Menopause: Symptoms, Hormones, Tests & Solutions with Sage Workinger-Brecka & Gary Brecka | TUH #227

When you're in your 30s, you're not thinking about menopause. I kept thinking, I'm not old enough to be in. It turns out you can be in perimenopause in your 30s.

The issue with menopause is that lots of things can crash at the same time. One of the things we noticed was rapid shift in mood, exhaustion in the morning, brain fog. Vito left the building, and you were just not the same person.

And I think it was just like a feeling of being overwhelmed constantly. And I kept thinking it was because of something else. And I think the main thing that forced us to really look at it was my frozen shoulder. My arm was stuck right here for almost nine months.

And just so you know, we were doing all the things. Red light therapy, sauna, cold, plunging. We have a hyperbaric chamber. She eats extremely clean.

When I went to doctors, so we tried acupuncture, cupping, physical therapy. I mean, we tried so much stuff.

When we did this Dutch test, getting that test was a game changer. When it came back, it explained everything.

And I remember, like, crying with you when we got all these results back, because you saw it finally. It wasn't just me saying, I don't feel good. You were, holy cow. I can see it in the science.

What were, like, big signs that you would say, okay, if you start to experience this, women, this is when it's time to get your hormones checked.

I think one of the main things was.

Ultimate human. Oh, boy. Welcome back to the Ultimate Human podcast. Today is a woo. This is a really special one, guys. I'm not sitting down with a PhD, an MD, a researcher. I am sitting down with my life partner to talk about menopause. I'm already scared. But we have been asked to do this podcast for years. I think that menopause is one of the most underserved areas for women. Um, we just went through it, my wife and I.

We are still in it.

But yes, we are still in it. We are sitting down, my wife and I, my life partner, my confidant, my best friend. We are sitting down to be very, very vulnerable about our menopause journey, including the testing. What did we do about it? What was it like going into menopause? What has it been like since we've solved the menopause issues? What hormones did Sage take? And I think every woman and every man should watch this podcast, because if you're not there yet, you're going to be there soon. So welcome to the podcast, Sage Breca.

Thank you, babe. I appreciate it. It Was quite the intro.

It's great to have you. My audience loves you.

Thank you.

Love me more, but they love you too. But guys, we decided that we would be super vulnerable on this podcast because there are lots of couples going through this. Women have a really difficult time getting answers. There's so many questions about menopause. We what do I test? How do I test for it? What should I be taking? Why do I feel this way? Why did libido leave the building? Why is my skin elasticity also leaving the building? Why is my mood and emotional state off? Why do I feel fits of anger for no reason at all? And it's all related to your hormones. We tie it all to the specific hormones and the best of all, we give you the solution. So I'm really excited to run this podcast.

Thank you.

Now that we're kind of on the other side of it, babe. We really are.

I mean, it's been 90, no, 60 days maybe. I mean, it's pretty small amount since I started hormone therapy, but there was.

Quite some time before the hormone therapy where we were in the thick of it.

We were really in the of it.

I did a lot of apologizing. Here's my advice for menopause. If you're a man and your wife is in menopause, as soon as you wake up in the morning, just say you're sorry. Say you're sorry. Yeah.

Just for waking up.

Just for waking up.

Cuz you probably did it wrong.

You probably did it wrong. Maybe you, maybe you sniffle messy. Maybe you moved the bed too much when you got out of bed. Maybe your feet hit the floor so hard that it was rude and inconsiderate. And we're just rude and inconsiderate.

Yes.

We're like bears. And so when we wake up, we get out of bed and seems like.

A normal giant children that are just loud and messy.

Yeah. But definitely don't burp.

No, don't do that.

Don't. Don't leave dirty dishes in the sink. If you wash the laundry and fold the laundry, put it back where it belongs, not in the wrong place. So yes, you can wash the laundry, you can fold the laundry and you can put it back where it doesn't belong. Everything is wrong. Okay, so we've covered some groundwork. There's a lot of good advice in here for men. I'm going to help you, help you get through this. I'm going to write a whole book on it. Navigating menopause for the average male.

You guys actually do need a book. I feel bad for guys because the.

Problem is you feel really bad for me.

No, because we didn't know what was going on with me. And you can attribute so many things to other things. So if I was really upset about something or really sad about something, you know, maybe we'd go, oh, well, you're, you know, PMSing or because you didn't sleep well that night. Or, you know, you can always just find another excuse as to why it's happening. But it got really intense over the last year, and I think the main thing that forced us to really look at it and start reading about it was my frozen shoulder. So the only book that I read that linked frozen shoulder to perimenopause was Dr. Mary Claire Haver's book, which I think is brilliant. And it's called the New Menopause. And I think she's coming out with a new one called the New Perimenopause. Don't quote me on that one. Anyway, New Menopause has a list of, like, a long, long, long list of symptoms that I started reading through, going, oh, my God, I have that. I have that.

I have that.

And all these things I could check, mark off. And I'm like, am I in it? Because I kept thinking, I'm not old enough to be in it. Turns out you can be in perimenopause in your 30s. Like this shit. Probably. Sorry, language. But this stuff probably started happening a long time ago.

