Episode #82: Why Balancing the Gut Will Balance Your Hormones, with Esther Blum

Hi, I'm Dr. Tabitha, the functional gynecologist. I'm a 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. 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. I want to be your functional gynecologist. So welcome. Okay, ladies, have you been on a hormonal roller coaster? Are you ready to get off? I know so many of you are struggling with hot flashes, night sweats, brain fog, weight gain that you can't get rid of, or you just, you're having irregular periods or they're super heavy. So many issues. And here's the deal. We're talking about gut health today because this is the key. The answer lies in the gut. I promise you, if you get your gut balanced, so so often your hormones will balance out. So my guest today is going to talk about this. I'm really excited because the gut gyne connection, I mean, it can't be stressed enough. So often we are not even looking at what's going on in the gut. We are trying to get these hormones balanced and it's like a juggling act. We're just chasing our tail, you know, trying to get through the pieces of the puzzles that come together. But we're not fixing the root cause issue, which is your gut health. So today my guest is going to talk about how your gut impacts your hormones. So this is really good information. I think everybody needs to listen to this episode. So share it with all your friends, every woman you know. You can even share with the men in your lives. Honestly, men's hormones are impacted the same way, you know, and they suffer from high estrogen and low testosterone and high insulin issues and so many things and they don't necessarily realize it. So this episode is really good. Okay, so hit subscribe. If you haven't hit subscribe, share this with everybody. You know, I would feel honored if you would leave me a five star review and let me know what you think of the podcast. You know, I do this for you and I so appreciate your reviews. I just want to read one real quick because I loved it. It was from Tay Tay Min. I'm thinking maybe she's in Minnesota. Five stars. Amazing doctor and content. I first found Dr. Tabitha last fall when she spoke about breast cancer and health. I have ever since followed her podcast and absolutely love her. She's so caring, smart, funny and genuine. I hope to one day soon work with her. Y I appreciate all she is sharing. It is life changing. Thank you. That made my week. You guys. Like that is what I want to hear because I am doing this for you. I want to hear that you're connecting and that you're taking all the golden nuggets I'm throwing your way and you're incorporating them into your life. You're making changes. You're on this health journey. And you know I am honored to be your guide. So if you want to work with me one on one, that would be amazing too. You can always do that. The links are in my show notes. I have a seven week challenge coming up. It is called the renew you challenge. It is so good. Oh my gosh. I mean, you will figure out how to get rid of that stubborn weight that you haven't been able to get rid of. You are going to gain freedom from food. It is going to be amazing. Like the women who go through this renew you challenge are always amazed at. I didn't know I could feel this good. I didn't realize how bad I did feel. Now that I feel better. Like it's really empowering and it's fun because it's a sisterhood of women all doing it together, supporting each other, lifting each other up, holding each other accountable. So, so good. So the link is in my show notes. I would love for you to join us. Thank you. The next one starts September 17th, I think. Oh my goodness. It's in the show notes. Okay, so let me just introduce my guest, Esther Blum. She's awesome. She's a wildly respected industry expert and the best selling author of a few books, Cave Women don't get Fat, Eat, Drink and Be Gorgeous, Secrets of Gorgeous and the Eat, Drink and be Gorgeous Project. She was voted best nutritionist by Manhattan Magazine. She's appeared On Today Show, Dr. Oz, a healthy you with Carol Alt, The Isaac Show, ABC TV, Fox 5, Good Day New York and Fox News Live. She is an in demand authority, frequently quoted in E. Online, In Touch, Time Magazine, the New York Post, the Los Angeles Times, In Style, Bizarre Self Fitness, Marie Claire and Cosmo. Wow. So that's impressive. She's been around a while. She is. Do you know she knows what she's talking about. So I am just super excited about this conversation because I can't stress this enough. The gut health is where it's at. So stick around. Listen to this episode Share with everybody you know. All right, love you guys. Here we go. Master to the Functional Gynecologist podcast.

Thank you so much for having me today. I really appreciate it.

Yeah. When I read your bio, I was super excited because you're a woman speaking my language. It's all about the gut health when it comes to balancing hormones, right?

It is. It's essential.

Exactly. So we're going to have a great discussion today, but I would love for you to just share with my listeners quickly. Like, how did you get into this?

Yeah, well, it was fairly linear. I was born into a pretty medical family. My grandfather was an ears, nose, and throat physician. He actually took my tonsils out when I was about 6 or 7. My father was a dermatologist. My mother was a nurse. My grandmother was a dietitian turned anesthesiologist. My grandfather actually trained her. So in the surgery, she put the ether mask over my face.

Oh, my goodness.

