You Don't Have Adrenal Fatigue—Here's What's Really Happening

Okay, we have to talk about this because we're at a moment in the wellness world where everything seems extreme. For example, one side tells us cholesterol doesn't matter and to eat 12 sticks of butter, and the other side is telling us to basically drink our urine and stack 17 peptides that we can't pronounce, panic about adrenal fatigue, and that if we're not doing a 96-hour fast that we're basically dying. And somewhere in the middle of all this, women in their 40s, 50s, and 60s with real bodies real hormone shifts, real time constraints, and real money on the line are trying to figure out exactly what works, what is evidence-based, what is woo-woo, and what is somewhere in between. Today's guest is Dr. Alan Bacon. He has a doctorate in dental surgery from the University of Maryland. He's a nutrition coach, physique and bodybuilding coach, a USA powerlifting coach, and has been formulating supplements for industry-leading brands since 2009. He's published in Muscle Fitness, the Alan Aragon Research Review, and a long list of other places. And here's what I love most about him. He sits firmly in the middle ground. He pushes back on conventional medicine when it deserves it, but he also calls out the woo-woo stuff when alternative has gone way too far. And he does it without being a jerk about it. He does it with actual research. In this conversation, we're going to get into where alternative health gets it right, where it's lost the plot, and where the actual science is and what it says about supplements, peptides, adrenal fatigue, and all the things we hear about every day and what we should actually be doing as women in midlife. We want to build muscle, lose fat, and feel like ourselves. Ourselves again. Welcome to the show.

Thank you for having me on, Natalie. I appreciate it.

So your Instagram really caught my attention because it stops me sometimes. You'll really call out some things that they could even be my beliefs or something I'm hearing a lot about, and you do it in a way that it's not— it's not tearing people down. It's just— it's more challenging the belief and backing it up with actual science.

Yeah, I mean, we've got— there's so many beneficial things about social media. Let's put it first that way. There's a lot of information that's out there. It's both good and bad because we can have access to all of this great information. The problem is being able to filter that is becoming more and more difficult. And it's becoming more and more difficult because everybody can position themselves as an authority in the space.

Yeah.

And it becomes very difficult to understand who to listen to. And I think that it's, it's really problematic for people that are just trying to live a better life, get healthier, improve their relationship with food, with their bodies. And to have people talking and pulling them in all different directions essentially creates a problem for them. Yeah, because what we are doing is we're creating inaction because of an overload of information. And so hopefully through some of the stuff that I do and through some of the work that I've seen that you do, you help people cut through through that noise to be able to make some decisions and actually make some improvements in their lives?

Yeah, I try to. I will say that I'm very aware of my wording with things, so I, I try to share that this is my experience or something that I figured out for me versus like this is the one thing for everybody, because I am very aware of that power, like an unintentional power. But when you have an audience, that people can sort of take what you're sharing as gospel, and I I try to, as much as I can, bring up, hey, I think we should all be our own health detective. We're all our own experiment of one, and we have to take in the information and do what's best for us.

Yeah, I mean, we like to use the research, and when you pointed out that I will most of the time really back myself up with peer-reviewed research, there is something to be said about anecdote or what works for me. Mm-hmm. I think that the way that we approach this when we want to do what's actually best for us and we're objective, smart people is to use the research as a guideline, but then realize that research is ever-evolving. Mm-hmm. And that there are some areas in the research where it may be a gray area. And as long as the research isn't pointing us into a, hey, this doesn't work at all, or, and we're pretty sure about that, or this is safe and not dangerous, then we can use that. Okay, well, personal experience really is something that we can shift to as a basis for making decisions. And I think that the difficulty that we find online these days is that the hardcore science-based crowd completely ignores anecdote.

Yeah.

And the anecdote-based crowd completely ignores science if it doesn't fit their anecdote. And neither of those things works out well for the person in the long run.

Yeah, that's a good point. I mean, and I think we definitely have lost the plot there because you're right, just because you've had an experience, that's not dismissive. Like, that's great you had that experience, that's what makes sense for you, but it doesn't mean that research backs that as a general rule for everybody.

No, and there's a lot of issues with I understand, I know my own body and it works for me. Because in— I mean, when we really look into things, people really don't know their own body, and that's, that's a big problem, is we have a lot of different reasons that we might believe something does work when in reality it either doesn't work very well, doesn't work at all, or there are alternatives that work a lot better. I mean, survivorship bias, sunk cost fallacy, positive priming, all of these things will influence our personal experience, and the placebo effect tends to be a lot more effective than even many drugs.

Okay, give me some examples of that because that's— I want to— that's interesting.

The placebo effect and how it works?

Yeah, like give us something that my women can maybe relate to because I think there's something to be said there because yeah, we do take that as gospel. Like, wait, that was my experience. This is what I saw with me, but you just had me think differently about that.

Well, this may— the first one that immediately pops to mind, they may not be able to relate with, but I want to give two examples to really show how powerful this is, and this may be beyond what the power of what they've experienced. But just to show you how far placebo effect can go, there are documented cases of drug workers, police, that when they're handling drugs and they believe they've been exposed to a drug, they have the symptoms of having overdoses of the drug. Their body gives them those symptoms even when they haven't been exposed. Just the belief of being exposed causes those symptoms. Wow. It's a powerful reaction.

Yeah.

One that has— was actually studied under controlled conditions. And maybe the women that listen to you can relate to, because I bet a lot of them are Lifters. They ran a study in competitive powerlifters to see how the placebo effect would influence performance. Now, this is a great study because it took people that were trained competitive powerlifters, so we're not influencing beginners and seeing some of those newbie gains coming into play. So we've got a baseline of control for this. What they did was they took a baseline for the squat, bench, and deadlift. They say, okay, well, we want you to do a 1-rep max on your squat, your bench, your deadlift. We're going to see what it is. Cool, we got that, that number. Then what they did was they took the groups— they had two groups of people— they gave both groups the first week a pill. Now it was an inert pill, I can't remember what it was, it was, it was something zero calories, nothing in it, just a fake little pill. And they told them, this is a new fast-acting steroid, we want you to take this, and in a week we're going to test these numbers again. In a week they tested those numbers again, and on average, these people that have been lifting for years as competitive powerlifters went up 22 pounds on each lift on average. A 22-pound jump in one week is absurd.

That's a bit unusual.

Yes, for trained lifters, it's absurd. Then at the end of that week, they told half of the group— because remember, they split them into two groups— they told one of the groups, half of the participants, hey, we faked this, this wasn't a real pill, and they gave them another week of training. And then they had them test again. The group that was told that it was a fake pill dropped back down to that baseline from the very first day.

Wow.

The group that was told, you're still taking steroids, kept all of those lifts up. We limit ourselves with our beliefs in many instances. I can't do this. I'm being, you know, I, I've got cravings. I've got issues because of my hormone status. I've got— and sometimes, yes, there is a hormone issue play. Many times, maybe it's a self-fulfilling prophecy, and in a lot of instances, the research suggests that that is true. And that's not to diminish anybody's experience, because when we're talking, you know, about hormonal changes that women go through, it's a very— the experience is very valid.

Yeah.

But even when we talk about things like cycle syncing, the influences of menopause, when we look at it under controlled research, it's not really as doom and gloom as a lot of influencers suggest that it is. And part of it is that opposite of placebo, the nocebo effect. So this mental viewpoint of how we view training our bodies, what works, really influences the outcomes.

So when you say that, I think people think of placebo as sort of a bad word, like it's dismissive, like it's all in your head, you're crazy.

It is all in your head, but that's, that's the funny thing, it really works.

But it's a good thing too, because if you think about it, just like you brought up limiting beliefs and things, I think we use that in our advantage. Like, if you— like, and I say this to women all the time— if you think you're old and it's not going to work and it's too late for you, you're— that you're going to be right. But if you come at it with a belief that it's possible and you're stepping into a better, stronger you, like, you can do that. So I think it's almost like we need a new word for it, right? Because it is— it's— it could be a very positive thing to, to shift our mindset around whatever.

Well, that's why we want to come at these, these topics from point of objectivity and understanding.

That makes sense.

When we understand what's actually happening, the underlying mechanisms, we can use these things to our favor and prevent ourselves from falling into those pitfalls. Because just like you said, expectation effects are the overall term, because expectation effects can mean a beneficial placebo, or it can mean a negative nocebo. What we expect influences the outcomes across pretty much everything. I mean, not, not just physical related. I mean, you know, when you talk about somebody that feels like they're chronically stressed, they get into that cycle of everything's bad, I'm going to ruminate over everything being bad, and then the stress builds up and it gets worse and worse and worse. If you talk to your positive friends, you know that one person in your life that no matter what's happening, she puts a positive spin on it and they live a happier life. And it's not necessarily that their life is dramatically different, their viewpoint of the world is different. These expectation effects, the way that they view things, the way that they train them, because these become habits. If you look at things as positives, you look at more things as positives. All of these things are a feedback loop that can lead to a better life or can lead to a worse life.

Makes total sense. What's interesting about you is I think you sit really strongly in a middle ground between conventional and alternative. I don't see— you're not extreme conventional medicine, but you're a little of both. How did you land there? Tell us a little bit about what— you're like a moral truth teller. That's how I'll classify you. You're the truth teller.

Well, I have a clinical background, so I have a— I mean, anybody that looks at any of my content out there can see that I've got a very, uh, you know, a real love of, of the actual data because I think that that is the base. I mean, it's like you're building a house, you need the foundation, and that's the foundation. And then that the anecdote and some of the other, you know, I never really consider myself an alternative medicine practitioner, but when there are things in the alternative space that might have some merit, I'll say yeah, I mean, we can look at that and we can see that there might be some reason to investigate this further. I found that space because, um, it's, it's just purely from a space of trying to be objective whenever I look at stuff and realizing that we don't have all the answers in research. Unfortunately, we don't. And we don't because there's a lot of things in play. It's really difficult to run studies. It's expensive. It's, um, I mean, you know, the cost-prohibitive nature of it is problematic. It's expensive to get people to do what you want them to do for long periods of time. It's expensive and difficult to control people to, you know, if we're talking about like nutrition research, is literally the toughest thing in the world to control because the second that you send somebody home, even if they've got a questionnaire that they're supposed to be filling out to show what they ate, I mean, anybody that's ever coached people knows, you know, with some people it's great, with a lot of people, yeah, they, you know, life crops up. They have bites, licks, tastes that they don't even think about. They don't think about, you know, what they're cooking foods in, which maybe throws the entire thing off. So to run studies that really give us great information, they're harder to come by than what we would hope.

Makes total sense.

Yeah. And getting a large enough population is harder to come by. And like I said, the funding is really difficult because it's— there's not unlimited funds. So like the person that funds something has to have a vested interest in it. And then people will complain, well, this is funded by X. Well, yeah, who else is going to pay for it?

Good point.

So like, you know, And, and yes, we— with the reason that we have in studies funding provided by or conflicts of interest section is because people need to be made aware of that. But it also does not invalidate the information within those studies because if that person isn't running it, nobody else is. You know, it's like saying, oh, well, the meat industry ran the study.

Yeah.

Who else is going to run a study on beef?

Good point.

Or the soy industry. The soy industry ran the study. Who else is going to run? The beef industry is not going to run a study on soy.

Yeah.

So, you know, so like it's really funny when you talk to a layperson about that and they're like, well, it's funded by beef or it's funded by dairy or it's funded by grain. It doesn't matter who you're talking about, right? Well, yes, of course it is.