Yeah. So, you know, one of the things we noticed was rapid shift in mood. You know, Sage is totally on her game. We built a business together, we ran a massive clinic together. We've traveled the world together. And she literally couldn't remember one thing.

Not a thing. Not a single thing.

Not from one minute to the next. Words. And she had trouble with words. Sometimes I would walk in the bathroom and she would go, I just want you to know that I am furious with you, and I have no reason to be furious with you, but I'm just going to be honest, and I would go, thank you for the warning.

We sat in the kitchen one night.

I will be on the other side of the house.

And you had not done a single thing wrong. And I just looked at you, and for whatever reason, I just. My blood started to boil. You had done absolutely nothing wrong. I mean, usually you do something wrong, but this time you had not. And I was like, I don't know why I'm mad at you, but I am. But it's kind of scaring me. So I'M going to leave the room, I'm going to walk away and I'm going to go to the bedroom and just, you know, get my book or get in the bath or whatever it was that I did that night. And I've never had that happen before. And thankfully it has not happened recently. But.

So, you know, the issue with menopause is that lots of things can crash at the same time. So there are three types of estrogen in a woman's body. Not one. Most women think they just have estrogen, but you have categories of estrogen, E1, E2, and E3. And we're going to talk all about those. We're actually going to show you the test that we did for Sage, which is called a Dutch test. It's a 24 hour urine test. I really recommend that women that are in perimenopause or menopause do this test because it looks at hormonal ratios and it doesn't just look at a snapshot in time like a regular blood test might. In fact, lots of women are told that they're fine. There's nothing wrong with you. But you knew that you were, you were off. Right. And you knew that the brain fog was real. This wasn't like, I get a great idea in the bedroom, I walk to the kitchen, I wonder what the heck I'm doing in the kitchen. This was like, I literally wrote something down and I can't remember the best. My best friend's name.

Yeah, it was bad.

You're like blonde hair. I'm like Victoria. The one you've known your whole life? Yes, her.

Yeah, that one.

Okay.

That one who's also suffering along with me.

Yeah, it was awful. Who's shout out to Victoria? She's hilarious. Hilarious.

And Josh. Josh is getting through it with.

Great, great.

They're also a perimenopause team.

Yeah, Josh and I are going through it together. We text about it all the time. Trust me. So, you know, as the, as the brain fog started to hit, you know, we also noticed that when she would wake up in the morning, you were more tired waking up even after a good night's sleep than you were the night before.

Like, exhausted, like a level of exhaustion I've. I just didn't know how to deal with. And I kept again thinking it was because of something else. And then I'm laying next to you and you bounce out of bed and you're happy and I got a 99% sleep score and braggadoo, you know, Braggadocious.

Post it on Instagram, to my 2.8.

Million followers, to everybody. And you made me feel not on, not. This is not to be mean, but you made me feel like I was lazy piece of crap because I didn't get out of bed that way. I wasn't showing up to anything that way. I mean, I was struggling to get through the day, and then it would hit, like, afternoon, and then I'd finally start to come through this cloud and I'd start to wake up, and then that's when everybody else is, like, heading to bed, and I'm like, okay, well, now I'm ready to work. Now I can go till two in the morning and get all my emails done or whatever. But I was. I'm worthless. I was worthless before noon.

And a lot of that. We're going to talk about this when we go to the whiteboard and talk about the test, but a lot of that was related to the breakdown and some of the precursors. So hormones are not just manufactured. Hormones need precursors. There's raw materials in a woman's body that are used to make hormones. One of them is called pregnenolone. And we make cortisol, we make aldosterone, we make other hormones from pregnenolone. But it's this dhea, it's this precursor in the body that acts like a construction material. And I don't care how good your contractor is, if you don't deliver materials to the job site, they're not accomplishing anything. And it's the same in a woman's hormonal system. If you don't have the precursors, the raw material, the construction product that you need to build other hormones, they become deficient. And what was shocking about this test was we discovered that she had virtually no cortisol. And so in the morning, cortisol is our waking hormone. It's responsive to light. One of the reasons why I love to get first light in the morning. You love to get first light in the morning. I generally encourage people, when you wake up within 30 minutes, get outside, get natural sunlight in your eyes, is because that sunlight actually helps your cortisol rise and helps your melatonin get lower. What we realized was she had so little cortisol. When you look at it on a chart of a normal cortisol pattern climbing in the morning, you see that yours was flatlined. She had no waking hormone. And at the same time, you couldn't even register any more melatonin in your system. Your melatonin was off the charts. She wasn't even taking melatonin, but her melatonin was off the charts. So imagine that it's like taking an Adderall to go to bed and then taking a sleep medication to wake up.

That feels exactly what life was like.

Yeah. And you were, you were a lot more energetic at night than you were during the daytime.

Yeah.

