Are Hormones the Ultimate Bio-Hack? with Wise and Well Maria Claps & Kristin Johnson

So today on Midlife Conversations, I've got Kristen and Maria, who I met through social media because they've got wise and well. And I really honed in on their accounts because I love what they do. They speak directly to us. They're talking to midlife women, specifically perimenopause, menopause, navigating all the changes that come along with that as far as nutrition and hormones and exercise. And what do we have to do to navigate this crazy time? You might not be seeing them on video right now if you're listening to the audio, but they both do not look like they are in midlife. They look, they're doing something right, clearly, because they look really good. So thank you so much for being here today. I can't wait to dive into these topics with you.

So excited for having us. We love that you have this podcast.

So I guess let's start with why did you decide to hone in on this particular topic? Because obviously you both have a nutrition background, you're both very smart. But what made you say, I want to help midlife women?

I mean, I think.

Sorry. That's okay. I was just telling her how we always know who's going to answer. I think we both feel passionate about this. It really, for me, I'll answer. For me, it comes down to, you know, I was going through some changes and I was like about 43 years old and I didn't like it. And I knew it was holistic minded enough to know that I wanted like a really great doctor in New York City. It just didn't end up being a great experience. So at that point it was like, okay, I have to go back and I, there has to be a better way. Need to get educated on this.

When you say it didn't, it wasn't a great experience. I hear this from women like what, what particularly was happening to you? Because I think some people say, well, my doctor said so that must be normal. But how, what made you say this is not a great experience?

Okay, that's a really great question because I didn't have an altogether negative experience. I wasn't gaslit, I wasn't told. This is all in my head. But I was given a lot of supplements. I was 43 years old. I was given full hormone replacement therapy. I was not menopausal at that point. Now we can talk a little bit about this later. I am not necessarily against 43, 44, 45 year old women even using HRT, but I was given hormone replacement therapy, massive doses of vitamin D of benzodiazepine. If I just case I needed it. Yes. This was from a very holistic, integrative center.

Wow.

And zero education as to why. What's going on, what's happening to your body. It's like I was just loaded up with stuff and sent out the door. So that's why it wasn't good.

Yeah.

What about you, Kristen? Similar experience or a similar time of life.

And I think that's one of the things that so many women start to kind of have. This aha. Is it's that early 40s, you know, we feel too young for these things to be happening. It was not on our radar. And then suddenly life goes a little sideways. We wonder what's going on. So mine was similar. I was, you know, raising three kids and active life. I was a competitive athlete. But all of a sudden my sleep went gone. Like, literally could not sleep to the point where I feel almost trauma To a certain point today, if something interrupts my sleep, I'm like, no, I can't go back to that time of life. But the body composition started to change. The brain fog was huge. The mood definitely changes. You know, the vaginal dryness. All of these things that I didn't have a great framework to understand because my mom had her uterus removed at 32 when I was born. So I didn't travel through menopause, observe it with my mom, and didn't know if this could possibly be for me because genetically we didn't have a baseline for her. So I ended up going to. I was living outside of Boston. I went to this phenomenal doctor, and she did the opposite of what Maria got. She completely gaslit me. She said, you are too young. She refused to. I said, could you just test my hormones? No. Like, flat out, no.

Wow.

And I said, well, could it be thyroid? And I was so desperate, I'm like, do I have Lyme disease? Could this be mold? I mean, I was trying to figure out everything, and she just told me, there's nothing wrong with you, and that was it. There's nothing wrong with you. And I was like, no, there is something wrong with me. So, you know, I had the nutrition stuff, started to dive deeper into trying to figure out the low hanging fruit of what I could try and influence, given that I had no medical provider who was willing to help. And then, you know, in terms of how we got into this, I think both of us, it's that pain becomes your purpose story. Because we started working with clients and all of a sudden they're having the same issues. And it becomes, okay, there is this unserved group of women. Why are we being unserved? And what is at the root of what's going wrong? And that's kind of where we ended up.

This is so interesting because what you both just described is literally what I hear all the time. And it's so rare that I hear of somebody having a different experience where it's like this combination of, like, let's really get to the bottom of this and let's figure it out. I really do hear these two extreme sides of, like, no, I'm not test. I don't understand why they do that.

Right.

In this over supplementation, like, one size fits all. Every woman needs this. So let's. I want to start with that. Like, what advice, first of all, do you give the person that just left the doctor and they just experience one of those two things?

