The Connection Between Gut Health and Hormones

Hi everybody, I'm Dr. Sanda Moldovan, periodontist and nutritionist. Welcome to the Holistic Dentistry Podcast, the show that gives you the tips and tools to detoxify your mouth for a healthier body as we explore together the root cause of disease. Remember, you're not healthy until your mouth is healthy, so take care of it in the most in a natural way.

Okay, hi everyone. Welcome to today's show on the Holistic Dentistry Show. I'm your host, Dr. Sanda Moldovan, and I'm super excited to talk to you about hormones, perimenopause, menopause, bioidentical hormones, the effect of gut and oral health, SIBO and Candida, things that we see in the mouth but also are really coming from the body. And with me today, is Lisa Smith. She's a functional medicine dietitian, gut health expert, and the founder of Lisa Smith Wellness. With dual master's degrees in nutrition and human biology, Lisa is passionate about helping individuals like you live their most vibrant lives by sharing evidence-based and cutting-edge health solutions through a personalized lens. Lisa, welcome to the show.

Thank you. It's so good to be with you. I appreciate coming on.

Yes, I'm excited to talk to you today, and I want to dive first into how did you get here? You know, we all have a personal story, and I'm curious how this functional medicine path started for you.

Yes, we do all have a story. That's what makes us so passionate about what we do. I started this when I was little. My granddad was a cancer surgeon, and that was— left a really big impression on me. We used to visit him every Thanksgiving and Easter, and his patients— this takes you back a few years— but his patients would bring us the Thanksgiving turkey every single year and the Easter ham. And they would always say, isn't that amazing? And they would always stay and talk, and they would say, your grandfather saved my life, or your grandfather saved my wife's life. And it was very touching and impactful. So I remember when they would leave the house, Dr. Sanda Moldovan, and he would turn to us and say, I would so much rather help my patients prevent this horrible disease than try to cure it after. And that was intriguing. I remember asking him as a, as an elementary school kid, like, you can actually help people prevent cancer? And he said, in many cases, You can, it's lifestyle dependent. So that really planted a seed in me and I decided at a young age, that's what I was going to do. I was going to help people for, I was going to help them prevent cancer. Well, you know, I graduated from college. I started pre-med, decided I did not want to work that hard. I wanted to have a social life and I went a whole different direction into sales for a long, a long time. Then after I had babies, I got to stay home and raise my kids. And I knew my passion was holistic health and functional medicine. Now layer on to the fact that I ended up with Hashimoto's after my second baby was born, but I didn't know it for a year. I went undiagnosed. I just thought I was sleep deprived and I got really sick, really, really sick.

Don't even know what Hashimoto's is, and I do have a lot of younger patients nowadays coming in with Hashimoto's. So what is Hashimoto's?

Yes, thanks for asking. Hashimoto's is hypothyroidism, but it's autoimmune. So, so what's happening in the body is something is causing the body, the immune system, to attack the thyroid gland, and that impacts every cell in our body. Every cell has receptors for thyroid hormone. So that affects things like immunity, weight, temperature regulation, moisture retention in your skin, your hair, your eyes, all of everywhere. Fatigue, biggest, the biggest player. We see exhaustion, constipation, anxiety, depression, like it affects everything. So going undiagnosed for a year, because I had a 2-year-old and I had a newborn, I just thought this is what happens. You get really tired. But I was, I got to a point where I was having trouble walking. My joints weren't working right. I was in chronic pain. I wasn't sleeping. Like there were all these things going on. I thought it was, I was terrified. I thought I'm this young mom and I might have MS or something. I was really scared. And what they found was this Hashimoto's, but it was pretty significant by that point.

Is that something that most doctors know how to recognize? Like if you go to a traditional doctor, let's say. Would they run a blood test or how would they do it?

