CGMs, Menopause and Metabolic Health with Kara Collier

And you can't manage what you can't measure. You know, is the famous saying, and it's true here, that first step is really awareness. You know, what are my levels, how do I respond to different foods, how does that connect to how I feel? And then what are the substitutions I can make that make it better. So you'll learn things that are unique to you, which is maybe I can't eat bananas on an empty stomach, but if I eat some protein first, it's fine.

Today on Midlife Conversations, I've got Cara Collier and we are talking about continual glucose monitors and how it can actually help with our journey for our health, for our weight loss, for our blood sugars, for all the things. She's a registered dietitian, but she's also the co founder of Nutrisense and I could not wait to interview her because I have been a fan, sometimes not so much a fan of glucose, continuing glucose monitors. I've learned a lot about them in the last few months and I really think there is a huge place for them that we are missing right now when it comes to our health. And I'm so glad to have you here because I really want to have a deep dive conversation about this today.

Yeah, absolutely. Excited to chat.

So let's back up a minute. How did you even get into this? Like, how did you become a co founder of this company and how did you become such a fan of continual glucose monitoring?

Yeah, so as you mentioned, I'm a dietitian. I've always been interested in nutrition and kind of how lifestyle factors can influence our well being. But I started my career in the field of nutrition in very traditional way. So I was working primarily in hospitals, working with really sick patients, mostly in the icu. Critical care, nutrition. And when you think icu, you typically think like gunshot wounds, trauma, you know, critical care. But 80, 90% of the patients that I would see in the ICU were usually complications of lifestyle related chronic conditions. So we would see people coming in with uncontrolled diabetes and now they're needing an urgent leg amputation or uncontrolled hypertension and now they're needing to be put on kidney dialysis. So it was patient after patient where we're seeing these really extreme situations that you could understand could be preventable. But we just didn't intervene early enough with the right information, the right tools, the right habits. So instead I was stuck with, you know, the medical staff trying to kind of fix things really, really late. And that's a lot of suffering A lot of time, a lot of costs to everybody involved that could have been prevented.

So I always wonder about that because it's like, you know, I've been in the ER before and I, when I am in there, I always wonder, like, people walk in, especially if you see somebody that is like grossly overweight. And I don't mean just kind of a weight, like, and I wonder, like, what Was there not signs before it got to the urgent or was there not? So to me, there's such a missing part of preventative. There's something going on that we're missing the mark on preventative, which is a big reason I wanted to interview today. Because what you do is very much preventative.

Yeah, absolutely. You know, we could spend five hours digesting all the reasons that healthcare today just skips over the preventative step. But it does, you know, what it does really well is acute care management. So you come in with an injury, you can fix it. You come in with an acute complication, you fix it. But what it really does not address is the prevention part or kind of the long term chronic condition management.

Yeah.

So seeing that every day was, you know, pretty frustrating experience. You know, you go into the field of nutrition and healthcare hoping to help people, but then constantly feeling like I wasn't actually helping people. And I tried really hard to make changes within the existing system. Um, so changing the food that we give to clients to patients, changing the way we educate them and work with them. Um, but in such a big system like that is just like hitting wall after wall and not really being able to make much of a difference. So eventually I decided to jump ship and create my own platform to make a difference in the way that I wanted to. So.

I love that you did that. I love that.

Yeah, go ahead.

I want to talk about this a little bit. Like what? So a lot of people listening, they are just starting to maybe be familiar with blood sugar and how it impacts. Most people know that diabetics have blood sugar issues. They may even hear that, especially in midlife. They might have gotten a number and heard their A1C is a little bit higher. It's pre diabetic. And their doctor says, you know, hey, watch your sugars. But how big of an issue really is blood sugars and how much of a role is this playing on our health right now?

Oh, yeah, it's a huge issue. So right now we can estimate that close to a third of individuals have either prediabetes or diabetes, but that is really not capturing probably a lot more people than that. So we know that close to 90% of Americans are not metabolically healthy. What?

