Unlocking Solutions for: Hormones, Belly Fat, and Fatigue | Free Webinar

To before starting, wanted to see if anybody had any specific questions they wanted to make sure that I answered. Or and if they could put your first name. I think we could see everybody's name, but if you could put your. Where are you joining us from? Is it mainly LA or anywhere else? Welcome. And if you could also put in the chat any specific questions you may be dealing with or you want to make sure that I answer. So I could kind of tailor this to who's part of a part of the group tonight. Hi, I'm from Indiana. Okay. Awesome. Welcome. Thank you. You. Hey, Usha from Panama. Awesome. Okay. So if anybody else wants to share, please feel free. And I will stop. I will stop the zoom as we if we have questions along the way. This is just a webinar talking about things such as what may be causing resistant belly fat, what may be causing fatigue, and what kind of imbalances to look for that maybe you haven't got an answer to or you're still thinking about. So this is this webinar. I'm based in Los Angeles for those who don't know me, and I am the head of the founder of Cyana Met Medical and Wellness center, based in Sherman Oaks here in the Valley. So turn off your phones if you can. I won't be long. We'll probably discuss for about 40 minutes and any questions or answers, I will take questions at that time. Okay. So a lot of people who come and see us kind of ask us some of these questions now. Why is it so hard to lose my gut, especially after age 40 and working harder than ever before, dieting and exercising, but the weight just doesn't budge, or you feel like you want to start feeling like yourself again. A lot of patients come to us and say, I just want to feel how back to who I was. I'm not looking for any big, big miraculous change, but just to how I felt before. And they may have trouble falling asleep or staying asleep, may have low energy despite getting a good night's sleep, or not enough energy to get through the door, get through the day. Or they, they kind of wonder to themselves, am I feeling this way and is this normal? They may feel down, depressed, unmotivated, or they may think, is this part of natural aging? Is this what aging means when I'm just irritable, don't have brain fog, have joint and muscle pain? And sometimes what happens with a lot of patients who come to see us, tell us, I went to go to the doctor and they first of all discounted my symptoms or Checked their lab work and said everything is normal. So this must be a psychological issue or just normal aging. And a lot of times patients come to us with lists of medications and they're like, I'm guess, having side effects from these medications. Is this, what can you, how can you help me get off these, some of these medications? And a lot of people just want to age gracefully. They want to live independently in the 70s, 80s and years to come. And they want to feel and look younger than their age. This one. So if you, if you said yes to many of these kind of questions, you're in the right place. And we're going to talk about some of these. What could be the root cause of some of your symptoms if they're dealing with fatigue, belly fat or inflammation or chronic pain. So I'm Dr. Sayana, I'm a board certified in internal medicine, functional medicine, obesity medicine and integrative medicine. And you may ask why I have so many board certifications, but it's just because it was important for me to understand the why these things were happening to my patients. And I just kept collecting these four certifications along the way. So a bit about me. I was born in, I'm South Indian origin. I was born in Southern Africa. I lived in Botswana and then came to Vermont for medical school, public health school at Yale, and then came to California because it was too cold in the East Coast. So when I was going through my own health journey as a physician, I had, you know, had many roles at that time that I was juggling. I was daughter to ag parents, I was teaching medicine internationally. I had a private practice here in la, mother to an infant and I was a wife. And this is how many of the people I see who come into our practice, they're either moms or grandmoms. They're working, they're juggling so many responsibilities and then something happens. And to me is when I had my own health journey where I kind of woke up being a patient. And it was very scary and lonely. And that's when I really realized what's so important in the journ of healing is partnering with your patients so you can really be there for them every step of the way so they don't feel alone through this and really look deeper as to why they're going through what they're going through. This is my why. This is my husband and my two kids. This is why I want to be healthy and why I want to be healthy for a long time. But if you could take a moment to write what Is your why? Why would you want to be healthy for the next 10 years? And if anybody's willing to share, you