So I agree with you. Like, this needs to filter into medical training. It has to.

Yeah.

Because we can't just rely on people like you and me who spent. Who burn their midnight oil learning.

Right.

Because not everyone does. And I, and I get it in that being a doctor is really hard. And most people trained for a very long time to do what they do.

Right.

And I know that most people are not going to be like me, a fellowship trained surgeon who walked away to do another. What is equivalent to residency and fellowship and like start over at 50. I get it. Not many people are doing, but like, it's hard.

It's hard. But, you know, medicine itself is really beautiful. I haven't given up on medicine. I mean, I think that, you know, if we can get people lined out, the ability of the body to heal is pretty amazing. I think taking the time and energy to put into understanding that for you, I think is always a worthwhile journey. I've seen. I'm sure you have too. People change right before my eyes, right. Like, you know, from literally their personalities will change, you know, like what they think they are and are not capable of will change. And I think that, think it's just a testament to like, when you do the work and you take the time, there is a result. If our medical system, which right now isn't even functioning, if our medical system is not, you know, able to do that for you, you know, please be your own advocate. As like painful as that sounds or as difficult as that sounds, I think it's the only choice, right. Is that you've got to be your own advocate and find somebody to work in partnership with you to really. I've learned from you guys every day. I learned from my patients every day. You know, it's hard to say you're done, right.

Because I mean, what, like, no, we're never done.

I'm like been a doctor for probably what, 30 years. I'm not doing the math, but probably 30 something years have been. Yeah, we don't for almost 20. There is yet a day where I don't learn something. Yeah, there's not one day where I don't learn something.

But you have to be open to learning something. And there is, there's a lot of kind of paradigm that is drilled into us that everything that you learn in residency, you just continue down that, you know, everything you learn in medical school and residency is true. And that's what you should continue to do. And so few people approach the remainder of their career with any curiosity. Yeah, I mean, that's why, that's why it's so hard to undo things.

Yeah, right.

I think despite all of what we're seeing lately, there is still that underlying nagging concern with people about hormones and breast cancer. I, I, I, I really think it still exists.

This.

Well, it doesn't help when, like the labeling of so many breast cancers is ERPR positive. Like, I had this conversation yesterday. Like, she's like, it's ER positive, it's PR positive, it's HER2 negative. What do I do with my hormones? You know, and so, I mean, I think that doesn't help, you know, but I know you and I have talked about this before. My opinion, and I'm curious to see what yours is as well. I don't think hormones are causing the breast cancer.

Cancer.

I don't. I think most of it's environmental. And then you add on inflammation and insulin resistance and emotional trauma and like all these other factors into it and that sort of is, is the spark that starts to drive it. But you're more in the cancer space than even I am. So I'd be totally curious on what your opinion.

Oh, there's no way that hormones cause breast cancer. It's just not even a possibility. And, and you know, you think of when you measure a lot of female hormone levels. I measure a lot of female hormone levels. What do the female hormone levels look like in your postmenopausal patient with breast cancer?

They're low.

They're like barely measurable. But, and the medical oncologist wants to blame this on estrogen hormones.

Yeah.

I'm like, show me the estrogen. Show it to me.

Yeah. And, and we have, even with the.

Women's Health Initiative, even with that very, very, very flawed study, there's a 30 some percent reduction in breast cancer in the women that got CE alone conjugated equine estrogen.

Yeah, right.

