455: Surprising GLP-1 Benefits Revealed: Brain Health, Pain Relief, Anti-Inflammatory Effects and More with Dr. Tyna Moore

If you're utilizing a GLP1 and you're not taking advantage of this, you're missing the boat. So I think it's such a great time to help these folks. This is why I think a really comprehensive strategy is needed and that's what I'm trying to get clinicians to understand inside. My course is like, you can't just prescribe these and send people on their way, right? There needs to be a comprehensive strategy because they are literally going through a neuroplastic event and we can make some really profound changes.

Welcome to Midlife Conversations. I'm your host, Natalie Jill, and I'm passionate about having amazing conversations that matter to us midlife women. On this podcast, I do what I do best, taking complicated health topics and breaking them down simply so that we can optimize aging together. I share actionable steps to help you thrive in what I believe are our best years to come. Join me as I interview the most inspiring people living their best midlife years and dive into essential topics like hormone changes, health optimization, weight management, blood sugar, emotional well being, relationships, beauty, and so much more.

GLPs have become one of the hottest topics GLP1s in wellness a hot topic. Seems like everyone is talking about them, doing them, some people even shaming them. You hear it from celebrities, influencers, even probably your neighbor. Med spas seem to be popping up, offering them wellness clinics, talking about wellness shots and even your telehealth company bringing them up as options. But clinicians seem to be prescribing massive doses and sometimes the wrong dose. And how do we know if they're right for us and are they only for weight loss? And what type of protocol should people be following that are interested and standard starting doses? Why do they make some people so sick and others seem to love them and thrive for them? And is there a proper way to use them and lose weight or use them for other things, other inflammation markers that we have going on in our bodies, especially in midlife. Today I'm bringing back Dr. Tina Moore. She's not only a personal friend, but she is my go to expert when it comes to this topic. I had never even heard of the term GLP1 before her. She's the one who created the buzz about how to do it right, the right types of doses, the questions to ask and how these can be used and should be used kind of outside of the box, not just for weight loss. Thank you so much Dr. Tina Moore, for being back here.

Yeah, thanks for having me. I'm excited to be Here again, when.

We did a part one quite some time ago, I knew nothing about this. You really schooled and educated me. I seem to know a lot more lately of following you and from people that follow what you teach, I've gotten a lot of questions and I always go to you as my go to expert. Can you just give a little background of you and your credentials? Because people are going to ask that, like, where did you come from and how did this even become a topic that was of interest to you?

Sure. So I am a licensed naturopathic physician and a chiropractor. And in many states in this country, we are primary care physicians. We're trained in a four year medical program and hold medical licenses. I can prescribe, I can do minor surgery, I can, you know, do all the things here. And my background was in regenerative medicine. And so I predominantly did regenerative injection therapies for orthopedic conditions. That was my wheelhouse. And early on in my career I realized that hormones were an absolutely necessary piece of the puzzle because as we now know, you know, with Dr. Vonda Wright publishing the the menopausal pain syndrome paper that she did last year, the musculoskeletal syndrome of menopause, if you will, some of us have been practicing that way for 20 some years. And so I never stopped prescribing hormones back in the day when the Women's Health Initiative scared everybody away. And I know that in midlife we have a whole certain set of issues that are not the same as a younger woman and not even the same as an older woman. This perimenopausal menopausal phase is a really particular time.

Fast forward, we get peptides on board and the 2000 and teens we start seeing peptides come on the scene. It fits really seamlessly into regenerative medicine practice. We have exosomes, we have stem cells. I had all the things GLP1s I only learned about a few years ago. And what I had known them for were for diabetes. They were not in the conversation for weight loss. They were as a treatment for type 2 diabetes. That was the only way I understood them. And then a few years ago, the weight loss FDA approval happened and the Internet seemed to go crazy. So I was like, why is everybody freaking out about this? We've been using these, they're peptides, actually. They're not just pharmaceutical drugs, they're actually peptides. We've been using these peptides for decades in clinical practice for type 2 diabetes safely and effectively. So what's going on? And I think some of it was pushback from the last few years and what happened there and people distrusting Big Pharma more and more. So I got interested because I started seeing the functional medicine space, the online health influencer space and mainstream media all combine into the same message, which really raised an eyebrow for me. And I think we talked about this last time. I was like, this sounds very propagandized. What is. Why is everybody pitching a fit about this? Started looking into GLP1 agonist. That's what they are called. We make GLP1 in our body. These just help it stay in circulation longer. So these are semaclutide, which, you know, is ozempic or wegovy bioidentical to what we make in our own body. It's just been tweaked so that it stays in the body longer. I started looking at what else it did in the body. And as I was researching, I was realizing very quickly that the clickbaity headlines we were hearing all over the Internet a few years ago and all over the television were very propagandized and that, you know, I'm just an insubordinate little libertarian.

I was like, what is. Why, why is. First of all, why is my community and the mainstream community aligning on this message to vilify it? And second of all, why are they not telling any of the other things that I'm finding in like, mountains of data, right? And so the first thing I do is I go top down. And I immediately, you know, looked up the data on GLP1s and neurocognitive function and neuroinflammation and how it is, and found out very quickly that it quells neuroinflammation. It's neuroregenerative. And there were studies happening in the pipeline for Alzheimer's and Parkinson's. And I was like, well, holy smokes. And then I just went top down, right? The second thing I look up is pain, because that's my wheelhouse. You know, pain is very neurocognitive. So, like, what's happening in the central nervous system? What's happening with pain? And in that case found some really compelling data and in fact found out that it is protective against muscle and it is protective against bone and it is protective to our joints. And I was like, well, this is not at all what we're being told, right? And that was right about the pinnacle when I won't name names, but there were certain health influencer doctors out there. Really doubling on this, you're going to lose all your muscle and diet kind of conversation.

The weight loss, I'm sorry, the muscle loss, it's not just muscle loss. That term, 40%, you keep hearing thrown around. That's for lean mass loss. That's total lean mass. Lean mass is all the soft tissues in your body that aren't bone, essentially, and muscle is part of that. And so that could be the fat in your liver, that could be the fatty infiltrate in your muscle that you're losing. So this 40% is really overblown if you understand that muscle's only a small portion of that. And the amount of lean mass loss that was happening is right on par with any low calorie diet or any severe caloric deficit, whether it's through restricted calories or through bariatric surgery. So I was like, why are people freaking out about this? Just don't dose your patients into starvation mode, right? And then I got really interested because I like to give the lowest necessary dose to an individual. I do very individualized medicine. There's no algorithm. It's, you know, what does the person in front of me need? And I started thinking, well, what about girlies like us? Like middle aged ladies like us who are, you know, smack in the throes of perimenopause, menopause. We're trying to sort out our hormones, which is incredibly difficult because our hormones are doing.

All over the place. It's much easier when the ovaries go offline completely because everything is exhausting right now. We're like, some months we're good, some months we're not. So the months that we're good and our ovaries are working, we're overdoing dosing on our estrogen cream, you know, so I was just in the middle of all of that hell and experiencing extreme tip to toe pain, extreme brain fog myself, you know, have seen it a million times with patients. So many women would come into my clinic, women like you, who were so lean, beautiful six pack abs, their whole lives, and then all of a sudden show up in my clinic and they're like, what the heck is this? Like, what is this?

Like, what's going on?

Yeah, like this £15 that just came on and I have not changed anything. And these women are the most, some of the most diligent, dedicated, you know, just, it's not just willpower, it's, it's just absolute, you know, commitment to tracking every macro and I mean hardcore, way more hardcore than I am. And they're Gaining the weight. And that is the beginning of insulin resistance. And that's all part of the menopausal syndrome, if you will. It's part of our estrogen leaving our body. It's part of our hormones going sideways. It's part of not just aging. It's not just metabolism slowing down. It is very intimately tied into what's happening with our hormonal milieu. As your estrogen wanes, you become more insulin resistant. That's just what happens. And so in seeing this in so many clients, and then it happening to myself, I'm like, oh God, it's happening to me. And I call it the thickening. It's where you just sort of.

Yeah, I, I probably stole that term from you without knowing it. You know, when you're around a friend that says something a million times and I now I say midlife thickening, I, I give you credit for that.