know, please do. But why do you want to be healthy and vital for the next decade or two? Is it mainly for your family? Is it mainly for yourself? Is it mainly so you can travel? Is it mainly so you don't not dependent on your kids? But why do you want to be healthy for the next couple decades? Anybody want to share or maybe think about that? And if you want to share, feel free to share throughout the webinar. So what is your why? And a lot of my patients say, you know, I really just want to be able to garden, be able to spend time with family, be able to travel, be able to really enjoy life because I work so hard and not be able to stress about it. Or I just want to not be in pain and I want to wake up in the morning and be able to get out of bed and do my daily activities. So what on the call today is anybody not. Is everybody familiar with functional medicine? Is functional medicine is a bit different than internal medicine? And I wanted to explain the difference for people who may not be aware is any. But everybody know why what functional medicine is. Maybe give a thumbs up in the chat if you do. Okay, great. So some people said a little and some of you I know are some of my patients. So they know exactly what functional medicine is. But this is internal medicine. And you may have heard of something called an internist. And I'm an internist and but I'm also a functional medicine doctor. So internal medicine is looking at this big tree of diseases, things such as if you have diabetes or high blood pressure, if you're overweight or you have a bunch of infections, you have autoimmune and or you're going through perimenopause or menopause. But functional medicine is looking deeper into the soil of what's feeding these illnesses. Things such as your gut balance, your lifestyle choices, your stress management, how are you managing your environment, have you been exposed to toxins? Which unfortunately is a big deal for a lot of us who live through the fires here in la. And so internal medicine is very linear. It's very much we give you a medication for whatever you're dealing with and see if that helps. And then functional medicine is really looking at the root cause, what may be causing your symptoms. If you're having a bunch of fatigue or joint pain, could it be your gut or could it be your hormones? At Cyana Medical we are a traditional internal Medicine practice. But we'd use science and evidence to really guide us with functional medicine. So how do what we do different? We write prescription if needed, and try and give patients the lowest dose for the shortest amount of time. But a lot of times in conventional medicine, we look at lab work and we tell our patients that everything is normal. But what is normal, and this is the biggest difference between internal medicine and functional medicine, is we want your lab work to be optimal. So it could be within the normal range. A good example is vitamin d. Normal is 30 to 100, but I'd like my patients to be at 77. 0, because that is optimal. And women, especially women of color, don't, are not capable of keeping their vitamin D up by themselves. So they might need to supplement that vitamin D. Why is vitamin D important? It helps you with weight loss, it helps you with sleep, it helps you with inflammation. It's an important vitamin to have on board and also helps you with your bones. So this poor woman here, she looks pretty miserable, but her labs were normal, but really on the low end of normal. How can we optimize a person's lab so they're optimal and then they feel good? This is the iceberg theory, which is think about an iceberg in the ocean. So the tip of the iceberg is what we do in conventional internal medicine. We look at symptoms, we wait for the patient to come to us and tell us something is going on. And then we prescribe medications or we might test labs. But in functional medicine, it's really a more of a proactive approach. Approach. It's what's happening underneath the ocean. What is your gut health? How are your hormones? What is your toxic burden? What inflammation do you have? And sometimes people discount a lot of their symptoms. And I go, I just must be aging, or I just something I ate. But what's actually contributing to this? Because as you age, that water level comes down and these symptoms become much more. So it's important to understand what's going on beneath the surface so you can live an optimal and vibrant life. So with functional medicine, we use multiple pillars. But in this, and I'm explaining this so you understand what could be contributing to some of your symptoms. So the first pillar is hormones and metabolism. And when I check hormones, I am talking about your stress hormones, your adrenal gland hormones, and these are two tiny glands that sit on top of your kidneys, produce the stress hormone cortisol. So if you're constantly worried and stressed or anxious, your cortisol will increase in your body. And your body doesn't know the difference between you being chased by