That is such a good question. I think that it is becoming so much more prevalent and there are a lot of reasons for that. We can talk about why, but it's becoming so much more common that I think even general practitioners are getting pretty savvy. It is a blood test and usually to really diagnose it, you want to look at several several blood tests, several different factors. A lot of times doctors will just run one blood test and that's the TSH, which I'll explain here in a minute. But I think people are getting more aware of it. And the TSH, so there are different, like I said, there are different tests that should be run. The TSH is when the brain tells the thyroid, hey, we don't have enough thyroid, we don't have enough thyroid hormone. So what I need you to do, the brain says, releases this TSH that stands for thyroid stimulating hormone, releases it, goes to the thyroid gland and says, pump out more thyroid hormone. But if the thyroid is being attacked by the immune system, it's doing its best, but it's not able to keep up. So that becomes, it's like a feedback loop so that the brain is recognizing there's not enough thyroid. The thyroid's trying to work with the brain, but it just can't keep up is what is happening. So, it's not pumping out enough thyroid. So then, the TSH keeps going higher and higher. So, when we— when a doctor looks at or a functional medicine practitioner looks at thyroid, your TSH will go the opposite way of your thyroid hormone. That's the easy way to remember it. Because sometimes people will say, "Well, my TSH is high. I must not have a thyroid problem." It's the opposite. That means that's the signal. The signal keeps going higher because the thyroid gland you know, hormone keeps going low.

You explained that perfectly. I love it.

Thanks. Thank you. Well, so that's, that's my story. I ended up getting really sick, and then remember that seed was planted as a young kid to try to help people prevent cancer. Well, I shifted that because of my own journey, and I decided I'm just going to help people live their healthiest lives. I have definitely never even went the cancer route. It's so complicated, and there's so many different players involved, factors and bio, you know, individuality that I now, I became a functional medicine practitioner and did that for years and continue to do it. But I went from having an office, a brick and mortar office like you have to now virtually.

Amazing. Um, you mentioned there's different factors that contribute to developing this autoimmune that leads to Hashimoto's. What are those factors?

Yes. So there's, there's a lot of research, Dr. Sanda Moldovanova, and what we know about autoimmunity, Dr. Alessio Fasano, he is brilliant and he's done so much research and, and you can look him up and he's, I don't remember if he's a biochemist, but he is brilliant in the field of autoimmunity. And what he has determined is that autoimmunity is a three-legged stool. So you have to have 3 legs for it to really take off. The first leg is genetics. There's, there's a genetic factor, which makes so much sense. But if you only have the genetics and you don't have the other 2 legs, typically it's not going to manifest. You're not going to see that autoimmunity. So when we're told over and over again, well, you have the genes for this disorder, you have the genes for this chronic illness, don't ever let that, for our listeners, don't ever let that be a label that you carry because because that's not the whole story. You can affect how your genes turn on and off. So, the second two stools, genetics. The second one is a leaky gut, also known as intestinal permeability. It's pretty common and we can talk about that, but you have to have that too. And then the third thing is some sort of trigger. It can be anything. It can be a stressful season in life. It can be exposure to a virus, any kind of pathogen, a bacteria. Parasites, mold, Lyme disease. Like, it can be any kind of trigger that's a stressor on the body or the mind. That can be the straw on the camel's back that sets autoimmunity into motion.

Yeah.

So if we can address leaky gut, we can make huge strides in someone with autoimmunity.

Amazing. You know, when we talk about leaky gut, I feel like even in my practice, you know, I look at people with leaky gums as a periodontist. I look at that and they We say leaky gums, leaky gut. There's so many people today suffering from leaky gut. Usually when I recognize it, I actually refer them to someone like you to help them with that aspect. Are you seeing an increase in leaky gut patients?

Definitely. Without a doubt.

What is your favorite way to treat leaky gut, for example?

