Episode 115: Uncovering the Hidden Truths Behind Hormone Imbalances with Dr. Deb Matthew

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Dr. Rob Whitfield, the board certified plastic surgeon specializing in explant surgery. Breast implant illness is a topic that is not often talked enough about, especially in medical community, but is something that affects many women. In this podcast, I'll be discussing the latest research, treatment options and personal stories of women who have undergone explant surgery in an effort to heal breast implant illness. In this podcast, we'll explore the symptoms of breast implant illness and delve into the latest surgical techniques for explantation and the recovery process. Whether you are currently experiencing breast implant illness or are considering explant surgery, this podcast is a valuable resource for anyone looking to take control of their health and wellness. So let's dive in. Welcome to the show everybody. Today I have Dr. Deb Matthew, America's happy hormones doctor, is a best selling author, international speaker, educator, wife and mom of four boys. After suffering from years of fatigue and irritability due to hormone imbalances, her quest to resolve her personal health led her to change everything about her practice medicine. She has been featured on national podcasts, radio and over 100 television appearances for the NBC, ABC, CBS and Fox. Please welcome to the show Dr. Deb Mathew. All right, I have a special guest, Dr. Deb Matthew, who gave me a big boost in my career in 2021. So I'm very excited to have her on the show today.

So happy to be here with you.

So Deb, we were talking offline and Dr. Matthew concentrates on taking care of hormone problems for women and I see a ton of those. And one of the more common things I get, Deb, is my patients with breast implants who have chronic inflammation as part of their problem is I have women in their, we'll say late 20s, early 30s, feel like their symptoms of maybe fatigue and decreased libido and changes in mood, hair loss, things like that are secondary to going through menopause.

Yeah.

And yeah, that's pretty surprising.

Yeah. And it probably isn't true menopause, but there are a lot of things that affect our hormones that make us have symptoms of hormone imbalances. But the younger that women are, the more likely it is that there are external things that are causing the hormone problems. It's not just that their ovaries are, you know, running out of eggs, which is what happens when we get to menopause. But, but there are so many factors in our lives that can impact our hormone levels that can cause a lot of these symptoms. A big one that I see actually is birth control pills, because birth control pills are synthetic man made chemicals that mimic our hormones, but they aren't actually the real hormones that our body makes. They tend to shut down testosterone. That's a side effect that we know about and sometimes we harness it on purpose because a lot of younger women are given birth control pills to help with their acne, even if they're not really interested or needing birth control. So we know that testosterone shuts down or we know that birth control pills shut down testosterone. And testosterone is so important for energy and motivation and confidence and self esteem and get up and go and get things done. And so if testosterone levels are low, then women just kind of feel flat, kind of feel blah, just don't really feel like doing things, tend to procrastinate, they've just kind of lost their zest. But another really important piece of this is that testosterone is very anti inflammatory. And so if your testosterone level is low because of birth control pills, then of course inflammation is the hallmark of breast implant illness. So if you have breast implants and you are, you know, have other predisposing factors, then low testosterone can just sort of make everything worse.

We a lot of folks that have low totals and low free testosterone, when we look at their hormone levels and many of them that correlates well with what you're saying about, you know, symptoms, how they feel. It's very, you know, it's kind of startling that that is such a underappreciated side effect.

Yeah. And I mean we know it because we use it on purpose for women who have symptoms of too much testosterone, because there are some women who have too much testosterone, but it can really make women feel unwell in some cases. And if we don't know to look for it, of course, then the problem just goes on and on. And that's not the only cause of low testosterone in younger women. Another really important one is chronic stress. And whether it's emotional stress, you know, you're busy, you're worried you got too much going on, or whether it's some kind of a physiologic stress like chronic inflammation, toxins in your body, hormone deficiencies, but any kind of stressor on your system impacts cortisol, which is your main stress hormone. And cortisol goes up to help you cope with stress. And in the short term that's great, it helps you cope with the stress. But when we have chronic stress day in and day out, then our cortisol levels can become chronically elevated. And elevated cortisol shuts down testosterone and you can have both at the same Time you can be on birth control pills and have high cortisol from chronic stress. It just all compounds together. And cortisol is also a really important regulator of immune system function too. So then you just get more inflammation. And if you have breast implants and you are predisposed to problems, again, just makes things worse.