Yeah, I mean, it's tough. I think that information becomes empowerment. And there are some decent books out there right now where women have to have a framework to be like, this is me, or this is kind of me, you know, so that they know. Because it could be other things, right? It could be autoimmune. It could be food intolerances. It could be that you're overworking out. It could be all of these things. So I think it's important for women to kind of step back and start to take a critical look at their own cycle at this time of life, you know, understand what hormones are supposed to be if they're on birth control or an iud, maybe start contemplating, you know, it's time to wash out from that stuff. And I think that that piece of informing yourself will help inform what's next. Right? Which is, what kind of a provider do I need? What am I interested in seeking? You know, what is the path that I want to follow? Even Maria and I will tell clients all the time, we can't choose it for you. You know, we can educate you, and then you can return to us and say, so this is what resonates with me. And then we can guide. But women need to sort of self, you know, figure out some things. And, yeah, finding someone who's going to test them in a variety of ways, you know, is it your gut? Do you drink alcohol every night? You know, is. Are you super dysbiotic? Do you not poop it once every four days? Like, we got other issues that need to be addressed before, you know, really, most providers are going to be able to do anything for you.

Okay. So what's your perspective on that, Maria? Any other a different side of that from with that, or is that the same thing that you would have said?

I, yeah, fully agree with Kristen in terms of like, just what should women do when they feel like they're changing but things are changing? Learning.

Learning. Okay, okay.

So where do they. Unfortunately, though, what we have a lot, Natalie, is we have women who've got really suppressed hormones because they're on hormonal birth control. And that means learning, challenging.

Okay.

Because we're looking at sons.

Yeah, let's talk about that. Because a lot of women were given. So it's interesting. Like, we're at the age especially. I mean, I'm being 51. We're all, we're similar ages, like being at this age. We were at the age where birth control was so normal in our 20s. Like, that was like everyone was given. So there was many women that were just given the synthetic birth control for years and years and years. Right. So then what happens is my, my OBGYN did the same thing as soon as I had shifted. Oh, you should go back on birth control. So, so let's talk about that first. Like, what is that creating when we just go on synthetic birth control to create a one size fits all, try.

To fix so many things. So many things. So first of all, it really hurts our bone development. And our, our peak time to build bone is actually 20s and 30s. Okay. So we are probably, if we're on. So the problem is, is that most women will go on birth control, say, as a teen, maybe come off of it if they want to have babies, go back on it. And now they're rounding the corner towards 50.

Right.

They' on this birth control. Average age of menopause, full menopause. What we mean BY that is 12 months without a period. How are you going to know if you're on birth control? You're getting, you know, when you do that placebo week, you get a withdrawal bleed. That's, that's not a real period. So now we're rounding towards that age of 50 and she's still on birth control. She's kind of disconnected from her, you know, menopausal process. Like, where am I? Because, like, if you're, if you take a woman, say, from 40 to menopause, we'll say average 51. Like, she gets. If she's not on hormonal birth control, she gets to see what's happening with her period, what's happening with her mood, what's happening in other parts of the body that's completely covered up and distorted when she's on birth control. So now, okay, now we're at 51, she's still on birth control. Kristen and I have spoken to women. 55.

Wow.

And that's because American College of Obstetricians and Gynecologists says women can stay on birth control until they are 55 years old.

Wow.

That woman could be four years menopausal, five years, six years. Wow.

It's like, it's just crazy because we have no idea what our own hormones are doing when we're doing that. You're really.

That's the thing. We don't learn about it either. You know, I think if you look back at like sex ed in high school and stuff, nobody sat down and talked to us about our period. Nobody talked about what was happening. And it was this, you know, the flow on flow, the friend, whatever is coming. And it became almost, almost like a combative friendship, right?

Yeah.

So, you know, it was anything we could do to suppress it. And I think if women understood that this menstrual cycle is much more than just a monthly bleed or a sign of fertility, it has goes into genomic expressions and genetic issues and whatnot all over, they might understand then how crucial it is to their health. And, you know, oral birth control, you're using synthetics, which we know operate differently. The progestins in them operate as endocrine disruptors. They actually alter halter. The estrogen receptor works. Oral estrogen comes out as a form of estrogen that we don't want. You know, women don't realize we need estradiol. And this is not what you're going to get with these pills and the oral formulation. So I think if we could educate girls earlier to understand and, you know, I was one, I had the heavy period, you know, a new tampon every hour with a plus pad. I had the six stick acne. I had all the things. And so, yeah, birth control sounded great to me, but nobody ever was like, that's not a normal managed bleed. We need to address the things that are causing this. Right. It was just, here's an easy button and then you won't have to think about it. And I did not go birth control after having babies. I had it, you know, from age 13 on because I was a heavy, fleeter, similar. Yep, yep. And then I went the IUD route because in my mid-40s or late 30s, I should say, I was like the hide the knives kind of girl. Once a month, my husband was like, you're a psycho. And he wasn't wrong.

