#151: Mastering Menopause with Betty Murray

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Hi, I'm Dr. Tabatha, the Gutsy Gynecologist. I'm a triple board-certified OB-GYN and functional medicine physician. I've embraced the world of functional medicine and wellness through my own personal health journey, and I'm super excited to share my wisdom and unique perspective as it pertains to women's health. After caring for thousands of women, I've come to realize that your gut health determines your gyn health and your overall And it's a super gutsy thing for me to go against conventional gynecology practice to bring you the truth. No more Band-Aid medicine, ladies. We're talking root cause resolution on this show.

So if you're struggling with hormone imbalance, weight gain, period issues, anxiety, insomnia, you name it, then you've come to the right place.

And I want to be your gutsy gynecologist. So welcome.

Thank you.

Hey ladies, I'm so excited for my guest today.

My great friend Betty Murray is coming on to talk to us. So I've been listening, you guys have been asking for more menopausal stuff, more hormone imbalance stuff, and Betty is a master at tying all of this into gut health. And why does gut health matter and how does food impact our hormones? So the cool thing is Betty's a nutrition expert, so she has this huge background in understanding food as medicine and how food can heal your body or harm your body. And she went on to get a PhD. She has been studying all of this, so it's pretty amazing to listen to all of the research. that she's done with the microbiome and our hormones. And I'm like, oh my gosh, this is my jam. This is right up my alley. This is what my ladies need. So I'm really excited for this conversation today. Let me just tell you about Betty. She's a nutrition expert, PhD researcher, certified functional medicine practitioner, and speaker. Betty helps women over 40 harness their hormones to lose weight, optimize sleep, restore energy, and thrive in life. During her research, she made four key discoveries that led to hormone and metabolic imbalances that plague women over 40. So restoring balance to these key metabolic and hormone pathways is the basis of her hormone reset program, which is pretty awesome. This program has helped her and hundreds of clients lose weight easily, reduce hot flashes, restore sleep, and turn up their energy without living on a diet of deprivation.

A Amen.

Oh my goodness. So she's host of the Menopause Mastery podcast and founder and CEO of Living Well Dallas Functional Medicine Center. So that's pretty amazing. It's an incredible center. She's got multiple specialties in there and it's, you know, everything I envision that women need for comprehensive care. She is frequently a featured nutrition expert on Fox News Broadcasting, CW33, NBC, and CBS. So we are going to talk about the nitty-gritty of why our hormones are imbalanced, what is causing this, and how to evaluate it in a totally different way than you're used to hearing. So she has some really Good golden nugget insights.

So stay tuned. Here we go.

And don't forget to share this with your friends.

Well, welcome, Betty, to the Gutsy Gynecologist Show.

Gosh, thank you for having me, Tabatha. I'm so excited to be here.

I am too, because you are just fabulous. You, like, are changing women's lives down in Texas, and I love everything that you're doing. And I just know that my women need to hear from you because you have a really amazing, unique perspective on like menopause and women in midlife. So I'm excited to talk about all of that.

Thank you. I love digging in and making this science easy for women to understand because I think, you know, we've been gaslighted through medicine for decades.

Exactly. So what did you go on to do your PhD studies in?

Well, so, so I, you know, I went back to get my PhD primarily because I wanted to understand why women I feel like we get the short end of the stick. You know, we have the joy of reproduction, but along with that comes a, you know, 10-to-1 risk for autoimmune conditions compared to men. We tend to go through this cliff dive of hormone change that's really horrible for a lot of women. And, you know, once we go through menopause, if we haven't replaced our hormones, then we age match men for stroke and heart attack, and we have a higher risk for dementia and osteoporosis. So I went back, I wanted to understand a couple things. And so the first one was I really wanted to understand why some women went through these symptoms and others didn't. So, and I knew it had to have something to do with our hormones and the differences in how we metabolize them. And then the other side of it is I wanted to understand the complex interaction with our microbiome. You know, in the last 20 years, we've been able to classify and identify these microbes, and we're also able to start identifying what metabolites and enzymes they make. And so there's a huge interaction effect there, and I had the feeling that there's, there's some pieces there. And so my actual dissertation is looking at the intersection of hormone metabolism a bacterial enzyme called beta-glucuronidase and whether there is a difference between women that are reproductive in the level of beta-glucuronidase with IBS, right? So very specifically looking at that because there's just so much interplay. And when I went down that rabbit hole, you know, when I was getting bored of looking at all these microbiome studies, I'd start digging deeper into the metabolism part and deeper into the mitochondrial activity. And I found a bunch of things that just aren't being talked about in, in the medical community or in the research community.

Oh my gosh, I am so excited for this conversation because I love talking about how the microbiome affects our hormones and vice versa. It's so integral. And like you said, nobody's talking about it, especially conventional gynecologists. I will be the first to say I didn't know anything about this just, I don't know, 5 or 6, 7 years ago.

Time's flying.

