Podcast Episode #42: An Expert Interview on Bio-identical Hormone Replacement and Nutrient Therapy

Hormone replacement, nutrient therapy, ice baths, creatine, rapid bone healing, and much, much more. In this episode, number 42 from BenGreenfieldFitness.com.

Welcome to the BenGreenfieldFitness.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 pound, get ready for non run of the mill cutting edge content from BenGreenfieldFitness.com.

All right, we are back. Welcome back. I know it's been a couple days since our last official podcast, but podcast episode number 42 has finally arrived and it is jam packed. The main topic today is going to be an interview with one of the nation's top authorities on bioethical, identical hormone replacement and nutrient therapies. I was very stoked to get this guy on the show, a physician from Texas, Dr. Roby Mitchell. He's also known as Dr. Fit and he literally is one of the world's top authorities on these topics. So that's going to be a fantastic interview. And in addition, we'll have the special announcements today. Got a jam packed listener Q and A. So stay tuned for tons of great content this week from BenGreenfieldFitness.com and by the way, we've got a little bit of a new format. In case you hadn't noticed, the sound quality is going to get a little bit better and we're going to be featuring a lot of new features as the podcast progresses into spring and summer. So stay tuned. Special Announcements okay, first thing is this. If you haven't been to BenGreenfieldFitness.com yet and checked out the post this week that was geared towards triathletes, I know we have quite a few triathletes that listen to the show, but I want to know why you do triathlon. I want to know what your rational and irrational fears, wants, desires and goals are for really doing the whole swim, bike, run thing. There's been some great responses so far, but go to the website, check that out. It was the last post that went up there. And leave a comment, let me know why you do triathlon if that's something something you do. I'm just kind of curious. Okay, and the next announcement is. Remember two weeks ago we were supposed to have that live online TV Q&A. We had a lot of glitches, but I promised I would film for you guys my top 10 bodyweight type of lean body Toning exercises. And I finally went ahead and did that. I actually threw a bonus in there. There's 11. And I put a video up on the show notes to this podcast episode. So if you go to the show notes and you click on the video, it's basically a half hour workout that I threw together. Basically just put the video camera on and went to town. My apologies towards anyone who is offended by me working out almost naked in that video. But it was really hot up there in the in the laboratory where I was exercising and so I had to strip down a little bit. But it's nothing too offensive, I promise. But I put the video on the link to the show notes in this podcast episode and I included a lot of exercises from the book Shape 21. And I don't know if all of you had heard about it, but we're actually taking 42 people, 21 males and 21 females from across the nation, giving them a free copy of Shape 21 and basically letting them train for 63 days to see who can lose the most amount of fat. I've completely redesigned shape 21. It has a holistic, allergen free meal plan in there. Now that's going to cause your cells to just way more rapidly shed fat, shed toxins. I'm really excited about that. But if you want more information about that book about getting in on the challenge, you have right now 10 days left to register for the challenge and it's pretty full right now. So you can do that by clicking on the link in the show notes to this podcast or just go to shape21.com and there's a link to go to the challeng challenge to be one of those 42 people that I select for that 63 day rapid fat loss challenge. Tons of cool prizes in that, by the way, by some really, really awesome, awesome sponsors like Cherry Farm and Action Wipes Millennium Sports Gym stick quite a bit of swag in that contest. Now I have a really great announcement for those of you who want to be able to listen in to the Ben Greenfield fitness podcast or those of you who have family and friends who want to listen in, but who don' to be tied to your computer or tied to your MP3 player to do so. What we've done is taken the top 24 episodes, the top 24 shows. We've actually put them in CD format, compact disc format. They're basically two cases. It's a 10 CD set, volume one and volume two of some of our most popular podcast episodes. And I'm going to put a link in the show notes to where you can get those. I've got only a limited quantity of those available. Basically there's 100 of them available and if you want to get those, it's basically a 10 CD set, 24 of our top ranked shows and you can conveniently play them from your home or car CD player. Both volumes come with a complete detailed show note for each different episode that's on those CDs as well as a link of some of the things that are mentioned in the audio episodes where you can go find out more. So anyways, if you want to get your copy again, I've only got 100 of them, but I did make those available. They're at BenGreenfieldFitness.com CD or you can click on the link to the show notes. I know there's a lot of cool links in the Show Note episodes for this podcast, but it is totally commercial. Free announcement free. None of the special announcements, none of the Q and A is just straight up interviews with some of the top experts from around the country. So that's all available online. You get 10 CDs and it's 47 bucks for the for the entire 10 CD set. That's about 1500 minutes worth of audio that you can listen to all summer long while you're driving around. So 100 of those are available@BenGreenfieldFitness.com CD and then the last thing that I wanted to mention was I noticed that it was quite interesting today that the FDA has warned consumers on May 1st they put out this warning that people need to stop using Hydroxycut products, which have been associated with a number of pretty serious liver injuries. The FDA recently received 23 reports of some serious health problems ranging from jaundice to elevated liver enzymes to seizures, cardiovascular disorders. And if you're not familiar with what Hydroxycut, it's a metabolism boosting supplement that's created to really amp up your central nervous system and it is similar to, for example, drinking a lot of coffee. So I would highly caution you to stay away from Hydroxycut. Once again, returns to one of the main things that I've talked about this show. On this show, if you're going to take fat loss supplements, they better be something that takes your health into consideration. That doesn't just look at how quickly you're going to lose fat, but how healthy you're going to do it. And everything that I do with my clients that I write on this show from the Shape 21 book to the thermal factor to the lean factor. I've screened everything to make sure that you're losing weight in a healthy manner because that's one of our philosophies, is that if it's not healthy, then you know, it's not worth it to shed a bunch of fat if you, if you're taking, you know, five, 10 years off your life. So anyways, I thought that was interesting that the FDA pulled hydroxycut. So we have a jam packed listener Q and A today. We're going to go ahead and get on to that. You're going to want to listen in tons of questions. Ice, creatine, weight loss, muscle gain, that type of thing. So listen in listener Q and A. Okay. This week's first question comes from listener Charles. He says, I have one question, although I don't mean to take up all your time. I think he's saying that because Charles was the guy that asked about how to gain muscle while training for endurance sports. While training for triathlon. He says, I was wondering if you could suggest a way to set up my workout schedule. For example, I'm usually