And.

And I went to my doctor and said, what's going on? And they said, we can put you on antidepressants. And I was like, you know, and no judgment. That's not what I needed. It was so clearly a monthly thing. And so my nurse practitioner said, go on an iud. It's great. Which I didn't know any better at the time. I did. And, like Maria just said my OB was like, just leave it in until you're 55.

And you're talking to the hormone. I'm assuming you're talking a hormonal iud.

My arena. Yeah, the Renaiud. And I mean, I had an IUD for 18 years to get that thing pulled and changed every five years.

I get. I mean, I was on. I was on hormone hormonal birth controls for 20 years before I knew anything that I know now. And it's just. It's unbelievable that, like, had I not learned what I know now, that I would probably still be doing that, too, and what that creates. So let's start with that. Let's talk about the difference between. Because there's some people listening that really don't understand the difference here. Like, what's the difference in your explanation between synthetic birth controls. Sorry, synthetic hormones. And taking bioidenticals so much, but.

All right, so there's like two main components. There's the estrogen component and there's the progestogen. And I'm kind of using that word very deliberately. So progestogen is a kind of umbrella term. It could be. There's this really, two main progestogens. There's progestins and there's progesterone. They are not. They're not. It's not even an apple to an orange. It's so incredibly different. Progesterone is natural, bioidentical. It's an exact copy of what your ovary would make. A progestin is completely different. It has its negative effects. The only way that they are exactly the same is that they will both serve the purpose of not allowing the uterine lining to proliferate. Beyond that, they completely differ. Progestins can have negative cardiac effects. Progestins can actually cause the estrogen component of your HRT to express different.

That's why it says warnings about smoking and all the things. When you.

Clotting, it increases clotting.

It makes sense.

Yep. Yeah.

So, I mean, it just.

It's.

It's really Horrible in so many ways.

Yes.

I just don't understand why they're not as common. A lot more women are put on progesterone these days. But every once in a while, Kristen and I will run across a client whose doctor has them on one of the most common ones, medroxyprogesterone, and it's just a dumpster fire. Okay, so that's the progesterone. Then we have estrogen. And estrogen can either be something called conjugated equine estrogen that comes from horse urine, or it can be a bioidentical estrogen, which everyone thinks is compounded hormones. And they freak out because it's, like, not FDA approved. That's not the case. We can get bioidentical hormones that are FDA approved if that's important to you. And that, again, it's an exact molecular copy of what you're overused to make. Interestingly enough, it comes from plants. You cannot eat flax and yams and think that you're going to get that same.

Yeah, that's an interesting thing. People think, by the way, because they think that they watched sex in the city and saw the yam thing or something, and they think that it has.

To be taken, like this kind of raw ingredient. It's called diogenin, but it's synthesized in a lab and it becomes estradiol.

Okay, well, and that's the thing, Maria, too, is that some of these formulations, there are three main estrogens that we have expressing in the body. And some women will get put on what they're told is bioidentical hormone replacement therapy, but it's using a different estrogen, one called estriol, which is the estrogen of pregnancy. And they're trying to essentially manage woman's metabolic homeostasis using Estriol, when really the body uses estradiol. So that's another thing, is that women have to understand which hormone of estrogen, which type that they're being put on. And the reason for that is we have two different receptors, technically three in the body, one sort of like growth and one sort of, you know, slowing growth. Right. It's like foot on the gas and a brake pedal. And only estradiol provides a balanced action on those two receptors, whereas estriol provides one that's very different, and estrone provides one that's very different. And that's what you're finding is birth control pills frequently. And the end product becomes estro estrone, which is their old lady liver. Toxic. Not a great estrogen that we want acting pregnancy is estriol. So we'll get birth control, estrone, and this bioidentical hrt, frequently called biased, that's mainly estriol. And women will be like, I'm on this HRT and it's not working. And that's when Marie and I have to be like, well, that's because you're not actually using the one estrogen that requires, you know, that handles all the things in the body that we need.