It was just like, yeah, my nanny and Poppy are going to take my tonsils out today. And so, yeah, so I was always surrounded by doctors making house calls. And, you know, my dad was really a country. I mean, he was a Brooklyn boy, but he was kind of a country doctor. And he would, like. People would stop him in the aisles of grocery stores or at a synagogue or parties, and they'd be like, can you look at this skin condition? And he would just totally. I was like, dad, you're a terrible business person. Like, get people in your practice. But he just. He loved what he did. And, you know, my mom was a postpartum nurse, so I was always just surrounded by medicine, and science came very easily to me. And so when it came time to declare major in college, I looked at kind of all the options because I didn't want to go to medical school. So nutrition came up. And when I looked into the curriculum, it was pre med to be a registered dietitian, Right? It was pre med, minus the physics, which was right up my alley, because physics was my weakest link for sure.

And.

And so I was like, oh, this is great. So I told my grandparents, and my nanny was so excited. She was like, this is great. I was a dietitian, you know, and my. My grandfather, my Poppy, he was like, what are you doing? You're never gonna make any money. You're never gonna be a success. I was like, oh, yeah, it's gone, man.

It is gone.

And my dad was like, don't be a doctor if you don't want to, because, you know, he forced me into it. And I don't, I didn't wanna do the medical residency. I said this is just too long. And I wanted to. The flexibility that came with, you know, being an entrepreneur and having my own business of private practice. And it's worked out really well. I mean, I've been doing this over 26 years now, so it's really worked out well.

Yeah, I wanted you to share that because I think there's so many women who feel a need or calling. Like, I figured my stuff out. I feel amazing. I want to help other women. And there's more than one avenue to, you know, helping people. You don't have to be a doctor or nurse. I think that is just so ingrained in us, in traditional, you know, society, like that's the only people that can really help, when in fact people who are coaches and nutritionists and everything, those are the people making the major difference because you're actually getting people well, you know, you're not just keeping them alive. So I love everything.

Right, right. And I, I mean, listen, I'm, I'm so glad I had like five years of hospital experience before I really went rogue and went in the more fun space. But I'm constantly in awe of just the procedures, the life saving procedures that can be done or my son broke his ankle like two weeks ago in a speed skating accident. And those surgeons, I mean, they're godsends. But then at home, I could go home and make him bone broth and give him a lot of protein and healing foods. And that to me is the real partnership where east meets West. And that's what I really like to see. It's like, okay, get your diagnoses or your tests or procedures, but then let's build on that and really support the lifestyle piece because that's 90% of it.

Oh my gosh, I love that so much. I think there's a time and a place for all of it, you know, and so if we can all just work together, people are going to be so much healthier. So you are focused mostly on women and hormones and getting their gut in alignment, right?

Yeah. The majority of people who come and see me are perimenopausal, menopausal women. And so before people even get their foot in the door to see me, I run complete panels for blood, stool and urine tests. And that makes sure, you know, that paints a fairly complete picture. If not, people need additional testing. We send, but that's where we start. Because you can't address hormone health without addressing the gut function. Otherwise you know, you're going to run into a lot of problems or miss potential problems, because I have yet to see anyone who has perfect gut function or really high levels of healthy bacteria. I mean, I've diagnosed SIBO and myself, when I run my tests, I'm like, whoops, we got some issues cooking here. So, you know, it's like, it's really, really essential. You've got to have really good gut function in order to detox estrogen proper. And in men and women, I do treat men too, and I see they run into problems, like, with estrogen dominance.

Awesome. Yeah. I want to talk about all that because I think it's super important. And you see men as well. That's awesome. So what are the most common complaints people are searching you out because of?

Yeah. So hot flashes, low libido, night sweats, insomnia, vaginal dryness, weight gain, brain fog. Those are all things that people come to me. And they come to me usually after they've seen about five to 10 doctors and they've been told, quote, unquote, they're normal. Well, you're normal. Everything looks fine. Well, this is normal for your age. But normal does not mean optimal. Normal in this country means obesity. Means you're on either a blood pressure medicine or a statin and. Or a prilosec or an H2 blocker because you're having reflux. Then you're on your CPAP machine and maybe you're on some kind of sleep medication or antidepressant. That's usually the profile of someone who comes to me and they've been on five to 10 diets. Nothing's worked or what worked in their 20s, doesn't work in their 40s, 50s. And what seems like overnight they've put on, you know, 10 to 20 pounds in menopause.

Yeah. Oh, my goodness. You just kind of described my typical patient. High five. You're so right. There's so many people struggling with these issues. So let's just dive in. Like, what is the biggest reason you think this is happening?

