Real Talk on Hormones & Hot Flashes with Humor with Carrie Jones

Humor, hormones, and hot flashes all at the same time. What could be better? Tune in, this episode is bound to be lively. Most of you know I usually record the intro when I do a guest interview after the fact, so I'm teasing some of the content that comes from it today. I don't think I need to actually. This is about 4 minutes before we go live, and I am so excited for you to experience today's guest. Most likely Most likely you could be watching this one on YouTube. We don't post every single episode to YouTube anymore. This one, most likely we will because it is the perfect trifecta. She's a great educator. She's an entertainer as well. And I think when we laugh, we learn better. You'll hear me ask her about that today, I promise. But don't miss this one if you have questions and/or you just want to get the scoop on hormones and hear it from an industry expert, Dr. Carrie Jones. Thank you so much for being in the house.

Oh my gosh, thank you so much for having me. This is going to be so— I'm just excited.

Okay, well, and I should tell everybody, I want you to picture this in our— in your head. This is how we met, literally, and it was like the universe talking to me. So we were at an event and 2 different people said, have you met Carrie Jones? And I interrupted. It was like I interjected between a conversation. And then finally it was like, I'm supposed to talk to this woman. And then I saw her on stage. So I hear you and I'm like, of course I'm supposed to. Like, she just, she so resonates. And so I want to start right there. I mean, you have this such fun methodology, the way that you teach, you use sarcasm, you use humor so brilliantly in your education. And so it didn't slip by me that you're doing it, but I want to know, is this just you? Is that just, you couldn't help it if you wanted to? Or do you find that the humor actually helps women maybe learn a little bit more and take action on what they learn?

All the above. I think I'm hysterical, whether my husband likes to admit it or not. And I'm also 48.

Late.

I'll be, you know, 49 in June and going through it real time with everybody else. And, you know, sometimes you just have to laugh and you just have to make fun of it and you just have to roll your eyes. And I've been doing this a long time. I've been a doctor for 20 years, the entire time in the field of women's health and hormones. And so I find when you add in the humor, like when you just call it for what it is and you just recognize and you create analogies and you're you, you know, you tongue-in-cheek roll your eyes. The entire process of aging I take seriously, but like not too seriously, because when your ears are itching and, you know, you smell sewer smell out of nowhere and you wake up at 3:30 in the morning, you're like, is this a joke? Like, what the heck?

Rude.

Yeah, exactly. And so what I get from that is, number one, you're a woman who laughs at her own jokes. Yeah, I get that. Totally.

Yeah.

And I get accused of that. Like, go ahead, just do the laughing. I know you're waiting. Okay. Okay.

Okay.

So we would get along so very well. Yes. And I totally agree. And we're in a moment where so much of what we're doing and talking about gets so serious. And yes, I want to— we're talking health and hormones and hot flashes and all the things. But I also want to ask you this right out of the bat, because I think we're talking both things. What we do right now, how we menopause, is really going to determine our longevity. And I don't know that we've ever thought about it before this, but these— it's like these two things are merging right now in time. And do you want to live to 150?

No, I do not. I, I realize all of these young longevity folk would love to. My family does live a long time. My husband calls me disciplined. He's like, you're a very disciplined and particular person. And I said, you know what, I have to be, because again, 3 out of my 4 grandparents have lived to their late 80s, early 90s. Even my mother-in-law's in-laws in her mid-90s or mid-80s, chugging along. And I said, I don't, I don't want to be, if I can avoid it, in a wheelchair. I would prefer not to have dementia. I would prefer to be mobile and active and, you know, causing trouble and laughing loudly. Like, that's what I would prefer to do. And so I started a long while ago in my health journey, but to be fully transparent, no, living to 150 and, you know, looking like Gandalf the Grey, like, no thank you, I'm not interested.

Right. And I find it so humorous, almost humorous or sad, I don't know which, but like we're theming here, better to laugh than to cry about it. We are spending, like, culturally, collectively, the big we, like, it seems like we're spending a lot of time talking about how to biohack so we can live forever, and then our day-to-day is not all that great. Why? Yeah, what are we doing?

