58: The Dangers of Chronic Stress and How It May Be Causing Disease With Dr. Tricia Pingel

Hello and welcome to the Kenya breasts podcast with Dr. Jen. The show dedicated to empowering women through knowledge, tools and resources to take control of your breast health journey. I'm your host, Dr. Jen Simmons, and I'm thrilled to have you join me on this insightful and inspiring journey. As a breast cancer surgeon turned functional medicine physician, I'm on a mission to empower women to live their breasts and need best lives. This podcast dives deep into all topics related to breast health, including prevention, diagnosis, treatment and holistic approaches to support overall well being. You know what I say, Breast health is health. So no matter who you are, a breast cancer survivor, newly diagnosed in treatment, living with metastatic disease, or you're simply seeking to improve your breast health, this podcast is for you. Join us on this transformative path towards better breast health and a thriving life. And now, let's get to today's episode.

Hello everyone and welcome back to this week's episode of the Keeping a Breast Podcast. I'm your host, Dr. Jenn Simmons and today I'm so delighted to have my friend and just one of the best physicians, clinicians, but human beings that I have had the privilege of coming across. This is Dr. Tricia Pingel and I want to give you her bio. I don't often read people's bios because I like to talk about them, but hers is so beautiful and I know that she has worked on how to best describe what she does. She's worked on this for a while and has really come up with something that I think so beautifully embodies her and captures her that I am going to read it. So Dr. Pinkel is the adrenal Whisperer. She is a leading naturopathic physician who specializes in stress and cortisol management. She has transformed and empowered countless women, guiding them from feeling wired and tired to a state of calm and connected. She has been featured on major TV shows and in publications like Mind Body Green and Prevention Medicine. She is a best selling author and a visionary CEO shaping the future of holistic wellness. She is a hip hop dancer and if you haven't followed her on Instagram, you need to put this podcast on pause and follow her on Instagram right this very second. Because if you, if nothing else, it will bring a smile to your face every single day. And we all need more smiles in our life. And she is a retired fashion model. And let me tell you, when this woman gets dressed up, as most of you know, if you follow me, I love fashion and I see this lady get dressed up and I am Drooling. I mean, she is hot, hot, hot. So, Dr. Pingle, welcome.

Thank you for having me. And I would love to have you dress me.

Yeah. Well, you did it for Runway. I did it for me. I just. I don't know what it is about me, but if you ask me, I don't know if we've ever talked about this, but if I wasn't a physician, like, have you ever thought about what your backup career would be?

Mm.

And do you know what mine is?

What's yours?

A dress designer.

Ooh. And then I can wear them.

Yes, exactly. Exactly.

Yeah.

And you can appreciate her from the seated position that she's in or if you're just listening. But this tall drink of water is so fabulous, I just can't even begin to tell you. So you have to follow her on Instagram. You just have to do it.

Thank you.

So I'm so delighted to have you here, because there are so many things that I want to cover today, but I want to start off with something that I actually have a genuine curiosity about, because growing up in the Northeast, and I don't know if it's a geographical thing, like, I don't know what it is, but I never knew what a naturopathic doctor was. I actually never heard of a naturopathic doctor until I started to learn about functional medicine six years ago or seven years ago or however many years ago it was. Now, I'd never heard of a naturopathic doctor before, and even now, I'm, like, not 100% on what the scope is, what the focus is, what the motivation is. And so, as a naturopathic doctor, can you enlighten us? Why did you make that choice?

Why?

What does it look like? What's the training? Like, what do you see yourself owning? Like, what space is that in?

You know, it's interesting, because the medicine that naturopathic doctors practice is actually the original medicine. You know, it was like, eat well, rest, take care of yourself. You know, have a little ginger. Have something. You know? Like, I remember my grandmother always being like honey and tea when you get sick. You know, it wasn't until we started bringing in a lot of technology and pharmaceuticals that it kind of diverted into kind of away from lifestyle medicine and more into pharmaceuticals. So a naturopathic physician, first of all, we're licensed state by state, so one of the reasons why you may not have heard of us being on the east coast is the west coast was earlier adopters of naturopathic medicine. But I have an undergraduate degree in biology So I had to have a science background, went to naturopathic medical school, which is a four year medical school where we learn a lot. Well, pretty much all of what the conventional doctor would learn as far as pharmacology, physiology, anatomy, you know, pathology and all of this. But we're also learning really deep dive into nutritional therapies, herbal therapies, acupuncture, physical medicine. So just taking it to the next level of a holistic type standpoint was required to do internships, work with patients through medical school, and take board exams when I graduated. So there is a lot of confusion as there's also a. I guess I think they call it a naturopath certification, which is very, very, very different. Yeah, so that would be where you have some sort of training. I think even health coaches can do it. And you do like an online program and you can be certified in herbs or whatever. This is very different. We are actually physicians. I am a licensed physician in the state of Arizona. And the reason I went this route was because I truly do believe that the body has the ability to heal itself in many different ways and that some of the conventional models have become so protocol based. And I kind of say like, like, almost like, I don't know how to call it a monkey manual, but kind of like a monkey manual. It's like, well, if this, then that. If this, then that. And there's no room for individualized health. And that is why I didn't go the conventional route. Now when we talk about functional medicine. Right. Very similar. It's just more so done. Typically people would get their degree and then get a certification in functional medicine, whereas naturopaths are kind of the originals where the doctors that just kind of went right into it from the get go. Yeah. And that's really the big difference. And I really love being in this space because it's allowed me to really develop relationships with my clients. I'm not just seeing them for five minutes and pumping them in and out. I'm actually learning more about them from a holistic standpoint, learning about their families. You know, funny story, my great, great grandfather was a physician for some very famous people at the time, and he was a house doctor. He would go to their house and sit and have dinner with them and, you know, treat their family. And he knew the dog and, you know, things like that. And that was kind of like when I went into medicine, I was like, I want to be that. I want to know, you know, if my client is the wife, I want to know the husband's. Name. I want to know if they have children. I want to know if they have a dog. I want to pet their dog. I want to be part of their lives in a different way than what medicine has become over the years. So that's kind of what drew me towards that.

Yeah. And you know me. I love to know the dog. And you love to know the dog.

I do. I was going to bring my dog for you today, but she. I was here for a long time today, and I just thought, I'm the leave her at home. But all my dogs say hello.

