Hormones for Healthy Aging, with Dr. Daved Rosensweet

What percentage of women who are in nursing homes are there because of hormone deficiencies at 80, sarcopenia, cognitive decline, loss of bladder control, osteoporosis, hip fracture. That's why they're there.

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Hello and welcome to the Five Journeys Feel Freaking Amazing podcast. I'm Dr. Wendy Trubo and we have an amazing guest today. I say that all the time, but we really do. Our guest today is Dr. David Rosensweet and he is the founder of the Institute of Bioidentical Medicine and the Menopause method with over 30 years of experience specializing in andropause and menopause treatment. Currently he spends the majority of his time training medical practitioners to specialize in menopause and andropause medicine using his organic and solvent free methods. David, welcome. We're so happy to have you here today. I know I'm speaking the royal we.

But thank you very much.

Wendy, it's good to have you here. My partner can't be here. He was here earlier. So it's like a rare animal in the sighting in the wild sighting. But he's not here with us today, so it'll just be you, me. So tell me, are you in the camp that all women should take hormones? Are you in the camp that women should only take hormones as needed? Like what camp do you fall in around hormones?

Well, you, you know, we can't. The words all. It's a funny word.

Always and never, right? I say to my kids, always and never never happened.

However, I'd say every human being, male and female, if you want to live strong and live long and avoid nursing homes and assisted living facilities and be happy and even be sex your 80s and 90s, well, let me just not even qualify it. I say yes. The kind to live, the kind of life that you're going to want to live, you're going to replenishing these hormones is the optimal way to go. Are there exceptions? I don't know. I haven't met up one, but I can't. I, I can imagine a couple of scenarios, but I say everybody, the science is that women who are treated with hormones are at less risk for breast cancer. Heart attack and stroke than women who are not. Women who've had breast cancer and really in dire straits because they've been often thrown into a menopause that is really intense. You're at less risk of recurrence if you're treated with hormones than if you are not. I think that's the main myth I love to dispel and to help antidote the poison. And the same poison has touched the medical world for men, although it's not as strong a poison as the WHI damage.

Yeah, I mean, I would say someone who had nasty, aggressive, estrogen receptor, progesterone receptor positive cancer, then maybe I wouldn't give it to them. But we also had Heather Sanderson on those podcasts who talks a lot about reversing Alzheimer's. And hormones is a major pathway for dementia, brain related dysfunction. And so when you talk about hormones, if you're looking to have your brain work, hormones are a huge category. So that you need to not step over. So, you know, I'm in your camp, actually, I think we're on the same page.

Even that one. I love that topic because people didn't have fear of hormones and fear of cancer, breast cancer, when I was growing up in medicine. And then along comes the WHI in 2002 and there's this explosion of false information where I had already been practicing treating women. And I dived into that information as well. And this is my current conclusion based on a lot of communications with world experts on breast cancer and hormones, like Auburn Blooming, for example. And is it all right if I say what my own particular view is, please? We're all at risk for thousands of diagnoses, a lot of them not good. And we're all at risk for hundreds of cancers. And as a male, I have an increased relative risk for prostate cancer. And that's newer and there's reasons for that. And women have an increased risk, relative risk for breast cancer. It's very prevalent cancer. But given that we're all at risk, women who are on hormones treated with hormones are at less risk for breast cancer, heart attack and stroke than women who are not treated with hormones. And this is the big one, this is why I wanted to address it. Women that have had breast cancer and have had that breast cancer properly treated have an increased relative risk of recurrence than a woman who's never had breast cancer. But if that woman has had that breast cancer properly treated, she has less risk for recurrence, less if she's treated with hormones, and if she's not. That's the science. Now, what about positive receptor sites? Best information I have. It's not relevant. Oh, no, it's got to be relevant. No, it doesn't have to be relevant. And the world expert on this is Alvaren Blooming. And how he sees it is. Well, I heard it this morning on a podcast that every single cell in the body has estrogen receptor sites in a woman's body, head to toe and auburn. Blooming described it to me once that he said, when you remove a breast cancer surgically and you look at the tumor, there's all kinds of cells in there, and some of them are very primitive, out of control. Pathologists can't even recognize that they came from the breast. But some of them are very normal looking. There's all kinds of degrees of differentiation taking place in any given tumor, in any given biopsy sample, and you're going to get positive receptor sites. But they're not the cells that are giving you the trouble. It's the undifferentiated cells that don't respond to anything. They're the ones in a tumor that are giving you the trouble. So, yes, people are concerned about positive receptor sites. Well, he is the only physician I know, and he's an oncologist who specialized in breast cancer. And he was treating women who had breast cancer with hormones for decades before the 2002 WHI. And he said, you can't tell. There is no, no one can substantiate that there's an increased risk from estrogen positive receptor sites than there is not.