What the heck? I just want to live well. If you see, I'm sure you've seen the card, it's the quote, it's, it's like, I want to arrive, you know, to the end of my life or in heaven skidding sideways. Yes, laughing, woohoo, what a ride! Like, that's how I want to do it. I And if it happens at 90, great. And if it happens at 80, great. You know, like, that's how— but at 150, it's like, oh my gosh, I'm only 48. Yeah, 102 more years. It— maybe I have the wrong mindset, but God bless them. I'm glad we have people like that. I just like to live well. I don't need to live forever.

Amen. Yes. You know, when everybody says, yeah, I want to age gracefully, I'm like, I don't. I want to age gracefully. Right. I want them to raise their eyebrows. I want to— yeah, yeah. Okay, recently, 20 years, you have coached a lot of women through this. How are you personally being in the rowboat with them? How are you managing your own midlife transitions, and what have you noticed?

I'm gonna knock on wood, I feel like I've been managing it really well. But I also, you know, like yourself, I had a, I had a big window into it ahead of time. I knew what I— I knew what was up ahead of me and what I was getting into from a younger age. I started working in women's health in my late 20s. I graduated from medical school when I was 27 or 28. And so I had the absolute luxury of all the women ahead of me who were like, you just wait. All my patients, you just wait. When you turn 45, when you turn 50. And I was like, no, it's not— that's not true. And sure enough, they were right. And so I got to watch the wonderful women ahead of me in the next decade ahead of me go through it so that I could make adjustments. And so that's, and, and I say all the time now, the Gen X and the millennials who were going through it, you know, like we once again are building the fort from scratch, but yet, but our, our daughters and our granddaughters and the subsequent, it'll be so different. It'll be so much easier. We will have so much research and so many things and it'll be common knowledge and it'll just be so much better than us paving the way right now. So do I get symptoms? Yeah, absolutely. My first symptom was brain fog. I went to— I had a brilliant idea. I was 44. I had a brilliant idea. I was like, oh, let me open that tab on my computer. And the time it took me to put my finger on my computer mouse Yeah. I don't remember what the brilliant idea was. Yep.

And I was like, wait, no, hold on. That was a brilliant idea.

And I thought, oh dang, this is perimenopause. And then I stopped sleeping. You know, I'd wake up 3:30, 4:30 in the morning and I've had phantom— I would get itchy ears that come and go. And then I had a really wonderful OB-GYN, Dr. Lakeisha McMillan. She said, have you had phantom smells yet? And I was like, phantom smells? What are you talking about? And then one day I stood in my room and I could smell the sewer. So I just assumed must be the bathroom, right? Go in the bathroom, I could smell sewer. My husband comes in, I'm like, do you smell that sewer? Like, we must have something wrong with the drain, the trap. He's like, Carrie, I don't smell anything. So there's me shoving his head down the sink like, smell harder!

You don't smell the sewer?

What's wrong with you? And then I called Dr. McMillan and said, yep, I have phantom smells.

Oh geez. So I want to say that was like maybe like placebo effect.

Okay, isn't that funny? And so I have— so I've been working really hard on this whole transition. What can I do? What, what's the most bang for my buck? You know, I'm on progesterone, the hormone. I still cycle regularly for the most part. And so how I take care of myself, what I prioritize, a lot of that's just continued to shift and evolved with age.

So speak to that. So given you dabble or deal in hormone therapy— you push her— what, what's the best time? And I mean, I'm going to ask a three-pronged question. So as a host, I apologize in advance, but they fit. So it's good. So number one, what's the best time for a woman to start hormone therapy? If she misses that window, What's the next best? And then for my listeners who are— they're 10 and 14 years past menopause and they never got that option, so many of them say, is it too late?

Yeah, such a good question.

Unpack all that.

