Latest / Wits & Weights | Strength & Fat Loss Over 40 / The Metabolic Storm of Menopause and HRT Timing for Fat Loss & Muscle (Karen Martel) | Ep 382

Transcript

The Metabolic Storm of Menopause and HRT Timing for Fat Loss & Muscle (Karen Martel) | Ep 382 · Wits & Weights | Strength & Fat Loss Over 40

0:01
Philip Pape: If you're a woman approaching or experiencing menopause, your doctor may have told you to tough it out that hormone therapy is risky or that you can start at any time if symptoms or labs get bad enough.
0:12
Philip Pape: But what if waiting too long to begin menopausal hormone therapy doesn't just mean suffering through hot flashes and sleep disruption?
0:20
Philip Pape: What if it means missing a critical window that could determine your metabolic health for the rest of your life?
0:26
Philip Pape: Today, my guest reveals why the timing of hormone therapy is about preventing a metabolic storm that fundamentally changes how your body processes energy, stores fat, and maintains muscle and bone.
0:39
Philip Pape: You'll discover why the conventional advice to delay therapy could be setting you up for visceral belly fat accumulation, insulin resistance, and accelerated bone loss.
0:49
Philip Pape: And if you think you can simply overcome these changes with more exercise and stricter dieting, you're about to learn why that approach falls short and what to do instead.
0:57
Philip Pape: Welcome to Wits and Weights, the show that helps you build a strong, healthy physique using evidence, engineering, and efficiency.
1:08
Philip Pape: I'm your host, Philip Pate, and today we're gonna look at one of the most critical but misunderstood aspects of women's health, and that is the timing of hormone replacement therapy and the very profound impact it has on your metabolism.
1:22
Philip Pape: Now you are gonna love my guest today as she returns for the third time, the wonderful, knowledgeable, and always friendly Karen Martell.
1:30
Philip Pape: Karen is a certified hormone specialist.
1:33
Philip Pape: She's a weight loss coach, she's host of the hormone solution podcast.
1:37
Philip Pape: I can't believe you're not following that by now if you're not.
1:40
Philip Pape: And she's helped thousands of women navigate that fine dance between hormones and metabolism.
1:45
Philip Pape: She's here today to discuss the cue the thunder metabolic storm of menopause and why the timing of starting HRT may be more important than you think.
1:55
Philip Pape: Karen, always an honor, always a pleasure to talk to you here on Wits and Weights.
1:59
Karen Martel: Thank you, Philip.
2:00
Karen Martel: It's so good to be here.
2:02
Karen Martel: I love coming on your show.
2:03
Karen Martel: I love talking to you.
2:04
Karen Martel: It's always good.
2:05
Philip Pape: Likewise, likewise, because we I think we have a lot of overlap.
2:08
Philip Pape: And then there are also things that are just like totally in your wheelhouse that I love to learn.
2:11
Philip Pape: I learn something new every day, 10 things when we talk.
2:14
Philip Pape: And so does the listener, and they're always asking for you as well.
2:17
Philip Pape: So it's going to be exciting.
2:18
Philip Pape: And it all you're also going to be coming into our group to do a live Q ⁇ A very soon after this comes out.
2:23
Philip Pape: So look for that, everybody.
2:24
Philip Pape: But you've had a lot of interesting guests on your show, like Bill Campbell, who I know very well.
2:29
Philip Pape: Um, you've been talking a lot about the menopause transition, which is roughly a, I think, three and a half year phase on average for a lot of women.
2:39
Philip Pape: You've been talking about how hormone uh changes, especially hormone loss of the key reproductive hormones, can drive fat distribution, changes in insulin sensitivity, bone health, muscle mass, metabolism, and weight, all the things.
2:53
Philip Pape: What is the latest we know about all this specifically with what you call the metabolic storm?
2:59
Philip Pape: Because we want to focus on that and how we can get ahead of it.
3:03
Karen Martel: So I will correct you on something there.
3:05
Karen Martel: It's not just three years, Phil.
3:08
Philip Pape: Okay.
3:08
Philip Pape: It's okay.
3:09
Karen Martel: We're we're looking, it's average now for women, the perimenopausal phase is typically eight to ten years, and it can go on longer.
3:17
Karen Martel: And and I think that that's an important thing to recognize because a lot of women don't realize what's happening to them when they're in their late 30s and early 40s, and they're like, hmm, what's happening here?
3:31
Karen Martel: My I'm getting a heavier period, or I've gained a little bit of weight, or my hair's falling out, or my joints starting to hurt.
3:40
Karen Martel: I'm got suddenly a whole bunch of new wrinkles that I didn't have a year ago.
3:44
Karen Martel: You know, these little things that just like this can for someone they can slowly creep in, and they typically start to do all of the other things besides look at their hormones.
3:56
Karen Martel: They're like, oh, I better start, I better change my diet, I better exercise more, I better do this, I better do that, which you kind of have to do those things.
4:04
Karen Martel: But you should also be looking at the hormones because the earlier you can catch the hormonal loss that starts to happen, the better off you're gonna be.
4:13
Karen Martel: And then the less of that metabolic storm, it's gonna be sunny skies.
4:18
Karen Martel: It's not gonna be a storm.
4:20
Karen Martel: And this is where so many practitioners are going wrong, and doctors are going wrong, is that they wait until a woman is a hot mess way into her 40s, even into her 50s and post-menopausal.
4:36
Karen Martel: Then they're like, oh, okay, now we'll give you hormones because you are still suffering so badly.
4:41
Karen Martel: And it's like at that point, many of these women are 10, 20, 30 pounds overweight.
4:49
Karen Martel: And these are women that are coming from a background of exercising and healthy eating and listening to our podcasts, and they're like health-conscious women, and they're going, what just happened to my body?
5:01
Karen Martel: And then it's so hard to reverse once it happens.
5:05
Karen Martel: So it's easier to prevent.
5:08
Philip Pape: Yeah.
5:08
Philip Pape: So there's two things that are big takeaways from what you said that I got.
5:11
Philip Pape: The first is the education on the timing, which is what we're talking about.
5:15
Philip Pape: I'm glad you mentioned the, you know, the three and a half years that I was referring to is the MT from the literature, right?
5:20
Philip Pape: It's that tiny period right before the final end and end of menopause, right?
5:24
Philip Pape: When you haven't had a period for a year and you're at menopause.
5:26
Philip Pape: And what you're saying is really, we have to back this thing up and look at the whole spectrum that goes from as early as potentially your late 30s, I understand, but mainly through your 40s and in your 50s.
5:36
Philip Pape: We were talking about Zora Benamu, right?
5:38
Philip Pape: Who's she's been on my show and vice versa, and you you're good friends with her.
5:41
Philip Pape: Um, and she talks about all the misconceptions that not just, you know, people, but women specifically have with menopause.
5:49
Philip Pape: And so that that's part of the discussion.
5:51
Philip Pape: The second thing you mentioned is how a lot of these women are doing the things, right?
5:55
Philip Pape: And and this is this is my population too.
5:57
Philip Pape: And those who listen to this podcast of like, you know, I know to track food or macros or whatever, you know, I know to, you know, eat the right portions, I know to eat protein, I know I should be lifting weights.
6:07
Philip Pape: Now, maybe they're not all doing that, but even the ones who are, and they're still frustrated and like, what's going on?
6:12
Philip Pape: And like you said, a little bit of gaslighting, whatever you want to call it, maybe it's more ignorance than anything, lack of training in the healthcare industry.
6:18
Philip Pape: And it's like, no, you gotta be a hot mess, you've got to be totally like begging for, you know, hormone therapy before you do it.
6:25
Philip Pape: So those are two huge takeaways that I think set the stage for like, okay, what is happening, Karen?
6:31
Philip Pape: Yes.
6:31
Philip Pape: And what do we do about it?
6:33
Philip Pape: Let's unravel the mystery.
6:35
Karen Martel: Yes.
6:35
Karen Martel: And so let's get into like the meta, like what's happening to the metabolism through these phases, because that is like the so important.
6:44
Karen Martel: And and it starts when we start to lose our our progesterone.
6:50
Karen Martel: So that's usually the first to go.
6:52
Karen Martel: And that's in our late 30s, early 40s.
6:56
Karen Martel: We run out of eggs, we come into this world with a certain amount of eggs, we start running out of them.
7:01
Karen Martel: And when we no longer ovulate, we are no longer producing the bulk of our progesterone.
7:05
Karen Martel: Well, second half of your cycle, progesterone is supposed to come on the scene, which raises our metabolic rate, it raises the basal metabolic temperature in the body.
7:16
Karen Martel: It also helps your thyroid to function properly.
7:19
Karen Martel: And so that is the first thing that starts to happen to the metabolism, is that is we don't get that rise in body temperature in the second half of the cycle.
7:29
Karen Martel: Progesterone is also super key for GABA production in the brain.
7:34
Karen Martel: It influences the GABA receptors in the brain, which GABA helps us, helps us all to sleep.
7:40
Karen Martel: It induces sleep.
7:41
Karen Martel: We know that when people do not get a good night of sleep, if you have, if you've ever worn a CGM, you will see that your blood checkers will be spiked when you wake up in the morning.
7:52
Karen Martel: Because it's like instant insulin resistance the next day when you don't sleep well.
7:58
Karen Martel: So without that progesterone, which is helping you sleep, that starts to go.
8:03
Karen Martel: So now we're not sleeping as well.
8:05
Karen Martel: So now we're getting more insulin resistant, right?
8:07
Karen Martel: Every time we, you know, especially if we're going for longer and longer stretches and if not good sleep, that's gonna start to really impact your body composition, your blood sugar regulation, etc.
