App INSIDER: The Cost Of Being A Bad-Ass - How To Cure Your Hormones With Dr. Sara Gottfried

Hey, podcast listeners, welcome to this app Insider interview with Dr. Sarah Gottfried, MD, author of the Hormone Cure. This podcast was not originally titled the Cost of Being a Badass, but upon publishing it, we decided that was probably gonna be the best name for it because we get into everything that you need to know about how to fix the consequences of living a really active lifestyle and doing lots of cool things. So you're going to get a lot out of today's episode. I hope you enjoy it. Feel free to share it with a friend, and let's delve right into the Hormone cure.

Welcome to the Ben Greenfield Fitness.com podcast. We provide you with free exercise, nutrition, weight loss, triathlon and wellness advice from the top fitness experts in the nation. So whether you're an Ironman triathlete or you're just trying to shed a few pounds, get ready for non run of the mill, cutting edge content from BenGreenfield Fitness.com.

Hey, folks, it's Ben Greenfield. And I have on the call with me a wife, a mother to two girls, a scholar, a yoga teacher, and a Harvard trained MD among other skills. She's got over 20 years of experience in medicine and she is the author of the fantastic book that I had the pleasure to read last month called the Hormone Cure. Her name is Dr. Sarah Gottfried and she is just a wealth of information when it comes to hormones, hormone balancing, hormone stabilization, and all those little things that kind of hold us back from reaching our goals, whether they're fat loss goals or performance goals or whatever the case may be. So, Dr. Sarah, thanks so much for coming on the call today.

Hey, Ben, I'm so happy to be with you today. Thank you.

So I'm going to jump right in here. You're kind of rogue when it comes to being like a classically trained md, Right? Because you went to Harvard Medical School and you're, I believe, a board certified OB gyn, Right?

I am. Although if we've got some guys listening, don't start cowering in the corner because I've got lots of material for you as well. I'm an integrated physician, so I take care of both men and women. But yes, I am board certified in gynecology.

Okay, gotcha. Yeah, and thanks for calling out the guys because I've actually read your book and I've been trying to get my wife to read it for a month and she hasn't yet. But I feel like. I feel like I got almost more out of your book than maybe she. Well, definitely more than she has yet.

Well, Ben, it'll still help the relationship. I have to say, when my husband read the book, he said, you know what, Guys totally need this material. Their lives will be so much better if they understand what their women are going through.

Yeah, for sure. And that's exactly what I was getting at. Like, I kind of understand the hormone cycles that she goes through just a little bit better now. So what made you kind of break out of the mold and, you know, go rogue, if you will, when it comes to kind of taking the approach that you've taken towards medicine?

Yeah, well, I would say I wasn't born in the mold. I was raised by a mother who's a serious whole foodist. I had a great grandmother who would show up at her house with suitcases of kale and Meyer lemons, and she really believed that the answer to health was not found at the bottom of a prescription, a bottle of prescription pills. She really thought it was through lifestyle design and the way that you think eat, move, and supplement. So that was something that I was born into. I have this lineage of looking at health this way. And then I would say I went into the mold very briefly by going through this conventional medical training. And then it was when I was in my 30s where I came back to this. I kind of came back home because I was one of those mid-30s somethings who was struggling with PMS. I had low sex drive. I was a runner, and yet I had this muffin top that just wouldn't quit. And that's when I realized that I needed to do the lifestyle redesign that I kind of grew up with that I was immersed in as a kid. And I had a hunch that my problem was hormonal. And it turns out that I had a cortisol that was about three times what it should have been. It took me a month to fix it, and then that just made all the difference. I lost 25 pounds. I graduated from couples therapy. It was a good thing.

Nice. Nice. Yeah, join the club with the cortisol issue. That's something I've struggled with quite a bit lately, is high cortisol for me due to training. And I know that a lot of folks out there who are probably listening in kind of have some of the same issues. So let's kind of start there. I know you've got a lot of top problems that folks face in your book, but because you brought up the 600 pound elephant in the room, especially for our listeners, the cortisol issue, let's just jump into that. What did you do about your cortisol.