But I had no idea of that, you know, interaction that was going on. And so that's my mission now, is to help women really understand that their gut has so much to do with what's going on with the rest of their body. And I would love for you to just explain to women, you know, basic microbiome, what you want to see, what you don't want to see. And I'm hoping that you Tell me my theory is right, that beta-glucuronidase increases in menopausal women as an innate intelligence in our system to reabsorb and reuse our estrogen as a protective effect. Is that right? Because I just have been making that up in my head as I go along, but it just makes sense to me because our bodies are made to be in homeostasis and do whatever's necessary. To keep us in balance, right?

Oh, absolutely. You know, I'd say the beauty of having gone through a dissertation is I've read— I'd say my current dissertation has 285 references in it. So like, I have read everything and anything there is to do about that. Like, just, it's obscene. It's— and I have a memory like an elephant. So it's all stuck in here. But, you know, so everybody, just to give a primer, just in case, you know, this is the first time somebody's listened to Dr. Tabatha, because I know this is your content. You know, if you think of your microbiome in your gut as a jungle. Inside that jungle, I have lots of animals, and the more diverse my animals are— so I have toucans and snakes and squirrels and all these different things— and the more of all of them, my microbiome is healthier. And, you know, our microbes, for all the messages that our brain sends down to the gut, they have 3 to 4 times as many that they're sending back. And so there's this huge interplay between the gut-brain axis, our immune system, Our digestive system, all of them play with the the microbiome. And so, if our microbiome is out of balance and all you've got are snakes and tarantulas left because you've had antibiotics or you've been eating a diet that has been starving out the good microbiome or you were born C-section and all the stuff that I know you talk about, all these things that make that jungle sort of like a rainforest that's been cut down can lead to your body overgrowing bacteria that make less favorable byproducts. So beta glucuronidase is. is an enzyme bacteria makes and actually our body makes it. So we make it in lymphoid tissues. We make it even in the trabecular bone. It affects actually the act of turmeric on anti-inflammatory effects with osteocytes inside the bone. So it's all this weird stuff. So it actually can help, you know, your bones actually either grow bone or not grow bone. So we have it expressed in all these places, but inside the gut, the bacteria make it. Uh-huh. And so I believe, you know, if we look at how a lot of research gets done, Most of the researchers will go out and they'll try and prove that something's bad. Like, we— your job as a researcher— so this is a primer for everybody that looks at research— your job as a researcher is to disprove your hypothesis, not approve what you believe. And that is not what gets published today. People go out and they go, I believe this, so therefore I'm going to go prove this. And then you manipulate numbers. I went through statistics. I know how to make something look different than it really is by just changing how it gets read. Right? So a lot of the research originally went out and looked at is beta-glucuronidase bad, right? And so if I have bacteria that are producing a lot of this metabolite, it affects your body's ability to get estrogen compounds that your body is done with from the liver that goes out with the bile and out with the stool, right? So it allows some of those, those compounds to be recirculated. So the idea being that those estrogen compounds, once they've been used and they're kind of— think of it as like a used up Hanky, you know, or a tissue. If you're done with it, you want to just wrap it up and throw it out. Well, yes, in some cases, if we look at chemotherapy drugs, the efficacy and the toxicity of chemotherapy drugs are driven on the fact of the level of beta-glucuronidase. So in some cases, certain things, too much of that can be problematic. Too much beta-glucuronidase has been associated with colon cancer because it leaves these sort of metabolic hormone byproducts that can change DNA and cause damage inside the intestines. But, you know, all of a sudden that was kind of where the research stopped. And it was like, wait a minute. And I, and then I started reading some research on breast cancer and then all of a sudden, 'cause in my head I'm like, well then it must be terrible for breast cancer. And, but the research doesn't really show that. Right. And then it was like, oh, so there is some body of research out there looking. And so if these bugs, A bunch of different bacteria in your gut can take estrogen compounds and basically take the wrapper off of them so you can't throw them out anymore. What it does is allow them to be recirculated through the liver back into the bloodstream. And the belief is, is that the microbiome making this acts as a reservoir for estrogenic compounds when the ovaries take a nosedive and cannot function anymore. We gain body fat because body fat can take testosterone through an enzyme called aromatase and make estrone. And estrone sulfate. So those 2 processes act as a reserve to help the body make that really protective estrogen-like compound. It's just not the same as estradiol, which is the compound that we do make when we're fertile. And so you're right, there is, there is some thought that this is actually a reservoir of the body trying and the microbiome trying to help you with hormones. And so in some cases it may be problematic. And then in other cases it may not be. And it's probably more to do with how much fiber and dietary things and all these other things that we can modify that can reduce those risks. But, but it does. I would say the research out there isn't clear, clear, clear. But I would say that that's a high probability that it helps produce a little bit of estrogen for us in menopause.

Yeah, I couldn't agree more. And I see it all the time when I do stool testing on my patients. I think about, okay, what is their age? What is their menopausal status? And 9 times out of 10, if someone is menopausal, not on hormone replacement, they have a beta-glucuronidase maybe somewhere around 2,000 or 2,500.