8:19
Karen Martel: The other thing is GABA is an anti-anxiety neurotransmitter.
8:24
Karen Martel: So GABA helps you to be calm.
8:27
Karen Martel: So now we don't have as much of this GABA response happening in the second half of the cycle.
8:32
Karen Martel: So we hear from so many women that anxiety starts to go up.
8:37
Karen Martel: And if you're not sleeping and you're so you're tired, you're slightly insulin resistant, but not only that, you're you've got anxiety, a little bit of, you know, just that like low-level anxiety feeling all the time.
8:52
Karen Martel: I'm sorry, but do we want to eat really well when we feel that way?
8:59
Karen Martel: Typically not.
9:00
Karen Martel: Typically, your body goes, give me the sugar, I need that dopamine hit, I need something to give me some energy, I need something to, you know, up my blood sugar here a little bit because it's wonky.
9:12
Karen Martel: And so you so this is the metabolic storm is now starting.
9:15
Karen Martel: As this continues on, you get less and less ovulation, less and less progesterone.
9:20
Karen Martel: Now we're bleeding heavier, all these things start to compound.
9:23
Karen Martel: Then, typically around mid-40s to late 40s, estradiol starts to kind of go up and down, but slowly starts to go down.
9:33
Karen Martel: So it'll have times where it goes high, but then it'll drop back down.
9:37
Karen Martel: And then, but it's slowly it just goes lower and lower.
9:41
Karen Martel: And it's estrogen, oddly enough.
9:43
Karen Martel: And I think this surprises a lot of women because women tend to associate estrogen with weight gain because of estrogen dominance.
9:52
Karen Martel: And we've got so much estrogen in our environment right now that acts like estrogen in the body, but it's a lot stronger.
9:59
Karen Martel: And so, yeah, estrogen, too much estrogen and too much xenoestrogens absolutely will make you gain weight, but too little estrogen makes you gain even more weight than too much, which is very surprising.
10:17
Karen Martel: But estradiol, so there's three estrogens.
10:20
Karen Martel: Estradiol is the one that we produce in our ovaries.
10:23
Karen Martel: That is the one that is like the master of our metabolism.
10:29
Karen Martel: And so as it starts to go down, many things start to happen.
10:34
Karen Martel: Number one, we have estradiol receptors in the hunger centers of our brain, right?
10:41
Karen Martel: So it helps regulate your eating patterns as well as how much you're eating.
10:47
Karen Martel: So people, women will become more leptin resistant, they'll have dysregulation with ghrelin levels.
10:54
Karen Martel: And so these are the hormones, these are our appetite hormones that tell us when to stop eating, gives us the signal to the brain, like, hey, I'm done, I'm full, and then as well as hunger, right?
11:05
Karen Martel: So just drives hunger sensations in the stomach.
11:08
Karen Martel: And so that becomes dysregulated as estradiol starts to go down.
11:13
Karen Martel: So we start eating more and we start craving more sugar and we start becoming more insulin resistant.
11:19
Karen Martel: It also helps us just to process glucose.
11:23
Karen Martel: Estradiol helps you to process it.
11:26
Karen Martel: So now we're becoming more insulin resistant as the estradiol is dropping, and that is not good either.
11:34
Karen Martel: And then as estradiol is dropping, another estrogen starts to come up because your body's super smart and it's like, oh my god, we need estradiol.
11:44
Karen Martel: This is the most important hormone for this body because it is.
11:47
Karen Martel: We have estrogen receptors on every organ, it helps every organ to function properly with in our brain, bones, skin.
11:55
Karen Martel: I mean, it is so crucial.
11:56
Karen Martel: It is not just about fertility.
11:58
Karen Martel: And so your body goes, we need to get estrogen somehow.
12:02
Karen Martel: And you can make estrogen from fat cells.
12:07
Karen Martel: And that kind of estrogen is called estrone.
12:11
Karen Martel: But that's an inflammatory estrogen.
12:14
Karen Martel: And so, and and it's terrible because it's a vicious cycle.
12:18
Karen Martel: The more fat you put on, the more estrone you're gonna make, and the more estrone you make, the more fat you're gonna make.
12:26
Karen Martel: So it's just this vicious circle that feeds into each other and makes you gain more and more weight.
12:32
Karen Martel: So we have this inflammatory storm happening, which is not good for weight or metabolism.
12:38
Karen Martel: And then our esterdiols dropping, we're getting more hungry, getting more insulin resistant.
12:44
Karen Martel: Where do we see, you know, you look at somebody that has type 2 diabetes or insulin resistance, where do they carry the weight in their gut?
12:54
Philip Pape: In their visceral, yeah.
12:56
Karen Martel: In their visceral, which is the worst kind of fat and most dangerous kind of fat is visceral fat.
13:01
Karen Martel: And this is the classic menobelly that happens.
13:05
Karen Martel: And I will tell you that you can be the healthiest woman in the world, and I really want everybody to hear this.
13:15
Karen Martel: And this can still happen to you, and it's an awful thing.
13:20
Karen Martel: It happened to me.
13:21
Karen Martel: I had been, you know, this Puritan paleo 10 years.
13:27
Karen Martel: I had kept at the same weight for 10 years.
13:30
Karen Martel: I thought I had this in the bag.
13:33
Karen Martel: I was like, oh, perimenopause, menopause, yeah, not gonna touch me.
13:37
Karen Martel: This is gonna be like a couple days of some hot flashes.
13:40
Karen Martel: I'll lose my period, and that'll be it.
13:42
Karen Martel: I'll be in menopause.
13:44
Karen Martel: Well, in my early 40s, I went into early menopause, which my health status didn't help with that, right?
13:54
Karen Martel: Like I'm very healthy, and yet I still was losing ovarian function early, earlier than I should have.
14:00
Karen Martel: And I gained about 15 pounds within a few months.
14:04
Karen Martel: And I lost my period, I was losing my period, I had itchy skin, I was hot flashing and night sweats like crazy.
14:12
Karen Martel: I was in the metabolic storm.
14:14
Karen Martel: And I'm like, how is it?
14:16
Karen Martel: Like, I didn't drink, I didn't smoke, I ate so clean, I didn't have sugar addiction, I was working out, I did everything, I was in this industry.
14:25
Karen Martel: This is what I did for a living, and I practiced what I preached, and it still happened.
14:31
Karen Martel: And so I I want women to hear that because they tend to blame themselves and they think, oh, I'm not doing XYZ hard enough.
14:38
Philip Pape: Yep.
14:39
Karen Martel: And it could purely be from the drop of hormones.
14:43
Philip Pape: And that's why I wanted to have you on, because there's two big aspects here.
14:47
Philip Pape: There's lifestyle, which we talk to death on this show, of course.
14:50
Philip Pape: And then there's hormones.
14:51
Philip Pape: And I mean, I know just from men talking to all every day in my communities about why can't I sleep over 40?
14:59
Philip Pape: Why can't why does this get hard over 40?
15:01
Philip Pape: You know what I mean?
15:01
Philip Pape: And it's like, take that times 10 for some of the women I speak to, not all.
15:05
Philip Pape: And that leads me to my question, though, Karen, because I want to get into even more of like the mechanisms of this because I know people love that, but it sounds like pretty much everything in the body is affected at some level.
15:16
Philip Pape: It's in the population, how would you break down women that are like affected by this severely versus kind of it's noticeable, but it's surmountable versus like they don't even notice it?
15:29
Philip Pape: You know, how would you categorize just in general?
15:32
Karen Martel: That is a tough question.
15:33
Karen Martel: And I've thought a lot about it.
15:35
Karen Martel: Like, why is it that some women just sail through this?
15:38
Karen Martel: And they could be women that are overweight, eating McDonald's every day, you know, like that don't exercise and they're like, Yeah, hop flash.
15:46
Karen Martel: Oh, I think maybe I had one hopflash, you know.
15:49
Karen Martel: Like, it's like, what?
15:50
Karen Martel: How is this possible?
15:52
Karen Martel: You know, so sometimes there's no rhyme or reason.
15:56
Karen Martel: I think that there's a genetic piece for sure.
15:59
Karen Martel: Uh there is some research that kind of shows, like, if your mom had a bad menopause or an early menopause, then you might as well.
16:09
Karen Martel: And that was definitely like my mom had a horrible menopause, and she went into it really early as well.
16:14
Karen Martel: And she was really prone to hot flashes, like me.
16:17
Karen Martel: And you know, so there we there is a genetic component and how you process those hormones.
16:23
Karen Martel: It is also what were you exposed to?
16:26
Karen Martel: You could be really healthy, but if you had exposure to some of these very common toxins that are in our environment, I mean, none of us are free from the toxins right now.
16:36
Karen Martel: Like we're we're all overloaded with them.
16:39
Karen Martel: So did you have a lot of heavy metal exposure?
16:43
Karen Martel: Did you have mold exposure?
16:44
Karen Martel: These things really mess with the hormones.
16:47
Karen Martel: Did you have trauma?
16:49
Karen Martel: There's a lot of really cool new research coming out that's showing that if you had PTSD or you've had early childhood trauma, that this affects how the hormone receptors work.
17:01
Karen Martel: And so when you're losing those hormones, you can be affected by it a lot more than the average person because you're more sensitive to these hormonal drops.
17:11
Karen Martel: So there's many different things that can go into this.
17:15
Karen Martel: And of course, of course, eating healthy, managing your stress, all of these lifestyle pieces, sleeping, et cetera, et cetera, they have to be part of this picture.