And since you brought that up the, you know, for the listeners, I kind of carry out the discussion. So it's kind of a reverse engineered discussion. I'll say, okay, we're going to help somebody, for instance, who comes in, has low total and low free testosterone. And many times, Deb, you know, they've tried bioidentical hormone replacement. And I'm sure you've probably heard this, but I get a fair number of people saying that they didn't feel that it worked. I always find that odd to me because if the predominant hormone in it was testosterone, like you're saying is going to be deficient now because of different things happening. It always peculiar to me when they say it didn't work because even though it's in a pellet or however they're using it, when they say it didn't work, I always kind of think of like, okay, this is a performance enhancing drug, drug that's on the doping list. And no professional male or female athlete around the world will ever risk their legacy, their endorsements, their financial livelihood on something that doesn't work. So when I hear that, I'm always think like, okay, well, that means the drug didn't get to the target tissue or the dose of the drug was not high enough to reach, you know, the therapeutic level needed in your, in your tissues. And then I always ask them like, well, what did they do? And you know, it seems like a woeful kind of series of. I don't think they're, they're intentional errors. Like it's usually like a dosing issue or it's a delivery issue or there's something in the, in the mix. But of course, testosterone works. I mean, it's pretty straightforward.

Yeah, well, I think one of the things that's really important to talk about here is the younger a woman is like, you started off by saying sometimes they're like in their late 20s and early 30s and kind of thinking that it's menopause. But if a woman is in her late 20s or early 30s and her testosterone level is low, something is happening that is making her testosterone level low. So the first thing that we would really want to do is look for what that problem is and get rid of it so that the testosterone can go up naturally. So if it's from chronic stress and if cortisol is too high, often we find dhea, which is another hormone, gets too low. And DHEA is the hormone that our body uses to make testosterone. So we want to try to manage stress and try to normalize cortisol levels. We can talk about if they're on birth control pills, maybe trying a different form of birth control that doesn't suppress testosterone. We can also give DHEA in the US it's an over the counter supplement. I only recommend it for women who have had a test done and they know that they're deficient in it. But if we give more of that, they can sometimes naturally make more testosterone and they don't even need testosterone replacement therapy. Once we get older and our ovaries aren't working as well, you know, then sometimes we really do need the testosterone replacement. But if a woman is on testosterone and isn't feeling better, of course we would want to look at levels to just see like you're saying maybe the dose isn't right. And there are different ways that we can do this. And so sometimes one way works better than another for different people. But if a woman still doesn't feel better and her testosterone levels now look pretty good, then it's likely that there are just so many other things going on that are keeping her from feeling well, that just slapping on some testosterone cream isn't going to fix all the problems and magically relieve all the symptoms. I see that a lot. Which is why when you're helping women, right, you do your whole comprehensive program because if you just looked at one little tiny piece of it, sometimes one little tiny piece isn't enough to fix the whole person.

Right. I feel, you know, that's unfortunately the siloed method. This does not really work well for our clients at all. And they come in with a whole host of endocrine, you know, problems. Many problems start with thyroid. And that seems, I don't know, in your experience, but it seems one of the most sensitive to inflammation. It seems like that goes off routinely and at seemingly first and then depending on who they're working with, it never actually gets regulated. It's just kind of this. They're taking a substance, whether it's armor or something else, and people are, you know, becoming more and more uncomfortable with synthetic then thyroid replacement like thyroxin. I don't know. That is, I get more worried about people who I take care of who have that problem. Because once you remove inflammation from their system that's really burdening their endocrine. Whether it's the feedback mechanism or what specifically is driving it, they will have the opposite. They'll get hyperthyroid. If they're taking especially a synthetic. I worry about them the most because that drug, just like we're talking about it works just like thyroid hormone replacement will work. Synthetic testosterone replacement works. If you're taking synthetic thyroid replacement and we do an explant and your inflammation drops precipitously, that can have the opposite effect. And you have. You'll get symptoms of hyperthyroidism.