Yeah, I mean, that wasn't in the who. I mean, the who. I was a resident when that came out. So we spent hours dissecting that study. And, you know, the, the, this was 2002. Women who got estrogen looked like they were at an increased risk of cancer, but it was all synthetic. You couldn't participate if you had symptoms. There were a lot of flaws in the study, and it sits, Ben Stone, like this. A crappy study. Even though it was big, it was a crappy study. So, okay, so let's, let's sort of go, okay, let's set the WHI to the side and talk to me about what? I mean, you know, if you're a listener, I'm assuming that my listeners are going, okay, if you're postmenopausal, why would they want to do this? You know, obviously women don't walk in and say, protect my bones, protect my brains, protect my colon, protect my heart. They say it's not working. Fix me or I'm having hot flashes or my vagina is like sandpaper. Like they're really, they're experiencing the downsides and often in their early 40s. But so what are you telling these women? What are the risks? What are the benefits?

Well, the risks are, I would say they're almost. There's almost a near certainty that if women don't replenish hormones and men don't replenish hormones, and that's whether you have symptoms or not, there's going to be some long term consequences for many that as physicians, we get to see people in all decades of life. Someone in their 40s isn't necessarily medically familiar with people in their 80s and 90s, but we were given heads up about this in our training. What happens to these older folks is. I'm not even talking about the acute symptoms is they lose their muscles, sarcopenia, they move from canes to walkers to wheelchairs. That's a defining moment for folks. It's tough to be taken care of at home. And they get incontinence, they get recurrent bladder infections. As you mentioned, so many women have cognitive decline dementia. I'm mentioning that there's these long term things that people don't see. As the gerontologist taught us in medical school, he said, here's what's really happening to old people. They're losing their muscles, they can't stand and walk with stability. They fall on their osteoporotic bones and in those days they died. Now they get to live another year. But the short term stuff is so significant. You've got a woman midlife, she's at the pinnacle of her experience, her knowledge, her wisdom. And when your mind isn't working and you're waking up in the middle of the night and you're not sleeping, you know this so well, Wendy, I'm not talking to you about this. You know this and you can't go back to sleep and you lose three nights sleep. Anyone lost three nights sleep lately? How's that going for you?

No, it's terrible. It's terrible. I mean, I'm postmenopausal and before I was treated I was like, oh, this is not going to end well for anyone, really. It's going to be ugly.

And then you named it. I don't know if I have anything to add. You name the big ones.

What about the risks of being treated? If you're treating a woman and you're saying, okay, look, here's the benefits, here's the risks what are you telling her? The risks?

I see only one risk. How about this? You're going to love this. There's a couple. There's a couple. Really? One possible risk is if you don't get skilled treatment and a woman is giving too much estrogen, she is at risk for breast glandular cell proliferation, thus increasing breast density. This is an unhealthy breast. This is a more vulnerable breast. That can happen.