17:27
Karen Martel: And I'm not saying that that's a waste of your time because no matter what, that's gonna like maybe I would have gained 30 pounds instead of 15 had I not been such a great eater and a good in exercising, et cetera, right?
17:40
Karen Martel: So there's these are tools.
17:43
Karen Martel: HRT, it's like it gives the body the tools to allow it to lose weight so that if the efforts are put in, it's gonna be a lot easier for that woman to let go of that extra fat that she may have gained.
17:57
Karen Martel: And I think that that's a that's important to hear.
18:00
Philip Pape: You're right.
18:00
Philip Pape: I mean, that tools is the way to think about it, just like with GLP ones, which can get so emotionally charged.
18:06
Philip Pape: And as a coach myself, like I don't want to be the one saying, well, you have to do it this one way, and I'm gonna help you white knuckle through a lifestyle change when that's not gonna, that's gonna look great for me either.
18:16
Philip Pape: When you all of a sudden your metabolism keeps tanking and tanking and taking, and we're doing everything.
18:21
Philip Pape: I'm like, yeah, but we're following the science, something else is going on.
18:24
Philip Pape: Well, the body's complex, there's physiology and there's chemistry involved, and that's what we're hitting on today.
18:29
Philip Pape: So, okay, you can't do anything about your childhood.
18:32
Philip Pape: You can't go back in time and change any of this stuff.
18:34
Philip Pape: Well, you can.
18:35
Karen Martel: You can work on your traumas and stuff if you have not.
18:38
Karen Martel: Yes, you're right.
18:39
Philip Pape: You're you can work on who you are today as a result of your childhood.
18:42
Philip Pape: Um, but so you've mentioned a lot of cascades, right?
18:46
Philip Pape: Related to thyroid and then sleep and insulin resistance and anxiety.
18:51
Philip Pape: You mentioned um fat distribution and inflammation from which can probably be measured in blood markers from something like estrone and glycemic control, you also mentioned.
19:02
Philip Pape: Now, what about the bone density and muscle side of this musculoskeletal piece?
19:08
Philip Pape: Where does that, how does that get affected by all this?
19:11
Karen Martel: Yeah.
19:11
Karen Martel: Testosterone starts to go too, which is a very important hormone for women.
19:15
Karen Martel: And that, of course, has lots to do with, you know, increasing protein synthesis, muscle building, bone formation.
19:22
Karen Martel: It's great.
19:23
Karen Martel: It's great for many, many different things.
19:25
Karen Martel: And so we do see that coming down as well in women in perimenopause.
19:29
Karen Martel: So that starts to affect muscle.
19:30
Karen Martel: But estradiol is also extremely important for muscle.
19:36
Karen Martel: It helps the the uh the satellite cells to work better.
19:42
Karen Martel: It they influence the satellite cells.
19:44
Karen Martel: Now, satellite cells, they're like muscle stem cells, it just helps your body to repair and after working out and helps to grow with the grow the muscles, etc.
19:56
Karen Martel: So without the estradiol, you can actually have more muscle loss and start lacking in that repair.
20:05
Karen Martel: So women will say, Oh, I don't recover the same anymore.
20:10
Karen Martel: Estrogen is really important for lubrication, lubrication of everything.
20:16
Karen Martel: Your vagina, your eyes.
20:18
Karen Martel: Like women will say, I'm getting dry eyes, dry skin, joints.
20:22
Karen Martel: So women will say, my joints are sore all the time, my back is sore all the time, suddenly.
20:28
Karen Martel: And this can be because of that estradiol loss.
20:31
Karen Martel: It also helps your body to make collagen.
20:34
Karen Martel: So all of these things really important when you're lifting weights and trying to put muscle on.
20:40
Karen Martel: And so we need the estradiol.
20:42
Karen Martel: It's also really important.
20:43
Karen Martel: This is kind of an odd one, but neuromuscular health.
20:48
Karen Martel: And that's like how your brain speaks to the muscles, and vice versa.
20:52
Karen Martel: And so that starts to go down when estradiol starts to go down.
20:56
Karen Martel: And so we have this once again, this perfect storm happening at the same time that all this other metabolic stuff is happening, your cholesterol starts going up, the blood sugar starts going up.
21:07
Karen Martel: Estrogen helps to raise cortisol binding globulin.
21:13
Karen Martel: Now, this is a uh binding globulin that binds up your cortisol, which you want the perfect amount, you want the Goldilocks amount.
21:21
Karen Martel: We don't want too much cortisol, we also don't want too little, right?
21:23
Karen Martel: Astradiol, as it drops, it actually makes it so that we have more free cortisol around.
21:32
Karen Martel: But in this day and age, women, we we tend to have a little too much cortisol in most cases already because we're stressed out, right?
21:40
Karen Martel: We're running around, we're doing all the artificial lighting and all these things that are coming at us all the time.
21:46
Karen Martel: And so now we get this increase in cortisol.
21:49
Karen Martel: Well, cortisol is catabolic, it's not anabolic, it's catabolic.
21:54
Karen Martel: It also raises your blood sugar.
21:56
Karen Martel: So this is all going up.
21:58
Karen Martel: Cortisol also, like you, if you have too much cortisol, guess where you put the belly, the belly fat on because of the blood sugar dysregulation.
22:06
Karen Martel: So now we've got more fat going to our belly because of the cortisol going up, and cortisol can affect, of course, then the muscle tissue.
22:15
Karen Martel: And muscle is the biggest processor of glucose that we have.
22:19
Karen Martel: And I know you talk about this all the time, fellow.
22:22
Karen Martel: This is huge.
22:24
Karen Martel: So as the estrogen is going down, our muscle can be going down as well.
22:30
Karen Martel: It's gonna impact all of these things on how your body functions, how it repairs, how it recovers from your workouts.
22:39
Karen Martel: So why we would deny women estrogen during perimenopause, during this 10 years, is just it's mind-blowing that we say, no, you can't have it because all of these things are gonna start to compound on top of each other.
23:01
Karen Martel: And like it is, it's the metabolic storm.
23:05
Philip Pape: Yeah, and does that storm, because I want to I want to talk about labs and markers and some of the things we've we've discussed on the other two times you were on, which for the listener, if they're curious, we did talk about testosterone in detail last time, and then ages ago for first time you were on, was just more general hormone and weight loss.
23:22
Philip Pape: But um, this storm, right?
23:23
Philip Pape: Is there an eye of the storm?
23:25
Philip Pape: Does it calm down?
23:26
Philip Pape: Does is there a fierce part of it?
23:28
Philip Pape: And the reason I ask is, you know, I hear this narrative of, okay, it's things accelerate, right, into the what I was calling the menopause transition, which was more of the short period right at the end.
23:38
Philip Pape: And then after that, are you, you know, do things calm down or are you kind of at a new baseline that's just suppressed all of this stuff for good?
23:46
Philip Pape: You know, like what exactly does that curve look like if you don't do anything?
23:51
Karen Martel: The curve typically looks like it is the worst during perimenopause and during the first few years post-menopause.
24:01
Karen Martel: That is where we see the biggest impact on weight, on our metabolism, on our uh brain function, all of the things that start to be impacted by the loss of that estrogen and progesterone and testosterone really hits hard during those years.
24:16
Karen Martel: And then there is a somewhat of a plateau for most women where they come out the other side of it, they don't lose the weight.
24:24
Karen Martel: And you can look, you can see this, and it's unfortunate.
24:28
Karen Martel: You know, you look around, I can see the women that are on HRT, and I can see the women that aren't on HRT.
24:34
Karen Martel: And I people get really angry when I say this.
24:37
Karen Martel: They do, because then then they think that I'm insinuating that everybody's needs to be on HRT.
24:41
Karen Martel: That's not what I'm insinuating.
24:43
Karen Martel: But look at the average woman that's in her 60s, and it is a very common body type, which is once again the insulin resistant, the belly fat, you know, it starts to affect your vocal cords, your skin starts to age a lot faster without the estrogen on board and the progesterone and testosterone.
25:08
Karen Martel: You know, the hair thins, you know, the body starts to go down, like as far as like posture goes, because the bones, we need estrogen, test, we need all three hormones for bone health and bone regeneration.
25:20
Karen Martel: So bone health starts to go down, hearts, heart problems start to go up, things like this.
25:26
Karen Martel: So all of this, it stays with you.
25:30
Karen Martel: So what we'll see on labs is women that aren't on estrogen or have never been on HRT or little too too little HRT, their LDL will be up and usually out of range.
25:42
Karen Martel: Triglycerides will sometimes be up as well.
25:44
Karen Martel: Hemoglobin A1C and blood sugar are all up, and they tend to stay up.
25:50
Karen Martel: And you can look at this if you have older clients that are you know in their 60s, 70s, and this goes for men as well.
25:57
Karen Martel: And you look at their labs, most of them are insulin resistant to some degree, and then many go on to get type 2 diabetes.
26:05
Karen Martel: And it's not all from hormonal loss, of course, right?
26:08
Karen Martel: There's so many factors in this, but that is just typically what we see.
26:13
Karen Martel: But the emotional roller coaster, the hot flashes, night sweats, the continual weight gain, that seems to chill in once they get through to menopause a couple years in.
26:27
Karen Martel: It's not such a wild ride, and things can stabilize, but that's not for everybody.
26:33
Karen Martel: I mean, my mom is 70 and she still gets hot flashes.
26:37
Karen Martel: And you'll and I've talked to many women that have felt the same way.
26:41
Karen Martel: Um, a lot of the urigen, like the you know, women will get uh vaginal dryness, atrophy, uh chronic UTIs, like all of the the genocuritant.