90%?

Yes.

I had no idea it was that high.

It's pretty staggering. So metabolic health in a very traditional way can be diagnosed as looking at five factors. One is glucose, but then we're also looking at weight. We're also looking at triglycerides and hypertension and hdl. And those together make up a good foundation of metabolic health. And 90% of Americans have one or more of those that are out of the normal range. And so if we're looking at metabolic health as a whole, the odds are not great or the statistics are looking pretty grim. And then by the time, you know, you get to an actual type 2 diabetes diagnosis, this is decades of kind of slow changes and slow damage to the system that's happening. You certainly don't go from metabolically optimal to diabetes the next day. You know, it takes a long time. There's a big stretch of habits and changes that we can make in between then.

And by the way, y' all listening, not everyone looks the part of this. I mean, I want to say there's a lot of people that look very fit. They look thin, or they. They look like they would be healthy. And they are still walking around with these high glucose numbers, high triglycerides, high hd, low. Sorry, high H, ldl. All of that stuff can be still happening, despite how you look. So when. Now, one huge problem I've seen, Kara, is you go to. You go to the doctor for your regular test, and they check some standard things. They check for a 1C. A 1C only shows your blood sugar has been high after it's been high for a long period of time. I think we're missing a gap there.

We're missing a huge gap. And A1C also has several flaws to it. Not just that, you know, we're capturing it in a little bit of a delayed sense, but A1C is measuring your average glucose over the last three months. And so there's a couple factors with that that inherently don't always capture the full story. One is that an average does not tell you everything, right? One person could have the same average as someone else, and then one person's having big ups and downs, really high glucose spikes, big glucose crashes, and then the other person has relatively stable glucose, and they might have the same exact average number. So we're really not capturing the full story when we're just looking at that average. And then the other flaw of hemoglobin, A1C is, it's, it's essentially measuring how much sugar has been stuck to your red blood cells over the past three months. So it's measuring, you know, that glycation on your red blood cells. And the reason it's three months is because the average red blood cell lives for about 90 days. So it has about a 90 day turnover, but again, that's the average. And there's actually a lot of people who either have red blood cells that last longer or last shorter. So different turnover rate, which skews the results of the lab value of the A1C. So I think it's close to almost 40% of A1C. Values don't match the true average glucose level. So it may not be off dramatically. You know, if your A1C is telling you your average glucose is two times what it's supposed to be, it's probably high. But if it's showing, maybe it's at, you know, right below the threshold of normal, you think it's okay. Could actually be in that pre diabetic range because A1C is super sensitive to picking up the right number.

Okay. And by the way, you all listening, before you tune this out and you say I'm healthy, I don't need to listen to this. I want you to know I am a completely healthy weight healthy bmi, healthy weight healthy, all the things. Eat unprocessed natural foods, no refined sugar, eating. My A1C was pre diabetic before I started wearing a glucose monitor. My A1C was that. And within four weeks I completely reversed it. Like it's not even close to pre diabetic anymore from wearing a monitor. So this is, this is important stuff. And most doctors are not telling you about this. And what we'll do is we'll hear sort of this, oh, we're taking them from diabetics, which is just not the case. I think this is a huge preventative thing. Diabetics do have access to these. That is not what we're talking about though, today, diabetics. This is a very huge, huge, important preventative measure or preventative way to make sure that you are in healthy range. Because you like she just said, we don't even see the A1C number until it's, we're already at pre diabetic level pretty much.

Yeah, absolutely. And as you mentioned, that's one of the huge myths that people think is, you know, you have to be overweight to be pre diabetic or diabetic. And just like you mentioned, we see so Many people where that is just absolutely not the case. And then the other big factor we see that many people aren't aware of is that you can also have a normal A1C and a normal fasted glucose level and see some abnormal readings on the cgm.

Yeah.