a tiger and you having a lot of things happening in your life. And it could even be exciting things. So the problem is if you're chased by a tiger, you get eaten or you get saved and it's done. But if you are constantly in the stress response and your cortisol keeps going higher and higher, then you're in an inflammatory state that there's no switch off button for because there's no end point. And it's this inflammatory cascade is what is the canvas by which you can have autoimmune cancers, all kinds of diseases. So it's important to know what is your cortisol and what are your other hormones such as insulin. A lot of times in internal medicine we may just check your hemoglobin A1C or your fasting blood sugar. We're not looking deeper to really understand what is going on with your, your blood sugar. And it's important to look at insulin because your insulin is abnormal 10 or 20 years before you ever become diabetic. Why would you have abnormal insulin? Because if your body feels like you're being chased by a tiger because of a lot of stressors, it's going to push up the sugar and push up the insulin response. And if there's no endpoint, your insulin just becomes resistant. So it's important to measure your insulin, your adrenals, your thyroid. As an internal medicine doctor, we check two labs for the thyroid, but the complete thyroid panel is five labs. And then the last set of hormones are your sex hormones. Look up your estrogen, progesterone, testosterone. Even if you're not planning on using hormone replacement therapy, or even if you're far gone from menopause or been in post menopause, it's good to know where these hormones are, especially if women are losing muscle. It's thought that women lose about 20% of their skeletal muscle by age 50. So we just are. And what is the currency of longevity? It's muscle. How are you preserving muscle? How are you staying strong at 89, will you be able to get up by yourself from the toilet without shaking or will you need assistance? So it's really important to focus on muscle building. But if you don't have enough testosterone on board, if you're not eating enough protein, you won't be able to make that muscle. So it's really important to investigate your hormones. The second big pillar is your gut health. How is your gut, do you have, what kind of bacteria do you have in your gut? How is the gut lining? Is it nice and snug or is it leaky? Is it causing inflammation or is it able to digest and process your food? How are your toxins? As a conventional internal medicine doctor, we don't look at toxins very much. We just look at maybe lead dead toxicity in kids because we know that can lower your iq. But we're looking in functional medicine at things such as heavy metals. My biggest toxin we see in Los Angeles is mercury because a lot of people eat a lot of sushi here and mercury mimics estrogen. It can impact the gut motility, it can be associated with depression and anxiety. And it's about how can you get that mercury out. Other toxins is, do you live in a moldy environment? Do you live in a home that has water damage? Mold can impact your hormones, can impact inflammation, and then the other kind of toxins. You think about pollution from LA fires, or if you live near airport or highway, you might have these toxins. And these toxins are disrupting your hormones. So it's important to measure them and understand them. And then with lifestyle choices, we talk to patients about how is their diet, how is their diet, how's their nutrition, how is their community, and how is their sense of belonging? Because a lot of people are very, very lonely. And are they putting an effort to improve that? Because if you do feel a lack of community, a lack of belonging and a lack of purpose, it's like smoking 15 cigarettes a day in terms of heart disease risk. So it's important to actually make sure you have those things. So here are some. Just some patient stories where a lot of people go to the doctor and they're like, I don't really feel sick, but something is wrong. And this is a common patient we see mainly above 30 to maybe 48. But she is angry before her period, she's irritable. Everything is. She's like the scary person with her family. Everybody wants to stay away from her and she's like this hormonal monster. And it's commonly due to a drop in progesterone. Why that might be the case. It might be she's just being really busy. She's a busy mom, dropping her kids at work, taking care of the household plus work. And so her cortisol, her stress hormone, is eating up progesterone. She goes to her internal medicine doctor or conventional doctor. They would give her things like an antidepressant or Prozac to help her with those symptoms. But in functional medicine, we Would check her hormones, give us some progesterone or give her some vitamin C, some cycle support, which is Chastebury Vitex, increase her progesterone naturally so she doesn't feel this awful the week before her cycle. But it's all about understanding why before jumping