Not even bioidentical anything. So, so there's no way that hormones cause breast cancer. And in fact, I would argue that breast cancer is a disease of hormone deficiency. It's not a disease of hormone excess. And even when you look in the postmenopausal population, I mean, listen, are you going to find someone with hormone excess as part of their physiology? Yes, but that is the exception, not the right rule. And mostly what you're going to find is profound progesterone deficiency. I, I have yet to have a breast cancer patient that has adequate progesterone levels. I don't know. I don't know if you're seeing this in your practice now. It may be true, true and unrelated in that I think we have profound progesterone deficiency in our society because we're go, go, going, not enough sleep, too much cortisol, burning your candle at both ends, trauma, poor nutrition, over exercise, like you name it. And we are doing it in terms of things that interfere with progesterone production. But at the same time, I can't ignore that. Right. It just seems to be a common thread. Now. Is it causative? I don't know. But there's definitely an association there. An association that the mainstream medicine does not want to talk about because A, they don't understand it and B, it doesn't serve their narrative because right now they're making a lot of money with the estrogen causes breast cancer narrative.

Yeah. Where do you like to replace progesterone? I'm curious. Do you like the progesterone creams? Do you like the vaginal?

So I'm very much a student of Dr. David Rosensweet. And so what I'm doing are the topicals in. In 100 essential jojoba oil. Just because I don't want to burden the. The liver with any more chemical than it needs.

Yeah. So.

And all of the creams or the. All the other formulations, the way that the progesterone gets dissolved is by adding some kind of solvent. And so I'm trying to get away from that. So I use suspensions, meaning that if you look at the box bottle, all the hormone is settled at the bottom. So you have to like shake, shake, shake, shake, and then, you know, and then apply it.

Yeah.

So but for progesterone, your ability to even suspend that is limited. So it's about. You can get to about 200 milligrams per milliliter, and then you can't really, really use much beyond that. So if you need higher progesterone doses, you can go to oral. And there's no. I don't have any issues with oral progesterone. I do, of course, have issues with oral estrogen, with oral testosterone because of the first pass effect in the liver and the toxic metabolites. So I do, I do.

Do.

I never use oral forms of estrogen or testosterone, but I'm okay with using oral forms of progesterone.

Yeah, We've used probably everything. So we've used the creams, we've used the pills, we've used the vaginal. When it comes to progesterone, Yeah. I don't use any oral estrogen whatsoever. And I find it, again, it's that personalization. Some people don't tolerate the standard 100mg, 200mg progesterone dosages that are going off to the pharmacy. So that's where we do a lot of customization of trying to get those doses to where they need to be, to where you. Again, you're metabolizing it, you're breaking it down, all that other good stuff. But progesterone is like a miracle hormone. You know, it's deficient nowadays as early as the teen years. Right. And that just exaggerates through those five shifts that we talked about. It's like sometimes the primary one. And that whole idea of cortisol steel and androgenic production and where progesterone fits into it is very real. You know, so. Or, you know, when we think generationally, we have a responsibility to understand this and manage it because we are passing it down. Yeah. Whether we like it or not. Yeah.

Well, I also think that, you know, that that young. That young woman who's coming to you with heavy periods and clothes clots and cramping, that's progesterone deficiency. She doesn't need birth control pills.

Right.

And. And the problem with birth control pills is that that is not bioidentical progesterone. And unfortunately, we have, like, no trials on bioidentical progesterone and what to use.

No. I think that it's so important with progesterone. I think progesterone safe saved me to be 100, because when I was on my journey of trying to figure out what I need to do differently, that was a big part of my personal plan, was going on progesterone and bioidentical progesterone through my 20s. I was on it from. Once I figured everything out, I was on it from, like 28 to 34, 35, and then got pregnant and then didn't need it for a long period of time and then went back on it again, probably late 40s now, obviously, you know, in my 50s. So that's kind of, you know, my progression with using progesterone.

Yeah. And I. And I think that when you know, what allows you to make progesterone and what doesn't, that is going to shift.

Yeah.

Because there are times when you are taking better care of yourself and times that you're not.

Yes.

And your progesterone level is going to shift along with that.