Yeah. So as you, as you practice, everyone is bio-individual. So we definitely need to tweak it. But they're based on each person. So, whatever works for you would be a little bit different, or maybe a lot different, depending on what we have going on, than what works for me. But in general, there are some things we wanna do. We wanna remove— if we think of leaky gut like a fire that's burning in the gut, we have a few things we need to do. We need to put the fire out, and then we need to repair the damage that the fire caused. And then we need to rebuild the structure, just like a home. We need to rebuild it so that it's working properly. So to address that in that 3-step process, we wanna identify what are these things that are contributing to leaky gut? You asked me if I see more of it now. We do, because there's, there's so many toxins in our food. There are so many toxins in our air and our water. Think about the, you know, the big attention that glyphosate, Roundup, has been getting in this country. It's on so much food and even, you know, the overspray can affect organic foods. It's not— they're certainly much better than foods that have been sprayed with Roundup heavily, but there's still a lot to deal with there from a toxin standpoint. And that's just one herbicide. That's just one. Think about all the other herbicides and pesticides and You know, things in our water. And even if you look at our city water, our tap water, there's so, there's so much evidence showing that there are drug residues, pharmaceutical residues. They could be antidepressants, anti-anxiety meds. They could be warfarin. They can be any pharmaceutical. They're all now in our water supply. So there are so many things going on. And then we think about how stress, chronic stress has just become an epidemic. People live on this very high cortisol, elevated cortisol state. These things all contribute to why it's happening more. So what we want to look at in the individual is what, what are some of the biggest reasons this person has the fire in their, you know, in their system? So is it relationship stress? Is it poor sleep? Is it a poor diet? Are there food sensitivities? So we look first, we do a pretty deep dive in identifying what's going on. The good news for our listeners is that a lot of times, intuitively, people know what's going on. So, you know, you hear someone, right? You hear someone say, every time I eat bread and pasta, I get really bloated and tired. That's a clue. Or every time I'm around this person, my gosh, I feel so tired and stressed when I, when I leave them. That's a clue. We just start paying attention. We go inward and we just start paying attention. That's a really big— that's low-hanging fruit. Yeah. A great way to get started. Then we can always run diagnostic testing and all that if, you know, as you're working with someone. But people have this intuitive wisdom. They know a lot about what's really bugging them. So first, getting rid of some of those things, having to make some changes and make some hard decisions and be consistent, that is huge.

Yeah. And I think when we talk about mind-body connection, which is so important, it's our mental outlook and stress is a major factor. When working with people that are dealing with autoimmune issues, you're working with leaky gut, do you incorporate some tools for them? And what are those tools in order to help them with these triggers such as stress?

I sure do. Yeah. So if we know that chronic stress is really a big piece of the puzzle. Then, then I talk about ways for that person that can start to bring that cortisol down. You know, some of the simple solutions are things like deep breathing regularly, making sure you do it when you wake up in the morning. You can habit stack it to when you brush your teeth, for example, or when you floss, right? When I do this, I'm gonna add this on. That makes it stick better. That's a great point from Atomic Habits, the book from James Clear. Great book. And he talks about habit stacking. That's one way to make new habits stick. So one way is deep breathing. Another way is figuring out what helps you to relax. Is it going for a walk? Is it spending time in nature? Is it gardening? Is it walking on the grass in your bare feet grounding? That has evidence behind it. That's not just woo-woo. That actually does something. It really helps our body to settle and start to bring that cortisol down. Deep breathing. This is a really cool fun fact. Well, I had a yoga instructor on, on my show once, and she said, when we deep breathe, like deep breathe, so our lungs go from, you know, up under our collarbone down to the bottom of our ribs. We never think about that when we breathe. We tend to breathe like from here up, but when we breathe down to the bottom of our rib cage, there are receptors, oxygen receptors, just down at the bottom that activate our parasympathetic nervous system. So they turn off fight or flight and turn on rest and digest. So that is pretty effective, but you know, there are more tools in the toolbox. There's to help the vagus nerve. The vagus nerve is the nerve that runs from our brain down. It's the longest nerve in our body through our, you know, through our body, our trunk down into our gut. We wanna stimulate that and some easy ways These are great. Humming, singing, anything like that, deep breathing, anything that actually brings some vibration in helps us to regulate that and helps us to bring that stress down. I love it.

