MenuPause by Dr. Anna Cabecca

Today I'm here with my friend, Dr. Anna Kabeca, and you're in for a big treat because she is not only just this incredible doctor that really specializes in the space of advanced aging. I like to. I don't. I don't even know what to call it. You call it midlife, middle life, mid age, advanced aging. I say it's like over 50, young. I don't know what do we call it? But she specializes in that. Yeah. What do we call that group?

I mean, really, it's just optimizing your health at any age. Yeah. Ok. Is really key at whatever this is the second spring of our life heading into.

Second spring.

Yeah.

Yes. I say reignited in our 40s and 50s. Reignited, redefined. Right. Because it can be. It can be. It doesn't have to be our mother or our grandparents, our grandmother's menopause. It doesn't have to be. Things have changed.

Absolutely. Yeah. Not at all. Not at all.

Tell us a little bit about one before we jump into what we were going to share today, because you got some really great things, some really informative things to share. But can you talk to us a little bit about why you even got into the medical field and why you decided to specialize in women's health?

Yeah. So one of the things, the reason I wanted to be a physician from a young age because my mom was in and out of the hospital. I was in and out of the hospital with ear infections, and my mom had diabetes and heart disease. And I realized when I was 16 years old that the research they were basing my mother's care on for her heart disease was all performed on men. So I was from there on a woman's health advocate. And I wanted to do research and to really dig in and understand how are women different? How should we be treated different? And so that's started me in my medical journey in women's health.

So take us back to what you've learned about women and as we age, because you'll hear somebody say, oh, my gosh, it's because I'm getting older. It's because I'm getting older. And I always say that doesn't have to mean a certain thing, but talk to us about what actually happens and what actually can we do about it.

Yeah. And this is really key. And this is where, you know, my journey was different because I learned as an ob gyn, I went to an osteopathic medical school, then I trained at Emory University in Atlanta in obstetrics, then went into solo practice. So in solo practice, you really have to. You are responsible for your patients and you follow through. There's not a colleague that sees them the next visit or whatever situation. It is you. And yet, for me, and knowing as much as I knew with my own journey, getting the diagnosis of early menopause and infertility when I was 39 years old, feeling like my doctor's bag was empty. And so for me, growing up in a culture where there was this hierarchy of medical care and every part of your body goes to a different specialist, there was no integration. And then for me, my doctor's bag was empty. And it led me on a journey around the world looking for answers. And I met Eastern healers and philosophers and some, you know, Chinese medicine and Ayurvedic specialist and Andean philosopher. I mean, it was just amazing the people I met that I was able to add different things to my doctor's bag.

Stuff that you were not learning in medical school, I'm assuming.

I never learned, nor did I even conceptualize that it was never. Once I was given the diagnosis of early menopause and infertility and told my only chance to have a baby was egg donation. That's the diagnosis, right? I didn't think, well, let me go around the world and reverse this. Well, but that is what happened. I became pregnant spontaneously with a child I was never supposed to have at 41. And that opened my eyes to herbs and lifestyle and things that I spent hundreds of thousands of dollars and didn't learn. Really opened my mind to how to address the natural changes versus the unnatural ones.

So let's talk about that. Like what? Talk to me a little bit about the natural versus the unnatural. Because I think in my perspective, some, especially women, we tend to get really caught up in the marketing and the ideas and the glitz of things. So we start adding in a lot of supplements, a lot of what we think are the right foods. We start doing, adding, doing adding, and then we don't actually operate from a clean slate. We don't know what's creating what, for example, and I know you and I had talked about this before, testosterone in women in their 40s. Typically, their OB GYN checks. OB GYN checks them, and they say, oh, you're low on testosterone. And then they kind of give everybody this bioidentical testosterone. Well, there's a lot of things that can happen when you do that. Like, how is that converting in your body? What's the pathway it could convert to estradiol? There's lots of Things that happen, and then we start treating the next problem that it created. Okay, now you're estrogen dominant versus, like, let's just actually look at what's going on with you.

Absolutely true. And I've run the gamut. I started with bioidentical hormone replacement and working in sexual health in 1999 and figuring out how can we use androgens in my clients with history of breast cancer and what can we do to help them. There's a healthy way and then there's unhealthy way. There's a way that we suppress our body's own natural production, which with high dose testosterone is happening. I've lectured and consulted for some of the most amazing age management clinics in the world. And this is a common problem. And what happens is over testosterone supplementation in men and women. We know in men it reduces testicular function and cause testicular atrophy. That is never good. Guys will be like, oh, I'll take that side effect. I'm like, if that's shriveling up my ovaries, I don't want that.