It's like a little bit high.

And, and I feel like that's protective, and I'm a little bit hesitant to like get aggressive with it, you know, and try to shift that microbiome unless there's something obvious going on with the rest with dysbiosis.

So.

I love hearing that the studies are finally coming out. We're finally starting to understand this a little bit more, and you are making it so easy to actually use clinically and help our patients. So that's the amazing part. So what other kind of stuff do you look at when you're considering the microbiome? Talk to my listeners about metabolites. You used that word.

Yeah, so the microbiome, they take in your food, so they eat some of your food. So the microbiome, the majority of the microbiome consume basically carbohydrate content and— and fibers. And so when they take those things in, they— they ferment them, which is why some people, if they have an out-of-balance gut microbiome, they get gassy and bloated because there's a lot of gas production that happens. Well, they ferment that and they make a bunch of byproducts. Some of these things are called short-chain fatty acids and that— those short-chain fatty acids become food sources, right? So they become food sources for the microbiome and then they also become in some cases food sources for the cells that actually make the intestinal lining and so— so to some degree, those metabolites are important. So for instance, one of the ones that they make, one of the metabolites is a thing called butyrate and butyrate is one of these short-chain fatty acids and it makes a mucus layer inside the intestines that becomes the fence to keep your— keep your bugs off your wall. Like we are good friends because we have a good fence, you know, the good fence. So we like each other because of that.

Uh-huh.

But what's interesting is butyrate has been shown even in research to help Slow down if it's in high enough levels and we have adequate levels, slow down the degree in which carbohydrates are liberated from your intestines in the form of glucose into blood sugar. So they can help modulate even diabetes risk. So your microbes make things like butyrate that can help your body actually manage other body activities. And, you know, they make many, many other things. They help us produce vitamins. They make things like B12 and B1 and B2 and K, and they help us, um, digest and metabolize phenols and all the antioxidants in your food. So we couldn't really survive without our microbiome. So all of these metabolites of what your microbes are doing are actually helping your body function. And so, you know, what we do know is that microbiome, the more diverse it is, the healthier it is. And the more we feed them, the more diverse it gets.

Yeah. And you mentioned the fiber. So let's talk about how do you Yes.

So, you know, it's— this is difficult because, I mean, Dr. Tabatha and I are, you know, in a community. And it's funny because we go to professional events and we have the vegans over here, we have the paleos over here, then we have the hardcore carnivores.

Yeah.

And then we have the people in between and they all, you know, and they can get along, but sometimes we wear our nutrition like religion. And can you survive on a carnivore diet? And have I tried it? I'm the world's worst about using myself as an N of 1. I will try everything. And, and I will not tell somebody to do something I haven't already tried.

Right.

You know, so I've done carnivore, and actually I have a history of colitis, and sometimes when— if I get a slight flare-up, a lot of carbohydrates, like a lot of broccoli and Brussels sprouts and things like that, are not going to go well. So I might eat more carnivore during that time. But the simple fact is, is dietary fiber will modulate your hormones on its own because of its binding capacity to the stuff coming out of your liver. So if you're perimenopause and you're estrogen dominant, literally raising the fiber in your diet can change your hormonal perspective. And then you— it changes what your microbiome is doing, so it may change it that way too. So we've got to get dietary fiber, and it's— and it really is a combination of soluble fiber and insoluble fiber and complex carbohydrates, most of which are— a lot of them are the FODMAPs that people with bacterial overgrowth may have problems with. But, you know, we should be getting no less than 30-35 grams of fiber a day. Spread out. So if you haven't been getting enough fiber, I wouldn't down that much all at once because you would be uncomfortable. But that— but we do need that fiber to feed our friends and also help our body function.

Yeah, without a doubt. And, you know, the statistics are like, I think we get 11 to 12 grams of fiber a day as an American. Like, we're super deficient.

You know, I've seen it as low as 7.

Gosh, I believe it. You know, if you're living at McDonald's, you're never seeing fiber. So let's talk a little more about insoluble versus soluble because I, I love that point.

Yeah, so most of the research— so a lot of your prebiotics— so your fibers act as prebiotics, right? And prebiotics and fermented foods have shown to be able to remodel the gut. So think of it as your, your gut is a neighborhood Right? And so remodeling, it's like their neighborhood got regentrified and a bunch of them moved back in. So fiber and fermented foods have shown to remodel the gut better than probiotics. Not that I don't use them, but probiotics have their place, but they don't colonize in a really, really great way. And so when we get soluble fiber, that's the fiber that, like, if you were to mix it up in water, it mixes well. Like, it doesn't have little floaties in it, right? Insoluble fiber is the, the fiber that we can't break down that is going to, you know, be chunky stuff in there. The vast The vast majority of your microbiome really consume your soluble fibers. They do work a little bit with the insoluble fibers, but it's mostly your soluble fibers. And so you can get that obviously in prebiotic supplements, but my preference is to make sure I hit that 35 grams in food source first. And then if we want to add some additional prebiotics, we do that because some, you know, again, some prebiotics are better than others, but you get them in things like sweet potato and your vegetable families and your healthy fruit.