Such a good question. So I am in the camp— well, I'll tell you what the guideline says. The guideline says if you're going to start hormones, you should start them within 10 years of your last menstrual cycle. So if your last menstrual cycle is 50 years old, then somewhere between 40 and 60 you should start hormone therapy. That's within 10 years, right? I have always been in the camp of like, the sooner the better. Why are we waiting? Because that means less time with hormone. This is assuming somebody wants hormones. I realize not everybody wants them or can do them, but let's say you want them and can do them. So the sooner the better. Don't wait, don't suffer, don't go without. Then we have women— I have women that are in their 70s and 80s that I consult with who are like, I still can't sleep, and I still sometimes get hot flashes and night sweats, and I'm having a lot of anxiety, and in fact I'm having a lot of vaginal dryness and urinary tract infections and all these things. I don't think it's too late. I do work them up. The most important concern we have is in the cardiovascular So I'm checking for plaque, I'm evaluating lipid profiles, cholesterol panels. But I, I managed to sit next to one of the, one of the amazing Alzheimer's and dementia researchers, Dr. Dale Bredesen. I sat next to him at a dinner. And I mentioned that I get consults from his trained practitioners who say, you know, Carrie, I have an 80-year-old that I, that I'm working with, and I think I'm going to put them on hormones. What do you think? And before I could say, Yes, do it. Dr. Bredesen was like, yeah, do it. And I was like, okay, that's what I said. Yes. And, and they're seeing benefit. Now, we don't have the literature behind it. I, I do want to make that clear. Hormones aren't a primary, um, prevention or treatment that we know of yet for dementia, Alzheimer's, or even heart disease for that matter. But we do know there's significant benefit for starting early, and there can definitely be, in my opinion, benefit even if you're too late. Now, if you're listening and you're 10 to 15 years out, you're 60, you're 65, the same thing applies. If you're listening to these, having symptoms, and you're like, gosh, I have all those symptoms still. Or maybe you don't even have hot flashes, because some people think the only symptom is hot flashes. Maybe you're like, gosh, I still can't sleep. I'm having a lot of vaginal symptoms, or anxiety, or I too— I totally get phantom smells, or my ears itch, or whatever it is. And you're interested you, you still qualify. Like, you can still talk to somebody about going on them. They've gotten rid of that, like, once you're— once you're too old, you're too old. And then if somebody's on them, I get the reverse question: I'm on them, do I have to stop them?

Yeah.

And the answer is you don't. You have to check in with your prescriber, you know, make sure you're on the right dose and following up. But I have a number of patients that are like, you're going to pry this out of my cold dead hand. Like, I am not giving up my hormones.

I love her. Yeah, her or him, I suppose.

Yeah.

Okay, so come back to that just for a second. So we've got somebody who just asked me this today. So this is getting very personal, and you may or may not be able to answer, and totally understand it. Apo(a), somebody's got that, and she is— LP(a). LP(a), and she is 10 years post, and she's wondering, like, somebody immediately put her on a statin, and she's like, and I'm not on hormones, but I have all these— she has all these symptoms. And I said, you know, I'm not a doctor, I can't advise you, but I do encourage you to ask questions about is there still an open door for you, and/or is it higher risk or not higher risk? Is it higher benefit? What would you suggest she ask, or how would you answer either way?

So this is what's interesting. When they look at the research on lipids heart, cardiovascular, a lot— majority of it's done on oral, swallow the estrogen form, as opposed to apply it as a cream or put it on as a patch. And what they found is really, other than triglycerides, swallowing can improve lipid markers. But of course, it also— it can increase triglycerides, and it can increase clot risk. So somebody who's 10 or 15 years post, really, no matter what, we don't generally use the swallow in a pill form. And this is important to know because a lot of primary cares in conventional medicine think that the oral pill form is the only option. Like, like, because it's easily prescribable, it comes in, you know, 1 milligram, 2 milligram of estradiol, and I'm just going to prescribe that. But they know there's some heart things with it, so they'll go, oh no, no, then I have nothing for you, which is not true. We have the topical. Now, the topical may not make a dent in the Lp(a), of course, or the heart, But that's not what we're using it for in her case. We're using it for the other women in menopause symptoms that she's having. So the estradiol cream or gel, the patch, if she's being managed well on a statin or Zetia or whatever she's taking for Lp(a), then yes, I would absolutely talk to her about like, let's not do the swallowing form, let's do the topical form. And here's the great thing. We can keep an eye on your cholesterol markers. Like, I can send you to a lab very cheaply to get a repeat, and we can make sure your Lp(a) and your cholesterol markers at large are not going in the wrong direction. So it's something we can actively monitor.

I love that. And I guess what I want to ask you is, um, so help me articulate this, but I think we're at a moment where there's, there's Western-trained medical physicians, yes, who maybe are limited in their scope or their knowledge and ability to, to either test or to prescribe because they simply haven't learned it. Not necessarily their fault, it just wasn't dished up in medical school. And then there's, okay, I'm a functional medicine doctor, this is what I've been trained in and do. And I think for I think for any consumer listening potentially who hasn't crossed over, there is a little bit, well, can I trust them? 'Cause even their Western doctor is saying, oh, that's voodoo in some cases. I mean, where will we get this merging of these two in this piece? It feels a little bit like there's sides right now.