to your prescription pad. And a lot of women in their 50s come to us and just say, you know what, I'm exhausted. My vitality that I had in my 40s is just gone. I feel completely out of order. And a lot of times patients, when we test their hormones, what we know notice is that inflammation is going up and their testosterone is going lower. So you can take different supplements to help this. Things like fenugreek, which is the. The herb in South Asia, can help increase testosterone. You could try fenugreek tea, but it's important to know why before jumping to different supplements and cortisol. This is our modern life in LA and beyond, where there's just a lot on everybody's plate. There's no time for us to pause, breathe, have some time to ourselves. And so everybody is running on this hamster wheel and. And the cortisol is always increasing. If you don't have a time to reset your cortisol, it's going to eat up other hormones and put you in inflammation. And the biggest thing high cortisol does is weight resistance, which is belly on your thigh, weight on your thighs, and weight on your belly. Thyroid can cause a lot of issues with hair loss and fatigue and depression, constipation. So it's important to get a good picture of what your thyroid labs are. Let's do a quick quiz to make sure everybody's awake. Which of these hormones affect your energy? Which ones do you guys think affect your energy? Is it progesterone? Is it cortisol? Is it insulin? Is it testosterone? What do you think affects your energy? I'll give you a minute to pick one and you can just put it in the chat. Which of these hormones affects your energy? Is it cortisol? Give stress hormone, Is it progesterone? Is it insulin? Is it testosterone? Okay, it's all of the above. So how each one of these do this is if you don't have enough progesterone, you just cannot stay sleeping. So if you're fatigued, it impacts your energy. If you have too much cortisol, you feel sluggish and brain fog, and that impacts your energy. If you have high insulin, you have a high amount of blood sugar in your system, so your body's not able to produce your own energy. And if you don't have enough testosterone, it impacts your energy directly because you just don't have energy for muscle building and for vitality of life. Question 2. Which of the following labs are important when evaluating your libido? A lot of women come to us saying, you know, I just don't have much interest in sexual activity. I'm pretty just not interested. Oh, I was. And not any longer. Which hormones do you think your doctor should check? Your testosterone and sex hormone binding globulin, your estrogen and progesterone, your cortisol and sex hor binding globulin, thyroid and cortisol levels. What you guys think? It's a hard one. Any guesses? It's a good guess. So testosterone and sex hormone binding globulin are the ones I would check. So testosterone is a hormone that really impacts libido. Testosterone is in men and in women, and we just have a much lower amount. We still have some and it still needs to be optimal. And the sex hormone binding globulin is a protein. And women and men who have abnormal sex hormone binding globulin that's really high, it binds up all that testosterone so you just can't feel it. And that's if you can lower that sex hormone binding globulin, women generally feel better. And this is why a lot of women on birth control feel lower libido, because birth control increases the sex hormone binding globulin. And then a lot of women who are trying to build muscle may have very low testosterone and a normal sex hormone binding globulin. Or some women who come to us have really good testosterone levels but very high sex hormone binding globulin, so they can't feel their testosterone. So it doesn't matter if they have a good testosterone. We need to address why you have a high sex woman binding globulin. Common reasons can be nutrient deficiencies like gut health and toxicity. So we see this commonly when women in their late 50s, 60s come and say, I think I'm getting Alzheimer's. I'm taking care of my mom or my aunt and she has Alzheimer's. I think I have early onset and I'm just like, can't find the word. It's at the tip of my tongue, but it's just not coming through. But generally it's not Alzheimer's. So what we do in cases like this is we check genetics that do have any genes for Alzheimer's. I have one. It's called The APOE gene. And it's a gene that is just because you have a gene, it doesn't mean you have to have the disease process. Lots of things can activate that gene. Things such as diabetes, things such as mold exposure, things such as toxins, things such as chronic stress. So we check genetics and say, you know, we reassure the patient, the person, you don't have any Alzheimer genetics, it's probably your hormones. And we check hormones and we realize they're out of balance. And if we improve hormones, improve inflammation, usually their memory and brain fog just resolves. And then when regard to weight loss, one