doing some sort of triathlon training six days a week and I'm lifting about four days a week. But I'm not sure to make real strength gains. What exercises should I really focus on and where would I want to keep my replacement ranges? I don't know if you care, but recently I've been getting into CrossFit workouts. I think that creating a hybrid program that includes exercises of high weight and intensity with low reps followed by a CrossFit style workout might be the best for me. Well, here is exactly what I do, Charles, with the athletes that I coach for triathlon during the off season, during the time when it's very important that an endurance athlete or triathlete or any athlete really prepares their body for the rigors of training, the rigors of competition. We focus on very specific strengthening of muscle groups that we know that are going to take a pounding and need to be strong. The rotator cuff, the part of the butt muscle that's called the gluteus medius, do quite a bit of extra adductor work. Those are the muscles on the inside of your leg. We do quite a bit of balance work, a lot of proprioception kind of mind, muscle awareness type of work. But then and one of the things that's really important that type of work is quite a bit of single leg type exercises, single leg strengthening. When the season rolls around, we tend to move more into the type of workouts that are in my book Top 12 Resistance Training Routines for Triathletes over at thestrongtriathlete.com and I'm gonna just read you one of those workouts. You can see the type of things because then we move into a little bit higher rep exercises that are done in more of a circuit style, very quick type of format. So for example, here's one that's called Extreme Core. And in this workout, that's one of those 12 workouts in the book. You do one set of 12 reps for each side. Alternating dumbbell chest press on a stability ball. You do one set of 12 reps for each side with a single leg deadlift. That's lifting a weight off the floor with one leg up in the air and one leg doing all the work. Then you do a single leg dumbbell row. Again, you're standing on one leg doing 12 rows on one side and 12 rows on the other side. Single leg squat, 12 of those per side, alternating dumbbell curl to overhead press. That's literally where you're curling a dumbbell and then pressing it overhead and then 12 per side of an exercise called around the World, where you're literally taking a medicine ball or a dumbbell and bringing it in a giant circle 12 times in one direction and then 12 times in the other direction. And that's done in more of kind of a circuit style format, as you could tell, a little bit higher reps, typically 12, 15 reps. But rather than having a workout that is all high weight, low reps, especially when you're doing as much triathlon training as you're actually doing, you may want to consider doing something especially during the race season around this time, like around a 12 rep range to 15 rep range range and keeping it in more of a circuit style format. So, for example, I typically exercise with the weights three hours a week in the off season, three one hour workouts. And nowadays I do three very short and intense 20 to 30 minute workouts. So that's the format that I utilize. So I'm going to move on to a question from listener Karen who says, do you have any opinions on ice baths or cold water soaks? I do. I actually after any tough workout, any real long runs, very difficult workouts, I go into my freezer, I take the bucket of ice, I dump it into my bathtub, I fill up the bathtub with cold water, I grit my teeth and I sit in there for about five to 10 minutes. And you would not believe how much this can reduce the amount of soreness and swelling that occurs from a hard workout. Basically what happens is ice will decrease things like swelling, tissue damage, blood clot formation, which is huge. If you do something like a marathon or ironman triathlon, muscle spasms, it can decrease pain. But the whole idea is that when you ice an area or you subject an area to cold, it constricts all the local blood vessels in that area. It decreases the tissue temperature in that area, and that constriction decreases blood flow and it decreases, essentially decreases metabolism. So you get a lot less bleeding in that area, you get a lot less cell death. The type of thing that would occur after, like an acute traumatic injury. Well, your muscles look like World War II after a workout. And so the ice can actually assist with decreasing some of that inflammation that occurs, some of that acute inflammation that occurs. And actually to. To restore blood flow to an area after you ice, you can use like a warm water or hot water soak directly after. And the other thing that I'll do if I really don't have much time at all, is just cold water in the shower followed by hot water in the shower, 30 seconds back and forth three or four times through. This would be most important. If you're, say, like a triathlete or someone preparing for a marathon or a 10k or something of that nature, you'd want to do this at least once a week during your longest run day, because running is what really kind of tears down the muscles and it can also decrease pain quite a bit as well. So I am a big fan of ice baths, cold water soaks, and I believe they were mentioned by. We had Lance Armstrong's massage therapist on here and interviewed Jeff Spencer. And there's a little search box@BenGreenfieldFitness.com where you can search for any of our past episodes. But you should check that out because he talks quite a bit about a lot of other recovery protocols. And that reminds me, by the way, I do have a most popular posts section. Now. If you go to BenGreenfulFitness.com and look on the right hand side of the page, you can see the top 10 most popular posts on our website. So check that out. I think that interview with Jeff Spancer was one of the more popular ones. So we've got another question about creatine. And this is from listener Sal. She says, I have a question I was wondering if you could answer. I am a serious marathon runner and I currently use creatine in my training. I use it for several Reasons one, it seems to be relatively safe with no side effects. Two, I'll take anything that helps recovery. And three, I currently do lower body work and core work in the gym and I believe creatine helps me build those muscles. However, creatine also causes me to carry extra water weight. I've heard that it does this. I've noticed it myself. I carry a substantial weight amount of water weight around my midsection. After a long run where I sweat a lot, I can see my abs. But if I take creatine and go a day or so without sweating, there's a lot of bloating in my abs. I'm worried that during a taper this will have a negative effect. When she says taper, she probably means decrease in activity leading up to her marathon. So when I rest for my marathon, should I top stop taking creatine or do I need to stop a few weeks in advance to get it out of my system? I want the benefits of creatine without carrying extra weight during the race. Also, will there be any problems with stopping taking it? Like withdrawal systems, I currently take about 5 grams after workouts and 3 grams on non workout days in the morning. Great question, Sal. Okay, first of all, you did mention that you'll take anything that helps recovery. Not convinced by the research that creatine is going to help recovery. Creatine is what your muscles need to actually create a contraction. And by taking supplemental creatine, you can increase the amount of time that a muscle can actually produce a stronger contraction. So let's say that you're doing a 20 yard sprint. Well, you might be able to go, you know, for 25 yards or 30 yards before you started to slow down, rather than 20 yards. Now, the idea for endurance athletes is that the creatine can actually help stave off the amount of carbohydrate that your muscles use during a