You just thicken up. And part of it's swelling, part of it's your immune system going rogue because your hormones are going rogue. It's all very intricate and interrelated. And no matter how hard I would try with a patient, no matter how hard I was trying with myself, I could not pull the lever to correct it. And it wasn't about weight. I'm really frustrated that this microdosing has taken off as a vanity weight loss tool. That is not ever what I intended. Yes. In a metabolically optimized woman who's on hrt, who's doing all the things, who's really got her shit dialed in and who's metabolically sound, you apply a tiny little bit of GLP1 and you will often see weight loss happen. But in every other woman, which is by far the large majority of middle aged women, that is not the case. And so the fact that there's all these telemedicine companies cropping up, saying that they're microdosing, saying it's for weight loss, I think it's really unethical and I'll tell you why as we go through this, you know, conversation. But anyway, to me, it was more about the brain. I was like, something in my central nervous system in my brain needs the lever pulled. And I, I likened it to my husband, who's an electrician. I told him, I said, I feel like I need you to go into my brain and like, reset the breaker, you know, when the breaker blows. And I feel like GLP1s will do this based on the mechanism of action and based on what I've studied on them. And he was like, huh, interesting. So I called all my girlfriends up, I called all my doctor friends up and I said, are you guys using these in tiny little doses? Because I think someone like you or myself, I mean, I could probably tolerate a little bit more because I have more body fat, but in gals like us, I was thinking like the tiniest little bit. And they all said, we are using low doses, but we're using the standard low dose. And we're using, in every single case they were using it for weight loss or appetite suppression. So maybe they were using it for vanity weight loss, but they were still using the standard low dose. And I thought, you know, that standard low dose would kill me. I think I'm like, I think that would land me in the, in the hospital. And so I decided that I was going to take a fraction of that. And I also applied it to any patient who was willing to work with me on it and who was open to it. And so I had a sprinkling of folks that we tried it out on first, first wave just to kind of see. And I grabbed folks who had a whole myriad of different types of conditions. And so while I say publicly that I don't practice anymore, it's because I don't accept the general public. I still have a healthy practice, I still consult with clients. And I am in a very interesting position because I have hundreds of thousands of followers and I from a lot of them. And so I've gotten thousands of messages over the past few years since I've been talking about this. So I feel like I'm in a very interesting particular position to understand how this strategy works out. Because a lot of people took to the streets and started trying it. Basically they got their doctors to sign up, a lot of doctors started doing it. And the results have been amazing, right? Just absolutely amazing. And most notably on inflammation, pain, immune system regulation, I mean that's really the big hitters, cardiovascular protection. But back to the so called microdosing, I've had several of those same colleagues that I talked to originally come back to me now and say, I don't know why you're saying you pioneered something. We've been doing this for years. And I'm like, no, you've been using the standard low dose and you've been using it for weight loss or for appetite suppression. I am having an entirely different conversation over here. And I'm talking a fraction of the starting dose and I'm talking about utilizing it for a myriad of other potential, potential positive outcomes. We're not talking treatment, prevention or cure. We're talking helping to stabilize homeostasis in the body. Right. It's a different way of looking at things. I'm not applying a medication to a condition. I'm trying to. And I'm using a lot of other peptides. I'm using hormones. I'm trying to get an individual's homeostasis back to baseline so that their body works optimally. That's the difference. And so that usually just requires a small amount. So that's where we're at.

So today, what I want to. I have so many questions for you about, for the metabolically optimization. Like I want to talk about that, but before I do that, I want to bring up a couple of the questions that I know people are thinking just for, for that general audience first first and then we'll get, we'll kind of dial to that. So I want to talk about the weight loss people first. The people that this is actually like really helping in fat loss and weight loss. And I'm talking the more like clinically obese or the people that have a lot of weight to lose that standard methods. Nothing was working for them. I want to ask you how you one, how do you feel about that for those people and why is there so much shame around it in the wellness community? What is that about?

That's a big question. I think it's absolutely hands down the most miraculous, innovative intervention I've seen ever in medicine. And I think it could save the world if done right. Yes. I think that folks who are dealing with the disease of obesity, something I didn't appreciate early on, that I really appreciate now that there is in fact a disease of obesity. We do not all have the same engine. I don't know how to get that point across to people. We do not all have the same engine. It's like asking your 1975 Ford to run like your 2025 E class Mercedes. We do not all have the same engine. And that's the best way I can explain it. We do not all have the same brain signaling to the, you know, signaling peptide hormones. It's not just GLP1. There's a whole orchestra of signaling peptide hormones, leptin, ghrelin. There's a whole suite of them and they work together and they don't work optimally if we don't have enough GLP1 in the system. We also have proof in studies showing that those who have type 2 diabetes, those who struggle with fatty liver, they have a reduced level of GLP1. In their bodies. We also have studies showing that when you take lean individuals and obese individuals and you feed lean individual, you feed them both fat, they both have the same GLP one response. It's made in our L cells in our gut and it's made in our brain. It must be doing something very particular in our brain if it's also being manufactured there. If you feed both of these types of people carbohydrates, the obese group does not have the same amount of GLP1 secreted from their bodies as the lean individuals. They are functionally GLP1 deficient, if you will. We also know that. Well, I know because in clinical practice I tested everyone's gut and 99% of my patients had compromise in their gut. Most people are dealing with some level. I know, you know, the gut well, leaky gut, inflammatory gut, all kinds of issues in the gut. If the L cells are trashed from chronic inflammation over decades, do you think they're making any substantial amount of GLP1? Right. And so we've got these now, we've got probiotics out there, we've got different supplements out there that help stimulate the L cells. We're trying to get the L cells to kick back on. Right. And that got me thinking, what if my decades long inflammatory bowel disease trashed my L cells and I'm functionally deficient? Right. I'm not even sure because we don't have the data yet. But I'm really intrigued about like SNPs, like genomics, you know, single nucleotide polymorphisms that code for GLP1. I wonder if those are different in individuals. I'm betting they are. Right. And I'm wondering how epigenetics. So there's lots of reasons to understand that those who are. We have. It's on a spectrum. Right. And so you can have folks who are obese who do not have the disease of obesity and you can have folks who have the disease of obesity and are not obese. But I do think that there's something there and I think that folks who are struggling. It's a risk tolerance ratio we can go into. I could do a whole episode on how a lot of these big scaries have been severely propagandized and how the data is just. Even since we last talked, the data is just not playing out. It is not leading people into pancreatitis. It is not leading people into thyroid cancer. We have the data on that. Again, this is not medical advice. Talk to your practitioner if you're at risk and you're concerned. But.

All that to say the risk of obesity long term is substantial to your overall health and the risk of cancer and the risk of all kinds of downstream impacts from that. And so it's like risk tolerance ratio. Right?

I think, just like you about it, I think it's so cutting edge. It's so breakthrough. I think it could change our entire. This could change everything. When it comes to obesity. I. People that are in my fat loss programs, if they're doing them, I think more power to them, it's great. It's. It helps them get better results. So I have no issues with it. But I do have a lot of colleagues that are really judgy about it and they really, it surprises me, actually. They, it's almost like this shame around it.

And they're fat phobic. What is it?

What is that? Is it fat phobic?

I think they're fatophobic. I think they have, I think they have obesity bias. I can't figure it out any other way. It is so egregiously ignorant at this point with the actual data that we have. And so many of these people I know as well personally, and I listen to them squawk on their Instagram and on their big platforms and I'm like, are you intentionally ignorant?

I'm surprised. It surprised me at first. I thought it was maybe they're worried about competition or something like it's going.

To take from them.

I don't know. It's so bizarre. But I think more, more people, more wellness people that I know that are true experts. They are for them, they understand them. But there are still, there's a pocket of them that are very vocal about how they're, they're dangerous and bad. And I, I'm, I'm, I'm, I don't understand that.

The research doesn't support that they have something to sell. I'm guessing it's interesting too, because those same individuals with these huge platforms that vilify GLP1s will simultaneously sell you BPC157 because it comes in an oral capsule that they can sell you as a nutraceutical. And I'm like, o, that peptide's okay in their body.

That's.

That one's okay, but this one's not okay. I gotcha.