A lot of stress. Like, a lot of stress and poor sleep hygiene. Right. Everyone you know is having a threesome, Right. It's themselves, their partner, and the phone or the iPad in bed. Okay, the iPad. The technology is the most disruptive piece I see. I'm sure you do too, right? It's the most disruptive piece I see in practice. And people say, well, I don't sleep. I'm like, try getting rid of blue light. Please just try it. Try some blue light. Blockers try actually putting technology down. Like I really try and shut my phone off by 8 or 9 every night because what's going to happen? Like, what are you doing? You're scrolling social media, you're sending texts, then you get triggered by a news story and you don't sleep all night. And the phone next to the head triggers higher cortisol levels. There's research out there to support this. So if you have to have a phone, listen, some of us have sick children. Some of my clients are caregivers. Sleep with the phone 10ft away and put on airplane mode or turn off the WI fi because. So you can use it to get calls if you need, but turn off the WI fi and that alone will do wonders for your sleep. And it really, really helps my clients as well.

Yeah, I think that's a great point. You know, you mentioned like, you see something, you're stressed out, you're making cortisol, you can't make melatonin then, you know, I mean, I think so many people are missing the mark and they're just not even making melatonin. They're not even able to fall asleep. If they do, they're not able to stay asleep. So.

That's right.

Great tip.

And the hormone, you know, the hormone balance starts from the top down. So if you're having chronic stress and you're in the perimenopausal menopausal phase, like your progesterone is just going to be in the toilet, right? So then you can't make gaba, you can't make serotonin, you can't make melatonin. So you really have to protect your brain and that precious real estate there and not let technology hijack that at all. Got to optimize and just, I mean, even if you're, you know, you don't want to spend money on blackout shades, just wear an eye mask. I mean, it's really, it's 10 bucks. It's like the most cost effective thing you can do for your sleep.

Yeah, definitely. I love that. Okay, so we gotta manage our stress, we gotta deal with our sleep. These are basic things that most of us have heard, heard time and again, right. And then you take it further, you do some advanced functional testing. What are you looking for that the other doctors necessarily weren't seeing or looking for?

So the tests I look at, you know, you can look at hormone, hormone levels in a blood test, but you look at their metabolites in the urine test. I do. It's called the Dutch test. It's a dried urine test for comprehensive hormones. So I can see. And the test is done over about 15 hours. You start testing, you do a test at 5 o' clock at night, 10 o' clock at night, and then an overnight test if you get up to pee, and then first thing in the morning and then two hours later. And so that really gives a very clear picture of your cortisol curve. What's your production like during the day? What's your production like at night? Do you wake up wired and you jump out of bed, but you're so tired and exhausted and then you crash later on? Is your pattern just really rock bottom low all day or are you just like rocking that cortisol curve? You know, I have people who are literally off the charts. So I look at your cortisol curve and how your adrenals are handling your stress. I will look at your hormone metabolites and see what are you producing. And I will also look at the detoxification pathways or how you're methylating to make sure you're going down the proper pathways. This is super important if you're considering hormone replacement therapy, because if you're not methylating well and you put someone on hormones, they're not going to detox or remove them well. And you don't want to jack yourself up on hormones where they're staying in your system. You want them to be excreted. What goes in needs to come out. So I will also look at, I do an organic acids test that looks at the neurotransmitters in your brain. So again, are you making serotonin? Are you making melatonin? Is your antidepressant even working? At this point, most people, I see no improvement in their neurotransmitters on antidepressants. So we reassess and say, do you even need this? Let me work with your psychiatrist and let's wean you off together. A lot of them wean off and they're fine. And we get them sleeping better and we get them on progesterone and estrogen if necessary, and the depression really clears up dramatically. It's such a quality of life thing. It just is transformative.

Yeah, I think that's such an important point. If your hormones are shifting and declining or are imbalanced, it's going to feel like anxiety or depression. And I don't think that we realize that in society and doctors realize it to the point where they give antidepressants because they know it sometimes helps, you know, and there's all these studies now for hot flashes and night sweats with antidepressants, but all we got to do is balance the hormones. So I would love for you to talk about that as it pertains to, like, nutrition. You know, where do you see women going wrong and really pushing that imbalance over the edge and making it worse?