And so as it takes decades to start to get to that diabetic level, the first signals of abnormalities that we typically see happen in those kind of after meal values, those swings in your glucose. And that's what we can pick up on the CGM because we're getting that movie picture of what your glucose is rather than a snapshot in time like those other metrics.

Makes sense.

Just real quickly touch on this, like taking it away from diabetics because we do hear this a lot and it's absolutely not true. You know, the people who make the actual hardware, their goal is to sell as much of this hardware as possible. So the more demand there is for it is actually going to drive prices down. So there's no supply issue where diabetics aren't receiving this. I think where a lot of people get upset is more in the insurance reimbursement, which again really is more of.

A different, different world. It's interesting too, whenever I was sharing about it, first of all, first of all it's funny people's comments like what you they see went on. They automatically assume something like I actually had a metabolic, reason I was wearing one. But people assume that I'm you know, doing something not right or whatever. But my actual, my sister's type 1 diabetic. I've got, so I have that my best friend is type 1 diabetic. So they're not the ones that were upset. It's people that aren't type 1 diabetic that want to make a big deal about it. I think these are important for everybody. Let's talk about how accurate or non accurate they are. And do you recommend that people finger prick and change? I'll tell you, in my case, as I was sharing before we started recording, it is critical that I also finger prick or it can be arranged off. What are you seeing with people on those?

Yeah, and this is true for all the different brands of CGM companies. So the two big players are Abbott Libre that people probably hear of and then Dexcom and both of them allow some buffer of accuracy. So they are tested and validated by the fda. You know, these are FDA approved devices but they're allowed to have a wiggle room of what is supposed to be, you know, up to 15% variation 95% of the time from what you would get from a lab value. So it is not. We. We like to differentiate between precision and accuracy. So the exact number may be different than what you might have at a lab value, but then the change in glucose values is very prec. That makes sense.

So you might. You might see 80 to 120, but. But maybe it's really 70 to 1 10. So you're saying it's still. It might be. The variance is still the same. It's just that actual number might be a little off.

Exactly. And this is per CGM. So the libre that we use, they last 14 days. So you may have to adjust that absolute value by checking it against something that has a higher accuracy, and then you can adjust it and then the changes in glucose will be accurate for the rest of the two weeks of that cgi.

Oh, okay. So that's important. Most people aren't doing that.

So you're saying only our app allows us to do that. So that's.

That's amazing. That's amazing. Okay. I love that because that was missing from mine. So that was. That's really important to know. Okay. This is something I could not find on anybody else's podcast interview. So I'm. I'm like asking it here because I was looking for this information. I could not find it. Can we talk about what actual healthy readings should be?

Yes, yes. This is a common question because you Google anything and what you're going to see are the metrics for diabetics.

Yes. And I'm talking non diabetic. Non diabetics right now, what's actually normal.

And so there are a few different areas that we're going to look at when we're reading the CGM values. So we're going to look at what's happening in a fasted state, and then we're also going to look at what happens kind of after you eat a meal. And those are two different things. So first, fasted, and this is, you know, typically defined as at least eight hours without food. And if we want to be considered non diabetic, then we want our glucose values less than 100 milligrams per deciliter in the fasted state. However, because we're really searching for, or we're reaching for what we consider more optimal health rather than just within normal ranges. So there's really a difference there. You know, if anyone doesn't know the reference ranges are based off of population averages, they're not necessarily based off of what is optimal. For long term health. So if you dig into the research, and there is a ton of research on this, we actually want to see our fasted glucose values more in the range of 70 to 90. Okay. So that is what we're, we're aiming for most of the time in the fasted state.

Okay, and then what is normal? Because when you look up, what should it be after a meal? What I see is as long as it goes back down within two hours, we don't have a problem. I don't. I think it's a big problem though, because if your blood sugar goes up over 200 after eating and it doesn't go back down for two hours, I think that's a problem. But we can't find that online.