Okay.

And even, you know, depending on what somebody's eating, you know, if they're paleo, obviously sweet potato and your starchy tubers and things like that. And if somebody's eating a more Mediterranean diet, your legumes have a lot of, of your soluble fiber. Um, even things like chocolate, right? So, so getting that in your food is helpful, and then you can always supplement a little more.

Okay, I love that. So you heard it here first, you need fiber for your hormones and for your microbiome. So many important reasons. And you touched on the fact that they help you absorb vitamins and minerals, they help you make vitamins, all those important things. So say a woman comes to you, she's, you know, on the verge of menopause. What is your favorite way to just get a comprehensive picture of what's happening with this woman?

So if I, if I can do all the things that I want to look at, you know, I always, yeah, It's so funny. I did a radio show one time and they were like, if you could only do one test, what would you do? And I was like, oh, this is probably—

That's a hard one.

When I was like, this is probably going to freak them out. And I was like, I'd do a stool test. And they were like, oh my God, what? And so if I could only do one thing, I would do a stool test because I can tell a lot about somebody's health just by the health of the microbiome and all those digestive markers and the inflammation. But in a perfect world, I would definitely do the stool test even if somebody wasn't having digestive symptoms. Because a lack of symptoms doesn't mean something's going on. But I would also want to look at 2 things. I'd want to look at their salivary levels of hormones if I could, and I'd also want to look at their urinary hormones because I can see how you metabolize it. And salivary shows you what's free. So if I look in blood, think your hormones have a taxi cab and they have to drive around and then they have to get out of the taxi cab. When you're looking in blood, you can't tell if they're in the taxi cab or not. So you don't really know how many are really active. But in saliva, I can see the active hormone out marching around. And then in urine, I can also see the active hormone marching around. And I can also see all these metabolites. So when I was talking about how we get rid of estrogen, all the steps it takes that the liver has to go through to get it to the trash can, it sort of gives us that picture. So we can have a really good idea, is, is somebody In current, like perimenopause, and their estrogen levels are wildly fluctuating, which is often what's happening. And is their progesterone low, or have they fizzled out completely? Do they have testosterone, or is it that their hormone levels aren't that wild at that step, but they can't get rid of them? So they've got a detox problem, which was a lot of my genetics. It's why I ended up here. I don't get rid of my estrogen well, and you know, being 53 today, I feel better than I did at 35, and I can tell you my 40s. was not fun because I felt like I was constantly chasing this hormonal imbalance and it's really what drew me back to school. So, you know, that woman that's in that transition, I think it's really important to look at that. And then because I help women particularly with weight loss around that sort of resistance situation where they're doing all the right things and it's not working, I would— I'd love to see some metabolic hormones too, insulin and adiponectin and leptin, uric acid levels. I like looking at that because it can also tell me is there a mitochondrial problem, a powerhouse That is now being affected by those hormone changes.

Yeah, I think that's a really important point is we, we want hormones to be the end-all be-all, but the cells that the hormones are binding to and trying to send signals to, if those cells aren't functioning, you can have hormones all day long and it's not going to work. So I would love for you to unpack that whole mitochondrial cell health thing a little bit more for women because It makes so much sense. All of a sudden, our hair starts to gray, we start to gain weight in the middle, we're tired, our brains aren't working anymore. And, I don't always see that shift just with hormone balancing. You got to do the deeper work and look at the mitochondria. Yeah.

I mean, like I said, that was the story for me. I mean, I've been in the functional medicine community for 18 years, so I'm an OG. Right? And when my hormones went south in my 40s, I went to everybody. I was like, help me out. And they just put me on hormones and thyroid and I was on this sort of rodeo and they're like, well, you gotta make sure you're eating the right thing. I'm like, okay, I'm low carb. I'm working out. I'm doing HIIT, you know, high protein, low carb, all that stuff. And what I really found in my research was there's a bunch of mechanisms. So your mitochondria is your powerhouse inside the cell, but it also produces things. So it's not just a powerhouse.

Uh-huh.

But we'll stick with that portion of what it does today. And, you know, nobody was really looking at, does estrogen do much to the powerhouse directly? Because there are estrogen receptors on the powerhouse and estrogen is actually produced inside the mitochondria and inside the ovaries. So, there is, you know, there is a target of estrogen on mitochondria. So, the first thing that I noticed, and I noticed it clinically, and it was based on Rick Johnson's work looking at uric acid.

Uh-huh.