And you have so much adorable dogs, especially that little piggy. Oh, my goodness. And if you hear my Ginger snoring in the background, it's because she's asleep right next to me. She's not moving. And she is a snorer for sure. If any of you have a King Charles Cavalier, but they can snore like no one's business.

Well, I have a French bulldog, so I'm with you.

Yeah, yeah. You know all about that. So there, again, are a lot of things that I want to cover today. And I know you spend a lot of time in the energy space. And we absolutely positively think about breast cancer as a mitochondrial disease, and mitochondria is the source of our energy. But we also think about it as a metabolic disease. And there is without question a stress component tied to getting a breast cancer diagnosis. But even more important is the chronic stress state that people have been living in for years and years and years where their cells have been bathing in cortisol for years and years and years. And that has some significant physiologic effects that I would love you to talk about. As it turns out, by the time they get to me, they have very low cortisol levels. Their cortisol is spent. So can you talk about that progression? Can you talk about that high cortisol state? What's happening there, what the effects are on the body and how that progresses down the line to where they're in my office, exhausted but still wired, but exhausted. Right. And their cortisol levels are barely measurable.

Yeah. It's an interesting process. And I think we live in a society, and I know particularly moms and women, I'm sure this applies to parents, to dads as well. But we try to do so much, and we just go, go, go, go, go. And we push ourselves and we get tired, and then what do we do? We push ourselves more. Right. We continue to just run through.

Right, yeah.

Power through. We just. We power through Everything. Our cell phones beeping, our kids need that, so and so needs that. We jump to this and that and this and that and this and that. And then we wonder why we're so. Then we drink more coffee and maybe we try energy drinks and we do these things that just kind of perpetually keep stimulating us. I think one of the biggest misconceptions when we get tired speaking on the energy front is that we need to stimulate when actually it's very much the opposite. We are over stimulated. Our society is overstimulated and we see this in our kids all the time. They're overstimulated. So, so what happens when we start overstimulating ourselves? I look at this in three phases. The first phase I call the superhuman phase. We feel great, we get everything done, we run off, no sleep, we're knocking things out. You know nothing about that, right, Dr. Jen?

Nothing. No, I'm totally foreign to that power.

Power, just powering through, getting things done, knocking it out. And you really don't have a lot of side effect to that in the beginning. In fact, if anything, it might feel very euphoric and great. And people from the outsides are looking and saying, wow, you are amazing. How do you do all this, right? And as every time that we have any sort of stimulus, stress, external stress, internal stress, beep from our cell phone things added to our to do list, it causes our body to release a hormone called cortisol. So if I could relate this, maybe this will help. If you're in the woods and you're just taking a nice calm walk and you see a bear, right? Your heart rate goes up, your eyes fixate in on that bear, your blood sugar is diverted to the muscles so you can run and you just run. It's a fear response. You run to get away from that bear. You don't know where you ran. You know, you don't see the pretty flowers, you run by, you just get there, you survive. And then if there's another bear, you do it again. And then you do it again and then you do it again. And then what starts to happen is you start to anticipate a bear. So let's say you're like, man, I'm tired. I ran from three bears today. I'm going to lay down and take a nap. So you lay down, take a nap, and then all of a sudden you're like, what was that? Oh my gosh, is there a bear? And there isn't one, but you think there's one there. So the problem with Being in that superhuman stage is you start to anticipate bears, you start to create bears, and then everything becomes a bear. And the body stays in that fight or fight response where we're diverting sugar to our muscles. We're not putting it to the brain as well. We're not putting it to our little fingers, our toes. We're starting to change our metabolism to adapt, to respond to stressors, as opposed to repairing cells, repairing our immune system.

I mean, can I also say that, you know, we divert blood supply. Like we don't put it to our fingers and our toes. We also don't put it to our breasts.

No, absolutely not.

That leads to a buildup of toxins in the breast. So that is one absolute connection that most people don't talk about. And I'm so glad you brought up that, like circulatory diversion, because that is one of the reasons why the breast is the canary in the coal mine. Because it's. If you're stressed constantly, it's not getting detoxified.

Yeah, and we detox at night when we're sleeping, when we're repairing cells, and if we're anticipating a bear, I don't care if you're actually asleep or not. I mean, a lot of people use things to help them sleep. And they look asleep, but their brain is going bear, bear, bear, bear, bear. And that means that our detoxification pathways are slowed. That means that our immune system is so worried about the bear that things can slip past. And what happens is we start to have a cortisol rhythm, then that starts to change. Now we're not at that stage one where it's on all the time. Now we're in what I call the roller coaster stage. And I know all of us have been here. People always think it's perimenopause and it could be, but it's basically, you wake up one day and you have a symptom the next day. You may not have it. You may have it at 2pm, you may have it at 8pm Sometimes you're fine, sometimes you're not. And we also start to see changes in immune function. Lots of little colds here or there, not recovering, asleep in the afternoon, wide awake at night, you can start to see changes in gut health. Most predominantly, I see a lot of bloating, constipation and malabsorption of food, nutritional deficiencies. And as this progresses, guess what? It causes more stress on the body. If the body can't, for example, make glutathione for immune Function because it's too busy running from a bear that's stressful on the body. So we end up in this hamster wheel of stress, internal and external, which leads to our cortisol to burn out and to immune system problems, which is why they end up in your office after all this time and say, wow, Dr. Jen, this came out of nowhere. Where did this come from? And when you really look back, I find this is years and years of just not honoring, I guess our I don't want to self care or our own process and saying no to other people and setting up boundaries and prioritizing ourselves and our health has to start happening when we're younger. And I don't know about you, but as a mom, I see the kids so overstimulated and I'm like, gosh, how am I going to teach these kids how to say no and prioritize and put up those boundaries when they're being raised with a constant bing, bing, bing, bing, bing all the time?

Yeah.

I think kids now too, right? Like, we're seeing these cancers happening younger and younger.

It's crazy.

And there has to be a stress response there. Right? It is linked and it's missed. I don't know many doctors, except for someone such as yourself, that talks to cancer patients about their stress outside of go see a counselor. You must be stressed. Yeah. And it's a shame. We should talk about it more.

We knew we need to talk about it more.

Yeah.