I feel it's gonna take time. It's just gonna take time. I think, again, That said, the Gen X and the, and the beginning Millennials, you know, they're having to pave the way first. The ending Millennials into, um, the next generation, as they come through medical school, they will have— because it's being demanded so much, because pharmaceutical companies are changing, um, because a lot of these telemedicine companies are coming up and conferences are shifting, guidelines are becoming more prominent. Then it's going to become much more common knowledge out of medical school. We just aren't there yet, unfortunately. My own family doctor, I believe she's in her 30s, and she just got into hormones. Like, she's just decided that I need to learn about this. It's all over social media, and my patients are asking me. And so when I had gone in to see her a couple of weeks ago, I was having ocular migraines, and I wanted it which I knew from hormones, and I wanted it documented in case I had to get any kind of imaging. And she said, well, you know it's hormones, right? I was like, I do. And she said, okay, well, it's time to put you on the birth control pill. And I said, oh, why? Why? And she goes, well, you're not 51 yet. When you turn 51, I'll switch you over to progesterone and the estrogen patch. And I said, I am on progesterone. Wait, hold on, why would I go on the birth control pill? But that's what she'd been trained— women in perimenopause go on the birth control pill until they're 51, and then once they're 51, because that's the average age of menopause, you, you evaluate and switch them over to something bioidentical. And I was like, can I reframe this for you? Like, can we try something different? And she was very open, but I had to really swallow my eye roll because that's how she had been trained. Now, to her credit, I'm thrilled that she's going to try to get training and learn more because she openly admits, I know nothing. But at the same time, I was like, ooh, but not that. Like, don't learn that. So I tell women listening— and I like her, I like my primary care— but for hormone distribution I find somebody else. And I'm like, it's, it's totally okay to either add to your healthcare team or even replace in your healthcare team. If you love your OB for OB things, but your OB is much more OB-friendly but not hormone-friendly, totally cool. Go find somebody who's hormone-educated. And if your OB or, you know, GP or whoever is not trained at all and actually quite condescending, I say it's the same thing if your pediatrician was mean. It's the same thing if your veterinarian was mean. You would find a new one. It's the same with you.

Yeah, that was brilliant. That was such great advice. Thank you so much. Okay, is there any woman who should not be on hormone therapy? We kind of touched on that, but could you elaborate on that just a little bit? This episode is sponsored by the Flipping 50 Menopause Fitness Specialist. It is the framework that we designed our entire membership and program based on. Since 2013, I've been developing that after 30 years of working with women in midlife. That was born, and in 2018 we rolled out the Menopause Fitness Specialist to train other fitness and health pros on how to actually prescribe exercise. Here's where we're going next, in case you want to get started now, that we're actually training physicians on exercise prescription, knowing they get very little of it in medical school, and hoping that it also bridges the gap for you who may be a fitness or health professional or want to be who works with women in menopause, because there is so much demand and so much room for you right now. If you are working with women in menopause but not getting all the results, don't have a reliable, predictable framework that gets you results over and over that people know, like, and trust, come and talk to us. We'll put the link in the show notes for today. That's the Flipping 50 Menopause Fitness Specialist. And if you want to head on over to fitnessmarketingacademy.com, it's where we have all of the content dedicated to you health and fitness pros.

So the biggest, like, hey, maybe you shouldn't be on hormone therapy is, like, active breast cancer. And in most all cases, oncologists are going to say, hey, we're actively fighting breast cancer, you shouldn't be on any hormone therapy right now. But even the BRCA gene, which is the— of course, the BRCA1 and BRCA2, which are the two big breast cancer genes, they're not the only ones, but they are the big ones that we know about— a paper came out, or was presented last weekend actually, about how they— that women with BRCA1 or BRCA2 who were on estrogen had less breast cancer. And so they were the authors of this paper were like, even if you test positive, because I hear this a lot, oh no, my, my BRCA in my family, or I tested positive for, you know, the BRCA, the BRCA, I can't do hormones. They're showing even that, like, not true. We still have to monitor, we still have to work you up. But it like this these authors were like, actually had less hormone or less breast cancer being on hormone.

So yay for them.