So help us. Yeah, it is a big problem. So after meals we're looking at both how high does your glucose, glucose go at any point in time? And then also, yeah, what is the shape of that glucose curve? So how quickly does it come back to normal values? And the reason I think that most people, you can't find this online, you can't get a clear answer is because you really can only answer those two questions. If you're wearing a cgm, and it's just now kind of gaining popularity to wear these devices because if you're just checking your finger, your, you know, your glucose randomly with a finger prick, you're never going to really know what your glucose value was unless you're checking it like every five minutes and destroying your poor fingertips. And so we haven't had the ability to really set true guidelines there. Um, but now that we have more people wearing CGMs, both diabetics and non diabetics, we're able to kind of dig into this deeper. And really what we're aiming for is that peak glucose value for non diabetics. We want to keep it under 140 milligrams per deciliter.

Okay, so hear this, everybody. I was eating an apple and it would go over to 2 over 200. Okay, that's a red flag. And I could not find anything online to support that. And even endocrinologists said, oh, as long as it goes back down, it's fine. It's not fine. We have, and I had actually something wrong. So we, this is important to know. So when you say Peak140, this is really critical for if you are non diabetic and you're listening to this. No, we should not have a blood sugar go up over 200 at any time.

Absolutely. Yeah. And that's where that's really early, early warning signs where you know, something is a little off. We need to really dig into this and double click and figure out kind of ways to adjust this to mitigate some of that high glucose response. Because we know there is research studies out there that are looking at oral glucose tolerance tests, which is essentially, you know, if anyone's been pregnant, then they've done one of these. But they also kind of randomly do it as a diabetes diagnosis as well. You drink a bunch of sugar and you do check, you have pure sugar and you check your glucose a bunch. And sometimes you can also check insulin along with it and see that curve as you're drink something super sugary.

And can you, if you, somebody had like, if you were to eat jelly beans, let's just say like a healthy person eats a pile of jelly beans, should it still peak at 140 or would it go higher?

It's usually not going to go much higher if we're in really optimal metabolic health.

Good to know. Yeah, good to know. Again, something that a lot of endocrinologists are not saying the right thing to. So this is really important.

Yeah. And because there's not clear, there's not like official guidelines which most of endocrinologists or doctors are just looking at, you know, what is the ada, American Diabetes association guidelines. But there is a whole gold mine of research out there kind of indicating that this starts to become abnormal and starts to become that warning sign for future problems. And that's when it's in, it's a really great way to intervene at that moment. So talking about prevention, this doesn't mean that you're diabetic if your glucose goes to 200 after jelly beans, but it means that we want to do a little bit of work. And like you were saying, you know, just in four weeks of adjusting some things, you saw those lab values follow the trend because we can make changes so much easier when we adjust it, when we're seeing early warning signs.

So some of it was interesting and I'm sharing this because I think somebody listening when they start monitoring, they could see a similar thing. And I couldn't find this information before. So I'm so grateful that you're on here with me right now for somebody else looking when one thing I noticed was that I didn't realize a lot of symptoms I had been feeling being tired, foggy headed. I just thought, oh, that's hormones, it's hormones. I'm 51, it's hormones. What I know now is it was actually chronic high blood sugar. Because I didn't know. And especially if you're somebody who's like eating all day long and you think you know and you're keeping it at this high chronic blood sugar, you will feel all those symptoms. So just by changing to I'm eating a few times a day or and I'm really watching like, like really lowered the carb, raise the fat, raise the protein, able to get it down. So after a meal it wouldn't even go over 1:20, which took some work to play with it. But that's why things like your app are so important.

Yeah, absolutely. And this is what we every single day from people is, you know, these symptoms I thought were normal or these symptoms I thought were associated with something else I can now very clearly see are when I have major swings in my glucose.

Yeah.