I saw a post yesterday, I think Jerry Seinfeld's son Shep, who my son went to camp with for years. That's the only reason I know his name. I'm not creepy. I don't like, I don't stalk celebrities, I promise you. But his son graduated from high school and got a flip phone. Right? Like, I love it. We need to bring back the flip.

Phone or the answering machine, Remember, smartphones.

Are killing people, remember?

And the availability.

Right. And the availability that we all have and we're all on all the time and available all the time. And so I thought that was so interesting. I hope the flip phone comes back and I hope we stop being so available. And I hope we've stopped being on so much. You know, for me personally, I recently, I had this beautiful, beautiful Facebook group called keeping abreast with Dr. Jen. And we had thousands of women in it, and it was of great value. But my alerts were dinging every moment of every day, and people wanting my opinion and people wanting my answers and people wanting my presence, and it was Stressing me out. Even though there was so much good happening there, it was stressing me out so much that I wasn't everything to everyone, that I wasn't on all the time, that I couldn't be there all the time, or that not for nothing, at the end of the day, I had, like two hours worth of responses to do to meet everyone's needs because I'm a people pleaser at my core. Like, I can't. I know. No is not a part of my vocabulary.

We're working on that.

That.

Dr. Jack.

I know, I know. If I'm being honest, Dr. Dr. Pingle is in my accountability group. And so, like, there's a lot of shame here as I admit all of the things that I'm supposed to be held accountable to in our group. And I'm guilty of not doing the things that she so lovingly and generously gives me. Her advice, her wise, wise, wise advice. And I'm trying to take it on as much as I can. But here's my, like, guilty admission that I'm trying to say no. And I had to shut down my Facebook group this week, which was so. It's so hard for someone who's a people pleaser to do that.

I just want you to know, I mean, you so much want to give to people, not just to please them, but just genuinely, like, you're just a genuine, you know, it's such a pleasure to have been able to get to know you over the last couple years because you're a genuine person. And. And it's hard. And I don't think you're alone in this. I think most of us that are empathetic, that want to share and love and hug, it's hard for us to say no. And we feel like, no, we're going to have to do that because it's better for them. But the bottom line is sometimes we do have to say no. And it's not. I mean, you're not going to serve people as well if you're not serving yourself. And I think as moms, we forget that. Yeah, we forget. And as business owners, we forget that if we just serve everyone, it'll be better. When this is, you know, my favorite one is, oh, I'll just start the diet after Christmas. Christmas is just crazy. I'll just do it after Christmas. Like it's going to be any freaking slower after Christmas. Like it's not. So, you know, that's why the New.

Year's resolutions are done by January 7th. Right. Like, it's no different. It's no different.

But. But you know, I do. When you were talking about the flip phone, one of the things that I really would love to bring back is, you know, you used to get up in the morning, have breakfast with your family, go to the office at 9 o' clock and check your voicemail, return all your calls during the day. And if people wanted to reach you, they had to call you while you were at the office, otherwise they were going to get your voicemail and then you didn't get the message until you got to the office next day. And same thing when you got home, you had to check your voicemail when you got home from work to see if people needed to reach you. And you had to learn when to reach people because you didn't know, you know, and there was a. I mean, I get the beauty of the technology, but there's so much research on that, just the cell phones alone, but also causing sedentary lifestyles, causing that constant stimulation of the brain, the constant overwhelm of information. I can imagine any condition, particularly cancer, you get diagnosis. And the first thing you do is go to Dr. Google and start typing in all the things. And it's like this download of information and you don't even know where to start. And that's exhausting. It's exhausting for our brain, it's exhausting for our adrenal glands. And there's something beautiful in some of the simplicity that we've lost as we've gained this technology for our bodies. And we have to physically say no now. Yeah.

And it's absolutely true. And not for nothing, but, you know, yes, you are tempted to download a ton of information, but part of how you got to that place in the first place is that you have gone through those three stages of adrenal function. Right. And most of the time, of course, there's going to be exceptions to the rule, but most of the time, by the time you get a cancer diagnosis, it's because that adrenal function has absolutely plummeted. And all the things that it is supposed to do in protecting you and promoting your health and giving you what it needs, what you need has been exhausted.

Yeah.

And so we're just. We're trying to get blood from a stone at that point.

Yeah, yeah, yeah. But that doesn't mean that it's hopeless. I mean, of course. And what's crazy is there's all these little things you can do that don't really take a lot of time. And it's something that people can do now, whether you've already been diagnosed, you haven't been diagnosed, you're just trying to improve your health. It's really just coming back to connecting with yourself, you know, and allowing. It's allowing it to be okay to drop the Facebook group, you know, because it's what needs to happen now. It may come back later.

It may come back later. And that's why, like, I never say never, but what I did say is not right now. Not right now when I have 3 million balls in the air and there are a lot of really important ones that I can't drop right now. Right, yeah. So I do want to get to the things that everyone can do right now. But before that, I want to talk a little bit about metabolic health and the connection between cortisol and metabolic health. Because there are so many people coming to me saying, I'm doing everything right, I'm eating right, I'm exercising, I'm doing all these things right, and I can't lose weight, my body composition is worse, my blood sugar is worse, my A1C is climbing. And I believe that you have some insight into this area.

Absolutely. I mean, if you're running from a bear, your body's not going to stop to have sex. It doesn't care if your hair falls out. Right. It doesn't care if you're fat. If anything, it wants you to gain weight. And let me tell you why. So when you. When you're in that fight or flight state, your body actually diverts the way that you utilize glucose and insulin. Right. So we have basically three sources of fuel. We have carbohydrates, fats and proteins. Right. And fats and proteins give us more sustained energy and sustained metabolics. But glucose is there for that quick responder.

Right.

So when we're constantly running from a bear, our body has to pull from whatever's right there, and it will actually make its own glucose from the liver. So instead of detoxifying and repairing cells, our liver goes more to, let's create some sort of quick energy to run from this. Insulin goes up and over time, if you can imagine, if you're always running into a bear, your body's going to finally say, okay, we've got to adapt to survive. And the adaptation is actually to raise blood sugar levels, pack on some extra fat, because the fat will actually be a source of fuel. It's our best source of fuel. So the body's actually adapting. And I think so often we get angry with our body during that moment. We're like, oh, gosh darn it. We're doing everything right. Why isn't it responding? And some of that anger is actually, ironically, a bear. And we have to let a lot of that go and realize where we're at in our lives. There is a lot of it. That's diet and exercise. That's important. But when you are under so much stress, cortisol will always win, because if it doesn't, you will get eaten and that is it. The bear will get you. So the body says, I'm going to downregulate the sex hormones. I'm going to downregulate detoxification. I'm going to put the immune system on alert for the bear. I'm going to raise my blood pressure so I can run faster next time. I'm going to make sure there's glucose available all the time so that I can run from that bear. And you don't get the impact from the food that you're eating in the same metabolic way. And on top of that, to add on top of that, just the release of cortisol alone depletes B vitamins, which are essential for energy production and for weight management. It depletes all your minerals, magnesium, selenium, to manage thyroid function.

