Latest / Two Girls and a Cup of Wellness / Hormones, Healing & Healthy Aging: Why Quality of Life Matters with Elise Clark- Episode 41

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Hormones, Healing & Healthy Aging: Why Quality of Life Matters with Elise Clark- Episode 41 · Two Girls and a Cup of Wellness

• Crissy Florio: And we're back. And we're back, guys. So sorry. We're having some technical difficulties today. And not sure where we were Elise Clark, FNP-C: You Crissy Florio: in this amazing conversation. but here we are again. We're gonna start this over. Not the whole thing, but but I think you need to ask a cr Elise Clark, FNP-C: Yes, yes, no. Crissy Florio: a question, Chrissy, because it is breast cancer month, and I've been seeing a lot of buzzed stuff about hormones and breast cancer. And okay. Well, I guess we can switch gears. Elise Clark, FNP-C: Yeah. Crissy Florio: so I was triple positive, right? So Elise Clark, FNP-C: Okay. Crissy Florio: estrogen, progestion, and HER2 positive. And I know when after I was diagnosed, the the thought of estrogen was like there's no way. I right and there's absolutely no way I could be on any type of hormones, or I I thought about all the hormone disrupting type of chemicals and all the things Elise Clark, FNP-C: Yeah. Crissy Florio: and like xenoestrogens and stuff like that. And Now there's more, I think, research coming out and more talk about that depending on the type of cancer, how you went through it, your journey and everything, that it may be okay and obviously talk to your Elise Clark, FNP-C: Mm-hmm. Crissy Florio: doctors about it. But what are your thoughts on estrogen and all the fun stuff around breast cancer? Elise Clark, FNP-C: Well, specifically, yeah, post breast cancer, I think it's an individual thing, right? Because I think there's several factors I always consider when I'm talking to patients about it. like, definitely what kind of cancer you had, how aggressive, what was your treatment? And then second question is, would you even be comfortable doing hormones? Because I have some patients where they are candidates, but they're still not comfortable. And then you still don't Crissy Florio: Yeah. that's huge. Elise Clark, FNP-C: want to push across that line either. But vaginal estrogen has by and large been proven to be safe in any circumstance post cancer because we know that it just stays in vaginal tissue. You do get a tiny bit of systemic absorption, but recent studies, kind of the general meta-analysis of it is that it's safe. Like that's the consensus at this point. As far as using systemic hormones, I think I have a little more. liberal take on it because I'm more comfortable even if we're unsure about its effect in the long run. Could it potentially cause a cancer cell to grow that's still left? That's kind of the big fear, right? If you have any cancer cells left that respond and grow in response to hormone, and we give it to you, theoretically we can make it grow again. That's the biggest concern. But even when that is an on the table potential risk, my thought is always quality of life. And if a patient is like, I'm willing to take that risk, of course I have to do a lot of consenting because if it is it's not going to be them that comes after me if something bad happens. It's going to be their family, unfortunately. And Crissy Florio: Yeah. Yeah. Mm-hmm. Elise Clark, FNP-C: thankfully I've never put myself in that kind of situation or had to worry about it. you know, legally I do want to protect myself and I also want patients to know like this is still a fear out there. Crissy Florio: Yeah. Elise Clark, FNP-C: But I think to me, we do a lot of harm in the treatment of breast cancer as far as taking all your organs out and Decreasing all hormone production with these long-term medications to help decrease hormone stimulation They wreak havoc on your bones your blood vessels your brain Crissy Florio: Yeah. Mm-hmm. Elise Clark, FNP-C: So we often forget about the side effects from the treatment for breast cancer as well now I'm not saying they're not necessary like if I was in that situation. I would be doing all the things right But I think we also have to look at at a certain point like are we increasing your risk of mortality? from other things by treating this breast cancer thing. And Crissy Florio: Yeah. Elise Clark, FNP-C: so there is always that balance too, because unfortunately, even after you have a breast cancer and you're successfully treated, you're still more likely to die of heart disease than breast cancer, even a recurrence. Crissy Florio: Mm-hmm. Elise Clark, FNP-C: And so to me, it's very nuanced, very whole picture, but I would say my thinking on it in general is if a patient is really suffering symptomatically and like their bones are thinning, they're having horrible hot flashes and night sweats, vaginal dryness is horrible, they're not sleeping, Crissy Florio: They're not sleeping because of that, right? Yeah. Mm-hmm. Elise Clark, FNP-C: then to me, as long as the patient understands the potential risks of those scenarios where we still don't quite know, then I'm willing to help them feel better in the years that they have left. And I think that's where a lot of people are moving, especially as, like you said, the evidence is stacking up for the safety Crissy Florio: Mm. Elise Clark, FNP-C: in a lot of different scenarios. And next year, I'm going to go to the... Harvard Menopause Conference that they do. You should come, by the way. I think it'd be fun. You should. Okay. Crissy Florio: Mm-hmm. I should come. That's my home that's my hometown. Should and I should tag along. Elise Clark, FNP-C: And you should. But they do, it's not functionally minded at all, but that's where they present all the research on these areas. They talk a lot about breast cancer and the updates on hormone replacement therapy. And so I really want to do that to get a little more studies and things in my arsenal to be like, okay, in what scenarios would I be comfortable doing it more? What do I want to educate my patients on? Because I do think the huge emphasis with cancer is survival, which I think it should be upfront. then afterwards, is it living well if you're suffering through? Right. Like, are you just suffering because now you Crissy Florio: That thriving. Yeah. Right. Yeah. Elise Clark, FNP-C: have no hormones and you