Yeah, I did a couple of things. So I had high cortisol. It was doing other things in my body. And for folks who are listening, especially the athletes among you, we know that you're pushing your VO2 max, and whenever you do that, that makes cortisol go up. Cortisol is a stress hormone, as many of you know. But the problem is it can get out of the optimal range. And it sounds like you've struggled with this too, Ben. It's not the sort of thing where you fix it and it's gone forever. You are forever vulnerable to this being an issue. So we've got to kind of stay on our game. We also have to approach it in kind of a disruptive, arrhythmic way to keep making progress. So what did I do? When I was in my 30s, I discovered phosphatidylserine. It just made a huge difference for me. Phosphatidylserine. So I'm sure many of our listeners have heard of that before. It's an extract from a plant cell membrane, and it's been shown to help with building lean body mass. It also changes your mood inside of. So it really made a dramatic difference for me. It was much more effective than having a glass of wine at night. I learned that did not work very well. And I also got religious about omega 3s. You know, I often. I don't know if you found this, Ben, but I've often found that folks who come to see me or work with me online will say, oh, yeah, I know, I need the Omega 3s. I've got the fish oil in my fridge. Then they take it maybe twice a week.

Yeah.

So I had to. I had to, you know, find religion in my Omega 3s. That made a huge difference. I also had to hit the pause button. Like, I was really good at pressing the pedal to the metal, especially when it came to running. I imagine you're good at this too, Ben. Very much so. And not so good at hitting the pause button. You know, kind of like a race car driver who finds mastery in figuring out when to take the strategic pit stop. We need to find mastery in figuring out when to hit the pause button before we blow out our tires, before we blow out of gas. And I think that's a very important piece, and I didn't realize the importance of it until I was in my 30s.

Interesting. So a couple of questions. Did you primarily turn to food sources of phosphatidylserine, or do you prefer to use that in a supplement? Form.

Well, I am a total geek biohacker, so let me just own that at the beginning. I have a sense, Ben, that you might be in this camp with me.

Mildly.

Mildly. Yeah. Okay. So, yes, I am always a fan of trying to get it from plant sources, but I like efficiency. I want to see if something moves the needle. Yes. I can look at all the randomized trials and sort of say, oh, yeah, it looks like this works for a population, but I want to know if it works in my body before I'm offering it up to anybody else. So I went to the supplement because I feel like that's a way to really know if it's gonna make a difference or not. So, yes, you can get it from plant sources. I'm just a big fan of going with what's proven with the best evidence. And that would be a supplement form.

Gotcha. And are you kind of in, like, the whole kind of like the Charles Poliquin camp of mega dosing with fish oils and omega 3s, or are you kind of more like a 4 to 6 grams a day type of girl?

I am in the four to six gram a day type of girl. I'm a fan of using food and supplements as information, and I'm also not an extreme type. What I really believe is that we want to go with the best evidence that we have. And certainly when it comes to women's health, this is less true when it comes to men's health. But for women's health, we've got a pretty shameful history of doing vast, uncontrolled medical experiments. So I'm a fan of going with what the best evidence tells us. And that's basically that 4 to 10 grams a day is where you find your sweet spot with omega 3s.

Gotcha. So you talk about a lot of other things in your book. As far as some of the big issues, your book is almost, in a way, the way that I was reading it, kind of like a cookbook for some of the things that you tend to see. You talk about modern women. I was thinking, though, as I go through this book, because I've done a lot of consulting work for particularly WellnessFX, where I get a chance to see the biomarkers of a lot of folks. And I was reading through your book and seeing a lot of things that I think men tend to struggle with as well. But when it comes to some of the more common problems that you talk about in your book, some of the more common hormone imbalances that people face, what are some of the biggies?

Yeah. Well, my book is about the top seven hormone imbalances that I see in women. And they are super fast cortisol, either high or low or both within the same day. Low progesterone, estrogen, either high or low, or again, you can have both. It's relative to progesterone testosterone. I wrote about high testosterone because that's more common than low testosterone. But I can tell you low testosterone is an issue as well. I read about low thyroid. I think that's my top seven. So there's certainly many others that I see. And I also have to tell you that my husband's just like, okay, when's the book for guys? And we talked about it, and he said, well, maybe we just need an app. Maybe we just need a laminated card that we could stick in our back pocket. Because men are a little bit less complex. And the good news, Ben, is that men are favored by stress. So stress doesn't, you know, bad stress, distress doesn't harm the male matrix the way that does the female matrix. So that's the reason for chapter four in my book on cortisol. I mean, certainly cortisol issues come up for men, but for the most part, your system, your control system, kind of your NASA for your cortisol levels is a little bit better regulated than it is for women.