Yeah, that makes sense. Yeah. You know what? I never thought of it that way. But, and I'm guilty of saying that about pharmaceuticals sometimes, like, well, of course it's funded by that, but it makes sense what you're saying.

So pharmaceuticals are an interesting industry because first off, let's put something out there. The wellness industry is worth like $70 billion and wellness spending is more than than the pharmaceutical industry spending, and that surprises people. But the wellness industry has a broad category. I mean, like, we're talking about supplements, we're talking about things like Vitaminwater, we're talking about, you know, your back massagers. And so it's like a broad category. So that's— there's one reason that it's so large. But to say that wellness doesn't have the money to, to really influence things is completely unknowing of the actual reality of the situation. And pharma— the issue with pharma is that there's a lot— there's a lot more regulation, but that also means that they get caught a lot more when they're doing shady crap. And everybody can think of examples of shady crap. I mean, the biggest one that ever comes up is not really pharma-related, but is another government-focused one, was like smoking.

Yeah.

I mean, for decades, well, even the doctors thought that it was—

the opioid crisis was really a lot of—

opioid crisis, exactly, is a really good one. And there's other issues that people have with the pharmaceutical industry, like, you know, jacking up prices when they don't necessarily— like, why is this, this drug sold in Madagascar for $1.50 and then $50 in the United States?

I went to the pharmacy yesterday, time of this recording, and I had to get a very specific pharmaceutical for like a mild infection that I have.

Sure.

And I'm, I'm a cash pay person. I don't use regular medical insurance. And I got a notification from CVS, and it said on the text that this one pharmaceutical was going to be $4,500. And I was like, what?

Now sometimes Here's the problem with this.

I didn't get it, by the way.

I probably wouldn't either. Are you okay?

Yeah, I'm fine. I got a generic version. Okay, good.

But so here's the other side of the coin. They're not always gouging you with those prices. And I think that people hate to face that reality too. But again, let's be objective about some of this stuff. Bringing a drug to market is massively expensive, like more money than you've ever seen expensive. It takes so much money for like Merck or Pfizer or somebody else to bring a drug to market. You have a limited window where you have exclusive rights to sell the drug, and so you have to make up the cost and a profit for that drug during that time period. So some drugs will be $4,000, legitimately $4,000. The thing that people don't like about that is that it feels like they're being gouged, but for the money to be there to run the studies, because you got to run these at multiple universities, you got to pay the staff, you got You gotta pay clinic fees, you gotta pay patients in many instances to come in. You gotta pay for the drugs, you gotta pay for everything that's involved in that. Then, I don't know if you know this about me, I have a background in regulatory writing.

I didn't know that.

For medical regulatory writing. So I do professional medical writing and regulatory writing is a branch that I'm actually just now getting into. And regulatory writing is we look at the studies that are being produced by these pharmaceutical companies and they're saying, hey look, these are the safety studies, these are the efficacy studies. We now need this put together in like a dossier to present to the FDA. So I actually have a little bit of a, like, an inside knowledge of what goes on with some of this stuff. It's extremely cost problematic, and it takes years to bring these drugs to market. So there's a reason that the costs are the way that they are. Now, the argument for the American public is, okay, well, if in many of these cases we can't lower the cost of these drugs, because if you don't— if you lower the cost of these drugs, then the pharmaceutical company will just say we can't We can't bring the drug to market. And so then you're screwed because you're now having to take an older generation drug that does not work as well. And you want these drugs, trust me, you want, you want the majority of these drugs that they're putting out to be on the market, at least so you have the choice, right? And I'm not saying you all have to take drugs, but I'm saying you need these as choices because let's be honest, look at cancer drugs now versus cancer drugs in the '80s. They were much more deadly in the '80s. They're still pretty deadly, but we're getting better and better and better, and you want that trend to continue.— to the point where we cure cancer.

Yeah, one personal example I keep thinking— that I think of as you're talking about this is my audience knows that we've had many cardiologists on. I have genetically high LDL, like genetically high LDL.

And are you on a statin?

No. And that's what I was gonna— this is my point of this. Um, I'm gonna be 55, and I had been telling myself for all these years, when I'm turned 55, I really— I can't just keep doing the alternative things. Like, if I can't address the LDL, I got to figure it out. However, I am one of those people that a statin very much negatively affects, even small. That's not just anecdotal. There's a lot of people that actually have side effects from statins. Even a tiny microdose for me does not work. There is a new drug in the market called Repatha that has a lot of promise. It's a PCSK9 blocker for people that don't tolerate statins and that have that gene expression. It is very expensive. So as you're talking, I'm like, that's an example where most people can't get something like that. But that is a cutting-edge, newer thing that they need more research, they need more support around. So just, that's what came up as you're talking about that.

Well, the other thing to keep in mind, so if we're talking about lifestyles of drugs, we still want the pharmaceutical companies to do this, and we still want them to charge the fair price, even if we don't believe that it's a fair price. Like, and yes, price gouging does happen, but that doesn't mean that every drug is price gouged.

Sure.

You've got a couple things from the pharmaceutical industry's perspective. One, you have to be able to fund the drug. Two, you have to be able to make a profit. The profit has to be enough to please the board and anybody that is— that holds stock in the company. Yeah, because if you don't, drugs aren't made anymore. Now here's how— here's how it really works out for the consumer. After the period where they have that— not the copyright, what am I— I'm blanking on it— the, um, the full rights to the drug itself, when it starts to go to generic, then everybody really benefits. But you still have to go through that period where the pharmaceutical company can make the money. So you actually benefited from this process when you saw the $4,000 drug and you're like, give me the alternative. That's— you're seeing this in action. So if we're like, oh, well, we don't want the pharmaceutical companies to come out with drugs because they're going to screw us and blah, blah, blah, you're shooting yourself in the foot.

Okay.

Or you're shooting your kid in the foot.

Definitely have me thinking different there. That makes sense.

And this is not to defend pharmaceutical companies from being assbags because there are a lot of instances.

No, you're— I get that.

There are a lot of instances where they are.

I'm about to ask you the other side of things in a second because I mean, I do believe why I wanted to interview you is I do see you really giving thought-provoking answers to things like this, and that's why I wanted to interview you. So I'm going to ask you kind of the other side. Is there anything that you see— and I know you're not like a heavy alternative health person at all, that's not your thing— but is there anything you do see in more the natural alternative health that you feel they're getting right but mainstream is still ignoring? Like any specific treatment, any example of anything that you're like, or diagnosis, or I mean, is there some— anything that you're like, wait, mainstream needs to catch up with this?

I mean, the thing with the alternative medicine is alternative medicine is oftentimes a beginning pathway to becoming formalized medicine.

Okay, how's that?

Formalized medicine is just when something has gone through enough testing to— for us to say yes, it has enough efficacy, and yes, it, it's— it works. I mean, even things like NAC is kind of following that route with some of its administrations. Fish oils have been following that route with some of their administrations. I mean, if There's, there are tons of drugs. I mean, half the drugs out there are based on natural plant.

So you're not— so it's not that you're against it, you're just saying, hey, let's not ignore—

I'm not, I'm not against it. What I'm against with naturopathy or naturopathy or however people want to pronounce it, because I've heard it differently, what I'm against is overpromising what something can do and misrepresenting something as having safety and efficacy data that it does not.

Okay.

The challenge and the drawback with naturopathy is that there are a lot of problems with products meeting what they claim on the label, whereas if you get something through formalized pharma, you're getting what's on the label. Now, I'm not saying a compounding pharmacy, which has some problems, but I'm saying if you get something from a formal, you know, drug pathway, you're getting what's in the drug. You don't necessarily get that with naturopathy. Contamination risks are in play, efficacy risks are in play with a lot of things. And this is, this is, again, we're talking about the goods and the bads of both. Yeah, that doesn't mean that everything in alternative medicine is wrong. It just means that some of the things have not been validated yet.

Most of the people that I personally know, again, anecdotal, because I'm just speaking in my personal experience here, but that I personally know in the alternative health space, they have a very real story similar to mine, where we maybe were dismissed by traditional Western medicine and had to literally become our own detective to figure out what's going on. I know my story dates back to being in my 20s and having really, really bad inflammatory stomach issues. Like, every time I ate, my stomach would hurt. And I remember specifically sitting at a doctor's office, it was my regular general internist, and I told him everything wrong with me. Like, I was telling him about heart palpitations and stomach and, like, everything, all these things. And he said to me, Natalie, we don't want to look at all these things. This is too many things. We're going to take one thing at a time. And when he did that, I ended up at a gastroenterologist. And by accident, when looking for an ulcer, they found out I had celiac. And that was my first taste of— I looked up celiac and every symptom there was something I had told my internist. And that gave me a switch in my life of, wow, I can't trust— I can't trust— it's not true, it's just my belief at the time— I can't trust Western medicine. Um, I have to look at alternative. And I believe, like, if— and I interview My friend Dave Asprey, who a lot of people will call out, but he has a similar story where he was dismissed for years and years. I think the reason we have these people getting up on a soapbox talking about these things is they went through their own personal journey.

Yeah, they feel disenfranchised from the system.

Yeah.

That's the thing though. Not everybody's going to be perfect. You're going to find doctors that are going to have misdiagnoses. You're going to find some diagnoses that are harder than others to trigger, and that doesn't mean that a naturopath is going to be able to identify issues any better than anybody else.

You know, that's the same thing.

Yeah, I mean, there's, there's human error involved in everything, and there are good doctors and there are bad doctors. There are good naturopathic doctors, there are bad naturopathic doctors. It's the same thing in everything. I mean, so I, like, I feel for people, and particularly women with women's issues, I think, were— have been disenfranchised for a long time. I think in the past 10 years it's gotten a lot better.

Yeah, look at the hormone conversation. Like, we were told they're going to kill us, basically, and now Now it's backorder because everyone wants— they've lifted the black box.

Well, we've also kind of drifted a little bit into the opposite direction where we're probably overprescribing.

Oh yeah, I agree.

Based on like, we will look at the data and we'll be like, well, that's not indicated for that. But the doctors are giving it for that. We're like, but why? And it's like, because everybody just demands it now. So we've got to be careful. I mean, and this goes back to that whole objectivity piece, because if we're going to be putting a drug in our body, you don't want to do it off of hopes and prayers and like literally understand like What am I treating? What drug is appropriate for that? At what dosage? And am I in the population that's appropriate to be treated? All these things need to be answered.

Yeah.

Before you start injecting something or before you start, you know, taking pills or anything like that, because there's so many issues that you could potentially cause. And that's, that's sort of the concern with naturopathy, is that because there's higher risks of contamination issues, because there's higher risks of lowered efficacy, um, I mean, if you saw that, that one naturopathic post that I made, one of the comments that was discussed in it— because I really want people to have some take-homes of understanding. If you do alternative medicine, that's fine, but like, do your research, and do your research beyond 'I saw a YouTube video about it.' Oh yeah, for sure. You know, and so one of the stats that we see is that people who try to use natural remedies when they have things like cancer die— like, I don't remember the exact percentage, I actually have it in that video— it was something like they die 86% They're more likely, 86% more likely to die when you're using naturopathic.

Let's talk about that one for a minute because this is a— that's a really— I know that's a really deep topic here around cancer.

Yeah. Well, especially, I mean, my dad died from it.