And so what were like the big signs that you would say, okay, if you start to experience this women, this is when it's time to get your hormones checked. And I also want to just dispel a myth really quickly. There was a study, it was published in the 2018, 2019 time frame and it was one of those studies, or 2012, I apologize, that LinkedIn hormones to breast cancer and linked estrogen therapy to breast cancer. That very same study, and I'm going to put the study link below, found upon a longer, more exhaustive study that hormone therapy was actually not linked to breast cancer. In fact, it was linked in some cases to a reduction in breast cancer. So I know a lot of women are listening to this and they think estrogen breast cancer or testosterone breast cancer, and those two are not linked any longer. Just because you are taking hormone replacement therapy does not mean you have an increased risk of breast cancer. So I wanted to put that out there. I wanted to actually give you the study so you could read it yourselves. Because I know a lot of women are hesitant to even start hormone replacement therapy. It's easy for men. We're like a rifle shot. Just give us testosterone, we're good to go. Right.

Not fair. And because it's true, the other thing.

To argue about in menopause, like that's not fair and that's also your fault. That's also not the creator's fault.

But I think that you're right. That test or that study, because I remember I have an aunt who they linked her hormone use to breast cancer because I don't think it had run anywhere in the family. So from a very early age, I also had it in my head I would never take hormones because I could get breast cancer. Like my aunt, now, I don't remember her whole story. I just remember that piece of it. And then when I've read in the new menopause book about this, further studies, it really feels like there's been this 25 year gap or more that women have suffered unnecessarily because of one bad study. And I also think that there's a difference between whatever hormones they were doing back then and bioidentical hormones that they have now. Am I right on that.

Yes, you're very right on that. You're not only right on the bioidentical hormone part, but you're also write that we just don't take rifle shots at women's hormones anymore. We used to try estrogen, then progesterone, then pregnenolone, then testosterone. And if hormone replacement therapy is called hormone replacement therapy for a reason, you know, I often ask the question, if you have two men, for example, one has a testosterone of 200, one has a testosterone of 800. Now, you wouldn't replace the testosterone at 800, but theoretically, one has a testosterone of 800, one has a testosterone of 200,' and you're going to replace their testosterone. Who gets more testosterone, the guy with 200 or the guy with 800? And I asked that question for a reason, because most people will say, well, definitely the guy with 200. But hormone replacement therapy is exactly that. It's hormone replacement therapy, meaning you are replacing the hormone. So when you take it exogenously from outside of the body, you drive your endogenous production, your internal production, down to zero, or you drive it very low. Which is why most male hormone therapy will include some kind of testicular signal so that the testicles don't stop producing hormone. Things like human chorionic and atotropin, kisspeptin, gonadorelin. These things, they actually tell the testicle not to stop producing testosterone even though there's testosterone in the bloodstream. So we know now with women that if you're going to replace the hormones, you replace the entire suite of hormones so that they stay in the same ratio. But I think when women are thinking at whatever age, late 30s, early mid, late 40s, which is usually when it starts, it used to be much later in the 50s. What signs told you? Okay, this is not right. I know what signs told me. I mean, you were just not the same person, not the same energy, not the same zeal for life, not the same what I would call positive aggression towards working out, positive aggression towards a wife. I mean, this. This woman loves to travel. She loves to get after it. She was working out all the time with Alexia Clark. She'd gotten herself in crazy good shape. We were traveling like crazy. We were so energetic, and she was so on top of her game. Like those little lists that you did, you would just cross those things off and get so much done. You were so organized. I might even say ocd. Just throwing that out there. Yeah. Can't be a sock in the corner against the baseboard. Or you can't do anything else?

No, no. All the laundry has to be done. The dishes have to be clean.

Yeah, that makes perfect sense to me.

That's a whole nother problem.

Yeah, I don't know why you can't paint the back bedroom because there's sock against the floorboard in the kitchen.

Well, only people with compt Gene break will understand that.

Okay, so someone watching this says, that makes sense to me.

Duh.

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I think one of the main things was the frozen shoulder. That was when I had to start doing a deep dive of research to figure out what was happening. My. My arm was stuck right here for almost nine months. And then the show what you can.

Do after hormone therapy.

Oh, yes. And then once I started my hormones, I'm like, almost all the way back. There's. I still struggle with some of it and I still struggle to put my bra on because it's hard for me to reach behind my back.

I put the bra on a lot.

Yes, you did. You were very helpful during those days. Thank you. So between frozen shoulder and then my period started going all over the place. So I remember a girlfriend of mine showing me her. She charts it on like an app.

Period tracker. Yeah.

Yes. And she would be like, oh, girl, you're in for it. When we started talking about it, and she showed me hers, and it would be like 22 days, 65 days, 98 days, and then back to 24 days, you know, and it was just all over the place.

Period roulette.

Yes. Like, basically you just, at that point, you just carry, you know, feminine products with you in your purse everywhere you go, because you just never know it's going to drop. So I. There was a time frame where it went 127 days. Now, you're not in full menopause till it's 365, from what I understand. But, yeah, I got to 127. And then she came back like, like, with a vengeance. And it was ugly and miserable and awful, like the first time I probably ever had it. And that's where I'm at now. It's just like bouncing all over the place and I can't figure it out. So I just carry tampons in my purse everywhere I go.