And so, when I read his book called The Fat Switch, I was like, okay, that's huge. And, I'll explain that in a minute. And then, I started looking back at my menopausal women and looking at the uric acid level. And, lo and behold, they may not have the high level that you would expect with gout because uric acid being high causes gout, but it was elevated. And, I started looking at it and lo and behold, we know that when women go through menopause, uric acid is elevated. It's part of the mechanism. Well, uric acid when it's high inside the cell, Acts as a danger response. It's actually the hibernation response. So, the mechanism inside the cell that basically turns that powerhouse down and slows it is the rise of uric acid. And so, think of that as a switch. It goes on and on. And, animals that hibernate, they eat things that turn that switch on that then— and it's controlled, it's genetically controlled. And, all of a sudden, they gain weight so they can hibernate through the winter. So, we have a bear metabolism. So when I was looking at that, it was like, oh, there's an estrogen target on the mitochondria. Uric acid climbs up, so there's got to be an interrelationship. It may not be causative but correlative with this increase in uric acid that then tells your powerhouse to run at half speed, right? So the rise in uric acid in a woman means the mitochondria are going to slow down. There's also— so our muscles are the biggest places that we need to burn fuel, right? So glucose or fat. So if we're sedentary or our muscles are insulin resistant, and they are the first ones to To be insulin-resistant. We won't burn it efficiently. And there's a transporter in the cell. So think of it, we have insulin brings glucose. So think of that as the guy that opens the door and pushes glucose through the door. We have a transporter in your muscle cells called GLUT4. So think of this as like a— it's like Chutes and Ladders. It's like a little slow side that sort of slides up to the mitochondria. But it's not an active transport. So it's sort of— it's sort of like barely tilted. Right? So it's not like a really steep slide that you get to slide really quickly. Well, that transport, think of it as that somebody just balanced that slide out so it has no pitch anymore. So that GLUT4 transporter doesn't really work in women as we go through menopause. Estrogen stimulates it. So all of a sudden, you have probably natural insulin resistant because 88% of us are estimated in the United States to be insulin resistant. And then, the non-active sort of let it sort of slide downhill transport doesn't work in women. And then our powerhouse is running at half speed. So all of a sudden, your mitochondria are getting messed up from multiple areas. So you could be doing HIIT and low carb, high protein, and you know, working yourself to death, and just the mechanisms inside the cell may not be functioning properly.

Oh, I see it all the time, you know, and I find that women, we we think that if we just do it harder, do it to 150 percent, that we're going to shift things when I. I feel like we're just driving things further into dysfunction, aren't we?

Oh, absolutely. I think if I look at— I have all these core tenets of my hormone reset program, but I tell my women right now, if you aren't sleeping and it isn't quality, and if you don't have that stress chemistry under control, I can't help you. We have to get that dialed in. Doing more will not help. And I am naturally wired to be a human doing more. So, this is my own personal experience. I protect my sleep. Like nobody's business. I don't care what's going on. My sleep comes first, and I had to cut back on a lot of stuff. I had to cut back on the level of exercise and the high intensity and things like that because I was just more was not better. It was making it worse because that your body thinks you're starving. It just thinks you're starving every day, and then it slows all the hormonal messages to get it to the cell to begin with.

Exactly. And you guys, Betty is type A, like perfectionist. Do it to the you know. Perfection. And if she can set boundaries and she can reel it in and shift things, then you can. I know that for sure.

Yeah, I'm definitely wired to be that way.

Yes. And you accomplish so much, but I believe it's because you're setting these boundaries and because you're honoring what your body needs at this time in life. It needs the sleep and all of that. So what is one way that somebody And, you know, going through this transition can really shift their mitochondrial health so that it's not in this hibernating state.

Right, right. So obviously we talked about the stress. So that's, that's something that for all of us is just this ongoing sort of, you know, roller coaster that we have to sort of manage. And sometimes we have to get well in an environment that makes us sick, and we may have too many irons in the fire. So it's— don't get me wrong, it's not like I don't have those stressors, but I really work hard on doing that. So we have to constantly address that. But when we look at what we do dietarily, so the other thing that I was curious about was, you know, obesity is a new epidemic. You know, if we look in the 1950s and '60s, matter of fact, in World War II, they had a harder time getting people into the armed services because they were underweight. Today, they have a hard time filling the armed services because they are not fit for duty because they are overweight. And we're talking about young, should be metabolically sound individuals. So some of it is seed oils, you know, so seed oils are bad. So no canola, no soy oil, no corn oil. And some of it is the high fructose corn syrup and processed foods. But the other thing that we have really done in our food supply is, is we eat a lot of foods that actually raise uric acid, right? So naturally raise it. So why would you want to eat something that turns on your hibernation switch? So the first thing we do is we already make all those other changes. We get the high fructose corn syrup and the processed foods and all that. The next step is then we look at how much of the foods you probably love that you're eating. So if your idea of a perfect meal would start with some really good aged cheese, a nice glass of wine, olives, charcuterie, you know, umami foods, foods that have this savory sort of thing. All of those foods, they're high purine foods, you know, salami, that kind of thing, all raise uric acid. Alcohol raises uric acid. Sugar raises uric acid. The food additives we've added in foods, so all those flavoring things that you see that say natural flavoring, yeast extract, you know, MSG, or whatever euphemism they're using, texturized vegetable protein, those all raise uric acid. So you could be dosing yourself daily With enough of that, that will stop your ability to burn fat. Period. And so, yeah. And so I we look at those uric acid levels and how to reduce them, and we test it, and we take it out. I can tell you if I'm having a last meal, I just described half of it. I love those foods that you know the I was having flashbacks, Betty.