Yeah. Which I think that's actually a wonderful thing, because what that means is thyroid function is restoring. You don't need all that medication anymore. But, you know, all that inflammation, like, was harming, because it's not just how your thyroid gland works, which is a lot of women. This is my story. Let me just tell you my story, because I'm getting all riled up here. My story is that for 10 years, I had symptoms of low thyroid function, but every time I went to get my thyroid tested, I was always told it was normal, even though I had this big old enlarged thyroid gland in my neck. And it took 10 years before finally my lab test went out of range, and I was told, okay, now you're hypothyroid. Even though I just had all the same symptoms, and I was put on Synthroid, which is that synthetic thyroid medication, and I was on it for another whole 10 years, and I felt absolutely no different. My lab tests were normal, but I didn't feel any better. And it wasn't until I learned this whole functional medicine, you know, whole person approach that I was able to, you know, deal with all of the different issues that were making me feel poorly. And I switched myself over to the natural form of thyroid hormone, and I felt so much better. And for me, because it had been so many years, I have Hashimoto's, which is an autoimmune condition that attacks your thyroid. So my thyroid had been attacked for, like, 20 years at this point, so I couldn't salvage it. But for a lot of women, where we can figure out that their thyroid is under attack earlier, sometimes we can salvage it. So just like you're saying, get the implants removed, get the inflammation down, and their thyroid can function better. But what happens to a lot of women is that even if their thyroid gland is actually okay, the thyroid gland is working. It's putting out the exact right amount of T4, which is the main thyroid hormone. That it makes. That T4 doesn't really do anything. It circulates in our bloodstream. But it's a pro hormone. It's like the precursor hormone. And so once that T4 thyroxine gets into our tissues, we have to convert it into T3. And T3 is the hormone that actually does the job. So that's the one that tells us to burn more calories and have more energy and keep our brain sharp and have a little bit of libido and keep our skin, hair and nails healthy and our bowels moving. So that hormone is so, so important. But inflammation, cortisol problems, nutrient deficiencies, imbalances in the bacteria in our gut, there's a whole list of things that interfere with us being able to convert that T4 Pro hormone into the active T3 that we need. And so for so many women, they have all the symptoms of low thyroid because they're not. They don't have the active thyroid hormone they need. But that's not the one that doctors are measuring. We just measure the other ones and they look fine. So we're told that everything is normal and then we just feel poorly. But it's a good thing that when the inflammation in the body is lessened, that thyroid function can improve, whether it's the thyroid gland can get better or whether now all of a sudden we're able to activate the thyroid hormone so people feel better.

It's diabolical how you were taught. Just check, you know, TSH and free T4, and if those are fine, then quote, unquote, your youthyroid are normal. And then people, you know, decreased energy, all the symptoms of hypothyroidism that are just obvious. And then like you said, if you check the other, the T3 or the reverse T3 or all these things that.

Are antibody levels, ye find other things, the TPO levels.

Yeah, that's a disappointing thing. Both from my background in training, I'm.

Sure, as yours, and I was a doctor going through all of it. Right. I did the training, I knew what my labs were. I didn't know any different. That's what we were taught.

Right, exactly. So that's. We've tried to help through a more comprehensive plan like you described. And I'm glad you mentioned the get, because while the amount of attention finally being paid to the GI tract, the microbiome, and where such a large majority of your lymphatic tissue is. So if you have an autoimmunity issue, I'm sure we can both sit here and forecast you're going to track it back down to the gut eventually. So maybe in terms of points that would help patients from just a dietary standpoint, maybe some guidance on that. Because I talk about it incessantly to the point where I probably, in my own head, I hear myself kind of droning about it because I'm saying, you know, similar things all the time.

Yeah, well, it's important for women to know that, like, what we're talking about is complex, right? Like all these things that you're doing are really complex. It's more than just removing implants. We got to get the body back online. But the good news is that there are some things, there are lots of things that are within our own control. And so there are lots of things that we can do in order to make ourselves healthy. And we do have to take some personal ownership in this because, you know, you can go see doctors and even functional medicine doctors, but all we can do is, you know, evaluate you, give you information, and then it's up to you to take care of yourself. So some of the most important things that I talk to women about in terms of diet is, of course, we need to avoid the bad things, right? The sugar, the starchy carbohydrates, the processed foods that spike our blood sugar, they create more inflammation, they, you know, make our immune system not work properly. So they're just going to make everything worse. And those are the foods that are available to us. And so many of the things that we kind of think are healthy things like granola bars and fruit yogurts and orange juice and things like that are really not such great things for us. And our blood sugar. Instead we want the whole foods, which are the foods that are found in nature that, you know, don't come in a package with a label with 42 different ingredients that you can't pronounce. And especially fats. In terms of hormones, we talk about healthy fats because your hormones are fat. Like these ones that we're talking about, estrogen, progesterone, testosterone, cortisol, they're all made out of cholesterol. So cholesterol is not a bad thing. Even vitamin D is made out of cholesterol. The thing about fats is we need the healthy ones and not the unhealthy ones. So we need to make sure that we are getting omega 3s, so things like nuts and seeds and avocado and fish and extra virgin olive oil. And if we from animal fats, we want to make sure that the animals are grass fed, free range because they have the more anti inflammatory fats compared with the grass fed or not grass fed. That's good. The corn fed feedlot, you know, the regular animals. So healthy fats in our diet. Women need enough protein. We often don't get as much protein as we should in our diet. And we need fruits and vegetables of all the different colors of the rainbow because they've got all the different phytonutrients. The plant compounds that are very anti inflammatory, anti cancer help our immune system function better. But food is really, really important to.