These are great simple tools anybody listening right now can incorporate these.

Yes.

You know, and even like you're talking about walking on a patch of grass, you know, I actually love to do that even when it's cold outside. I, uh, what we redid our backyard and I told my husband, I want a patch of grass. I want to be able to go there. And I actually— in the middle of the patch of grass with my two cats, they're actually eating grass. I'm just grounding, you know, just connecting with nature. It's like, even if I do it for 10 or 15 minutes, I feel already so much better.

I was going to ask you, what is it that you feel? If people can think about it and say, oh yeah, I really mean to do that, but I never get around to it, tell us what you actually experience, because that Helps people to say, oh my gosh, I can do that. That's so easy. I'll start that.

It's very easy. Basically, I walk outside barefoot. It's usually in the morning when I have my coffee. You know, the cats are always up early as well. So I step outside and, you know, I put my feet in the ground and I like to feel the actual grass, the dirt underneath. And I almost feel like my whole body is relaxing because there is that— those negative ions that come from the earth. And, and, you know, I love grounding, you know, it's It's basically when we're walking on carpet or walking in buildings, we build this positive energy, which can cause anxiety and a feeling of, you know, being on the edge. But as soon as our feet, or my feet, are planted on the earth, I immediately feel the sense of relaxation.

It's a real thing. It's true. And then you bring in the other thing I was going to say. It was perfect. You bring in animals. If we pet our animals, if we have animals, That helps us to release oxytocin. That also brings our stress down and it brings our bonding. And we tend to, that's that love bonding chemical that we release. But so you're, that is so wise of you to go out here grounding and you're petting your cats. That's huge. Those are great ways.

Yeah. You know, you know, it's amazing. They both love to sit on dirt. You know, we have this patch of dirt, isn't it? But they both will go there. I think, you know, for animals is like, they know, they have this intuition that they have to ground. But we somehow lost that as humans.

Mm-hmm. Mm-hmm. I think it starts young. Yeah. People slap shoes on our little feet. Then we think that's what we're supposed to do. But no, I'm with you. I'm always barefoot. And it's so funny you said that. So every day I have two dogs and I, one of them, I throw a stick for because she's still a baby and she's a little wild. But she, when she rests, Dr. Sanda Moldovanova, she lays on the dirt, not the grass. She goes and lays on the dirt.

Amazing.

Same thing.

You see? Yeah. This, you know, innate intelligence. That's what they're supposed to be doing. So yes, we have to follow the example of our pets, Lisa. That's what it is.

That's right. They're normally happy, right? They don't carry a ton of cortisol around.

Now let's talk a little bit about nutrition. When it comes especially to all this overgrowth and dysbiosis and the gut, is nutrition like, you know, something all size fits all, or one size fits all, I mean, or is it just you personalize it for you?

Great question. And the diet culture would have us believe it's one size fits all depending on whatever they're peddling. But there are some things that are applicable to all of us. That is, we need the right amount of protein, we need the right amount of fiber, right? And we need plants. Just like we need to ground, we need plants in our diet. And We need to reduce as much as possible ultra-processed foods. So that is one size fits all. Now, within those pillars, if you will, there's a lot of personalization that happens. Your food sensitivities, especially going back to the toxins piece I mentioned earlier and the leaky gut, food sensitivities are at an all-time high. They're more common than ever. So we want to look at what foods make you feel good, what foods don't make you feel good. I am a dietitian. I work more from a functional wellness practitioner standpoint, but as a dietitian, you'll see we kind of run the gamut on our opinions and we're all very opinionated. But I like to say that if there are foods that you love, then don't label them as like, oh, I'm, you know, I'm being bad having this, you know, choose Choose what delights you. And if it's ultra-processed, then, then choose when you're going to enjoy that treat, but make your diet mostly lots of plants, enough protein, good— what, for carbohydrates, good whole grain-based types of choices. So I don't know if that's too general or if we want to get a little more specific, but those are my rules of thumb.