Wow. So I'm going to say this. For me, hormone replacement therapy is life changing. Now I'm 51 and when I, before I was taking hormone replacement therapy, what really got me interested was the hot flashes I had out of control. I mean, I think you guys might have commented on one of my funny. I make funny videos about hot flashes because I was having them like five, six an hour. It was crazy. And I did all the like, supplements. My nutrition's dialed in. People would be like, oh, you just need to. I'm like, I get the nutrition, I get the exercise, and I'm still having them. My estrogen is gone, it's leaving. So for me, hormone replacement therapy, mild levels of it. I don't, I test my blood, like I'm sure you recommend has been life changing. And what's crazy to me is how many times somebody will message me and they'll say, please tell me you're not on hormone replacement therapy. And I'm like. And I, my answer is always like, why do you say it like that? And it's. And they have such a bad belief about it or they think it's, it's cheating or. So can you speak into that? Because for me, I'm like, they're, I feel like they're missing it. They think I'm missing it. So if I get, I want to have some help from you here. Yeah.

We actually just wrote a long form article in our little public community about this because we do hear from women. We hear a couple things. We hear, one, I want to go through menopause naturally. And you know, I commend you for that. That's great.

Like having a child naturally, good for you.

But menopause naturally means you're going to die shortly after your 55th birthday. So that's the reality, right? You want an ancestral approach to menopause. Be prepared for an early death. That's what that means. And then the others who say, well, you know, HRT is like this cheating thing, or you're looking at it like a disease process or Something. But the reality is we recognized as a country back in. What was it, Maria? 1942, it was determined to be hormone deficiency syndrome was the catch all phrase for the diseases of aging that were striking women over the age of 50 more so than men. And there were, I believe it was like 55 million or something women menopausal at the time. And they were, you know, dropping dead of heart disease and osteoporosis, fractures and Alzheimer's and all of these things. And the medical establishment said, gosh, gee, this is because we're outliving this age where we used to die and these women are without their hormones. Let's call it hormone deficiency syndrome. There was a huge push to provide estrogen to these women. It was seen as a preventative measure for the chronic diseases of aging. It was actually seen as an anti aging sort of biohack. For sure. It was that way for like 50, 60 years until we had this horrible study called the Women's Health initiative. Yeah.

In 2002. Was that. Yeah, it was terrible.

And you know, it was a poorly designed study. They drew the wrong conclusions from it. They used bad subjects. I mean, there's so many things wrong with it. But it literally overnight was able to unravel what was. 60 years of addressing women's health issues due to hormone.

I remember my mom stopping when she. That study came out.

Yeah, same. And you know, my mom ended up with two types of breast cancer afterwards. Her life completely went downhill after she was, you know, had her HRT pulled. So, you know, that HRT piece, it's. Unfortunately, we have two generations of physicians who are told that estrogen is dangerous. Which. Okay, how about when we have. Have huge levels of estrogen when we're carrying a baby? No one's developing cancer while they're getting pregnant because of this high estrogen. And then we've got a med school curriculum that does not teach it. So we have people woefully under skilled and unprepared for it. And the only message out there is estrogen is dangerous. And that's so patently wrong. And actually a very new idea. Yeah, it used to be.

And it's wild that you're saying this because even I'm educated on hormone replacement therapy and even I had this like, thought when I was gonna go on it because it's so ingrained in us that it was bad because of that study.

Right, right. And the doctors, they're scared of it. And you know, I think any physician, understandably is hesitant because they don't Have a toolbox, right. To handle hrt. So they kind of look at it like it's bad, it's scary, it's naughty, which is just ironic and crazy because it's l. What regulates the female body.

Let me tell you. It changed my life. So I. I think if you're suffering right now, like, I'm like, get tested and do this. Because it's not even a huge amount of levels, but it's such a small amount. Mean, within two days, my hot flashes stopped. I felt like myself again.

But here's the thing, too. Natalie, Jill. Is they. There are so many women. We just had one, I think, this week. Maria, too. Who said I didn't have hot flashes or I'm not broken. Like, we see. You know this. I don't have these issues. You know, kind of, you ladies must have something else wrong with you sort of thing. And we hate to tell y', all, but symptoms or not, you're gonna suffer from hormone deficiency.

Yeah.

The sad thing is, you just might not learn about it until you're 65 and you've developed early onset Alzheimer's or you've got an osteoporotic hip that you just broke slipping out of your car.

Or worse thing, like plaques. And once you've got atherosclerosis, this. You're.

No.

You pretty much cannot use hrt.

Yeah.

Wow. So that's interesting. I didn't know that. So once you have that, you cannot use it. Interesting. Why is that?