26:56
Karen Martel: I always get it mixed up.
26:58
Philip Pape: GSM will call it genital related uh diseases.
27:02
Philip Pape: I'll just go with that.
27:08
Karen Martel: It's always a mouthful for me.
27:09
Karen Martel: Uh, but that is in 50% of women, that doesn't go away.
27:14
Karen Martel: You know, you you know, I've women will say like, no, my vagina's dried up.
27:18
Karen Martel: There's no it's it's not getting better as I age, it's staying the same.
27:24
Karen Martel: And it gets thinner, the skin gets thinner and thinner, and and that's a horrific thing to for women to go through.
27:31
Karen Martel: And it's it's absolutely terrible.
27:32
Karen Martel: I've talked to women that have said that they've torn, you know, through when they have sex, they tear, they have micro-tears, that they can't even have sex anymore.
27:42
Karen Martel: There, I had one woman early, oh, it's closed, like there's nothing getting in there.
27:46
Karen Martel: You know, and this is real all of this is reversible.
27:48
Karen Martel: A lot of it's reversible, which is nice to hear.
27:51
Karen Martel: But yeah, so I would say that for some women, yeah, it plateaus and it gets a little bit easier for sure.
27:58
Philip Pape: So it's reversible.
28:00
Philip Pape: That's kind of the silver lining, but what if we just don't have the storm cloud at all?
28:03
Philip Pape: That's what we want to talk about now.
28:04
Philip Pape: How do we get ahead of the storm based on this bleak picture of the future that you don't want to have and decide I'm gonna take control of my health?
28:12
Philip Pape: Because I think that's what it comes down to is you're empowering yourself, listening to you know, your podcasts and others like it, that the healthcare industry may not be the one doing it.
28:20
Philip Pape: And I see that on my end.
28:21
Philip Pape: You and I were talking before we got on about performance-based blood work.
28:24
Philip Pape: You know, if you go to your doctor and you get just any old labs for whether it's cholesterol or testosterone or it's um blood markers or inflammatory markers, they have their ranges and it's based on sickness and disease.
28:35
Philip Pape: It's based on the population, it's not based on optimality, performance, and being proactive, right?
28:40
Philip Pape: So, and I know you you talk about this stuff all the time on your show.
28:43
Philip Pape: So, at what age should women start to do what to get ahead of it and at least understand, maybe I don't have to do anything, but I've got the knowledge, or hey, this is giving me the indicator that I need to think about that, you know, taking action.
28:55
Karen Martel: Yeah.
28:56
Karen Martel: So embrace that you can't diet, you can't supplement, you can't intermittent fast and cold plunge your way out of hormonal loss.
29:06
Karen Martel: It's gonna happen to every single one of you.
29:08
Karen Martel: Whether you have symptoms or not, you know, it doesn't matter because what's going on on the inside happens to all of us, right?
29:17
Karen Martel: So you will lose bone.
29:19
Karen Martel: You are gonna lose cognitive function to some degree.
29:22
Karen Martel: Uh, you're gonna lose skin elasticity, you're gonna lose vaginal elasticity.
29:27
Karen Martel: Like these are things that just they depend so much on hormones that I don't know of any woman that isn't impacted by this.
29:35
Karen Martel: Like we start losing bone in our 30s, I do believe.
29:38
Karen Martel: Like it or even earlier.
29:40
Karen Martel: So this is happening across the board.
29:43
Karen Martel: And so it's really good to go, okay, I'm losing ovarian function, changing my diet is not going to bring back ovarian function.
29:55
Karen Martel: There's nothing that can.
29:56
Karen Martel: We're not there yet.
29:57
Karen Martel: One day I think we will be, but right now, no.
29:59
Karen Martel: There's nothing that's going to bring that back.
30:01
Karen Martel: And I think that that gives a big relief for women because this is the time to start looking now at your hormones.
30:10
Karen Martel: And now there are many things that they could do at that point.
30:13
Karen Martel: Like if you're in your late 30s, early 40s, and you're just starting to notice some of these things, oh my gosh, there's some great supplements that can really help with, you know, helping with the production of progesterone when you ovulate, helps with ovulation, helps helps with the hot flashes and night sweats.
30:31
Karen Martel: And so for sure, if you don't want to go to the HRT thing yet and you're still cycling regularly and your periods seem to be okay, for sure, support your system through the diet lifestyle and supplementation.
30:43
Karen Martel: But then when it starts to get to the point where those things are no longer working, you're getting up there in your age in your 40s, and then you go, okay, let's go in and test.
30:56
Karen Martel: We want to see what's your glutenizing hormone, what's your follicular stimulating hormone?
31:01
Karen Martel: These are brain hormones that are telling your ovaries what to do.
31:05
Karen Martel: And those signals and those levels of FSH and LH start to go up the harder they're having to work to get your ovaries to ovulate.
31:15
Karen Martel: And so that can be a really good sign for women to go, oh, I'm struggling here.
31:19
Karen Martel: I have a regular period.
31:21
Karen Martel: I would not have thought that my FSH was up.
31:25
Karen Martel: And so that's one of the markers that I always want to see is the FSH, because that really tells us a lot about estrogen because women can have regular periods, but their FSH can start to elevate, which is just telling us, once again, the brain is going, ovaries, come on, what are you doing?
31:43
Karen Martel: Like, like let's wake this up a little bit.
31:45
Karen Martel: Like, and so FSH in a fertile woman ideally is below 10.
31:51
Karen Martel: When and it fluctuates, there's a different range throughout the cycle.
31:55
Karen Martel: You're supposed to test it on day three is the ideal day to test it.
31:58
Karen Martel: So if uh you're a cycling woman, you're usually going to be around three to five on your the first, you know, within the first three days of your cycle.
32:07
Karen Martel: As you get older and you stop ovulating as often and your ovaries are starting to quit, then once it gets above 10, that's that's like okay, start watching.
32:19
Karen Martel: But if it gets above 20, I would say that is your like, oop, now I've got to really look at HRT because there's nothing else that's gonna bring that down except for HRT.
32:31
Karen Martel: And there's actually a little bit of research that shows like women that the FSH, when it gets above 23, is when they start to see the weight gain happen.
32:41
Karen Martel: So this can be a really good like indicator of what's coming down the pipeline and when to start intervening.
32:49
Karen Martel: And so for some women, it's just like baby baby dose of that estrogen during if they see that their FSH is 15, 20, and it's like, okay, maybe I need a little bit of estrogen, even at just certain times of my cycle.
33:03
Karen Martel: You know, this is when you want to work with a hormone practitioner.
33:06
Karen Martel: Progesterone for sure, like as you stop ovulating, your periods are getting heavier and they're getting maybe closer together, and your sex drive has gone out the window, you're not ovulating anymore.
33:17
Karen Martel: Because sex drive goes up for women when the when they ovulate, obviously.
33:21
Karen Martel: It takes and it tells us, go out and have sex, right?
33:23
Karen Martel: So women will say, like, my libido just is like gone and I'm bleeding super heavy and my periods are getting shorter.
33:31
Karen Martel: Progesterone.
33:32
Karen Martel: Because remember, if you don't ovulate, you're not producing progesterone, and that's your signs.
33:37
Karen Martel: And so putting in some progesterone in the second half of your cycle can be a lifesaver for women and fast, like where they start using it and they're like, oh, like this is amazing.
33:51
Karen Martel: I sleep, my mood's better, I don't have anxiety anymore, I feel so good, I lost five pounds.
33:58
Karen Martel: And they can ride that out, they can ride the progesterone train by itself for a while, typically.
34:06
Karen Martel: And then, like I said, mid to late 40s.
34:09
Karen Martel: Now we're gonna watch that estradiol.
34:12
Karen Martel: And as that FSH goes up and the estradiol goes down, which is very hard to test at this point because, like I said, it's a roller coaster ride.
34:22
Karen Martel: So you'll sometimes test it and it looks great, and it's like, well, that looks okay, that's enough.
34:28
Karen Martel: And then, you know, suddenly you're getting hot flashes and night sweats, and you're like, what?
34:34
Karen Martel: But my estrogen was fine.
34:36
Karen Martel: So really go on symptoms, right?
34:39
Karen Martel: So estrogen, once again, really important for libido.
34:42
Karen Martel: People think it's all testosterone.
34:44
Karen Martel: Heck no, we want estrogen for libido too.
34:47
Karen Martel: And so if you're getting these little symptoms like the hot flashes, night sweats, a little bit, you know, a lot of weight gain or a little bit of weight gain in the belly weight gain, dry skin, dry hair, itchy ears, all of this is signs that your estrogen is not high enough for you.
35:05
Karen Martel: So it could look okay on paper, and your doctor could be like, you're great, you're in, you're well within your range.
35:12
Karen Martel: Well, the freaking range is like if you're between 20 and 400, you're good.
35:19
Karen Martel: So for you, and every woman's different.
35:22
Karen Martel: Me, I'm very estrogen driven.
35:25
Karen Martel: So when my estrogen even drops a little bit, and I have a high SHBG, which means I have a lot of my estrogens getting bound up and not being used.
35:35
Karen Martel: And so for me, if my estrogen drops even a tiny bit, it's a I get every symptom in the book.
35:42
Karen Martel: And so I'm very sensitive.
35:44
Karen Martel: So I have to keep my estrogen up.
35:46
Karen Martel: And I've talked to other women, they didn't even notice anything.
35:51
Karen Martel: They're like, it just gets lower and lower and lower.
35:54
Karen Martel: And then they're like, Well, do I need the estrogen?