contraction. It has what's called a glycogen sparing effect. And so you essentially are able to exercise for a little bit longer period of time without using quite as much of your valuable carbohydrate stores. And it can actually help you to produce a little bit stronger force or a little bit more wattage during a muscular contraction. So you push off the ground a little harder when you're running or you, for example, push the pedals a little bit harder when you're cycling. Now, most studies with creatine supplementation, as you have discovered, Sal, cause weight gain. They can cause some bloating. Creatine is what's called Hydrophilic, that means that it attracts water. And so when creatine is taken up into the muscle, the muscle will take water up along with it. Now there are several different forms of creatine out there and there are some that are less hydrophilic than others in terms of carrying water along with them. I take one form of creatine called CREO2. It was specifically designed for endurance athletes because it is a little less hydrophilic. It doesn't cause the type of water bloating and related weight gain as some of the other creatine, what are called monohydrates powders that are on the market. I will put a link to that particular creatine product in the show notes, Sal but then the other thing is that you asked about if you should stop taking it when you rest for your marathon. Well, the whole idea is that if you stop taking it after a few days, all that valuable creatine that you've been supplementing with is not going to be in your system anymore. And so yeah, I guess if you were taking the creatine it was helping you train harder and longer and basically making your training sessions more valuable. It would allow you to get in better shape for your marathon. But I personally would kind of like it in my body for the marathon as well. So even though it might have helped you gain valuable fitness leading up to the marathon, I would consider continuing to take it up to the marathon provided that you can get your hands on the type of creatine that's not going to cause that extra weight. Otherwise you would still get some benefit. Because you've been using creatine in your training, you would need about two weeks for it to get out of your system. And by the way, that five gram that you're taking after your workouts and that three gram on non workout days, that is the correct dosage. That's what you would actually need to see what's called an ergogenic effect or a beneficial effect from creatine. So I'll put a link to that creatine product in the show notes. And let's go ahead and move on to a question from this is our last question from listener Kelsey. She says, I raced Ironman Canada last year and have had some complications as a result. After some terrible coaching and poor nutrition advice, I had a very difficult race. I gained more weight in the year I was training for Ironman Canada than I have in previous years sitting on the couch. Believe it or not, I hear that a lot. A month before Ironman Canada. I was diagnosed with a stress fracture on both my tibias. I cut back running for the last month and pushed myself through the run on race day. As you can imagine, the run was long and cold. Yes, I was up there. I remember that. Eight months later and the fracture is still far from healed. I've moved to a new city. I've been struggling to find medical support. I've been off running since the race on my bike as often as possible. But I would love to heal these suckers soon. Living in Victoria, B.C. means I have access to some unbelievable running trails and it's killing me not to get on them. Any recommendations for stretching, supplements, etc. I have a dairy allergy, so I take calcium, a multi and vitamin K daily. Is there anything I can do to help move this injury forward? First of all, I would consider the fact that if you're still experiencing, still experiencing symptoms from the stress fracture and let's see you cut back running. Okay, so you've only cut back for the last month or I'm sorry, it's been eight months since your fracture is healed. First of all, I would just ask you to make sure that it is a stress fracture, that it's not something like chronic inflammation between your tibia and your fibula, or there may be other things going on, compression syndrome, things of that nature. So I'm assuming that you've probably gotten a bone scan or an X ray and that you know it's a fracture, but if not, make sure that you do get a proper diagnosis that that actually is a stress fracture. As far as healing of stress fractures, first of all, you can reduce a lot of the stress that is placed on the tibia and the fibula and those muscles along the front of the leg by making sure that you maintain quite a bit of flexibility in the back of your legs, in your gastrocnemius and your soleus, your calf area muscles. So I would be doing quite a bit of calf stretching on a daily basis. I like some of the yoga moves like down dog. Those also do a great job at stretching what are called your dorsiflexors. And that can help alleviate a lot of the issues that come along with stress fractures. I would also be focusing on strengthening the muscles on the front of the leg. One of the best ways to do this is by leaning back against a wall, standing up nice and tall, and then just pointing your toes rapidly up and down and up and down, up towards your head and then down towards the floor and you'll start to get kind of a burn in the front of your legs as you do this. And that will help build some of the muscles on the front of your legs that can again, help keep stress, some of those areas that are being stressed on your tibias. So there are a couple of exercises that you can do now as far as supplements. You have to be kind of careful by doing something like taking calcium or taking something like phosphorus to say, help with bone replenishment because a lot of those ingested minerals are not going to be absorbed. And taking large, large amounts of those can contribute to kidney stones or to bladder stones. So you want to be careful with, say, just taking those to actually cause new bone to be laid down. There's one supplement that I know of that has something called lactoferrin in it which supposedly helps to target the minerals that you need into the bone to help a little bit more with what's called osteoblast formation or the laying down of new bone. It's a product that one of my friends told me about several months ago and he said that a lot of his people that he was working with actually were seeing a decrease in, I'm sorry, an increase in bone density and an increase in how quickly muscles, or, I'm sorry, bones were healing. Now, I personally haven't used this before, but the stuff's called Osteodanks O S T E O D E N X and it has that lactoferrin stuff in it. It also has vitamin D, folic acid, zinc. It's got a glucosamine chondroitin blend in it as well as a turmeric root extract. There's another one that I have used before that's a glucosamine chondroitin. It's called Capraflex. That one's designed more for arthritis. It has some of those same ingredients like the glucosamine, the chondroitin, the turmeric. It doesn't, I don't believe, have this lactoferrin in it that the osteodenx has, but I would consider trying either of those. I'll put a link to those after your question as something that could help versus say, just taking a bunch of calcium. So that's what I would look into. Great question. And remember, if you have a question, you can email me ben greenfieldfitness.com if you want to ask an audio question, just call our toll free number 1 877-209-9439 or you can Skype me at the Skype number or the Skype name, Pacific Fit. So let's go ahead and move on to this week's very, very cool interview with a guy who goes by the name of Dr. Fit, Dr. Roby Mitchell. And this interview is jam packed with very practical information on bioidentical hormone replacement therapy and nutrient therapy.