So I want to head over to the whiteboard and show you guys exactly what we found out when we did this Dutch test, this 24 hour urine test. I'm going to compare that to the blood test, the lab test that we also did through 10x health, and show you that sometimes the labs don't tell the full story. I talk about this a lot with heavy metal mold toxicity, viral pathogens, bacterial infections, and other kinds of toxins that we put into our body that don't necessarily show up on the labs, but they have other manifestations. Brain fog, weight gain, water retention, fatigue, sometimes crushing fatigue. You go and get your labs done. The labs are normal. The doctor tells you everything's normal. You're actually very healthy. Your liver and your kidneys are fine. Your cbc, your complete blood count is normal. Your comprehensive metabolic panel looks normal. Nothing is jumping off of this page. So we really don't have a reason for why you feel that way.

Well, and that's what got so confusing, is because we also did a vibrant wellness test, which was the mold, microtoxins.

Parasites, whatever, we did get rid of all those.

And. But that, you know, when, when that hit my mold was like, where a 9 was high, I was a 49. I mean, I was off the charts for mold. So that was probably contributing to the brain fog, too. So we didn't think so much about it being hormones because we're like, it must just be mold. But then when I started to clear that out and the symptoms weren't going away, it just was confusing. So to have the full picture and have as many, you know, not everybody can get all the tests done, but I think the blood test says a lot. I think the urine test says something different. And I think the, you know, the other mold and mycotoxins has a whole nother picture. If you can do all three, that's what saved me, at least. And then also the gene test just helps, like, account for a lot of it too, because so much of your genetics Your methylation is tied to hormone balance. And I think that was probably the only thing I was getting right, was that I was on my vitamins every day like clockwork. I never, ever, ever miss my supplements. And. And so at least I was keeping that in balance. For a lot of people that don't keep their methylation in balance. Like I was in the beginning and I was estrogen dominant 700%. And I was a crazy person then, too. No, babe, I know.

Don't be so hard on yourself, please.

I. You still love me.

I do still love. Thank you.

So. But that showed us a lot back then, too. So that was five, almost six years ago now to show me that if my homocysteine levels are raised because I'm not in balance, then that means my estrogen goes sky high too. So it would have been interesting to take this hormone test back then. You do see it in the blood labs, though. We did see the homocysteine raised. We did see the estrogen dominance. I think my testosterone was normal then.

Yeah. And remember, you can be estrogen dominant because you're producing too much estrogen, or you can be estrogen dominant because you're not clearing estrogen.

And I wasn't clearing it.

And you were not clearing it. In fact, if you look on some of these tests, you will actually see the COMPT gene mutation, which so many OBGYNs overlook. It's called COMT. We affectionately call it COMPT, but it stands for catechol O methyltransferase. These are catecholamines in the brain. Catecholamines are the four neurotransmitters that are involved in the fight or flight response. They're norepinephrine, epinephrine, ephedrone, and dopamine. One of those we call adrenaline as well. And so think of a hormones like adrenaline, dopamine, dopamine, the main driver of behavior, you know, adrenaline is what happens when we're hopped up, you know, epinephrine, norepinephrine. So these are the same cascades of neurotransmitters that are involved in a fight or flight response. So if you have this gene mutation, which. Ladies, listen up, not the vast majority, but about 42 to 44% of you have this gene mutation in addition to the MTHFR gene mutation. But when you have this gene mutation, you have a tendency to go to bed tired. But when you go to sleep, your mind keeps you awake. So you lay there and you ruminate on the dumbest little thoughts you Just have these most innocuous little thoughts. Did I get everything on my grocery list? Did my belt match my shoes? Did I return in that email?

Makes it worse. If you're a type A mom like I am, so then you're worrying about everybody's problems.

She has show tunes going through her head. She tells me.

Yeah, show tunes. There's a lot that goes through my brain that doesn't make its way out of my mouth, which you should be grateful for.

Okay, I'm sorry. So these catecholamines, when they rise, they also trigger anxiety. This is why anxiety very often doesn't have a specific trigger, meaning you can't always point to the trigger that causes it. This is why the vast majority of people that suffer from anxiety have had it on and off throughout their entire lifetime. So they had it as a child, but didn't know how to explain it. And as an adult, they realized it was anxiety. This is also why anti anxiety medications don't work for the vast majority of people because it makes them feel like a zombie. You're tranquilizing this response in the body rather than using methylated vitamins to help you break these neurotransmitters down. So when you look on a hormone test, you'll see that compt in addition to regulating these neurotransmitters that create this fight or flight response lead to anxiety, lead to waking thoughts at night, and also lead you to consider any scenario as the worst case scenario. So if you got trouble at work, it's the worst possible outcome. If you've got trouble at home, it's the worst possible outcome. If you've got friction with a family member, it's the total end. And that is because those are fight or flight neurotransmitters. Those are worst case scenario neurotransmitters. They're ancestrally meant to protect us, right? They're instant on. Somebody's standing in front of you with a knife, you know, don't have a lot of time to warm up. Eyes have to dilate, hearing has to be more acute, heart rate has to increase, extremities have to flood with blood. Those same reactions can happen without a trigger. And so people that are listening to this, that have those kinds of feelings, just know that you're not crazy. That is a rise in catecholamines can be mitigated with the right methylated multivitamins. And this also helps. This very same gene mutation helps to clear estrogen. It sends estrogen down what we call the E2 pathway, which is a way of eliminating it. And if you're not doing that well, you can become estrogen dominant. Now, Sage, and I'm just saying this because you're sitting here, but very fit, very muscular, very low body fat. And on thin side, she's very lean. So, you know, when I was estrogen.