No.

We know we have to empower our body to heal and address the underlying cause, why the testosterone is low in the first place. And what happens if we're just doing testosterone? We get anger issues, irritability issues, burnout, divorce, I mean, novelty seeking behaviors with high testosterone. And if we're not addressing the underlying issues, then we're requiring that person to take testosterone until they have to stop because they can't afford it, their doctor won't prescribe it, whatever happened. And that stop causes that person to go into a deep depression. Now, this is not being consented, but that's an absolute side effect of abruptly stopping testosterone. And that's a problem that should tell you that, well, we're interfering with the entire HPA axis. And like, look, I will supplement with it and I love it. At times there's a need for, you know, and I would say the perimenopausal time period when you're juggling kids, juggling work, juggling a spouse or whatever it may be. You know, pellets can be a great thing because you can't do that. One more thing, like remember to take your supplements, your pill, your trochee, whatever it may be. But ideally I do troches or creams for hormone replacement and I like to have pause time in supplementation. And I also train an individual woman to listen to her body. You can't be on the same dose all year round because you're missing the intuitiveness of what your body needs and doesn't need. So for example, in the summer months, you're outside, you're playing more higher vitamin D, all your receptor sides are or more alive and more oxytocin, right? And then you need less of your hormone supplementation. And so being really able to fine tune it, it's a powerful thing. But it always takes more than hormones to fix our hormones. And that's a missing piece of the puzzle too.

So when you say it takes more than hormones to fix our hormones, tell me what you mean by that.

So because I studied reproductive hormones as a gyn, I know the pathways, the metabolic pathways, like what testosterone is converting to what estrogen metabolizing. Those are important things to look at if you're on hormone replacement, by the way. But I studied this, right? But what I realized through my own journey and through early menopause and infertility and all of that is that the things that really shifted my hormones were the lifestyle was eating keto green, which I call my lifestyle. Healthy greens, low carbs, intermittent fasting, no more snacking and focusing on the mindset, the increasing oxytocin. So getting more insulin sensitive by getting into ketosis and intermittent fasting, staying away from sugar, addressing cortisol, which is your stress hormone. And it's acidifying to the body, it's catabolic, it will break you down, break down muscle. Men don't have so much of an issue. They have 10 times as much testosterone as women that women were more sensitive. And then increasing oxytocin. Those three hormones are the major players for health and longevity. I give the analogy. If you think of a university setting or a school body, all the students, we have hundreds of hormones just like students in a school. Each one has its own specific giftings and its purpose and its interaction. And then you have the teachers at the head of the classroom, I would call that insulin and cortisol. And if they are behaved and on top of it and are highly functioning, your students in the classroom behave. But if they're sitting on their feet, up on the desk, sleeping at the front of the classroom or whatever it may be, you've got chaos in the classroom. The same is true with our hormones. And oxytocin would be the dean of the school or the principal of the school. And oxytocin is that overpowering, benevolent hormone that is the love and the connection and the reason that things happen in a certain way. How we enjoy life, life, the reason we live. So that's that oxytocin hormone. Oxytocin hormone is the most longevity hormone we have. And in that it helps rejuvenate muscles even into our 80s. We've seen studies out of Berkeley that looked at increasing oxytocin level in 70 and 80 year old males and showed an improvement in muscle cell regeneration.

How do we increase that? How do we increase oxytocin?

Oxytocin is that hormone of love, bonding and connection. So it is secreted in abundance at times of orgasm and affection, intimacy, kissing, hugging, playing, laughing and doing things. We enjoy shopping. If we're enjoying a walk on the beach or a sunset.

Did you just say shopping? Everyone's like, okay, shopping. Okay, great.

I know retail therapy, there is a reason, you know, and breastfeeding.

Breastfeeding too. I know. For a younger, breastfeeding would do that as well.