Right.

All these little CO factors in our body that are required for the things that make us feel good and look good are drained directly by cortisol and also indirectly by cortisol. Cortisol is there for a reason. It's there to get us through an acute stress. You know, when my mom died, it was a huge hit. Huge, huge, huge, huge hit to my heart and to my soul. And it took me down. And cortisol kept me alive because it kept me going. It kept my heart beating. It kept me going while I was in the lowest point. But if you don't come out of that, the body's going to try to save you long term. So we need to, you know, recognize the benefit of cortisol, but not adapt to it in such a way. Adapting means you're surviving. So I always try to say change the mindset on it a little bit. I mean, I know it's frustrating if there's a little bit of extra fat there, but if you can recognize that cortisol rhythms are out of whack, it's your body protecting you while you figure out how to get that under control. So let it protect you so you can figure out how to get it under control. Because we have to wake up every day to get better, right? So. But it does it changes mineral status, it changes blood sugar, it changes hormone metabolism. We're not going to worry about our skin, our hair, our nails when we're running from a bear. Right. All these things that can be misdiagnosed or maybe diagnosed inappropriately. You know, you go to the doctor and say, oh gosh, my mood, I have a lot of anxiety. Well, here's a meditation medication for that. Well, why would you have anxiety? Because there's a bear, you know, of course you're going to have anxiety. That's a normal response. Response. Yeah. So we can hit you over the head with a mallet and knock you out and make you ignore the bear, but the body still knows the bear is there. So there's a lot of work that needs to be done at the root level with cortisol in order to get long term impact. And this goes for hormones, this goes for immune system, this goes for liver health. I think the toxin issue is huge. You know, if, if your body isn't clearing those toxins out of the cells, you know you're going to develop disease and fatigue, right?

Yeah.

So we really have to go back to basics with always putting stress management and cortisol management in all protocols in all scenarios so that you can get better utilization out of that wonderful food you're eating and the exercise that you're doing.

Yeah, because it also has profound effects on the gut. Right. It basically shuts down your digestive. Digestive capacity. Because you don't care if you digest that meal because you got to run away from that bear.

Well, these two nervous systems work side by side. The sympathetic and parasympathetic nervous system and you know, they're ironically called fight or flight and rest and digest, right?

Yeah.

So you can't rest and digest in fight or flight. At the same time. Your body has to swap it off. And we're supposed to spend 80% or more in the rest and digest. And on average, especially here in our country, we spend 80% in the fight or flight.

Yeah. Just constantly, totally flipped.

We are completely flipped. And I think one of the biggest mistakes we make when we start to gain weight is we say, oh, I need to go to orange theory, I need to run harder, I need to push harder, I need to burn myself out. I need to, you know, exercise to exhaustion. And that's keeping us in that fight or flight. And it takes a lot to understand that in order to actually lose that weight at that point. And you really have to be doing exercises that strengthen the body, but also do it while you're in a calm state, in a parasympathetic state. I always laugh at the people that are taking a huge walk and they're like on their AirPods having a business meeting and I'm like, wait a minute, we're not getting the benefit out of this because you're walking. You're supposed to be enjoying nature and breathing in nature and calming the body.

Yeah.

But you're like having an argument with your co worker.

Yeah. Although I'll tell you that for some people like me, sometimes it's just like getting out into the sunshine and it is better than, you know, I do work in front of a treadmill because for many of us that have desk jobs, it's a lot of sitting every day, which isn't good either. Right. Like, sitting is the new smoking. Because we do have these stressful lives and we're not doing anything to burn off that cortisol. So for me, sometimes if I have to take a meeting outside, at least I'm outside. At least I'm getting sunshine, at least I'm seeing the nature. I may not be appreciating it to the full of its extent, but that at least we're doing some of it.

I think it's a great practice.

Some is better than nothing.

I think it's a great practice to do that. I think you also, though, have to have the practice at some point during your day where you're not doing other things, even if it's just 20 minutes.

Agreed.

@ night before bed, where you do some Pilates or some breathing or, you.

Know, a stroll after dinner.

Yeah.

Where that is the agenda. The agenda is the stroll after dinner. It's not the meeting, it's not the phone call, it's not the. It's the stroll after dinner.

Yeah, absolutely.

You. You said something that, that brought up fertility for me because I think that this is an area that is so under examined where there are so many millions of people struggling with fertility. It's only getting worse, actually. And, you know, the way that we have been dealing with infertility really has not changed in decades. Right. And we're giving these women all these hormonal stem medicines and that kind of thing. But can you talk about the role of stress in fertility?

I would love.

Fertility is actually on the spectrum of what I do because they're in the. They're in the fertility doctor's office about 10 or 15 years before they're in my office.