Hey, podcast listeners, this is Ben Greenfield. And as promised, I have on the other line an expert in nutritional medicine, a guy who really practices what he preaches. This is a physician whose nutritional expertise combined with his avid enthusiasm for fitness.

Which you'll see if you go look.

At some of the pictures that I'll put of him up on the show. Notes of gaining the nickname of Dr.

Fit.

He has invented exercise devices for home use. He's trained doctors, pharmacists, healthcare professionals from all over the planet on successful therapies for arthritis, wrinkles, sinusitis. He's an expert in enhancing physical performance through nutritional medicine, through alternative medicine. He graduated from Texas Tech University School of Medicine. And this gentleman's bio is too long for me to go over. We'd be here all day long. But very honored to have Dr. Roby Mitchell on the other line. Dr. Mitchell, how you doing?

Great, Ben. Good to hear from you.

Fantastic.

And like I said, I have some pictures that I'm going to be putting up on the show. Notes and ones of you doing some extreme downhill skiing. Another one looks like you're involved in some pretty extreme martial arts. Tell me a little bit about yourself and your background in exercise and in medicine.

Well, I started as most people do. My first introduction to exercise was in high school sports. So I played basketball. But then I brought broadened my horizon a bit. Just before getting out of high school, I started in martial arts and went on to get my black belt and did a lot of competing in martial arts. Actually, Chuck Norris and I used to spar together. He used to come and do some guest teaching for my instructor.

Okay, I gotta ask you, who wins.

In a spar between you and Chuck Norris?

Chuck Norris won every time. So, yeah, particularly after he went and did his movie with Bruce Lee there. But I was the only one who could kind of even keep up with him. So that's why I always got put out in front of him. But it was a good education for me.

And from that point, where did you go in terms of exercise and learning more about the tie between medicine and performance?

Well, so from that, then I went on, while I was there at Texas Tech, I just used to run. I ran and played basketball all the time. So I ran and played basketball, ran and played basketball. And then I came up with. With a knee injury. And it just so happened at the time, my girlfriend was a triathlete. So in order to get me rehabbed for my knee, she started me to cycling. And so I started cycling and enjoyed that and got pretty good at it. And she said, well, since you've already got running under your belt and you've started cycling, you might as well take up swimming also. And, you know, we just started doing these triathlons. So that's how I got into doing triathlons. And she kind of coached me into that.

So it was a woman that snagged you into it. That was my story as well. Same thing.

Definitely. Definitely.

So, you know, I run more than a mile before I met my girlfriend, who's now my wife, who ran me into the ground. But, yeah, it's funny, that's what she.

Did to me in the pool. Right. So I definitely was not a swimmer. So she. Yeah, she could definitely swim circles around us. But I thought that being in shape for running and having great aerobic capacity, cycling and so forth, that I could just get in the water and just swim. But it didn't turn out that way.

Now, somehow the water isn't like that.

You got to use a whole different set of muscles, and swimming is a lot more technical. So you really got to know, in order to excel at swimming, you really have to understand the technical aspects of stroke technique and breathing and that type of thing. So you have to think a little bit more swimming than you do cycling and running, but got that under and then took courses. And that just kind of made me want to. To explore more physical activity. So I just. While I was there at Texas Tech, they offered different classes, you know, and scuba diving and kayaking and sailing. And so I just took everything and. And then took up skiing. And so the more things that I took up, the more things that I like. And so. So, yeah, I would recommend that for a lot of your listeners is to not limit yourself, you know, to activities that you're just good at or you're just used to doing. Broaden your horizon and get a different perspective on lots of these other activities, because not only does it enhance you mentally, but when you. As I found out with swimming, when you broaden your horizon athletically and do a variety of things, it challenges your body to exercise different muscles.

Yeah, and that's a good point. That reminds me of a book that I recently read called Brain Waves, and it actually split people's skills into auditory, visual and kinesthetic. And although certain people are strong in other areas, one of the most important things that you can do, for example, if you're an auditory person, is engage in sports or in activities that are more visual and more kinesthetic to grow yourself from a physical and a mental standpoint.

So that's a great tip.

Now, right now you are working as a physician and tell me a little.

Bit about your practice.