Breastfeeding, labor and delivery. Pitocin. If anyone's received pitocin, that is oxytocin. We administer pitocin in labor to help increase contraction. So when this. Well, in general, our body's producing it. So when this baby is born, and this is the danger of having sex with someone you don't really like. So this, or you know, you shouldn't be with this. When this baby is born, you are bonded with that baby. That is oxytocin. That is that imprinting hormone. And the same is true with sex. So we are imprinted, like all of it. You're like, oh, I'm just going to have this fling with this guy and all of a sudden it's like, oh, when is he going to call me? What can I hear from him next? I mean, that's like ridiculous. What are you thinking? It's oxytocin. Hormones affect our behavior, right? And our behavior affects our hormones. So knowing that in coming out of a pandemic, especially that we've had high stress, cortisol and oxytocin oppose each other. And so high stress time, cortisol is running low. And that's why we see abundant burnout, divorce, relationship issues and a sense of anhedonia, isolation and depression right now.

And what's interesting, and maybe this is off topic, but it just came up for me is that people that are on birth control pills for years and years and years, they're actually not experiencing their true hormone expression. So I would imagine that could also mute who you feel connected to or who you're bonding. Is that accurate or am I jumping too far there?

No, absolutely. Actually, there's been great research looking at that. That on birth control pills, you may choose someone you're really not physiologically attracted to. You don't have that connection. So it does affect your hormones. The other thing was really interesting. Out of Texas Christian University that was published a couple months, looked at attractiveness. And I think this is. So did you hear about this study? And it was looking at immune factors, and it showed that people with higher immune function were perceived as more attractive. Okay. The headlines read, more attractive people have higher immune function. The opposite is true. If you have higher immune. And this is according to the research, if you have a higher immune function, your body's able to fight inflammation, respond better, you are perceived as more attractive. So healthy is attractive. And that's the difference. I was. I mean, I was unhealthy at. In my 30s and early 40s. I was so unhealthy. Right. And so unattractive in so many ways. You know, to understand, like to have the body be able to heal itself, that's power, that's confidence, that's, you know, empowers you and that's attractive.

Yes.

Makes sense to recognize, too, the things that we do on the inside improve the perception of us.

Talk to me about maca. I just discovered MACA not too long ago. And it was when I was that person, by the way, that was given bioidentical testosterone 10 years ago from an OB GYN. Did it for years thinking I needed it. And then what happened was I started looking like I was estrogen dominant. So then a different doctor gave me progesterone to counter that and dim to get rid of the estrogen. And next thing you know, I'm on all these things and I'm not feeling amazing. And I finally went to a naturopathic MD and got off everything and started over. And now I'm on no bioidentical hormones. None. What was happening with me is testosterone was converting to estradiol, which is dangerous. So that's why I get caught up on that conversation. And I've talked to many women. This has happened to me. But MACA is what helped balance my hormones for three months, is taking that. So can you talk to us about what that miracle thing is and why that works and how it should actually be used?

Yeah, absolutely. And I'm with you on that. The journey with bioidentical hormones. And I think, again, there's that place, but then there's over supplementation. And always if we're replacing it young and committing you to it, that's a problem. Always look for the underlying reason and it starts with supporting the adrenal glands. And this is where maca comes in. So I was flatlined with my hormones in 2006, 2007. I mean, I am 55 now, to give you perspective. I am 55 with that miracle baby is 14. Teenager. In 2006, 2007, my hormones were flatlined. And part of my healing journey was. Was going to Peru where a nurse who worked with me had been a nurse midwife in Peru. We went and stayed with her family and very, you know, that long history. I mean, forever. They were in Peru and they said, well, if you're infertile, drink maca, and if you're tired, drink maca. And then they elbowed my husband at the time and said, it's the Peruvian Viagra. Drink some maca. Well, and I, of course, at that point, I'm like, yeah, give me that stuff, right? Let me drink it. And. But as a scientist, I was like, huh, what's the history? What me, really? Why is this the medicinal food? And I researched. And the ancient Incans would take maca before they went into battle to give them stamina and energy. Wow. And if you look at the composition of maca, it's very specific. The proteins to maca are maca yins and very specific to maca. This root only the Peruvian maca for. And. And. And it's high in arginine, which increases all three forms of nitric oxide, which increases blood flow, which is how Viagra works. And it's also high in histidine. Histidine also helps with orgasmic function. And so these are. I mean, it's a beautiful food. Now, I couldn't tolerate maca by itself, and my family, from a family of chefs and food as medicine, so I started combining other superfoods with it. That is where my formula, Mighty Maca plus with 30 superfoods, combined with organic Peruvian kosher maca. I've been using the same source since 2009, has come into play. And what we see, we see improvements in energy and improvements in cognition, a decrease in hot flashes. Perfectly safe in my.