Okay, so, so for obesity, and I'm going to move over to the other side of who I really want to dive into in a minute, but on the obesity topic, when people are obese and need this and we, they are an ideal person working with a practitioner and they're saying they got super sick at first or it was, they could not. Is it too, is that a case of too high of a dose as well?

I think we really need to consider personalized dosing and understand that not everybody can start at the standard dose that it's offered at. And I think if, you know, if the manufacturers were to be savvy, they would be a lot more inclusive and open up the opportunity for a lot more people to utilize these comfortably if they were to onboard them potentially at a lower dose. And I, we now have both manufacturers are offering the vial form instead of just the pen. And so I think there's some opportunity there. But I think any prudent physician will tell you that we want to make our, our patients as comfortable as possible. And so starting an individual at a dose that they can tolerate. And it's exciting because the Journal of Diabetes just actually just published an article about microdosing GLP1s and I was like, what? It was an opinion piece. It wasn't a study, it was an opinion piece by a very well respected endocrinologist. But they were talking about using it as an onboarding strategy. So not at all what I was trying to discuss. But they are talking about it for the use of diabetes and obesity in terms of, hey, let's consider that we might want to onboard people at a dose that's tolerable and doesn't make them violently ill for weeks on end until they adapt. Eventually they will adapt, but like, why put them through hell?

And honestly, I think with any pharmaceutical that could be the case. I mean, I'll share with my own thyroid stuff like having a low thyroid, I don't want the standard dose. I actually get compounded a tiny microdose because sometimes a microdose of things are all that's needed. I was even talking to my cardiologist who I absolutely love, who he in very rare cases when he will suggest a statin for certain genetic markers, he microdoses the statin. He doesn't have people take it every day. He has. So it's like this could be applied to all types of medication. We don't have to because how can you say a 300 pound person needs the same prescription as 120 pounds? It just doesn't make sense.

It doesn't make sense. And I have found that those who are struggling with obesity definitely usually need a more standard dose. That's why I think it's so unethical that these telemedicine companies are trying to sell microdosing for weight loss. I think it's so incredibly unethical because.

They need a higher standard, a higher dose.

Every patient I've dealt with, when we last talk, I had only had one patient that had obesity that we'd used it for. And since then I've worked with several and consulted with several. And again, I hear from everybody, like all of you guys are texting me all the time, right? Like there's a lot of people in the community who are on these are their families are on them. And so I'm like the go to and they 9, 99.9% of the time need a more standardized dose. All that to say though the other part of my strategy is to go really slow and low. So starting out as low as necessary and holding. I think time under tension really matters. The standard way of dosing these in for obesity or type 2 diabetes is to ramp them up pretty quickly. And there's some understanding, and I get why they're doing it. There's some understanding that people will acclimate to them quickly. So you got to keep ramping the dose up. But I haven't found that to be true. I found that you can hold for a while. And so I'll give you an example. In most of the individuals that I've worked with who do have obesity and have a significant amount of weight to lose, we get them somewhere in like the middle.

At the highest end, we get them somewhere in the middle of the dosing tiers and we just hold them there. And then all of a sudden the weight starts falling off. Especially if they're doing all the things right, especially if they're really being compliant with the lifestyle pieces that I think are absolutely non negotiable. And so, you know, all that to say is we're learning. And I think the medical community's learning. And the studies were done a certain way. And so that's what doctors have to follow, is the standard of care is to follow what the study did. And so the studies ramp people up pretty high. But what we're seeing now, I think that that's concerning. Whether we see it in the data is irrelevant because I'm hearing it from people I know several people in the obesity community glp. There's like a whole obesity GLP one community out there. My friend Dave Knapp, he kind of heads it up. He's like an investigative journalist. And a lot of these folks are stuck at the highest dose and they're regaining their fat and it's not working anymore because receptors get desensitized just like anything. You can get insulin resistance, you can get leptin resistance, you can get any, you can get hormonal resistance to any of the hormones we're taking, you know, our sex steroid hormones like testosterone, estrogen, progesterone. So I think that there's a real concern there too.

So what do they do if that happens? If that, if you get resistant to it?

Well, this is why I made my course and you know, really encourage folks to check it out and encourage doctors to buy it and learn how to deal with it's. It's a comprehensive of strategy. It's, it's literally the way that I've been practicing for 20 years in clinic. I just wrapped it up in a GLP1 bow. It's really about treating metabolic health. And I think these folks are not necessarily hitting the gym. They might be doing a lot of cardio but as you know, like that's not the only solution. So you know what, the foods we're choosing to eat the way we're choosing to move our body or not, are we optimizing our sleep and respecting it?

You know, see, I want other people in the wellness space to really hear what you just said because, just because somebody. So GLPs are not a competition. This is like, it's a work together. Like to me, I'm like, well, people that are on GLPs for weight loss, they really need to understand how to train, how to eat right, how to do their protein, all, all of this stuff, it becomes even more important because just trying to crush, if you think it's just going to crush your appetite and that's it and you're just going to lose weight, there's a whole host of other things that can come up. Can I talk about the big scaries for a minute? Because I want. You said that there was a lot. There's no, nothing really supporting these big scaries. And the three that we keep hearing is, is basically your pancreas is going to explode. Like what's. Tell us the truth around that. And we also hear that you're going to rapidly lose muscle and that you're going to have gastric emptying problems. So those are the three big scaries. Can you speak into those?

And that your eyeballs are going to rot out. I've seen a real going around that your eyeballs are going to rot out.

Yeah, let's talk about it. So I do think biliary issues are a real concern because this does slow down gastric motility. So it's going to slow everything down. And your gallbladder and your, your pancreas and your gut are like BFFs, right? They all work together. So if we slow down gastric emptying, what happens? What I'm seeing is folks who traditionally eat the, I call it the whatever diet. When you ask them what they eat, they say, I eat whatever. It's like the standard American diet, right? The SAD diets. That's the acronym, Standard American Diet. They're crushing a lot of fatty foods, fried foods, maybe not the most nutrient dense foods potentially. And then they go on a GLP1. They're not giving the given any counseling. I really do think a lot of these issues are a dosing and management problem. And the onus of that needs to go on. The doctors who are doing the dosing, that's why I created this course for the doctors.

They're putting them on a dose. They're crushing their appetite completely. Appetite control is one thing, appetite crushing is entirely a different one. And so now these folks are eating hardly nothing. And what they are eating, they're still kind of eating their crappy food, if you will. And maybe they're still crushing chick fil a on the side. When that gastric motility has slowed down and the caloric intake has dropped significantly, everything slows. You actually need the food in the mouth to get peristalsis going. And so everything slows down. The gallbladder gets sludgy. Then they go eat a high fat meal that taxes the gallbladder and they throw a stone. The people that probably need GLP1s the most that are in that obesity crew, those folks have a much higher risk for gall stones and biliary issues. They have a much higher risk of pancreatitis already because they have fatty pancreas. They have a much higher risk for gastroparesis already because their vagus nerve is being destroyed by the hyperglycemia that happens with type 2 diabetes. And so the people most at risk for these conditions are already at high risk and they're the ones most likely utilizing these peptides. So we have to consider that first and foremost when we slow down all that gastric motility, they're not eating anything. They're gallbladder. All bile gets sludged up. They throw a stone into the pancreas. That is the number one reason for pancreatitis is a stone being thrown. It's not like the pancreas just melts it's because it got a stone thrown at it.

So if you're still like eating fiber and going to the bathroom regularly, then this would not necessarily be a thing. Is that if I'm hearing you correctly?

