Episode 121: The Real Reason You Can’t Sleep and What to Do About It, with Dr. Inna Lozinskaya

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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 today. My special guest today is Dr. Aina Lozinskaya. She is a medical doctor, international speaker, mentor and the expert in traditional integrative and functional medicine with the focus on hormone optimization, health, longevity. Dr. Aina practiced hospital medicine for over two decades. Her quest to restore her own health led her to discover functional medicine and completely change her practice. She founded Midlife Wellness Institute in Denver, Colorado to help her clients achieve peak performance and vitality using her four step core framework that helps her clients optimize their hormones, restore energy, weight, sleep, focus, look and feel years, sometimes decades younger. Welcome to the show, Aina. Well, I've been chatting with Dr. Aina offline here for just a moment and because of our expertise in hormones that that's kind of where we'll begin. Everybody listening to my show knows I take care of patients with breast implants or problems with chronic inflammation. That chronic inflammation, we feel is really a driver in problems with thyroid and problems with the adrenals, problems with both testosterone and estrogen. And so I really appreciate Anna coming on the show to help us, you know, sort through some of these hormonal problems.

Sure. Thank you for having me.

So let's dive into that. I think thyroid seems to be the most sensitive to chronic inflammation.

Yes, it's probably the first line of defense once somebody is inflamed. Cortisol goes off too high, too low, depending on the stage of inflammation and duration of it. And cortisol is your foundational hormone. And when the body is inflamed, the whole playground switches from thriving to survival. And one big part of survival is to make sure that you are conserving calories, that you're not losing weight, that you're not getting wasted. And so your body will turn off thyroid production and everything just sort of freezes, just slows down. Just survives. And your thyroid is responsible for telling your cells to burn fat and make energy. And when body is going into survival mode, everything sort of shuts off to a degree at least. And thyroid, of course, is directing that. So it's very natural that the more inflamed you are, the more thyroid is affected. Another side of it, when the body gets into inflammatory mode, of course it's either begins or at least at some point, there is leaky gut component to it. And your thyroid needs very healthy gut, and it needs very healthy immune system, and it help and it needs nutrients to work properly. Once you have leaky gut, inevitably you'll become deficient in nutrients. So thyroid just cannot be produced sometimes. And often when gut is leaky, it also starts leaking the certain food particles into your bloodstream, and your whole body gets exposed to toxins and to. And gluten is one of them. And of course, there are certain toxins that will affect your thyroid, just directly knocking out some healthy tissue or activating your immune systems that will attack thyroid tissue as well.

I'm glad you brought up the gut, because we discuss, as it rel to my patients who have chronic inflammation, a lot of gut dysfunction, and they have a lot of probably underappreciated micronutrient deficiencies because of it. They have a lot of absorptive issues because of it. And they try to do all the things, and sometimes they show up to my clinic, having been started on quite a few supplements in an attempt to really help them. And I think maybe what you just said highlights the problem. Right. It doesn't help them to be on 10 to 30 different supplements daily if in fact they have a problem with absorption, which is leaky gut to me is just, you know, obviously we have compromised absorption of our nutrients. And so you brought up some good points. And so for the audience, let's just recap a little bit about nutrients you need for proper thyroid hormone production. Iodine, selenium, zinc, iron, tyrosine, vitamin D B vitamins, of course, and magnesium. So my patients typically are compromised in the majority of those, either through a lack of absorption. Absorption, or genetically, they don't methylate well. So they're B combo. B vitamin utilization would be poor. They also can have vitamin D pathway problems where either they don't transport or absorb. So it's a more complicated question, obviously, but it makes sense that that would actually go off first. Certainly that was a great description by you about that. So obviously I see people have been put on either more natural substances to help their thyroid function. And then I have people on synthetics. I will let everybody know that I'm always extremely concerned about someone I explant who's on a synthetic, because becoming hyperthyroid is a very common problem. After I explant someone and their inflammation drops so much to Dr. Ina's point, when you take that away, your body will start to work again. And sometimes it works aggressively and properly. And so everybody listening, you know, hormones do work, obviously, and synthetic hormones do work. So transitioning from those to maybe our sex hormones, which. It's a wildly problematic area. I mean, I have women come in who've been on birth control for decades because obviously they have estrogen toxicity that wasn't properly treated and they were told to be use this to help them. It's not a great plan, but they have a lot of difficulty with estrogen production and they have a lot of suppressed testosterone. So maybe kind of for the audience, help, like your explanation for thyroid. When you're in that, you know, survival mode and your body's inflamed, what does it do to our sex hormone and our androgens in general?