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It's hard.

Yeah, it's, that's not an easy thing. So anybody listening? Like you're not going to start eating 100 grams of protein a day because Dr. Deb and I said that and gain muscle. That's not how it works. You will probably do a lot to help yourself in terms of how you feel throughout a day because you'll, you know, your energy stores will allow you to burn, I would say more evenly always. And then for, for athletic performance, it's always better to have a higher protein diet. I think just in general, I don't, you know, you don't have to be an athlete. I do find a lot of problems with, you know, absorption. So tell everybody, you know, they need to eat more protein. And then I kind of on the side, I go, well you're probably going to have to have some digestive enzymes to help with that because we typically don't as we get older. I'm 55, I mean, I don't make the same number of proteases, which are the enzymes that break down proteins that I did when I was in my 20s and 30s and 40s. So we do obviously talk about that as well. And then doing everything you can from the probably most important thing I pin in recovery is sleep. I think women that I interview and have consultation with, they have really bad sleep patterns. It's like an epidemic of poor sleep in women.

And some of it of course, is our lifestyle, right? Like we're up on our computers and our phones and the light makes it so that we're don't make melatonin. We have a hard time falling asleep and then we have to get up too early. But for a lot of women, hormones actually play a role in quality of our sleep too. So if you're stressed and cortisol is too high, cortisol is kind of like long acting adrenaline. And we're supposed to have a circadian rhythm so that it's high in the morning and you can hop out of bed and get going. And then it's supposed to be low at night so that you're relaxed and you sleep and you sleep through the night. But for so many people it gets flipped around backwards. It's too low in the morning so you can't, it's so hard to drag yourself out of bed. You know, that's, that alarm goes off and you just want to keep pressing the snooze button. And you need some caffeine because caffeine gives you a little boost of cortisol so your brain can function like a human being and you can get going. And then at night we get this boost in cortisol. So now for a lot of people, they get a second wind at night, like 10 o' clock at night, they're, they're wide awake, they're sometimes getting their best work of the day done late at night, but then they take an Ambien or something to fall asleep. And it's become so common, like it's almost normal to need coffee in the morning and to take a sleeping pill at night, but it's not normal to feel that way. And another part of this cortisol being out of whack is the afternoon crash and burn, you know, two, three in the afternoon, where you need another cup of coffee or sugar or something, a nap to get you through till dinner. But cortisol problems are a really common cause of sleep disruption in women and in men. But another really important one is progesterone. So for women over the age of 35, as we are tippy toeing our way to menopause, you know, we're in this perimenopausal time of our life, one of the first things that happens is progesterone levels start to go down. And progesterone, of course, is one of the hormones that goes up and down over our menstrual cycle and it's the main calming hormone. So it's so important for helping us to get into that nice, deep restorative sleep and sleeping soundly through the night. So we feel, feel refreshed in the morning. But a lot of women will notice that they're waking up in the middle of the night, you know, at 2am and at 4am and initially it's often worse that week before a period. So I find that a lot of women will come in and they'll complain that they're not always sleeping well, but they haven't noticed the pattern that they tend to have disrupted sleep before their period. And then after their period they sleep fine for a while and then it happens again the next month. And then as we get older and our menstrual cycles are, you know, getting even closer to menopause, then sleep just becomes disrupted. A lot, a lot of women will notice night sweats. So for a lot of women, the night sweats happen years and years before they end up with Hot flashes. But this disrupted sleep is such a common symptom of perimenopause. And you don't have to be in perimenopause to have low progesterone. There are younger women who have low progesterone because of use of birth control pills or chronic stress or other things. But the younger you are, if you know, if you're in your 20s, is probably not perimenopause. There's external factors causing it. But nonetheless, progesterone is such an important hormone for quality of sleep, and it's not the only one, because thyroid problems make women not sleep well. If testosterone levels are off, women don't sleep well. So having balanced hormones is really important for quality of sleep. Of course, hormones are not the only thing that causes sleep disruptions, but a really, really important one, especially for women over 35.