That's good advice. I'm seeing a lot of patients now with, at least when I look at the mouth, I see a white-coated tongue, which usually is an indication of Candida. And I'm seeing more and more of that. Now, what do you do for somebody that has, let's say, an overgrowth of Candida in the gut?

Yeah. So remember there were 3 steps with the leaky gut. We had to remove triggers. We had to repair and then rebuild. It's very similar. We want to remove triggers. And then we want to rebuild because it's like if you went and— so think of Candida. We all have Candida in our system. That's not the problem. The problem is when it overgrows and we see that white tongue, you know, that— or we have chronic bad breath. That could be— you and I have chatted before about this. That could be due to a number of reasons, but oftentimes Candida is one of those, one of those causes. So we want to look at, you know, what's causing the Candida. Is it someone just on a, you know, a course of antibiotics and it wiped out all the good bacteria? Not all of it, but a lot of it. And now this other stuff is overgrowing, or is there a tendency to eat more simple carbohydrates? So are there a lot of carbs in the diet, maybe too many, and it's out of balance with protein and fat and fiber? Is there someone drinking a lot of alcohol? Do they drink soda every day? So we want to look at what's happening with the system that that's showing up. And then once we figure that out, then we change based on whatever that is. Very often what I find is that carbohydrates, simple carbohydrates, are sneaking in under the radar. They can even sneak in in healthy foods that we buy. So we're like, oh, I'm having a healthy smoothie and I'm having, uh, you know, a healthy protein bar. Well, we can start to find that those simple carbs are loaded in there and that can upset the balance of someone's system. So first step, we're figuring out what we need to remove, and then we think of it like a garden. If we just went and weeded everything out, good and bad plants, but we didn't plant anything, in 3 months, what would we have? We'd have a weed garden. You know, it's the same thing. We don't want to wipe it all out and then do nothing because we'll have all the bad things coming back and growing. We want to then make sure we're getting good probiotics in there to start to build the good bacteria, which will offset the stuff that overgrows, the opportunistic or pathogenic organisms in the gut.

Yeah. Now, do you find— I want to talk to you a little bit about, you know, hormonal shifts, perimenopause, menopause, hormonal shifts. Do they cause dysbiosis? Do they affect the microbiome?

Yes. And it goes both ways. So, so our hormones, estrogen, progesterone, testosterone, as they rise and drop, they affect our gut. And at the same time, our gut dysbiosis affects those levels too. It's pretty fascinating. That's one that's less known. We do know that hormones affect the gut. We think about before we get our period, we can get some cramping and bloating, which is related to some— to those hormonal changes. But then we'll have bathroom changes too. I think, you know, we, we might tend to be constipated or we might tend to go a lot more. And that, you know, we can see how the hormones affect that gut motility. They'll definitely affect the bacteria. Everything's this beautiful symphony, and, and it can kind of throw it off. But more interesting, even more interesting, is your gut regulates your estrogen levels. So this is really interesting. There is an enzyme called beta-glucuronidase in our gut. We know that our gut, just like our mouth, has a microbiome. Or for, you know, for our listeners, our mouth has this ecosystem of good bacteria, bad bacteria, all these organisms. Our gut has a microbiome too, this ecosystem. And that's what we're talking about. Candida can overgrow or something else can if the ecosystem is off. Well, if we, if it's off, that's, we call that dysbiosis. Dys meaning bad, biosis meaning, you know, or, or unbalanced biotics. So it's just, it's out of balance. It allows, it's like the garden where more weeds are growing than plants, than nice plants. So with dysbiosis, part of our microbiome— this, I love this part— is called the estrobolome. The estrobolome is responsible for regulating our estrogen. Normally, when our body is done with estrogen, it just puts it in the system to then be excreted, to be eliminated. So I like to think of it like a garbage truck. It packs it in the garbage truck and it's ready to head out of the body. But if we have dysbiosis and our estradiol is off, then what happens is the body produces more of this beta-glucuronidase. Beta-glucuronidase goes to that estrogen that's already packed on the garbage truck and it says nope, and it knocks it off the garbage truck. It says no, it attaches to it and says nope, you're not going out of the body, we're going to recycle you. So we end up with estrogen dominance sometimes when we have gut dysbiosis for that reason, because it's kicking the estrogen off the garbage truck and having it go back into circulation.