So I'll give you a little bit of background about how I got to this point. So I went to Texas Tech Medical School and I did a. It just so happened that when I was there, they offered a PhD program, which I took advantage of also. And while I was doing that, the guy that I was working under, Dr. Peter Pang, he was from Hong Kong and he had been for some time trying to establish a liaison or student exchange program between Texas Tech University and Jinan University, which was in mainland China. And it just so happened that when I was under his tutelage that everything got into place for a student to go to mainland China and study traditional medicine, traditional Chinese medicine. Now this was back in the mid-80s when, you know, by conventional standards, all that stuff was still woo woo medicine and witchcraft. And that's how I had been trained to think about things like chiropractic and acupuncture and those type things. But as I said, I had a history of martial arts, right? And I had been a karate instructor and had always fantasized about going over to the Orient to study martial arts. So here was this free trip to China. So even though the proviso was that I had to study this witchcraft, I took them up on it and went over there to my surprise, once I got there. And so looking at the results that they got, it made me, I was very intrigued because I saw that they were able to do some things, make a big impact in some of the medicine and some of the maladies that we treat over here with medications, they were able to make an impact and a scientific measurable impact, an impact that you could measure scientifically with some of these alternative therapies, acupuncture and so forth. And before I left, I was able to walk cholecystectomy or a gallbladder removal in a patient who was wide awake, right? His stomach cut open and they're taking his gallbladder out and this guy is wide awake, them using acupuncture as the only form of anesthesia. So I left with that on my mind. But I came back over and Finished up my conventional medical training and became an emergency room physician. And as often happens, you graduate from school, you start working and other things and don't exercise as much and you change your diet, you know, you're busy, you grab a donut and coffee and that type of thing. And so I started putting on some extra pounds. And along with the extra pounds came an elevated blood pressure. And being a physician, particularly a busy physician, I did what I would have advised the patient to do, which is pop a blood pressure medication. I started taking a blood pressure medication and it made me very sick. And that was a wake up call for me to start thinking back to the experience that I had in China where those physicians had used use this philosophy of getting the body back in balance. If you do that, then the disease goes away. Well, here I was with this blood pressure problem and the medication obviously wasn't going to work for me. So I started doing some of these natural therapies, changing my diet and looking up some information back in my old biochemistry books about what makes blood pressure normal and why it goes awry. I figured out some things, some of the biochemistry of hypertension and did those things and I got my own blood pressure back under control and, and got my weight down. So that made me ethically and morally, you know, have to at least present those options to patients. And fortunately, a lot of the medical literature was starting to go in that direction. We were reading a lot more in the conventional medical literature about this impact of fruits and vegetables and exercise and just the whole behavior modification implementation and how that was happening, such an impact on disease. So I had that to kind of back me up and started giving patients some of that information. And to my surprise, I found out that there were lots of people who wanted that information. They didn't want to be on drugs. They wanted to get their bodies back in shape in a natural manner. So that made me pursue that a little more. And I did. And finally that led me to just ditch the emergency medicine career and just completely changed my practice to this. And it was a pivotal move, but I started doing that and then I had to find some mentors who had been doing this because I was just completely fish out of water as far as nutrition. I had never been taught any of that. So I went and studied with Dr. Hugh Reardon there in Wichita, Kansas, that had been doing nutritional medicine for years. And then I went and studied with Dr. Jonathan Wright out in Washington, that is kind of the father of nutritional medicine here in the United States, and studied with a couple of other folks and got that background and so started doing that type of practice and got good enough to where I'm one of the supposedly experts in it now. So that is how I got to where I am now. So those are the patients that I see now, those who want, as an objective, they want to get their bodies back healthy again. So we're not. When you come to me with high blood pressure, I don't treat high blood pressure. Right. So I teach you how to re establish a normal biochemical environment inside your body. And once that happens, then the blood pressure normalizes the cholesterol, normalizes the blood sugar, the weight, the migraines, the pms, whatever.

Now, in addition to nutritional medicine, you are also recognized as an authority on bioidentical hormone replacement. Do you find that the two are linked when you're working with someone, for example, on getting their bodies prepared for peak performance or on eliminating symptoms of, say, fatigue in an athlete or even.

In just a regular individual?

Oh, certainly. So you have to understand that hormones are. They're kind of like the computer programmers of the body. So you have this keyboard of DNA that's in every cell, and that is the blueprint that tells that cell how to perform hormones. When they're secreted from the thyroid or the testicles or the ovaries or the adrenal glands, they go through the bloodstream and they dock on these cells and they go inside and they start typing on that DNA keyboard to tell that cell how to perform optimally. Around about age 27, those hormone levels start to drop. And so that's when we start to see cell dysfunction and we start to see the advent or incidence of different diseases or the symptoms that we associate with aging.

So that happens when you talk about that hormone drop at 27 years old. In your experience, do you find that in both males and females or when we're talking about hormone replacement? Because I know a lot of guys.

Listen to this show.

Are we just talking about perimenopause in women?

No, no, no, no. We're definitely talking about drop in performance in men also. You can see that in peak performance athletes. So you watch football players or track runners or any athlete, any professional Sport around age 27, 27 to 30, that's when you'll start to see them, what we call lose their legs. Right? So the peak performance is not there. And that is because of this gradual rheostatic drop in hormone levels.

So with bioidentical hormone replacement or with nutrient therapy, the two topics that you're Considered an expert in how do those tie into treating this drop in natural hormones that you're finding in individuals who are 27 +.

So I really consider myself analogous to a car mechanic. So I'm a car mechanic for the body. So I get the owner's manual and I look at the parts that are supposed to be there to make this vehicle run optimally, and I just try to make sure that all of those are there. Okay. So I put them up on the rack. Oh, this guy's oil is low and his transmission fluid is low. So let's bring up the level of the oil, Bring up the level of transmission. There's a spark plug missing. And let's put that back. So it's the same analogy. So we analyze, do analysis on patients to find out if there are vitamin deficiency, if the vitamin D level is low, if other vitamin levels are low, if there are mineral deficiencies, and if any of these hormone levels are low, let's bring those back up. And just as with a formula one race car, you bring those things back up to their proper level, and then the person can gain optimal performance. Now, of course, the person has to eat correctly and they need to do a little bit of exercise. But as the physician, my job is to find out if there are any nutritional or hormonal deficiencies that we need to address.

So what type of hormonal or nutritional deficiencies do you observe more frequently in the population that you work with?

