Ditch PMS, with Dr. Tabatha Barber @fasttofaith

Welcome to the Five Journeys podcast. Live like youe Matter. Dr. Tabitha Barber is triple board certified in obstetrics and gynecology, menopause and functional medicine and is licensed to practice in over half the country. She's the host of the Gutsy Gynecologist show where she shares her wisdom and knowledge with women everywhere to reclaim their health. She's also a keynote speaker, mentor, wife, mom, and grandma.

Holy moly.

I'm so excited to have you here. And I can't believe you're a gram.

I know. It's like the best thing ever. I promise you it's better than having your own kids because you get to.

Spoil, especially when they get grumpy. You're like, you can have it back, you know? Yeah, exactly.

It's so good.

So welcome to the show. We're going to talk about hormones today because lots of people struggle with them. Yeah.

I feel like I have to just say one word because I have two. I'm between two gynecologists, so I'm just gonna say my two words now and then I'll just. Just let you guys go back and forth like any good husband A little bit.

Wait, I apologize. There's two words that said I apologize. Or you're right. There's the two words.

Right. Perfect. You gotta be used to this. You're married to a gynecologist. Come on.

I. I am, but she's wonderful.

Oh, please. Our 15 year old loves to talk about how I gave them sex ed when we were out at a restaurant. And because for me, sex ed is like just sort of the color of water and the way you breathe. I don't remember it. I'm like, I don't remember doing that. She's like, everyone was looking at us. And I'm like, you always say that.

It's a Russian couple apparently looking at us. Oh, yeah.

I see vagina at the dinner table and people are like, what are you doing? I'm like, I don't know. To me, that's just normal, you know? What's the difference?

It's a vagina, right?

Exactly. It's like looking in an ear.

Yeah. People, when they ask me to look in the ear, I'm like, you know that's the wrong cavity. Right? I'm like, south of the border.

He looks so uncomfortable right now.

I love it.

No, no.

I mean, he usually.

I'm not.

Kids. How many of our kids did you deliver?

I delivered three of our kids and I've delivered about 35 or 50 babies.

That's awesome.

We're, like, a significant portion of that. Yeah.

So no problems here.

All right, so let's dive in. So when we talk about hormones, how would you. I mean, everyone always says, oh, my hormones are off, or, oh, my thyroid's off. How do you define it? And which ones are you talking about? Like, let's get on the same page.

Yeah. I think these are all really good questions, and I think a lot of women don't realize that hormones could be referring to a lot of other things and not just estrogen. You know, like, estrogen's the queen bee. Everybody thinks that's the main hormone in women. Hormones are also referring to your thyroid hormone that you're producing, your insulin that your pancreas is producing, like so many hormones, your stress hormone, cortisol. But the biggest thing that I want women to understand is that when your sex hormones are imbalanced, it's usually the result of something else going on somewhere else. It's not the cause of your issues, it's the result. And so it's usually issues with your gut, issue with too much toxic burden, issues with your adrenal glands, issues with your thyroid. Those in turn create dysfunction in your sex hormone production and lead to hormone imbalances. So what I see over and over in my practice is, you know, women coming to me because they're not, quote, unquote, on the right sex hormone medication. Right. They're not on the right hormone replacement, the right bioidenticals, and it's because they're not taking care of the other systems. They're just trying to keep their sex hormones balanced. And you can't do that if you're not fixing the root cause of the issues. So it's kind of like you're constantly chasing this lab value and these different levels of hormones when you haven't really addressed the root cause of the issue.

I always love to say to my patients, if a lion's chasing you, you're not going to want to have sex. It's a bigger problem. We need to address that. You know, your adrenals are going to run the show, especially at our age. Not that you look it, or I don't think I look it, but at our age, that the adrenals are really taking over a lot of the work on hormone balance. And so if your adrenals are stressed, they're not going down that sex pathway, they're going down stress. So you sort of, by definition, have a hormone issue because your adrenals are upset.

Exactly. And every day I hear, well, you know, I'm just like everybody else. So because we all are overstressed and that is our quote unquote norm, people think that it's okay and that our bodies should be able to handle it. And I say, like, even if you're handling it mentally, that doesn't mean your body is handling it physically. It does not. Like going from dusk until dawn the minute you wake up, being just mindless and go, go, go. That is way too much, you know, on your sex hormones. You're constantly pumping out cortisol and adrenaline to handle taking care of your kids, making your deadlines, reading emails that are stressful, or even over exercising. Like, I get people working out, trying to train for marathons and all this heavy duty exercise and you're just pumping out cortisol non stop. Like you mentioned, you're stealing your progesterone, you're stealing your body's ability to make your sex hormones. And so it's very common for women to be imbalanced. And I'm sure you would agree, like when we went to medical school back in the day, this kind of stuff wasn't talked about, right?