Yeah, the first two things I need to address, and people don't bring on the hate here, but it's caffeine and alcohol. Alcohol. For every cocktail you drink, you have a cocktail. Your blood alcohol level is elevated for up to six hours after one drink, and your estrogen partners with that and mirrors that. So your estrogen will be elevated for six hours after one drink. So you don't want to put yourself in an estrogen dominant state or really get your levels up too high after you're drinking. You also don't want to put too much stress in your liver when you're on hormone replacement. You want to really support your liver and make sure your hormones, again, whatever comes in, gets processed, hits the receptor sites, and gets excreted as it's no longer needed. Caffeine also is a huge contributor to insomnia in menopause. You're just either your detox pathways slow down or, you know, you're worn down further by stress. If your cortisol levels are off, you know, think about where you are in life in menopause. Often it's a time where you still have kids at home and you have aging parents. Right. So you're sort of that sandwich generation. It's a really great time to say no to things, to take things off your plate, but also to take caffeine off your plate so you can sleep better. So a product I recommend that I love, I have no financial ties, but it's called Four Sigmatic. It's by a company called Four Sigma. It's called Perform, and that has cordyceps and cacao. So you get like the gentlest boost. I mean, I think it's 5 milligrams of caffeine. But you also get really great mental focus. So you don't rely on the coffee to clear up your brain or brain fog or give you good mental focus. So that is, you know, caffeine and booze are really the starting points for good nutrition.

I couldn't believe it was like night and day difference. I just woke up one day and I couldn't tolerate caffeine anymore. Like, what in the heck? You know, I was like, okay, it must be because I drank 20 cups of Starbucks to get me through the past years of med school, residency, you know, practice. But no, it was because I was transitioning into perimenopause and things were slowing down and I had estrogen dominance and literally I would drink one cup of coffee and I would be jittery and nauseous and irritated and I couldn't focus. And then I got tired. So I was having the total opposite effect coffee was supposed to have. You know, so I, I love that you're just calling this out because that is something easy that women can play around with. You know, get the four sigmatic mushrooms are amazing. You know, get something to replace it if you enjoy sipping on something warm, that kind of thing. But I love that. And your, your point about the alcohol and the liver? I think we need to stress that again to women because they don't want to hear this. You know, like you said, we like our cocktail cocktails. That's how we socialize. It's something fun to do. But every time, you know, women wake up 2:00am, 3, 3:00am it's that blood sugar and estrogen drop because that alcohol is finally wearing off. And I kid you not, I get women that feel amazing just by getting rid of their nightly cocktail. Don't you see that all the time?

Yeah, the energy and the brain fog clears up a lot and the irritability clears up a lot. You know, if you're really irritable, that can be, you know, a, it can be fatigue from insomnia, but it can also be a congested liver. So you want to make sure, you know, you're up and running. And the other thing is, you know, you really have to think about, okay, well, why am I relying on that drink? Like, what purpose is it serving? Okay, well, it relaxes me, right? It's my nightly routine. This is what I always hear. It's my nightly routine. I'm like, well, you can just as easily put a glass of kefir, you know, aqua kefir, or there's a product I love called Rock Grace. Again, no financial ties, but they make this rose water with adaptogens, a little ashwagandha and some crystals infused in there. It comes in a wine bottle and they make sparkling and flat. So that can be a great substitute. I think it's just the self care, the pouring of the wine, right? But you can easily steep yourself some lemon balm tea and chill it and put it in a wine glass or, you know, at this point I just have like water with salt and lime is like my cocktail. But no one's ever, like, looked at me twice when I was out to dinner with friends, and they were ordering cocktails, and I'm like, I'll have a club soda with some grapefruit juice. And, like, no one gives a crap. They're so worried about themselves. They're not thinking about what you're doing, so.

Right. Oh, I'm sorry. I was going to say, if they do say something, it's probably an issue they're having, projecting onto you, you know, sometimes.

Right, right, right, right, right. Because you can trigger insecurity of, like, oh, shoot, don't judge me. And of course, being a nutritionist, I mean, you know, when you're out with friends, they're like, don't look at what I eat. I'm really not about that. I just have to do what works for me. And I know that if I have that drink, I'm going to have a horrible night's sleep and I have to work and be on for my people the next day or podcast. So to me, it just. I can't function that way. But here is the cool thing, too, is once you. You know, for me, I knew when I cut back on alcohol, Right?

And, please.

I wrote a whole chapter on hangover recovery in my first book, Eat, Drink, and Be Gorgeous. I mean, that was like an ode to my twenties. I lived that. Okay. But eventually I was like, I really need to get in a clearer headspace. And now, to me, there's nothing that unwinds me more than sitting with. I don't know if I have any here. I have these cute notepads, right? And just sitting with my notepad, like, making lists of things to do, writing down some gratitudes, like meditating and reading a book with the dog and my husband in bed, I'm like, I am so happy right now. Or doing some yoga stretches I love to do, like, backbends before bed or just some deep breathing. So you've got to think about the big picture of your stress management again, which probably got you into some of the menopausal struggles to begin with. So you want to make sure you're supporting yourself. Like, the better your gut health is, the better your stress management is, the better your balance and your sleep is, the easier the menopausal transition will be for you. So there is a reward. There is a pot of gold.