35:57
Karen Martel: I don't have hot flashes, I feel good, I don't have vaginal dryness.
36:01
Karen Martel: I'm like, I feel awesome.
36:03
Karen Martel: Can you feel your bones going?
36:06
Karen Martel: Can you feel the muscle going?
36:09
Karen Martel: You know, like there's things that you can't see.
36:11
Karen Martel: What about your brain?
36:12
Karen Martel: You know, you may not think that you you or you may think that you're fine, but maybe you're not with your cognition.
36:21
Karen Martel: You know, it impacts your sleep, it impacts your mood, it helps to estrogen helps us to make serotonin.
36:29
Karen Martel: So it's, you know, if you're a little bit more depressed, if you don't have the energy, it helps with dopamine, it helps with glutamate, it's like oxytocin.
36:38
Karen Martel: So it's like help even thyroid sensitivity.
36:43
Karen Martel: So these things women don't maybe realize are from estrogen loss.
36:50
Karen Martel: And so you just you want to monitor, you want to tune into yourself and go, you know what?
36:56
Karen Martel: I am a little, I'm not how I was five years ago.
36:59
Karen Martel: So maybe we, you know, biohack ourselves, put in a little baby dose of estrogen, and just see how it makes us feel.
37:07
Karen Martel: The beauty of hormones is you stop them, it's a it's gone in a day.
37:12
Karen Martel: So it's not like you're gonna have this like lasting impact.
37:15
Karen Martel: So if you don't feel well when you start taking HRT, then that's your sign that either you don't need it, or you need a different delivery form, or you need a different dosage.
37:26
Philip Pape: So anybody listening might be thinking, well, that's really great information and it's overwhelming, uh, Karen.
37:32
Philip Pape: Because I was thinking when I try to communicate anything in this optimization realm or performance realm or health.
37:40
Philip Pape: You mentioned biohacking.
37:41
Philip Pape: I love the idea of experimentation, right?
37:44
Philip Pape: Especially when you can get a quick feedback like that.
37:46
Philip Pape: You mentioned several buckets, and I just want to like reframe them from what you said to me for the audience.
37:52
Philip Pape: The first one is the first one is the biomarkers, which which I'm categorizing as your labs, you know, it could be urine tests, could be saliva.
38:00
Philip Pape: Like there's different forms of this, and you're the expert in that.
38:02
Philip Pape: And go check out Karen's podcast for like deep dives on you know specific labs and tests and all that.
38:07
Philip Pape: Um, so there's that, but then understanding how to interpret that, which is where the real trick is in terms of optimal ranges, but also your range and your trend over time and understanding what you should be, plus cycle to cycle, which for women is an extra wrinkle that you know, men don't have to deal with that.
38:24
Philip Pape: So that's kind of the blood work optimization or biomarker piece.
38:28
Philip Pape: The second piece you mentioned is symptoms, which I'll I'll label as part of biofeedback, right?
38:33
Philip Pape: That is just your body's telling you something.
38:35
Philip Pape: And it could be in a so many different ways.
38:38
Philip Pape: Like you said, it could be physical manifestation, it could be mental, it could be uh emotional anxiety, and um, it could be just things that aren't what they used to be for you, like like you said, you know, libido and vaginal dryness or whatever.
38:50
Philip Pape: And then the, I guess the last bucket I heard, and maybe I'm missing something, is self-experimentation of you've got to do something at some point to at least understand this beyond just the data and trying the progesterone cream or trying the estrogen.
39:05
Philip Pape: And a lot of these are safe.
39:06
Philip Pape: And like, you know, the Women's Health Initiative did did horrible things for our understanding of safety in this world.
39:13
Philip Pape: But understanding that means you could approach it with a little more freedom and flexibility to try things, get off of them, and not worry if it's gonna like grow a third arm or something.
39:23
Philip Pape: Um, and I'm just just joking, but you know, or it's gonna give you cancer, which is the real serious thing people are worried about.
39:29
Philip Pape: Did I kind of paraphrase like the big buckets, Karen, that we just talked about?
39:33
Karen Martel: Yeah, I think that that's a great way to put them all into the buckets like that.
39:38
Karen Martel: And and and I don't want to overwhelm, like I I always try really hard not to overwhelm the woman, right?
39:45
Karen Martel: Because you get so much information out there, menopause is a real hot topic right now.
39:50
Karen Martel: There's all these different opinions.
39:52
Karen Martel: And the bottom line is when we look at the research, we know we see that they're very safe.
40:00
Karen Martel: And you always have to remind yourself you had these hormones for the majority of your life.
40:08
Karen Martel: And so when you question, like, oh, like maybe I'm not a good candidate, or maybe I shouldn't do research here.
40:14
Karen Martel: Is this dangerous?
40:15
Karen Martel: Is it gonna cause cancer?
40:15
Karen Martel: Is this blah, blah, blah, blah?
40:17
Karen Martel: Did you think like that when you were 16 years old, when you were flooded with these hormones?
40:23
Karen Martel: No.
40:24
Karen Martel: And so hormones are part of our physiology.
40:28
Karen Martel: And yes, menopause is natural and all of that.
40:32
Karen Martel: And people will say, Yeah, but this is natural for us to lose our hormones.
40:35
Karen Martel: Well, it's natural for us to also get heart disease and die early.
40:39
Karen Martel: Like that's the this is the thing.
40:42
Karen Martel: And it's like, well, what's the alternative?
40:44
Karen Martel: You know, we we are trying as a species to live longer and longer, and we are grabbing on to anything and everything that helps us do that.
40:53
Karen Martel: We're taking the supplements, the medication, the everything, the diets, and so hormones are in those categories where it's like at least these are bioidentical.
41:05
Karen Martel: This is something your body's produced in your whole majority of your life, and they impact our wellness.
41:12
Karen Martel: And without them, we do start to age much faster.
41:16
Karen Martel: And they've done their research on this.
41:18
Karen Martel: They did one study that showed that women within like six months of being in menopause biologically aged nine years.
41:27
Karen Martel: So biological ages, how fast are you aging on the inside?
41:31
Karen Martel: That's insane.
41:33
Karen Martel: And so hormones are one solution to this life of ours, that we want to live an optimal life.
41:42
Karen Martel: We want to stay as healthy as we possibly can.
41:45
Karen Martel: Then hormones should be something to be looked at and don't get dogmatic about it.
41:51
Karen Martel: Don't think like, I'm not gonna do hormones, and so I'm gonna, I see this all the time, right?
41:56
Karen Martel: I'm better than all of you, basically, because I don't need to take hormones, or I'm not going to, and I'm going to get through this without them.
42:07
Karen Martel: And it's not a badge of honor to do that.
42:10
Karen Martel: It to me, that's stupidity.
42:12
Karen Martel: It's like, why would you say that?
42:15
Karen Martel: You know, like because what are you saying to all the women that are suffering immensely?
42:21
Karen Martel: Do you know that women, the highest rate of suicide is women in menopause and perimenopause?
42:29
Karen Martel: So to say that, what you're saying to some woman who, you know, is on the brink of taking her own life because of the loss of these hormones.
42:43
Karen Martel: You're saying to her that she is weak and that oh, she should be able to get through this.
42:49
Karen Martel: And we don't want that.
42:50
Karen Martel: Like if you're cho if you're choosing not to do hormones, great, that's your choice.
42:54
Karen Martel: Awesome.
42:54
Karen Martel: But don't make it sound like it's that oh, some other woman for choosing to do hormones is in the wrong and is less than you.
43:03
Karen Martel: Yeah.
43:04
Karen Martel: And I think that that's like really important to get across.
43:08
Philip Pape: It is because you see that a lot, that kind of messaging a lot in the fitness industry on Instagram with a lot of things, especially by younger people who haven't experienced it yet.
43:17
Philip Pape: Let's be honest, who are like, yes, like I'm gonna do it now.
43:21
Karen Martel: People that didn't have it bad, and they're like, oh, it's that bad.
43:24
Philip Pape: Different experiences.
43:25
Philip Pape: Same thing with GLP1s, like having talked to like I was a little bit a little bit intransigally when it came out, just for a brief moment.
43:33
Philip Pape: And then I shaped up after talking to just a couple human beings who like have experiences, right?
43:39
Philip Pape: Which is what happens in that um, yeah, it's a tool, and you choose to do it, and nobody should judge you, and you shouldn't judge them, and whatever.
43:46
Philip Pape: So speaking of actually speaking of the GLP1s, GOP1 agonists and all the new ones coming out, where does that play into the hormone situation?
43:56
Philip Pape: You know, I'm not we talk a lot about appetite and weight loss and all that, but specifically with HRT and GLP1, like what's the overlap or interaction?
44:04
Philip Pape: And what should people be aware of if they're gonna do one or both potentially?
44:09
Philip Pape: Um, yeah, because that's kind of a new new thing now.
44:12
Karen Martel: It is.
44:13
Karen Martel: And we we started using GLP1s a couple years ago in our clinic.
44:17
Karen Martel: I also took them.
44:19
Karen Martel: Um it and it was a lifesaver for me.
44:22
Karen Martel: Like it really was.
44:23
Karen Martel: It it changed, it literally changed my life.
44:26
Karen Martel: And and I hear this all the time from women.
44:28
Karen Martel: And there's some women that, you know, no matter what they do, no matter what, they can't get off the weight that they gained from menopause.
44:37
Karen Martel: And it's and we don't know why, because these women will replace their hormones, they'll they'll be lifting weights, they're prioritizing protein, they're doing all the right things, myself included, and they still can't get it off.