No, no, we never talked about it.

I don't think it's talked about now. Let's level the playing field a little bit. It's not talked about now. I mean, the other point I think to add to what you're saying is I think part of the issue is, yes, what's going on today. But even if people have an amazing lifestyle today, it's the accumulated 40 years of past abuse that has caught up. They could be meditating 24, 7, but if the last 40 years was they were working 14, 16 hours a day or whatever else, then you have to address that. Oh my God, you have to rebalance that.

I couldn't agree more. I think that's a super important point, that it's the accumulative effect. It's really not what you did yesterday or last week. It's what you've been doing for years to lead you down this dysfunctional pathway. I see that all the time as well. It's like I did all the stuff, I took care of the kids, I got a successful business, I've been going hardcore non stop and now all of a sudden I can't function. It's because your body will allow it and keep up with you for so long. It will beg, borrow and steal from all of your other systems to stay in balance. But then you reach that breaking point of like, you're Just depleted. You got no. No iron left. You got no B vitamins left. Your gut is a hot mess, and your brain will reach its breaking point and say, enough is enough. We're not going to do this anymore. We're not going to keep pumping out cortisol. I'm going to downregulate these systems, and we're going to get back into restoration mode. Right? And we have to listen to that. That's where we're falling short, is we're not listening to what our body needs.

Well, what are some of the common symptoms that people will show when they've gone off the cliff, when they've asked too much of their body, when they've really gotten too far? What do they see?

So the pattern I see over and over with women is it starts with bad pms, Bad PMS leads to heavy periods, heavy periods and breast tenderness. And then they're more irritable, and then they're fighting with their spouse, and then they have no libido. And you get into this pattern that goes on and on, and eventually you start to feel fatigued and you don't have any drive for life. You don't want to get up in the morning and do anything. And I. And I have a lot of women who get to the point where they're like, I just don't want to get out of bed. I have no interest in my husband. I could care less about my job anymore. Like, I'm just not happy, and I don't know what's wrong with me. I'm doing everything I've done, and, you know, it's no longer working. And that is your body, like, finally reaching its breaking point. So the problem with conventional medicine is that we don't teach patients to listen to all of those symptoms as warning signs from your body. That woman's body has been screaming at her for, like, two or three years. Probably those heavy periods are your body's way of saying you have too much estrogen, you don't have enough progesterone, you're making too much stress hormone, your gut is a mess. And if we could say stop and help patients listen and get in tune with those and treat symptoms as messages instead of annoyances to be covered up, then we can finally make some headway and not get to the point where, you know, we're dealing with chronic fatigue and autoimmune conditions and all of these chronic ailments that really don't need to happen. Wouldn't you agree?

Right.

Yeah, 100%.

I want to actually, I thousand percent agree with you. And we talk about, I know in our practice we talk about listening to your body and listening to the signals. I want to back up one step though, to even get more basic than that, which is people believe that PMS is normal, it's a Motrin deficiency, ibuprofen deficiency, that having heavy periods is fine. That's just how life goes.

Well, their friends all had it and their family.

So I want to really get to the basic what is actually normal, what is common? And maybe then we'll talk about optimal. So what's common? What you're talking about is what's common and what we see in the world. And then there's like the. What are we human beings built that we can actually optimize our health?