Yeah, exactly. So perfect segue. Let's talk about gut health. So you mentioned you do stool testing. What are you looking for? What are you seeing in these? Perimenopausal women.

Yeah. So I always check the beta glucuronidase, which is an enzyme that helps facilitate estrogen detox. So I make sure that you are eliminating it through your stool and not recycling it in your gut again and again. So that's really important because if estrogen dominance is an issue, you know, then we need to look at things like your fiber intake, your nutrient intake, make sure your liver function, make sure you're really supported. Then, of course, I look for dysbiosis. I look for pathogens and bugs and worms and protozoa and parasites, and make sure that you're not fighting really chronic infections. So I do see a lot of reflux, and I do see very high levels of H. Pylori. And you can say, you know, most gastroenterologists say, well, so what? It's ubiquitous. Everyone has H. Pylori. You know, it's a huge problem. That's true. And if your immune system is handling it, you won't have symptoms. But the people I see are having severe reflux and bloating and heartburn, and they're just really suffering. So we do treat the reflux and. Or the sibo. And the test I do isn't a SIBO test per se, but the way the bacteria balance, you can kind of pick up, okay, this actually is sibo, which is small intestinal bacterial overgrowth. And then I look for a leaky gut also, and make sure, you know, look at your immune function, autoimmune markers, gluten sensitivity. So I look for all of those things because. And it's much easier to put people on an elimination diet when they really see the evidence there's a need. It's much harder without testing to just say, you know, why don't you try cutting this out versus no, you actually have a sensitivity. Your gut is wildly inflamed. Let's calm it down. And it just improves adherence a lot better with supplements and diet.

Yeah, I couldn't agree more. You know, I love getting stool testing with my hormonally imbalanced patients. It's a game changer. Like, as soon as I put them on that gut healing regiment, everything starts to balance out. You mentioned the fiber. Can you talk about that a little bit?

So fiber is wonderful at binding and pulling out excess estrogens. And again, I see this in men and women. So I love to have my people make chia or flax pudding. Flax, especially for men, because it's great for prostate health. And it's really simple. It's 2 tablespoons of ground flax or whole chia seeds in about three quarter cup of nut milk. That could be almond, coconut, hazelnut, hemp, whatever you like. And then if you want a little sweetener or flavor, you could put some cinnamon, you could put some flavored stevia if you like, but that is. And you put again two tablespoons of the seeds. That's a great way to help bind and pull out excess estrogens. But again, you could go on. If you're following like a fodmap friendly diet, you can take, there's a product called Sun Fiber that's made from guar gum that's very fodmap friendly fiber as well. So anytime you're getting enough fiber in there, and of course, fruits and veggies, great, great, great sources of fiber. But sometimes we just, we need a little bit more. And I see people eating, you know, whole food diets who sometimes need a bit more fiber than they're getting.

Yeah, I just think about a typical day for a lot of people and there's no veggies in the breakfast. You know, you're usually eating something on the go, something carb heavy. You might have a little bit of lettuce or salad for a lunch and then you might have like a cup of broccoli for dinner. So you really, I mean, we as Americans are not eating enough fiber. I mean, what is the average, like 10 grams or a day or something? We're probably getting 35 to 50. I mean, it's crazy. And that's why we have colon cancer and hormone imbalance and cholesterol issues, so.

Right, right, right, right.

Yeah. I like the little hack though. You know, just like get your flax seeds in or something easy that has a bulk fiber. So I like that.

Yes, because, and you know, I put up a post like this week, like, constipation is not a Miralax deficiency. Like everyone's taking Miralax and everyone's taking all these or drinking senna tea and they really actually just need some good hydrochloric acid supplements. And the reason why so many people are getting all of these chronic gut infection is they have low hydrochloric acid. This is a natural manifestation of stress and hormone changes. Okay. And as your estrogen and progesterone decrease, you lose that mucus lining in the small intestinal tract and you lose a lot of digestive fire. So I love putting people on once the H. Pylori heals, putting them back on hydrochloric acid to create Fire in the digestive tract and prevent all of that bacterial overgrowth from coming back in the first place. Or, you know, Swedish bitters or like the product called Ibero gas, you know, any of those will really start activating the bile flow to promote healthy digestion.

Yeah. I think that we have so many people who get caught up in the problem of not making the acid when they need it, then, you know, having it come up later after they've eaten, they get on the acid. Acid blockers like protonics, Pepcid, oh my gosh, Nexium, all these things. Zantac now causes cancer, but.

Right.