That makes so much sense because you tend to see that the overtraining and the over fatigue and the stress issues happen. You know, because I work with a lot of endurance athletes, for example, like triathletes and marathoners, and many females, and I tend to see these issues more often than not. You know, you throw a dozen eggs against the wall of training, and most of the ones that crack are, you know, the females. Why is that?

There's a lot of reasons. You know, we're more complicated hormonally. And if you just look at women who are menstruating for a moment, we know that the timing of a knee injury is going to vary across the menstrual cycle. Women become more klutzy in the second half of their menstrual cycle. So hypothetically, that's between day 14 and 28. The way that we send a message to our fast twitch fibers versus our slow twitch fibers, that also varies over the course of the menstrual cycle cycle. So we have those kind of complexities that men don't have to deal with. Really, the only. Some of the fluctuations men see are more, you know, after age 40 or even as early as your 30s, you can start to have a decrease in testosterone, especially if you're not wrangling the beast of stress and kind of managing that in a successful way. But that's one of the changes that happens. The other one is the ratio for men between testosterone and estrogen. So that can change over time. But you don't have sort of these daily dramatic changes in estrogen, progesterone, testosterone, cortisol, as you do in women.

Right, gotcha. You hear children screaming in the background. I was actually telling Sarah before we started this recording that I am at a vacation home in Seaside with about, I think it's slightly over a dozen children downstairs, all walked in from the beach. So just so listeners know, I'm not at the zoom, just the vacation house. So anyways, as far as the cortisol issue, you touched on some of those things that some of the reasons you tend to see it more often in females, some of the supplementation strategies that you used for yourself with something like that, but you also touched a little bit on lifestyle dialing, back running, for example. You talk a little bit in your book too about breathing and meditation and that stuff maybe is a little bit, you know, considered woo woo by some people. But tell me a little bit more about that and how you use that or how you use it in your patients to control cortisol and balance hormones.

Oh, definitely. You know, I think a lot of people, even if they buy into this idea that I want to promote, which is that I want to change the conversation about hormones, I think the choices that we have right now suck and we need to totally upgrade the options that both men and women have. And I also think that you don't want to deal with, you don't want to mask symptoms with the latest prescription or pharmaceutical. I don't think that's the answer to health, just as my great grandmother would say a long time ago. So similarly, I would say don't try to find all your answers in supplements alone. I think it takes figuring out how to optimize the way that you eat, move, think and supplement, and you really speak to the movement piece. But even within the movement piece, I would say there's ways to be more adaptive or less adaptive in how we exercise, how we train, but getting back to how you think and how you feel. This is a key part of what's going on with your cortisol levels. And it's, you know, old school was to think just about your cortisol levels and ignore the receptors. But just as I'm sure Our listeners have heard of insulin resistance and how your cells can become numb to the effect of the hormone insulin. You can have cortisol resistance. You can have what's called glucocorticoid resistance. Cortisol is one of the shining stars of the glucocorticoid hormone family. And you want to have your receptors to be fresh, happy and joyous. You don't want to have sluggish receptors. There's a cost to being a badass. There's a cost to over training. And one of the ways that you prevent that cost is to change the way that you toggle back and forth in your nervous system between the sympathetic nervous system and the parasympathetic nervous system. I love hearing kids in the background, Ben, because I've got two kids and it just, I don't know, it just feels like home to me.

Exactly.

So very briefly, because I know this makes everyone's eyes glaze over. So I'll try to keep this kind of fun and interesting. I think of the nervous system in an astonishingly simple way, which is that there's two halves. There's the sympathetic nervous system, the fight or flight, the so called stress response, and then the other half is your parasympathetic nervous system, your rest and digest. And you need both for mastery. Most of us are hanging out too much in the sympathetic nervous system, the on position, and we want to toggle back and forth because all the healing, all the repair, all the recovery from injury happens in the parasympathetic nervous system. So how do you do that?

Something like sleep is so important, right?