I see. Where is this enzyme being produced by bacteria, the beta-glucuronidase?

The beta-glucuronidase is produced in our gut. I would need to look at exactly where that, whether it's some of the bacteria or where that is happening, but it is being produced in our gut. So I, I'm guessing it is from the strains of bacteria that are overgrown.

And what happens is when there's like an overgrowth of yeast or bacteria, you get an increase in beta glucuronidase.

That's right.

Okay.

And we can see it on a gut test. We can see levels on a gut test of what's normal and then what's elevated. And when it's elevated, we know it's very likely that person is going to have estrogen dominant symptoms.

And what's the problem for those people listening with estrogen dominance in our bodies? And I see this, by the way, with both men and women today.

Yes, yes. I'll tell you, there's a really interesting thing about the gut too that has to do with men and testosterone. So some of the symptoms that we'll see with estrogen dominance in women would be heavy cycles, very painful cycles, lots of breast tenderness, weight gain. Just the things that we see when, when someone says, I have bad periods, we tend to think estrogen dominance may be a key player in that. And then with men, we see more of a— they tend to get a softer body type. So rather, so we tend to see that, that their chest muscles tend to develop more like breast tissue and their arms tend to get softer. And that for men, interestingly, that is due to another enzyme related to the gut. That's called aromatase and aromatase, right, is related to dysbiosis and that will cause testosterone to be converted to estrogen.

Interesting. Okay. Which is not good, you know, because they're going to drop in testosterone. They're going to have this a lot more estrogen and they're going to start acting like women, basically.

Right.

Yeah.

We don't want that. We like— yeah, we don't want that. Exactly.

My goodness. So is that something you test for? Let's say somebody comes with, you know, menopausal symptoms. You do tests for that as well in your practice?

You've had tests for that as well. Yes. Yes. There are different tests that we look at. Some are gut tests. Some are hormone tests, but you can test for, for these different things. One of my favorite tests, because it tells us so much information, is the GI-MAP. It's a stool test and it shows us, oh my gosh, it shows us indicators for leaky gut. It shows us the beta-glucuronidase, so that estrogen dominance enzyme levels. It shows us pathogenic bacteria, good bacteria. So it shows us kind of the makeup of what's going on in that ecosystem. And there's more too. There's so much in it. That's a good one.

Yeah, I love it. I mean, we have to test, you know, even in my— in the mouth, we have to test to see what I'm dealing with instead of doing one size fits all. Type of medicine.

I appreciate you shared that with me, the oral DNA test and some of the other testing. I appreciate that because that really does help you get to the root of what's going on.

Now, if somebody's listening now and like wants to start supporting their gut and hormonal balance right away, um, and of course by extension their oral health, actually, what 3 simple daily habits would you recommend?