Yeah. Yeah. So one of my good friends, he's a top oncologist and he is very— I mean, he is like, believes that any, anything cancer, obviously he's really traditional with the chemotherapy and the radiation. And I'd asked him once about some of these alternative treatments. He said, I'm all for the alternative stuff with the conventional stuff. He's like, I'm not dismissing eating right and meditation, all these things, but—

well, eating right's not alternative medicine.

Well, okay, so I shouldn't have said that. So, but, well, well, let me explain where it can kind of be. It can— so if you're in a hospital, like, you're in the hospital, like, what they're serving you there, I don't think is like great nourishment. So sort of they would— I would say, like, you know, obviously we want unprocessed, natural, real food, fruits and vegetables. You want phytonutrients, antioxidants. So that can fall unfortunately into that alternative category because some doctors think it doesn't matter. They're just looking at the caloric. That is true. You'll see people going through chemotherapy eating their junk food next to them. I don't know. So there's some— so my point on that was he said, "I don't have any issue with adding some herbs and doing the mindful stuff and eating different and trying some things, but don't dismiss the Western stuff." I'm just— I'm curious around that because this is a really scary topic for people.

I don't disagree with him with a caveat.

Okay.

And I'm sure that he would agree with me on this caveat. It's just something that you didn't say. So, you know, he might have said it. You might have had that conversation. If you're going to be doing this, like taking some of these herbs, please discuss this with your oncologist because some can cause problems with the drugs. Oh, for sure.

Well, that— yes, for sure.

And so if there's— if there's a known interaction between a drug that you're taking and the Western drug, take the Western drug. Do not replace it.

What do you think about the people that do say, like, oh, you know, I, I overcame stage 3 or stage 4 and I didn't do any chemo, I didn't do any radiation? Like, what do you— is it— are they just an anomaly, or what, what's your thoughts there?

I mean, there's a lot of people that smoke for their entire lives and don't get lung cancer. You know, genetics are very different, and that greatly influences the way that these things play out. And if a person got through that kind of stuff without anything. It could be a lower grade of cancer, it could be a less aggressive form, uh, they could have had great genetics, they could have just got lucky, you know. You can— there's too much variation in this kind of stuff. That doesn't, that doesn't discount the benefits that actually treating these things brings, but you do have to have that conversation with the pros and cons because, I mean, chemotherapy is a poison and nobody's pretending that it's not a poison.

Totally.

It's specifically a poison, but that's why it works, because it poisons the bad cells. It's, it's toxic to the bad cells. The problem is it's also toxic to good cells. The issue once you have metastases is that's where the real problems come into play, is, is that you can't really get everything in many cases because you're destroying all the good cells at the same time that you're destroying the bad cells. So hopefully you do this when it's young enough, when it's, it's less metastasized, it's less grown out, that you do destroy all that— those cancer cells, you destroy the surrounding good cells, and then everything else is fine and it heals its way back in.

Um, you know, and so a tremendous amount of shaming around people that choose one direction or another, like, especially— okay, I don't know, people— let's just say somebody has always leaned more towards the natural, and now they're struggling with something hardcore like that, and now they opt for chemo and radiation. I feel like they get a lot of shame around that, like, it's going to be poison, it's going to be bad.

I would think that in their circles, yes. Because that entire identity— and this is a problem, by the way, and this is not to be accusatory for anybody listening because I'm sure that there are people that this is their identity, but I want to bring this up because I think this is a self-reflection moment. If your entire identity is around, "I'm natural, I'm a naturopath," that's a naturopathic fallacy, that's a natural fallacy that you're creating a problem. And the same thing with like you know, there's, there's no chance that anything else will ever work from the hardcore science group. You're, you're losing your objectivity because you're treating this idea like a religion and not like an idea.

Good point.

And I think that that's where people really get into problems. I mean, we see this in nutrition. I mean, we're, you know, I'm mainly fitness nutrition focused, and we see this nutrition all the time. People will treat their diets like a religion. Yeah, I'm a carnivore.

It's like their identity. It becomes our identity. You're right. A vegan.

It's their identity. I'm a vegan. I'm a carnivore. I'm a— I do keto. I mean, even the keto people are getting in there. They're creating their— and then they'll join the keto groups on Facebook, and then everybody else will tell them that keto is the right way. And then you get to join the vegan groups, or you join the naturopath groups, or you join whatever it is. And then you're like, well, this is what worked for me. And everybody's like, yeah, that's what works. Well, yeah, yeah, I mean, you're in a carnivore group. They're going to tell you that that's what that works.

You're absolutely right.

You know, so you're, you're creating your echo chamber, and then AI became an even greater echo chamber. Give me proof that carnivore works. Here's proof.

You're exactly right.

It just ignored all of the other data.

I will tell you, because I go to a— I go to a biological dentist, and you'll appreciate this because you were in dentistry, but I, I like whole health dentist, like that whole idea of connecting it with with not just drill and fill. So I go to a biological dentist who— biological dentists notoriously talk about root canals being bad over years and years, which is what she says, what they say. However, so I have, I have two— well, I have two old— I have two old—

they're not—

but I'm gonna share here. So I have two old root canals, and in my mind, meet Natalie's, again, anecdotal, and for 30 years I've not wanted those anymore. I thought, okay, these— because I do believe in toxic load and so forth. But my— what I— what you will like that my biological dentist said, you'll like this. When I said I want to get one of them out, she said, are you having problems with it? Okay, that was the first thing. Second thing, she didn't entertain it until I had blood work showing inflammation and I had a new CBC scan that showed an infection. Now she's like, okay, now that's a reason. But here's the big thing that she said that I really appreciated. She said, anyone that comes in if they are thinking their root canal is causing an issue and they really believe their root canal is causing an issue, I do want them to get it out. Because if they think and they believe it's causing an issue, which goes back to what you said earlier, they will create an issue, is what she said. And I appreciated—

they'll experience— they will likely experience the symptoms, at least experience the massive stress. But that kind of goes back to that whole—

right, that's what I'm saying, it's what you said. So I'm connecting it here. So what I like about her is she doesn't say everyone should come in and get the root canals out. That's not what she She says, yes, if it's infected, and yes, you've got blood markers showing inflammation, that needs to be looked at. And if you believe something is creating a problem with you, we have to take that seriously. So I liked that.

It's a decent approach. What we need to do is we need to actually explain the truth to people and then have them make those decisions. I, you know, I think that the issue is that there's so much misinformation out there that people will think, okay, root canals are bad. It's filled with gutta-percha.

I'm one of those people, by the way. It's okay, I can take it.

Gutta-percha is the most inert thing possible. Like, you're not getting inflammation from that.

Now it is, but it's still like taxidermy in your mouth.

I think it's— that's like saying your bone's gonna cause you problems because your bones are in your body.

I'm not gonna argue with you because you're the dentist, not me.

But bones, bones are rather avascular. I mean, there's a reason that, like— so, like, let's say when we take the tooth out, we have to do bone fills to prevent gum tissue from growing in and to keep bones strong, because that's how— the only way. And we actually make sure that there's blood in there. We, we we mess around in there a bit to create blood, not to like creep people out when we do this. Yeah, but we mess around in there to make sure there's blood because we want to infuse that with blood. Regular bone is, is not very vascular, and you know, it's just, it's not really problematic from an inflammation standpoint unless we have like the gut aperture really extending out into tissues where it shouldn't be. And you can see this radiographically. There are instances where what you're talking about is true, but you have to take that on a case-by-case basis.

Now when you say shows an infection, when it shows that, that's—

oh, when it's an infection, get it out of there. Yeah, yeah, get it out of there. Because if you've got a root canal that has had these issues, a retreated root canal, they don't—

No.

The prognosis is low. They can work, but it is, in my opinion, get it out.

So we're kind of saying similar things, but here's where the difference is, and this is fine. This is what I want, why I wanted to have you on. We're both agreeing that like, yes, if you have a problem and it's infected, there's something that's—

Oh, yeah.

That's got to go. It's got to be addressed.

Get out.

But what we're also saying the same is what you believe is going to manifest, basically. So if you believe something, too, you're going to present symptoms. Where we're differing is like, and this is fine, you're saying like in general they're just not problematic unless that's happening. And I'm saying I believe, I believe, but it's a belief again that I just think that long-term in your body it's not a great thing.

We would— so here's the thing, that you know how many people get root canals?

A lot of them.

Yeah. And, and we don't really see any, you know, if this, if it was truly a problem, we would see this en masse. Now here's the thing, Some people may be more susceptible to some issues, particularly those with autoimmune problems.

Oh yeah, I'm an example of that.

So, and so that could be an exception that maybe we've got some issues going on because of that. But that— but then it's like saying, hey, well, squats are good, and you— and people like, well, that guy that has one leg can't do squats. It's like, okay, well, yeah, well, we've got an outlier there. So, so yeah, under certain conditions that could— that can be problematic.

What you just said is different than what a lot of dentists will say because people do get dismissed a lot of times. There's definitely a case where someone says, I had a root canal, I have these issues, and the doctor's like, no, it's fine. So you're— but where you're going is more of a middle ground, which you're asking questions and you're saying, well, it depends, like, do you have these other things? Is this— so, and I think that's part of the issue here. I think both— not to make this two-sided thing, but I think both groups need to kind of come over a little bit with it being open-minded.

So yeah, I think the conversation helps because you can— I mean, like with patients and doctors, I think the conversation helps because you can really identify, okay, well, this is what we This is what we see. Let's talk about your situation. Let me give you the pros and cons of everything. I mean, so you said, did you have the root canal taken out?

Oh yeah, I pulled it out.

Did you have the whole tooth taken out?

Oh, I did. It's a molar and I don't care, so— and it— and it's great.

So you're just missing the tooth right now?

Yeah, and I'll get a ceramic implant eventually.

Okay. Did they do a bone fill?

Yeah.

Okay, good. Yeah, that's the— that's one of the biggest concerns that I have is that a lot of times people will do this type of thing and they'll be like, okay, well, I'm worried about the root canal. And in a lot of cases cases the root canal is not giving them any problems. I've had people so many times come in and they're like, I want you to, to take this out. I'm like, is it causing you a problem? They're like, no. And I'm like, don't mess with what's not broken. Like, let's not, let's not look for problems because the issue is you create problems. Yeah. When you, when you go looking for problems.

Well, for me, I want— it was a definite link on my blood. It definitely showed a scan, an infection on the scan, and I already have two autoimmune.

So to me I was like, oh, there's an infection on the scan, get it out.

Yeah. And I did.

So And but so then the issue comes into play because a lot of people come in and they'll say, well, it's not really giving me any problems, should I get this out? I'll be like, no. And they're like, well, why not? And I'll be like, well, if we get that out, you're gonna have to do a bone fill. I, I mean, you don't have to, but I 100% tell you to do a bone fill because what's going to happen is that entire area is going to collapse in. Those two teeth on either side are going to drift in. They're going to lose all that bone that was there that was supporting them. And now all of a sudden you've got a domino effect where you're losing teeth and teeth and teeth.

Yeah.

And so when people are like, I want to get this out because I'm, I'm afraid that it's, it's going to like irritate me or cause inflammation or something like that, I think about the downstream effects. And I'm like, well, are you willing to do all this other stuff afterwards? And from a— I mean, we took the Hippocratic Oath, right?

Yeah.