Sleep, you know, that's when the whole repair conversation happens. You've got to master your sleep or else you're going to fall down a hormonal flight of stairs. Especially as an elite app athlete. And I think it's really important throughout your day to figure out, okay, here's my top three. Here's my top five strategies for how to linger in my parasympathetic nervous system and love up the matrix of my body and get the repair going so that I'm not, you know, feeling like an 80 year old in terms of my right knee function. So I can tell you, Ben, that I have a lot of people who work with me online who say to me, okay, just don't talk to me about yoga. I can't stand being in a yoga class. It makes me want to, you know, stick needles in my eyes. Please don't send me to a yoga class. So there's many other Things you can do. I happen to be a yoga teacher because it works really well for me. But I love heart mass. I love the inner balance app that you can get on your iPhone. I think that's a super powerful way to get external accountability around doing some of these things. You can take a hot bath, you have sex, orgasm is a really effective way. I know I have to keep this PG rated.

It's really interesting. You and I are on the same wavelength about a lot of this stuff. I recently tested my cortisol levels and they were off the chart due to my ironman triathlon training. And I've found a lot of the stuff that you just went over to be incredibly helpful. I certainly do tackle things from a supplement standpoint, but deep breathing exercises, having a day of yoga a week. I'm learning Tai chi right now just off of a DVD that I got off Amazon. That's incredibly effective sleep and like you say, even sex. And I actually, while we're on the topic of both sex and heart math, I test my heart rate variability religiously every morning. I used to use the HeartMath app and now I use one called Sweet Beat. But my heart rate variability is at its highest the mornings after sex. And that's another, you know, I think incredibly restorative activity that flies under the radar. But yeah, I'm in complete agreement with you about, about a lot of that stuff. And I think it's just, you know, it's the stuff that people don't do. People will go and pop whatever, 20 fish oil capsules, but not relax.

It's true. And the sad part is, you know what, you're just not going to see the results be as powerful as they could be. If you start to combine the synergism of improving, for instance, your heart rate variability. We know that when you do that, it lowers cortisol by 23%. I mean, that's fantastic. You combine that with some phosphatidylserine, maybe some vitamin C if you're an elite athlete, and and omega 3s and that is, you're golden. I mean, that's just a really fantastic, powerful combination. But it's also, you know, the latest with hormone science is that you can't just go on a protocol and stay on the same boring protocol for the rest of your life. It's kind of like training, right, where you've got to be arrhythmic, you've got to be disruptive, you've got to find the newest, freshest ways to change the dance that's happening between your hormones and the receptor for the hormones, which is like a lock on the door of a cell. And the hormone fits in like a key. So you don't want to jam that lock by creating resistance. You want to still have a really good dance there.

So let's say that someone's listening in and they've been beating up their bodies. They do have high cortisol and they've listened to what you've just said about receptors, about kind of overloading your receptors or the receptors becoming insensitive. What are the long term effects of something like that, of just like year after year of stress and cortisol and whether it's exercise or mental stress, what happens?

Yeah, so I affectionately call this the cost of being a badass, because I think a lot of people think of stress and they're tired of that generic conversation about stress.

By the way, that will be the title of this podcast.

Well, it turns out that there is quite a cost to this. So let's just go through some of those. I describe them and give all the citations in my book in chapter four. But here's what happens. It turns out that things like Alzheimer's disease actually starts in your 20s. It starts decades and decades before you start to get lost when you're driving to the grocery store. So you've got to reduce the inflammation in your body. One of the key ways that you create inflammation in your body is with a stress response. That's not helpful. So having high perceived stress or raising the amount of stress in your body, such as with training. So what's the cost there? The cost there is inflammation, increased risk of dementia, increased risk of Alzheimer's disease. It also fries your hippocampus. And that's the lovely part of your brain that we all need that does emotional regulation and also memory consolidation. We need that. And cortisol fries it. Cortisol depletes you of happy brain chemicals. It makes you run low in serotonin. And, oh, by the way, women have much lower serotonin levels than men, like 57% lower. It is that lovely brain chemical in charge of mood, sleep and appetite, among other things. And it's like a, a gatekeeper in your brain. You want it to be in the Goldilocks position, not too high, not too low. It also makes you store abdominal fat. Even if you're relatively fit, you can still have this layer of visceral fat that is metabolically hijacking you. We don't want that. It can shorten your telomeres I imagine you've talked about telomeres before, Ben. They're the. The cute little caps that are on your chromosomes. Elizabeth Blackburn got the Nobel Prize for her work on this. And it turns out that women who have chronic perceived stress. Because Elizabeth Blackburn looked at premenopausal women with a lot of her initial research. She found that women with the highest perceived stress on average shorten their telomeres the equivalent of 10 years. So she was looking at women in their 30s, and she found that these women were aging 10 years faster than women who have eustress, you know, kind of the normal amount of healthy stress.