Like literally, that would be my dinner when I was an attending, you know. On call every third night. I was a single mom because my husband lived in a different city doing a fellowship at the time. And I literally— that would be my dinner. I would just make myself a charcuterie plate with a glass of wine because I wasn't on call and I couldn't function. I fell asleep every day during lunch. I, you know, I was exhausted, falling asleep behind the wheel. Oh my gosh, that makes so much sense. Wow. I hope somebody else is like, epiphany right now.

Yeah.

And it's not that I never eat that stuff, but believe me, yeah, that would be— and I'd have a salad with it.

Okay.

I'd want to balance that out. And especially if you were on that sort of high protein ketogenic diet, a lot of the diets that are recommended out there will represent a lot of those bacon and things like that. But all of those things and what we know genetically is some of us have a hair trigger response for for uric acid and some of us don't, right? So some people can get away with it better than others. Our genetics matter. And, you know, that would— I would add that to my list of things. I'd want to know somebody's genetics because I'd want to be able to help them figure out how they're wired so they can avoid some of the things that they shouldn't have. Maybe not take it out completely, but it just doesn't become a daily thing.

Do you think that a family history of gout is predisposing you to just having genetic issues?

It could be, especially if you have a family history of gout without reason. You know, if somebody— if you know you've got like Uncle Bob whose favorite foods are sausage and hot dog and beer and he starts his evening with a Jack and Coke, okay, so he's probably causing it. But if you have family members that really don't have some of those backgrounds that you would think, then, then there may be a good sign that you, you have a tendency to make uric acid really well, you know. Inside the cells.

Oh my gosh. So let's talk about genetics because you mentioned that, and there are a few SNPs that women just should really know about themselves, right? Because it does really affect their hormones and their gut and everything. So let me hear your favorites.

So, you know, probably the first one is the MTHFR, or methyltetrahydrofolate reductase. So everybody's gonna have to pass that quiz on how to I'll have to spell that later. And that, that simply is a gene that affects how our body metabolizes folate, which is B9, into its most active form, which is what they call a methylated form. And essentially what that form of folate does is it picks up its best friend B12 that has to get metabolized into a form called methylcobalamin. And they basically turn a dial that makes— basically it takes an amino acid called methionine and makes homocysteine. It sort of turns that dial, so makes it go around and around. And the byproduct of that chemical reaction is a thing called SAMe. And SAMe, think of SAMe as tape on a light switch. And it's— the light switch is your DNA. So when we're born, let's say our DNA light switches are all in the most perfect position. No cancer genes turned on, all the perfect ones are turned on—

off.

And then we have tape over them so you can't move them. So it's kind of like your grandma's heater in the bathroom. She puts tape over it because she doesn't want you to turn it on and burn her house down. I had a grandma that did that. Don't take it out, just tape it over it, you know. So you want that tape to stay in place. If I cannot manufacture SAMe, then the tape's going to dry up, wear off, and we're going to turn on things. So it's associated with diseases— breast cancer, Alzheimer's, cardiovascular disease, autoimmunity. So knowing your methylation status is important. And about 49% of Caucasians, 47% of African Americans or African descent, and Hispanic cultures have high prevalence of this. So it's almost 50% are going to have mutations. So that one's really important. Some of the other ones that are specific around estrogen are your CYP1B1 genes, which handles the very first step of your body in the liver trying to get rid of estrogen. And anything your body does, it has an order. So you can't like skip and go, okay, I'm not going to do step 1, but I'm going to do step 3. You know, you have to go in order. And so people that have mutations on that gene make a more toxic level of an estrogen metabolite called 4-hydroxyestrone that is then more likely to cause some of that DNA damage. The challenge is, is then that first step has to pass it to the next gene, which is comethyltransferase or COMT, that then methylates it. That is also dependent on your folate and B12 levels, and it wraps the next wrapper around that estrogen. And then has to pass it off to either a thing called glucuronidation that your microbiome will either make better or worse, or sulfation. You know, so I look at those genes and, and if people are mutated, and I actually have double mutations on every single one of them, I was like, oh, everything's illuminated. Now I know why my 40s were so crappy.

Yep.