And so when a patient comes in and they're like, well, I want to essentially destroy this tooth that is non-problematic, I'm like, that, that's going to cause you problems.

Yeah.

So we don't want to do that. So, so you have that conversation with the person. But under your case where you're talking about having infection and all those other issues, I mean, yeah, you've given a reason.

Yeah. Okay, I want to talk about some of these other ones that are big topics, and I don't know really fully what you're going to say here, but I'm going to ask because you've got some things that I pulled from your answers.

It's just like Russian roulette.

Yeah, I don't know. I'm curious, like, okay, adrenal fatigue.

It's a made-up condition.

Tell us why.

There's no diagnostic criteria for it. There's explanations for everything that adrenal fatigue claims to be. So whenever anybody says, well, it's adrenal fatigue and I've got that problem, You're like, okay, well, what are your symptoms? And they'll tell you your symptoms and you'll be like, well, this is why. And it has nothing to do with the adrenals.

So give me an example. So typically what you'll hear, somebody was like high stress, high cortisol. I'm just telling you that what I'll hear, like high stress, high cortisol. They have nervous system dysregulation, which is the new buzzword around nervous system dysregulation. And now they tank and they're exhausted and they're saying they have adrenal fatigue.

It's because you have stress. It has nothing to do with your adrenals. I mean, the adrenals, if you test these people that say this, your adrenals are functioning. They're doing their job. They're doing exactly what they're supposed to do. The adrenals aren't out of whack. It's because you're not dealing with the stress in your life.

So you're not denying there's stress. You just don't like the label. No. And you're not like— Oh, no.

It's because it's not the adrenal gland that's the problem.

Got it. So, okay. So you're not denying stress. You're not denying—

Now, there is a thing called adrenal insufficiency, but that's an actual medical condition. And that is where the adrenal cortex is having problems producing hormones.

Ah. So it's more the name of it. When we say adrenal fatigue, you're like, that doesn't make sense.

Adrenal fatigue is one of those things that, like, in medicine we know that it doesn't exist, but it, it really caught on in, like, naturopathy because if you tell people they have adrenal fatigue, you can sell something to fix it. And the problem with it is those fixes ignore what the actual problem is because you're attempting to fix the adrenal gland, which is not malfunctioning. And that's the problem with adrenal fatigue, is that it's a diagnosis And then you talk to the people that diagnose adrenal fatigue and you're like, okay, if something— like, let's say the adrenal fatigue is insufficiently putting out hormone.

Yep.

We should be able to measure that, right?

Sure.

But you can't. When somebody— when it's adrenal fatigue, it's never, it's never out of whack.

So the better term is stress and burnout, basically.

You just have stress and that causes a whole host of negative issues.

Including burnout, where you could—

yeah, yeah, you're going to feel really drained, you're going to feel really fatigued. But then what is the answer? The answer is not getting adrenal supplements to address your adrenals, it's to stress relief. Read a book. Meditate. Become mindful. Meditation is a very powerful thing.

Well, I think there's some supplements that would definitely help, but they don't— not for adrenal, like glycine. Take glycine, for example. That's going to help calm you down.

Glycine can help with sleep because it helps regulate body temperature. And so if you get better sleep, it can be stress relief.

Or magnesium. But these are all going to help calm you and help you sleep versus fix it.

Yeah. I mean, theanine. Can be a beneficial thing there. People point towards ashwagandha, but the real cortisol effects are a little bit questionable. I don't think— I don't have a problem if people want to try, but if people want to try it, do at least do one of the two standardized forms, the Sensoril or the KSM-66. Don't just take regular ashwagandha, okay? Because regular ashwagandha, there are active constituents in it, and there can be thousands of different active constituents. And one ashwagandha is not the same as another ashwagandha. So get one of the of the forms that actually makes sure to have a certain level of the beneficial things like Sensoril. Sensoril is the one that you really want if you have high stress.

I find glycine, theanine, and magnesium just do wonders, those three things.

I like them. I like them. I do glycine. I do 3 grams before bed every night.

Me too. Yeah.

For women, my wife is perimenopausal.

Okay.

I was like, try the glycine because hot flashes are obviously— temperature regulation is a real issue. I don't think I have to tell anybody that's gone through menopause that that's a real issue, but glycine actually helps because glycine's main effect is it helps temperature regulation in the body. It's not like it's going to knock you out, but it helps you get deeper, more restful sleep, less waking up. I really do think it's one of the things that helps the most.

Yeah. I love adding glycine. Okay. The next one. This is a big topic, but peptides.

Peptides. The problem with talking about peptides is that peptides are an entire classification of drugs. That's like saying opioids, you know, are we talking about a specific one or is this a problem that's relevant to the entire class? And, and people— the biggest issue that we're seeing today is that people are getting taken advantage of because influencers can make money off of having a peptide code. And we have to be very careful when money is involved in a message. If somebody can make— like, I know a couple guys that are making near a million dollars a year with peptide codes, and it's because they're using— they're taking advantage of people's fears. And some of the messaging that they're giving is, you know, your doctor never listened to you, but you take these peptides and it'll fix all the problems that you have. And like, that's disingenuous from the start. I mean, just because a doctor didn't listen to you doesn't mean that these peptides are good drugs for you to take. And again, this is an entire classification of drugs. It's an entire group, right? So some are great, some work really well, some are appropriate for certain people, some are not appropriate for anybody. And we're treating all of them as if they're supplements these days, and they're not supplements. Some of them are very dangerous, and some of them we have no idea how dangerous they are. And yet people are injecting these willy-nilly, or, you know, moving towards the pill version. So that's what's really scary about this. Again, I got— I took a Hippocratic oath. Yeah. And when I see people doing things that will potentially set them up for real problems later, we've got some issues. And that's not to say that some of these can't work because we got tons of peptides. There are a lot of peptide drugs that pharma has come out with. Insulin is a peptide drug.

Sure.

I mean, we all know GLP-1s.

Yeah.

You know, and those are great for the right people used correctly because there's, you know, there's the big concern about GLP-1s and muscle loss and bone loss and all that stuff. And it's actually a valid concern, but it's not because of the GLP-1s themselves. It's when the drugs are being abused. It's when they're being run incorrectly. I mean, if you're this and you're not lifting, you're not eating protein, you're not—

if you're in an extreme calorie deficit, you're not eating, you're going to have problems anyway.

Yes, that's what starvation does. And people are using GLP-1s as starvation aids. They're not using them as—

no, it's fueling eating disorders in some people.

Yes, it's fueling a lot of eating disorders. And I am a huge fan of GLP-1s and people that are indicated for them, for the obese, for people that have diabetes. This is not an indication, but I'm actually in favor of people that have addictive personality disorders for certain things, you know, like alcohol, smoking. It has not been— the studies are going through right now. It has not been indicated for these yet. It's being off-label use, but in my heart of hearts, I know that this is within the next 10 years.

But it sounds like a very small dose is not it, not weight loss doses for that.

Not necessarily, no, but you do still see the effects of weight loss doses. But again, you're going to tailor that depending on the person. You know, if the person doesn't have a ton of weight loss to use, you would use those lower doses. I feel this is prediction, this is purely speculation. I feel that within the next 10 years we're going to see this indicated for addiction?

I feel like— I mean, again, this is my speculation— I feel like that it's going to basically get rid of obesity and type 2 diabetes and the addiction. So I think that that can be amazing. I, I don't— I, I think peptides are great when it's medically supervised and it's individualized. It's like, as you said, it's a prescription. But it is concerning when you see somebody— it's like a fitzpo on social media stacking like 10 different peptides and then saying to message them. Because that's a weird cocktail.

And half of them aren't legal. And then you don't know— because some of these aren't legal, you don't even know the interactions between them. You don't know the efficacy, efficacy and safety of half of them. And, and so you're, you're literally using yourself. People get super mad at pharma, and then they literally will use themselves as guinea pigs just because they, they hope upon hope that this is the, the secret, you know. And this is the thing: what works is still the nutrition. There's 4 things that work, 4 things that work. And every question that you have about health, for fitness and nutrition, there's 4 questions about getting the best body composition, about getting the best health, about getting the— 4 answers rather— getting the best health, getting, you know, whatever. I want to improve my gut health, I want to improve this, blah, blah, blah. Fitness, nutrition, sleep, stress relief. Those are the 4 pillars of literally everything. Well, how do I get, you know, how do I relieve stress? Fitness, nutrition, sleep, stress relief? How do I get better gut health? Those 4 things. How do I get a better body? Those 4 things. How do I get better bone density, strength, longevity? All those 4 things. Those are the 4 pillars. The problem with GLP-1s are, at least anecdotally, I'm seeing a lot of people use them as ways to circumvent those 4.

Yeah, it's like a short— like they want an easy button.

They want an easy button. And there's more than enough research out at this point that will point to the fact that unless you get those habits down, it's much more likely than not that you will regain all that weight the the second that you go off. And a lot of these people that are abusing these drugs aren't looking at these drugs as a lifelong thing. I can tell you, if you are indicated for these drugs, the right expectation is you're going to be on them for the rest of your life.

Yeah, just like you might be on thyroid medication or insulin. Yes.

Yeah. That doesn't necessarily mean that you're going to have to be on them, but that's the right expectation. If you go into this, if you're actually indicated for the drug and you go into this thinking, I'm just going to do this for 3 months and get off, that's not right, man.

No, you're right.

You haven't looked into the drug.

Yeah. What about on peptides? I wanted to ask you about BPC-157 because that, that's the one that seems— I mean, gosh, that's been out for many, many years. People using that. I've used it for surgical recovery. What are your thoughts there?

What happens if you stimulate VEGF in tissues other than the ones you want to target?

Well, that could fuel cancer growth and other problems, I'd imagine.

Cause a lot of problems.

Yeah.

You can have unwanted blood vessel growth, leakiness and swelling, worsening of retinal and neurovascular diseases, potential support of tumor growth, abnormal tissue remodeling, clean healing. I mean, it's a really big problem. The mechanism by which this is supposed to work— now let's be clear about this, there are no studies in humans suggesting that these actually work. No one's—

For BPC, there's nothing? Okay.

Nothing, not one. There are a couple studies in humans, but they're the shittiest ass studies you've ever seen. They gave some people BPC-157, they didn't have a control group, and they're like, "Do you feel better?" They're like, "Sure." You're like, "Okay, cool." This is basically based off of all animal data, and animal data is great, but animal data works as a staging point to do human studies, and it doesn't verify efficacy and safety in humans. Now, the, the thing with BPC-157 is it's intriguing and it's possible that it could work. It's a lie to say that it can't be patented because there actually are a couple patents on it already. Okay, it can be patented. It's more difficult to patent, and if pharma is as evil as people say, they would they would 100% jump in on this type of thing because you can patent it for a variety of different reasons. It's just more difficult than a brand new drug out of nowhere.

So you wouldn't personally use this, or would you?

I tried BPC-157. It didn't do anything for me.

Okay.

But I only tried it for 6 or 8 weeks.

I definitely did it with surgery healing a couple of times and I did heal. But, but, and, and I said all this, I didn't do that alone. I also did hyperbaric oxygen. There's other things I did. So it's hard to know. Like what thing, you know, helped.

That's sort of the problem a lot of times around this, on top of the fact that one of the issues with this stuff is that the number one thing for healing is time and positive thinking. I mean, if you look at the biopsychosocial model of pain, yeah, and you look at rehab, this is one of the things that I was, I was kind of alluding to earlier in the conversation. If you tell somebody that what they're doing is beneficial and just to stay patient it's going to work, they experience better outcomes.