Well, if you have a history of biliary issues, work closely with your clinician. And I think this is why we don't go to med spas. This is why we don't do telemed. This is why we go to a doctor who knows what they're doing. Because I think the clinicians or, you know, or. Or find a good reputable telemedicine company, but the companies, the doctors that are respectable are gonna hand hold their patients, right? They're gonna just do this very carefully. And I have one gal I'm working with that I consult with. She gets. I consult with several people by referral only. And she gets all of her medications from her specific clinicians. Right. I'm not prescribing anything. And her GI doc has literally has her come in the office and administers the shot. She comes in once a week just to check in. That's how close he's holding her hand. And I think that's the way to do it. Because she has some issues and concern over pancreatitis. Right. In the past. So these are things that we have to consider. And the gastroparesis, like I said, the vagus nerve is the nerve from your brain to your gut, and it gets destroyed by high glucose levels. So when people are rocking high blood sugars for extended period of time, as in the case of type 2 diabetes, especially if they didn't know that they had type 2 diabetes, rocking. You don't just land on type 2. It takes you 10, 15 years to get there. So all that damage is happening in that time. Then they throw something that significantly halts or stalls their gastric motility if they take too high a dose, and boom, they get gastroparesis. It's transient, it goes away. We have studies on that. It takes a while for the peptide to get out of your system. And then gastric motility returns. There's no permanent freezing of the stomach. And then I think we have to talk about the thyroid thing really quick. Yep. That is a black box warning. I know people are very concerned. The black box warning was on rodents. And these rodents develop this type of medullary thyroid cancer very readily. Humans do not. It's very rare in humans. It's very common in rodents. They gave. When you look at mice studies or rat studies, they're giving those animals most times like 10 to 12 times the dose they would give a human being. So they're giving them these super physiologically high doses and then they're developing medullary thyroid cancer. What they didn't tell you is the control group of the rodents also develop medullary thyroid cancer. So how they made that a causative link I don't understand. But it is now a black box warning and everyone thinks it's going to happen. The data is actually showing that it might be therapeutic for the thyroid. That said, if you have a history of thyroid cancer, family history, personal history, obviously risk tolerance, again, talk to your clinician, make sure this is right for you. I'm not giving medical advice. I'm not telling you don't worry about it at all. But the things that I do worry about would be the gallstones. So I'm really hyper. I'm a naturopath. I start with the gut first. I'm really hyper aware that people are having good healthy gastric motility, good healthy digestive support. We get the enzymes on board, we get the ox bile on board.

I would imagine Tadka, things like that.

Yes. We make sure everything's going before we start the GLP1 or concurrently. I'm hyper fixated on that and I really want them pooping every day. I want things moving and so I think that's the big one. I think the muscle loss piece, like I said, I think we already hit that. It's right on par with, with any heavily calorically restricted diet or bariatric surgery. Just don't starve your patients.

Yeah. I think when people are talking about like hair loss and muscle, like they're literally not eating, like they're malnourished at this point. That's, that's too high.

I think that's part of it. I do, I will say even at tiny doses I've seen GLP1s they tend to unmask hormonal issues. So if you have an underlying hypothyroid issue, which I would say most. I've, I've, I will die on this hill. I think every woman over 40 should be on some dose of, of thyroid medication, period. It's, it's a longevity and protective tool. Like being subclinically hypothyroid increases your risk for cardio.

Yeah, I'm on, I'm on a compounded T3. I like it's. And it's very, very low. It's like a very low dose, like the lowest you can get, but it makes a difference.

You get what you need. Right. Like it's a little sprinkle. I mean, there's, there's a study that goes way back to when I was in medical school, showed that women in particular who were subclinically Hypothyroid had a 250% increased risk of dying of a heart attack because of it. So, I mean, we don't want to, we don't want to leave the thyroid slugging along. We want to give it a little love. But I think that you throw some GLP1 on it and the hair will start falling out. Right. Or if your progesterone's off or your. That makes sense.

You're aggravating something that's already there.

Yeah. And a lot of these women are like low key, long term PCOS gals, and they don't know it. And that's a cardinal symptom of PCOS is hair loss. So then you throw a GLP1 on it. The GLP1 one gets things moving, it gets metabolism going. And if you don't have the CO factors because you've been malnourished for a long time and you have a lot of hormonal dysfunction, people unmask.

That makes sense. I, I know, I know somebody personally who, who had, who has had underlying alopecia. So then, and she's, she was thinking maybe that is the cause of that. But it makes sense what you're saying. If that was underlying, that everything could get aggravated.

I think it does. I think that's why I'm such a proponent. That's why in my course I double down on, on hormone replacement therapy and making sure that all these things are addressed. And I lay it out in a hierarchy of like, what's first, what's second, what's third. We always support the adrenals, we always support the thyroid, and then we go up the hormone hill because just one of those being off can. Not only that, but it'll make the GLP1 not work as well. There's a whole group of people who have messaged me, a lot of people. There's a whole subset of people where these don't work at all. It doesn't matter what dose they take. They get no benefit whatsoever. They lose no weight or they have. The needle doesn't move for them. And, and nine times out of ten I say, are you strength training? Are you on hrt? And they say, no, that's.

Well, it all has to be, it all goes important. I want to talk about toxic load for a minute and inflammation. And then I'm going to. I want to move sort of into that metabolically optimized eyes woman. And I think you and I kind of bonded over pain and inflammation and autoimmune and all the things. Like, I feel like I've got this long list of crap that I've dealt with in my life. So I've chased that and I. And to me, toxic load is like.

Like it's.

There's a lot of things in the world that are toxic, but as we get older, things start compounding. So you, Your hair color, your. Your products, your. It's just everywhere. Like, it just starts compounding. And. And for me, my ruptured breast implant kind of tipped everything over to a. To I firsthand experience what toxic load can do to my body. I don't believe it was just the implant. I believe there's a whole bunch of toxic load and then that rupture kind of tipped things over. So I believe inflammation is. Is super real. Can you speak into just toxic load and inflammat you see happening with midlife women in general when it comes to inflammation?

Yeah. Well, one of the things that I have pushed back when. When influencers or health folks have said people don't need GLP ones. Tina, just live a clean life. I always say what I tell my patients, which is how you got to me, how. How people got into my office. Like, what is that back history? It's lengthy. You know, I mean, myself personally, in second grade, I grew up in California. I was living in Northern Calif While they were spraying malathion over all of our houses to kill off the fruit flies because we had a fruit fly infestation. And like, all the dogs were dying, all the bugs died, we all got the shit sprayed out of us. How do people come to you in the first place? Right. If you're a clinician, there's a history there. And there's a bucket, a toxic burden bucket. And a lot of people get that bucket starts overflowing. And it's not for me to judge. And there's no amount of carnivore diet or clean eating or anything that's going to get them out of it. There's no amount of sauna. Yeah, we can dial it down. We can really help to start pulling some of those layers of the onion off. But I'm not here to judge if their immune system's freaking out and then you hit middle age. I mean, that's the reason why everything goes Sideways when you hit middle aged.

Yeah.

The minute you start to lose estrogen. Estrogen is super protective and anti inflammatory progesterone is super protective and anti inflammatory progesterone starts to wane. Gosh, I have women in my clinic in their 20s and 30s that I put on progesterone like you know, tiny amounts as needed. We go back up to physiologic dosing. This isn't super physiologic, this isn't pharmacologic dosing. This is just physiologic dosing. And so I interrupt this episode for.

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Women hit middle age, the wheels start really falling off the car and the hits the fan and it's miserable. And they hear this weird, dogmatic, polarized, you know, narrative on social media which is like, well just, you know, it's, it's always something, go vegan, go carnivore. It's something hardcore and that's going to solve everything. And people are so short sighted. I get messages all the time as I know you do too. I know you just recently went through this with your back imaging that you shared just because they had a personal experience that is therefore the solution for everyone. Well, I, you know, it's like all the women who come into my comments and they're like, well, I don't need to use hormones, I'm 58 and I just do carnivore and I keto and it's amazing.

And I'm like, dress in 10 years.

Yeah. Like, have fun, raw dog in your menopause. But we're not all built the same. And we don't all have the same engine and we don't all have the same brains and we don't all have the same immune system. So you're n of one lady do not give a shit. Because that's not how it works in the world. Right. Like, that's. None of my patients react the same to the same substance ever. It's, it's everyone's.

No, I mean, it's like, say, look, you can look at guys and girls. Like, I look at my husband too. Like, we have very different genetic makeups, very different labs, very different everything. Like, he could honestly eat whatever the frick he wants and he will not. He will always have an eight pack. Like, it's just not gonna. He could do whatever he is. That's who he is. Me, I look at a donut and I would have issues. So it's like we're just built different.

It's all different. And we have to honor that. And so I think that your toxic burden by the time you get to middle age is like, I don't even think it's weird worth. First of all, middle aged women need to stop listening to 25 year old influencers.