Can we pause there, David? So if a woman has that, would she know? Would she say, okay, my breasts are getting bigger, they're sensitive, my nipples don't feel good. Are she going to notice symptoms or is this something happening behind the scenes?

Well, a lot of women are going to feel it. They're going to feel breast tenderness. And the method we teach, we call it a no breast tenderness method. That you can get breast tenderness in the beginning and it can easily go away. And there's ways to address breast tenderness. But if a woman has breast tenderness and breast fullness, one possibility, not all possibilities, is that she's developing increased proliferation of breast glandular cells. That's not an absolute risk. Cancer has so many complex causes, but it's one of the known risk factors for the breast not being healthy, even getting into cancerous changes. So we don't want to over treat women. We don't want to produce breast glandular cell proliferation in a midlife woman. But good medicine is not going to do that.

What are you giving them just to go down the rabbit hole? What are you giving them to change their breast density?

Iodine is the vanguard of it.

Are you painting? I remember reading a protocol that was like IV, I think it was IVB 12 and painting the vagina with povidone. And I was like, oh, I'm not doing that. I can't cope with that.

It wasn't that. It was. I know. You know about Myers Cocktail. Well, John Myers had a lot of different things that he was great at. And he used to hold seminars for physicians. And prior to the seminar for physicians, he'd say, listen, if anyone, you've got a woman who's got fibrocystic breast pain, invite her to the seminar. And what he did is he lined these women up on the stage, draped them so the audience couldn't see the pelvic exam he was about to do. Painted the cervix with iodine, not povidone. He used pure iodine, not iodide, but iodine. By the end of the lecture, the women who started out that lecture with breast pain, the breast pain Was gone pretty dramatic.

Can give it orally Iodorol or some other fork. Yes.

We're not painting anyone's cervix these days. Yes, Iodorol is great. Lugal's works. I'm a big fan of David Brownstein, who's one of the world's. He's at the top of the mountain for knowledge about iodine. So he has a product. So we like David Brownstein's product, but he worked with Dr. Abraham, who invented Iodorol. So they're just about identical and more robust dosages than people are used to giving, which is. Which is an art because when you give 25 milligrams of iodine, for example, I dose, that's a high dose. But when you reduce someone's fibrocystic breast disease and you get a negative thermogram, prior to that, you had a positive thermogram. Like in our training program. I list serial thermograms of a woman who had breast pain and heat showing up on the thermogram, which is a sign of inflammation in her breasts. And she had breast pain. Then we gave her iodine. And then over time, the redness on the thermogram disappears and her pain went away. You have to monitor the thyroid very carefully, and you have to understand thyroid. If you see an elevation in the tsh, don't freak out. You're going to see an elevation of tsh. Rather dramatic, more than we're usually used to. But if you ask the woman patient who's on iodine of that dose, well, how do you feel? Well, I feel good. That's not true of a true hypothyroid. They do not feel good. And then if you do that, if you're also doing a free T3 and free T4, you're going to see a normal free T3 and free T4. Because iodine to be taken up by glands, glands love iodine. Thyroid gland loves iodine. Breasts, glands love iodine. But to get the iodine from circulation into the cells of the glands, you need something called an iodine symporter in order to do that. The pituitary participates in that by elevating the tsh, which will elevate the symporter, which will get the iodine into the glands. So you see this temporary elevation of the tsh, you just check in with your patient. You keep monitoring the patient. But to really reduce and eliminate increased breast glandular cell proliferation is a miracle.

That's very cool. I literally haven't done the protocol. But I remember reading it and thinking, that's a really cool protocol. Are you doing anything to help women process their estrogen properly so that they can excrete it so they don't recycle more toxic forms of estrogen? Is that anything you focus on?