And so we're suppressing our acid production even more and we're just putting these people into these horribly vicious cycles, like you said, with bacterial overgrowth, because there's no acid to kill them off. Right. We're suppressing all that acid. So how hard is it to get patients off of that and really get back into balance?

It takes me a few weeks. I actually, this is a lot of people roll their eyes at this, but I'm telling you, it's my go to protocol. I have my people juice an entire bunch of celery first thing in the morning on empty stomach and add in 2 tablespoons of fresh aloe gel. And that helps also rebuild the fire. Rebuild digestive fire. But putting out the reflux in about two to three weeks. And then I have them start weaning off and kind of doing it every other day and every third day, really weaning off the H2 blockers. Getting more fiber in is also. And having regular bowel movements really helps. And also, you know, eating foods that are free of allergens and triggers, you know, getting people off gluten and dairy really, really helps. And then getting optimal levels of trace minerals like zinc, Zinc in particular keeps that pyloric sphincter closed. So once you optimize someone's zinc, and that can take a couple months, that may not be a three week process, but just avoiding trigger foods does wonders. I had this man come to see me. He was in my early days of private practice and he was going to the ER every six weeks thinking he had a heart attack and he was overweight, but had the most ridiculous chest pain. And every six weeks they'd send him home and say, you have bad indigestion or reflux heartburn. So he came to me and I said, you've got to get off gluten and dairy. So he did. And in nine months, he lost 70 pounds. He never went back to the ER and it was just that simple. I barely put him on supplements. I wasn't working too much with supplements in my early days and he did great. So the dietary interventions are number one. And I know I always talk about supplements first, but obviously, you know, getting a nutrient dense foods, you can even clear out grains. If you're autoimmune, you can get on a good, it's called an AIP diet. Right. Autoimmune protocol or a fodmap friendly diet if you have, have sibo. All of those can reduce or eliminate the triggers that are causing that vicious reflux and it will clean up the good bacteria. You know, once you get rid of H. Pylori, you won't have all that reflux either.

Oh, that is so I think helpful for my listeners because I know that there's so many women struggling. I mean, I would say probably 40% of my patients come to me on, you know, acid blockers. It's pretty common to get prescribed that. So I want you guys to hear this. There's a way to get off, and you should get off it. You know, when those medications first came out, they were indicated for short term use, like four to six weeks. And now we are putting people on these for like 5, 10, 15 years. Like, it is so scary to me. Like, you, there's a way to get off. You shouldn't need that. So thank you for giving them a little bit of hope and perspective. You know, that there's a way because you can't usually just stop taking it or wean off. You know, you'll end up in the ER like that guy.

Right, right. And you know, listen, if common sense prevails here, guys, if it's, if it's a real structural issue and you truly have a massive hiatal hernia, get the surgery, get it, you know, get it tucked back under your diaphragm. Get your diaphragm sewn up. That's, that's an option if you're young and healthy. But the downsides, I watched my dad take H2 blockers for years and I was like, you've got to get off. And his bones just, he was literally bent over in half. He had like degenerative discs and he couldn't. His digestion and swallowing became such a struggle for him as he aged. So you want to optimize your bone density and during menopause, as your estrogen falls, also you're at increased risk of, for fractures and osteopenia. So it's like, it's Critical. I mean, if you want to have bones and you don't want to be hospitalized for fractures, which are the leading cause of death in elderly people, it's sarcopenia and fractures. So it's not even an option. Like, you got to figure out how to get off this. It will save your life. I mean.

Exactly.

Really imperative. Yeah.

Yeah. I think that's a super important point for women because, you know, we just wait until we get that diagnosis of osteoporosis. We aren't preventative, we aren't proactive, and you getting off an acid blocker is one way to be proactive to prevent that bone loss. So I love that. Thank you. Another thing that you made me think of is I've had so many patients with eosinophilic esophagitis, and just getting them off of gluten has, like, resolved their strictures and their. Their challenges, you know, and these people were destined to be on Nexium for 20 years with scopes and dilations, you know, chronically, and it was just some dietary interventions. So I just. I think people really need to take a second opinion, a third opinion, a tenth, and go outside of the conventional medicine world and really search for answers if you are kind of scared, stuck in that type of situation. Don't you agree? Yeah.

I mean, that's why, like, this podcast, the work you're doing, it's also important because it's not the education. And I don't think people stay on it because they want to. I think there's just. There's no education around it. And people will say, is this okay to take long term? Oh, yes, yes, yes. But it's really not. And so the educational piece is really powerful. And then once you do get off it, you gotta tell all your friends and family, because.