Yeah.

And second of all, they need to stop listening to men who can't prescribe. I'm so tired of the chiropractors who have absolutely no experience prescribing any of this, just all over it. I'm like, buddy. But you know what's funny about them? If it's over the counter, like progesterone, they're all for it. So anything that they can distribute. Right. But if they can't distribute it, it must be bad. And I'm like, Look, I have 20 years of clinical experience in this, 30 if you count my time with my mentor in this world. And like.

No two people are the same. And when women hit middle age, all bets are off. So that said, GLP1s have a tremendous impact on quelling the immune system. It just calms it down. We don't want to suppress the immune system because we still want it to work. But it sits on. There's GLP1 receptors on your immune cells. It sits on your mast cells and stabilizes the histamine response, which is huge. It sits on.

Explain what you mean by that, because histamine is a trendy topic right now.

Histamine, I just did A podcast about it on my show. Histamine is where your immune system's going crazy. That's it in a nutshell. So you have these mast cells, M A S T, and they line your skin, they line your gut, they line your lungs, and they blow histamine when they're triggered. And it's like the Marines. It's not elegant, it's indiscriminate. And it's just like all hell breaks loose. And so, so histamine can be super inflammatory and that sets off a whole cascade. And one of the things that no one's talking about is lipopolysaccharides. Not to get too technical, but lipopolysaccharides, which are secreted by bad gut bugs, will trigger the mast cells to blow histamine. And so it becomes this like self serving, feed forward mechanism in the body. And it's a real mess. And so once people are in these loops of inflammation, they oftentimes can't get off the roller coaster. Even with the best of diets, even with the best exercise. Exercise might aggravate them, sauna might aggravate them, cold plunges might aggravate them. All of these things can aggravate a histamine response or your immune system. And so once they're in that downward spiral loop, I'm not judging. I just want to apply whatever I need to apply to put out the fire, right? Because that's the doom loop of diabetes and dementia. Like that's a and cancer.

So we've totally normalized taking bioidentical hormones, taking, doing HRT. We have completely normalized taking T3 or doing something for your thyroid. We, we have definitely normalized berberine with meals to get your blood sugar down or even doing small levels of metformin. Even the biohackers do it. Why is this thing so controversial when this does all those things? This helps with everything.

I think there's a lot of players in this. I think we've got a lot of industries that are profiting off of the diabetes industrial complex. So for everything from joint replacement to.

Obviously the cardiovascular disease complex, that's a whole thing, right? Lipitor is the number one selling drug in America for a reason. I think that the pharmaceutical companies who don't have a GLP1 in their pipeline are.

If there's a peptide that can be used, that might make a lot of other pharmaceuticals irrelevant. Because the things you didn't mention are people are completely fine with being on statins for life. They're completely fine with being on blood pressure meds for life. But why is this suddenly a thing? So there's that, that the, the junk food industry has something to lose. Their, their sales are down. They've come out and said it. The CEOs have come out and said it. Just go look it up in Forbes magazine. Everybody's very concerned. Big tobacco, big alcohol problem there. Because there's good data to show. I mean, shoot, they've got studies now. This is in mice. They've got studies showing it. It quells heroin addiction, it quells opioid addiction, it quells alcohol abuse.

This is huge. This is like, oh, the way you talk about it and hearing that, like, it feels like some dose, some level of this almost everybody should be taking because why wouldn't you? It's like preventative.

Huge. Yeah. The opioid and the alcohol studies were in humans. I mean, we've got. This is just a phenomenal tool. Now. You can eat through it. I say chew through it. You can chew through any dose. You can out drink it. I know people who are on the highest doses who admittedly have alcohol problems still, they still drink a lot. So it's not like a magic panacea, but it definitely plays on dopaminergic pathways in your brain, which is the reward pathways, and it just turns it down. So it got my husband off of alcohol. My husband's a known alcoholic. He is very forward about. I mean, he shared this publicly on my podcast in the past and we had him on a baby dose of semaglutide for. You know, the thing that I haven't mentioned, these are healing. They're healing, they're regenerative and they're anti inflammatory. So I do actually believe that the longer someone's on them, the more of a healing impact it's going to have. We have data showing that it regenerates cardiovascular tissue, it regenerates the pancreas. It's, it's, it's regenerative to muscle, it's regenerative to bone. And so I think that time on the peptide matters. And I'm a big proponent of using a personalized dosing strategy and then cycling it, going off and on it. You can't really cycle it. If you're on a super high dose, that becomes problematic. So in order for receptors to stay sensitized, I cycle everything. Anyway. All that to say is he, he used it for about nine months and then went off of it and then decided to like, he would drink a little bit while he was on it. And he was like, I don't wanna drink anymore. And he is firmly convinced that it was the GLP one. I don't know. I mean, I think maybe too he just decided to quit. I have no idea. It's his life, it's his body. That's the thing. We're all individuals. We all have a different way of responding to things. We all have a different neurochemical pathway set up. We all have a different neuroimmune modulated. Like your brain is impacting your immune system. Direct is the chiropractor in me coming out. Your brain health is impacting your immune system absolutely directly, which is directly impacting your metabolic health. And so it's ridiculous for people to assume we're just going to treat metabolic health, we're just going to do dietary interventions to reduce insulin resistance. I'm like, okay, well what are you going to do about the immune system? Okay, let's take it a tear back further. What are you going to do about the inflammation in the brain? GLP1s hit all of those.

It makes sense.

Okay. That's why I'm so excited about them.

Do you remember? And maybe everyone listening has not heard this, this but LDN got real popular for a while. Low dose naltrexone for, for the intention was to hit inflammation and it never, it people, everyone was trying it, it was like this big buzz but it never really took off. What, what do you know about that? In comparison with. Was LDN just hitting one like what was that?

Low dose naltrexone. So I've been using that since 2008. Huge fan, like dispensed a lot of it in my clinic, have been taking it myself. I cycle cycle it, I cycle it in 90 day increments. I think that's key to keep the receptor sensitized. That works completely differently. So you have opioid receptors on your cells and naltrexone binds those. And the idea is you bind the receptor so that the cell will sprout new receptors. And those opioid receptors are very intimately related to your immune system. And so in a roundabout way it turns down inflammation. I think it's a nice adjunctive tool. I don't think it's the most powerful lever you can pull, but I do think it's a pretty powerful lever. And I'm a huge, you know, for some people it's life.

I mean absolutely life changing. And for others like myself, I stay on it and when I go off of it, I, I don't notice A huge shift. But over time I start to notice, I feel worse. So I go back on it because I have, I'm like an autoimmune girly to the hilt. So I'm a fan of it. I, I think it's a powerful but, you know, very much like GLP1s at tiny doses. It's not monotherapy, it's part of a comprehensive toolkit. So I think, you know, we have different things that pull different levers, that have different mechanisms of action, action depending on what we're trying to do for the person. And all of that matters. But what really matters is, you know, if we're over here trying to put out the fire with our water hose of peptides and LDN and everything else, but the person's still pouring lighter fluid on the fire through their diet and their lack of exercise. That's, I think we start to get into trouble. And that's where people need these ever increasing doses of GLP1s. And then they start to dose into side effects and that's where we start to get problems.

Okay, when you, when, when we look at the midlife woman and I'm talking most, not, not the anomaly that's listening, that, that's like Brooks. That's not who I'm talking about. But, but a lot of them, especially if you've got, And a lot of my listeners, they have autoimmune, they've got pain, they've got a lot of things. There's a lot of benefits in, as you say, baby doses or in tiny doses. And from many women I've heard that they tried a, what they thought was a micro, microdose or whatever, but they said then they couldn't eat or they lost too much weight or they started losing muscle or, or.

Whatever, insert, whatever. And my initial thought, because I have you in my head, is that it was not actually a mini dose, it was not a baby dose. It was the wrong dosing for them. What is that accurate? Or is that? Because I would imagine at the smallest, tiniest dose, you should get the benefit without those things.