Wow. 10 years.

10 years. So that's a big deal. You know, another piece that is coming out of this personalized medicine movement I'm so excited about, which is where all of us within a couple of years are going to have a card that tells us our entire genome, and we're going to be figuring out, you know, how to personalize supplements and exercise and our food plan. Based on our genome. It turns out that there are certain genes, such as the short serotonin transporter gene. 45% of Caucasians have the short gene, which is where you become cortisol resistant. Your cells are just constantly bathed in this high stress, high cortisol environment, and they just give up. It's like the boy who cried wolf. They just become numb and they're just like, forget it, I'm not dealing with this anymore. And then you see higher rates of fibromyalgia, higher rates of post traumatic stress disorder. You don't want that. Like, don't go down that path. We want to really manage cortisol before it starts managing you.

Yeah, absolutely. That's really interesting. And so what we're talking about, it seems like, is somebody who starts to get almost like chronic disease by maybe even trying too hard to live healthy. Ironically.

It'S true. I think in some ways we chase the wrong things. I'm constantly kind of looking at, okay, what do we not know? What are we not talking about? That's really in front of us. That's very important. And I would say this is one of those costs of the modern lifestyle. Both men and women are affected. Women are especially vulnerable. And, you know, as we try to cram our day with seeing the people we love getting the exercise that we need, eating, you know, the nutrient dense foods that take so much more time than just eating the crap that's available in a convenient way, as we try to cram all that in. Oh, and, oh, yes, rocking Our mission, which. Which for most of us takes a few hours a day as we do that, and we're running like hamsters from one thing to the next, there's definitely a cost to it. And so we've got to figure out, okay, let's think of this in a. Almost like a sprint recovery mode. Like, how do you craft your day? How do you architect your day so that you have moments where you're sprinting, you're totally focused, you're on your game, you're rocking your mission, you're stepping into your power, your agency, and then you have moments of recovery. Like, what does that cycle need to look like for you?

Right, Right. Interesting. So when it comes to this type of hormone imbalance in women and men, to a lesser degree, with the high cortisol issues, I know that you tend to see other hormones that get depleted because everything's getting shuttled towards cortisol formation. And in women, I know a big one of those is progesterone. And progesterone deficiency is something that you kind of mention in your book. Can you talk about that a little bit? Why it's important and what people can do about an issue like that?

Oh, yes. The short version is that low progesterone, it's what makes us feel like a total bitch. Progesterone is the hormone that soothes you. It's like nature's Valium. It's like nature's Xanax. And we want to make sure that we've got the right levels of progesterone, and also that it's getting into that receptor. Because guess what? Progesterone resistance is the number one reason why women have pms. Premenstrual syndrome. So low progesterone is definitely a problem. Here's the deal. Much to my chagrin, I learned as I started really studying these hormones in a different way, like, different than what I learned at Harvard Medical School, I found that cortisol's the boss. Like, it's the big kahuna. It is made, no matter what. It is the top priority in the body. So if you're like me, and maybe it sounds like you, Ben, and you are a bit of a stress junkie. Recovering stress junkie, let me put it that way. If you run around with high cortisol, it tends to block the progesterone receptor. And I'm sort of a double risk here because I have the high cortisol, that puts me at a greater risk of having pms then my high cortisol will block my progesterone receptors. So my progesterone can't get in there to soothe me and calm me down. And then there's sort of this vicious cycle that I can get into where cortisol's higher, it's blocking the progesterone. I'm not making enough progesterone. And before you know it, I was a total bitch in my 30s. So what we want to do is we want to give non suppressive therapies. You ready to talk some therapies here?

Let's do it.

All right. Yes. So I'm a fan of giving things that are not going to suppress your body's ability to make these hormones. So I developed this three step strategy. And the first part is that you're filling in nutritional gaps and you're changing the way that you eat, move, think, and supplement. So when it comes to low progesterone, one of the key gaps is vitamin C. So we found that even a small amount, 750mg, will raise your progesterone level. That also helps with the high cortisol that happens in people who push their VO2 max hard, who breathe hard when they're exercising. So this is probably for most of our listeners, vitamin C is very important. Step two, if you've got low progesterone, is to take one of the proven botanicals, such as Safran. Safran has been shown to help in randomized trials with pms. It's also effective in depression.