Your conventional doctor, so that they will go and they will read the new literature and they will start to question how they practice. Because I promise you, we practice the way we were taught in Med School 100 years ago, and it's already antiquated. And we just. We get ingrained, we get into our way of doing things, and we don't change, we don't grow. And I just think that's a real, you know, it's not helpful to society. I think once you quit learning is once you should quit practicing medicine, you have to be a lifelong learner. You have to keep questioning, you know, don't you agree? It's just.

Yeah, I mean, amen. And not only that, but too, also dietitians, too the education is extraordinarily antiquated. And there's lots of dietitians I see online saying, don't give up gluten. Don't do that. I'm like, well, I don't know what patients you're seeing. You must see everyone who's radiantly healthy and has no issues. And it may not truly be a gluten sensitivity. It might be a glyphosate sensitivity, which is great on the gluten, but either way, most people I see, and I'm talking 90 to 95%, feel better off gluten. Less bloating, less distension, resolution and constipation and heartburn. Better blood sugar, better sleep at night, less brain fog. I mean, read. You know, Grain Brain is a great book to read by Dr. Daniel Perlmutter. David Perlmutter. Pardon me. You know, just the neurological effects on the brain is.

When I eat gluten, I'm, you know, depressed on the couch for three days. There's no. Really? Oh, God. Yeah, yeah. They just take over. It's horrible. It's an absolutely horrible feeling. So. Yeah. Yeah, I couldn't agree more. You know, you need to investigate, like, why is your body acting the way it is? You know, like, perimenopause should be a transition, but it shouldn't be hell.

Okay, will you please put that on your Instagram account?

That is my.

That is a writer downer, people. That is awesome. Yeah, it's transition. It shouldn't be hell. You're not descending into the gates of hell. Everything can be a little wonky. Your cycles can be wonky, but it shouldn't be flat on the floor either. You should be functional at the same time.

Yeah, exactly. Well, I love all the work that you're doing. So you work one on one with men and women, right?

I do. I work one on one. And when people see me again, we do testing and I become a very staunch advocate for my clients to liaise with them, with their doctor. I'm often calling doctors. Sometimes I call insurance companies. And if the. If my clients or patients. Doctors aren't amenable, then I just help them find a new doctor. And. And when people have the team in place, it's remarkable because imagine this, right? And this is. I'm just painting a picture of what the average person goes through. Who I work with is. I'll say, okay, you know, you're a great candidate for the following supplements. And also these hormones would be great for you. And they say, well, I'm going to Take this back to my doctor or my gynecologist. And then the doctor says, well, that's an off label you use of the hormones. Or, I'm not going to write that prescription. Or here's a birth control pill. Just take this, it's fine. Well, birth control pills were not meant for menopause. You don't need to suppress ovulation when ovulation ain't happening to begin with. You need to suppress hot flashes and.

Boost.

Your neurotransmitters and your brain so you can sleep. And you need to replenish vaginal moisture and all of these great things. So if a doctor is not amenable or doesn't want to be bossed around by a dietician, no problem. I refer them to other colleagues who have no problems writing a script. Because the difference I see in my people is amazing. They go from not sleeping to sleeping in days. They go from horrible brain fog to mental clarity to remembering things. They go from depression and anxiety to even keel. No crying jags, no irritability with family members. I mean, these are big quality of life issues that enhances libido. So, my goodness.

Yeah, I couldn't agree more. People should have advocates. A team is amazing. Like, if you can have a physician, a nutritionist, a coach, like, the whole works. And everyone should feel comfortable in their egos to work together. Right? You know, like, I have no problem when my nutritionist says, hey, let's add in this. Or I don't know, you know, why did you want to do this? And just we talk it out. I think in listening to the patient, like that is key. If the patient doesn't feel any better, then why are we doing it that way? You know, if you tell me they're amazing, then I'm going to go that direction and keep doing it. Like you said, these people feel better with this approach. I mean, I just see it every single day.

Yeah, that's it. And really, you know, as practitioners, I feel like we can't be too attached to. To the outcome. It's kind of, you know, my patients, too, will often push back and say, no, you know what? That doesn't work for me. Like, okay, great. Thank you for telling me. Let's find what does work for you. Like, if you're not feeling well or something isn't sitting right or your doctor wants to do something a little differently, you know, okay, as long as you feel better. That's all I really care about. I'm not attached to any of it. But, you know, you do need support, you do need advocacy, you need structure, you need accountability. That's how you get people better. And when they know that they have people in their corner, supporting them like that frees up so much stress in mental real estate because nothing is more stressful or time consuming than sitting, having to call doctors and say, no, I, you know, we're being gaslit. Where the doctors literally said, you don't need all that, you're fine. But I'm not fine. I'm here in front of you. This is a problem. So, you know, we really have to teach everyone how to advocate and get their needs met.