Yeah. You know, let's. There's so many topics on here to Unpack. I'm so excited. I love talking about this. But, so let's start with one very basic, fundamental is that when your body is under stress, the hormones divert. So you go into a storage, storage phase rather than a utilization phase. So if your body has a choice to go to cortisol or go to progesterone and you're running from a bear, it's going to go to cortisol. Okay. So that means when you put progesterone in, it also has the ability to convert into cortisol, so making the injections less beneficial. Right. Because the body says, okay, that's great, I'm glad you want to have a baby, but I'm over here running from a bear and I'm going to take that progesterone and turn it into something else. So we have to remember that our hormone system, our endocrine system, can divert at any moment. And that's the beauty of it. We can adapt right in a moment. So what happens when our body's under stress is we tend to store more estrogen rather than utilize it. We tend to convert progesterone into cortisol, which causes imbalances between estrogen and progesterone. So a lot of the times the reasons why we're not getting pregnant are not that we don't have the hormones, it's just they're not being utilized appropriately or they're being stored. So that's a really important thing to remember. And that makes a lot of these treatments unsuccessful or sometimes successful. But they end up with an estrogen dominant type scenario afterwards and a progesterone deficiency type scenario which, you know, gets them at higher rates of, of cancer development as well. Another thing to consider with, and I don't want to go too deeply into this, I know it can get complicated, but when you are running from a bear, you deplete B vitamins. And many women with fertility issues have the MTHFR mutation where they're already having problems with utilization of folate into activated folate. They're already deficient in B12 and these are still so pivotal in our detoxification pathways. So what can happen is you're putting these hormones in, the body's under stress, it doesn't have the nutrients it needs to clear out toxins or even manage hormones to begin with. And it doesn't know what to do and it gets more stressed out. We have a, external stressors which I think are pretty obvious, you know, life, life stuff. And then we have internal stresses which is like a B6 deficiency. Right. That stresses our body out. We are on a. On a conveyor belt to produce energy, and the energy is to make a baby, in this case. Right. So if we're missing a nutrient that's important as we're going down this conveyor belt, we can't produce the energy needed to produce what we want. So that is very stressful on the body when it cannot produce its product. Right, yeah. So fertility is impacted by stress in so many different ways, and yet we come at it from, oh, you're deficient in progesterone. Oh, you just need more estrogen, you know, and that might not be the case because you can put all that in and still have it be unsuccessful. We need to also be looking at what is cortisol doing what, what are our nutrient levels? What's our toxin status? You know, is our body running in fight or flight? We're not going to stop and reproduce when we're running from a bear. Naturally, we're not. That's a protective mechanism. Yeah, right. Yeah. So much to talk about. And, like, that's an overview.

It's interesting to me, though. I mean, I think on some level the fertility doctors do understand that stress plays a part, but I don't know that they're actively working on it or that people understand what it means from a physiologic standpoint. I also want to say that most prenatal vitamins contain a really toxic form of B9.

Right.

They have. They have folic acid in them, and this is not good for anyone. It's amazing to me that we have allowed this in our system and it's become standard of care.

Oh, me too. And I. And you know, to clarify for those that may not know, your audience may be familiar, but that MTHFR mutation, that when you have it, when it's working properly, it's supposed to take folic acid into activated folate. And when we get pregnant, everyone's like, take your acid, Folic. Folic acid. Take your folic acid. Well, folic acid does nothing. It's the methylated form that's required. Yet the prenatal vitamins are loaded full of folic acid, and a large percentage of us have these mutations. I have both genes. I can't convert folate. Well, yeah, and that has a massive impact on your immune system, your detoxification pathways. And if those are off, you're stressed out. Just the fact that you don't have activated folks, folate is stressful on the body. It needs it. It needs it to grow a baby, it's required. So, yeah, there's a lot of. I think. I think it's getting better. I think as we get wonderful people like you and more doctors really looking at how can we change this or every scenario in health, I think we're starting to realize how important these nutrients are and really focusing on what our body does in arrest reparative state. Yeah. And part of the reason why we're having all these problems, in my opinion, is that we're not in a rest state. So we're not absorbing the right stuff from our food. We're not absorbing our supplements. We're taking loads and loads of supplements and urinating them right back out because our body's like, you know, I can't.

Help you with this right now.

Yeah, I got to answer this text message. Like, leave me alone. Like, you know, and I think we really do need to just go back to the basics and be like, okay, let's just back up a little bit and take a look at are all these efforts that we're putting forth, all this technology that we're using, is it actually being utilized by the body right now or not? And if not, my suggestion is always back away. Focus on the cortisol response. Get that in check. Nutrients, herbs. I look at four pillars. There's nutrition, there's movement, which focuses more on exercise. That's parasympathetic in. In nature supplements to supplement the losses in your particular case from the stress response and mindset. Because there's been tons of documentations on if you have fear or anger, you know, some sort of emotion in the amygdala, it changes the way that we process the next things in our prefrontal cortex, which then gives us more fear to something else and more fear to something else and more fear to something else. And when we're in fear, that's a bear. Yeah. And I think it gets very scary when infertility. You know, you want to have a baby so badly, so it consumes you, and that's understandable. And. But there's a lot of things where we. We almost have to, at some point say, okay, I have to trust my body, I have to support my body, and I have to know that I can make this happen and not worry about it as much and just support it, you know, and there's a lot of stuff. A lot of stuff to unpack in that, you know, oh, puppy dude. So looking at those four aspects and just kind of backing up for a moment, just going back to the Basics and really focusing in on that. Most of my clients in the fertility realm, and I'm certainly not a fertility specialist, but there's been many people over the years that have come to me with failed, you know, in vitro attempts where we took three months. Three months just to really hone in on their cortisol response. And then they went back, and now there's babies, I call them little pingle babies running around. And I love it because it wasn't me. I wasn't the fertility doctor, but I.

Know my husband's okay with that.

I know. But because they just slowed down, trusted their body, and really addressed the stress response. Now their body allowed them to create these beautiful little creatures. So, you know, don't give up hope on it if it's. If there's a lot of attempts going towards it and it's not working. Just step back a second. What is the body trying to tell you? We have lost a lot of that connection between listening to what our body's trying to tell us. If we have a pain in our elbow, we think, oh, man, let's stop it. Like, oh, what's wrong with us? When we should be saying, why do we have a pain in our elbow? Did we do something?

Yeah, I'm so glad you brought that up, because we really, truly have become completely disconnected from our health in that aspect that you're talking about, and in the fact that we are just one unit. Right. Like, we're just one system. We're supposed to be functioning like as a symphony in harmony. And we, as a medical system certainly have fragmented everything, and as a result, everyone has fragmented their care. So we're not connecting anymore, and we're not thinking about what could be happening that's leading to this, what could be happening that's causing this. And we've become disconnected with our health, and we have the lack of health to show for it.