Now we have to be aware of things like clot, you know, like if you've— you have a blood clotting disorder, you had a clot in pregnancy, you thick blood, you know, do blood testing for this marker called fibrinogen, which is like sort of the stickiness of your blood. It's really high. It just means we don't use the oral form. Don't swallow your hormone of estrogen. We'll do topical instead. So then it may help direct our route for you. We are careful with estrogen if you have weirdo bleeding we can't figure out and we're concerned. So if, like, let's figure out where the weirdo bleeding is coming from, um, before we add in more estrogen, because that can often make it worse. So there are a few, like, and you'll see people go, well, what about high blood pressure? I'm like, if your blood pressure is controlled, then it's not a contraindication, you know, same LP(a), if things are controlled, like, you can still use topical, you can still use the patch or the gel. Again, when it comes to estrogen, progesterone is generally at large considered safe.

Talk about the breakthrough bleeding. This is a little off topic, but yeah, during the pandemic there were so many women who like would have a breakthrough period, like they're postmenopausal. I did. I'm like, what? Like, I'm spray painting my grays in my hair because I can't get a color and I have a period? Are you kidding me?

Rude. So not fair, right?

Yes.

So a couple of reasons. Um, well, stress being a really, really, really big one. Breakthrough bleeding with postmenopausally can be a couple of reasons. The most common are a polyp or a fibroid. They have decided to grow, they get stimulated They're generally stimulated by estrogen or estrogenic things. So that could even include plastics, parabens, phthalates, like estrogenic environmental type chemicals can cause them to bleed. A worst case scenario would be something called hyperplasia. If it develops into endometrial or uterine cancer, hyperplasia just means thickening. And if it progresses, progresses, progresses, You know, God forbid we could develop cancer. However, having said that, in cases of what I have found really significant stress or illness, you know, people got COVID and then they're like, what the heck brought my period on? There is a misfiring communication between the brain and the ovaries and the uterus. And then women are like, I started spotting, like, what the heck is this? I'm like, oh yes, extreme cases. And I would classify our pandemic as an extreme case. It's also not uncommon to spot or bleed after vaccination, and that's any vaccination. So women who got the COVID vaccine, but even like the flu vaccine or tetanus— you got a tetanus booster— I like have had lots of women who were like, uh, that screwed up my period, or it brought on bleeding, or, you know, it just shifts the immune system enough that for some women it manifests as bleeding or spotting.

You mentioned estrogenic, and I want to ask you about that. So soy, at one point Gytrogenic, estrogenic. Um, do we still think that? Is that kind of old school? And/or the relationship between potentially hot flashes, night sweats— there are a lot of people who believe, no, this is great, I should get more of that. And then the other school of no, no, no. I have found it go both ways, but most often I've had clients with hot flashes and night sweats and we just cut it out. Let's try this because we got nothing to lose. And they, they proof.

So soy— the— there's some components of soy, and I didn't name them, so bear with me. So there's genistein and daidzene that are in, and they're, they're phytoestrogens. They have to be broken down by the stomach acid and then the microbiome in the GI tract. And not everybody has the microbiome in their GI tract to break it apart to get the phytoestrogen content. So yes, is soy, when it breaks down, considered a phytoestrogen?

It is.

Is it the same percentage and strength as an estrogen in your body, like an estradiol? If you take estradiol replacement therapy, is it the same thing as soy? It is not. So if we— I mean, just easy numbers. If you have an estrogen receptor and estradiol binds to it, that's 100. Like, big fan, best friends. They fit together like a lock and key. Got it. The, the phytoestrogens from soy are much, much, much lower. They're like a 10, maybe a 5, you know, on the scale up to 100. So if you don't have any estrogen in your body, some women love when they add in phytoestrogens, ground flaxseeds, again, soy products, fermented soy products, because at least they get 5 or 10% on the receptor as opposed to zero. But if you already have good levels of estrogen, or you're taking estrogen as a therapy, then it's possible that the soy could bind to the receptor and take the place of your actual estrogen. So instead of getting 100, which would make you feel better, because that's what you're looking for, you only get 5 or 10%. So I have had women say, I feel way better when I do soy products or phytoestrogen products they probably were, you know, really low levels of estrogen, close to a zero. And so they're like, they get a little boost, a little bump, and they're like, oh, I feel so much better. Whereas other women are actually using estrogen or have estrogen still cycling in their body, and then their phytoestrogen is taking the home of the estrogen, and then they're like, well, now I, now I feel like I have low estrogen because it's their actual estrogen can't bind. I, I never— I don't— I'm not vilifying food at all because now people I know go, well, I'm gonna stop soy, I'm not gonna eat flaxseeds. I'm like, no, I get it. But also, how much are you doing? Because sometimes, sometimes people, when you tell them something's good, they're like, cool, I'll do a million, right? So suddenly everything is soy. Soy milk, soy protein powder, soy bars, tofu, edamame, tempeh. Like, all of a sudden their whole— and you're like, soy burgers. You're like, stop, stop, just enjoy it. Just enjoy some edamame sometimes. Just enjoy some tofu stir fries sometimes. Don't make it your lifestyle.