And so those are those swings you really just can't capture with any other type of data. And what is really amazing is after a while people start to really enhance that mind body connection where now you start to get that feeling without having to necessarily wear a CGM 24. 7. And you know that my glucose is high and that's why I'm getting kind of brain fog, that's why I'm crashing or my glucose is low and that's why I'm feeling this way. And so people can start to eat more intuitively over time and really enhance that ability to listen to their internal signals and know kind of what it means and what to do next. So being able to connect that hard data with like your subjective experience is really powerful.

So how do you help people at Nutrisense? Like if they, they have, how does this work? Like, how does somebody's listening and they're like, oh, my doctor hasn't given me a cgm. Can anyone get a CGM through nutrients? Can you do that? And then how does it line up with the dietitian? How does that all work?

Yeah, so we offer monthly plans. So each CGM lasts 14 days. So all of our plans are at least two CGMs and they vary based off of price depending on how long you want to commit. So you can kind of do a month to month if you just want to try it, or you can do longer if you really know, you know you have a health goal or a lot of health improvements to make. And all you do is sign up on our website. So we take care of all of the headache of getting the devices, you know, you don't have to deal with a doctor. The prescription you don't have to go anywhere. You just sign up on our website with a little bit of a health questionnaire and then we'll ship the devices to your door. You put them on at home. As I'm sure you can attest to, they're very painless. I would be ready for it to hurt. Really don't feel it?

Yeah.

Yeah. At all. So I always describe as kind of like an easy button because it comes in a contraption, and then you just put it on the back of your arm, you push the button, and then it's there for the next two weeks. So it's not like an apple. Watch where you take it off and put it back on. It stays for those full two weeks. You can do your normal activities.

Do you worry about getting wet and stuff? Like, I mean, I take a shower with it, but do you. Would you go swimming in it? Like, do you worry about that? Like, I've been kind of worried about that.

Yeah. You can go swimming. It is recommended by official guidelines to not have it submerged in water for more than 30 minutes at a time.

Okay.

I will say, if you're doing a lot of sweating, like hot yoga or longer swims, there are these, like, really cheap sticky devices, like adhesive wipes you can get. Okay. You can order them on Amazon and get a pack of 100 for, like, $3.

Those on top. But does that protect it in the water? I didn't even know that. I'm thinking. I'm like, double check.

It's actually this. It looks like an alcohol wipe, and you wipe it on your skin before you place it, and it's just like an extra layer of edge adhesive. And I find that that works really well if you're just worried about it coming off. I play beach volleyball, so I'll wear one. And I'm, like, diving on it in the sand, and I'm sweating a bunch. And those adhesive wipes, it's never fallen off.

Amazing. Yeah, mine's never fallen off. I was always worried about it, like, stopping to work.

Like, if it was, it should be fine for that. It's more than that. It breaks down the adhesive and it might fall off.

Okay, so good to know. So good to know what? I want people listening right now. I want them to know, because I would love everyone to go work with Nutrisense. And by the way, we do have a coupon for you. It's Natalie J25, which will save off of your first month if you do that. But what do you want people to know about, like an experience with this, like, what can they expect? What would change for them? Like, why do you want them, even if it's not with nutrients, if they were just to start wearing a monitor, what do you want them to know is possible?

Yeah, absolutely. I really think about it as first it becomes a discovery piece where you're learning a lot about yourself that you really could never know without the data. So related to that might be things like you were mentioning where connecting some of those subjective feelings, a lot of people get brain fog or energy crashes or three o' clock swings, the three o' clock thing. So starting to put together some of those feelings, but also starting to understand your personal glucose responses. What's really interesting, and when we began working with real clients, and we've now worked with thousands of them, is seeing how different each of us are. You really can't have a prescriptive one size fits all approach because how you respond to certain foods and how I respond to certain foods is just not going to be the same. As an example for myself, you know, when I first started wearing CGMs, I was trying all the different foods and I tried every fruit basically that exists. And the fruit that I consistently have the lowest glucose response to is bananas, really with really high glycemic index. And I can say that that's not true for everyone. You know, we see a lot of people who have much higher responses. But what we're learning is that just through a variation of genetics, microbiome, epigenetics, you know, probably many factors we can't even quantify, we have different glucose responses.