Yeah, so the first thing I would do is I would recommend they reduce or eliminate as much as possible processed, ultra-processed foods. Ultra-processed foods are things like crackers, snack foods in boxes and bags, cereals, just, you know, regular cereals in a box, those kinds of foods, those convenience foods. And what they do is they feed our bad bacteria or, or they cause overgrowth. So if you think about the bacteria really simplified in our gut, as the good guys and the bad guys as armies, whatever we feed will grow. So we wanna be mindful about what we feed. What really feeds the good guys are fiber-based foods, like prebiotic fibers. And that's, that's just a, you know, 50%, a 50-cent term for meaning really good fibers. We get mostly from vegetables, things like Um, asparagus, avocado, leeks, garlic, onion, and then certain fruits as well. Apples, bananas. Those are all really good sources of these prebiotic fibers. Those are food for our good bacteria. So if we'd reduce the things that are causing the bad guys to grow and we increase the things that cause the good guys to grow, now we've got this really nice ecosystem that's working for us. Those would be two of the big things I would recommend. The third thing, we touched on it, is how to recognize what is increasing your stress levels. Because elevated cortisol also contributes to that leaky gut, that intestinal permeability. And maybe, would it be okay with you if I took a step back and just said, what is leaky gut? Just explained it in a real quick vision. Okay. I'm chatting away like everybody knows what that is, but I realize we all have an idea of what that is, but there's a real simple picture that I like to use to explain it. If we think about our digestive system being from our mouth to our butt as one tube, we don't think about the organs, the stomach, or any— we're just thinking about the tube and food goes in, it gets processed, it goes out. And that is meant to be. Semi-permeable, and it's only semi-permeable in the right conditions. So basically, all that means is things are supposed to stay in the tube until they're gone. Like, the body takes out what it needs, but in general, things are just like a garden hose. If you and I went to Lowe's, you know, you went and I went and we both bought a new hose for our garden, and we were so excited because we were going to use it tomorrow and start spraying whatever we have left you know, in the fall for plants. But some little kid, neighbor kid came by and he put pinholes all through our brand new hose. When we go to spray that water out tomorrow, water will come out, but it's also gonna spring out all over the place. That's leaky gut. That's a great picture. So the thing, it's meant to go one end to the other end. Things are starting to spring out before they're not supposed to spring out like that. And then the body in its wisdom says, that's not supposed to be here. What is going on? And it mounts an immune response. And then we have things like bloating. We have bowel irregularity. We have mucus in our stool. We have increased incidences of weird symptoms that might be related to Candida, which we talked about, and some other gut problems that we might have joint pain, rashes, all these weird symptoms. Inflammation. You brought up a good point.

A lot of people that have joint pain don't realize it could be coming from their gut.

Exactly. It doesn't seem like that would make a lot of sense, but it does. It's the generalized inflammation response that just lands then in the joint.

Yeah. I'm glad you explained that. And you mentioned the third advice is to diminish stress, which everyone needs, definitely, especially here in Los Angeles. Because everybody seems to be stressed.

Yes, it's a fast-paced community. And just to go back to stress, the reason is because elevated cortisol contributes to leaky gut.

It does, and it also contributes to people clenching and grinding. I, I've treated more clenching and grinding in the last 3, 4 years than ever before because of the stress level. Yeah.

Wow. You've been doing this for 20 years, right? So you've seen a lot of change then.

Yeah, yeah. Much, uh, egotomy. Yeah, if you're clenching and grinding, that's probably a good idea to check your cortisol level. Yeah.

Yes, exactly. Yeah, so those would be my top 3, and they're, like we said, they're easy, at-your-fingertips ways to start to deal with some of these things.

Yeah, I love it, Lisa. It's been so enlightening chatting with you. Uh, where can people find you?

Oh, thanks for asking. Yes, so my website is Lisa Smith Wellness. And I have a podcast which you have come on. I'm very excited about that. And that is called the Pretty Well Podcast. So that's found anywhere people listen to their podcasts. That's also my social media handle, Pretty Well_Podcast.

I love it. Thank you so much for enlightening us about leaky gut and hormonal balance and the three pillars of that can trigger autoimmune. And I'm looking forward to hopefully chatting with you again on the podcast.

Absolutely. Thank you for having me. Thank you. I loved being on.

Thank you. And everyone, thank you so much for joining us. You can go ahead and message me on Instagram or on my YouTube channel if there is any other topics that you're interested in. And please leave us your feedback. Until next time, stay healthy.

Thank you so much for joining me this week. Please make sure you check out the show notes for any links mentioned in the show. If you like today's show, please invite your friends to listen as well. That would mean a lot to me. Do you have a question you'd like me to answer? Message me on Instagram @DrSandaMoldovan. This is Dr. Sanda Moldovan, and remember, your mouth is the gateway to your health, so take care of it in the most natural and best way possible.