You know, and you can see that in urine tests. But, you know, what that ultimately does is it affects how you get rid of your estrogens. It's also responsible for getting rid of your catecholamines, so cortisol, dopamine, norepinephrine, and epinephrine. So you're more likely to be anxious if you're not good at this. You're more likely to have high stress and not get over things, not be able to sleep well. But the good thing about it is we can manipulate those nutritionally, which is why I was so interested in it. And so those genes are really, really vital. And when I dug through the literature, you know, you start looking, CYP1B1 is associated with breast cancer risk. Also associated with metabolic syndrome, obesity, diabetes. Same thing with COMT mutations. So the women that carry some of these mutations along with some of that hormone stuff start to have all these metabolic problems later on that you know get ignored because no one looked at women's hormones because we were an outlier and they would prefer to gaslight us.

Yeah, exactly. So what is your favorite way to test genetics? Do you have a certain test you use?

Yeah, so I currently use— and I've been doing genetics for over 10 years, so I've used pretty much everybody commercially available. I currently use The DNA Company.

There's—

for several reasons. Most of your genetic firms, when they do— when they start to create their tests, the question that they ask is, what gene is responsible for X disease or X condition? And then when they answer that question, they're kind of like, okay, now we know. Right? So there's the APOE gene that is called the Alzheimer's gene, and if you carry a 4, you have a higher risk for Alzheimer's in your lifetime, right? And if you carry 2 4s, it's the highest possible risk. The better question to ask is, of the 100% of people that, let's say, carry a 4 on both sides, one from mom, one from dad, if only 70% of them get Alzheimer's in their lifetime, what did the other 30% that had it do that kept them from getting it? That's important. So that was question number one. The other one is, is genes don't act in isolation. So knowing MTHFR is helpful, but if I don't know the best friends around it, I can't really tell you what its expression is doing. And so what the DNA company did is they asked the first question correctly, is what did the other people that carried that same gene do that kept them from getting disease? Because now it's actionable. And then, what did the pathways— so what did these genes combinations do? And then, how do we address them and try and affect gene signaling? And they actually did studies on 7,000 people. So they're the only commercial DNA company that did that. And so, I like it because it actually helps to paint that picture because I was taking the data and doing all that in the background, figuring out the pathways. So, it's much more effective. I mean, this week, everybody probably heard a couple weeks ago that like one of the Hemsworths, I think. I can't remember which one it is. They, you know, figured out that he had an ApoA4, and he was going to go take a break from acting because he was so worried about his Alzheimer's risk. And it was like, oh my gosh, somebody stop that man and have him call one of us that understands this, because you are young. There are some minor things that you can probably do, and you will never get Alzheimer's, right?

Exactly.

That's— it's not a guarantee. Your genetics are a predisposition but not a guarantee. It's It's what you do that turns that thing on or off.

Yeah. Oh my gosh. That is where conventional medicine is really falling short. We do some basic gene tests to see, are you at risk for this really big disease? But there's absolutely no counseling, no intervention, no modification, no understanding of, you know, how you can alter that gene status, like you said, you know? The genes are the gun. Your lifestyle pulls the trigger or not. So, yeah, I think that's so important. What do you see as the most common combination? Probably what you had with the MTHFR and the COMT mutation. Yeah, yeah.

You know, it's funny. I have my podcast, Metopause Mastery, and on that podcast, you know, I was talking about the DNA, and I had Kashif Khan, the CEO. You know, give me my answers. He and I are have become professional friends, and so he videoed and we we did this exchange, and I was like, you know, I'm just going to play that so you can actually go out and hear me go over my genetics. And when he gets to my estrogen, he's like starts laughing. He goes, oh my God, you're estrogen toxic!

And I was like, I know.

So I would say I I don't see a lot that have my exact combination because like I said, I have a lot that doesn't really work in that pathway, but I've been able to manipulate it and manage. It and check it and see that I can make it work by doing a lot of dietary manipulation. But you will see women with MTHFR and CYP1B1. I see a lot of MTHFR and COMT mutations together and this is the person that is wound up, can't figure out why they can't mellow out, they can't sleep, and they tend to have a lot of hormonal problems just because they can't exit those hormones. They don't get out of the body. And so they're stuck and they're just— they feel wired and tired and their PMS is terrible and they want to rip everybody's head off.

Are you using SAMe in these women or are you using something else to manipulate that?

You know, I don't generally use SAMe directly just because, you know, sometimes there's a more elegant way. So I think of it as sort of like a river. If the river's rolling downhill and I want to affect the pool of water at the end, you know, in some cases I could build a dam and that's how drug therapy usually works. So I just build a dam. And who cares what happens above it and below it? Just build a dam.

Right.

And SAMe in some cases can be kind of like building a dam because it automatically gives what your body needs to make. And there are times that I may use it. My preference is to go around it and give precursors to give the things that— it's kind of like cake-making mix. I'd rather get all the ingredients there and let the chef, your body, make it rather than try and intervene. I have found that SAMe in a lot of cases, not all, has a honeymoon period. It feels good for a while and then all of a sudden it doesn't. And it's probably because there's some break that has happened that isn't getting fluid sort of shifting back and forth.