And do you get that in an herbal form or more of like a tincture?

You can get it as a tincture. I tend to go with what was proven in the studies, which are generally in capsules. Another one is Chasteberry, and that's now had five randomized trials looking at the effectiveness of Chasteberry. When it comes to pms. It looks to be almost as effective as taking a selective serotonin reuptake inhibitor. And that was studied both as a tincture, mostly in Europe, and then it was studied as a capsule, something called fertility blend, because, oh, by the way, it helps you increase your fertility.

But doesn't Chasteberry something that guys shouldn't use if they're trying to optimize their libido or their testosterone levels? In the case of a man, yeah.

You know, honestly, I don't know the literature on men in chaste berry quite to the same degree that I do on women. When I write that app, I promise I'll answer that question a little more thoroughly. But chaste Berry is sort of famous for making people feel more chaste. So there is this quality to it. You know, kind of the lore. The lore within the botanical world is that it can affect your libido. Although I can tell you, for most of the people that I prescribe chaste berry to, they've not noticed that. And if anything, they've found that their libido goes up because they don't hate their boyfriends or husbands as much as they did when they had pms.

Interesting. I just wanted to make sure no guys out there are castrating themselves through herbal use.

Yeah, we're talking to the ladies here.

Yeah. Guys, guys, this one's for the ladies, so go tell your significant other. So we've got vitamin C, we've got saffron and chaste berry. Anything else for women who are struggling with low progesterone?

Well, those are the things that I found to be most effective. There's a few other food strategies that I think are valuable. You know, if you have high cortisol, there's a few things you want to look at. You want to look at your use of caffeine. I see that you are similar to me in that you love the bulletproof coffee. And it's funny, I'm doing a study with Dave Asprey where we're looking at whether bulletproof coffee raises your cortisol. I think it might not raise your cortisol, because we know that coffee raises cortisol, but probably it's because of all the mycotoxins, all the mold that's part of the cup of coffee that you're drinking. Anyway, I'm getting off on a tangent here. Other things that you can do include cutting out caffeine and seeing if that makes sense. Makes a difference. As always, the villain here is sugar. So sugar will raise your cortisol level and cause problems with your progesterone. Alcohol as well, if you're getting too much alcohol, that can cause problems. So those are some of the other lifestyle tweaks you can make.

Yeah, I've always wondered that, actually, about caffeine and cortisol myself, because, you know, I know a lot of people who are maybe getting towards the. Towards the stages of adrenal fatigue. They rely on. Rely on caffeine to kind of fill that role that is no longer being filled by cortisol. And so I've always wondered if maybe if you're using caffeine moderately, if that's actually keeping your body from kind of having to churn out cortisol by acting a little bit on your liver to enhance glucose production and things of that nature. But that'd be interesting. Keep me updated on that study because Dave is. I'm training for Ironman Canada right now and doing an experiment in which I stay in full ketogenesis for the 12 week buildup to Ironman Canada and upgraded coffee is one of the sponsors of that experiment. Just because that's one of the breakfasts that keeps me in ketosis. So it's interesting stuff.

Nice. Good luck with that. That sounds fantastic.

I haven't been doing salivary cortisol profiles, but I've been doing blood cortisol profiles and they've been dropping consistently since I got on that protocol. So far, hasn't been an issue with me. So a couple other things that I wanted to ask you about. Just kind of like big picture things. There aren't a lot of doctors that seem to be talking about a lot of the problems that are in your book. And I'm curious about why this stuff flies under the radar, why people get to the point where they throw up their hands in despair and go read your book or have to go hunt down someone like yourself.