No. Well, yeah, go ahead, Maria, because.

Okay, so with. With HRT earlier is orders of magnitude better.

Okay.

To the point where. Well, I'll just say you didn't ask this, but I'll just say anyway. To kind of set the ground rules. Kristen and I believe that you don't. Do not have to wait until you're menopausal to start. When you're in some stage of perimenopause, you can absolutely start.

I'm still in Perry, by the way. Maria. Yeah, I'm still. I still.

Yeah.

Good. Good. Yeah. But once you have plaques, like, the estrogen can cause, like, a plaque to rupture, and it could be interesting.

Okay.

Mobilize things.

So plaque on what level? Because I Like. Like plaque. Like, you actually have clogged arteries. Like, you've had a scan and you see that or just you're showing markers for it. Like, at what level?

If you've got a CAC Score that's outside your age, you know, it's. And the hard thing is, is CAC Scores for women aren't super relevant until after the age of 50.

Okay.

So just because you might be 46 and you have a clear CAC doesn't mean you don't necessarily have soft plaques circulating that are vulnerable. Right.

Okay.

And the good news is, is that usually a 46 year old isn't so estrogen deficient and she still can safely start estradiol. It's when you're 61, you're outside your 10 year window, you get a CAC score of, you know, 250 and you're like, oh my gosh. And you're just. I want to, I think I want to start hrt. That it starts to get dangerous because estrogen is so potent and it has such a, such improving effects on the vasculature, loosening up the fibrinogen, the proteins that cause clotting, all of this stuff, that it can actually stir up these plaques that have been laid down and then put you at risk for other issues. So it's not impossible. We have, we have women in their 70s who've started it. Just then you need a provider who's going to, you know, look at your cardiovascular disease health and monitor you.

Yeah. Because I would say most people probably it's just kind of like getting, looking at degeneration on an MRI and you're, you know, some, everybody's have some level, I would imagine in your 60s, 70s, you're going to have some level of plaque just from living. So that's, that's why that came up for me as a, as a. What about the cancer connection? Now I know that the study was flawed and that's not there, but what if somebody has had breast cancer or they have had a history? Can they still do bioidentical?

It's a bit challenging. It kind of is going to depend on the staging of the cancer, what stage cancer it was and how far they are out from diagnosis. You know, I believe most of our kind of mentors believe you need to be at least five years. Having said that, we do know a couple of colleagues who have had a cancer diagnosis, breast cancer, and who have, I would say summarily, you know, kind of completed treatment and went right back on their hrt. Two people, you know of at least. Right. Okay.

I know of a third person. Yeah, yeah.

So yeah, there's also the connection. I've heard, and again, this is, you are more the experts on this than me, but this actually happened to me. So in this, and I've heard this happen with a few people where we were given the wrong dose of bioidentical, where it's not monitored correctly, and it converted to something else, like through a different pathway. So, for example, my real story was doing a bioidentical testosterone that was too strong and it was converting to estradiol and creating an issue there. And that really checked me into the importance of regular testing and working with somebody that knows what they're doing. Can you speak into that at all? Because I think going too high on levels can also be problematic.

Kristen, you can grab that and I'll chime in.

I mean, you know, we need context for too high. Right. So there's physiologic levels. That's a term that is weighted, so to speak. When you say physiologic levels, what we're saying is we're replicating this, the status of estradiol from your youth. The hard thing with that is it can be a big range, but physiologic levels are frequently. Your baseline is like 250 to 350. Well, we have an entire group of physician credentialing bodies that don't want your estradiol above 80. Okay. So what you were told was too high and versus might not have been.

Got it. Okay.

Correct.

And also there's too high all the time. Like, Right. Every single day.

Right.

And then there's high or peak would be a better word. You know, one day out, out of the month.

So, yeah, got it.

And we kind of a nuanced conversation. Yeah.

Our genes can influence those pathways, but lifestyle frequently influences those pathways. Right. So it's looking at inflammation, stress, your glutathione status, you know, understanding kind of what your gut health is. That's a huge piece of it. What's the condition of your liver? That's why we tell women all the time. You don't just be like, oh, I have these symptoms. I'm going to go dial into HRT until you dial in all the other foundations of your health. Health. Because those are the things that influence those pathways.