So that's what I was trying to get at at the beginning. I feel like the inmates are running the asylum here because all these doctors and pharma and telemed companies are claiming to be microdosing. And they're not. They're just doing standard dosing. They're just using the low dose, the lowest dose, which is the standard low dose. And then maybe they go up one. But I am hearing from so many influencers who are seeing doctors that I know, and these same doctors are going on podcasts or calling me up saying, I don't know why you said you pioneered this. I've been doing this for years. And I'm like, well, that's funny, because I talk to your patients all the time. Time.

Yeah, I. We had, we had a few interesting. Because I, Because I interviewed so many people. I. I've definitely texted you, like, so and so this, so and so that, so and so this. And it's, it's. It is funny because the dose I've learned from you, the dose that they're saying is a starting or is not what you're talking about, you're talking a tiny amount.

Yes. And I'm really talking about it. Yes, we can. We can. For those of us who need the tiniest dose, a weight loss impact might happen. But I'll tell you what, like, Like, I don't have a. I've been on and off GLP1 cycling them for the past two years, and I don't have a six pack. Like, I still have a flubby tummy, you know, Like, I'm not using it if I want weight loss. And to get below my set point, I have really got to dose myself into side effects. I just don't think microdosing is a weight loss strategy whatsoever. And with the. These telemed companies that are average, the thing that pisses me off is these telemed companies and all these other influencers are advertising it, and then they're bringing my name into it and they're saying, well, Dr. Tina said it was safe. I even just, well, I, I texted you there was people running ads with my name crazy. They bought my program, and then they turned around and made an online weight loss program out of it. And I was like, well, you bastardize my entire strategy and then you put my name on your ads. It's crazy to me. But anyway, and then they asked if they could come on my podcast, which I thought.

And now there's like, there's even a network marketing company. I heard that's. I don't even. I don't know anything good or bad about it, but there is literally a network. Network marketing company. So I've seen a ton of influencers now talking about how they're doing small doses or they're saying microdosing. But they're all. And they're all, they have a way to sell it, which, to me, I don't know anything about that company or not, but to me, it's. I'M already concerned because then you don't have a doctor that's kind of working with you and overseeing and customizing to you. So I have a lot of questions about that.

Well, in a small, you know, a little. I always say a little bit too much can be a lot too much. Just the tiny. And you, I think, experience this. And these are the people who are calling me, saying, I am sick on my couch, puking my guts out for two weeks. I lost a ton, ton of weight, but I'm on a microdose, and I'm like, what's your dose? I always ask, what's your dose? And like I said, I have hundreds of thousands of followers who message me. And every time I get that message and I see it, I ask them, what's their dose? And inevitably, it's just the standard starting dose.

Yeah. So when I first interviewed Tina, I was like, oh, I got to try a microdose. I've got to try the tiniest amount. And same experience that you're describing. Where I went and got what was told was a microdose. It was not. I called you. You did, like, way less than that. And even you even said. You even said to me, you might not be a candidate for it if your blood sugar is going that low or whatever. So it has to be very unique for everyone. And I know for me, made blood sugar way too low at what I thought was a tiny, tiny, tiny dose. So it is very customizable. You have to really understand this.

And I talk about this strategy inside my course. I have a whole module on dosing, and it's. It's. People have to understand the whole strategy so that they therefore can have an educated conversation with their doctors about what appropriate dose for them. And that, I think, is the most important part, is if you can empower people with education, then they can have conversations that are educated with their practitioners, and then their practitioners learn something. I learn things from my patients all the time, and I'm so grateful for it when they bring me new information, because as long as they're not doing it in a combative way, it's like, hey, yeah, let's work together on this. This is cool. I hadn't heard of this. And so that's what I'm to get out there is I just want more doctors to understand how to do this right. And the course is for clinicians, but I let the public in because I. The public's really well educated right now, you know, and they deserve. I. Who am I to Gatekeep and say, no, you guys can't have this level of education. Like, why not just open it to everyone? And that's what I was going to make two different courses and I was like, screw it, that's too much work. And it's this. Most doctors don't understand metabolic health well enough to not have this information at the level it's at. And, and most of our followers are so savvy and well educated that they deserve to have a more clinical conversation. Right. And so is there any difference to you between.

And I know this is probably stuff in your course too, but is there a difference to you between. Because I watch people positioning it different like Ozempic or Semaglutide and then tirzepatite and now there's another one people are talking about. Retuotide. Is that what it's called?

Yeah, Retatrue tide. Let's talk about those because I have some thoughts. Okay. What's your question though?

Well, I wanna know what's the difference? One. And then what I'm seeing is biohackers talking final one. As if it's like some superior and they're saying It's a GLP3. I'm confused. I don't understand what that means.

I'll tell you. Well, I have some thoughts.

I think the biohackers, most of those guys get an affiliate cut when they sell what we call the gray market. You can buy peptides online in many cases without a doctor's prescription and you never know what you're getting. And I just talked to a pharmacist the other day, a compounding pharmacist, and he's like, the thing about, about those is that they sell you a certificate of analysis to tell you if it's like 98 pure, 99 pure. But what you don't know is it, is it heat stable.

You know, how long will it stay shelf stable once you reconstitute it? There's a lot of variables here and I, you know, I, I wholeheartedly go for the prescription version anytime I can versus the gray market. Okay. Straight up. Just because. And if it's even 1% off, off with something in there, like what if there's an extra peptide on there? Right. Or I'm sorry, an amino acid. Right. Like in that. Because a peptide is just a chain of amino acids and really a group of peptides is a protein that's as simple as it gets. And so I just think there's variation there and it concerns me a little anyway, that Said retatrutide is the thing that they know they're going to be able to sell because there's a huge lawsuit going on right now between big pharma and the compounding pharmacies. And some people may have heard about that and some of the. So because of that, the research companies are getting cease and desist letters to take their semaclutide and tirzepatite off their website. So reta Truetide at the end of the day is gonna be the only thing these folks can sell.

This is a marketing thing. It's a marketing. It's always a marketing thing.

Yeah, it's always a marketing. I'm selling no peptides, I'm not taking any patients. I sell education. That's, that's, you know what I'm trying to get at.

Okay, this is interesting because it's confusing for people we're hearing. It's like that makes sense.

Well, let's talk about it though because every benefit I just shared with you over the past hour is about GLP1s specifically. Tirpatide is a dual agonist. It's got GLP, it's got GLP1 agonism and it's got GIP.

GIP doesn't do what GLP1 does. And so it's a 5 to 1 ratio. You've got less GLP1 in there and more GIP agonism. And so for folks who, who insurance.

Hepatide, you're saying wait.

And so for po, folks who get all of these wonderful anti inflammatory benefits, the desire to not drink as much, the clearing of this acne, the joint pain resolution, all of these wonderful things are getting on a GLP1 which is semaclutide, all GLP1, okay. And then they go on tirzepatide and they don't get all of those benefits. It's because there's not enough GLP1 in there or them.

Makes sense.

And Tati is more expensive in many cases. Retatrutide is 15 to 1. So you're getting. It's a triple agonist, you've got GLP1, GIP and then glucagon agonism. Totally different beast. If you're trying to cut, if you're a bodybuilder and you're just trying to cut out really fast, great. If you're trying to lose a ton of weight, great. If you're trying to get the fat out of your liver because you have fatty liver, great. Reditru Tide might be your girl, but it's 15 to 1. And there's hardly any GLP1 present. And so when I do, I've tried retreat twice now. I got nothing. It did not help. I take it for brain fog, I take it for autoimmune disease, and I take it for pain. Nothing. And it doesn't really suppress appetite that well.

And does tirzepatide do all those things for you or you like semaglutide?

Kind of does, but semaglutide, it's like, I'm really a fan of GLP1s and Tirzepatide. All of these are known as incretins drugs. They're not all GLP1 heavy. And that's what people don't get. Redatrutide is really very. Got very little GLP1 in it. Tirzepatite has some GLP1. Not as much as semaclutide is just pure GLP1. And so when I'm talking about, like, giving it to patients with mast cell activation syndrome to stabilize their mast cells, I'm talking about semaclotide. I'm not talking about tirzepatide. And I think that's a distinction that people do not understand. And so I'm over here talking about microdosing GLP1s for a myriad of health conditions, and the bro science guys are talking about microdosing retatrutide, and they're not. Their strategy of microdosing is very different than mine. Some of these folks are saying, just take the same standard dose, but break it into tiny little increments every few days. I mean, it's like all over. It's like the inmates are running the asylum here, but they're talking about retatrutide. And I'm like, you clearly do not even get what I'm saying, because I'm having a different conversation.