Yeah. We're practicing reactive medicine rather than proactive medicine. And we really need to think about how do we keep ourselves well and what do we have to do for our body to stay well, rather than waiting for something to happen and then treating that. And when something happens to me, you know. Yeah, I can get bummed for a second. Like, if I'm tired, I'd be like, oh, man, I'm tired today. And then I'm like, wait a minute. Why am I tired? What do you need to say to me? Do I need more water? Do I need. Did I not eat well? What do I need? What do you need? And I start Just meditating on my own body. What do you need? What are you trying to tell me? And the answer always appears. And I usually feel better afterwards too. And really learning how to understand what our body needs and what our body's trying to say to us. We're so quick to dismiss it or get angry at it. Especially, especially earlier we were talking about the weight gain that you can't lose. We sit there and stare at ourselves in the mirror and tear ourselves down to the point of just. And granted, I'm a fat. I was a fashion model, right? I mean like I grew up where. And maybe this will relate to many of you out there, but I grew up where you show up and you be what they want you to be. And what you want doesn't matter. It doesn't matter if it's 40 degrees and you're in a swimsuit on a beach, it's. You're gonna look like they want you to look like you feel great, right? You need to look happy when you pick up this cup and drink this product. You need to look, you need to be that. And if you don't do exactly what I say or be exactly the weight that I want you to be or whatever, you're not good enough. And I grew up in that world and I think as a society we kind of have that world as well. It's like whatever everyone else thinks matters more what we think. And then we tear ourselves down based on other people's expectations. That's a huge bear that we do to ourselves, that we actually can change, right? As we get older and our bodies change. Like how beautiful is that? Like how beautiful is that? Like I gave birth to two babies and I have a little tiny thing to show for it. And you know what? I have two beautiful children to show for it too. So so be it. You know, I put good fitness, I exercise, I take care of myself and that's all I can do.

Yeah, but like you said, we, we hold ourselves to these near impossible standards, right? Like we're looking at the 40 year old celebrities and the 50 year old celebrities and even some of the 60 year old celebrities. And we're not seeing the ones that are struggling in the ways that we're struggling or seeing the ones that don't appear to be struggling. But let me say this about that. Even the Jennifer Aniston's of the world, her struggles are real too. And there's no way that she looks like that 24 hours of every day. Right? And that she has tough days and tired Days and all of this, she has it, too. So I have really worked hard in this last year of acknowledging that what you see, that you think is true out there is someone's very, very highly curated version of what they want you to see. And the truth is that everyone is struggling. Everyone has tough times, because life isn't like this. And you get there and stay there. Life is this.

Anyone who's growing is struggling, right? Because you don't grow without struggle. I mean, the reason why I'm here, and I'm sure the reason why you're here, is we went through struggles and we thought, I can give back to the world in some way because of what I went through. And the other thing is, you know when I think people are the most beautiful is when they're actually really upset because they're crying and they're bringing forward their vulnerability and their love, and their makeup's running down their cheek. And I'm like, beautiful soul. I mean, I know my patients are like, gosh, I cry all the time when I come in here. I'm like, you're so beautiful. Like, just that you're just ripping your soul open and feeling comfortable sharing that with me. That's one of the most. As a physician, that's probably one of the most beautiful things I see on a daily basis. And it's also the people who get well the fasting fastest because they're willing to just be like, I can be ugly and I can be real with you, and that's cool and vulnerable and vulnerable. And, you know, it's okay to be that way. And we're. It's taken me a long time to learn that, just growing up in that world, you know, and beating myself up for so many years, saying, well, you have to be dressed perfectly. You have to be. Your hair has to be done, your makeup has to be done. You have to show up and be present and perfect and say the right thing all the time. That is freaking exhausting.

Yes, I know.

It is exhausting. And I don't know why we do it to her. Can I just show up as me today? Because that would be great. And I just made a point at one point in my life, I was like, I'm just going to show up with me and take it or leave it, and that's what you get. And my health benefited from it. And I see that every single day in women that just show up and say, I'm just going to be me today, and they get well. So, you know, beating ourselves up over this and trying to accomplish something that what we think is going to accomplish, even with health, you know, we're faced with a health challenge and we're like, yes, you need to have the confidence that your body can beat it, but you also have to have the confidence and the understanding that your body may need to just rest for a while or it may need you to be nurturing to it for a while.

Yeah.

And that's okay too.

Yeah. And so many people are like, geared up and they're gonna fight this, Right? There's a lot of those kind of aggressive war like tropes surrounding cancer. Right? You're gonna beat it. The fight against cancer, the war against cancer, the survivor, the warrior, that all these, all these words. And I actually write about this in my book, it's kind of the last thing that all of us need. Like, we don't. We don't need another fight. We don't need another war. And so many people are like, what can I do? What can I do? What can I do? What should I do? And for so many people, the answer is you need to do so much less. 100%, so much less.

You can't repair if you're running from a bear. And when we fight, we're in fear. I mean, it's not. Fighting is a weird word. You know, taking action on your health to feed it well, to exercise, to meditate, that's taking action on something that's not fighting. That's just being proactive. And I think we use the word fight, fight. And when I say don't fight, they're like, oh, that's mean. Yeah, I'm gonna beat this. But you have to do it in a way that's nurturing and loving and accepting. I mean, my. I. I sat with my mom for nine months while she passed of cancer, and it was heartbreaking. But the one thing I did have, I shared with you. The what? She told me her number one regret in life was it was about a month before she passed. She was at my house and I made her a steak because she wanted steak. And I'm plant based, by the way. I don't make steaks. But I made a steak for her and she could only eat a couple bites because she was so thin. She was just so thin. And she was a professional model as well. So she was thin from the beginning and then got really, really thin. And I said, mom, you know, going through this process, do you have any regrets? And she said, I only have one. And she goes, I wish I wouldn't have spent so much time worrying about that stupid £10, because I would give anything for £10 right now. And that was a really.

Oh, my God. I just got chills.

That was a really profound moment for me. And that's the moment where I started to say, how often do I look in the mirror and beat myself up physically, not realizing that I woke up today and I can do whatever I want to do today. I have the power to do that. I'm not plagued with the disease that's keeping me. She couldn't get up and walk to the bathroom by herself because she was so weak towards the end, you know? Yeah. And that's. And that's, you know, I thought, God, what an interesting regret you would think it would be, all the things you said to people or like, you know. But no, it was that she worried about weight. So I don't know. I don't know if that resonates with anyone out there, but there's just so much beauty in the world to focus on and so much love when you're healing, no matter what you're going through. And we're all going through something. Something.

Yeah.

So we have to have love for ourselves and each other to just work through that process. And it will also benefit your adrenal glands.