Yeah. Oh my gosh. Such an important message. I hope everybody got that. Such an important message. So awesome. Where can my listeners find you if they want to work with you?

Yeah. So first of all, I love to talk with you all on Instagram. I'm at Gorgeous Esther. E S T H E R so Gorgeous Esther, if you go to my website estherblom.com and you add your email, you will get my three part training series on how to crush your cravings in three days. So this is great because during the pandemic, I mean, people's cravings got really bad. People, people were snorting lines of chocolate chips off the counter and slinging back the wine. So just this is going to help you really rebalance yourself. But there's so much more in there other than crushing your cravings. So definitely opt into that. And then for five of your listeners, I have opened up five spots in my calendar for a 30 minute gratis consultation. And this is for people who really have a specific problem that they're committed to solving. So maybe it's weight loss, it could be hormone balance, it could be insomnia or gut issues. So if you are in that camp and you're very serious about figuring out how to nail this, I get on the call with you for 30 minutes and you take away three customized tools that you can start using to get on the right path. So for that you go to estherblum.com C A L L oh my gosh.

Thank you so much. That is really awesome. I hope everybody jumps on that and takes that you up on that offer. Because I think that when people finally feel heard, you know, and they can say, this is what I'm struggling with and someone actually listens and gives them new options, that is where the magic happens.

That's where the magic happens. That's right. It's just knowing what's out there.

Yeah. That there are other options.

There are other options. You don't have to suffer. This is not normal and it's not all in your head. And yet there's also, you know, the other takeaway is there's nothing in you that can't be balanced and restored and healed. There's rarely anything in you that's not reversible. So keep fighting for yourself. Don't give up.

I'm so glad you said that. I mean, I must say that every third episode, like God created our bodies to heal and to handle things, you know, it's just that we keep intervening and we keep adding stuff to it. We need to figure out what to remove and what to support it with. So. I totally agree. Oh, my goodness.

Yeah. Well, what a pleasure. This is like mutual adoration society.

No, you're just a wealth of knowledge and you, you know, you have the same mindset as I do. I think we just. You have to find the root cause. You have to figure out why you're feeling so miserable. I always say sex hormones are not the cause, they're the result. Like if you're imbalanced, it's something else is going on. Right.

So, yes, holla.

Hesitate to reach out to you or me and get some help.

Amen. Amen.

All right, well, thank you so much for coming on.

Thanks, Dr. Tabitha.

All right, ladies, that was a great episode. I hope that you're starting to understand that you have options. If you aren't feeling well and you're not getting the answers that you are looking for, there is hope. There are people out there who have the answers. They know what to look for. They look at things differently. We're looking at the root cause issues. We're trying to figure you out from the cellular level and get you back into balance. So I just, I hope you feel inspired and excited and I hope you got some good tips today because we did talk about quite a few things that you can just start doing at home today, making shifts. You know, you can stop drinking alcohol every night. Keep it for a special occasion. Consider giving up coffee or switching it out to something else. Four Sigmatic is a great product that is mushroom based and it's amazing. So that is another option. You know, think about your gut health. Think about how your diet could be impacting what's going on. Think about medications, like heartburn medications. Are they affecting your health? So, so many awesome golden nuggets today. I hope you got something that you're going to take away and you're going to do something about, because when we are on this path to wellness and vitality. It's a, it's a journey. You have to keep working on it regularly. You know, it's not a one and done. Like you can't just flip the switch and be done. So it's a lifestyle, it's a mindset shift. It's all of that. It's keep looking, keep searching and you will continue to improve and get better and you might have something else that comes up and needs to be dealt with, especially in the perimenopausal years when and you're kind of on this hormonal roller coaster. No fault of your own. That's just the biology of it. But it doesn't have to be crazy, out of control, miserable, right? It can be smooth and pretty well controlled. So thank you so much for joining me. Like, I just, I'm honored to do this for you guys. I love meeting all the amazing guests that I have and hearing their wisdom and so often we totally align. So I love that. But don't hesitate to reach out to me and work with me or work with Esther. You know, we are here for you. I do the same testing that she does. I love the Dutch test for, you know, hormone metabolites. It's like a detailed picture of what's going on with your hormones. Stool testing. I do a GI map where you get so much good information and when you can get your gut balanced. You can balance your hormones so many, so often. So I love all that she's doing. You probably already know I'm licensed in over half the country. I think it's 28 or 29 states at this point. So you can definitely work with me one on one. Don't hesitate to reach out. Go to www.doctor Tabitha.com. that's three A's. No I and reach out to me. Schedule with me. You know, email me. I want to hear from you guys. I do this for you. So go out, have a kick ass week and keep working on you. Bye, ladies.