This is so important for women to understand. Yeah, so important. Like just because we're all experiencing it doesn't mean it's normal. It's not normal to have heavy periods, painful periods, calling into work or not going to school or college because of your period. We're supposed to be able to live in harmony. We should probably have a couple days where we're a little more low key on the energy because we are physically bleeding and you know, losing some iron. But it shouldn't be wiping us out. It shouldn't be changing who we are as a person and our ability to function. Those are signs that you have hormone imbalance. I like to explain to women like when you're riding an estrogen roller coaster of extremes with estrogen imbalance, imagine dropping from a one story building. It hurts, but it's not as bad as dropping from a 10 story building. So when you go from extremely high estrogen, it drops really low right before your period. That huge drop feels terrible. It feels like PMS irritability, breast tender, all these terrible feelings. If you're on a smoother curve and you don't have such a significant shift in the levels of your estrogen if they're in the optimal range and then they drop so that you can shed that lining for your period, that just feels, oh okay, that's a little different. But life's not like being interrupted or anything like that. That's normal. That's what we should be feeling. And we've unfortunately in this country gotten to a point where we just think periods are a nuisance. We don't need to have them, anything to do with them. You know, I was trained, just remove the offending organ. You know, if it's bleeding too much, you burn it or you remove it. And that is just such an archaic way to think about it when really our body's just saying, help me please figure out what's going on and. And let's get back into balance. So to your point, Ed, we have to teach, especially young girls, we have to teach women to embrace the idea of using your menstrual cycle as your vital sign, as a gauge of how healthy you really are, and not something to, you know, just be ignored and push under the rug. So I would love for women to embrace the idea of, hey, I get to have my period every month. I get to know what my body's doing, and I get to know if I'm in balance or if I need to fine tune some things. Because you can go so much farther that way. Right?

Well, it's so upsetting for women when you take it on the flip side that when women don't get their periods every month and the system is dysfunctional, it's only at that point that women recognize, oh, my goodness, it actually really worked to cycle. And when I'm not cycling, it's not right.

Yeah, we see this all the time. We put our young girls on birth control pills the minute they have any symptoms related to their periods, right? If they have some spotting, if they miss a period, if it's painful, if they have pms, if they have acne, give them the birth control pill, and then they're on it for like 10 to 20 years for a lot of women. You know? And now what we're starting to see is women try to come off of that pill, and their brain and ovaries aren't communicating because you have been taking synthetic hormones all of these years. So your brain and ovaries aren't even talking. There's no production of your own hormones. And so when you stop these synthetic hormones, you expect your brain and ovaries just to start communicating again. And that does not always happen. That communication doesn't come back online. And it's only then that people are like, oh, well, my period's important. My period is a problem. Let's take care of this. And I would love for women to understand that I don't want you to wait until you're infertile or have fertility issues. I want you to be on the birth control pill only if you need it for birth control and that you've ruled out any better option and that you know what you're signing up for. Because here's the thing. We do not give full informed consent when we give people Birth control pills. I know myself. I was on it starting age 15. If I would have known that it was going to cause chronic leaky gut issues and gut dysbiosis and vitamin and mineral deficiencies and be part of the development of my Hashimoto's autoimmune condition, I might not have signed up for that birth control pill for 20 years. But nobody told me that. And I get it. We didn't know that then, but we know that now. And so women need to know what they're signing up for. And I'm all for birth control, right? Like I'm a high school dropout who had a baby. That's how I got through medical school without having another baby, is I used birth control. But I would have liked to have known what I was signing up for because maybe I would have paid attention to my gut health. Maybe I would have tried a different birth control option. You know, so many things. And I just think that we treat this medication, these synthetic hormones, like it's a sugar pill, like it's no big deal. We just hand it out like candy. And we need to stop that. We need to actually look at the long term consequences of what we're doing to women's health.

I would totally agree with that.

I mean, just for, I think for more context, let's talk about where, where the estrogen comes from. The synthetic estrogen. A lot of it is Premarin, which is pregnant mare's urine, which is. If you're a horse and you're pregnant, that's a good thing. If you're not a horse, we got to be careful. Long term, using horse hormones is probably not the best idea.

But let's take a step back. So we've covered women of reproductive age and the birth control pill. But Lynn, there's a whole host of trans transitional things that occur for women when they're going from reproductive years to perimenopausal years to postmenopausal years, when your hormones are imbalanced in those years. Because there's certainly the PMS and the mood dysfunction and the breast tenderness and the heavy periods. But as you're transitioning out of that, what are the things women notice then?

Oh, my goodness.

What happens at that in the Perian post?

Yeah, that's a great.

How long do we have?

Right.

Yeah.