You're having a very conversation. You're saying, let's take the actual GLP1 and let's break that into a very, very small, the minimal dose that you. You can do to start tackling these things.

Yes, that's.

That's what I'm hearing you say. Yes. What. When? Okay, what's the rumor about this is they're going to be illegal and you can't buy them, and compounding labs can't sell them. Is that. Is that true?

No, not entirely. So back with the Obama administration, there was the advent of the 503B pharmacy. So compounding pharmacies fall into either 503A or 503B. 503B is basically mass production of pharmaceuticals when there's a shortage. So a few years ago, for example, we had an amoxicillin shortage and so they were able to ramp up production. It's basically to cover our ass in case we can't get medication in this country. And so the Obama administration legalized mass production of pharmaceuticals under this 503B category. If and when there shortages of drugs, Those drugs just GLP1 Tirupatite and Samaclutide just came off shortage. That's what all These lawsuits are about.503 a pharmacy is like your little compounding pharmacy down the street. If they have the ability to do like they have to have a special room with a special hood, if they have the capabilities to do sterile injectables, they will be able to continue very likely to do GLP1s under that umbrella of 503A. And the caveat is that it needs to be different enough and distinct enough from the brand name version because those are on patents still. And so you might see them mix mixed with B12 or you might see them mixed with something that will help with.

Side effects, or you might see and there has to be a clinical indication that the individual getting this prescription cannot tolerate the brand name. So it's going to get a little more difficult out there. I think we're probably going to see some of these telemedicine companies go by the wayside and it's probably going to get more expensive, but it's not disappearing.

So it's so you'll still get them. It's just that it's going to have to require a workaround or more pricing or doing a little research and finding.

Understanding that it's getting dicey though. I just heard about a clinician who, you know, we use these, we use digital chart notes, our EHR as they call them, electronic health records. And I never did insurance billing. I was always payment at time of service. But most doctors are under a billing insurance kind of umbrella. And she was told that if she utilized any compounded GLP1s that she would not get reimbursed, her services would not be improved. Wow. So they're finding different ways to really come down on doctors. I think this is going to become more challenging, but I don't think they're going away. And the brand name big pharma companies have, like I said, come out with their own vials. So the vial option is there. I think we're going to have some workarounds. I just don't think it's going to be, you know, we. We just hit like the heyday there for a minute. Yeah.

Do people. Couple of questions I didn't ask you. I want to make sure. I asked if you're on a GLP1 for weeks, weight loss, do you need to be on that rest of your life?

I think it depends on. It depends on a lot of factors. It depends on. I think a lot of obesity is being driven by inflammation and again, going back to the central nervous system. And so depending on that individual's reason for the body wanting to hold on to the excess weight, I think it can vary. I think in some folks, yes, they're going to need to be on it. I think some people are so metabolically compromised that. But it's like they're too far gone, you know, and age is an issue here. Gender is an issue here. There's muscle mass, amount of muscle mass. I think for those folks who really, particularly the younger ones who maybe haven't been on the type 2 diabetes train for very long or the obesity train for very long, I think those folks, so long as they're doing all the things that we talk about, you know, eating nutritionally dense food, really utilizing this time to change their ways. GLP1s actually cause neuroplasticity. They can cause your brain to rewire in a really favorable way. Neuroplasticity is something that's so hard to come by as we get older, but it means that our brain, what wires together, fires together. It means that our brain can rewire itself. And if you are under the umbrella of a GLP one time that you're using it right, you have this wonderful opportunity to make all of these potent lifestyle changes and hardwire them into your brain. And it's so cool. So if you're utilizing a GLP1 and you're not taking advantage of it, of this, you're missing the boat. So I think it's such a great time to help these folks. This is why I think a really comprehensive strategy is needed. And that's what I'm trying to get clinicians to understand inside my course is like, you cannot just. You can't just prescribe these and send people on their way.

Right.

There needs to be a comprehensive strategy because they are literally going through a neuroplastic event and we can make some really profound changes. So imagine a younger person, they get to the gym, they learn to strength train, they start eating well, they start setting their circadian rhythm and getting up with the sun and going outside. They Start doing all the things they prioritize, prioritize their sleep and their overall wellness and their mental wellness, and boom, those are the people I think probably have a better chance of coming off. Yeah. But. But for the people who are on them for life, you know, you're also looking at a life of like, at least the average American our age is on five different pharmaceuticals for life.

Well, I also look at if you're a type 1 diabetic, you're on insulin for life, or if you're like, and I'll be on. I'll be on estrogen for life. I'll tell you that right now. Like, I can't pull it out of my dead hands at age 99. Yeah. No. So, yeah. And thyroid medicine, same thing. So I feel like it's. It's not. I mean, it's. I guess you don't have to be on for life, but if it's super supporting you and it's helping you, it make. It makes sense. What about some of these oral ones people are talking about? Is there anything to that? These people that say they take these, they're going to naturally enhance your own GLP1. Is there any truth to that?

Supplements. So there is one supplement that I've run across that is a hops extract that does stimulate natural GLP1 production. I think that, again, everyone's response is going to be varied on that. Be depending on the health of the gut and the health of their L cells. I think that Akkermansia, there's a couple products out there with that probiotic in it. Akkermansia should stimulate the L cells to go. Sodium butyrate is what Akkermansia triggers to get the L cells to go. So sodium butyrate as a supplement. I don't think any of these lead to appreciable weight loss, but I think they are adjunctive and I think they're tools. And I like to use all of them when I am taking somebody through a GLP1 experience. And so I think they're adjunctive. And again, they, they stack back. Right. So I don't think pounding berberine or pounding Akkermansia is the solution. And I don't think it's going to replace. It's not nature's ozempic.

Right.

But I do think they have a place that makes sense in supporting the gut health.

That makes sense. So I know you, and I feel very strongly about this. So I'm gonna, I'm gonna just discuss it for a minute. So I. But I teach when people come through my fat loss programs is I teach women to be a health detective. I don't ever feel we just should listen to a podcast and go to our doctor and, and just say, I heard this. What is your opinion? We have to. As women in midlife, we have got to really start educating ourselves and learning so we know the questions to ask and then we have to monitor. Just like as I shared my experience when I got all excited about this, you know, year and a half ago, or whenever it was I interviewed you when I wanted to explore and I had to if. And I. And I knew a lot and I still was getting wrong information from doctors. Doctors. Like, like wrong doses, wrong information, wrong stuff there. So can you speak into that a little bit? Because I know you developed this course initially for doctors, but now you've really. You want general public to be able to come through it while you still have it available for them. Can you speak into that and your experience and why? Because you, you've seen patients, you know, and you could have just. Why, why was this important?

Because I was a really sick little kid and I went through medical training so that I, I could arm myself with information. I spent half a million dollars so that I could arm myself with information. And the more I learned, and especially when I got out and practiced and really started practicing and talking to patients, the more I realized how clueless people were and how much information is being gatekept. And I think it's changed now that we have the Internet and we have all these health influencers, but now there's just like this massive overwhelm that people have and it's so confusing. And so I wanted to create a platform where I downloaded my clinical strategy for optimizing metabolic health. First and foremost, I just, like I said, I wrapped it in a GLP1 bow because that's what people are listening to. And I do think GLP1s can synergize with every single module in there. There. You know, patients are only given the information that the doctor knows, but more importantly that the doctor wants to manage. And I'll give you an example when you go in, if you say, I want all these specialty tests done, I saw them on the Internet. If your doctor is unfamiliar with them or doesn't know how to read them or doesn't know how to manage what the out. Because they're legally responsible for the results on that lab test, and if they don't know how to manage that, they're not going to run it.

That makes sense.