Sure, again, inflammatory mode. Body goes into survival. And there are certain things that are associated with thriving mode. And it's very different state when somebody is on survival. It run by different hormones, it run by different nutrients because body has different demands and different focus. And so the way I usually explain it to my patients, when you are in survival mode, everything, the whole focus on feeling great is no longer the focus for your body. And so the hormones that are supporting that thriving state are not going to be produced in enough amounts. It never shuts down to zero, but it certainly goes way down so that you feel the difference. Like your estrogen, your progesterone, your testosterone, all of those hormones have numerous functions in the body. It's not just sex hormones, but there are a lot of other things they support and other systems. But again, your testosterone, let's say it's your get stuff done hormone. It's your hormone of motivation, of energy production, of getting things finished on signing up for projects and getting them completed. When body is in survival mode, last thing at once is to go after another project. Last thing it needs is for you to be motivated to keep going and doing things. So naturally, testosterone just going to go way down, but it will produce just enough to support the key functions, but it's definitely not enough to feel good and it's really not enough to thrive. Same with progesterone. Progesterone is nature Anti anxiety. It has again a lot of very important functions in the body, but one of the functions is to support pregnancy. And the very first thing that your body wisdom will do is when body is struggling, last thing you need is to get pregnant. And so progesterone gets shut off very early. And we see it very commonly in women, even young women nowadays. I see 20 or 20, 25, 30 year olds coming in and their progesterone is very barely existent. I see a lot of young people nowadays with extremely low testosterone. We didn't see that 20 years ago. At that age, 20 year olds, 30 year olds and jump into replacement to me makes no sense in those situations because first of all there is a reason for body to do that. So if you just keep throwing hormones, I usually say hormones have to come into a healthy body. You cannot override body's wisdom. Body will protect itself. And so if it needs to survive, it will focus on those things that are important for survival. And that's your cortisol, your stress hormone, androgens like DHEA is repair hormone, restoration hormone. And while it participates in early stress and it goes way up, but eventually it goes way down. Because again if we're surviving, we're not repairing, we're not resting, we're here to just get through and stay alive. And it's not about your sex hormones at that point. So it doesn't feel well and body shuts off everything that's unnecessary. And sex hormones in a way, is that icing on the cake, if you will, that is responsible for feeling great and manifesting in your life in your best way. And it's not what survival is about.

Right? I mean I see folks all the time with those combinations and probably, you know, if you took a little sample of the majority of my patients, their cortisol levels are all high when they show up. And then obviously I don't do anything to make that better. I operate on patients and I stimulate cortisol production. But you know, going, I just want to, before we go away from that, we want to get back and always want everybody to understand. Like the gut brain axis is extremely important and your absorption of nutrients is extremely important. So we talked about that as relates to thyroid. But similarly we need the same, if not some other nutrients for the sex hormone production. Healthy fats. Dr. Anna mentioned DHEA and those usually in your experience and mine, like not everybody's getting everything through diet. And then supplementation is a, a very slippery slope depending on obviously source of the supplement and then its formulation. So I have a very strong group of patients who don't absorb well. So we converted everything to liquid that we could or powder that we could just to help give them a better opportunity to absorb. That ends up making a bit more sense to me both physiologically and it makes it easier for the patients from a emotional standpoint to not have to face 30 supplements and pills and time up those things because that's compliance goes down the more complicated. We make things for patients too. So I want them to feel comfortable all the time that they're getting what they need to support their immunity and then to help absorb, we're using the liquid. Those are all easy. I don't get pushback on using the liquids. So I think those are very important takeaways from a discussion around Formans. Maybe let's transition to your expertise about out the cortisol and or adrenals because all of my patients have a lot of adrenal problems. So in terms of adrenals, what can you impart for us on adrenals? How best to move forward if you're having troubles with your adrenals?