And perimenopause can be a couple years. It can be 10 years, it can be 15. It. It's really just saying that you are at a time where your cycle is not balanced and optimized you're not ovulating consistently every month. And so we kind of call that the perimenopausal years, the years before and leading up to when you stop cycling and making reproductive level hormones. So I actually came into practice after whi study came out and I inherited a practice of many older women. So the gentleman I replace who retired, he was 74 when he retired. And so almost my Entire practice was 50 and north of 50 and so many women on these hormones. So I inherited this practice of 80 year olds on their hormones. And this study comes out and says everybody has to come off. And their primary care doctor, doctors all freaked out and took everybody off their hormones. And I had women come into me threatening me, like, you got to give me my hormones back. Life is hell. This is not fair. What is going on? I had women having strokes and heart attacks being taken off of their hormones abruptly. Like it was very eye opening for me. So I was seeing the opposite side of what this study was coming out saying and scaring everybody. The study came out and said, oh my gosh, you know, hormone replacement therapy is deadly and scary for everybody. It causes breast cancer, blood clot and stroke. It took us how many years, 10, 15 years to actually decipher that study and come to the conclusion and understanding that it had many flaws. The average age woman was 64, so she was already menopausal a decade or more when she was put on these hormones, hormones. And so she probably was already developing cardiovascular disease and diabetes. The hormones were synthetic. Like you said, they were made from horse urine, conjugated equine estrogen. That is not the hormone that our body makes. And of course our body reacts differently to it. The progestin arm in the Prempro group was a synthetic progestin. It's not the same as progesterone, our body's natural hormone. And so there is an increased risk of blood clots, stroke and cancer. And what we tried to do is lump it all together, meaning all hormones are bad. You know, and people, people got smart. Eventually people started realizing, like, if estrogen is so bad, why don't younger women have breast cancer and blood clots and all of these risks? Why is it menopausal women. So we wised up. We understood that there's a huge difference between these synthetic prescription hormones and bioident prescription hormones. And now we're finally the pendulum is swinging back to understanding that women do slow the aging process and keep their health longer when their hormones are above this negligible level. I don't necessarily agree that we need to be in a reproductive state of hormones, you know, until our 80s. But I do think there's benefit to being in, you know, a nice optimal state of maybe a perimen menopausal level. I like to see women kind of hang out around age 47 for a couple decades because honestly, if you looked the year 1900, the lifespan of a woman was 49. That means we didn't live past menopause, we didn't have to deal with being postmenopausal for decades. And now we're just in our prime at menopause. We are like just getting successful in our careers. Our kids are finally growing up and we can enjoy our husbands and our partners and like we're at the prime. Why would we want to go downhill at that point? Right. So I think it's very reasonable for women to say, yeah, let's just put the brakes on this aging process, but let's do it safely and understand what we're signing up for. And it's a totally individual decision. And I think that every woman deserves that informed consent, you know, to do that. Men would never put up with that crap. Right.

Men just get the testosterone. It's easier. Right. Way less complicated. Let's start there.

Yeah.

If you couldn't get the testosterone, the people in the House of Representatives, they'd be throwing a fit. You get your testosterone back the next day.

That is true. But I want to actually go back to what we were talking about before, which is in our society, it's normal to have hot flashes. It's normal not to sleep X, Y and Z. Like that's all normal. And when you look at nature based societies, women actually just stopped having periods and didn't have all these symptoms.

Yeah, perimenopause is not a thing. In Japan, women just stop.

Yes. That's why your wife's book is so important, because the environment.

We did it together.

Oh, you did it together. Oh my gosh, Doctor, I apologize. The book that you wrote together is so key because we did not see all these hormone imbalances 50 to 100 years ago. And it's because of these endocrine disruptors. It's because of the environmental toxic burden on our body. Our liver is so busy trying to handle all of the alcohol and all of the plastics and all of the pesticides and all of the crap that it's being exposed to all day long. It can't even metabolize our estrogen. It can't even do its basic job. And so you're right, there shouldn't be 10 or 15 years of crazy hormonal swings of perimenopause. I didn't learn about that in Medical School 20 years ago. It's because it wasn't common. But now everything's in plastic, right? Every food that we buy and purchase and make, it's all in plastic. Everything we drink is in plastic. And our body is just bombarded like it never has been before. And you add that with the chronic stress, you know, you get the leaky gut, and it's just this miserable imbalance.

Well, this is why I call the adrenals the liver and the gut, the medical holy trinity. Because the chronic stress will shut down the liver's ability to detox, and that will also shut down the gut's ability to do its job. And now you have the whole system shut down. And don't forget, your adrenals are what are producing your female hormones in menopause. So your adrenals are like, I'm busy, I'm busy. Don't ask me to do that. So you're not getting your testosterone and your estradiol because you're utilizing it in the cortisol like you call the cortisol steel. But let's talk about the liver a little bit more, Tabitha, because you referenced it just now. Like, what does the liver have to do with all this? Because women are thinking, well, why are we talking about the liver? I want to talk about my hormones. Talk about the liver, please.