I will tell you right now, it stopped my hot flashes. Stopped them. And it made my flow, my monthly flow, way less. Like, I was having Matt really struggling with that, and it, like, completely changed that. Took me three months of using it, but that. It changed that.

Yep, yep. I mean, really, I see that over and over. Improvements in hemoglobin A1C, blood pressure, inflammatory markers. I just did my labs, actually, and this is something I like. There are four Key lab markers. I like all my patients to have. I like the full my VIP elite panel that I used in my concierge practice, but for four, and now maybe five key markers that everyone should know, like the waist size or shoe size or hat size. We're in Texas, so we all know our hat sizes. I want you to know these numbers and I'll share them with you because they will improve over time if you're doing something right. Just like I always say, treat the patient, not the labs, but the labs give us that. What gets measured, gets managed, gives us those markers. And especially for high end, very invested people like your audience, these are key four markers. And we look at the first one, which is the hemoglobin A1c. The hemoglobin A1c is your measure of blood sugar control over time, and that is key. Now, your doctor might not flag it until it's greater than 6. That's prediabetes. But when it's greater than 5.3, every point above 5.3 increases your risk for Alzheimer's dementia exponentially. So we want it down below 5.3. And mine at one point was 5.7. I had diabetes on both sides of my family, lost my parents to diabetes, and both my brothers are pre diabetic. My hemoglobin A1C is 5.0 as of yesterday.

Wow.

Yeah.

Okay, so hemoglobin A1C, we check for what else? What are the other three?

We check for vitamin D, 25 hydroxy. Now we think, okay, we get a lot more than vitamin D from the sun. So get as much sunshine in your eyes, on your body, on all your skin with no lotions whatever, as much as possible.

No sunglasses before noon.

I've learned that recently or after four, right? Absolutely. Really, really work on that. Because that's going to affect our primal brain and our secretion of our hormones to wake us up and get us to sleep. So this vitamin D is also, and people don't realize this, it is important for our hormones to work for the receptors for progesterone and oxytocin. If we have low vitamin D, we're less connected, we're more depressed. Oxytocin is also affected. So you want that number for vitamin D to be greater than 50. I believe in nanograms per milliliter greater than 50 and 50 to 80. My breast cancer patients, I want them all in the 80s. But I'm going to do vitamin D3 with K2 supplementation.

Can you explain why that's important?

Yep. Vitamin D says deposit calcium, vitamin K says where. And we don't want it on our cardiovascular vessels, we want it in our bones. If we're depositing calcium and we want it in our own receptor site, that's critical. I have a vitamin D on my website that's a D3K2. To give you a gold standard example of that ratio. Then the third hormone I think is so critically important is hscrp. That's the highly sensitive C reactive protein or cardio C reactive protein that is more sensitive than a general crp.

So.

So we want to look at that and we want that number to be one or less, not three, not anything. And I'll tell you why. Natalie. I had a patient who came to my office, 57 year old woman, I consider that very young and she was maybe 50 pounds overweight, had been to four specialists. She'd been to her internist, her cardiologist, her endocrinologist and her GP before she saw me. And she came in for her pap smear. I said, I'm thinking to myself, man, you look terrible. What's going on? So I sat down with her and talked for her a bit. She gave me her symptoms and I ran these labs. And her HSCRP came back at 111. 111. I sent her to oncology. She had metastatic cancer that should have been detected at like at 5. I also have a patient who did my magic menopause program. She came in like difficulty walking, ankle, knee pains, all that stuff. And her hemoglobin, her HSCRP was 32, hemoglobin A1C was 5.9. And within just a couple months of following these shifts, like I call them the Keto Green way. Doing what you do and I do is very similar. So the Keto Green Way. And it went down to less than 3 in just a couple months. And her hemoglobin A1C dropped to 5.4. So still working on it, but what a big shift. I mean, I can't do that with prescriptions. So the fourth one that I love is a marker of our adrenal glands. And when we're checking it in the blood, and all of these are quick blood tests, you'll get them back in 48 hours. So it's the DHEA S and that is a marker. DHEA is a marker of our adrenal glands and the DHEA sulfate is the one we measure in the blood. Sometimes I tell people DHEAs and they get a DHEA. It's not telling me the same thing in the saliva. We'll look at a straight DHEA in the blood, DHEA sulfate. And that's a marker of adrenals. In women, I wanted over 150, 200 in men, 250 to 300. I've got it. I used to be in the teens with post traumatic stress disorder. I was in the teens with that number. And then I managed to get it up with Mighty Maca Plus. This supplement is the thing that changes, improves that adrenal function. And DHEA is the precursor to testosterone and estrogen. Our body will intelligently proportion that. And so dhea, yes, is an important marker. And when it's low, we have less resilience, we have more depression, osteoporosis, low sex drive. Of course. Right.