First of all, it's important to test because when you're helping somebody to get their adrenals regulated, get them out of stress response or fight or flight response, you need to know where you are, where you starting. We see patients who come to us and their cortisol is very high. And we also see patients who come to us and they're extremely depleted. The stage three or four adrenal fatigue, what we call where they just don't have enough cortisol around to work. And of course it comes with. So with its own risks. That's when people start getting allergies and environmental allergies and sensitivities and then eventually they just get more and more inflamed and that opens up your risk for the immunity and potentially cancer. Because cancer is really, it's just extreme inflammation. And so it's important to know where your cortisol is. So we absolutely test everybody and we absolutely just make a reference to previous discussion. We definitely test gut on every single patient who comes in. Because until your gut is regulated and body gets nutrients it needs and stop shifting all those toxins inside the body instead of getting them out, everything else we do is not going to stick. Everything else will help somewhat. It sort of will take an edge off, but it's not going to be permanent and it's not going to be the best results. And so. And gut and cortisol really work very Closely together, they support each other or they take each other down. So when cortisol is, we use adaptogens, first of all supplements, at least in my belief, it's probably 20, 25% of success. The 85% of your success comes from your nutrition and your lifestyle, your habits, in other words, how you live your life, what your body sees, what you eat. And are you able to get rid of toxins, are you doing it efficiently? And of course, hormones are extremely important. And your cortisol is a foundational hormone. That's where it all begins and ends. Cortisol is abnormal. Nothing else can work, even if body is making it. So that's very important to understand. So again, we test cortisol on every patient who come to us and make sure that as part of hormone optimization, we regulate their gut and we regulate their cortisol, helping them figure out what are the lifestyle habits that maybe used to work for them when they're 20 but no longer work for them. Are they getting enough sleep, Are they eating good food? Are they eating the right things that bring the right nutrients into the body? Are they doing things to help themselves to flush out toxins? Are they conscious about what they're allowing to come into their body? Because again, everything that crosses your lips or comes through the skin or gets in surgically is either really good for you or it's toxic. And body has to work really hard to get it out and hopefully it's capable. So everything is connected, everything works together. Body is this big symphony and really the only big tool we have to react to any kind of stress, whether it's physical, chemical or emotional, is our cortisol. Short term, we react with adrenaline, but it only lasts in your body for several minutes. It's your cortisol that is tool for long term survival and long term dealing with chronic inflammation. And when your cortisol is off of balance, nothing else can work in your body. So it's very important to get your cortisol back to normal. Whether you're using specific herbs when cortisol is way too high, or you're using different herbs when your cortisol is too low, what supplements you need to nourish yourself, all of that is very important. But until we get your lifestyle habits back in order, making sure that you're sleeping well, that you're eating the right things, that again, you're doing the right things to flush out toxins and not to bring extra toxicity into your body, cortisol has really hard time to go back to balance. It's functional imbalance. It always comes back. We're not born with adrenal problems. It's something we acquire because of our lifestyle and the environment, internally and externally. So every time we're working with cortisol, every time we're trying to bring it back to balance a, we need to know where we start. Too high, too low, reverse circadian rhythm. And then we have to figure out, look through your life story, look through your habits, look through your nutrition and see what is it that you're doing is not serving you well. What needs to change to allow your body to get out of that stressful mode and get back to dealing with inflammation and resolving it.

Can you. Because you brought up circadian. We'll touch on that in a moment. You said test. Are you doing serum tests, urine tests, combinations.

So with cortisol testing, specifically, blood levels really don't help you. Blood tests in the mornings that we do in traditional medicine does help you to exclude diseases. So if somebody has Addison's disease on Corp. Cushing's disease, and it's a very specific condition that is actually rare, that's what blood test will help you with the rest of it. Cortisol is really not all that helpful. So I like a combination where we test your saliva, which shows us what hormone actually comes to the peripheral tissues to do the job and at urine to look at metabolites. Because that gives us a picture of sort of a whole big bird eye view picture how much cortisol, total cortisol, is even produced. So that we will see in urine, in metabolites, and then in saliva, we'll see how much of that cortisol is actually available to work.

Yeah, I was thinking about it and cortisol production, obviously, when you brought up circadian, maybe just touch on that so that everybody kind of understands obviously there may be. And I have just like you have a lot of troubled sleepers.

Yeah.

And they're getting up and in the night multiple times, maybe they go to the bathroom, maybe they just wake up and then they have to try to get back to sleep. There's a lot of sleep disturbance. So how does that play a role in the cortisol issue?