Yeah.

And so BBC157 sits smack dab in the middle of that territory. It has so many people speaking it up that expectation effects are massively positive, which may be explaining all of the benefit that we're seeing in people. And when people are like, no, that's not possible, like, you know, I, I know my body, that's— I bring up BCAAs. BCAAs for 15 years. Everybody swore they worked.

Yeah.

And then we did studies and we're like, oh crap, they really don't.

Right.

Supplemental BCAAs, all aminos. Or what? One, you need all the aminos, but the second that you're taking an adequate amount of daily protein, even the EAA products that have all the aminos don't do anything. And you're like, ah crap. So when this is controlled under a condition that I should be in already, eating a good diet, nutrition, fitness, stress relief, sleep, eating a good diet, it essentially makes this null. But nothing you could say to those people, you know, I, I can feel the energy, it's protein. Like, it is very difficult for your body to break that down in energy. It can, but that's not— it's the least preferred form of energy for a body. Like, if you want energy, take some carbs. Well, I don't want to take carbs because they have calories. Well, your amino acids have calories. No, it says zero on the label. Well, that's a labeling loophole. The FDA allows you to put zero with free-form amino acids, but it really has the same calories as carbs. Oh shit. So these conversations became more and more convoluted over time. And my concern with BPC-157 is not that it doesn't have potential, it's that the potential for problems is just as high as the potential for benefits. And you may not see that in the short term, like people may run it a few times for injury recovery, it may be completely fine. But the problem is with the way that it, um, with it works, the VEGF and angiogenesis— angiogenesis meaning the, the production of new blood cells— one, it can produce those blood cells where you don't want them, but two, the blood cells that they produce can be abnormal, fragile, or leaky rather than healthy functional ones. So in the short term, you could be increasing blood flow to those areas that traditionally need some better healing, like things like tendons ligaments, soft, you know, the soft tissues that are notoriously difficult to heal because they don't have really good blood supplies. Yeah, it could be great in the short term for them, but then people get on the thing where they're like, okay, well, this works really well for me, so I'm always going to take it, and it makes my gut health better, and it does all this stuff. Well, if it's affecting your gut health, then it's worth working systemically. And so then we really do need to worry about these things over time. Are you producing these more and more and more leaky, abnormal, fragile blood vessels that is going to show up in 10 years?

Yeah, that makes sense because we've, we've pretty much put— you're right, in the wellness community, I think we've put BPC as this, like, that's a safe one because people talk about it the most.

It's not.

I—

so here's, here's the funny thing about it as, as being the safe one. Not to completely cut you off, but just the point.

But you know what I'm talking about? That's like the most— like everyone's like, oh, that— I just use BPC. It's like, it's an easy— they think it's just the safest one.

But if it works like they swear it does, that's when you have to have concern for these problems. If it doesn't work at all, then we don't need the concern for these problems. But they're swearing it works, right? So then you have to be concerned about these problems. And the same thing with like tumor growth. It doesn't necessarily cause tumors with the way that angiogenesis works. It's unlikely that it would give you a tumor, but it is a real concern that it would make a tumor that you get a lot worse, a lot quicker.

Yeah.

So it could work. But if it works, at what dose? For what injury, in what population, for what length of time. We don't have answers to any of these questions, and yet people are just injecting these like crazy.

Yeah, you're— no, you're totally right.

And so as, as a doctor that has a DEA license and works with people and talks about the pros and cons of medications, no legitimate doctor can get behind these because we don't have a single safety study done on this. We don't have a single efficacy study done on this. Yeah, but everybody swears that it works. I mean, you can, you can say that about so many things.

What about— do you know much about— trying to pull up the name— thymosin alpha-1?

I'm not— I haven't specifically looked at that one.

That's like a newer one we're hearing about, like, for our immune system. Wondering— I was wondering if you had anything there, but nothing.

So the immune modulation is a concern, and it comes with just as much concern as angiogenesis.

Okay.

Immune modulation. If— I mean, what is an autoimmune disease? It's, it's hyperly functioning immune system. So are you going to trigger some of that? Are you going to trigger issues where you're going to cause other problems in the body? I mean, micromanaging your immune system, you know, and this is the kind of the weird thing with— this is not like aggressive, but you know how like naturopaths are like, we want to keep things more natural, and then all of a sudden we're constantly trying to micromanage our body's natural processes? It's like, well, this is a little bit off off kilter from what the message is.

Yeah, you're right. I can see that.

You know, and so when we try to do this, we can cause problems because we're in a delicate balance, and our bodies typically, outside of a disease state, will typically know how to regulate itself. I mean, we see this with insulin, we see this with cortisol. Cortisol and insulin aren't bad things. They serve a lot of very beneficial processes.

Yeah, sometimes, like, I know that when cortisol is— I mean, I went through this myself— when cortisol is spiked, it's your body's way of getting rid of something. It's like trying to clean— like, you could have an underlying something. You're— it's raising cortisol for a reason. Like, there's— everything has a function. So when you have— just like when I was sharing, I had hives with my cortisol. It's your body trying to get your attention. So, oh yeah, yeah, there's—

well, so, and we want cortisol to spike every day. We want it to spike. We want it to spike. It's what wakes us up in the morning. We want it to spike every time we exercise. It's what liberates energy. It aids in fat loss., and people never really think about that. Yeah, they're like, but cortisol makes you fat.

Well, I don't think— well, yeah, I think that's part of the conversation, but I think more when you look at nervous system and stress, when you have cortisol all day long, that's the bigger thing with midlife.

The source is problematic. Yeah, exercise is a big driver of cortisol, but that's a beneficial outcome.

Yes. You have to know what's causing it. Like if you're just sitting there and you're getting that spike, there's something going on.

If you have constant, really high-grade stress, I mean, you see this a lot of time with people with like PTSD, stuff like that. That's really problematic because completely elevated cortisol for really long periods of time for stress-related reasons is a problem. But people worry about spikes. Spikes, you don't worry about.

So like those people that are— More consistent. Like when you take a steroid and you're elevated like that for 7 days. You, that whatever, the prescription steroid for when they— that gives you fake cortisol, like that feeling. If you have that all the time, that's problematic, basically.

Yeah, it causes a bunch of health problems.

Yeah.

So it's kind of like— it's kind of— excuse me— it's kind of like the difference with like blood glucose spikes. Blood glucose spikes in themselves are not inherently bad, but constantly elevated blood glucose, particularly, you know, well beyond the postprandial period, are problematic. And the problem is that influencers have used cortisol, insulin, all these other things Literally everything that we've talked about are like the new buzzwords. I mean, BPC-157 peptides are the new buzzword these days. People have moved away from some of these other things and they're like, okay, well, how can we sell this? Well, inflammation sounds scary, so like let's sell a peptide to treat inflammation. And it's not necessarily something that most people should be treating. I mean, even anti-inflammatories, when taken regularly or in high doses, can attenuate the benefits of exercise, but the benefits of exercise would help you far more for typical inflammation problems than anything else.

Okay, tell me about NAD+.

NAD+ is an interesting one. Both NAD+ and NMN have been pushed recently in the longevity space. You got to be really careful with some of these longevity medications because you have to understand that it's really difficult to monitor longevity. Like, you know, do you give a person this and then you follow them for 60 years and see. And what do you base that against, you know? So you have to see this over large-scale people. The problem with NAD currently, there's no evidence whatsoever that it will lead to tangible anti-aging benefits. They're speculation based on mechanistic data only. And like we talked about earlier, something can happen mechanistically, like we can see a cell do X, but that doesn't mean that it's in a magnitude or in a way that will lead to benefits. There are compensatory mechanisms in the body. Maybe it's not strong enough. There's a bunch of different things. The problem with NAD+, in my opinion, is if we're going to use mechanistic data to make the leaps that it will improve your health and be anti-aging, you could also say— and this is just playing devil's advocate— elevating cellular NAD+ levels could exacerbate chronic inflammation by increasing the release of pro-inflammatory cytokines from senescent cells. That's a lot of science talk, and there is research to back this up to say, hey, theoretically, if we're going to use the same level of evidence that it increases our longevity, we could say that it increases inflammation.

Wow.

And that's not necessarily the best thing. And, you know, NMN even had a study where—

which is the precursor to NAD—

yes, which is— so they're tied together because when people are using NMN or NAD, they're trying to get the same outcome. Them. When they looked at it in young athletes, it didn't just fail to help them, it actually interfered, interfered with mitochondrial adaptation from exercise. And so we've got a couple things that stand out to us in a mechanistic way that maybe we should be conscious of instead of massively injecting amounts of these or taking pills of these for long periods of time. There's potential for concern with some of these things with the same level of rigor as the benefits that are being claimed. And that's where things get, you know, really concerning.

Not to mention some people just really do not feel good taking it and they're forcing it in thinking it's a good thing, and we've got to listen to that as well.

Yeah, and it's possible too, because these are understudied, you know, compounds, there could be some other things going on that we just don't know about. And that's not to say that, that, you know, doom and gloom about this type of stuff, but it is basically like the same thing with, with any peptide that you take in isolation. Look at the individual that you're thinking about and then be honest with yourself about what that can and can't do.

Makes sense. I want to ask you about a couple of the really extreme things that I want to get back to some practical stuff because I can't ignore these things. Urine drinking. What is that?

Why? I know.

That's what I thought. What is that even coming from?

Well, your, your buddy, Dave Asprey, injects his own urine.

Well, I don't know about that. I didn't know about that. But that's— Yeah. I love Dave, but I'm not saying that everything's the same. I agree with everything.

Yeah, he has a big platform where he tells people to inject their own urine. I didn't know that. The one that you're talking about was Dr. Pompa.

What is that? Where did that even come from? That sounds so gross.

It's kind of a fringe thing. Unfortunately, it is within the naturopathy grouping, but it's fringe even to that.

I always try to find the reasoning at least, but I couldn't find it.

There is no reasoning. There is no reason. That's the problem is then like, I mean, you saw like the research that I put out about it. It's like nobody knows where this came from. It's literally just some people started telling others.

Very clickbait.

But I think that that's why a lot of people do a lot of these things, because if you say something crazy or you say something contradictory to the science, it gets people to listen. And they've done A/B testing on, on things on social media and, and even long before social media. They did A/B testing in magazines and stuff like that. If you have a title of like an article or a social media post or something like that, if you say the benefits of protein, no one's going to pay attention.

No.

If you say the dangers of protein, 1,000% spike, of course, views. Yeah, the negative works really well. Contradictory evidence to what someone believes works really well.

Um, disruptions, hyperbolic.

Yeah, you need to just— yes. Yeah, you need to disrupt that thought process, and I think that's where Pia's coming from. Okay, I can't, I can't tell you because I, I'm a logical thinker, let me put it that way. I can't tell you why people are doing this, but they're saying everything from like you put it on your face because it will help your skin, to you drink it because— and I mean, it's, it's every benefit under the sun. I mean, it's the same kind of thing like ice bathing was like 5 years ago. Remember 5 years ago where like everybody was into like ice bathing, but everybody that was really pushing the ice ice bathing, was selling ice bathing tubs and stuff like that. And apparently it like fixed every problem.

Speaking of— yeah, what do you think of that? We have a cold plunge that's basically empty in my backyard right now. There's nothing in it because I didn't like it.