Oh, my gosh. The liver is key. It's so important. And, you know, women need to understand that the liver takes something from its active fat soluble form to its inactive water soluble form once your body's done utilizing it so that it can be removed from your body. So your liver has a really important job of once you're done using your hormones of deactivating it and helping it remove. And your body, your liver needs certain vitamins and minerals to be able to do this process, which we just, you know, we don't have enough of. We don't eat a good enough diet, we don't absorb it in our gut. All kinds of issues. So estrogen dominance is a really big deal nowadays. And it's because of the reasons we mentioned. But it's also because your liver cannot not metabolize your estrogen out of its active form appropriately. So, you know, we have three major estrogens that go down these pathways after they've been used. We want it to go to the liver to be hydroxylated and methylated and sent to your stool and urine. But what's happening is your liver is so busy processing all the alcohol you drink because we've been in pandemic for two years and taking your Tylenol PM every night to sleep and all the food you've been heating up in your plastic, plastics, like your liver is busy doing all of that. And so the garbage never gets taken out. Your estrogens get backed up, they go down other pathways. And the most concerning pathway is one called 4 hydroxy that is actually damaging to our DNA and our cells and it can increase our risk of developing cancer. So it's really important for you to have those estrogen going to the liver and being appropriately detoxified because if that doesn't happen, they go down the other pathway. And so sometimes it's just you need more magnesium and B vitamins. You know, for me personally, I have a couple gene mutations. I have MTHFR and a COMT mutation. So I don't process my estrogens well. And what did that look like? That looked like me hemorrhaging through my pants one night at a girls night out because, because my estrogen was way too high, you know. And so I see this picture time and time again of women drinking two or three drinks a night to handle their stress. Right, I deserve it. I had a hard day, the kids are too much, this helps me fall asleep. And that is really taxing on your liver. And that contributes to this estrogen dominance picture. And so you add that with the stress like we talked about, you add that with the xenoestrogens and it's just a set up for disaster. And so what I noticed this is, you know, I've seen this time and time again is women, they're on the birth control pill a long time, they can't tolerate it anymore for whatever reason, it's usually gut issues. So they transition over to an IUD or an ablation to try and get rid of the heavy periods and the painful periods. If that doesn't work, they get the hysterectomy and then a few years later they're diagnosed with breast cancer and everybody's shaking their head. I don't know what the problem was. I was healthy, I didn't have any issues. You did have issues. You had estrogen dominance for over five years that nobody addressed. And now the result is, you know, breast cancer. And so we need to take a step back and say, are we actually doing women any service by burning their organs, removing their organs, handing Them, these medications that aren't really getting to the root of the problem? Or do we need to stop and learn how to test hormones, learn how to understand hormone imbalances? Because, as Wendy knows, gynecologists aren't hormone experts. Gynecologists are trained surgeons. Right. We spent four years learning how to cut and sew you up, how to deliver your baby, how to repair you after you tear and have an episiotomy, how to do procedures in the office for abnormal Pap smears. Like it was hands on. I was gonna do something with my hands, and I loved it. But that's not always the answer. The answer is actually, like, learning the endocrine system and like you said, how it's all interconnected and how our adrenals and our thyroid and our gut and everything are affecting what women are experiencing. And until gynecologists wake up and accept that fact and start to, you know, treat patients in a different way, we're not going to make any headway on breast cancer or any of that stuff.

Do you have any patient stories around estrogen dominance that might illustrate this for people so that they actually understand it, like, make it real?