thing I want to all of us to understand that weight is not just about calories we eat and calories we burn. It's much more complex than that. And it's way to do more with inflammation is to do more with what we're stress level and our hormones. So this is where I would like you to understand the hormones and metabolism. So these are the fat burning hormones that you want to make sure are optimal. Things such as thyroid, you want to make sure it's perfect. Things such as testosterone, you want to make sure it's improved as much as you can because these hormones help you burn fat and fat storing hormones. You want to make sure your estrogen levels are in good place. Cortisol is not too high, not too low. And insulin is quite low because those hormones, if elevated, also help restore fat. So you want to measure these levels and optimize them before jumping to a medication or starving yourself. Because it's not just about that. Okay, so one more question. I only have five. Which of these changes should should you make to help balance your hormones and which. So which of these food substances really helps you balance hormones? Increase your carbohydrates, so like increase your bread and pasta, increase fiber, which are things like avocados and beans, or decrease protein or decrease fat. What do you ladies think about what change should you make to help balance your hormones? Which is one. If there's one thing you get out from this webinar, what's the one food you should either eat more of or less? And how would it help your hormones? Any guesses? Okay, so the one one thing I would recommend you try and do is increase fiber. And why fiber? Because fiber is a substance that binds up toxins and dirty estrogens and helps you eliminate them. And these are kinds of substances that make you gain weight and disrupt your hormones. So you really want to make sure you're eating fiber on average. An average American eats about 10 to 12 grams of fiber. And we need around 40 grams of fiber. Especially if you're a woman above 40, you should really be aiming for 35 to 40 grams of fiber. So what is fiber? And I'll give you some examples. So whenever I ask my patients, are you eating enough fiber? They're like, yeah, I eat plenty. I eat a lot of salad. Unfortunately, a big bowl of arugula or spinach only has 0.2 grams of fiber. And remember, I told you to get around 30 to 40. So things you can do that are quick hacks for fiber is a bowl of Black beans have 15 grams of fiber, and avocado has 10 grams of fiber. In terms of fruit, I would go with a bowl of raspberries that have 8 grams of fiber and then just add them and incorporate them to your life where it's the raspberries, the avocado, and try and increase your fiber in your diet, because fiber binds dirty estrogen helps you eliminate that and really helps improve your insulin. So fiber is the biggest food group that a lot of Americans are not focusing on. And I think especially women, because we're just so busy and you need fiber during your perimenopause, menopause, and post menopause transition. So this is one of my favorite organs, the gut. And a lot of patients come to see us with weight. They want to lose weight. And the biggest thing we do is we check the gut, because the gut has a lot of inflammation in it, and it's how you process your calories, it's how you process your hormones. And symptoms they may have are things such as constipation, diarrhea, gas, bloating, gallstones, but they don't. Sometimes they don't even have any symptoms. But it's important to measure your gut. And a common concept we see is something called leaky gu, which is this picture at the bottom. This is a healthy microbiome with the gut lining, and this is an unhealthy gut lining. People who have an unhealthy gut lining tend to be overweight, may have rashes, may have inflammation, and have symptoms such as fatigue. Every time they eat, they have to go to the bathroom or they feel just bloated. And sometimes they don't have many symptoms. But it's really important to actually check and see what their gut lining is. And it's something unfortunately, conventional medicine doesn't check. But functional medicine, we check a lot. And even if you don't have gut symptoms, I would really advocate to checking for the gut because you probably have hidden gut symptoms that your body is just tolerating hidden gut inflammation. So a lot of men and women come and say they're still tired after hormone replacement therapy. So common reason for this is having a lot of toxins. And if you have a lot of toxins, you may not be able to feel your hormones as much because cause of of that sex hormone binding globulin. So here's a question number four is toxins like mercury had no impact on your hormones. Remember, you'd get mercury from things like fish, silver fillings in your mouth, or even, unfortunately, the air. Do you think mercury has any impact on your hormones? You want to answer? You can put in the chat. I'll give you guys a couple more seconds. Okay, so the