So for your listeners, one of the most important mineral deficiencies is going to be magnesium. I was a race medical director with.

The.

Ironman out there in Hawaii, and that's what we found on these peak performance athletes, is that potassium and magnesium are two of the minerals that are just critical for peak performance in athletes. When I was growing up, it was salt. So the football coaches would give us these salt tablets. But we found out that the minerals for peak performance that really affect your peak performance, or the magnesium and potassium. Now, there are some other nutrients that are very important. For instance, iodide. We're just really starting to find out a lot more about iodide and how it not only is a substrate for thyroid function, thyroid hormone function, but it's also one of the key elements in keeping down the microbe level in your body. As these microbes, particularly fungi, start to overgrow in your body, then they can zap you of strength and performance. They really start to overgrowth, and they lead into many different types of diseases. So the iodine.

I'm sorry to interrupt.

Is that A problem that people need to be concerned about. Fungi?

Oh, certainly, certainly, certainly, you know, in the ecosystem of the world. I mean, fungi, they are the, you know, they overtake everything, whether it's crops or the internal environment. So they're the cleaner uppers. Anytime they detect that a system is starting to fail a little bit, they're kind of like the vulture cultures of the internal ecosystem. So anytime a cell is dying or is dead, then yeast proliferate to come in and try to clean it up. As we move past 27 and thyroid levels start to go down and oxygenation starts to decrease in the body, then that's a signal for fungus to start overgrowing and start decomposing things. So definitely that starts to happen. That is the underlying factor. It seems to be in most of the chronic diseases that we face today, whether it's autoimmune disease or things like heart disease or Alzheimer's cancer. It's the body's response to this inflammatory response that happens when your immune system is trying to get rid of it, trying to combat this yeast. It creates this chronic toxic environment. Right. That either causes disease or cells to respond in such a way that they try to survive that environment. And that's what cancer cells are. There are cells trying to survive a toxic environment.

So you've got. Magnesium is one deficiency that you observe. You have this presence of fungi and the fact that iodide deficiency or therapy with iodide can help with that. What other nutritional deficiencies or hormone deficiencies do you see and how do you work with them?

So the B vitamins are very important, and some of these are a little more important in women, particularly menstrual.

Just briefly lost you there as you were saying, that the B vitamins were important, particularly menstruating women.

So there.

I would say that nutrients across the board, maybe. Can you hear me? Okay. Okay. Women need to pay a little more attention to. Because if they're. Particularly if they're menstruating, because every month women write a big nutritional check in the form of the blood loss that goes with their menstrual cycle. So, you know, every month the body prepares a woman as if she's going to get pregnant. So it takes all those nutrients and shunts them down to the blood around the uterus. If she doesn't get pregnant, then all of that nutrition just goes down the toilet, so to speak. So women in particular have to be very cognizant that on a monthly basis they're writing a big nutritional check. So again, these B Vitamins are very important, and it's very important that the whole complex of B vitamins be added. And again, for women, the iron is a little more important when they are menstruating, and particularly for women athletes. So they want to make sure that if they're doing a multivitamin mineral, that they have some iron in there. Zinc is very important, again, for the immune system, but also for thyroid function. Selenium is very important for thyroid function also. Another nutrient that athletes in particular need to be cognizant of are these essential fats. So, essential fats, and this is what we find in the fish and the raw nuts and avocado and coconut oil. These essential fats, structurally, right, they surround the cell membranes and they allow cell membranes to breathe, so to speak. This allows good nutrients to come into the cell and toxic waste to move out of the cell. If you get those cell membranes saturated with this harder fat, like the saturated fat, then it creates a cell wall that's not able to breathe as well. It's kind of like a person that has emphysema or copd, and they're not able to exchange oxygen very well. So very important for athletes to have those essential fats saturated in all their membranes in order for them to have peak performance also.

Now, to my understanding, most of these compounds would be considered nutrient therapies. But how about this bioidentical hormone replacement?

So the hormones, again, these are kind of like the fluids in your car. So the oil and the transmission fluid and the radiator fluid and those type of things. These are extremely important for cell function because, again, these are the computer programmers that type on the DNA to make cells function optimally the way that they're supposed to function. As they go down, then certainly performance goes down. But it also can lead to some of these chronic diseases that we have, whether it's depression or heart disease or migraines or chronic fatigue or whatever. So we definitely want to keep those hormone levels up at peak. Testosterone, of course, is a hormone that a lot of people have heard about. People think that it's a male hormone, but there are no male or female hormones. Every male and every female produce exactly the same hormonal composition is just we produce them in different amounts. So men will produce a lot more testosterone than women. But women produce and need and benefit from testosterone also. So as testosterone levels start to go down in women, we see a decrease in muscle mass, we see a decrease in brain function, we see a decrease in sex drive, we see changes in the lipid Biochemistry and so forth. So the testosterone variant, important for both sexes, the opposite of that is true also. So estrogen, women produce more of it, but men produce and need estrogen also, and progesterone and DHEA and all these other hormones. Thyroid is a hormone that is a common denominator in dysfunction in men and women. Women tend to have more problems with thyroid related diseases because of their production of estrogen. Estrogen is a hormone that will inhibit, inhibit thyroid function. And that happens because nature wants women to have a little more fat just in case they get pregnant. But that is a very important hormone, particularly for performance for both sexes.

Now, Dr. Mitchell, when you're looking at someone's thyroid levels, most of the time when someone comes into my office and they bring in their blood work with them and they say that the thyroid levels are just fine, but they're very fatigued, they have what's called a TSH.

Value, do you look at more than that?