Yeah, for sure. I love that you said that. I want to jump to energy. And I know that we talked about it in the context of cortisol, because we kind of use cortisol to get that energy. That's. That's our energy hormone. But there's also the whole issue of mitochondria and how we generate energy. But that's probably the number one complaint of people is that they just don't have the energy that they want, the energy that they need. And it's such a vague thing that in a normal doctor's office, it just gets normalized, Right. Like, oh, it's normal to become. To have less energy as you age, and it's normal to have fatigue and you're just getting older and this and that. And so I would love for you to address what. What do you say to people who come to you and they just don't have the energy that they want or need or should have.

Have. Well, I think when you brought up the mitochondria, very important. That's your conveyor belt, right. Where you have all these little things that have to go together in the mitochondria to create ATP. These are nutrients. Right. If we don't. If we're under stress, we don't have the nutrients. We, we can't make ATP if we're toxic. We have toxins in our body. It blocks the mitochondria. So there's a lot there. All of those things, ironically, are worsened with stress. So when we're overstimulated, we're going to get tired because we're running all day long. Brain fog is one of my favorites. Without, they're like, I'm tired and brain fog. You know, you walk into the kitchen and you're like, why? Why did I come in here? Well, you're so busy focusing on the stressor that your body didn't pay any attention to why it was walking into the kitchen. It just fell out. And people go, well, do I have dementia? Is my body falling apart? I'm like, no, you're just stressed. You're stressed out. We have to address that. So energy issues come from the mitochondria not having what it needs to produce energy, or the energy going to the wrong place, being focused on the wrong place, both of which are repaired by learning how to be in that parasympathetic nervous system more often and providing the body with the nutrients that it needs to produce energy. It's not as complicated as people think. You know, if you're sleeping well and resting well and getting the proper nutrients and not constantly running from a bear, your mitochondria can catch back up. You know, livers need to clear toxins, that type of thing. So a lot of the protocols that I do with people come from managing the cortisol response, but also come from giving the nutrients to the mitochondria and helping detoxify the toxins that are blocking, you know, the mitochondria from working. And I mean, that's it, right? But I will say, if you're one of those people that constantly forgets you don't remember driving home. Somehow you get home, but you don't remember driving home. You walk into the laundry room and you're like, darn it, shoot. I'm telling you right now, that's an adrenal issue. The adrenal glands are having an impact on your health. And if they're having an impact on your health, there's an impact in your gut, your heart, your immune system, your brain, your hormones, your thyroid, your mood. They're all impacted because when cortisol is released, it impacts every single system in our body. In fact, that's what my book is. When someone approached me and said, would you like to write a book? I said, no, that sounds Stressful.

Let's just get that out there. It for sure is.

Yeah. And the publisher said, no, no, no. I really think you're onto something. Can you tell me why stress is such an issue? And I took a napkin. Yes, I took a napkin and I put cortisol in the middle and I drew how many things cortisol has a direct impact on, and it was every single body system. And then I went further and said, when this body system is impacted, what nutrients do we lose? And does that then feed back and cause more cortisol problems? And the answer was yes, in every single system, the entire body is impacted by that stress response. And that is going to result in fatigue. It just is. So if you're finding, you know, you need to take a nap in the afternoon, you're awake in the middle of the night, you know you're having health symptoms that everyone says, oh, you're normal, that's fine, don't worry about it, you're good. That's just getting older. Check your adrenal glands. That's. Everyone says, how do I know? How do I know? If you're being told that you're, that this is normal and you don't feel well, it's probably rooted in cortisol. Yes.

And the interesting thing is that when we are in training, when we're, when we're learning, when we're studying, we are told, taught to think about the adrenal glands first and then the thyroid and then the sex hormones when we're talking about hormonal health. And that's because you cannot have the others without first having this adrenal health. But then the interesting thing is that they never really tell you how to reclaim adrenal health. So you talked about four pillars, you talked about nutrition, movement, supplements, and mindset. So I would love for you, in our time remaining today, to just give people some action items, give them something that they can use to maybe start tomorrow to reclaim their health, their adrenal health in these areas. Because almost all of us, you said yourself, we're living in this sympathetic fight or flight place way more than we're supposed to be, way more that we're actually in that state probably 80% of the time and in rest and repair 20% of the time. And it should be the other way around.

And that's the starting point. That's honestly the hardest thing for people is the mindset piece. Most people can pick up the nutrition, and we'll talk about those too. But honestly, one of the best things you can do is start to work on getting your body into a parasympathetic state, stimulating the vagus nerve, right? One of my favorite ways to do that is dance. That is my favorite way to do it. I'm a hip hop dancer, right? So I love music and dance. But singing, for example, when you rattle your throat with singing or humming, that can actually put you into a parasympathetic state. One of the number one things that I tell my patients is I say, okay, I want you to think back to when you were a kid. What did you love to do? What, like, just brought you so much joy? It was like, if your parents were like, go do that. You were like, yes, right? And go do that. Get back to whatever that is. Because when life takes over, we lose it. When I went to med school, I had kids, I got married, I was doing a job, I stopped dancing. I didn't have time. I don't have time to dance. I gotta pay the bills, right? And I lost not only that connection of my brain to my body and my ability to move in that way, which is so important for health, but I lost my joy. I lost the thing that makes me happy and smile, you know, I mean, you know, just like many of my friends would know, you turn on a good song and, man, I don't have a worry in the world. I don't even know what my body does at this point. I just dance. And there is so much joy in that. My mom, when she towards, when she was getting towards the end of her cancer, really took up painting again. And she went through the process, you know, she passed on, but she was, she was okay. I mean, she was okay with it because she was doing something that she loved and joy. And she went out doing something. Enjoy. So we get so caught up in our left brain.

Thing is, there's a lot of work around. Once people let go of their fear of death, yeah, they, they reach this state where they, they no longer are embodied in this stress state. And they, I mean, listen, we're all going to die of something. Granted, lots of people die prematurely, but it's wholly different to die in this calm accepted state than to suffer through the fear and the anxiety that surrounds death. So it's so interesting that you said that, and I'm sorry too.

I mean, even if you don't have a terminal diagnosis, you can live your life in fear and be constantly running ragged and constantly always trying to catch up or you cannot.

Yeah.