I can't think of any reason to really do a cold plunge. There is even the research that was put out about it. There was a huge podcaster that I'm sure people will recognize when I say the claim. He said that if you get in a cold tub every morning, it will raise your your dopamine by 250% and all this kind of stuff. And what he didn't mention was that the study that looked at that had the person sit in the cold tub for an hour. Oh my gosh, a full hour up to their neck.

That's dangerous.

Yes, he didn't mention that. He said 3 minutes in his podcast, but that's not what the study showed. And that effect gets lessened the more that you do it. Your body attenuates it. So the very first time that you do it, yeah, your body has this like like massive reaction. But like, it's just like if you— did anybody ever do swim team when they were younger? Oh yeah, you jump into the pool in the summer, it was really cold at first, and then like the more the summer went on, it kind of got a little bit easier. It never gets super easy, but it gets easier and easier. Yeah, same thing kind of happens. You kind of attenuate to the, to the cold. So the dopamine response didn't really work that well. And then it was really interesting because if you looked at like the data on what if I just do something else instead, 10 minutes of cardio did the same thing, but that was 10 minutes, and then you didn't have to sit in a tub for an hour. So like, it was almost like everything that they they suggested that cold plunging did was either not true or there was always something better.

It never really resonated with me. I tried it. We had one. We got one. We tried it. My husband liked to do it just because that's who he is. He just likes to show that he can do it. But like sauna, to me, there's a ton of benefit. I could connect the dots on sauna. Ice baths, I couldn't.

So there's an interesting thing when you compare— because the biggest thing for ice bath was the claim for recovery. Right? Um, but that's because you see some lowered markers of inflammation. But just because you see some lowered markers of inflammation doesn't necessarily mean it's a good thing or it's going to provide a real benefit, because there's a difference between something mechanistic and something playing out in the body. And what they found with ice bathing was that, yes, there were some mechanistic showings of, okay, well, this lowers inflammation, but it didn't seem to actually improve performance. So like, it wasn't actually providing a recovery benefit in a practical sense. And then it was lowering the benefits people were getting from training. So the cardiovascular health benefits from endurance, the, um, the muscle building benefits from, from weight training— it was preventing this from happening because the inflammatory response is a very real response that is necessary for your body to adapt to the stresses that you put on it through training. And so not only was it not actually providing recovery, it was making their workouts less ineffective.

Oh yeah, that— but you're right, everybody was showing that. You're— it was like a whole thing.

Well, then the typical response from the ice bathing crowd was, we'll just space it, because they started to admit that. They were like, okay, yeah, okay, well, we see that, so just ice bath 6 hours away from when you train. But that was fabricated. They made that up. There's no study that shows that if you ice bath 6 hours away from when you train, all of a sudden these effects go away. And if you think about it, it's not like you work out and then you have all the benefits from that workout and your body is fully recovered and you've built all the muscle in 6 like that usually is like a 48-hour process. And so 24 to 48 hours. And so when we look at this time period of spacing out 4 to 6 hours, I'm sure that it would ameliorate some of that issue. But I think saying, hey, if you do this, you're going to be completely fine and then you'll get recovery benefits. One, we don't see those recovery benefits, but two, it probably doesn't fully get rid of this problem. So you're still ice bathing and getting into something super uncomfortable for no actual benefit other than expectation effects.

To me, I like to focus on joy, and that had none. Yeah.

So— Well, I like sauna a lot better.

I love my sauna. But my sauna, it relaxes me. It's different. Like I'm going— it's like it helps me. It's like a calming thing. So I feel like I'm sweating. There's a lot of benefits. It feels good. Yeah.

You're not white-knuckling it through the entire experience. So sauna gives that benefit, which stress relief.

Yes.

Remember one of the 4 big pillars? There we go. We got it right there. The other cool thing about sauna is it does not ameliorate the benefits of training. Sure, it increases blood flow, which in some cases is neutral, in some cases is an advantage. There are some, um, studies that suggest a potential recovery benefit. Now, there's not a potential recovery benefit like if you train in the morning and you do sauna and then you train it a little bit later, it might actually impair that training about— because it's more stress on your body, right? You're still having to, to thermoregulate and all that kind of stuff. So like if you've got like two-a-day bouts or you're doing something, I wouldn't do it then. But like if you got a whole day off and tomorrow you're you're gonna train again, yeah, sure, knock yourself out. The benefits to sauna may be a bit overblown in the sauna circles, but there aren't really major negatives outside of make sure that you're hydrating and replacing electrolytes.

We can't deny it's good to sweat. So even if everything else wasn't— like, so it's good to sweat, it's good to relax, it's good to sleep better, it's good to shut down stress. So if whatever helps you get to that is also gonna be beneficial, I believe.

So the thing that we see, because you'll see a lot of comments about like Finnish studies when we look at this type of stuff. There are certainly benefits in like cardiovascular disease. That's usually not the people that are doing it, but there's usually, there's usually benefits in cardiovascular disease. And there are benefits in people that do not exercise because it's a hormetic stressor, so it semi-mimics some of the benefits of cardio. But if you exercise regularly, if you're a fit person, we don't really see—

makes sense—

those benefits. So like when people talk about, oh, you got to do sauna because it's got all of these like wide range of benefits, benefits. It's probably not relevant to the people in this— they're listening to this fitness health podcast because you probably exercise. But there's no massive negative, and it's stress relieving for many people. So like, it is a net benefit if you view it that way. If you don't find stress relief in it, please don't do it.

Yeah, if it's too stressful, you shouldn't do anything.

If you feel like I'm getting stressed because I'm wasting time that I could be using doing something else— like, if meal prepping is going to make you feel better, and that's part of those 4 pillars, nutrition— if meal prepping is going to make you feel better, and that's when you have the time time, skip the sauna.

Okay, I'm scared to ask you about this one because I'm a big believer in this, so I'm kind of scared to ask you, but I'm going to. I want to ask you about compounding pharmacies, but let me first— let's share why I personally like them. I like them because I'm one of those like super sensitive people to things, and I— so I like to be able to not like— so for example, I take T3 for my thyroid. The standard dose you get is just too strong for me, so it's compounded very small for me. Same with progesterone. I I'm just sensitive to things. So I personally like compounding pharmacies. Why are they so controversial and what are your thoughts?

They're controversial because they don't test very well.

Share more.

There's a lack of— there have been a few studies looking at compounding pharmacies. There's not a massive amount of data. So just to put that out there. But the studies that we've had aren't extremely promising. They tend to have— the biggest issue is that they tend to not meet label claims. By wide margins, like up to 80%.

Really?

Yeah. They tend to not have the drug in there, so they suffer from a quality standpoint. They are also much higher in contamination risk.

Interesting.

But the biggest issue is that is meeting label claims. Now, obviously, that's going to be, that's going to be specific to, you know, whatever pharmacy you're working with and then whatever technician is doing it. And that's kind of the problem is like even if you find a pharmacy that you like and I get compounded, um, tretinoin.

Okay.

Actually not by choice. My— yeah, my doctor says I like to use this. She probably makes some money off of it, and I'm just like, okay, whatever, it's fine. But I've had kinds where I'm like, this is— the formula is completely off. Like, they screwed this one up.

Um, and that's a topical though.

It's a topical. Yeah. And so like, I, I've seen ones where I've gotten it and it's been completely screwed up. Um, but yeah, the, the problem with them is that— and the other problem with them is they will often do illegal things. And so it was not legal for them, literally up until a really bizarre change by RFK, like 3 months ago, 2 months ago, it was illegal to prescribe and to serve BPC-157 among many other peptides to humans. You should not have been able to get it.

Yeah.

Now the only way that you could get it get it is through a research pharmacy site for research purposes. They could not sell it to you for use. The problem with that is that makes it gray market. And I know there's a ton of people that will say— because I've heard this all the time and I've seen it— people will say, well, my doctor prescribed it for me. Not legally, he didn't.

Interesting.

Yeah, they cannot legally prescribe it now. It is not legal to prescribe BPC-157. It is not an important—

that's in every state, no matter what. It's not like—

no matter what state, it is not legal to prescribe it. They have decriminalized the— so it was part of the 503 Compounding Pharmacy Act where it was not allowed to be compounded for human use until like 2 months ago. Now the problem with this administration and making those choices, and this is not to be political, this is specifically about choices like this, they want to do things that improve people's health, which is great. We want to push you know, whole minimally processed foods. Love it. We want to spread more words about removing ultra-processed foods from the diet. Love it. Awesome. We then want to give people drugs that have never been studied.

That—

hold up. You just said you want to do things for people's benefit, and now you're telling them inject drugs that have never been studied in humans. Make this make sense.

You, you make me think—

you—

I like interviewing you because you're giving me a lot to think about, and you're definitely challenging some thoughts I have.

I'm not telling people that you're dumb for taking BBC 157. What I'm telling people is—

I'm not hearing that.

Look at the inconsistencies in the messages that are coming out here and let's be a little bit—

I'm not hearing that at all. I don't even feel like you're not confrontational.

I'm not trying.

No, it's good. It's good. You actually have me thinking different. So like when I think of, so for me the scare of compounding pharmacies going away is I think they're super important. For me, I'm being selfish.

'Cause drug costs will go up.

Yeah, well, I'm not taking— Like, if I want a compound amount— for example, testosterone, I don't want testosterone injection, I want a tiny bit of cream that I can use every day. Like, that's compounding pharmacy. Same thing with my progesterone, I want it comp— like, so I like that it can be precise. That scares me that that could go away.

You could still get cream through the standard FDA channels from a regular pharmacy.

Okay, well, I didn't know that. Like, you could still get— but what about things like T3? Like, if I want to compound a T3 or progesterone, I don't know that we can, because compounding pharmacies can take something and make a smaller, much smaller microdose. Same with GLP. Talk about GLPs for a minute. So, like, take tirzepatide, which you even said could help people immensely with type 2 diabetes, possibly addiction later, whatever it is. Not everyone needs a 2.5 milligram starting dose for weight loss. Like, some people will have huge benefits from taking 0.50. That's a compounding pharmacy.

So what scares me is if those go away, it would have to be taken on a drug-by-drug specific specific, you know, look to see if they have those lower doses. In many cases they have lower doses, or, well, with GLP-1s we're now getting pills, and now you're going to be able to titrate that by splitting pills.

That's interesting.

But if you've got an injectable, it kind of depends on what the injectable form is and if you can dial that in to a specific dosage. There are some that you can—

like progesterone from CVS has peanut oil in it. Some people can't have peanut, like, so that's why the compounding—

they have alternatives for that though. They have alternatives for that in standard medicine though.

Okay, well, that would be good too. I mean, I think that's, that's my, been my concern with compounding is that I don't, I don't have anything against compounding.

Here's the thing, it's not that compounding itself is bad, it's that compounding in practice doesn't seem to be great.

Okay.

And I say that because if we look at, um, the compounding pharmacies and we see more than half are not giving the dosage that's listed on the label within, within a 20% margin of error, it's a, it's a large margin of that it's— that they're outside of. That's problematic. Now, the good news is it's typically never in the wrong direction. It's typically never you're getting more drug than what you thought, because that would be even more problematic. Like, people would start dying from that stuff. Oh yeah, you know, if you're overdosing on drugs. But like, it's, it's rough in cases where people are really trying to treat a known problem and they're like, this drug isn't working. And then like, you don't— you move away to a different drug, and that drug could have been the, the answer for Yeah, but it didn't work because you got it through a compounding pharmacy and you didn't get the drug.