So all these things are so important. Let me ask you about the testing because there's. I've had other doctors that I've interviewed. I've got my own doctor and I want to make sure. I want to hear from you too, because I don't want to confuse people either. Testing. Do you suggest people just do blood? Do you suggest they do blood, urine and saliva? Give me your opinion on that. And I've got other interviews that I've had opinions on that. But I'm curious what you say first. And then I've got more questions around that.

And this has been a really. And I've actually lectured and trained physicians on this. And it really. I say we're going to look at all your body fluids at one time or another. They each tell us something, saliva tells us something. And if we do a quick baseline salivary test before you're on hormones, once you're on hormones or if you're on steroids, saliva is not accurate except for looking at dhea. So there's that. Then urinary testing looks at metabolites, your estrogen detoxification profile, and helps me understand how is your body using, metabolizing these hormones. That gives me another picture. So something like the Dutch test or zrt, you know, some of the labs that are looking at that are very good serum tests. And I like serum tests because they're quick. I can get a quick answer and get a quick. And if I'm using.

And that's blood. Correct.

Blood. Blood. And if I'm using troches or injections or pellets, I can see those hormones. But if we're using topicals, we're not going to see them.

That's what happened with me, by the way, is. And I Wouldn't have caught it without the Dutch test and the saliva test. Because without that my blood looked normal.

Yep.

Okay. So good. I got. I like that you are aligned with that. I also don't think people should just start self treating things without getting this accurate test and talking to somebody to do a reading. Can you give some light on that?

I think that it's really hard to get physicians to do your testing. And I think that having control of your own testing, it's an important. It's like, you know, I mean it's like we're smart enough, right? It's I think about it in 500, in the 500s, the Middle Ages, what 1500s, 500 years ago, they didn't let people read the Bible. You're too stupid to read the Bible. We're not too stupid to interpret our weight on the scale. We're not too stupid to look at. Is this getting better or worse? Just tell me that. Are these numbers getting better or worse with what I'm doing? That's basic and I think that's powerful. All of us, in my opinion, need adrenal support in our 50s and 60s and beyond.

I also am going to go out on a limb and say I do suggest working with a doctor that's more functional medicine or that is a more has naturopathic in with them. That has more of a holistic. Including this. Because traditional medical doctors I find do not test for all these things.

Right? No, absolutely right. And don't know, like my doctor's bag was empty, you know, I mean I knew that and I was a scientist before.

I don't think it's intentional. I think you're doing what you learn in school.

Right. And if you know, in most functional. And I love the naturopathic physicians. I was like, man, if I had known even about naturopathic schools, I may have gone to one. You know, I really love that and I also love understanding all components. I am an osteopath. Alignment, you know, our physicality is really crucial and our fascia is connected all over the body. And did you know and this is something for our athletes, that our fascia has hormone receptors in it. So as we start going through high stress, perimenopause, menopause and progesterone estrogen levels are depleting. Our fascia becomes stiffer. All of a sudden it hurts to do what you used to do or you're less flexible. So supporting your body's natural production of hormones, decreasing inflammation and supplementing when needed makes a huge difference. On what we can do and how we feel.