So cortisol has circadian rhythm. Cortisol is the hormone of awakening. So it starts producing somewhere around 3 in the morning. We're still asleep. We make very small quantities and it's slowly rising and it's supposed to rise high enough somewhere between 5 and 6 in the morning, closer to 6, when sun is up and it's starting to get lighter, cortisol rises enough to wake you up. And as we wake up now, it shoots up within the next hour and you get to your maximum energy and maximum awakening and maximum productivity really in your morning hours. So your cortisol normally will stay up in the morning, of course, within the healthier limits, but it will stay up. And so normally your morning is really your most activity and most productivity. And then it stays up. And then somewhere around noon, it starts trickling down ever so slightly. You're still very productive, you still have ample energy with everything as well. And so your day is going, you're doing things, you're still productive, you're focused, you're sharp. And it goes down to the point where somewhere around 5pm or so, when sun starts going down, your cortisol starts going down as well. Enough that body knows work day is over, we're ready to decelerate, to slow down. It's time for an evening meal. Somewhere around six or so, family gets together, activities switch, your work is over and you're supposed to go to lighter activities. It's sort of that downtime that everybody needs, that we really lost the ability to have it in modern society. Society. And the sun continues going down, your cortisol continues going down as well. And then somewhere around 9pm or so, your cortisol, first of all, it's dark outside and your cortisol is always around. It's never goes to zero. It's your survival hormone. So you will have some. But somewhere around 9pm it's low enough that you start getting sleepy. And as your cortisol goes down and, and it's dark around, it allows your melatonin, your hormone of sleep and restoration and cleanup, it allows melatonin start rising. Now, what we see in modern society, unfortunately, we wake up in the morning and we are tired because cortisol is probably not high enough. And we are boosting ourselves with coffee and then another coffee and then maybe some pastry and we get some sweets because that will rise your cortisol. So you sort of mimic circadian rhythm just to get some productivity out of yourself. And then we navigate through the day and cortisol is somewhere. And we make what we absolutely have to make happen. And those who are very out of balance and very depleted will tell me I have to have another cup of coffee somewhere around noon. And I definitely will have coffee around 3pm and they will have something sweet because otherwise they just falling asleep at the desk. And then in the evening we just keep building up that cortisol because it's not enough. So body is trying to hug onto it and hold onto it. And by the evening we come home, we get dinner and we get energy burst because finally we made enough cortisol that we were accumulating all day long and we have lots of tasks still to do. So instead of normal deceleration and going down, a lot of people will get this whole energy boost in the evening. And now they start getting stuff done and they staying up past midnight when I mean all of us are guilty of that when we're younger and it works for a while, it just doesn't work forever. And so cortisol from our wrong lifestyle habits and the pressures of modern lifestyle instead of being very high in the morning and then slowly going downhill in the evening, eventually we retrain our body. It's slow, it's not overnight. It takes us years to get there. But once we're there we can't just say one day, just kidding. I decided to change and things change. It takes time and it takes a lot of support at that point. So when people lose that circadian rhythm and we see it all the time where in the morning you're dragging and there is no energy and you need all that coffee and pastry and what have you. And then in the evening you can't really decelerate and you cannot go sleep because now your horse is always high and we're exposed to ton of light until we go to bed. And the worst offender, we're looking into blue screens. Whether it's TV or it's your phone or it's iPad. People often tell me, oh, I just read before my bedtime because I know reading helps you slow down. Well, what do you use for reading my iPad? Well, you're exposed to blue light. Your brain gets constant stimulation with blue light. It cannot make melatonin, it cannot make your hormone of sleep and it keeps getting, you keep triggering your cortisol production so the whole thing is reversed. And for the body that by itself will create a lot inflammation because now your body is working against nature and you cannot get away with that forever.

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And there are other things that can keep you up in the middle of the night. And I definitely test cortisol if women or any of our patients, if they wake up in the middle of the night, first of all, I actually want to see their cortisol sample or saliva sample because I want to know what is it that's keeping them up in the middle of the night? Is it high cortisol? And then we need to figure out why is it? Sometimes it's food sensitivities. You'll be surprised how many times. And I definitely test for it in my practice. How many times people say I do all the right things. I'll wake up five times and then I go as well. Like I will wake up at three and then I struggle, fall asleep and then I'll wake up several more times before six. And sometimes it's as simple as they're eating something they're sensitive to and dinner is a big meal and so they go for something that they think is really good for you. And if they're specifically sensitive to that, you just revved up your immune system. Of course you cranked up your cortisol. And so sometimes it's food sensitivities eating their own things. Sometimes it's as simple as people really. We teach them to stay hydrated and they're busy during the day, so they hydrate late in the evening when they're finally home. And of course that water needs to go somewhere. So you need to drink first part of your day. Not.

Or they drink wine at night or they drink wine to unwind.