Wow, that makes, that makes sense.

And so compounding pharmacy itself could be a very, very wonderful thing. My problem with them is because they don't meet the same quality standards. That's the issue. It's the quality standards that are the problem for me.

Yeah.

And there are, there are issues with them potentially having cross-contamination with a bunch of other stuff. So when you talk about peanut oil, well, cross-contamination issues is a problem with compounding pharmacies. So like, if you're one of those people in one of those groups and they get a little bit of the wrong thing in the wrong, you know, it could be concerning.

Sure.

They use, they use the same, you know, palette that they're mixing drugs on, or the bowl, or the gloves, or whatever, you know, and they accidentally cross-contaminate or whatever it is. It's, it's a lot more common in compounding pharmacies. That makes sense. So compounding pharmacies, I don't necessarily know, like, I don't think that I would say I want them to go away because I don't think that that's my stance. I want them to have better regulation, but that's—

You're more concerned about safety. So that's what I'm hearing.

Yeah.

Yeah. It's like, just like, let's just make sure we're actually getting what you're saying or putting, just like you would with supplements.

Yes. I'm, I'm more concerned about safety and I wanna make sure that the person that's getting the drug, because I, I'm also thinking about this from a practitioner perspective. Mm-hmm. I wanna make sure that if I'm giving a person a drug, they're taking the drug and we get an adequate idea of what that drug at that dosage, at that frequency of distribution is doing. And I can't say that with a compounding pharmacy in many instances. Like, I get a concern of like, okay, because like sometimes we'll come back and a person will be like, I'm not feeling any effect. And I'm like, at that, at that dose, like, we've, we've upped it a couple times because you've said this over and over and over. I'm like, at that dose, like, I can't, like, I can't put on a prescription a higher dose. Like, even if I know, like, it would get you into the right range, like like on paper it looks like I'm gonna kill you. So, you know, it causes a bunch of problems. So like compounding pharmacies, if you go through a compounding pharmacy, like I said, I'm being hypocritical because I get my tretinoin through, but I get my tretinoin through it because I know that if I put it on my face and it's completely wrong, at worst it'll burn me temporarily, you know. Like I'm not, I'm not ingesting or injecting something from them.

Yeah, I mean, I definitely get my progesterone and my T3 from a compounding pharmacy.

So, and you, you may be working just fine. I mean, you may be getting exactly what you're supposed to be getting.

Yeah. Okay. I want to go kind of back to sort of what actually— what you believe works. And this part is cool because I know we're both definitely aligned on these things, but I wanted to get your perspective on when a woman is just midlife. And I know you're not a midlife woman, I am, but we do agree on a lot of these things.

I'm married to a midlife woman.

You're married to a midlife woman.

Let's do it.

So, let's talk about that for a minute. Like what do you actually think? You have a woman in their 40s, 50s, 60s that's listening right now and they're just they're feeling off. They're like, they're feeling fluffy, their metabolism slowed down, they're feeling maybe less motivated. Like, kind of run us through, like, what do you want them asking themselves? What do you want them looking at? What's important?

Well, this goes back to what we were talking about earlier with— first, I want to, I want to start with education because I think that if we understand what's going on, we can remove some of the nocebo from the equation. Because I think that women, particularly midlife women, have nocebo up the butthole. And this is not the person's fault that has this. This is what social media is doing to you. Yeah, because social media is spreading a lot of misinformation, and it's a lot of doctors that are spreading misinformation. And it's absolutely hilarious when you look at the research that they're using to spread this misinformation, because you're like, one, this is half the time it's not even in women. Half the time the research they're using are in mice, and you're just like, this is absolutely crazy. That you are saying. And if you hear the tagline, women aren't small men, run. You know that you're going to get some bad information because most of the time what's being substituted is mice data. Women are not large mice, and we should never be using mice data as a proxy for women. The experience of midlife, particularly for women, is very different than men, and the experience is completely valid. And that needs to be said, and that needs to be acknowledged. And I think that this is where male doctors in particular in the past have really done a disservice to women. I think that they did not acknowledge that, and I think that the experience is real, but that doesn't mean necessarily that you're broken. And I think that that's the information that needs to be put out there. And unfortunately, when you're having people tell you you're going to lose all this muscle, you're going to gain all this fat, your metabolism is gonna— is gonna drop, you're broken— they're telling you you're broken.

Sure.

And the problem with that messaging is, one, it's not true. We have the research to show that it's not and two, what that person is doing is they're stealing autonomy away from you. When they are giving you wrong information, you can't make the right choice for you. As a middle-aged woman, if you're told your hormones are the reason that you're having all of these problems, your hormones are the reason that you're gaining weight, your hormones are the reason that you're losing muscle, your hormones are the reason this, this, that, they're stealing autonomy from you because they're telling you something wrong. And then what's really funny is they're turning around and they're selling you their book or their their weight vest or their supplements to treat something that's not true. So they're preying on you, and that's really problematic. When you talk about, you know, it feels like my metabolism is going down—

wait, I want to interrupt for one quick thing there, because what you said, when they're preying on you, and that's wrong, because I could technically put myself in that category. I share all kinds of things that I do and share. However, I will say, and I'll speak for my friends, um, that I have a lot of great friends in this space that books, it comes from very well-meaning intentions many times. I understand there's marketing and people that don't have well-meaning intentions, but I do believe— like, I know anything I share, I really believe. It's like something that's— and I, and I try to be very real. This is what's working for me, this is what I'm learning. But I don't think it's always bad intentions. I just wanted to be careful there because it's—

in my, in my experience, you've been very objective because even in things that you disagree on, you're like, well, well Well, tell me the story.

Yeah.

You know, and I think that that's all you can ask of a person. And I'm not saying that a person has to be right 100% of the time. I'm saying the ones that I'm particularly thinking of have been told that they're wrong, have been— it has been explained to them.

And they're not open to that.

Not only are they not open to it, they're doubling down because it will lose them money if they are open to it.

Okay, well, that I understand. That makes sense.

That's very, very different.

Yes.

Yes. So hey, trust me, as a person that puts out information like I do, one of the things that I respect the most is when somebody looks at something, they were like, you know what, I was wrong, I'm going to change. And I think anybody listening to this, there has never been a person in fitness and health that has not said that. So like if Natalie comes back after this and says, hey, I had a talk with Alan and this particular thing I'm going to change my mind on, cool. I've done that a ton of times. Let me give some examples just to throw myself out there. There. I originally thought that, that we had to have— we had to meet the anabolic window. We had to have protein a certain amount of time after.

Oh, I used to believe that too. I, I used to believe I have to eat every 2 hours or my muscles— yes, itself.

Yeah. And that's, that's actually one that's coming back up in women's circles, which is completely not true, by the way, because like in caveman times, women would all have degenerated away to nothing.

I must do cardio on empty stomach every morning, or I'm not running like all that.

All— I fell into all that stuff. And at the time, it was because we didn't have the data to actually disprove a lot of it. And we were kind of going off of, well, the really big, you know, physique athletes are doing it this way. And then we found out it wasn't that it was super beneficial, it's that it didn't matter. And so just because they did it, and there was no negative to it, but they did it and they had the best bodies, so why don't we emulate that? And that's a logical thing until you get some more information. But that's what this It just happens. That's what happens. We start to learn and we start to make some changes. And actually, one of them is one of the ones that I'm going to touch on here that answers your question directly. You had talked about women saying, "I feel like my metabolism is going, you know, things are harder." I used to think that metabolism probably started dipping in 30s, or if not the 30s, maybe at least the 40s, right? I mean, that makes sense. Like, and if I would say that to the majority of people, people like, "Yeah, that's my experience. That's what happens." We were wrong. Ponzer 2021 came out with a study. Thousands and thousands of people over the entire age range, men and women. You can't say that there weren't women in this study. Yeah, there were tons of women. The average age for menopause in women is 51 years of age. This looked at everybody from 18 to about— I was like 88 or 89, something like that. And thousands of people, men and women, and they found that metabolism didn't change from 20 to 60. Sorry, 40-year-olds that think that their metabolism has changed— it hasn't. Some things have changed. It's not your metabolism. That's okay. That means that we start to look in the areas what has changed and what can we do about it. Because if we know it's not metabolism—

things change that make your metabolism work differently. So it's not your metabolism just changes, but like, for example, if your thyroid's not working right, that's going to affect your metabolism.

That's going to be an outlier, but that wouldn't be something that would be considered in this because if you've got pathology, that would take you out of—

okay, that makes— that's fair.

Yeah, that would take you out of this data set. Yeah, we're looking at people that are otherwise healthy.

Everything else is—

but menopause is not a disease. Yeah, let me, let me put it that way, because many people are treating menopause like a disease right now. But menopause does not alter your, your resting metabolic rate at all, and we've got a lot of studies to show that. We do see a lot of extra challenges though, and they account for a lot of the, the things that, that people are experiencing. First, one of the best studies that we have about midlife life in women, the Swan Study. It's funny because depending on who you talk to, you'll get dramatically different, um, interpretations of the study if you account for age-related changes that men experience too. So just age, men and women will experience, you know, after 30s you start to lose a little bit of muscle, and then it ramps up a little bit more in your 40s, and then it gets really bad in your 60s. Most of the reason that this happens is because people don't lift weights. And yes, you're a lot less active. But if we look at the SWAN study, looking at just women, the average woman, which is probably not as good as the women that are listening to this podcast, because women listening to this podcast are really interested in their own health, they're probably exercising more, they probably take care of themselves more—

I hope so—

we see almost no muscle loss over the entire menopause transition once age-related changes are accounted for. It was like 0.45 pounds over the entire change multiple years. If we look at fat gain, it was something like 2.5 to 3 pounds gained, but BMI didn't even change over the entire menopause transition. So we can't really say— and it's funny because when I point it out that way, you're like, well, like, 2 pounds is not really that much over years, is not that much to gain. Half a pound of muscle— it's 0.45— half a pound of muscle loss is not really that much to lose over years. In this period that I'm being told is going to be dramatic. Now, here's how I would word it if I wanted to scare you. I'd be like, it's going to double your muscle loss, which it does, but double of almost nothing is still almost nothing. And it's not likely related to the hormone changes, because even when we do things like give women estrogen, give women testosterone, we don't see this prevented.

So what I think is, um, what I see with midlife women um, is a couple things. When I see that they spent many years not adding the adequate muscle we needed to add— so in 20s and 30s, when it was a lot easier, they weren't adding it, so they relied on just being slim or whatever it was in, in use. So what happens now is now we get perimenopause and menopause, and we do have the dipping hormones, so our mood's changing, right? We've got things changing. We do have a toxic load, like, so you're getting exposed to more and more things. So you have your body just— it's just wear and tear, basically. I'll say more wear and tear. You're aging, so things maybe don't work as on point.

Don't put that on women in their 40s. You are not aging. You are young as hell. I'm doing well. I'm doing well. I'm joking.

Yeah. So I think whether you like the word toxic load or not, which is something I definitely believe, I think we're exposed to toxins everywhere all the time, but there is a load level. Like you constantly are in— I'm going to take an extreme example. You mold and you've got— you had, I don't know, you had gut issues and now you have— you're using all kinds of toxic products. There's just a lot of stuff that can build up where maybe in your 20s your body was a little bit more efficient and in your 50s it's just not. I'm not saying it's an excuse. I'm just saying there's different variables that change that.