actual answer is false. Mercury does have a direct impact on your hormones. I have patients who come to us on hormones and they're like, I don't feel much different on the hormones without them. And a lot of times when we check their toxins, they may have high levels. And the common one we see in LA is mercury. And we bring down the mercury level and whoa. They're like, I feel so much better. I can actually feel the hormones. Or we can actually lower the hormone doses because they're feeling better on it. So in terms of toxins, what am I talking about? So things such as heavy metals, so stuff like mercury from your silver fillings from the air, or from things like sushi or fish in general, or arsenic, which is common in LA water, or things such as cadmium, which comes from secondhand smoke exposure, all of these toxins impact things like the thyroid and your ovaries. And then if you live near a GA gas station or live near a freeway, you might be also exposed to these toxins. And then mold is a common one. All these toxins impact your cortisol, your hormones, like progesterone and testosterone. So it really causes weight resistance, belly fat, and fatigue. So again, if you're going to a conventional doctor and like, they've checked everything and they've told you your labs are normal, make sure they've checked things such as your gut health, your toxic burden, and state of inflammation, because you may not be thinking about that. Another common thing I see a lot in LA is iron deficiency. Some of my patients are vegetarian or vegan, but a lot of them have a condition called sibo, small intestinal bacterial overgrowth, and that that causes bloating. And if you have sibo, you're not able to absorb your nutrients as well as you should and can have a lot of fatigue. And again, iron levels should be above 100. If your doctor says your iron is normal because it's 40, it's not normal because the range is 40 to 220. And another common thing we see in LA, or if in general in women, if you check, a lot of women have autoimmune markers and they may have gone to their provider and said, I have joint pain, I have, have, have some weakness. But the doctors may not be checking these autoimmune markers and it's important to have them checked because if you have one autoimmune condition, you are three times more likely to get the second. And it's because you haven't cleaned up that canvas of inflammation. So these autoimmune diseases just keep going. Last question. Which of the following statements are true about autoimmune diseases? Genetics of the cause of autoimmune disease, stressful events are the cause of autoimmune disease, Your lifestyle choices are the cause of autoimmune disease, and your gut health is the cause of autoimmune disease. Or all of the above. What do you guys think? You may have autoimmune disease yourself or you may, or you may know someone who does. Any responses for that one? What do you think is true about autoimmune? So the answer is all of the above. And the thing with autoimmune diseases is it's important to know that just because you have an autoimmune disease, it doesn't have to progress. And it could actually reverse if it's in the early stages of autoimmune inflammation by addressing your gut health, improving hormones and reducing inflammation. So it's important to know that just because you have an autoimmune disease, it can improve. And that's again, looking at functional medicine principles. And then, and one thing we spend a lot of time in our practice is looking at sleep management, stress management, how is your nutrition, how's your movement. So for things, people, things you could implement right away is try and walk at least 6 to 8,000 of steps a day. All the women on here try and see if you could lift weights at least for at least an hour and a half in a whole week period. How can you lift weights safely? Are you walking around six to 8,000 steps? Are you sleeping without waking up? At least six hours a night. And you know, if you're having stress, try and see if you can do a meditation or if you can see a therapist or talk to your girlfriends, talk about ways of managing stress because stress is always going to be there. But it's your stress response that determines how your body will manifest that in terms of disease. And, you know, we talked a lot about, we talked a bit about nutrition. I said the biggest thing you want to do is make sure you're eating fiber. Your success really depends on your health. How healthy you are is really how successful you are. A lot of people come to functional medicine because they're not feeling well. Well, so questions we commonly get, or any functional medicine practice mostly get, is, is this covered by my insurance? Yeah, I want to test my gut, I want to test my hormones, I want to look deeper. Unfortunately, this is not considered medically necessary in insurance language. Kind of like other things like you, you know, your, if you have car insurance or house insurance, it only really kicks in if