That's another thing. So your liver gets cranked up. So your liver, your time to detoxify. First of all, your body cleanses around the clock. It, it's 24 hour a day process. But at night, when everything else is calm, when everything or other demands are gone, your body does what I call deep cleanse or deeper cleanse. And your liver is very busy in the middle of the night. But it has to be available to flush out toxins. So when somebody drinks alcohol late in the evening, in the middle of the night, a liver really has to be awake and working really hard. And it's not even working hard on the toxins. You accumulate that during the day. It's working hard because alcohol is a frank toxin and a little bit is okay. But when it's during, like when it's late in the evening or when it's too much, or when it's every evening or every, almost every evening, it's a lot of toxicity to deal with. And your liver will wake you up in the middle of the night. And liver hour, in Chinese medicine, they believe that liver hour is somewhere around 3am so no wonder, and it's tragic often when I get, and it's common for executives actually because level of stress is insane during the day and in the evening it's just really hard to decelerate. And sometimes they feel like a glass of wine with dinner will help to relax. And it does for several hours. And so it sort of allows people to fall asleep. But then in the middle of the night, the very same thing that wine at dinner time will wake them up and keep them awake. Important to understand. So it's toxins that can keep you up, it's food sensitivities that can wake you up. It's cortisol issue, it's deficiency, it's melatonin deficiency. Sometimes in women past 35, it's progesterone deficiency. Because your progesterone makes GABA, which is calming neurotransmitter. Sometimes it's estrogen or testosterone deficiency, sometimes it's. It's thyroid. So there are a lot of things that feed into that insomnia. So it's very important to test and it's very important to know the story. We spend hour, hour and a half, sometimes two hours with every client just to listen how they live, what goes through their head, what they lived through, what their experiences. What is it that's feeding into this? Just not sleeping at night today, tonight.

Yeah. I mean, there's many times. There's not quick fixes. They've accumulated so many habits over so many years that it's very difficult to unwind them. They may be taking anxiolytics at night, antihistamines at night, drinking all the above, and just to, you know, help them get off to sleep. But then they can't stay asleep, and they never achieve the cycles of sleep, the depth of sleep, the quantity of sleep, the quality of sleep that you have to have, have in order for all the magical things to happen at night so you can repair and recover, because that's when that happens. As you pointed out, detox is really a constant process, but recovery is, you know, dominant through night when you're not out doing everything. So I was just going to ask, in terms of the sleep, once you understand their. Their sleep, you know, we kind of do simple things. Like I said, three, two, one, stop eating three hours before bed, stop drinking a couple hours before bed, and certainly get away from the blue light, the screens and things. An hour before bed, get the room cooler, get the ambient light in the room shut out so that it's dark, it's cooler. If you need, like, noise, obviously noise, if you need earplugs, airplane, whatever, whatever, the things they're going to help you shut down, then do those things and then their bedtime, awake time, those are, you know, we have to. To discuss those, like you said. Do you ever find folks need to go maybe have cognitive behavioral therapy for their sleep disturbances? Do you see people who need a bunch of therapy that way?

Not in my practice. It's always in the back of my mind. So it's one. It's definitely something in my toolbox. I have to say, in six years of doing functional medicine, we didn't run into anybody who did not start getting very sound night sleep with gut repaired and restored, detoxification optimized, hormones optimized, and lifestyle habits enhanced or optimized. So is CBT a tool Absolutely. And I'm sure we also make sure, wants to make sure that sometimes we do have to make sure that they don't have obstructive sleep apnea because that will keep them awake in the middle of the night and give some non unrest sleep. So we have to look into everything. And CBT is one of the tools. We never had to use it actually so far knocking on the wood.

I think both you and I are fortunate because we're in a very specific group. So we have a little patient bias already in terms of who can come see us and how much they can use their resources to do that. People who don't have a lot of resources working in a traditional insurance based model wait a year to just to be seen by a cognitive behavioral therapist for their sleep disturbance. If they've tried and ruled out all the other things. If they've had a sleep test and are on, you know, a, obviously you have to use the CPAP machine if in fact you have sleep apnea, which is always, you know, a battle. People don't like the mask. I personally have to wear a CPAP every night. I have a congenital problem with my airway. It's just a little bit narrow. I'm not overweight. I'm not got a specific problem with my jaw or anything like that. It's just, it's an anatomic, you know, problem. So I agree with Dr. Ana. I mean, you have to be worried about if you don't have a partner. Well, let's just. Everybody thinks that snoring is a synonymous factor with sleep apnea. It's not. You can have silent sleep apnea. So it's, it's best to get a sleep test. And I, I don't feel bad about saying that. I, you know, I don't care how old you are. If you think you're waking up and you're not sleeping and you're, you're feeling, you know, fatigued and everything. I mean, it's worth a shot to make sure you don't have that problem. Because I think it's a very, very high percentage of people who have problems with sleep apnea going to have problems with Alzheimer's.