And dominant, I had a tire around my belly.

Yeah. And she started to develop this little tire. Women think they're getting fat, but they're not. They're getting water retensive. And the estrogen band is that band right below your belly button, moving laterally around to your flanks and back behind you. Like if you put your hands in your back jeans pocket and lifted your hands up, your palms would cover this other problem.

Loaded and off. Yeah. It wasn't a huge difference and it was really just that I noticed it, but I know it can be a lot worse for women too.

And just so you know, we were doing all the things, all the things. Red light therapy, sauna, cold, plunging. We have a hyperbaric chamber. She was getting in on a regular basis. We have pulse, electromagnetic field. We sleep at an EMF tent. She eats extremely clean, like Sage's diet is so clean.

I am. You said today that I have one of the best diets. And I do. I think that's why I didn't suffer so much, much with the three day water fast, because I don't think I had all the detox symptoms that a lot of people get with the headaches and the poor sleep and all of that. I actually felt pretty good and alive because I eat very healthy. I always tell people I don't eat like an asshole because I don't eat fried food, processed food, fast food. I eat very healthy, whole, whole foods. So I think that that helps even when other things are going wrong. I was doing a lot of the right things, but it was a struggle because I wasn't fixing it and I couldn't understand why.

Yep. So being the best biohacker in the world, I said, we need to really take a deep dive here. Let's get a full picture of the hormones. Let's look at everything and not just take a snapshot. So not just take a blood test. So we did this Dutch test. She did this blood test, Dutch test.

I had to pee on a stick five different times throughout the day and.

Frustrated her and made her mad.

Because I'm such a perfectionist.

Maybe now would be a good time to apologize for that. I don't think I ever got an apology for that.

There's so many instructions with it. I'm gonna just tell you this right now. If you're like, particular like I am, it's, you know, I like it all laid out. I like it at the right time. You have to set alarms. Yes. I'm a perfectionist. So, yeah, that was a lot. But then I also had my blood work done within like a month of each other. Gene test we already knew about and the mold test was last year. So a lot of testing to figure this all out.

So we. I'm trying to shortcut this for a lot of women that are.

I know, exactly. Because not everybody can afford all of these things.