Okay, let's talk about that. Because I love this topic. Because I love when I. When I think of women that were going through my fat loss programs and they would come in automatically with it must be my hormones. And I'm thinking, let's clean up your diet first. Let's clean up your workouts, your nutrition, your hydration. Let's get all that going first. Get all the artificial sweeteners out, and then let's test it. So I'd love to hear your take on this because I love that you just brought that up. I think, I think hormones are so important. But I want to talk about the lifestyle stuff too.

Yeah, we actually just had today, I. We had someone message, a client, longtime client, who had just done a retest on a gut and she said, oh my God, I've gained 15 pounds. It's got to be the HRT. What's going wrong? And I said, okay, it might be. It could be some other things. How's your stress? And I literally went down the list and this was in a chat message. And she came back and she goes, well, yeah, I did just take a new job and I'm super stressed. And my sleep's been kind of crap because I just haven't been, you know, focusing on it and I don't really know what my macros are. And I'm like, okay, here's the thing, ladies. We have to be intentional at this time of life. We have to choose. And our nutrition, our sleep, our movement, all of these things have to be lived with intention. Not so that we can be some bikini competitor, but legitimately so that we can make the most out of these hormones. And that's what we try and get women to understand is like, sure, your hormones might be influencing them or they might be going sideways, but that's not the hormones doing that. It's possibly really your lifestyle choices that are doing it.

What type of. I know that you're going to probably say it's kind of customized for everybody, but I'd love to hear just some general thoughts on nutrition from both of you. Like, what do you think are. Must, like, women must do this in their. In midlife.

Okay. Yeah, this is a fun topic. They have to eat enough. We see a lot of women, so many of our clients, they are just under fueling.

Okay.

They're just under nourishing themselves. They're not eating enough. We would say that, you know, we're gonna kind of bust that, you know, intermittent fasting, it's so popular right now. We would say that it's not really that helpful. We need to eat, we need to nourish ourselves. And we particularly need to start, you know, breakfast meal one. Whatever you call it, you need to get a minimum of 30 grams. You set yourself up metabolically for the entire day by that. By that.

30 grams of what?

The protein?

Yeah. Sorry. Yes. Huge fan of protein. I think that many people are under muscled in midlife and I think totally gotta be adding protein. So I love that. So, so you. So you're not, you're not particularly a fan of fasting, but you are a fan of getting higher protein in. So what other, what other sort of things are you saying? I want women to know this.

Yeah, I mean we, you know, we think time restricted eating has a place, but we couch that in. Give your digestion 12 hours off while you're sleeping.

Yeah. So you're like modified. I like that. Modified fasting.

So a break during the night and then look at. And you'd be shocked how many women are like, yep, yep, I do it. And then we get a food journal. I'm like, you ate a beef stick at 9:30 at night and then you were having breakfast at 7, you aren't doing it. You know, so being really aware of that 12 hour fast and you know, if you want to go to 14, great. But right when you start to get to 16, the problem is you only got eight hours left in the day. So to get enough protein eaten in those eight hours becomes really a task. It's a chore. Right.

And I will say I am somebody who does that. But I, like you said, I have to work to get the protein in. So it's like a very conscious effort. And I put protein first because I think that is even more important than the fasting aspect.

Totally. And it's, you know, if fasting works for you, that's great in terms of like if someone's got insulin sensitivity issues or they've got a disordered eating pattern or something, not a problem. But if it's not not working for you to get the protein in in that window, then your window's too small. Period. Done.

Makes sense.

Yeah. And then, you know, carbs, I mean women, this is a discussion they don't like to hear. But as fun little science fact, we have estrogen receptors in the gut lumen. They impact how we or our level of estrogen, I should say impacts how we process carbohydrates in midlife. As that estrogen declines, so declines your tolerance for carbohydrates. So it's not that we're like, oh, everyone needs to be low carb, but we do need to be very intentional about our carbohydrate intake given our hormonal state. And even once you add hrt, yeah. We aren't fully regaining that carb tolerance of our 20s and 30s and women don't like to hear that. They love their carbs and we're like, that's fine.

There's also different categories of carbs. So true. So like, like to me and tell me if you don't agree. Of course. But like said, I. I'm. Fruits and vegetables are like a whole different ball game than to me eating muffins and donuts and start a lot.

Of starch and sweet potatoes constantly and everything else. Sure, absolutely. I mean, Marie and I are huge fans. Like, give us our asparagus and our arugula and the broccoli and all that kind of stuff. Not a problem. Dark berries.

So those are still carbs. And I think women forget that and I think. Because I think those are important too.