44:51
Karen Martel: Like I got some of mine off through prioritizing more protein and lifting heavier with with my trainer, Pam Sherman, who you know.
45:01
Karen Martel: And she really helped me out, and I was able to get off quite a bit of weight, but I still was left with probably about 10 pounds that I just couldn't shake.
45:11
Karen Martel: And I was like, okay, well, I guess this is it.
45:14
Karen Martel: Like, this is my body now.
45:16
Karen Martel: I'm gonna accept it.
45:17
Karen Martel: And then the GOP1s came out, and I'm like, hmm, I'll try that.
45:22
Karen Martel: Yeah, why not?
45:24
Karen Martel: I've been waiting for this my whole life.
45:26
Karen Martel: It's a medication that actually works for weight loss that doesn't make you suffer.
45:30
Karen Martel: And I I did very small doses, I never went very high.
45:35
Karen Martel: I got off that 10 pounds plus another five, which you can see I'm not too skinny.
45:40
Karen Martel: I don't have wasempic face.
45:41
Karen Martel: I didn't take it too far, which for sure some people do.
45:44
Karen Martel: And I just take a very micro dose now, and it's really helped all my markers, it's really helped with my menopause.
45:51
Karen Martel: I don't get night sweats anymore.
45:52
Karen Martel: You know, I can keep my body at a really good weight, which is awesome.
45:58
Karen Martel: Like to be.
45:59
Karen Martel: I'm 40, I'm turning 50 in a couple months.
46:01
Karen Martel: And I'm like, oh my God, I look better now than I did at 40.
46:05
Karen Martel: And this has helped from hormones, it's helped from my lifestyle for sure, but also from the GLP ones because, and it's like, that's such a nice thing to be able to have that as a tool for menopausal women that you know, all else fails.
46:22
Karen Martel: We could have, you know, a micro dose of these GLP ones, get off that weight that we gain, go back to ourselves.
46:29
Karen Martel: And that's a it's it's glorious.
46:31
Karen Martel: Like it's just a huge relief.
46:34
Karen Martel: And we get a lot of the that's what we get for in our peptide program, is we get that midlife woman that and you uh you get the stories all day long in the community of I hit perimenopause, I hit menopause, I I hit 52, I'm 55, I gained 20 pounds, I cannot shake it.
46:53
Karen Martel: I've been trying to lose this 20 pounds for the last five years.
46:56
Karen Martel: It will not budge.
46:58
Karen Martel: I don't know what else to do.
46:59
Karen Martel: And then they go on these and they lose the weight, and they're just like, they're so grateful.
47:05
Karen Martel: And the research shows that women that are on hormone replacement therapy and do and go on a GLP one, that they'll lose 45% more weight than a woman that's not on HRT.
47:17
Karen Martel: So that just goes to show that you know it's really important to have those tools in place, even though you're doing even though you're doing a GLP one, which is a quick fix, but it is important to have the diet in place, the HRT in place, the weightlifting in place so you don't lose the muscle.
47:34
Karen Martel: Do it right.
47:35
Karen Martel: Like I really, really I what I promote the most is we can do these and we can do them in a way that is safe and that is right for the body.
47:46
Karen Martel: And what what we're seeing and all the fear-mongering, a lot of it is because it's not being done right and they they're being overdosed and they're not eating well, they're not being taught how to eat properly and work out, you know, and take the proper supplements and stuff like that while you're doing it.
48:03
Karen Martel: So it is important to do that.
48:05
Philip Pape: Yeah, and by the time this episode comes out, the one with Jamie Sells or would have come out, or we get into some of those exact topics.
48:11
Philip Pape: But it's funny because I think of some of my very earliest clients before any of this stuff existed, where they were consistent, they were training, they were controlling for their calories, they were eating protein.
48:22
Philip Pape: Some of them were even on HRT, and something was just keeping that metabolism lower.
48:29
Philip Pape: And I wonder, so with the GLP ones, I mean, it really is just the appetite that it affects.
48:35
Philip Pape: I mean, that we know that's basically all it does.
48:37
Philip Pape: The the dual agonist does a little bit more, and then there's new ones in the pipeline.
48:40
Philip Pape: Like Eli Lilly has a triple agonist that affects your like liver fat and glucagon, right?
48:45
Karen Martel: I think it's way more than the appetite.
48:47
Philip Pape: Oh, well, you mean just the semaglitide?
48:49
Philip Pape: Yeah, you're right.
48:50
Philip Pape: It's like addiction and everything else.
48:52
Philip Pape: Is that where you're gonna go?
48:53
Karen Martel: But not even like it is.
48:54
Karen Martel: Yes, I do.
48:58
Karen Martel: But number one.
48:59
Philip Pape: I was gonna actually ask that.
49:00
Philip Pape: I was gonna, I was setting that up.
49:01
Philip Pape: I was setting up the question, not like saying it as truth.
49:04
Philip Pape: I was gonna say, so what worked for you then?
49:07
Philip Pape: Like, were you controlling, were you monitoring your calories and did you eat less, or did you eat roughly the same and you just actually started losing?
49:13
Karen Martel: I definitely ate less.
49:15
Philip Pape: Yeah, yeah, yeah.
49:16
Karen Martel: I definitely ate less, and that the appetite suppression is definitely a real thing.
49:20
Karen Martel: And it's like, oh my god, it's so it can be really hard to eat.
49:24
Karen Martel: And sometimes that's actually a sign that you need to lower the dose because you still want to be able to put in the calories, and because the weight loss isn't dependent only on the appetite suppression, which is a very weird thing, but so I'm two years out since I've lost the weight.
49:44
Karen Martel: Okay.
49:44
Karen Martel: So I went on it, I lost the weight, and then I've been maintaining since.
49:48
Karen Martel: And I'm at such a low dose that my hunger is the same.
49:52
Karen Martel: I'm eating the same amount of calories as I did pre-GLP one, and I'm not gaining any weight back.
49:59
Karen Martel: And even the pre my practitioner, she's like my peptide hormone coach that does all of our coaching.
50:06
Karen Martel: She's jacked.
50:08
Karen Martel: She should see her.
50:09
Karen Martel: She's shredded.
50:10
Karen Martel: Like you've never seen a woman like this.
50:12
Karen Martel: It's just she's crazy, huge guns on her.
50:15
Karen Martel: And she's been on the GLP ones for she had total weight loss resistance, could not, no matter how much she worked out, could not lose the weight.
50:24
Karen Martel: And like me, it was maybe like a 15-pound extra weight on her, but she didn't like that, right?
50:30
Karen Martel: Like maybe 15-20 pounds.
50:32
Karen Martel: Anyway, so she loses it on GLP ones.
50:36
Karen Martel: She now, she was just telling me the other day, she averages, I think she said 2300 calories a day.
50:42
Karen Martel: She's maintained the weight loss, and she she eats a hundred, I think she said 150 grams of protein a day.
50:51
Karen Martel: So she's not having any problems.
50:54
Karen Martel: And she is not, she has not gained any weight back.
50:58
Karen Martel: My thyroid, I had to lower my thyroid medication, which I'd been on the same dose of thyroid for seven years.
51:06
Karen Martel: I had to lower it because my thyroid started to function better and my levels went over range.
51:14
Karen Martel: So that's metabolism.
51:16
Karen Martel: My metabolism got better.
51:18
Karen Martel: My friend Dr.
51:19
Karen Martel: Amy Horneman, she's a the thyroid doctor.
51:22
Karen Martel: Same thing with her.
51:23
Karen Martel: She's been on the same dose for 10 years, and she had to lower her medication because she's she was my redosing GLP1.
51:30
Karen Martel: Lowers inflammation, it does something to the metabolism.
51:34
Karen Martel: It's so it's like the appetite suppression that tends to go away after a couple of months or lighten up for most people.
51:42
Karen Martel: And everybody freaks out, oh, my hunger's coming back.
51:45
Karen Martel: Should I increase my dose?
51:47
Karen Martel: And we're always like, no, don't increase.
51:49
Karen Martel: Like, don't increase unless you've been stalled out for a while.
51:53
Karen Martel: You know, if you're not losing weight and you still have more to lose, okay, slightly increase the dose then.
52:00
Karen Martel: But in most cases, hunger starts to come back and the weight still continues to come off.
52:08
Philip Pape: You need to eat more.
52:09
Philip Pape: It's like you do need to eat more in that case, right?
52:11
Philip Pape: To maintain the same.
52:12
Philip Pape: Yeah, I've heard it's gonna be interesting because I it's too early for any long-term studies to tell us exactly what's going on.
52:18
Philip Pape: It will be fascinating to see.
52:20
Philip Pape: By the way, Amy Horneman's coming on not till next year, though.
52:23
Philip Pape: So I didn't know your friends are there.
52:26
Philip Pape: I would have reached out.
52:26
Philip Pape: Yeah, no, she's very busy.
52:28
Philip Pape: Oh, it's amazing.
52:31
Philip Pape: I try not to, you know, you know, take too much advantage of our contacts.
52:36
Heather: Yeah.
52:36
Heather: Hello, my name is Heather, and I am a client of Philip Pape's.
52:41
Heather: Just six days after I started this cut, my family and I were in a 7.9 magnitude earthquake here in Adana, Turkey.
52:48
Heather: As I tried to process the stress and trauma, my first instinct was to say, oh, you've been through something hard.
52:55
Heather: This is not a good time.
52:57
Heather: But instead, I reached out to my coach and he got me under the bar that day, and he helped me keep my macros that day.
53:03
Heather: And not only did I realize that I was doing something fantastic for my body, but I realized that I was doing something fantastic for my mind, and that it was going to help me keep the mental clarity that I was gonna need to get my family through what really has been a very difficult two months.