Yeah. But it. But getting that test was a game changer. When it came back, it explained everything. So let's head back to the whiteboard and let's take a look at what we learned from this test. So this is Sage's Dutch test, and this is a 24 hour urine test. I think this is the gold standard for women's hormones, especially if you are perimenopause, premenopause or post menopausal and you want to get an accurate picture of your hormones. The reason why is this doesn't just take a snapshot in time. It looks at the ratio of hormones. And listen up, women. The ratio of hormones is as important as your levels because at some times during the day, they can be at different levels. So when you just take a blood test and just get a quick snapshot and you don't really get the true picture, and then it's hard to prescribe hormone therapy because you don't have the full profile. So before I explain what's going on here and before we go into this test, understand that estrogen is a category of hormones. So women have something called E1 and they have something called E2, and they have something called E3. So there is estrone, E, S, T, R, O, N, E, E. Estradiol. Yeah, estrone, estradiol. I'm going to tell you number three here in a second. But it's this estradiol that I want to focus on here for a minute. And the third one is estriol. Okay. So the importance in understanding that there's three different variants, if you will, of estrogen is that they are active at three different times, meaning some are more prevalent postmenopausal, which would be E1. It's a very weak estrogen. Some are more potent during your menstrual cycle when you are still a menstruating female. That would be E2. In fact, E2 is 10 times more potent, 10 times more potent than E1, and 100 times more potent than E3. These are still important. But estradiol, the most potent estrogenic hormone, is 100 times more potent than estriol and 10 times more potent than estrione. The reason why that's important is like, this is the master hormone, and this is very high in premenopausal women. And then it tanks in menopause. Okay? So when this hormone tanks, let me tell you what this hormone is responsible for. This estrogen hormone is responsible for mood. It's responsible for skin elasticity. It is very linked to your emotional state. It's linked to your libido. It's also linked to your menstrual cycle. So why does your menstrual cycle stop when estradiol tanks? Because this is the main potent hormone for your menstrual cycle. Why does your mood get thrown off? Why do you have emotional outbursts? You're happy one second, you want to kill somebody the next. That's because this is a very, very powerful form of estrogen. And why does your skin look like all of a sudden you started aging? And why does the elasticity of your skin change? Why does libido just leave the building? Because this is the main driver of all four of those things. Okay, so when we look at the Dutch test. Let me erase this for a minute. I'm just going to walk you through this. When we look at the Dutch test, you see, this is the summary of the testing. And thankfully, Sage has just been very willing to be vulnerable about this. Now, the good news is we fixed all of this, but she's been very willing to be vulnerable about this. And I'm going to show you guys a follow up test when we get one done. Because she's on hormone therapy now, and almost all of these consequences have been mitigated. So you see this little arrow right here that's pointing to this little purple square? This purple square represents postmenopausal. It is pointing directly at the postmenopausal area. It's not in the green range where it would normally be if she was still having a normal menstrual cycle. Same with progesterone, which, by the way, helps women sleep, can also help men sleep. So what I would suspect is that mood would be off, skin elasticity would be off, the menstrual cycle would have ended or be very, very off. I mean, massive gaps in timing because this hormone, which is between 10 times and 100 times more powerful than the other estrogens and is floored out and in the postmenopausal range. So if you see this, you have a perfect explanation for why you're feeling the way that you do. The thing about progesterone is when progesterone floor is out, you have a difficult time falling asleep and staying asleep. This is why sometimes progesterone can be a magic pill for men and women, usually in younger ages, that are having difficult time sleeping. The other thing that I want to point out here, and I'm going to explain this later in the test, is that we have a waking hormone called cortisol. And if we look at waking in the morning versus nighttime, a normal pattern for cortisol, as you may know, and this is one of the reasons why I think that you should be getting morning light, is that cortisol is rising in the morning. Cortisol is our waking hormone. It's responsive to light. That's why first light in the morning, getting sunlight in your eyes in the morning is such a good thing. It actually starts to fall in the morning into the afternoon. This is why you feel more energy later in the morning, because you feel that energy in the morning and you feel lack of energy throughout the day because the cortisol is falling. This is very normal. And then as you go into your nighttime sleep pattern, it falls off to a low. This is when melatonin starts to rise. So actually look at Sage's cortisol cycle. So do you see here how cortisol is barely rising? This means it's really hard to wake up in the morning. So this is one of the catastrophes that also happens in menopause. Why? Because cortisol is made from another hormone called pregnenolone. It also makes aldosterone, but it's made from pregnenolone. So when you go into post menopause, your estrogens start to drop. The most powerful estrogen gets flow floored out, the mood changes, the skin elasticity changes, libido leaves the building and you feel like a crazy person, right? And your menstrual cycle is all jacked up, if you even have a menstrual cycle. So that explains those four things. If we don't have cortisol rising in the morning and falling later in the morning, this is waking, this is morning, this is afternoon. So by mid morning it's peaked and then it starts to fall off during the day. But look at this low rise in cortisol. She has no cortisol I'm going to show you why. Because her pregnenolone, the precursor to make this hormone, was also floored out. Which is why, if you're going to do hormone replacement therapy, talk to your OBGYN about replacing the entire suite of hormones including pregnenolone, testosterone, progesterone, E1, E2 and E3. The other thing is, look at what's happening in the afternoon as cortisol should be tanking. Look at the direction of her cortisol. So her stress hormone is rising when the circadian cycle should normally be tanking, right? And then it barely goes down and matches her normal cycle. So we're out of the hormone. We've run out of the hormone cortisol, which makes it very, very difficult to wake up in the morning. Look at the 24 hour free cortisol. Look where that's pointing. It's completely deficient. Look at her ability to clear cortisol, very deficient. That's a solid F, right? On a 0 to 100 scale, 30% is a solid F. So we're not clearing cortisol, we're not producing cortisol. It's actually rising for a prolonged period of time when it actually should about this point, start to fall off so that she's in a normal circadian cycle. So now your circadian rhythm is off. You're trying to wake up in the morning without a waking hormone. You're trying to go to bed at night without a sleeping hormone. Your mood is off, your energy is off, your menstrual cycle is completely out of balance, your skin elasticity is decreasing, libido has left the building. And this seems like a major catastrophe. And all of this is linked mainly to these two hormones. Let me show you something going on on the next page. I won't bore you with all of this. These are the different phases. You're welcome to look at those. So look here. This is what I meant about a precursor. Okay? So remember, these purple blocks are postmenopausal. So when you see these things pointing to these purple blocks, that is the postmenopausal block. This is the postmenopausal range, right? So you see that all of these hormones are in this postmenopausal range. Look at this. See this postmenopausal range here? The important point that I want to make now is that there is a hormone called pregnenolone. Pregnenolone is this precursor. Look at this dhea, also low in her progesterone. What kind of sleep can you expect to have when your progesterone is like this. So it's like, it's literally like an evil wizard. I mean, it takes your libido away, makes your skin less elastic, throws your menstrual cycle off, throws your mood and emotional state off, and throws your sleep into the toilet because the progesterone is also off. Now progesterone is going to become two other hormones. It's not important. I don't want to get too deep into the hormone therapy here, but you see if this is in the post menopausal range, so are its sub constituents. Then we look at what DHEA becomes. Well, DHEA comes over and helps to makes the Android hormones that are precursors for testosterone. This has not yet fallen. It also makes testosterone which becomes free testosterone. So if we look at this cascade of events, her E1, which is a relatively weak estrogen, is floored out. The most powerful estrogen in the body has become postmenopausal. This actually increases in postmenopause. Her most powerful estrogen hormone is floored out and even her E3 is off. So all of these hormones are floored out. It is no wonder you feel the way you do. This is why I love this test, because it gives your doctor a chance to actually replace all of these hormones. Look at the metabolized cortisol. Look at this, guys, there's no way. And then guess what happens. All of this happening at one time throws women into fight or flight. You're stressed out because libido's