you have a flood or if you have an accident. But if you have to do oil changes and stuff, it's all on you. So maintain your health by exercise, nutrition, but to know what's going on in your body, look deeper, Try and find out what your body's trying to tell you. And we have, we've been in practice for over coming to 15 years and we have patients we see at some point and they're like, I think the symptoms aren't so bad. I'm going to wait, but try not to wait. You know, work with us, work with another practice because waiting just makes the disease worse. There's a good, there's a great quote by Dr. William Oslo, the father of medicine, and he says, when disease is early, it's hard to see, but easy to treat. That's when you can use lifestyle, you can use supplements, you can really improve it and make an impact and reverse the disease. But when disease is, is far gone, that's when it's hard to treat. It's easy to see. Maybe you have rheumatoid arthritis and you can see your arms, or maybe you have cancer, but then it's difficult to treat and you need medications and more heroic efforts to get you better. So try and work on lifestyle principles right away. See a functional medicine doctor and practice like us to test and see what is your body trying to tell you. So a lot of times I just know, well, how much does it cost to work with you? Do you, will you be a primary care doctor and will you review my current labs and will you work with my current medical team? You know, yes to all of that. We can help with primary care, we can help with functional medicine. We'll definitely Review your current labs, but most likely you haven't had enough. We usually take patients into programs and into memberships where we see them for three months or six months and really try and work on a common, on a solution for some of their symptoms or just improve and optimize their health. So is this for everyone? It's not for people who are not ready to change. Like, if you're like, I'm not ready to give up my old habits and really get into feeling better, then functional medicine is definitely not for you. Wait until you really have some sort of why, where you're like, I know why I'm doing this, then it's much easier that to get new habits and to be motivated. So this is ways you can work with us. I just want to give you two ways. One is you can see Jasmine, who's our onboarding coordinator, talk to her about these are my symptoms. What could I, how could I work with you guys? How is what options do you have for me? And there's a QR code for those of us who are not tech savvy. You could text us at 818331 again, 818-3314386. And then here is we don't do one off visits generally, but these are other providers. This is Serena, Pennsylvania, and this is Annie. We all are functional medicine certified. You could come and see us for two and a half hours and do the longevity labs. What are the longevity labs? These are the labs probably a doctor has not checked. Things such as autoimmune markers, your hormones, your insulin, your inflammation, all the basic stuff I talked about today. Not the gut health and not the toxins, but at least everything else. This is something you could test with us. We are in Charmen Oaks. You would come and do the blood work and come and spend two and a half hours with us to go over that. And we'll also give you a PDF which will explain how to interpret those labs so you can do it yourself at a later stage. So don't guess, start checking so you know what's going on with yourself. And I want to leave some questions, some time for questions for people who have questions about their own health and what they, if they want any answers from a functional medicine md, now is the time and it might just benefit the group. So if you have any questions that you want to share, please ask them in the chat that you feel comfortable sharing and I'm happy to, to answer those. Right, well, if you guys have questions coming forward, please, I know so many stuff on YouTube. There's so much stuff on podcasts about functional medicine. But don't be comfortable or don't accept whatever symptoms you have. Especially our current healthcare system says you're normal, but you're still having a lot of symptoms. Look deeper. And of today's talk, I hope you've actually gotten some good things you can implement right away, which is eat 40 grams of fiber a day for your insulin and for that inflammatory estrogen, and make sure you're walking at least 60 to 80,000 steps a day, because I think it could really, really help. I have one question. It's. I've had a partial hysterectomy and is on HRT patch, but don't feel great. Yeah, I would, I, I would say is your HRT patch a combination of estrogen and progesterone? Generally, what we prefer to do is bioidentical hormones. Bioidentical hormones or hormones that your body is from is more like similar to your own hormones, but they still are hormones and they still have the risks of hormones. So one thing you can try and do is do oral progesterone and