Don't go crazy.

Don't go crazy. Yes, it's the same with ground flaxseeds. Don't put it in everything. Yeah.

And so you kind of describe this musical chairs, right? So it's like not everything can sit on the receptors. Somebody's going to sit down first, so you better decide which one you need or want. Got it.

Yes.

And it's— and it still kind of sounds like it's back to each individual woman. Test, test it. It, see how you feel.

100%.

If it feels better, keep doing it. If it doesn't, stop.

Yeah.

Hello.

And again, I've had— you probably have too— plenty of women who were like, you know what, I'm going to ramp up my, my phytoestrogen foods. And they say, I feel better, I feel great. I'm like, fantastic. And then other women, just as you said, are like, I feel worse, I actually feel low estrogen, I don't like how I feel.

Yeah.

Okay, then let's dial it down. Let's not do that much.

Yeah. Okay, I'm going to ask you a topic. I don't know that's fair game, but I'm going to do it anyway because that's the moment we're in here.

Because here we are. I know.

So we're at the end of this era or the beginning. I don't know which it is, but a lot of people say GLP-1s are going to be like in vending machines. It's so popular, you know, and so easy to get your hands on. There's the lovers, there's the haters, there's the influencers shooting up on Instagram saying, you know, almost like a persuasive argument, like, don't you want a body like mine, here's how I got it, right? What do you think is— what are we going to see? Usually it's, you know, 5 or 10 years from now we're going to see something.

Will it be good?

Will it be bad? What is it?

Well, what's interesting is GLP-1s have been around a long time, what, like 20 years? You know, it's just not been used to the degree that it's used now where it feels like everybody has one or is on one. And with GLP-1s, so I'm It's very much like the phytoestrogen conversation. I am totally okay with it, but it does come with like, what is your dose? How often are you doing it? Are you doing the other things to— for success? Are you building muscle? Are you getting enough protein? Are you hydrating? You're taking care of all the foundational things? Are you diabetic? Are you not diabetic and just have stubborn weight to lose? Are we microdosing because of inflammation and autoimmunity? Are we macrodosing this because you have significant diabetes and insulin resistance? So you can see it's definitely a nuanced conversation. And I think we're going to see the biggest fallout in the people who are using it as a quick fix, where they're— they are dropping weight, which is great, but then they're not building the muscle. So now they're becoming what we call sarcopenic, and they're not getting enough protein, and they're not taking care of themselves. And then they go off of it, and their own GLP-1 in their own body is a mess. And so we see people who are like, and I gained it all back, and I'm hungry all the time, I guess I need to go back on it. As opposed to somebody who is doing it more thoroughly, I would say more foundationally, Even the people who microdose it, we say the same thing. Even if you're doing really tiny doses, more for inflammation, autoimmunity, maybe to lose a little weight, I'm still asking, are you lifting weights? Are you eating enough protein? You know, because if you're on a GLP-1, but you're still drinking, smoking, straight West Coast, like, it's going to be a disaster. It's those people we're going to see are the disaster.

Yeah, I think too, um, I've had a few people who are the opposite. Like, they weren't eating too much, they were actually already eating too little but struggling with weight loss. And their doctors very willingly put them on it. And I said, "Did you have a conversation about the fact that you get full, like, really quickly? Like, you're barely eating enough as it is?" Because that's a huge concern. Like, what are we— we're going into a caloric deficit when you've already had one since 1985. That's not good.

That's not good. And it's only going to add— and I'm sure you've seen this— it's only going to add to that disordered eating pattern.

Yeah, for sure. Yeah. Okay, I would love to ask you a few rapid-fire questions.

I'm ready.