Yeah. Well, you know that. That scenario that I mentioned of, like, going through all of the medicines, all of the procedures and still having issues. I have one patient. She did all. She didn't have a hysterectomy, but she had the ablation. She ended up with breast cancer a couple years later. And she went through surgery, radiation, and chemo because she had in her lymph nodes. She had big swollen lymphedema, arm. So she had a lot of issues afterward. But then her period came back and she was like, what's going on? I'm on tamoxifen, you know, and she was my friend and colleague because she was an obstetrics nurse, and I helped deliver babies with her. You know, she wasn't my patient. And she just mentioned this to me, and I was like, like, that's not okay. What did your oncologist say? And she said, oh, my oncologist isn't worried about it because I'm on tamoxifen, which is supposed to suppress your estrogen. And I said, it's obviously not being suppressed because your uterus is growing, aligning and bleeding. So I would love for you to actually do hormone testing to look at how your body is metabolizing your hormones, because if you check your blood work, it can give you some indication, you can get a level of how much hormone you produce. You can see your estradiol, estro and estriol, but it doesn't tell you what your body's doing with that. It doesn't tell you if it's going to the liver or if it's being turned into this 4 hydroxy that's more DNA damaging. So she did a Dutch test and her 4 hydroxy was 22%. So 11% is like the max of what you want to be producing. And I said to her, this, tamoxifen is not doing anything to manage what pathway you're sending your estrogen down. So even though your estrogen is low overall, it's still going down the wrong pathway. And that is enough to, you know, cause this growth of the endometrial lining. Because we need to understand estrogen's a growth hormone and we need progesterone to keep it in check because progesterone puts the brakes on that growth. And so she didn't have any progesterone in her system and she had the wrong estrogen. And so we had to really do some liver detoxification and get her liver functioning again. We had to heal her gut and do all of this other work for her tamoxifen to even work or do what, you know, that medication was supposed to do. And, and her oncologist was lovely and she was grateful that I helped her to learn and to understand the importance of this because it's very much just trained in us like, oh, you're on the medication, don't worry about it, you're fine. And not to stop and think about what's actually going on in the body physiologically. So that story sticks with me hardcore at. And I feel like she prevented recurrence because now she knows better and now she knows to love on her liver regularly and do all of that stuff, which is so important.

The thing I always love to talk about with people on that, Tabitha, is I always love to, excuse me, bring it back to the gut because I know we're going to talk about the gut. And I always like to say to people, you know, we do a lot of stool testing and it tests the beta glucuronidase. And I just love to say, look, this, this is putting you at risk for breast and uterine estrogen dependent cancers because let's sort of back into that. That beta glucuronidase in the gut is not helping you get rid of your hormones. In fact, it's helping you recycle toxic hormones. So can you talk about how the gut Relates to hormonal balance a little bit, because, I mean, I love beta glucuronidase, but you probably can tell a little bit more story on it.

Oh, that's why I call myself the gutsy gynecologist, because I truly believe it all begins in the gut. You cannot bal your hormones unless you balance your gut. Just like you said, there are bacteria that you do not want to have too much of that will make an enzyme that will cut the garbage tag off that your liver works so hard to put on there. You know, like I said, your liver is trying to get rid of those estrogens. It puts that garbage tag on and it goes to your stool, and those enzymes from that bacteria will cut it off and you'll reabsorb that estrogen. That's fine if you're menopausal and you want a little more estrogen and it's the right kind of estrogen. But most of the time where I see it is estrogen dominance, perimenopause. Women don't need to be recirculating that estrogen. They really do need to be getting it out of their system. One of my favorite bacteria, I suppose it's made from yeast species is Saccharomyces boulardae. So that's often in probiotics, and it will help bind and help get those toxins out and those used up estrogens and things like that. So I love women to be on a probiotic. You know, people say, oh, not everybody needs to be on it. But I believe in this day and age, we all need support for our gut. I just. I have yet to meet a person who doesn't. And so it really does matter what's living in your gut, what those bacteria are doing. Like you said, they make this enzyme. So I think for a lot of people, just knowing that is like. Like, wait, what? I thought, you know, they just digested our food. They do so much more. And without the right bacteria, we can't absorb the vitamins and minerals we need for your liver to do its job. We can't absorb the healthy fats to even make your hormones in the first place. Like, everything starts in the gut. It's so important.

And I feel like the most important thing for any. And I feel like we really ignore the men in this conversation. So let's include them in this, too, that if you get real, you go, when the women sit across the desk from you or on the other end of the phone and they say, I eat really well, I'm Actually finally sleeping. But I'm not losing any weight because this is where. What do women care about? Their hair, their gut? Only because it's fat and because their skin.

Right.

So your hair, skin, nails. And if they're not balanced, if your gut's not balanced, if your liver's not balanced and your hormones aren't balanced, you won't be able to be at your weight that you expect to be. That, I think is really. Because what's happening, if you have inappropriate beta glucuronidase in your gut and you're going back and recycling toxic hormones, your liver, your already poor, overloaded liver is like, can't cope with that. Let's store you in the fat. So now all these women are walking around with extra fat, and it's not the best fat. It's angry and it's inflammatory fat. So I think when we tie it back to what does that look like on the ground, it means you're not losing your weight, which I think really gets women's attention. Like, if you can't lose weight, we're talking to you. It's a hormone, toxins, fat issue.