That's wild. That happened to me with sweet potatoes. A quarter of a sweet potato skyrocketed my blood sugar and you would think, oh, low glycemic, It's a sweet potato. Like tangerines do not pineapple does. It is fascinating. Now, mine was a way bigger range than I would say most people that are metabolically fully healthy would be. But I think I want people to try them. Even because of what I went through, because I thought I was 100% metabolically healthy, I thought there is absolutely no way. And that helped me catch things wearing it. And now I just have that thinking about them for everything. Not just health and preventative and women, especially in menopause years, but being somebody that was in weight loss and fat loss for years. My gosh, this could have helped so much clients.

Yeah, absolutely. And you can't manage what you can't measure, is the famous saying. And it's true. Here that first step is really awareness. You know, what are my levels, how do I respond to different foods, how does that connect to how I feel? And then what are the substitutions I can make that make it better? So you'll learn things that are unique to you, which is, maybe I can't eat bananas on an empty stomach, but if I eat some protein first, it's fine. Or maybe I can't eat pineapple at 10pm but if I eat it at 10am it's okay. Or maybe, you know, if I can have that big birthday meal, but I need to go on a walk afterwards or work out beforehand. So you start to learn the tools and strategies that work for you that are really backed up by your own body's data. And then eventually it transitions from a discovery learning tool to a behavior change tool. And this is where I think the power of driving real weight loss, real long term success, really managing our health overall is so powerful. Anyone who's worked with clients in the health space knows that you can educate somebody with the best information in the world, the best knowledge in the world. And at the end of the day, the only thing that's actually going to drive long term success is consistency. Right.

I love that you have to be consistent. And something else I want to share that I had not shared prior is that I had gained, I wouldn't have said I was overweight at all. I just gained, I had probably gradually gained about 12 pounds. And I just literally thought, age, menopause, whatever, I still muscular, lean, all the things. Once my blood sugar got under control, effortlessly £12 came off like, like crazy. Like I had no idea that was the connection. Yeah, if you're not eating candy, you.

Don'T think that, you know, exactly. It's incredible. And then the other part of that is it really drives the motivation to stick with the habits that do work for you. You know, we all know the feeling of I, I'm on the wagon, I'm doing all the right things and then I fall off the wagon and I regain the weight. And part of what helps make habits sticky in the long term is having that true internal motivation that you want to do it. And seeing real data helps people drive that internal motivation. So when they see, when I go on a walk every single day, my glucose is good, I feel good, everything is good. They're more motivated to always do that because they've seen it works and they're getting that data, that biofeedback, that real time feedback. Part of the problem that health habits are so hard to stick to sometimes for people is that long time gap between the action you're doing and either the reward or the consequence. You know, I could eat candy every day for the next however long, and I might not see my glucose levels rise from like an A1C level or even weight gain start to happen for a little while. But if I eat it today and I see that big glucose spike, it's like, okay, I don't want to eat that anymore. It's not nearly as motivating.

No, I get it.

Really driving that behavior change.

I do have another question about the opposite side of it. How often do you see low blood sugar? How much of a concern is that really for people? Is that a true rare thing, hypoglycemia, or do you see that trending watching people with this? And can you create that in yourself by trying to be too strict?

Yeah, there's certainly the extreme side, not even just related to hypoglycemia, but over tracking and over obsessing that I think everybody needs to be mindful of. And that's the same with tracking your calories, tracking your macros, tracking anything. It can also become too much. So if you're starting to feel psychologically that it's more stress than helpful. Yes, that's something we have to be honest with ourselves about. And that's why sometimes I think tracking can be really powerful in a periodic way. So maybe there's this period of really making improvements. Maybe you do it for three to six months to gain insights, really get the flywheel going. And then you track both your meals and your glucose and other metrics, once a quarter or once every six months to make sure you're still on track, but not obsessively.