Well, you're bringing up something that definitely occurs and you've obviously been doing this work and it is an issue. I don't find it in my patient demographic. I don't find it as commonly as we might suspect. And we will always see it in that 24 hour urine hormone test. But if you've got unexplainable estrogen dominance, you got to investigate where's all this extra estrogen coming from? And is it coming from the gut and a dysbiosis? And if the gut is in trouble, how's the liver doing? And is the liver having trouble? And if the liver is having trouble, as midlife livers are not youthful livers, there's a lot of water under the bridge there. So there are times when part of the process is you start identifying that there's metabolic processes that are problematic here. And the women are not processing, they're not biochemically changing the parent hormones into the metabolites. So why not liver and gut?

That's the holy triad. Adrenals, liver, gut. To me, that's holy triad. Okay.

And so sometimes we refer people out and say, we got some liver and gut repair to do.

Yeah. You know, it's funny because if I do hormones on my patients, I'm saying that we gotta fix your gut and we gotta, we gotta have your adrenals liver, gut be optimized, otherwise you're, you're dead in the water. Like, we, we really have to do these simultaneously. We can't do them one at a time, otherwise you just won't get well. So I realized we spent most of the time talking about women. You also treat men, right?

Yeah, definitely.

Can we spend a few minutes talking about how would men know that they're, that they're hormones are off? You know, we always talk, there's a lot of talk about women, but men get low testosterone and it's deadly for them. So how would they even know that they've got an issue?

We didn't know, nobody knew until this magic blue pill came out called Viagra. And explosively overnight, it became a super popular drug. And what did we learn? That there was a tremendous number of men out there with erectile dysfunction who were not talking about it. So the same process goes on that happens with women, you know, at the age 20, the ovarian hormone levels at the absolute maximum they're ever going to be plus or minus a couple years. And then they gradually decline until age 95. They always decline. And then there's a precipitous event that takes place around menopause men, same thing. Now, some go slower, some go faster, but the, the rule of thumb is a man really knows it. Just like women. Hot flashes, can't sleep, cognitive dysfunction in women, erectile dysfunction. They know it when this is not working well and they're very inspired by that. They do not like it.

They, men love their penises. So like anything that's wrong with them, they're gonna get, gonna get their. So other than erectile dysfunction, what about belly fat, weight gain? Are there other things? So I'm assuming for men that when they have testosterone deficiency that their brain won't work well, their mood will be different. But what about in the body?

All of those things.

Yeah. So the belly fat, the brain dysfunction.

We have an online questionnaire and we have a long list of symptoms for women that ferret out deficiency symptoms. And we have a long list for men. And there's a lot of them. But what brings them to the physicians is the erectile dysfunction. Now there's a certain group of men who, they're used to working out in the gym and they really care about their fitness and they start realizing that what they used to be able to build muscle and feel good, their routines are. Now they're winding up fatigued and they're not as strong as they used to, and they're disturbed by that and they're health sensitive. And we'll see a certain number of those men. And then libido is another one that bring men in and there. And, and another thing that brings men in is their wives have picked up on compounded bioidentical hormones and their wives are saying, hey, listen, I'm getting interested again. What happened to you? So we see a lot of men for that way. But yeah, there's muscle loss, there's mood loss, there's motivation loss. Men who are, you know, they've, they've bought into every active and creative lives and that they start having cognitive issues, they start having motivation issues, they don't want to show up for work, they're grouchy around the house. So there are a long list of symptoms. But I wanted to return to the big one called erectile dysfunction. When that testosterone drops low, there comes a point where they cannot sustain an.

Erection, I feel like when you get to that point, that's like end stage renal disease. Right? You had this issue for years and now what you really see is the final straw. But to me, the erectile dysfunction is also. There's a cardiovascular component to it that if you have atherosclerosis in your heart, you're going to have it in your smaller vessels that will get in the way of having the blood flow to get the erection. But to me, the lack of ability to get an erection is the end of the road.

Right.

You, you. So I'm trying to get to people before they're at the end of the road. So. So for me, it's like, okay, if you're caught, if your brain isn't working as well, if you have muscle loss, if you have easy fatigue, if you notice a decrease in your sex drive, then to me, those are the early red flags. And the late red flag is, is the loss of an erection. Like, that's really. That to me, is like the diagnosis of Alzheimer's.