Oh, of course. That's one of the most useless blood tests that a person can get because they are so misleading. So again, these hormone levels fall in a rheostatic fashion, so like turning down the knob on your radio. So it's a very subtle decline and you get a deficiency, you get deficiency symptoms long before that is reflected on a blood test. So a person, and if they go to my website, they can look up all the different symptoms of hypothyroidism. And there's a lot of them because thyroid affects every cell in your body. And depending on your genetics, you may have different symptoms from person to person. But the blood test is definitely not a way to evaluate a person for thyroid dysfunction. A doctor has to make that clinical diagnosis. So I have to sit you in front of me and look at you from head to toe because the body won't lie to you about its lack of thyroid cells in the body respond very predictably to low thyroid levels. And so the physician has to know how to read a person's body in order to tell whether they're hypothyroid or not and not depend on those blood types.

And what type of things do you look at when you're reading someone's body?

So starting with their hair, I'm looking for split ends and frizzy hair, dry hair that doesn't have the luster to it. So as collagen levels go from skin and hair, then you start to lose the luster of hair and you start to lose the elasticity of skin. As thyroid levels go down, things start to dry Up. So scalp may be dry, there may be dandruff there, there may be patches of psoriasis. As I go down, I'm looking for bags under their eyes. So there is a pathology called myxedema where things start to swell. So this can happen. This is what causes those bags under the eyes. I have them stick out their tongue. If the indentations of the teeth are reflected on the edges of the tongue, that's what we call scalloping. That's a primary indicator of hypothyroidism. Even person just coming in when I shake their hand, if I feel like their hand is very cold, right. That tells me that their circulation is low and they may have thyroid disease. On the fingernails, I'm looking for ridge nails, splitting of the nails, any cracking of the nails, very soft nails. Again, the thyroid is not getting in on the DNA and coding for the assimilation of these proteins that help you make good collagen and strong meals and strong skin. I'm looking for any type of fungal infections, fungal infections or the feet, I'm looking for any history of fungal infections that they have jock itch in men or athletes feet, or vaginal yeast in women. Irritable bowel syndrome and those type of things on the feet especially. So this is because it's so far away from the heart. This is usually where low thyroid symptoms will show up first. So I have remote thermometer, a laser thermometer that I can point at their toes and see what the temperature down there is. Look, a lot of people have a 20 degree difference between their sublingual or the temperature under their tongue and the tip of their toe. So all of these cells in your body, they're like fish swimming in the same fish tank. They need to be around the same temperature. If you've got a 20 degree difference between the temperature under your tongue and that in your toe, something's wrong. So I look at that also I look at the integrity of the skin. The thyroid hormone is very integral to making collagen. So if you, if you're developing wrinkles, if you are losing elasticity of skin, that says that there's a hormone problem there. The way a person carries their weight. If you're building up a lot of fat around your abdomen, what we call truncal obesity or this Android obesity, that's a signal that you're building up fat because your body is not metabolizing because of low thyroid. So those are, those are just. Again, people can go to my website and get a more extensive list, but those are some of the things that I look at as a patient's walking in the door and I sit down and start talking to them. Dr.

So it goes a lot deeper than.

Just that blood test.

Now, you talked about testosterone, estrogen and thyroid. Is it three of the hormones that you look at? Are there others?

Certainly. DHEA is another hormone. The adrenal glands produce hormones also. Actually, the adrenal glands is two glands in one. So it has two different sets of hormones that it produces. So these adrenal hormones, such as cortisol and these, what we call glucocorticoids, are very important in certain metabolism and mineral metabolism. So keeping your sodium, potassium and those types of balances in balance. But then there's the other part of the adrenal glands that produce epidermis, epinephrine and norepinephrine. So these fight or flight hormones also. So those have to be looked at also. So hormonal therapy, Yes, a very comprehensive treatment program that you have to look at and make sure that the levels of all those hormones are where they need to be. Because these hormones, they interact with each other in a synergistic manner. Cortisol and thyroid, for instance. Right. One doesn't work well without the other. So if you don't, you don't address cortisol deficiency and you just give someone thyroid, the person may still have low thyroid symptoms because the thyroid synergizes with cortisol in order to work as well, and vice versa. If they have a thyroid deficiency and you only correct the cortisol levels, then the person is not going to do well. A lot of these women go for hormone replacement therapy and they go to a doctor that only knows how to replace estrogen, estrogen or maybe estrogen and progesterone. And they get on those hormones, they may feel a little better, but they don't have their energy and their skin is still bad and they have all these other symptoms. So it has to be a comprehensive assessment of all these hormones. Again, just like a mechanic would do in assessing an automobile.

With such a delicate balance between the hormones, do you use different types of tests for each different hormone or are you just doing, for example, blood test or saliva test?

So there's blood test or saliva test and there's urine test. The most comprehensive test is what we call a 24 hour urine test. So the person takes a kid home and they, over a 24 hour period, they give us a sample. So this is the most complete picture that we can get of how a person is Producing hormones. And we can look at the biochemical pathways. You know which way. When this person has dhea, is it being transferred into estrogen or is it being transferred into testosterone? When they produce estrogen, there are a couple of different pathways that estrogen can go also. So that gives us the most complete picture. You can get some valid information from blood testing also. But again, that is more like a snapshot. So that gives us a moment in time of what the hormonal balance is. Whereas the urine, the 24 hour urine test is more like a movie. Right. As compared to a snapshot. And then the saliva test, again, that is a snapshot. But you can do serial saliva samples.

Right.

That gives us a little better picture. So those are useful. But in the end, again back, like with the thyroid, is the, this clinical assessment that you have, asking questions and looking at the person's body and so forth, that helps you make the critical decision? I don't use that many tests anymore. When I first started doing this, I depended on the test a lot. But at this stage of my experience, I don't really need the test so much.

Now, if we have a listener listening into this show and they're thinking that they may have some of these symptoms that you talk about and they actually are interested in getting tested, Give them an idea of if they are tested for a deficiency or for an excess, what the treatment is actually like. Do they expect to be taking bioidentical hormones for the rest of their life? How does this actually pan out for someone?