Yes.

So that's kind of my, my take on tracking anything in general. But with hypoglycemia in specifically, it's actually fairly rare in non diabetics. There's two different types of hypoglycemia. One is reactive, which is like after a meal, and then the other is in a fasted state. So I would say reactive we see more often. And typically this is I just chugged a bunch of juice and my glucose shot up and then it crashed after.

What happened to me. Yeah, yeah, definitely.

And it starts you on this cycle and that's more common because you basically, you know, you gave your body a bunch of sugar at once, so it pumps out a bunch of insulin to deal with it, and then it kind of over corrects. Yeah, it essentially gave yourself Too much insulin and then it drops the glucose low and then your body tries to correct it again and then that usually triggers hunger and then sometimes the cycle keeps repeating so that one is easier to fix because we fix what you are feeding your body and making sure it's not shooting too high makes sense. The other side of it is the fasting hypoglycemia. And usually this is in the middle of the night, I'm sleeping, everything's fine and my glucose plummets. And usually people wake up, they have night sweats, they have nightmares, headache symptoms. Yeah, they feel, feel it and that's not that common in non diabetics but it does happen and there are a wide variety of reasons why that might be occurring. So certainly not a one size fits all approach there. Often there are low hanging fruit that we can address. Like if you drinking alcohol before bed, that can drive hypoglycemia in the middle of the night. There are certain medications and supplements that might be related but.

Or also the reactive thing you're talking about because if you have a big thing of ice cream before bed or a sorbet, even worse, there's no fat, you know, you're just having the pure sugar. You could have that. Reactive.

Yeah, exactly. Right? Yep. Yeah, yeah.

Well, this is fascinating. I'm so happy I had you on. Okay, so if people want Nutrisense, where do they go and use coupon Natalie Jill 25. That'll at least save you some money on your first month. But where do they go to nutrient? What's the website? Where do they go?

Yeah, so the website is nutrisense IO and just like I said, all you do is sign up on the website there and pick the plan length. If you really aren't sure, I always recommend going with the month to month option because then you can switch to a commitment plan if you, if you kind of like the experience. If not, we have cheaper plans for three months, six months or 12 month minimums. And then as we mentioned, all of our plans come with one on one dietitian support. And so that's something that we found really important when we were building this company is data is one part of it. But having that human side is so important. You know, people are complicated. We're not just numbers. And so having somebody else on the other side to talk to through, talk through with, you know, and ask questions, see what's happening is really helpful. So all of that dietitian sport is through kind of like a texting basis within the app. Okay. And they'll reach out. Yeah, they'll reach out proactively. If you aren't sure what to ask her, what to say, they'll give you some insight into what they're seeing, tips that they think. But you can also ask them questions at any time.

This is so good. I love that you're doing this. Listen, especially women, if you're listening and you are my age, 51, and you've never looked at this, I suggest doing it, do it for a month. Like, do it like she said, for a month. Because this not only did this, did I correct things by doing this, but this gave me so much awareness into my health that no regular blood test was giving me. I had no idea. Because this is where. If you've got things in your genetics and you think they're not presenting it like, you're going to see all of that. And even if you don't, you're going to have such more control over how you're feeling, your mood. I've been such a fan of bioidentical hormones, but honestly, I put this before that now because I feel like a lot of those shifts that we feel through hormones could actually be blood sugar issues, especially as we're getting older and especially with what you said, 90% of Americans being metabolically not healthy. That's crazy. So I highly suggest everyone go, go do this, do it. It's worth it.

Yeah. And just kind of in addition to already 90% aren't metabolically healthy, menopause also, in and of itself, makes us less insulin sensitive, which is going to drive GL even higher. So, you know, there's a clear connection and correlation there of once we kind of go through menopause and are postmenopausal that we see people have higher glucose values overall. So it's even more important at that stage.

Well, this is so helpful today, Cara. Thank you so much.

Yeah, it was a pleasure, Sam.