Right. So, yeah, I mean we. The protein has to get hit and it's got to get hit every meal. I mean, we see women, they'll be like, I got my. We had someone who just today messaged and said, I'm doing really good. I'm getting at at least 90 and often 120 grams. Okay, but she weighs 150 pounds and she's at goal weight. That is not enough.

No, she's almost body weight.

Yeah, it's. We need to bump up that. So we would say, you know, optimal carbohydrates or I should say optimal protein and you know, lowest carbohydrate tolerance you can get kind of thing. And then, you know, fat. We see fat as a great lever. It's like tweak it, you know, learn. Start maybe it at half the grams of your protein and then see, how's your performance in the gym? How's your satiety? How's your mood? Are you a hangry bitch at 4 o'? Clock? Might need a little bit more fat in your breakfast and lunch, you know.

So I want to talk about fat for a minute because. And again, this is not you. You are working with more people on this level than what I've seen. But I just want to give you my experience with it. So I think back to when we were in our 20s and it was so incredible to be fat free. That was. Everything was fat free. Everything. Right. I remember eating gummy bears fat free because they're, you know, fat free. They're fine. But went through this whole thing of being over sugared and not right. And then we went this whole other direction and I watched recently that everything has gotten so extreme with this like carnivore and this keto. And I actually think that women can go too overboard with fat, especially in midlife. I'm. I'm seeing that. I'll tell you with myself. I'm on a lower fat diet now, which has been been. That doesn't mean I don't have fat. I definitely have it. But I went lower than what seems trendy right now with all the keto and stuff.

So I'd love to hear your thoughts.

On that because I do think, think sometimes women are treating because something says keto friendly as like it's an unlimited thing.

Yeah. Maria, do you want to talk about act state of priority?

Well, I don't remember it as good as you do that. Yeah, absolutely. We're not fans of keto unless you need it for a medical reason. Okay.

Yeah, like, like diet like you have a cancer, diabetes, something that you want to really.

Depression.

Depression, yeah, yeah. I mean we look at fat and say, look, you know, keto and Carnivore, I think if someone has, if they have a therapeutic need and it's short term, like for me, I had some radical spine surgeries that put me in a massive state of physiologic insulin resistance. I wasn't overweight. I didn't have these things. Literally couldn't handle stuff, plants. I had oxalate issues. Like I had all this stuff. Right. Carnivore was great for a short period of time. Right. And then I needed to kind of come back. It can create some orthexia, some disordered eating patterns, you know, all of these other kind of things. And keto, like you said, keto's become like Paleo, right?

Yes.

It's not macronutrient agnostic like Paleo, but it's got the wrong focus, which is fat. And you know, we can't just interchange keto and low carb because then women don't pay attention to that fat macro. And the concept of oxidative priority is essentially your body has a decision tree as it goes and burns through fuels. And if you are someone who wants to, you know, reduce fat on the body or just not be adding fat for, let's say you're not in a recon phase or something, then eating excess dietary fat is actually going to prevent your body from mobilizing the fatty acids that you have stored. And it's going to. It has kind of an unlimited capacity for this. So we can't over fuel on fats and expect our bodies to change.

Oh, that's so good. I'm so glad you just said that because I feel like not a lot of people are explaining this and people are. It's. I just, I don't love the direction it's been going with women and I. It literally reminds me of the 90s when people were completely cutting out fat. Like the opposite problem.

Yeah.

Eating too much sugar.

Yeah.

So I love that you just said that. Okay, let's talk about movement, because there are some people midlife, and I'm a huge fan of movement. Obviously, I'm a huge fan of it. And I feel a body emotion stays in motion. But we have women saying they're in pain, they've got the injuries, all that. So they're not being doing, including movement as a priority. Can you speak into that and how that affects us?

Yeah, well, I mean, so the most common population you're going to find in, say, physical therapist office working on the shoulder because they've got a frozen shoulder are going to be midlife women, and that is because that estrogen has declined or is in decline.

Wow.

So. And so few people know this, so few physical therapists know this, so few GPs know this. Op orthopedists know this. But yeah, I mean, that's a big, big problem. Like, we get to midlife and, you know, we want, you know, there are some women maybe who don't have this happen to them. It doesn't happen to everyone. But, you know, your joints can really, really suffer without estrogen. So, you know, Kristen and I will go back to. I mean, movement is phenomenal. We both, we both agree with you. It's like a critical part of a healthy lifestyle and healthy aging. If you can't do it, you maybe want to look into hormone replacement therapy. And again, with hrt, it's sooner is always better for so many reasons.