Ok, one more question then. I'm going to ask you a lot of questions about menopause because I want to know more about that. You mentioned intermittent fasting and I know especially in my communities are going to say, but wait a minute, Natalie, you didn't talk more about that. What I've historically told my communities is there's a lot of benefits to intermittent fasting. A lot of benefits. However, and I want you to correct me if you see something different too. I'm not saying this as fact. I believe that for most people, most people to eat all your food within four to six hours and fast the rest of the time is very challenging for people to make it a lifestyle. I think it can work for sure. I know the benefits. I think it's challenging. What I encourage my people in my Thrive program to do is two things. One, put a longer gap between meals. They were not constantly secreting insulin and I tell them to do a longer gap at night. So let's say you stop eating at 6. You don't eat at least for 12 to 14 hours over the night. So you get a longer gap in there. And I find they get a lot of the benefits without having to go to extreme eat all your food in four hours. Can you share your thoughts on that? Where you are maybe different or where you agree? I'm just, I'm genuinely curious.

Yeah, no, exactly right. What you're talking about this for. Like when I would hear about these four, six, whatever hour eating windows and they're eating during that entire time, like what are you doing? Right. That is ridiculous. And it's ridiculous. It's a very male, you know, dominant kind of philosophy there. Right. Because guys, again, for women, I found exactly what you did. We need and I write this in my first book, the Hormone fix. It's a 13 hours because research showed that 12 and a half hours between dinner and breakfast with women who have had a history of breast cancer had a significantly reduced risk of recurrent breast cancer. So 12.5, 13, that's my threshold.

That's great. That's exactly what I teach. Okay.

All of us need that. And then in my second book, Keto Greens 16, I went to 16 hours to push us a little bit. But that eight hour eating window, it's like two meals, you know, meals, maybe a shake in between, you know, I mean if we need something and I want to maintain that blood sugar stability so you're not getting these highs and lows and things that are already on top of hormonal swings and perimenopause and menopause, that's just. It's just not good. And, yeah, I'm with you.

So here I am not a doctor, I don't have your credentials there, but I am, I would say I'm a fat loss expert. I've helped so many women through this. And I will say this too, that no one's really talking about. So our generation, and I'm speaking, us women in our 40s and our 50s, we lived through the era of you have to eat every two hours or your body's gonna eat its muscle. That's what we were taught. Right.

People are still teaching that.

Right, right. So here's the problem. We learned to do that in our prime years. Like in our 30s and our 30s, we were doing that. We were, you have to eat every two hours. You're gonna eat your muscle in your body. 20s and 30s, we were doing that. So what happened was we were in this constant secretion of insulin constantly. We created this issue. So now we have to unlearn that. It's a big thing to have to unlearn. And so that is one of the first steps, is to know you don't have to eat every two to three hours. You don't have to do that. You're not going to. You're going to survive. You're going to survive.

Exactly. Because we were worried about fasting. And it's so crazy because as a physician, I remember so often saying, okay, we need these labs fasting at least 12 hours between dinner and breakfast. And we just say that as physicians. And then I started wondering, well, and for some people, that was really hard. Like, oh, my God, you mean I can't have a snack in the middle of the night? I'm like, no. But I said, well, how come 12 hours? Because it takes that long for our body to get to its baseline glucose level. And insulin, it really takes a long time to get to baseline. And so why are we, you know, feeding? We're creating insulin. When we have, we've done this, we've created insulin resistant and metabolic syndrome through an entire country. And when I see something that says for a menopausal woman, she needs to eat three meals, three snacks, we are setting her up for a nursing home. Seriously.

Especially when we add in the old food pyramid. That's all there. But no, that you start. I encourage my women to really, really look at grains, dairy and sug, like in a whole different way. That's a whole nother Topic here. But speaking of which, let's transition over to your book because you've got a fabulous new book out called Men, you pause. I love the name. Talk to us about that and what people can find in that and why this is so important to go grab this book.

Well, it's really important to grab the book because there's a few things. There's five different six day eating plans in here and each of them pause something that can be the reason we're hitting a stumbling block or a plateau or not feeling as great as we can. And it's true in our, in our world, sometimes we get, I get stuck and doing the same thing all the time. So there's five different plants here and they are amazing. And they're. I incorporate herbs, spices, nutrients to balance each of them. So one's an autoimmune plan, one is completely vegetarian, vegan, plant based, one is carnivore, one is a cleanse, and one is a carb up plan. Because sometimes we've been so carb restricted. And that's actually what I'm making in the background, some almond pistachio scones. So they're still low carb. But you know, explain your definition of.

Carbs because this is, I think, I don't even know. I've never asked you, but I'm guessing it's very similar to mine. So what are your favorite carbs for people?