Yeah, I hope everybody heard that, because you really do need to get the gut balanced in order to lose weight. I see that all the time with weight loss resistance or weight regain, you know, it is so much more than calories in, calories out. It has to do with inflammation in your body at the cellular level, your cells being able to do their job. What I see a lot of is women have this chronic gut dysbiosis. They got the wrong bacteria living in there. And they have leaky gut because they're chronically pumping out cortisol from their stress. They're on synthetic hormones. They're taking NSAIDs for their PA periods, like Motrin and ibuprofen, that kind of stuff. And so, you know, they're developing food sensitivities. Their immune system's reacting to everything that it's seeing. It's not supposed to be seeing, all this undigested proteins and different things. And our immune system's reacting. It's trying to protect us. Right. Like, our body is always trying to do what's right for you. It might not be what you want, but. But your immune system's reacting because it's coming in contact with things from the leaky gut that it shouldn't. It's putting antibody tags on stuff that it shouldn't. And now you're reacting to stuff that isn't inflammatory in and of itself. You got people Reacting to broccoli and almonds and Brussels sprouts, you should be able to eat that food. But because your immune system is pissed off and confused, it's reacting to everything it's seeing. And so you have to. I tell women, you have to heal that gut. You have to remove those triggers that are confusing your immune system and angering it. And once that all happens, your immune system will calm down. Those antibodies will almost always go away. You can reintroduce those foods. That's not a lifelong sentence of, oh, my gosh, I can never eat broccoli again. Right. And so. So I feel like patients piecemeal things together, and so they get frustrated because stuff doesn't work. You know, they say, oh, I did food sensitivity, that didn't work. I did a gut regimen that didn't work. I did a thyroid thing that didn't work. It might be because you're not doing it in the correct order or simultaneously in the right way, because it really does matter that we, like I said, heal the gut while calming the immune system, helping it forget it was angry, and then trying to reintroduce stuff. And if you're going to try and get your systems balanced without doing that first, it's just not going to work.

Right, Right. So do people have to have a functional medicine doctor or gynecologist? Or are there tests that people can ask their doctors, their gynecologist to do to check their hormones? That's meaningful? Because I usually say to people, if your cycles are regular, it's probably going to be within normal range.

Right.

It's pretty rare that it's out of range. Unless you're where I am, which is just about done with the system, done with menopause, or completing the process, or if you're at the very beginning and it's still dysfunctional. So what are the things that people can ask their gynecologist to check that might be meaningful?

Oh, my goodness. So I always say that this, you know, with a caveat of if you have your conventional gynecologist check hormone levels in labs for you, they might not interpret it the same way that a functional practitioner interprets things. And so you have to be careful when they tell you everything's good, you're fine, because they're looking for disease. They're looking for a diagnosis that they can attach an ICD10 code that insurance is going to cover and that a medication is going to, you know, work for. That's not what we're looking for. Usually we're Looking for imbalances. And when it comes to testing hormones, it does matter what day of your cycle you're on and what your cycle is doing. So if it's really irregular, then it's going to be a little more complicated to interpret those levels. So I really encourage women to find somebody who understands all of that. Because if you go to your standard conventional gynecologist, they'll probably check estrogen on whatever day in an FSH level. And if they're not at one extreme or the other, they're gonna tell you you're fine. And that's gonna give you a false sense of security, like everything's okay. You know, we see that all the time. Hemoglobin A1C is my favorite example. Right. That's a three month average of what our blood sugar's doing. Conventional medicine will do it. If you have diabetes, then it's paid for by insurance. That's when they will check it. I like to check it before you get that diagnosis. I want to know how you're trending. So if we do an A1C and it's 5.6, your conventional doctor will tell you you're good, I'll see you next year. That's the standard.

You don't have diabetes yet, Right?

They might not even say that part.

You don't even Pre diabetes at 5.6.

Really?

Only 5.7 is pre diabetic.

5.7 is pre diabetes. So next year you're 5.7. Oh, yeah. You're pre diabetic, but you don't need any medication. Just watch what you're eating. I'll see you in a year. Whereas as a functional practitioner, I see 555 6. And I'm like, let's evaluate what's your fasting insulin doing? How is your stress hormone throughout the day? What can we do to get you off this path toward diabetes and puts you on the path going the other direction? So it's very much of how you're interpreting and evaluating these results. It's not so black and white. I don't want to wait for my patient to have outright disease. That is not how you'll ever feel well and get optimal. That's just how you're going to manage that disease. It's a totally different way of looking at it. So I encourage women find a functional practitioner. They're out there. They really are.