And it's connected to the gut, and that's what everybody needs to remember is connected. Connected to fat, how we metabolize fat how we absorb fat. You know, part of why I was so deficient and which is what I was talking about with the. That hustler phase is because, you know, my diet back then was Diet Coke and popcorn. Right. That was healthy, quote, unquote. So my gut was shot. I had a gluten issue. I had so many different issues. But as I work to heal my gut, I think that's probably, you know, in my life, stabilized too. That's probably what took away the need for supplemental progesterone, you know, so it literally came up on its own over time. But I mean, all. Again, it's all interconnected. And that's why, like, really harnessing the hormone conversation in a healthy gut and a functioning liver, understanding cortisol trauma, all of those pieces are really important in this conversation.

So the book that we've been talking about is the Hormone Shift, and I have my copy here. You have your copy on.

Yes, I do.

Yeah.

So I know this is your third book.

Yes, it is.

How was this book writing experience as compared to the others?

This was really good. I mean, I think I knew I had a message that I wanted to get out there. So it was. I want to say it was easy. I'm not sure if that's the right word, but it was very clear. That's probably the better word. Yeah, very clear. That always helps. Helps, you know, like, pretty much the only kind of disagreement I had with my publisher is they really wanted a menopause book, and I really wanted a book for all ages and stages, you know, But I knew the story I wanted to tell and the message I wanted to get out there. So I didn't find this one that painful. Some of the other ones have been harder for different reasons, but they're more in my head, it's just finding the time to get them out. Right. So we'll see what happens next. Yeah.

Well, what I like about this book is that it's approachable, and I think women can take it to their doctors.

Yeah.

As an offering. Like here. Just read it. Yeah, just read it so that we can partner on my health. Because that's really what we need to do anymore is partner with people on their health. Because gone are the days where doctor knows best. Like, I'm sorry, the patient is the doctor of the future. And I know that that sounds a little daunting, but the truth is that there is no provider that's going to know you better than you know yourself. And your. Your instinct, by and large, is right. And I think doctors in the future are just going to be trusted guides.

Totally, hopefully. Hopefully trusted guys, which is what we were. And you know, if you look back in history, that was the doctor. You were sort of like the village elder or the shaman or, or these people that were more, you know, it's almost like all the movies we've ever seen. Like, the answers are within you. I'm just here to pull them out of you, you know, that type of thing, you know, so we will go to that. And I almost, you know, to use a more modern, modern analogy, you know, we are kind of like only as good as you are, you know, because if you know yourself really well and can tell your story well, the, the length of time for us to get to the right conclusion is much shorter. Right. So again, if you've done this work, you've thought these thoughts, you sort of worked your, your way and muscled your way through it, then when you show up to us, we're like, ah, yes, that goes with that, this goes with that. And you can very quickly, you know, understand what's going on with the patient versus you being very unaware or very disconnected from yourself and the doctor being outside of you, trying to, like, trying to pull or fish, you know, find. Trying to find that thing that's going to be the thing to make you better. So we all work better when, when we are all functioning on all cylinders and really invested in this conversation. You have to be invested in yourself for sure.

Yeah. Well, Dr. Taz, this was a wonderful, wonderful time to spend together. I really, I really, I so appreciate you and all you do and your perspective and your commitment to really making medicine what it should be.

Well, thank you. I hope we can keep the fight up. I'm so glad to know you and all the work that you're doing. I think it's incredible and can't wait to have you on my show again too. But, you know, I truly believe there's just a better way we can do it. And it begins with us. It begins with having a medical home and a medical team. And I am determined to see this mission through. So I still have so much work to do, even though I'm like 20 years in, probably another 20 to go.

Yeah, that's okay. Okay. Where can people find you?

So you can find me on my website. It's wholeplus co, so it's h o l p l u s dot co and then I'm on Instagram at Dr. Tazmd, tick tock, all of it.

D R T A Z M D amazing. Well, thank you again for joining me and thank all of you for joining us today. We so appreciate you and. And we are here to serve you because it's only together that we're going to be able to spread this message and make the impact that we hope to make and know that. I will be back next week, same time, same place. It's Dr. Jen Bye for now.