the estrogen patch. But I'd say if you're not feeling great, then what is your gut doing? How is your gut processing these hormones? Do you have high levels of toxins that need be interfering with how you're processing these toxins? Has your sex hormone binding globulin been checked? If it hasn't, I would definitely check it. And one hormone that you probably need is testosterone. We do testosterone in both men and women, tiny doses in women, and they feel pretty phenomenal from that. Let me see what the other questions are. Yeah, and so when we're thinking of hormones, hormones are one piece of it. But don't forget about the other hormones. Is it your adrenals? Is it your thyroid? It may not just be just your sex hormones, but it's probably a combination and a common thing. I always tell patients with hormones, think of the adrenal glands as the wise grandmother and think of the thyroid as the supporting mom, and think of the ovaries as the sensitive grandchild. So a lot of times in regular medicine, we just focus on maybe the thyroid, maybe the ovaries. But a lot of times it's the wise grandma, it's the adrenals that's the issue, and that's what we need to address. And all the other hormones kind of fall into place. But. So one person asked about bloating in their lower belly. I would say the first Thing you need to do is test placebo, sibo, small intestinal bacterial overgrowth and a leaky gut. I would bet there's something there. What's the best way to lower my inflammation? The best way I would say to lower your inflammation is to reduce your stress level. So it's important to get into some sort of practice for that. And then the second thing to reduce when you're in stress, your cortisol increases, inflammation gets worse. And other things you can try are natural supplements such as green tea, turmeric, turmeric, fish oil. Those things can really help inflammation. But it's really lifestyle like, what can you. Movement reduces inflammation. Also getting enough fiber reduces inflammation because it binds the toxins and gets it out. Yeah, I'm not a huge fan of chimera. Chimera is a combination patch. I would say separate your hormones and think you'll have a better impact. So asthma and allergy and functional medicine. So the question with asthma analogy is generally why? Why do you have asthma? Why do you have allergies? And it's usually the gut lining. So suggestions would be try some magnesium, because magnesium relaxes your bronchioles and will really help in terms of asthma. And for allergies, I would try some L glutamine. It's an amino acid. It's safe to take. It helps heal your gut lining. It's going to take some weeks, if not months to see a big difference. But you should see something for allergies and asthma. What is it telling us? It's telling us that you have a leaky gut. Why do you have a leaky gut? Probably from toxins or inflammations. So always keep peeling the onion. Try and find out why, because, you know, saying just take turmeric, saying take glutamine, take magnesium, is still very much band aid medicine. There's still supplements, but the question is why? And try working from why. Perfect. Okay. I hope this was helpful for you guys. I'll stay on for another minute in case people have questions. You know, feel free to put it in the chat. And again, if you are going through stuff, look at functional medicine and look deeper because there is answers. And if we. We are not finding answers, then it's just because people are not checking or your provider's not checking. How can we make the gut stronger? You know, in places like Africa, the gut lining is very thick and strong because they've seen infections, they've seen parasites. So the gut lining is very thick and they have very, very low incidences of things like cancer and autoimmune because the gut lining is very thick. So in our sterile environment in the US we are at more at risk for diseases such as autoimmune and cancers and chronic inflammation because our gut lining is very permeable. So I'd say things to best ways to make our gut stronger is feed it good food. Feed it a lot of good prebiotic food. Things such as asparagus. Do a lot of probiotic foods such as fermented foods. Feed it a lot of fiber. Make sure you test, is your gut in a good place now? What's the. What's wrong with it? Is it too much over bacteria? Is it bad bacteria? Is it too much, not enough good bacteria, or is it. Is the gut lining weak? So test and then treat. But if you want to just blanket things, you do, I say take nutrition, do nutrition, make it serious, and maybe add bone broth, because the bone broth can really help your gut lining. If you're vegetarian, the equivalent would be L glutamine. So really work on your gut. It is really the biggest organ center that processes everything. And be focused on it, because I think it would really help you. You're welcome. Okay, ladies, there's no other questions. Thank you so much for joining us this evening. I hope you got something useful out of it. Take care.