Well, if it's building up, you would just have a lot less of it to affect you at that time period.

Okay.

Well— I mean, but that would— in theory support what you're saying.

So you didn't put muscle on in your 20s and 30s. And now you got all these, whatever those outside variables are. So your hormones changing, whatever is happening different. Now you're feeling less motivated. You've got other people in your ear saying, yeah, it's just age. Yeah, it's menopause. Yeah, it sucks getting older. So now you've got that mindset thing playing in. And now the last thing you're going to go do is try to build muscle, or you go in and you don't know what you're doing. You're doing 3 sets of 12 and you're not really creating progressive overload. And you're frustrated. And maybe you go too fast and hard and you get injured. So now things start compiling and now we have this story that, you know, I'm old and I'm falling apart. So, but in hindsight, what's really happened is we didn't build adequate muscle when we should have and now we're letting time catch up and now we're building up a story. So it is true that we are going to have a problem if we don't add— if we don't stop muscle loss and if we don't add muscle loss, if we don't take— because we're going to have problems with our bones, we're going to get injured more. So it is problematic. So that part's real. Now, what brought us there is not just the age though. What brought us there was choices along the way in our 20s and 30s. I stand by that because anyone I know that really did work out and add muscle younger, it's a lot easier in 50s to keep going with it and to 60s.

It is, it is easier. The real issues that we see, I think that you're on to something there. I want people to understand though, you're not doomed if you didn't work out in those periods because you can always improve from where you are.

No, not at all. Coming from.

That is, that is a lot of where the story is coming from. The real issues that we see with the perimenopause transition and people feeling validated in saying it's the hormones that cause these issues is that the experience is very real. I mean, you've got vasomotor symptoms, you're not sleeping as well, you're having hot flashes, you're having all these things that make you feel like crap. Yeah, it's not that your metabolism is too slow.

I did, I had hot flashes like 5 an hour. I couldn't, it was horrible.

My wife keeps having them while I'm trying to sleep, and you know, I added estrogen and they stopped, just so you know. She actually did too, and it's made things a lot better. But me being the selfish husband, I'm like, stop heating up.

Oh yeah, my husband did that too.

My husband did that too. But this is where I want people to come from as far as understanding goes, because I don't want to say that it's not harder because you certainly have a harder job during this period than men do because we don't have these issues that we're facing. But this is the empowering thing. If we can identify where the actual problems are, we can affect them. Them positively. And what you were saying is one of them— start lifting weights, because that's going to make a massive difference.

But you got to feel good enough to do it. So I do understand that part. So, Alan, my real situation, um, 3 years ago is— I'm a fit expert, like, I'm— I was fit, I've been lifting forever, like, that's— and I'm a fat loss expert. And 3 years ago I started putting on pounds, and I was like, what the heck? I dialed in my diet more, I got to work out harder, was not moving. I didn't know I had ruptured breast implants. I didn't know that I had. So I had other things going on. So yeah, if I had just said, oh, it's hormones, it's menopause, let me just add hormones, that wouldn't have fixed it. I had bigger root— I was also living in a house with black mold, so I had things going on. So I cleaned all that up, removed it, and the weight just came off. So, so there's just more to it than, you know, it's hormones or menopause, for sure.

Well, it is, it is cool that we see across the, the menopause transition that if you, if you're lifting weights, not only do you prevent those age-related declines you actually gain muscle and you can improve your metabolism over those time periods. The, the biggest issue that I see, especially when we look at all this data, is that when people feel bad, they're less likely to follow nutrition well, they're less likely to go to the gym. I mean, we've got distinct data on women where once the menopause transition comes into play— now keep in mind, this is not aggressive in any way— you and I can probably both say most women don't eat enough protein. Oh, for sure. Now maybe your audience does.

No, they—

because they're small.

It's a constant thing to have to worry to get it in.

Yeah. But like if we're talking about gen pop, like think about like your friend or your mother who is not into fitness.

Oh yeah.

They're eating like 30 grams of protein a day.

No, it's not enough.

So one of the issues that we see across this menopause transition is that women's— just the regular women who are already not eating protein, their protein drops by 30%. Their protein intake across the transition drops by 30%. Their fiber intake drops by 50%. They massively increase saturated fat. You're eating like shit.

It's true.

And this compounds with the fact that you feel bad, and you know, which is a legitimate feeling. And you're like, you know what, I don't want to go for a run like I used to. I don't want to go into the gym. I feel like crap. I just want to sit home. I just want to veg.

That was my whole point. When you feel like that, that's— that creates the problem.

We cannot always do something about feeling bad. You get on MHT if you need to, if it's an appropriate thing for you. Talk with your doctor and see if that's a good choice. But what I want to do is I want to bring something empowering into the conversation and say, hey, look, we know that if you take control, you will be rewarded. Yeah, if you, you know, make sure you take control of your nutrition, you take control of your, your fitness, you take control of your sleep as best as you possibly can, because that's a big ask during this period. These levers still work just as well as they do for men, as they do at any other time in life. There are studies looking at men and women when we put them on weight training programs. Women gain just as much muscle as men again, on the same training program. You do not need a special program. I know that people like to feel like a special little snowflake. Nobody is. Like, functioning works the same for fitness regardless of menopause status, regardless of, of age. Now people will say, but then why do men have a lot more muscle than women? Well, because it's relative. So you gain in a relative sense in the same way that a man gains. If a man has a higher baseline his absolute's going to be higher. But if he gains 2% muscle with a workout program, you'll gain 2% muscle with that workout program, assuming similar nutrition and all that is in play. And we've had multiple studies that have looked at this at this point. There's no special thing that you do. There's no difference that you make in, in a nutrition protocol, in a fitness protocol for a man or a woman at any stage of life. You make changes off of a few things, but this is regardless of sex. You make changes based off of personal preference, you make changes based off of goals, you make changes based off of injury history. That's about it. You know, if a woman comes to me and she says, I really want to work my legs more, we might have a higher ratio of leg work. We're not going to ignore upper body work, but we might have a higher ratio of leg work. If a guy comes in and says, I really want to have an impressive chest, well, I've not heard that much from women.

Man.

So he's probably doing more pec work than a woman is, but that is not because of his gender, or not because of his sex. It's because that's what he wants to work. If a woman came to me and said, I want really nice pecs, okay, same program as the man that wants that thing, because it works. And then you adjust based off of individual variation and autoregulation. You know, some people need a little bit more volume than others. Some people react to different exercises a little bit better than others. Some people just have preferences. But again, And again, not sex-specific, not hormone-specific. And so it's— people are trying to overcomplicate this because that's where you become famous. Whereas if you tell people, "Hey, once you get programming variables down, this isn't that complicated. Once you get a good nutrition down, this is not that complicated." And that's not to say that it's easy because it's not easy. It's difficult to eat whole minimally processed foods when you're not used to it.

I think human psychology plays a big role here too, though. People want certainty. They do. They— people crazy.

That's where GLP-1s come into play.

Well, just start— it's not even just easy button, it's certainty. So I think what happens is people are— they want this is the answer, this is the thing, this is the way. And I, and I understand that, um, it's not— maybe not realistic, right? Because it's— I don't think— I think everything's always changing and there's a lot of variables and we're all individual and there's a lot, but it's very hard when we just chase certainty and being unique. So it's not certainty like, this is the only way to work out. It's certainty for like, this is what's going on with me and this is what's going to work. That's what creates this confusion. And I don't disagree that marketing and social media and online, it just adds more confusion to all of that.

It cuts through uncertainty and gives you a guide that makes people more likely to act. So like if I tell people, hey, so Let me give an example. There is a woman doctor who tells women that they have to lift 4 sets of 6 reps.

I know, I've had her on my show. I know.

We don't know where this came from. It is made up. It's completely made up. There are actually a lot of studies looking at—

My concern is people can get injured if they don't—

Well, I mean, you need to build up to that, but there's nothing magical about that.

Yeah.

But it tells people exactly what to do, so people like that. That. Yeah, and that's great. The reality is, I mean, anywhere from 4 to maybe like 15 or 20 reps will do the same thing if we're looking at building muscle. Um, you know, as long as you're above— if we look at the research, as long as you're above 55% of your one rep max for whatever lift it is, or so in women, I mean, you're gonna, you're gonna do just fine. So the good news is that gives you choice. The bad news is choice causes some people to procrastinate.

Yeah, I used to post workout videos. I mean, all the time. That was like my— built my, my business initially on workouts years ago. And I— when Instagram first started, it was like workout videos and people would always say, how many reps? How many sets? And I used to say, it doesn't matter. Do what's challenging for you. But I realized that didn't work psychologically because people wanted the like, do this.

Yeah. Yeah. Giving people distinct recommendations usually makes them pay attention a little bit more because they think it's special. Totally. Have you heard of the McGill 3?

No.

So McGill was this really kind of famous spinal health guy, and he's kind of gotten a little bit derided because he did the same thing with like the 4x6, where like people started to point out your recommendations don't really make sense when you look at the research, but he kept doubling down on it as like this is the only answer. And, and so he's kind of moved out of the limelight, but he had this thing that is still super popular in powerlifter circles It's called the McGill 3, and if you follow these 3 prehab warm-up rehab exercises, like, you'll never have an injured spine.

Yeah.

And there was nothing magical about these exercises, but it made people focus on these 3 exercises, so it made them do something. And movement of the spine is good for the spine, so in practicality it kind of works.

Yeah, that makes sense.

But it's only because it made people do something. But he was promising people that these 3 exercises— he got super technical with the science But it was literally just like listening to a kid just make extra words on their 5,000-word essay. Essay. It didn't make any sense, but because he used so much jargon, people were like, okay, that makes sense. It's like all you got to do is say mitochondria. You know, we're doing mitochondrial efficiency. That's a big thing these days. If somebody says mitochondrial efficiency, we're usually kind of getting into like, is this a relevant territory or are we just saying mitochondrial efficiency? But he did the same thing with, with, uh, with rehab, prehab exercises, and people were like, yeah, it works really well. And I was like, well, what were you doing before? Oh, nothing, because I was in so much pain. I'm like, so you went from doing nothing to actually moving, and you did the movement which made you feel better about moving? Yeah. Oh, okay. You know, so we find this a lot, and you just have to be careful about this because 4x6 may be a great recommendation for person A, but maybe a shitty recommendation for person B. And if person B learns 4x6 is the only thing that works, then you have now just created a barrier that does not allow them to improve themselves. They get frustrated and they quit. And so it's a very, very difficult thing to put out erroneous information like that because what you're doing is you're creating barriers to entry for people to actually improve themselves.

Makes sense. Well, Dr. Alan Bacon, this has been fascinating. I feel like I could talk to you for hours. I'm— I like hearing your perspective on everything. Y'all follow him on Instagram. I'll put all this in the show notes because I, I do love how he brings up topics and just helps shift perspective and helps us look at all things. I do think we should all be very open-minded and not have a fixed mindset when we're taking something on. I'm— you have to do what feels right to you, but learn all sides and listen to that. Where else can people find you besides Instagram?

You can head over to my website at mauiathletics.com. M-A-U-I. All of the links to my social media are on the bottom. You can check out my blog. Book. A lot of good free information there for you.

Thank you so much. Thank you.

Thank you, Natalie. Appreciate it.