So if there's a deficiency, first we want to know why that deficiency is there. Do they have a deficiency because they have a substrate deficiency? So are they not giving themselves the building blocks that are needed to make that hormone? Is it because they're 60 years old and things have declined and are in decline? Do they have an infection of some organ that is causing that organ not to perform as it should? First we want to assess why they have the deficiency. If you have a deficiency of just because you're getting older, then that is probably not going to reverse itself. So you are going to need supplemental hormone. Right. In order to maintain your levels. Right. So that organ.

Sorry, I lost you there for just a second. I think the problem is we're having a little bit of a hailstorm outside. But you said that when you're looking, you kind of cut off when you were talking about the deficiency in the organ.

Yeah, with age. So if it's happening because of age, then then that is not likely to reverse. So in that Instance, that person will have to be supplemented with testosterone, estrogen, progesterone, dhea, whatever the hormone may be. If I find many times we find, for instance, with thyroid hormone, that the thyroid deficiency is because they don't have enough selenium or they're not taking iodide, or there's an infection in the thyroid. And once that is addressed, then thyroid function comes back on board and we can reduce or even eliminate thyroid replacement. So again, it's about the core reason, the fundamental reason why that hormonal deficiency is there, that dictates whether that person will need to be on it for an extended period of time.

Are there specific resources that you would point the audience to to learn more about these considerations?

So there's a very good book by a friend of mine, Mark Starr, called hypothyroidism type 2. That is the book that I would get first because this is such an epidemic in the United States and it's so critical to peak performance. So thyroid hormone controls your ability to metabolize sugar. Right. So that's we're talking, you know, oxygen, spark plugs and combustion there. Right. So that's particularly for US Athletes. I mean, that's key. That book is very good to read. There's a Dr. Jonathan Wright that has a very good and readable for the layperson book on hormone replacement therapy aimed at women. It's called Natural Hormone Replacement for women over 40, and I would say for women over 27. Actually, these hormonal deficiencies could happen at any stage in life. Some people are born with hormonal imbalances right out of the womb. So it really doesn't matter about your age. It certainly increases with age. But when we see women having these PMS problems and problems with depression and kids with overweight and ADHD and those type of things, many times those are hormonal imbalances that can be corrected. But his book is very good and readable. I mean, it's only 60 pages. It gives people a good foundation of information that they can then just have a good discussion with their doctor where they go in with a little more information. And this is something that I would definitely recommend for everybody. Before ever going in to talk with a doctor, you need to arm yourself with a little information so you kind of have an idea, at least about how the conversation should go. And you're not just taking information from the doctor, because there are a lot of doctors out there that really don't have a clue about the specifics of hormone replacement therapy and optimal fitness and that type of thing, that's not how we were trained in medical school.

And of course your website, Dr.fit.com and.

That'S spelled with two T's.

I'll put a link to that in the show notes. I'm going to put a few pictures of Dr. Fitt as well. He obviously practices what he preaches. And you have a quote on your website that I'd like to finish with and hear why you, why this is your favorite quote.

What is that favorite quote, Dr. Mitchell?

Let me see now, I have a couple of them. I'm not sure what.

Dr. Well, the one that I'm looking at says you'll never medicate your way out of the diseases you behave yourself into.

Correct. Again, it was my experience with my high blood pressure and I tried to medicate my way out of that. And this is what we've been trying to do for years and years here in medicine is give people these medications. But what we're to take away these diseases like high blood pressure, high cholesterol and so forth. But what the medical literature is very clear about is that our most effective interventions are when we get people to change what they eat, start to exercise, get rid of the cigarettes, reduce their stress. So these so called behavior modification techniques, that's really the answer. So you got to behave yourself out of the diseases that you behave yourself into.

And you know, if I could add, I see a lot of people who would appear to be healthy on the outside because I coach people like Ironman triathletes. But you sit them down, you start to talk to them and you find out that they're actually struggling with a lot of the things that you talked about today with fatigue or with poor energy levels or insomnia. And so I would just tell people out there in the audience if this describes you, then delve into some of.

These resources that Dr. Mitchell talked about.

Today and educate yourself on a little bit more than just say fitness and healthy eating. That's a fantastic place to start. But sometimes it goes a little bit deeper than that.

Right, Dr. Mitchell?

That's correct. Again, you got to think of your body as a machine, a Formula one race car. And again, particularly for those that are out there at athletes trying to seek optimal performance, you have to know what are the integral parts that allow you to have optimal performance. And these hormones are a huge key. The nutrition is a huge implementation also. So you have to understand those basic things going in before you are able to understand the things that you have to do in order to get peak performance.

All right. Well, Dr. Mitchell, Chuck Norris's ex sparring partner and an expert on nutritional medicine and bioidentical hormone replacement, thank you for coming on the show today.

Thank you, Ben, and keep up the great work. A lot of people need what you're doing.

All right, we'll talk to you later.

Okay, bye.

Bye. What a fantastic interview with Dr. Fitt. All right, let's wrap it up here. Remember, the BenGreenfieldFitness.com CD is available from BenGreenfieldFitness.com or just click on the link in the show notes to this episode. All of the things that I mentioned during the listener Q and A are available again in the show notes. Remember, if you're a triathlete, go to the website, go to the post that came right before this podcast and tell me, why do you do triathlon? Just leave a comment there. Check out that shape 21 lean body video and get registered. It's completely free for the Shape 21 Lean Body Challenge. I'm actually sending out a free book as well when people register for that challenge, but that's going to be a pretty neat deal. 63 day fat loss challenge going into summer. And then finally next week we are going to be featuring an interview with Dr. Cody Dahl on live cell blood analysis. That should be a really, really interesting interview. So Amir, if you have questions or comments, you can a comment or on the blog or you can email me ben@bengreenfieldfitness.com and until next week, this is Ben Greenfield signing out.