53:17
Heather: Here I am on the other side of eight weeks.
53:20
Heather: Got my kids through all the things that we have been through.
53:23
Heather: And I weigh 12 pounds less than I did, and I got a new PR on my bench press.
53:28
Heather: I have a long way to go, and there are still things that I really want to accomplish, but now I know that I can, and I'm really grateful.
53:35
Heather: Thank you, Philip.
53:38
Philip Pape: Yeah, it's just it's a whole thing.
53:39
Philip Pape: I mean, there's we're gonna be talking about this stuff for ages, and there's still gonna be lots of controversies about it.
53:44
Philip Pape: But look, if from a medical and a health and a metabolism standpoint, there are other benefits that we start to see, it'll be fascinating.
53:49
Philip Pape: Not to mention, I did mention addiction, like people who have addictive, get more addictive brain chemistry are helped tremendously to the point where they may need to be on it for the rest of their life, so to speak.
54:00
Philip Pape: But yeah, no, I I guess that that's all that's all I wanted to cover on that.
54:04
Karen Martel: Well, and well, and women have so much, like, I mean, so do men, of course, but you talk to these women and myself included, where their whole life uh was spent watching everything they put in their mouth: calorie counting, exercising, doing the math, like freaking out about, oh my God, I ate the cupcake.
54:25
Karen Martel: Oh no, okay, I'm gonna have to like intermittent fast tomorrow.
54:27
Karen Martel: I'm gonna have to like go low carb, I'm gonna have to go keto, I'm gonna have like we as women drive ourselves insane.
54:35
Karen Martel: I have been thinking that way since I was 13 years old.
54:38
Karen Martel: I have been fighting my weight and I've been fighting with everything that I put in my mouth.
54:43
Karen Martel: It was always a constant tally in my brain.
54:46
Karen Martel: I'm not proud of this, but it's just the way it was because I was so I could so easily gain weight that if I if I wasn't that strict, I would immediately start to gain weight.
54:59
Karen Martel: So I had to be so careful of everything that I ate.
55:03
Karen Martel: And I had to stay eating like paleo and grain-free and low carb and watch my blood sugar and make sure I exercised and all of these things.
55:12
Karen Martel: Not to have to worry about that for the first time since I was 13 is like I can't believe how much uh space I have in my brain to think of other things.
55:24
Karen Martel: It's just a huge mental relief.
55:28
Karen Martel: And I hear this all the time from women that have had the same struggles where they've fought this their whole life, and maybe they had food addiction and sugar addiction, and they've were obese their whole life, and then suddenly they can lose the weight.
55:41
Karen Martel: It is like, how can some I just don't understand how people judge that?
55:47
Karen Martel: How do people judge that somebody wants to take this medication?
55:52
Philip Pape: Right.
55:53
Karen Martel: Food addiction is is just as harsh as cocaine addiction, for heaven's sakes, but yet people don't see it like that.
55:59
Karen Martel: It's like, well, you chose that, you you could choose to exercise, you could choose to eat better, and it's like, screw you, you don't know what it's like to be overweight and not to have the energy to work out or the mental capacity to eat well, and maybe you've got sugar addiction or food addiction, like it's a disease.
56:20
Philip Pape: Yeah, and everything you kind of alluded to when you said talked about stress and addiction in the brain, and makes me think of the um some of the work that like Stephen Guillonet talks about, uh you know, he's about about brain-related genes and how um, you know, the genetic component, there's such a difference between people.
56:37
Philip Pape: Um, there's another guy I want to get on the show, I forget his name, that he's like 19 or 20, and he's like a genius when it comes to appetite research.
56:45
Philip Pape: And he talks about this stuff all the time.
56:47
Philip Pape: There's such a wide spectrum that what if, Karen, it's just the fact that you're reducing that anxiety and that brain, that cognitive load and all that stress.
56:54
Philip Pape: And that's why your metabolism's approving.
56:56
Philip Pape: I don't know, right?
56:57
Philip Pape: Like so many things that cascade.
56:59
Karen Martel: And a lot of people will say that.
57:00
Karen Martel: They'll say, I don't have anxiety anymore, I don't have the the hamster brain anymore.
57:05
Karen Martel: And they don't know what it's what it's doing, but they're like, I've I have so much relief in my brain from taking GLP1s.
57:12
Karen Martel: People that have inflammation, they're like, My inflammation's gone, my gut's better.
57:17
Karen Martel: Like all of these things can start to improve.
57:20
Karen Martel: And I think, you know, would we ever say to the person that's been depressed their whole life or been riddled with anxiety and they choose to go on an antidepressant or they choose to go on an anti-anxiety?
57:32
Karen Martel: Would we sit there?
57:33
Karen Martel: Would we attack them the way people are being attacked for taking a GLP one?
57:38
Karen Martel: Right.
57:38
Karen Martel: Never.
57:39
Karen Martel: And would we start to do you see all over social media the side effects of SSRIs?
57:45
Karen Martel: Hello.
57:46
Karen Martel: The side effects are they're long lists.
57:51
Karen Martel: So, yes, GLP ones, yes, they can have side effects for sure.
57:55
Karen Martel: And we don't want those side effects.
57:57
Karen Martel: However, the the like, do does the good outweigh the bad?
58:02
Karen Martel: I think so.
58:03
Philip Pape: Yeah, yeah.
58:04
Philip Pape: Is that and it's all individual.
58:05
Philip Pape: It it's funny you mentioned the um, well, not the SSRs, but I did an episode called Osempic Envy or something.
58:11
Philip Pape: I came up with this term called Osempic Envy.
58:12
Philip Pape: It was the idea that there's this like weight loss wars that are war that are waged in public on social media, just like there's political wars waged in public where if you were in a room with human beings, you would not be talking like that or treating each other that way because it's on such a point.
58:26
Philip Pape: We do this.
58:27
Philip Pape: So it's like imagine you're in the room with the person, how would that conversation go, you know?
58:31
Philip Pape: Um I wanna the I guess the last thought I have about all this, because we're I know we're barely scratching the surface, but it's going back to the complexity of some of this is our healthcare industry is inadequate, in my opinion.
58:45
Philip Pape: I think I think in yours as well, to address this.
58:47
Philip Pape: And if, you know, unless you get lucky and there's an individual here or there, what does the future hold?
58:53
Philip Pape: Like, I this is more of an optimism side of me trying to and trying to pull this out of you too, Karen.
58:57
Philip Pape: Like, what does the future hold as the different industries change, as maybe there's more practitioners like you, as maybe technology like AI or and more advanced like labs and genetic testing comes into play?
59:09
Philip Pape: Like, how do you see all this coming together like 20 years from now?
59:13
Philip Pape: What are women gonna have as their resources?
59:15
Philip Pape: What is your vision for the future?
59:17
Karen Martel: I have a really positive vision.
59:18
Karen Martel: Like, I really see a lot of change happening, and there's you'll get the naysayers on social media, they're like, oh, menopause is just becoming a money grab and blah, blah, blah.
59:28
Karen Martel: And it's like, you know what, you guys, stop.
59:31
Karen Martel: Like, we need to be talking about it.
59:33
Karen Martel: Even like the good, the bad, all of it.
59:35
Karen Martel: We need to be talking about it.
59:37
Karen Martel: And it's finally getting talked about.
59:40
Karen Martel: So it's like, let us let us talk about it, let us scream it from the mountaintops, because only four to seven, I think it went went from four to seven percent of women are on HRT.
59:50
Karen Martel: So the majority of the public, the women, then there's millions and millions of women that are in menopause.
59:57
Karen Martel: So majority are not on HRT and are not getting.
59:59
Karen Martel: This information, so we may see it because we're in social media and in the field in this field, but majority of women still don't get have that information.
1:00:08
Karen Martel: Doctors don't have that information, and they're trying to change that.
1:00:12
Karen Martel: And I see that change coming.
1:00:13
Karen Martel: I mean, we just had a big panel at the FDA where they're working on getting rid of the black box warning off of the estrogen package packages because right now it says estrogen causes cancer.
1:00:24
Karen Martel: And they have zero, zero research to back that up.
1:00:29
Karen Martel: And so they're like, why is this on here?
1:00:32
Karen Martel: Like this just is unnecessarily scaring women that they something that could really benefit them.
1:00:38
Karen Martel: Like, take this off.
1:00:39
Karen Martel: And so that's gonna happen, I think.
1:00:42
Karen Martel: I think that they're gonna start.
1:00:44
Karen Martel: There was another woman that was at Congress that was trying to get so that um in med school that doctors that there was more on education on menopause.
1:00:53
Karen Martel: Because right now, less than 7% of doctors are taught anything about menopause.
1:00:57
Karen Martel: And if they are taught something, it's like, you know, a couple hours basically, and that is it.
1:01:03
Karen Martel: But none of them are taught anything about perimenopause, none of them are taught about bioidentical hormones.
1:01:09
Karen Martel: They actually have to go get extra training for that.
1:01:12
Karen Martel: So I think more doctors are going to start to be educated in this.
1:01:16
Karen Martel: Public is starting to be more educated in this as we're becoming, you know, more and more, we're taking our health into our own hands.
1:01:23
Karen Martel: And so it's all about finding the right information out there with podcasts and blogs and all of this.
1:01:30
Karen Martel: And so I see that women are becoming more and more empowered.
1:01:34
Karen Martel: They're seeing that, hey, you can be 50 and you can rock your 50s, 60s, 70s, and beyond.