Definitely.

Before we kind of wait, I have to say something.

Yeah, go ahead.

I can't go away without saying that what you've just highlighted that I really think all listeners need to take to heart is whether you're pre something or you've got something, it's reversible, right? You can get onto an off ramp that will change the trajectory of your illness and either resolve it, remove it it, or decrease it so it's not there anymore. Last week was Hashimoto's Resolution Week. I had two patients who went from positive antibodies to negative. And I said to them, if I looked at you now, I wouldn't have called you Hashimoto's. So if you're listening, disease resolution is possible with the functional approach. Because you said that. And I just can't stop without highlighting that because it's so near and dear to my heart. Thank you for letting me interrupt. I'm so glad you said that.

I mean, I'm a living example. I had raging Hashimoto's. You know, my TPO antibody was over 900, so they didn't even tell me a number. It just says greater than 900. And I was on Synthroid.

Stop measuring.

Yeah, we don't measure that high. I was on Synthroid. I was miserable. And today I don't have measurable TPO antibody levels. I don't take thyroid medication. I have decent hair. My weight is stable, so that stuff is reversible. I didn't have to end up with a hysterectomy. I got control of my heavy periods. I reversed my estrogen dominance. Like, that is such an important point. But you have to do it. You have to take control. Doctors cannot heal you. Like, I'm sorry, but we can't. We can guide you, but we cannot heal you. That's the truth.

Amen to that. All right, Ed, back to that.

That actually is a perfect segue to what I was going to ask is you pick. You can either pick or both if you want. What? I like that top. Besides seeing a functional medicine doctor, because obviously that is. Well, according to all of us, that's the best, but that's not always accessible to people. What are the top three things people can do in terms of either food or lifestyle? Whether you're menstruating or you're in perimenopause? What are the things that. What are the top three things that you would say just for people to. To start even thinking about?

Oh, my gosh, you're right. Most people don't need a functional practitioner. I mean, I don't want to say that because I want to keep a job. Right. But honestly, there is so much that basic stuff that we're not doing that we could be doing and that is seriously cleaning up the diet. We have to stop eating this standard American diet out of boxes and bags. If it didn't look like it grew out of the ground or came from a mother, don't eat it. It needs to be in its natur form. You need to eat your vegetables every day. You need to eat the rainbow, you need to get your clean, lean proteins in. That is key. Stop eating from the middle of the grocery store. I only shop from the periphery, you know, nothing out of the boxes and bags. For women, you have to quit drinking so much alcohol. Like literally our bodies were not made to process more than one to two drinks max. And if you're drinking every day like that one drink, like have your glass of wine if that's your thing. But more than that, you're actually adding to the problem. And there's better ways to de stress. We can talk about that. That's a major thing. And then really understanding that you are in control of your thoughts and your thoughts are in control of your physiology. So if you can reel in all this mindless activity that you're doing all day long and actually stop and deep breathe and process and accept your body and love your body and give it some self care, set some boundaries on your time and on your energy. Like I, I try to schedule my energy more than anything because I only have so much energy and if it's negative energy, I don't have time for it. So that to me is like the biggest thing women can do. You can clean up your diet, you can decrease the alcohol, but until you start to set boundaries and be more mindful through your day and get in that parasympathetic mode of rest and digest, you're always going to be chasing disease in my book.

Well, we most certainly appreciate your time and your energy. So thank you. Thank you.

Yeah, yeah. Thank you so much.

So you're listening to Dr. Tabitha Barber. Where can people find you? What do you want to promote? And we'll make sure everything is in the show notes.

Oh yeah. So go to Instagram or TikTok. Now I'm doing TikTok because I'm crazy at the gutsy gynecologist. My website, Dr. Tabitha T A B A, T H A. It's all A's, no eyes. And I have an awesome email book. It's the gutsy gynecologist's guide to balancing your hormones. So it goes in a little more depth of the gut, the adrenals, the brain, all of the stuff we talked about, the liver. So check that out. It's a great resource.

Awesome.

It's amazing.

Thanks for listening to another episode of the Five Journeys podcast live. Like youe Matter. Dr. Tabitha Barber was our guest today, and we've been so privileged to have you on. Thank you.

You. Thank you.