Okay, how important is protein in the scheme of things for women for aging optimally? 0 to 10. 10 is great.

Um, I would say it's an 8.

How important is hormone therapy for longevity?

So, okay, I feel like I have to caveat this. I would, I would say it's in the 8 to 10 because a lot of people would say 10. They're like, you have to do it. But we all know a lot of women who've not done it and are doing pretty okay. So I don't want women to feel like you absolutely have to, you are not a cool kid if you don't do it. It is immensely helpful. I am pro-hormone, and you should probably consider it. But sure, there are women who don't do it and do fine.

How much is stress management important to longevity?

100. Hmm.

Okay.

100.

Telling. How important is sleep?

Oh, 101. If I had to pick, like, if I had to pick anything, sleep is the first thing that I would pick to focus on.

Resistance training?

10.

High-intensity interval training or sprint training?

Um, I'm gonna say like 6 to 8 because I'm a big fan of it, but not every day, maybe once a week.

Walking?

10. Awesome, get your steps in.

What question didn't I ask you that I should have?

What question didn't you ask me? Oof. I still get asked the question. You probably do too. Like, that sounds great and all, but hormones cause cancer. Or my mom went on hormones for a month or two and developed cancer. Or my friend, my friend went on hormones and she developed cancer, therefore hormones cause cancer. And that's still a whole big fear. One, around how is cancer formed in the body, and two, hormones as a big— is a big umbrella when it comes to cancer. Cancer is complicated.

And I would say that there are a lot of people who can attest to the fact that maybe even physicians in this space who have had cancer and are on it and claim the hormones have been life-saving for me.

Yes. Yeah, most definitely. So now we're even learning about like testosterone, you know, testosterone breast cancer. And if your testosterone levels are good, seems like you have better outcomes. Estriol, which is E3, estriol binds to estrogen receptor beta. Which is the other main estrogen receptor that is much more protective. So how do we support that? By using estriol. Estradiol itself inherently is not cancer-causing. However, what we fail to talk about are the huge amounts of endocrine disrupting chemicals that have to go somewhere in our body, and they often end up in places of fat, like in our breast tissue. And they dysregulate all sorts of systems and contribute to the cancer discussion. But yet it all comes back to often, well, estrogen causes cancer. It's a one-to-one. That's what's causing it. I'm like, oh no, it's so much— cancer's complicated. And cancer's generally slower growing. So if you start hormone therapy in January and God forbid have a positive, you know, biopsy for breast cancer in February, It's not the hormones. Cancer's been simmering for a long time before it gets big enough to see.

Hormone disruptors. What's the biggest, biggest source of them that you think most of us are exposed to and maybe take for granted? We're just bypassing, missing that.

I think it's a couple of fold. One, I think it's the air pollution because we don't really have any control over it and we don't necessarily know it. So for example, I live in an area that has a lot of forest fires in the summer. I can smell the smoke, so I'm aware of that chemical.

You're sure you're smelling the smoke?

Well, I— well, see, that's a good question. My phantom smell. If my husband says it, it's true. We have smoke. Okay, but smoke is a phantom smell. People need to know. But other, other environmental toxins or airborne pollutants we don't necessarily smell. And especially if you are in like around farmland or places where people spray, they're intentionally made unscented, and then you have no idea, and then you breathe it in, or it lands on the ground and you track it in and your shoes or your pets bring it in. I mean, unfortunately, that's a big one. The second one is fragrance, and fragrance is a hard one because everyone likes things to smell good. And so your detergent, your cleaning, and your skincare in the little tree, in the plug-ins in your car, in your house, or the Uber you just got out of, and the hotel you stayed in. And just everything is covered in some sort of— for the perfume and the cologne that you wear, everything is covered in fragrance, which is an endocrine disruptor. And the final one, which I think, again, these are like the hard-to-control things, are the plastics. I think we need plastics. I think of all the medical supplies you know, that we required. We couldn't do it with metal or wood. But at the same time, the— it's just ubiquitous, and it's so— it's so endocrine disrupting when they get into our system. I think— what did they say? We have a credit card amount a year plastic in our— it's like, what? Ew.

Like, right?