It's not as late as it used to be.

Now, why.

I mean, I totally respect your desire to pick it up early and for men to show up early, although they don't.

I don't see men at all. I only see their wives and they're.

Like, yeah, they don't tend to do it.

No.

And what's the final inspiration? But we're seeing young men who are having libido issues, erectile issues, as never before. This world has changed and my patient demographic has changed and younger and younger men are having difficulty and they're hearing about low testosterone. And, you know, best case scenario, they come in before the erectile dysfunction has gotten. But there's a series of steps and you could pick it up on an intake questionnaire. Like, a young man should wake up with an erection. That's adequate testosterone. And if you question him, do you still wake up with an erection? Well, no, it's been a while. Well, his testosterone has already dropped. So there are early signs. It's more like, practically speaking, when are the men going to show up? And a lot of young men are showing up these days. There's great popularity. They've heard about it, they've heard about the testosterone, and they show up for a variety of reasons. Some want better performance, some are using them in an appropriate way. The athletes have been using it inappropriately. But I don't know that I can say more than that. They do show up. I can tell you that.

I'm glad they're Showing up. Do you see a lot of patients who have a porn addiction? Because we've spoken to people who say like porn is everywhere and young men are drowning in it. And that can lead to its own erectile dysfunction if you can only get an erection associated with escalating porn. So do you see that? Is that anything you screen for? You see that in your practice?

I haven't. But of course you're naming some real perils and some real gauges of consciousness deterioration that's is so much more prevalent than we ever dreamed of. And that dysfunctionality, that's a big topic. That's a Pandora's. And then, you know, take the long range view. It's a tough one to do. But if you take, if you try and picture how do I want to live when I'm 80 and 90 and have I had parents or relatives that have gone into assisted living facilities and nursing homes and how they felt about that and how did they do in those facilities?

I don't think you get out of those alive. You know, it's not like you go in as a temporary measure. You go in and that's it, that's the end of it.

And then with some foresight, how do you get to prevent going in there if that matters to you? You pick up on hormones that are going to. Like we have on our medical board we have a woman who for many, many years she was working with nursing homes. I asked her once, what percentage of women who are in nursing homes are there because of hormone deficiency. She said 80. Sarcopenia, cognitive decline, loss of bladder control, osteoporosis, hip fracture, that's why they're there. It's so challenging to announce the prevention as worth 32 tons of cure type of thing, but really investigate these hormones. And you know what, it doesn't matter when you, if you, if you're 75 and you've never done hormones, investigate it. I started treating my mother and my mother in law when they were in their mid-80s to advantage. There's extra precautions we take, there's a few extra things that we pay attention to. But anytime you think of it, figure it out, go for it. It's, it's really the best stuff out there.

Okay, this has been really cool. David, where can people find out about you? Where can they reach you?

They can download a free copy of our book, PDF copy if you want, you could offer that to them.

We'll put that link in the, in the show notes and then. Do you have a website?

Yeah, we do. We have several of them. And if you just put my name in Google, you'll, you'll, I'll pop up.

We'll put all that in the, in the show notes. So thank you for being on the show. This has been, this has been really interesting because it's near and dear to my heart, having recently transitioned into the next phase of life. So I'm really grateful that you were able to shed some light on this, and I'm sure the listeners will like it. So thank you for being here. If you're just tuning in, go back and listen to the beginning. But this is Dr. David Rosensweet, and we're talking about hormones and how to optimize them in for both men and women in all the different phases of life. So, David, thanks for being here on the show. This has been really great.

Wendy, it's an honor to meet you. We're in the same medical tribe and I so respect what you're doing. It's, it's such a gift.

Right back at you. So thanks for being on the feel freaking amazing podcast. You've been great.

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