Yeah, definitely. If sleep in sleep deprivation is the biggest risk factor for any kind of dementia and specifically Alzheimer's dementia for sure.

Yeah. I mean that's when I got a bad sleep test. I was like, well, I'm getting, I've got so much sleep CPAP paraphernalia. It's incredible. Like, like I just came back from A big trip. I carry it on my trip. I have a travel one. I have a. I actually was so worried I took one that was smaller as a backup in case there was a problem with my main one, because I know how bad I feel if I don't use one. So now it's in the back of my head all the time, you know, And I do all this to get, you know, proper sleep. And I am someone who tracks things. I'm that person. So I have an ultra human ring. I have a whoop strap. I have a Polar H10 chest strap. If I want to be really, really dialed in on my HR case or all these things. Obviously, sometimes.

And I think it's wisdom, honestly. I know when we diagnose somebody or when I ask somebody to do the test, I often meet resistance. And I understand it's. You know, it's not. When we're younger, everything just works right. And it's very hard to accept that something changed and something just cannot get itself fixed. But I would say, you know, in my clients, we mostly take care of professionals, and the result is so important that it becomes less important, what it takes to get there. And I think ultimately it's actually wisdom. And if somebody's overweight and they lose weight and they no longer have sleep apnea, wonderful. So if it's something that is functional and temporary and with adjustments and optimization, that goes away, I'm all for it. But if it's something that, like you said, you know, your airway is a little bit narrower, or for some people, it's something with their jaw or some. If there is a reason why it's happening and it's not going to go away with just lifestyle optimization and other things, then why would you sign up for high risk for dementia? Or why would you sign up for low performance, loss of focus and just not feeling great and constantly being tired, if there are little gadgets that take several nights to get used to, but after that you feel so much better and you perform so much better, why would you even consider struggling and suffering? Right.

I think the number one thing everybody should be concerned about is your brain health. So if you want to avoid cognitive impairment, dementia, Alzheimer's, memory loss, obviously you have to prioritize sleep oxygenation for your brain while you sleep. And then those things like, I focus on air quality and food quality and fluid quality and using. If you have problem with sleep apnea, a cpap, and then your intention about going to bed. It's a very important. When I hear people say they get like three hours, four hours, five hours of sleep. Now I train for many, many years and I was sleep deprived for many, many years. And when I hear people say those things, yeah, it's kind of comical because your performance goes down. This is well documented below six and a half hours of full sleep. They've done this study many, many times. It's not so. When I hear somebody, especially a higher functioning person say that, I'm like, okay, sure, you can tell everybody that and you may in fact believe that yourself, but that in reality is not how so thank you for joining us. This has been a very insightful conversation. And please let my followers and anybody who was watching, where can they learn more about your practice and get in touch with you.

So my practice is called Midlife Wellness Institute. We're located in Denver, Colorado, but we also do telemedicine. So I have patients all over the country. Although we do have to see you in person once a year. So people will travel and once a year and the rest of the time we can do a lot of things virtually. You can learn about us on our website, midlifewellnessinstitute.com if you want to learn more about hormones and solutions for optimized hormones, you can download free guide from our website. Again, midlifewellnessinstitute.com we do offer free discovery calls and we get a lot of calls from people who are interested in either in hormone optimization or longevity high performance anti aging. And we don't always know whether we're a good fit. And I want to make sure that we are able to help you before you travel. And so we offer free discovery calls and you can sign up on our website again midlifewellnessinstitute.com and I really hope it was helpful. I just always tell people each decade of life has its own demands for wellness. What got you successful in twenties will not be enough in thirties. It will definitely not feel good in forties and it will frankly tank your health in fifties. So each decade has its own demands and it's wisdom to know what's important and to deliver because body will deliver back. And you know, I'm coming from 26 years of hospital medicine and 2/3 of our country ends up in a nursing home. It's just tragic and all of it is avoidable and so live longer and longer. I think we really need to focus on living healthier and healthier so we can enjoy each decade more than previous. And that's our goal.

Awesome. We're going to have everything in the show notes for everybody. So thank you again.

Again, Dr. Aina, thank you.

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 our online store, Dr. Rob's Solutions. At DrRobSolutions MyShopify, 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 can overcome breast implant illness. Take care.

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