And there's a choice there. And I think that's One of the hardest things for people to do, you know, when you go to the doctor and they say, oh, just, you know, do some meditation or go see a counselor. No, it's not that easy. It is. It is a lot of work. But one of the easiest ways to do that is refind your joy in your heart. What do you just love to do and do it and make time for it? And in those moments, if you're not worrying about everything else, your body has a moment to be like, oh, the bear is gone. And then if you start doing it repetitively on a certain schedule, the cortisol starts to say, oh, hey. Like for me, cortisol says, hey, it's six o' clock Monday. She's going to dance class. Yay. This is great. We're going to chill out. The bear's gone. We get to dance. Right. It's just. It's a different way. So the outlook, number one thing is reframe that bear. What if the bear wasn't scary? What if the bear was just a little cub that you had to divert, you know, give it some food and go do what you want to do for a while? Right. Why do you have to run? Why are we so scared? Yeah, number one. And I think that's probably the biggest, one of the hardest things to do, but probably the number one game changer in the people that I see get well the fastest is they just have to let go. They have to let go and accept and trust and be okay with that reframing. And then when your body's calm like that, those efforts in the nutrition, the movement and the supplement will be so much more impactful. And that's where you really start to see changes. Favorable changes in weight, thyroid hormones, immune system, gut health. That's when it all comes together and really elevates you to the next level of health. But if you haven't made that choice to reframe that bear and connect with something you truly love to do, it's a lot harder to get the benefit out of all those efforts. And then it's exhausting. And then it becomes a chore. And then eating healthy becomes a chore. And eating healthy shouldn't be a chore. It should make you feel good. Like, I get energy when I eat, right. But if I was in Fight or Flight, I wouldn't.

Yeah, yeah. And, and not for nothing, but the way in which a lot of people eat does contribute to that, right? Like, there is a huge difference between, between sitting down and having a meal with friends or Family in a kind of joyous, restful state, or grabbing a sandwich as you're running out to drive, carpool, or whatever it is. Eating standing up by the kitchen counter. There's a dramatic difference between those two things.

And people would say, it's time. Well, I don't have time. And I'd like to argue if that's the case. Write down everything you do in a day, because I know I love to watch, like, I watch series on Netflix, like, slowly to kind of. But I could cut that out to sit down with my family. Like, there are moments I could shave five minutes here. You know, I could take social media out completely. Right. There's little things you could do. And one of the things we brought back in our family, there's two things we. We brought in our family that have really helped. Number one, the phone. We kind of treat our cell phone like the old school phone. You wake up in the morning, you don't check your phone right away. You have breakfast, you sit outside, you have your coffee. You don't go to work or check your phone until, you know, at least an hour, if not two hours from waking. And then at night, we hang up the phone, put it in a drawer. Don't have it on your person. It's away.

Yeah, right.

I mean, I'm a concierge doctor. I still have to check my phone. People would say, well, for work, I have to check my phone. But I can be mindful about when I check my phone, it doesn't have to be in my pocket. Right. The other thing is we brought back game night. So Sunday nights, we all sit at the table, we eat dinner together, and we pick a board game, and we just have fun as a family, and we laugh and we connect. You know, my mission in this world is to reconnect us to ourselves and to each other, because I feel like, stress. We have disconnected from everything. And oddly, we are the most quote, connected we've ever been with technology, but yet the most disconnected in human to human contact. And so that's what we brought back. And it's brought so much joy for me and for my. My husband was kind of. At first, he was like, game night. Like, I'd rather just watch tv. And I was like, no, we're gonna do this. And he's having a blast with it, too. And the kids are having a blast with it. So those are two things you can do, just little things. Well, three, find something joyous that you used to love to do. Put restrictions on when you're going to use your phone and then bring back some sort of family activity from the 80s when we used to play Trivial Pursuit on Saturday nights. Right?

Yeah. So fun. So fun. Dr. Crinkle, this was amazing. There was so much valuable information here and you gave so much insight into why people are suffering and they don't have to be and that they're. There are some really, really simple things that everyone can start to do today, tomorrow to make a tremendous impact on improving your health and setting the stage for health. Because, in fact, that's what it comes down to is that unless you set the stage for health, you're never going to achieve it. So, ironically, the Runway model came today to set the stage for health for us. And I'm so, so, so grateful that you, you did. Where can people find you?

DrPingle.com is a great part, starting point. And of course, come find me on Instagram. Dance with me on Instagram, laugh with me on Instagram. You know, I figure if I'm going to go onto social media to, you know, for, to spread my message, I'm at least going to have fun doing it like this, you know, So I figure I'm going to use that time to have fun and connect with people. So if you follow me from hearing this, please say hello and tell me where you're from and that this is where you found me. And if you want to dive more into how on the nutrition, exercise supplement and mindset, you can certainly check out my book. It is available@drpingle.com as well, total Health Turnaround. And it's kind of an introduction to just the steps to take and the education on how stress might actually be impacting you and what you can do about it. So I'm just thrilled to be here and spend time with such a lovely human. Thank you for everything that you do for your audience and for your people. You are an absolute joy to be friends with and to just as a co, I guess, a colleague in that respect. So thank you for having me.

Thank you. That was very kind. If you like this episode, and I can imagine that you didn't, please like it, comment, share it with someone who needs to hear it. We are all looking for more energy these days. We are all looking to do this life better. And there were so many pearls of wisdom today on how exactly to do that. And make sure that you're following Dr. Pingle on her Instagram. Make sure that you're following me on mine. Pick up a copy of the Smart Woman's Guide to Breast Cancer. For anyone who is struggling with a breast cancer diagnosis or really anyone who is just trying to recapture health. Because as I always say, breast health is health. And I will be back next week, same time, same place. It's Dr. Jen. Bye for now.

Thank you for joining me on this episode of the Keeping abreast podcast with Dr. Jen. I hope you found the discussion informative and empowering. Remember rest. Health is health, so by staying informed and taking proactive steps, you have the power to optimize your well being. My team and I encourage you to apply the knowledge gained from today's episode to make positive changes in your life and share what you've learned with others. If you enjoyed this episode, please subscribe to our podcast and leave us a review. Your feedback and support mean the world to us and help us to reach more people who can benefit from these conversations. Stay connected with me on social media where I share additional resources, advice, updates and announcements related to breast health. You can find me on Facebook, Instagram and YouTube. Dr. Jennsimmons and remember, MyGen has two N's so until next time, remember to stay proactive, informed and confident in your breast health journey. The key to your health is you.