My favorite carbs are dark green leafy vegetables, sprouts and cruciferous because. Yep, those are the best.

See, we don't need bagels are not. When people see that I'm eating a ton of vegetables and fruit and they're like, where's your carbs? Those are the carbs. Those are the vegetables. And fruits are amazing carbs.

Yep, yep. And yeah, exactly. And so. And then for some of us, we have, you know, again, prone to insulin resistance or highly, you know, highly sensitive to glucose in any form. But making sure that we're doing low glycemic fruits will make a difference or we're having that. And I like, I love digestive fruits like mangoes and pineapples and papayas. Those would be an evening, right? Evening. And so you're not crazy creating these crazy blood sugar swings. But one of the. Another reason that's really important, Natalie, that menupause is good for people to have and to gift is because I've surveyed three separate communities right now, Mine, Magdalena's and Anna Bocino's community. And I asked the same question. What did your mom tell you about menopause. What did your mom tell you?

Gosh, my mom said it sucks.

Is that it? Everyone said nothing. Yeah. There was no education around men.

They just said it sucks. And there's no. Like, it was like. You don't really talk about it.

Yeah. Nope. My mom didn't talk about. I think she was in menopause. I remember one time giving her a hug, and she said, my breasts are tender. Be careful. And that was it. Like powering through, struggling. And so I think we should open the conversation. We should have a daughter, should be asking their moms. We should be talking to our daughters. We should be talking to our friends, because it's not the same for everyone. And also, we don't have to power through. I'm giving natural solutions in menopause, and my book, the Hormone fix is my Magna Sopus. I address so many aspects, and of course, vaginal health and sexual health is a part of that too. But understanding how we can empower our physiology. I mean, when I learned this and was able to incorporate this into my medical practice, Natalie, I went from doing two to three surgeries per week to needing to do two to three major surgeries per year.

Wow.

That includes incontinence surgery, major hysterectomies, any of those.

Huge change.

The body is so powerful. And what you teach and how you empower and accountability and community. I mean, that is. That's. That's what we need more of.

Yes. Okay, tell it. Make us drool for a minute. What? Tell me your favorite recipes. Like, what is it? What are the. Like, people are going to die when they know they can make this and it's good for us.

Oh, my gosh. There's so many good things. Like. And I've just did my almond fig pistachio scones.

Oh, my gosh.

Because those are rich in zinc and tyrosine, and they're good for libido and testosterone production naturally. And then the almond scones, almond flour, and it's nice to have something like that. That's a super good treat. And in my book, it's in the carbut plan with honey. But I substitute out monk fruit, and you can do that. And then last night on my Instagram channel at the girlfriend doctor, I did shakshuka, which is a delicious, delicious. I made a big one, you know, one pan, because if I have less to wash, I'm very happy. So shakshuka's with. It's a Middle Eastern dish with a tomato sauce and pepper and eggs, and it is it's like, easy, delicious. Everyone in the family. So good, so good. And then of course, I've got, you know, in the carnivore plant, I make some really amazing recipes with using spices and I mean all the recipes. And my tabbouleh and my kefta. Oh, my gosh, those are so good too. There's so many. There's so many.

Okay, so everyone go get this book for you and a gift because you're gonna get your holiday shopping early. Whatever you need to do. I get this. You can hold it if you see her on video. Look at that recipe. Oh, my gosh, look at that.

And it's all color. I mean, it really is a gifting recipe. I received it because they just went out yesterday.

Who was your publisher? Your book looks like Rodeo. I did the four color copy of my first book too, so I love those. They're such great gifts and coffee table books. Okay, where can they go get the book? Where do you want them to go get it? I know they can get on Amazon, but is there a specific place you want them to go that's better?

I think Amazon is great. So Amazon definitely support your local bookseller. But Amazon is absolutely great and working on getting in.

She's in like the top at the time of this interview. She's in like the top category of like gluten free. And now I'm calling menopause menupause. Menopause. You were in like three. I think autoimmune too. You had three top categories on Amazon.

Gluten, gluten free, keto, and menopause.

So good.

Thank you.

This is awesome. Thank you so much for being here today. And people can find you on Instagram. It's probably the best place right now. Or where do you want them to find you if they want to learn.

Instagram at the girlfriend doctor. And my website is dranna.com amazing. Oh, my gosh. That.