If you go in and you ask for a TSH and a free T3 and a free T4 to assess your thyroid. But you want to reverse T3 too. They're not going to give you half of those because they don't know what to do with that information. And it's not their fault. Like they have the training they have. Right? I have the training I have because I have particular interests and my particular interest led me down this pathway to learn these things. So I don't dog the doctors. But their hands are tied. They have a limited amount of information, they have a limited amount of time and they're just trying to do their best by you. You know, I don't think it's a, it's not a gre. Doctors aren't getting rich. Maybe the plastic surgeons, but it's not a greed based business. It's. It's a really rough industry. In fact, I just read a terrifying statistic. Female physicians have the number one overall, far above and beyond other physicians, male physicians and any other industry. Industry. The number one most suicidal. Wow. Category is female physicians.

Wow.

They're hitting burnout and they're ending their lives. So it's, it's a rough, you know, and I think that patients are now fed up and they want better answers and they come in and sometimes they're very demanding and you're. It's like expecting an electrician to do your plot plumbing. Right. Like, you can't ask, you can't ask your electrician to fix your plumbing too. They don't fix everything in the house. Right. So I think we just have to understand that it's the onus of responsibility to educate ourselves is on us.

Yeah.

I think more, more education we can provide. Like your podcast. My podcast. That's why I have it. I'm literally my podcast. My agenda is to download my brain into the Internet before I die so that this information doesn't leave the planet with me. And that's what I'm trying to put in. That's what I built that. I spent a year building that course out because I wanted it to be so comprehensive and feedback's been amazing. I'm getting feedback from clinicians who were like, this is exactly what I needed to implement these strategies in my clinic. And I'm getting feedback from the general public saying I almost took it away from the general public. And I got all this pushback from students in there. They were like, don't take it away from the general public. Because one lady said finally, after all of these years, she said, I've gone to like seven different functional medicine doctors. I've spent tens of thousands of dollars. I bought all the books, I listened to all the influencers. You finally put it all together in one place. Place. It makes sense. So finally it makes sense, right? So I don't know, you are like.

You are the original person that was truly teaching and talking about this. So I, I feel like everyone should learn this from you because otherwise we're, we're hearing like trickles or we're hearing what got trendy and we're hearing little sound bits. You all. I'm going to put all this in the show notes. Whether you're watching this on YouTube or listening on my podcast, if you go to and I'll have this in the show notes. But if you go to midlifeconversations.com forward/glp1 that takes you to a really extensive four part video series. She did. That's that, that's free literally to go deeper on these topics. So there's that. But if you're like, I don't even want that. I just, I want in your course and you want to do that right now. If you go to midlifeconversations.com forward/glp1training. So GLP1 training that will link directly to how you can get her course and then you can add. She's giving a generous discount for, for listeners if you put, she'll have, she said she'd have a coupon box that said now you put Natalie, Jill, one word that'll take off a significant amount of that course since you're a listener here. But this is phenomenal. Just like I would advise on when you're learning about hormones. I always tell people, you've got to learn yourself, you've got to go deeper. Thyroid, you've got to learn deeper. Gut, you've got to learn deeper. And people are like, is it ever going to stop? No. We have to keep learning. We have to be our own detective, our own health detective. We cannot rely on just our 15 minute doctor's appointment. We also cannot rely on, on. We can't expect our doctors to know everything about all topics. We have to learn it, ask the right questions and get and become educated ourselves. I know some of you don't want to hear that, but if you're not doing well, you've got to figure this out. I also want to share a lot the reason a lot of. I was really thinking about this. Tina, I don't know if you've noticed this too. I was thinking about most of us in the more natural health space. And I'm certainly not all natural, believe me. I color my hair, I do the things. But in the more natural space and the more holistic or functional medicine, even sometimes naturopathic, the reason we all got into these spaces is because of our ridiculous genetics, because of our broken in the western medicine world, because of our need to figure out what was going on ourselves. So a lot of times when people are like, well, this seems extreme and why isn't my doctor talking about this? Your doctor might not have walked through all this stuff. And so sometimes I think it's good to learn from those people that did because if you've walked through autoimmunes, you've walked through pain, you've walked through you. A lot of people have had to self teach and self learn and that's why they're so adamant about giving this back and also sharing. And so I love learning from those people. I don't, there's nobody that I've partnered with or really like have referred to programs that hasn't walked through the stuff themselves. Do you notice that, Tina?

Yeah, absolutely. It's, it's so important for empathy that people understand, you know, and it's, it's, it's just been really, it's really bizarre when I see clinicians being really dogmatic about anything because the answer is always somewhere in the middle. It's always gray. It's always, it depends. And online everybody wants a polarized answer. And, and I know that the listeners, well, what do I do? It's like, well, it depends, right? It depends on so many factors. And it's not just about the magical. What's the, what's the starting dose? It's like, what's your long term goal? What's your short term goal? What do you plan on doing in nine months? What else are you going to do adjunctively with it? What else? What other boxes do we need to check off? Right. And I can't treat everyone. And so, and neither can any of these other doctors. And I'm not saying I'm superior as a clinician to anyone else. I just know that the shit I know, I know really well.

Yeah.

And I know it because I live it. And I think that's really important because it's. Yeah, it's the wild west out there and there's a lot of people monetizing on stuff too, that because it's trendy without having put themselves through it. I will never suggest a treatment for someone Unless I've actually undergone it. Yeah, like I'm like as a guinea.

Pig, I try everything. I, there's nothing I won't. I'm like, I will try before every supplement. I talk everything, I try everything first. I want to know. And you know, I just, I really watch this conversation. You know, my gosh, I'm about to have my 13th surgery, which is really embarrassing in itself. And I, and I almost, when I first, when I, when I needed, when I knew I needed to have my disc replacement, first person I texted was our mutual friend Chalene. And I said, I don't even know if I want to share this because I'm so embarrassed. And she's like, yeah, like I could basically give you a day like you're, you're going to share it. I don't know how to not share things, but it's real. And yeah, I do have two autoimmune. I do have ruptured disc in my back. I do, I do have things that have happened. I did have a ruptured implant. I have all that and I share it all because I'm not going to be a victim to it. And I want people to learn from what I'm navigating. And I do think a of lot of people like close off being in tune with their body or they feel dismissed by a doctor so they just give up. I don't want that for people. I want you to keep digging. If your car was making a noise or not working correctly, you would get it fixed or get a new car. Right? You wouldn't just ignore it. We can't just ignore our bodies. When I was having my blood sugar dysregulation. My gosh, Tina, I don't think I really knew you then when I was first navigating that every traditional doctor I went to, oh, you're type 2 diabetic. Here's metformin. No real answers. And it took my friend saying parasites can do that or we got to look at your gut health. And then it took me getting finding out I had a ruptured implant. It had to be a detective myself. So you got to dig, you got to dig, you got to dig. So I highly recommend watch her four part series. Even if you're not going to do her course, I want you to at least see it and get the additional information. So midlife conversations.com forward slash GLP1 if you do want her course, midlifeconversations.com forward slash GLP1 training training or GL1 training. And thank you so much for being here and teaching all this. I'm sure I'll have you on for part three, of course, because I love this.

Thank you. I loved your questions. I think they were great. And we got to actually cover more things than we did on the first one. So I'm honored for the opportunity.

What do you want people to know kind of as a parting words here?

And that no one's coming to save you and your health is your responsibility. Responsibility at the end of the day. And so my mission on this planet is to help people understand their health better and get the answers that they need. And the people who like that kind of style like my content and, you know, come follow me on my podcast, come check me out on Instagram or wherever. It's Dr. Tina everywhere. It's D, R, T, Y, N A and dig. Like learn to dig. And I. You got to be a terrier. Just to add on to what you were saying. It's, you got to be a tenacious terrier if you're going to get that bone. You got to get that bone no matter if you bloody your nose or how many ways you got to dig in to get it. But that's, that's the world we live in and that's how we have to navigate it. Now. I love that.

And do not message me or Tina asking for your particular dose because I am definitely not a doctor. She is not your doctor. And so, so what you've got to do is you've got to learn. And that's why I, I would watch her four part series. So you, you got to start being a detective yourself. But she will not answer any messages about what is your particular dose. She cannot legally do that. She was, she's not going to do that. I certainly have no business telling anybody anything about a dose. I am a person with microphone here. I am not a doctor. So I'm just doing the interview here. But I hope everyone really does take learning this topic. It's not going to go away. So let's, let's learn it so we can be our most powerful, incredible midlife selves and keep thriving. Thanks, Dr. Tina.

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