Do you feel that, like you said, with the chronic levels of stress and the. I don't want to call it high or low cortisol levels, because maybe just the disturbance in cortisol would be a better way to describe it. So it's not to your point, peaking and troughing at the correct times. And it's been said on my show by other guests that that's one of the contributing factors, like you said of many. But this thing where women have to get up at night and go to the bathroom like an old man with a prostate problem is baffling to me. So every time somebody says that, a woman says that to me, I'm like, well, what are you doing in the several hours before bed? Are you drinking too much fluid before bed? Because that's an easy fix. And oftentimes that's not really the case. But it sounds like, as you're describing it, it, as others have described it, it's such a disturbance in hormones, however we're characterizing it, whether it's progesterone, testosterone, cortisol, all of them, thyroid, they're not happy. And that subsequently makes for a poor night of sleep.

I think if you're not sleeping, nothing works, right? Your immune system doesn't work well, your blood sugar's not balanced, you can't think straight. You were grouchy.

I had a post. I rarely get calls on the weekends. I mean, I have such a dedicated team in my office that really is incredibly responsive to Pat, that it's rare that at night or in an after hour situation I ever get a call. And what I do, I'm like, oh, this has got to be bad, right? I'm Always like, this is, you know, what's going to happen here. In particular, this, this patient was really kind of upset on the phone and, and hadn't been sleeping. It was the main driver of the, the issue. And certainly after surgery, I mean, I tell, you know, patients, and we help patients, you know, understand like we're going to cause a big spike in what Dr. Matthew is talking about, cortisol. Like I am the number one driver of cortisol in the world when you come see me. So surgery does that and it's a big stressful event. And then we want to do our best to get people out of that sympathetic stress state into a parasympathetic state. So you come to my office and we have these lovely lymphatic massage devices that also have a warming mechanism. So it helps create a more parasympathetic state. And we do hyperbaric oxygen therapy and red light therapy to help with, you know, hormonal balance. And we do, you know, all the things. But if you don't or can't get to sleep, none of that really, it's not a substitute. Like it's all meant to support, you know, the quality and quantity and depth and breadth of, of sleep and the number of cycles of sleep. And at some point I'm gonna get one of the sleep experts on my show because it's my favorite thing, like to. It's probably, I mean, it's not the most difficult to hack because you can do it. It's probably the most important thing to hack to better help yourself from a day to day basis. Because if you don't rest well, I mean just the cumulative effect of that is. It's bad.

Yeah, I think they've done studies where they've taken perfectly healthy college boys and kept them from sleeping for just a couple of days and caused their blood sugar to go up. Like they're getting pre diabetes just from a couple of days of not sleeping. Right. And we use it as torture for hostages. You know, I mean, like it's a really harmful thing to not sleep. So important.

And it suppresses testosterone levels in those, in those studies that they've done, it's very, very powerful. And people, when they say they get four or five hours of sleep, I just look at them and I'm like, they're so full of shit. It's not possible. Like I was a resident, a surgery resident for six years in the very old training model. And yeah, it was bad for a long time. I had to do it. It wasn't a choice. You know, I was, the beeper's going off and you know, I was like, I still have that kind of, if the light is on, it's from sleeping in those call rooms where you could see the, the light under the door. It freaks me out. Like, I'm, like I'm waiting for somebody to knock on the door or the beeper to go off. One of the, you know, 9,000 ways I got interrupted or the phones ringing. Like back then we even had regular phones in the rooms because if somebody slept through their beeper, you know, the nurses obviously had to get a hold of you. So, you know, I, I talk about maybe sleep and certainly dietary protein intake. I prob, I talk on those things probably over and over again. So maybe for some steps that folks could take to learn more that, you know, whether it's your programming, where, where would you like send them to learn more about this if they're interested?

Sure. So I have a practice in Charlotte, North Carolina, and there's lots of information about, you know, hormones and, and how they impact so many parts of our function and how we feel. And the website is called signaturewellness.org and I'm on Facebook at Dr. Deb Matth on Instagram at Dr. Deb Matthew. Lots of information.

Thanks for coming on Deb. I really appreciate it. It's been great to have you.

Thanks.

Thanks for joining me today. I hope you found the information and stories shared on this podcast helpful and informative. Remember, taking control of your health and wellness is key to recovery from breast implant illness. If you're looking for additional resources and support, be sure to visit, visit our online store, Dr. Rob's Solutions at drrobsolutions.myshopify.com you'll find a wide range of wellness products and supplements to support your journey to recovery. From specially formulated detox supplements to personalized skincare products, we have everything you need to aid your recovery. Visit Dr. Rob's Solutions today at drrobssolutions.myshopify.com thank you for listening and we'll be back with another episode soon. Remember, you're not alone in this journey and together we can overcome breast implant illness. Take care.

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