Like, what? Yeah. And plastic doesn't break down. Hardly. So it doesn't really break down in our body either. But man, is it causing problems with a lot of our enzymatic reactions. It's a bully, and it doesn't have the same feedback. Like, at least estrogen is like, okay, you know, if somebody— if progesterone is there to counteract estrogen, estrogen's like, all right, cool, I got you. The receptors, you know, like, they— everything communicates in the body. Plastic? You think plastic cares what the hypothalamus thinks? Or what the ovaries are. No, it's gonna— it's a bully. It's gonna do its own thing. It's not inherently part of the system, so it doesn't know better.

So if there were 2 or 3 things that a listener were thinking, okay, if I were going to take action— there is so much. Yeah, you know, to do, and she's already got, you know, 15 things and 15 people knocking on her door saying, I need this from you. What, what would be be some of the biggest positive impacts that somebody could make in their immediate environment or their, their day-to-day schedule that might make the biggest difference?

One, when we go to the fragrances, I think that's a hard one for people because they like decorative candles and they like their plugins and they love their perfume, you know, that they put all over to smell good, and they have everything scented, especially, you know, as we record this at the holidays, everything's scented for the holidays. And if we can cut that, you know, get rid of your decorative candles, or be careful of the kind of candle that you buy, be careful of the amount of perfume that you are using, or for him, cologne, the plugins, the scented detergents and things like that, just being really mindful of it, take stock of it first. How much scented do you have all around you all the time that you're breathing in? And maybe start to weed some of that away. Read labels so that when you run out of something scented like detergent, maybe next time buy something more clean, more healthy. I'm not saying throw everything out now because that's very expensive, but, you know, just start to pay attention to those things when it comes to— and then we talk about the basics, right? Drink out of glass, use stainless steel. Store your food. Don't use plastic. Don't heat in the plastic wrap. Try not to use plastic water bottles all the time. It just— it's, it's, it doesn't have to necessarily cost a lot of money because, you know, people will talk about like, well, you should get air filters or air purifiers or water filters. Sure, that's great if you have the budget, but if you don't, let's start with these manageable things that you're already doing and like start to pare down, start to shift. Start to make different choices and start there.

Do you notice— so you're a woman who's probably walking the talk, you're doing all these things. So you get a patient that comes in and she smells all wonderful, like she just walked out of, you know, Saks Fifth Avenue perfume counter.

Yes.

Are you negatively impacted? I—

it depends. In the spring I am because I'm usually very allergic. It will set off my histamine response and I'll start like sniffing for sure. But I have— I feel like I've done enough work in my body. For those who don't know, when you breathe it in, it goes to your liver and it has to go through— it gets processed through phase 1 of your liver and then phase 2 of your liver, and then you get rid of it. And so if you are stuck getting from phase 1 to phase 2, if there's a backup there, That's when people usually say they're very scent reactive. Like, they're like, oh, I can't even go down the detergent aisle of the grocery store. You know, I can't handle perfume. I get a migraine, I break out, I get hives. I get, you know, that usually I'm like, oh, we have a liver issue trying to get from one phase to the next. You are stuck and it's, it's building up, it's backing up and causing issues. So we can definitely thankfully work on that, support the liver. To process it through.

Amazing. Yes, amazing. Okay, tell everybody what, what projects you're working on, any stand-up comedy in your future, or where can they find you and follow?

No stand-up comedy, nothing, nothing, nothing other than conferences. Um, I am at drkerryjones.com. You can find me on Instagram @dr.carijones. I am on YouTube at Dr. Carrie Jones, and I have a podcast which is Hello Hormones with Dr. Carrie Jones. But on my website is basically the link to everything, including, um, even like ebooks. A lot of the things we've talked about, like either labs or symptoms or going through, I have all that for free on my website for women to quick grab and learn for themselves.

And I would be remiss if I didn't ask this out loud, because often this is the next question. They meet you, they like you, they think you're funny, and they want to work with you. Do you do telemedicine, or does somebody have to live next door to see you?

You— unfortunately, I do not do telemedicine at the moment. I saw patients for a long, long time and am not seeing patients for— for basically I'm educating. I've written a book that will be published in September of 2026. A lot of travel, a lot of building of a platform for education for people, because one-on-one is amazing and I loved it. But also when you find yourself saying the same thing every day, as you know, I was like, you know what, I think I need to back up and get more into grander, broader education. This information needs to be out there. Mm-hmm. Beautiful.

Well, we can't wait. So come back in September, share the book with us, and we will be sure to share it with our audience too. Thank you again for being here. Thank you for having me.