1:01:41
Karen Martel: And like you can do it in a way that is super healthy.
1:01:45
Karen Martel: You can use hormones, you can work out, you can lift weights, you can take the right cell phones, all these amazing biohacks, peptides, peptides are exploding.
1:01:55
Karen Martel: And these can be incredible, not just weight loss.
1:01:58
Karen Martel: I'm not talking weight loss peptides, I'm talking about all the other peptides.
1:02:01
Karen Martel: There's hundreds, if not thousands, of them at this point.
1:02:04
Karen Martel: And they can be this amazing like therapy that, you know, working with somebody that understands peptides, it they can enhance everything.
1:02:13
Karen Martel: I've tried, I've tried so many different ones, like growth hormones and uh mitochondrial stuff.
1:02:19
Karen Martel: And like, I love it.
1:02:20
Karen Martel: I love being my own like little biohacker and taking my health into my own hands and being like, how good can I feel?
1:02:26
Karen Martel: And so I just think we're gonna start seeing more and more of this.
1:02:30
Karen Martel: And women are gonna start taking more and more in charge of their own health and go, oh, I can, I can feel amazing.
1:02:37
Karen Martel: It doesn't matter what age I'm at.
1:02:40
Philip Pape: That's great.
1:02:40
Philip Pape: So it's like uh it's like a perfect storm the other direction, the way we want it to go, right?
1:02:45
Philip Pape: Maybe a little regulation over here, education for doctors over here, controlling your health, lots of choices, lots of options.
1:02:52
Philip Pape: Who knows what amazing technology is going to come down the bike path.
1:02:55
Philip Pape: I I tend to go to that first as my engineering brain of like, oh, we can get AI and clone Karen's brain, and then we can, you know, get everybody the hormone help they need, you know?
1:03:05
Karen Martel: I think that's all coming.
1:03:07
Karen Martel: I do.
1:03:07
Karen Martel: And I think there's lots of like cool at-home testing that's happening right now where women are able to test their hormones from home, like by just peeing on a stick, and they have these little devices now, and we're gonna start seeing like stem cell transplants for the ovaries that's happening right now in Mexico where they're rejuvenating the ovaries.
1:03:27
Karen Martel: You know, it's not legal here, but it's legal that they do.
1:03:30
Karen Martel: Well, let them try it out first.
1:03:31
Karen Martel: Yeah, it's like ridiculous expensive.
1:03:34
Karen Martel: I'm like, why wouldn't I just take hormones?
1:03:36
Karen Martel: I'm like, I asked the guy, I met the guy that owns the clinic, and I'm like, it's like $30,000 for treatment of the ovaries, and you might get a couple more years before you hit menopause.
1:03:45
Karen Martel: And I'm like, nah, just take the hormones.
1:03:48
Karen Martel: It's cheaper.
1:03:49
Karen Martel: But these are all things that are happening, and I think that we're demanding that more research is done on women and on women's bodies.
1:03:57
Karen Martel: And I think that that's starting to happen.
1:03:59
Karen Martel: We're starting to see some really cool stuff coming out of different uh, like Felice Gersh is coming out.
1:04:05
Karen Martel: She's come out with some great research papers on hormone replacement therapy.
1:04:09
Karen Martel: Um, Louise Newson, these are like the menopause like gurus in social media.
1:04:14
Karen Martel: The Newsom Clinic, she just came out with some new research.
1:04:18
Karen Martel: Uh, mental health stuff is coming out, like being brought more awareness is being brought to it.
1:04:24
Karen Martel: So I think that it's going in the right direction.
1:04:27
Karen Martel: Of course, you're always gonna get the shit with it.
1:04:29
Karen Martel: Sorry if you don't swear on your podcast, but you're always gonna get the garbage going along with the good.
1:04:34
Karen Martel: And that's all gonna be part of it.
1:04:35
Karen Martel: You're gonna get the people that are out just trying to make money.
1:04:39
Karen Martel: It's like, well, whatever.
1:04:41
Karen Martel: Like, just who cares?
1:04:42
Karen Martel: You know, it's just do what's right for you and your health and educate yourself on it.
1:04:48
Philip Pape: Totally agree, totally agree.
1:04:49
Philip Pape: And that's what we're trying to do, right?
1:04:50
Philip Pape: So people need to connect with you.
1:04:52
Philip Pape: I'm sure a lot of our listeners already know you, Karen, but I want you to connect with them even more.
1:04:56
Philip Pape: So I'm gonna mention one thing and then I want to turn over to you to send them the best place.
1:05:00
Philip Pape: For those of you who are already in physique university, um, you're gonna get to see Karen in there on the 14th of October for a live QA.
1:05:06
Philip Pape: You can ask her anything you want.
1:05:10
Karen Martel: I love it.
1:05:10
Philip Pape: Yeah, there you go.
1:05:12
Philip Pape: So if you're in there and you're listening, you get it included.
1:05:15
Philip Pape: If you're not, I'll have a link to register.
1:05:16
Philip Pape: Yes, just full transparency.
1:05:18
Philip Pape: It's a paid coaching program, but it's very accessible.
1:05:20
Philip Pape: And so if you want to see Karen in there, that's your chance.
1:05:23
Philip Pape: Karen, where would you like people to go right now and check you out?
1:05:27
Philip Pape: All right.
1:05:28
Karen Martel: So I got something for everybody, which I'm so happy I get to offer that.
1:05:33
Karen Martel: But we can prescribe in every state.
1:05:36
Karen Martel: So I run and own a telemedicine clinic where we focus on women in midlife.
1:05:42
Karen Martel: We do not deny the woman that's in her perimetopausal years hormones.
1:05:47
Karen Martel: Uh, and so we take a very functional approach to HRT, which I feel is is missing and is lacking a little bit right now.
1:05:57
Karen Martel: And so we look at every, we look at the lifestyle, and and Phil's gonna come into my group as well and do a QA.
1:06:05
Karen Martel: And so we focus a lot on, you know, all the lifestyle aspects and then as well the HRT, and we really try and look at everyone from an individual standpoint.
1:06:14
Karen Martel: We don't, we're not, you know, set on one type of protocol or delivery form.
1:06:19
Karen Martel: It's like, what is gonna work for you?
1:06:21
Karen Martel: And we will work for you with you until we find what is gonna make you feel your best and to give you that protection, the heart, the brain, bone protection that these hormones can give you.
1:06:33
Karen Martel: And if you choose not to do hormones, well, we've got a whole arsenal of other stuff that we can help you with that well, if you're choosing not to do hormones, that we can still do all of these other things that would it's gonna help you to age better.
1:06:46
Karen Martel: And then on top of that, I also have a membership group for those that can't afford the private coaching.
1:06:53
Karen Martel: Um, we also have this very affordable group where we have an amazing community of women.
1:06:59
Karen Martel: We've it's been going for like seven or eight years now.
1:07:02
Karen Martel: And uh, and then I also just came out with my own line of over-the-counter hormone creams and oils, which is amazing.
1:07:12
Karen Martel: Um, and I'd love to give your audience a coupon for them.
1:07:14
Karen Martel: So these are creams and oils that contain bioidentical USP grade hormones.
1:07:20
Karen Martel: These are no different than the hormones that are in them are no different than what you would get from a pharmacy.
1:07:26
Karen Martel: That's the grade they're at.
1:07:28
Karen Martel: We do all sort of like third-party certificate of analysis and purity of the hormones.
1:07:32
Karen Martel: They're very clean products, and they are marketed as beauty cosmetic hormones and creams.
1:07:40
Karen Martel: That's how we can promote them and how we can sell them online without a prescription.
1:07:45
Karen Martel: And many, many women buy these.
1:07:48
Karen Martel: We have an incredible estrogen face cream that has been shown to just do absolute wonders for the face, um, shrinks your pores, helps with your fine lines, etc.
1:07:59
Karen Martel: Uh, just came out with a vaginal moisturizer.
1:08:02
Karen Martel: Uh, we've got a progesterone melatonin oil that's amazing for sleep.
1:08:06
Karen Martel: So that's, you know, I'll pump up my own stuff here, but it's it's such an awesome thing to be able to offer women because it's so affordable.
1:08:16
Karen Martel: It's way more affordable than prescription hormones.
1:08:19
Karen Martel: And you don't need you don't need the actual prescription.
1:08:22
Philip Pape: What's the name of the line?
1:08:23
Philip Pape: What is like what's the brand?
1:08:24
Philip Pape: Or what do you call it?
1:08:25
Karen Martel: Hormone solutions.
1:08:26
Philip Pape: Hormone solutions.
1:08:26
Philip Pape: Okay, just like you.
1:08:27
Philip Pape: So if everybody wants to grab that, you can go to witsandweights.com slash Karen Martell and you'll get uh 10% off with my code Wits and Waits.
1:08:34
Philip Pape: Um, I'm gonna be checking those out myself.
1:08:36
Philip Pape: I know we have a lot of women in the community that would be interested.
1:08:39
Philip Pape: And then Karen's uh hormone coaching, which I hear nothing but great things about over the years that I've known her.
1:08:43
Philip Pape: And then this new telemedicine clinic is awesome.
1:08:45
Philip Pape: I love that uh direct approach to healthcare in a way that's individualized and functional.
1:08:50
Philip Pape: So thank you, Karen, so much again for doing this with me.
1:08:53
Philip Pape: I'm excited for our upcoming collaborations, and I hope everybody listening really enjoyed and got a lot of this episode.
1:08:58
Philip Pape: I know they did.
1:08:59
Philip Pape: Thank you so much, Karen.
1:09:00
Philip Pape: Thanks for having me.