Yeah, I couldn't agree more. I find that, like, let's give the ingredients, like you said, help the body make and do those processes as opposed to either stopping the process or giving the end result of the process. That's why antidepressants work for a hot minute and then they don't, because they're kind of keeping your serotonin around a little bit longer, but they're not actually helping you make serotonin, right? So if you're low, you're still low. And yeah, you might feel good for a little while, but then you go right back to needing another one. I need a second one. I need a third one. And then you're down this pathway. So, oh my gosh, you just have so much wisdom. I love it so much. We could go on all day. So So you work with clients right in the Dallas area?

Yeah. So I—

yeah.

So I own a clinic. I own a clinic called Living Well Dallas Functional Medicine. So we, we have multimodalities. So we have clinicians there. I have psychiatry, internal med, nutritionists. So we're kind of a one-stop spot to get everything taken care of. And I do work with women all over the United States in my Hormone Reset Program, where we put together this kind of, you know, understanding of the metabolic processes to help them lose weight. You know, and then I have my Menopause Mastery podcast where I share all this geekiness All the time. Love it.

It's so good. Oh my gosh. So like, what is the most important thing a woman going through this transition needs to know, Betty?

You know, I would say first and foremost is that you don't have to accept the symptoms. And you don't have to accept, you know, the, the sort of conventional answer of we'll just cover that up with synthetic birth control, or that you just need to deal with it, or you're depressed and you need an antidepressant when It's very clear your hormones are the problem and that there is access to doing a lot of things. And you do have control of it because you can do things with your diet, your lifestyle, your microbiome, and, you know, seeking out somebody like Dr. Tabatha where you can get bioidentical hormones and really replace what your body expects to have. And you don't have to accept to feel bad if it— and this is— I'm going to get on my soapbox, but you know what? I'm all about women. If men had to go through what we went through, There'd be a billion drugs on the planet. They would be free, and they'd be candy dispensers in the bathroom.

And it would all be covered by insurance.

Totally, totally.

Exactly. So, oh my gosh, Betty, thank you for giving my listeners hope and helping them realize that there is so much that they can do.

Like, we really do need to take back control as women.

Shifting just the food you're eating can have tremendous effect on how your body's functioning.

So I love that. I love it so much.

So I will have all the links in the show notes.

My ladies can connect with you and start following you.

What are you on social media?

So I'm on Instagram, which is where I probably am most. I'm Betty Murray. So B-E-T-T-Y M-U-R-R-A-Y underscore PhD.

Awesome. We'll have all those links in there. So thank you, Betty. You're awesome.

Thank you. Thank you for having me. Good to see you.

Oh my gosh. I know you got so much out of that episode. It's awesome. She and I are so much alike in our thought processes and how we take care of women, and I just love her. So essentially, all that comprehensive evaluation and testing she's doing, that comprehensive approach to healing the root cause That's literally what we do at Dr. Tabatha. You have a whole team working with you. You can do the Healthy Her program, which is comprehensive stool testing, food sensitivity testing, hormone and adrenal testing with the Dutch Plus test. You can also get hair tissue mineral analysis to see if you have heavy metal burden or mineral imbalances. which often drive hormone issues, thyroid issues, adrenal issues. We look at your blood sugar and your insulin, and we turn over all the pieces of the puzzle, right? So that you can get the full picture of what is going on with your health, or lack thereof. Because I liken it to whack-a-mole. So when I was a conventional gynecologist, I would focus on the one thing, you know, in the gynecology spectrum, like heavy periods. And I didn't pay attention to the gut or your moods or anything else going on in the other symptom systems. And so I would potentially get the hormones better, and it's like hitting the whack-a-mole, then something else pops up. Then you realize your thyroid is struggling or you have gut issues and you've, you know, you go to the gastroenterologist and they work on that and you fix that one thing and then up pops the next. So it really is so important to take care of all those moles and whack them all, right? For lack of a better analogy, you have to turn over all the pieces because if don't see the full picture, the picture actually can look like something different if you have missing pieces. So I love doing the Healthy Her program with my patients. It's been life-changing for my patients, but also for me, because I actually feel like I'm making such a difference now. Whereas before, when I would just give birth control pills or do a surgery, It didn't feel like I was actually helping women heal and like moving the needle and giving them their health back. And now I can say that. Now I can say, wow, I'm actually helping women have amazing lives. They feel like themselves again and can get rid of all those symptoms. But you do it by healing the root cause issues, right? So that there's no more whack-a-mole. So if you are looking for that, please reach out to us. We are here for you. I have an entire team. We're going to help you. We're going to hold your hand and walk you through the whole process, and you're going to be the amazing woman that you deserve to be. So reach out. Tell me what else you want to listen to, what other topics you want to to discuss, um, if you want a certain guest on, any of that stuff. I want to hear all of it. And I would be so honored if you would leave me a 5-star review. That lets iTunes know that you guys care about this stuff. Tell iTunes, like, we as women care about our hormones and our bodies and being healthy. And if you tell them that, then they have to listen. So go have an amazing kick-ass week. I am here for you ladies. Just let me know what you need. I'll see you soon.