gone. You're looking in the mirror and you're like, wait, all of a sudden I'm aging faster. I can't wake up in the morning, I feel like a lead balloon. I have no motivation, my mood is completely off. You get something called flat affect or mood numbness where the peaks and valleys of mood disappear. So you don't get really, really, really happy. You don't get really, really, really pissed off. You're just kind of very melancholy. There's no positive aggression towards life. There's no positive aggression towards working out. And stress causes the brain to release acth, which stimulates the adrenal glands to make hormones, including DHEA and cortisol. So stress aggravates this even more, even more. And mainly the stress hits during the day when your cortisol should be low. So you see that even though she doesn't have a lot of cortisol, the stress is actually causing it to rise when it should be falling. So this is why it can Wreck your metabolism. This is why women feel so off and they feel like a crazy person and they have brain fog, like they literally can't complete a coherent thought. This is not them breaking down. This is their hormones going in the tank. And we don't have to suffer like this. Women, you do not have to suffer with the consequences of menopause. We know how to treat this now. And this is the gold standard test. So DHEA production, thankfully is still in the normal range. It's postmenopausal, but it hasn't completely flattened itself out. Look at this. Waking in the morning. So what do we want More of cortisol. What do we want? Less of? Melatonin. So melatonin upon waking. We want melatonin in the cycle from here to here. The lower the melatonin, the easier it is to wake up. Cortisol rises in the morning, melatonin falls. Look at her. Melatonin off the charts. So no cortisol, no waking hormone, plethora, an excess of melatonin. So it's no wonder she feels like a lead balloon, or she used to feel like a lead balloon getting out of bed in the morning. This is not them being lazy. This is not them not being motivated. They literally do not have the hormones to accomplish a normal day. They wake up more exhausted than they went to bed. And it is hard to even get out of bed and find motivation because the motivation is gone, because the mood and emotion is off. And the ability to actually just get up and conduct your day is even harder because you are literally being drugged by your own body. Your melatonin is through the roof. I mean, this is off the charts, right? This actually cannot register any more waking melatonin. So it's like taking your sleep medication in the morning and taking your Adderall right before bed, right? So take an amphetamine, try to sleep, and then by the time you fall asleep, you wake up in the morning, take sleep medication. That's kind of how it feels. Your body is drugging you because the hormonal cycle is so off. The DHEA production is also in the postmenopausal range. So this is what you'll see on this Dutch test. This is why I love this test. This is why I think every woman who's going through menopause should do a test like this. Hopefully you have an OB GYN that can read this test. And then what you do is you do the prescription based on these levels because you have a 24 hour urine test. So the next thing we're going to do is talk about exactly what hormones she's on. Because. Because Sage not only had the mood, the emotional, the poor waking cycle just absolutely felt like she couldn't get out of first gear. And some nights she was getting good sleep but not getting good rest. And this is because the hormonal cycle was so off. So in addition to that, when you go in and you replace these hormones, you don't just replace the hormones, you replace the precursors, like pregnenolone. It's better to do your testosterone in the morning and do your estrogen in the evening. That's more in tune with your circadian cycle. So usually you will split your hormone doses into two types, and I'm going to show you exactly the doses that she's on. To add insult to injury, there is a correlation between frozen shoulder, what's called adhesive capsulitis, and menopause. So as she plummeted into menopause, she actually got frozen shoulders. She got adhesive capsulitis, and she couldn't raise her. Oh, that was good. She couldn't raise her arm above about right here. A few weeks after she was on hormone therapy, she could raise her hand all the way above, above her shoulder and point straight at the ceiling. Her mood improved, her emotional state improved, her sleep improved, her brain fog went away. All of these things are perfectly normal. Don't think you're crazy. I also want to point out the fact. I think I talked about it on the podcast, but I also want to point out the fact that the very same study that linked estrogen supplementation and estrogen hormone therapy to breast cancer was debunked in the same study by furthering the study over a prolonged period of time. Happy to link that study below. So women do not be afraid of hormone therapy because you think it's going to increase the risk of breast cancer. In fact, in some areas of the study, breast cancer went down. The breast cancer risk was reduced by being on hormone therapy. So years ago, we used to take rifle shots at these hormones. We used to just give estrogen, or we just give testosterone, or we just get pregnenolone, or we would just give progesterone. And that is not a way to treat women. If you're going to replace the levels, you have to replace them all, and that way they feel normal again. Listen, there's what I share on this podcast, and then there's what I share with my inner circle. If you've been following me for a while, you know how I hold nothing back. Here. But my VIP community, that's where the real magic happens. Picture this. You're struggling with energy crashes, brain fog, or just feeling like you're not operating at your peak and you don't know where to get real answers. But here's what really sets this apart. You're not just getting my insights. When I have incredible guests on the podcast, VIP members get to submit questions for a private podcast segment. So that world renowned expert we just interviewed, you get exclusive access to their knowledge tailored to your specific situation. This section is under the private podcast section in the Ultimate Human Community. And speaking of exclusive, you're getting my personal protocols, the exact tools I use for water fasting, gut optimization, and morning routines that have taken me decades to perfect. This isn't theory. This is what works in the real world. The community launches challenges throughout the year where you get direct access to me and my network of experts. It's like having a personal health advisory board for less than $100 a month. Your health is your wealth. And this investment pays dividends for Life. Join the VIP community at theultimatehuman.com VIP and and step into your ultimate potential. Now, let's get back to the ultimate human podcast. This is why a standard blood test doesn't tell the whole story. We pulled standard blood on Sage at the same time. She'd been very willing to share this too. This is another byproduct of menopause. As you become less sensitive to insulin, so the hemoglobin A1C, the three month average of your blood sugar starts to rise. She would have been pre diabetic and at 5.7, she was at 5.6. I can assure you my wife eats very, very well and she exercises every day. She is the cleanest diet in our house. There is no reason for her to be almost pre diabetic. The rest of her levels look amazing. You know, kidney function, her blood urea nitrogen, her creatinine. When you look at her iron levels, they're all within the range. She had done an IV at close to this test, so it had B12 in it, what's called a Myers cocktail. So we can, we can discount this level. Her vitamin D3 is in a great range, between 60 and 80 nanograms per deciliter. So when you're walking through labs, I mean, look at her. She's not on cholesterol medication. Cholesterol is amazing. Her triglycerides are fantastic because she doesn't eat a lot of sugar. Let me actually blow these up. So her ldl cholesterol. She is not on a statin. Total cholesterol. Her triglycerides are in a great part of the range. They're nowhere near 150, which is about the high end of the range. 149. Healthy levels of HDL cholesterol. Because she eats fish oil, olive oils, a lot of good, healthy saturated fats, black seed oil. So everything is looking good. Even her thyroid is relatively in the normal range. It's a little low on thyroid hormone, T3, but her homocysteine is fantastic. You know, she takes trimethylglycine for that tmg. So these labs tell a totally different story. There's the stress, right? There's the stress coming from cortisol right there, which is no reason. I mean, no wonder why she was actually floored out. Her testosterone would still tell you that. You know, you should have some libido. Your testosterone's still in a good range. You know, the high end of the range is 50, but the low end is 4, almost 6 times that level. You have free testosterone. You know, it's not zeroed out. Your cycle appears to be in the same phase. Phase. So there's no reason for your cycle to be off. The test did pick up the fact that her DHEA was on the low side. It's not flagged low, but look at this. You could. You could increase her DHEA by 100 points, and she would still be in the normal range. This will eventually have an impact on testosterone and other hormones because it's a precursor for those things. But what I'm telling you is this lab doesn't tell the right story. Okay? Everything is within range. Her hermatic rate or blood viscosity, her total red blood cell count, her immune system's not lit up like a Christmas tree, so it just doesn't tell the right story. And sadly, what happens is people just do a simple blood test, and it says, hey, you're healthy. Everything's within normal range. Or it's slightly out of the range. That's why the Dutch test is so powerful, especially for women. Okay.