Well, I think there's a lot of ways in. You know, one way in is that there are men and women out there who feel the way I did in my 30s, who just feel like crap, feel like they're pushing a rock up the hill and just like, oh, my God, I never thought life would be this hard. This was supposed to be the best years of my life. What is going on? I'm too young to feel so old. And so folks who feel that way might have had a similar experience to me, which is I went and saw my primary care doctor, described how I was feeling, that it was a stress case, I was a runner, and that I didn't want to have sex with my husband. And I was a total grouch and I was offered an antidepressant. I was also offered a birth control pill because of course, that's the cure all for anything hormonal is just to put the woman on a birth control pill, which is a disaster. Like, it robs you of testosterone, it shrinks your clitoris by 20%. We don't want that. So as I looked at that prescription, I had the prescription for the Prozac and I had the prescription for the birth control pill. That was a defining moment for me where I was just like, omg, we are treating these problems with exactly the wrong things. So I think many folks get to that situation of coming up against the gaps in conventional medicine and just realizing that what's on offer is nowhere near what they want to really live their best life possible. I think that's true for athletes. I think it's true for many of us. You know, just ordinary people who are trying to make it through our days. So that's one piece that the healthcare system's broken and the things on offer suck. Another piece is that, you know, we live in this amazing, disruptive time where you can get so much information on the Internet. And I can tell you, many of the clients who come to see me are better educated about hormones than any of the doctors that I work with. That was more when I was in conventional medicine. But that's the sad truth. I mean, we get taught in medical school. I'm not blaming the doctors because I went through the same training as they did. It's just kind of a lack of access. But I had 30 minutes of nutrition training at Harvard Medical School. That's the same amount of time that Andy Weil had, and he's 70 years old. Like, it hasn't changed.

How much training did you get?

30 minutes.

30 minutes of nutrition training at Harvard Medical School.

That's right. I mean, I learned like every Nobel prize worthy scientific experiment for the past 50 years, but 30 minutes on nutrition. Wow.

Wow. So that's one of the issues is that doctors don't seem to be educated and they seem to be prescribing pharmaceuticals and things of that nature rather than going after some of these more natural methods that you describe in your book. And the last question that I want to ask you is if you could kind of tell people who are listening in, who maybe whatever, they're out on a walk and they just want a few of the big takeaways right now as far as the biggest wins that they can go after when it comes to hormone balancing. Almost kind of like a where to start to start to dig in and start to fix things. What are your recommendations as far as, like the basic roadmap for people to get started?

Yeah, two things. And I love that you asked this question because women and men who have hormone issues, the last thing they want is some gigantic project. So here's the roadmap. You two things. Number one, root cause, root cause, root cause. The more that you get curious about the root cause of your symptoms, your injuries, your issues that are on your dashboard, the more you're going to be able to find the best, most sustainable results. So find the root cause. I even Have a quiz that I can offer to our listeners today so that they could check and see what hormones could be out of whack out of those top seven that we talked about, I can can share that in a moment. And then number two, I would say cortisol. Cortisol. Cortisol. Like chase after cortisol. It is the elephant in the room that doctors are not testing. And yet it is a major part of endurance athletes and why they get injured, why they have inflammation, why they have accelerated aging. It's really important to be addressing cortisol. I sometimes joke that it's the. The bad boyfriend from college or high school and you knew it was a bad idea to go there. You knew it was going to blow up in your face, but you went there anyway. So cortisol is a bit like that. There's definitely a cost to it. And if you focus on cortisol, many of the other hormone imbalances will automatically get fixed. That's one of the downstream benefits of how these hormones are interdependent. So even the things that I mentioned today, like hitting the pause button, using Interbalance as an iPhone app, it's a free app that you can download. You just need a sensor to measure your heart rate variability using phosphatidylserine omega 3s. Like, these are really simple ways that you can get your cortisol into balance.

Gotcha. Gotcha. What's the link to that quiz if I wanted to put that into the show notes for people?

Sure. Yeah. The link is the Hormone Cure Book, thehormonecurebook.com quiz.

Okay, I'm going to put that down. So if you're listening in and you want to read the book, which I'd highly recommend, and you want to take that quiz, you can go check out the show notes. I'll put a link to all this stuff as well as to some of the. Some of the recommendations that Dr. Sara gave for mitigating cortisol and kind of working on progesterone and stuff like that. But don't let this book scare you off because it talks about hormones. It's actually really easy to read. I've recommended it to several of my clients and I do really recommend that you check it out. It's a good book, ladies, for understanding what's going on with your body's guys, for understanding not only what's going on with your bodies, but also what's going on with your significant other. So, Dr. Sarah, I want to thank you so much for coming on and sharing your knowledge with us today.

Ben, it's been so much fun with you. I have to tell you, you had me with that tattoo over your right deltoid. So the answer was yes, no matter what the question was.

The tribal sun. The tribal sun gets him every time. Cool. Well, thank you, Dr. Sarah. And for those of you listening in, this is Dr. Sarah Godfrey and Ben Greenfield signing out from BenGreenfieldFitness.com visit BenGreenfield.

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