Yeah. And so, so explain. Talk a little bit about that, about hormone replacement therapy and inflammation and pain. Because you just said you might want to look into that. Is that, does that directly help with inflammation and pain?

Yeah, it does. I mean, estrogen, again, regulates our inflammatory process. We need a balanced inflammation process, just inflame without uninflaming. We need estrogen to do that. Estrogen also changes the lubrication in our joints. So this is why, you know, women will think that they're developing this osteoarthritis. It's actually that you have low estrogen. Also, estrogen changes the fiber structure of our muscles. So suddenly you're weaker because we change from fast twitch to kind of slow twitch. And we, you know, suddenly all that peloton stuff that you were doing doesn't work.

Yeah.

And your, your body becomes softer. Right. And that's because we're changing that muscle structure and architecture because of estrogen's loss. And then also estrogen impacts your connective tissue. And I'M someone. I was a perfect example. I was a highly competitive rower. I rode at the national level and world level in my 40s. And I had more surgeries than I would like to ever admit to because I blew tendons off my elbow, I blew out my knee, I blew out my shoulder. And looking back, I was so low estrogen. And it just kind of irks me because had I known, wow, would I necessarily have had those things. So women become much more susceptible to repetitive use injuries because they're just not having that fluid glide of the connective tissue, ligaments and tendons. So when women are in pain, I get it. I mean, for me, and I think for Maria, too, one of my number one signs that my estrogen is off is I will get body aches again.

Wow.

You know, I'll feel like the tin man getting out of bed sort of thing. I'll be like, crap, you know, need a dose change sort of thing. But, you know, I get that women say, I don't want to move because I'm in pain, but I will push back on that as an athlete and say, pain responds to movement, and you need to glide your body. And I don't care if that's just you, a yoga mat and a foam roller, you need to be moving your body.

Kristen, I'm so aligned with you. I. I mean, I had. I had four major injuries in the last two and a half years. I tore a bicep, I had a ruptured disc. I know pain. I get it. And I will still stand by a body. Emotion stays in motion. You have to work through it. You have to work through it. You have to move where you can or you create a pain cycle.

Yeah. And I think the hard thing is that, you know, I was an athlete, so the doctors I was working with saw me as an athlete, for one, but also worked with athletes as doctors. The most women you end up with, let's say, some sort of orthopedic injury, you end up in an orthopedics office. Whether it's a do who's not going to do surgery on you or a surgeon who's going to do surgery on you, they're not thinking about getting you back into the gym. Right. And so women are kind of being told, like, I mean, I literally had a doctor look at me and say, you'll probably never do a push up again. And I was like, challenge accepted.

Love it.

And they're like, you know, but most women will be like, I can't do that because I've Got this achy thing or I just had surgery and I'm like, ladies, do not listen to that. You need to move and you absolutely need someone who's on your side in getting that movement to happen. Happen. I had seven surgeries in two years over the last 36 months and was on my bike, on a trainer with my arm, you know, full shoulder, done my arm, the pillow, everything. Holding on to one thing, taking pictures and sending to my surgeon. He's like, I don't want to see this. But you know, it was. Your pain will reduce when you.

So true. I'm with you. I tore my bicep and the same thing. I had this, the thing and I'm still walking and doing the other things. You need that movement.

Yeah.

Well, this is so informative today. I have, I'm going to have to have you both back on because I have so many more questions and we're running out of time here. But let me. Where do, where can people find you? I mean, tell them about your social. Where is the best place? How can they work with you? All the things?

Sure. They can find us on Instagram at Wise and well, we try to be as education forward as you are.

You have a lot of great information there.

Thank you.

Thank you.

Our website is the same name, Wise and well and we work with women in a six month month coaching program where we will teach you about nutrition and one of a huge part of our program is teaching you all about hrt. What type do you want? Why would you want.

Amazing.

Who does not want it? What are options? You know, what can you expect if you don't do it? What can you expect if you do it?

And can you help with testing too? Can you help us? Amazing. Amazing. Yeah.

We love to do women's metabolic health. So we'll test the gut and we'll look at those pathways that you referred to and detox and adrenal and all of that. That's kind of standard. But we do a lot of metabolic testing in terms of looking at fasting insulin. How's your thyroid, how's your inflammation, how's your oxidative stress, how are your lipids? All of those things we love really.

What a naturopathic would do and what, what we would hope doctors were doing, but a lot of them are not.

Yeah, right. Yeah.

Amazing.

Yeah.

This was fantastic. Thank you so much for being here today.

Thank you for having us.