Was that it?

We're back.

Oh, we're back.

Yeah.

Okay. Cause I'm like, I got other symptoms to talk about.

We're back from the whiteboard. So let's go through the symptoms.

Okay, So I see a lot of women that talk about feeling itchy, and I did have that. Not to a point where I felt like I was gonna crawl out of my skin or anything, but they talk about itchiness, itchy ears, ringing in the ears. Trying to think of some of the other list of symptoms that women.

Exhaustion, morning brain fog.

Yeah.

Libido. Left the building.

Yeah.

Also my fault.

Yeah.

Yeah.

Honestly, if you just.

This is where I don't want my.

Parents to hear this, but, you know.

Your mom and dad are watching this podcast for sure. So are our nieces. Sorry, Coral.

So tell me. I mean, I'll say hi, but, you know, I'm not going to initiate because I'm just not there. I'm like, I'd rather watch a show or read my book.

And so the world became about just very mundane things. Again, super not sage. And that's what really made us.

I don't wanna be in big crowds. I don't wanna be around a lot of people anymore. I don't know. Just weird stuff is very different than I was before. And I think it was just like a feeling of being overwhelmed constantly. And so I just retreat and try to keep it in my, you know, all these struggling thoughts in my head. That's why I laugh and say that 95% of what's spinning around up here doesn't make its way out of my mouth. And everybody should be grateful for that.

Right.

Because I don't want to end up in a mental institution.

I don't think it ever got that.

But honestly, like, put me in a white padded room, I feel like I'd feel safer. But it's better now, though. I don't wake up with those feelings anymore. I don't wake up.

You're a lot more energetic and super back on your game.

Yeah.

And your frozen shoulder is gone.

Yeah. That's game changer. That was. That was brutal.

Yeah.

Frozen shoulder. I. But when I went to doctors, so we tried acupuncture, cupping, physical therapy. I mean, we tried so much stuff. And then I went to a doctor that said, well, we'll just put you under anesthesia or a light twilight, whatever, and we'll just rip it out.

Rip it. It's called manipulation under anesthesia.

Oh, don't do that.

Do you see a video of manipulation under anesthesia? It is.

Yeah. I saw a video and I was like, I'm not doing that. That's insane.

It's like they're breaking your shoulder.

It looks like they're breaking your arm. So the fact that I got on hormones and three weeks later, I already was able to move up without pain is wild.

Here's the wild thing.