have no bones and you have no muscles? Like, I know that's a pretty intense description of things, but. Crissy Florio: No, but but it it is. I remember after my treatments were done going down this spiral of I gotta eat all of the things that are cancer fighting foods. I have to do all of the things. And I was just so fear-driven. Everything that I was doing was like almost like frenatic rather than conscious and calm and until I I I I did some like coaching on that and This one girl helped me through a lot of it. but I know that every woman that I talk to who has experienced a breast cancer diagnosis, cancer in general, but I talk to more breast cancer survivors, they all feel the same way. It's that, it's that after treatment of like, how do I get back to life? How do I figure Elise Clark, FNP-C: Yeah. Crissy Florio: out this new quality of life? And what does that mean to me? What what matters to me? And those are really great questions Elise Clark, FNP-C: Yeah. Crissy Florio: to ask themselves. So I really appreciate you taking that that the quality of life, your overall health and wellness and joy and you know, what makes you happy is is essential in thriving and not just surviving a diagnosis, but how do you really truly thrive and become a better version of yourself and happier Elise Clark, FNP-C: Yeah. Crissy Florio: and healthier and more appreciative and all of the things. And this disaligns not with just breast cancer because I see people with insulin resistance and obesity. And I'm trying to Elise Clark, FNP-C: Right. Crissy Florio: talk to them about how life can be better. And if we replace some of these hormones, you'll start to feel better so you can get to the gym. You know what I mean? We can do these different things so you can be right. Especially thyroid. That's like I mean Elise Clark, FNP-C: Right, so you have the motivation back. Crissy Florio: thyroid and testosterone are two of my favorites. But And you focus a lot on thyroid as well, right? Thyroid health Elise Clark, FNP-C: Yeah. Yeah, I treat a lot of, yeah, I use it a little bit off label for optimization, right? Like if someone Crissy Florio: Mm-hmm. Elise Clark, FNP-C: has like symptoms of hypothyroid, but their levels are technically normal, but very low normal. I will use it in those situations. But having come from that endocrinology background, I did a ton of thyroid patients. I think what people don't realize about endocrinology is a lot of it is thyroid and diabetes. And then there's other like fun stuff and complicated stuff mixed in, but that was the bulk of what I saw. So metabolic health is always something that I've really enjoyed. And then I was using the GLP ones before they were cool back in the day. And then thyroid, it just makes such a huge difference in people's lives and wellbeing. and Crissy Florio: Life changing. Mm-hmm. Elise Clark, FNP-C: my mom had been hypothyroid for at least a decade before I got into functional work. And so then we did more extensive labs for her and she found out, plus later she had Hashimoto's. So there was this whole Crissy Florio: Mm-hmm. Elise Clark, FNP-C: other thing to kind of help manage that made her feel significantly better. course adding on T3 was life-changing for her because so Crissy Florio: Mm. Elise Clark, FNP-C: much thyroid is I think undertreated even when we know it's there. I love treating thyroid especially in women because it has this light bulb moment for a lot of people who like I didn't realize I felt so crappy because now I feel better. So I'm sure you have that experience too. Crissy Florio: Mm-hmm. Yeah. Yeah. Yeah. Yeah. My dad, I have Hashimoto's and I finally bit the bullet after World Link. And I said, all right, I'm gonna try this. Cause I was originally on Livo Thyroxy, and I went, bonkers. I said, This is nuts. But then as you know, it gets harder to think and it gets difficult to keep Elise Clark, FNP-C: Yeah. Crissy Florio: the weight off. And I'm like, all right, we're good, we're gonna try this. Neil said it's gonna work. And I'm like, it's been life changing for me. And then on top of that, my dad Yeah, we'll do what Neil says. Elise Clark, FNP-C: We do what Neil says. Crissy Florio: But I'm a snail guy. My dad's down fifty pounds. he's a whole new person. And then he's chasing after Elise Clark, FNP-C: that's awesome. Crissy Florio: my mom and all that stuff too. But hormones have changed their lives. Yeah. Well, he they Elise Clark, FNP-C: You're like, I could have done without that dad, thanks. Crissy Florio: see my business partner, but they like to share this stuff with me. I'm like, my goodness, please stop. Stop. Elise Clark, FNP-C: Too much of an open book, maybe. Crissy Florio: But the thyroid is just it's it's I explained it last night on Instagram. I'm reading an excellent book. You'll love it, Elise, if you haven't read already, called The End of Alzheimer's. Elise Clark, FNP-C: yeah, I, well, I didn't finish it. I read most of it. It is very good. Crissy Florio: It's really good. So I'm gonna get tested next week for the gene because it's on both sides of my family. So I'm pretty sure that I have it. It's Elise Clark, FNP-C: That's awesome. Crissy Florio: been something I've been toying with. But he talks about thyroid as the car. Like you can rub it up when Elise Clark, FNP-C: Mm-hmm. Crissy Florio: you're young. And then as you get older, it's like, Elise Clark, FNP-C: Yeah. Crissy Florio: why not check out what's going on now? Why wait Have you ever seen there's just because he may not be the most gorgeous man on this planet, there is a documentary with Chris Hemsworth. who's she talking about? Is it Robbie? Elise Clark, FNP-C: I was like, which direction are we going here? Crissy Florio: Chris Hemsworth did a documentary, and I think that he did it with Dr. Peter Atia. This was probably a couple of years ago, where yeah, Elise Clark, FNP-C: I vaguely remember this. Crissy Florio: like he he actually tested for the gene for I believe it was Alzheimer's. I think so. Don't quote me on that. But they did different episodes based on specific type of longevity practices Elise Clark, FNP-C: Mm-hmm. Crissy Florio: and things that he could start doing now and like grip strength and Elise Clark, FNP-C: Yeah. Crissy Florio: Cold. It was something with swimming in cold. And it was really fascinating. And not to mention that Chris Hemsworth is to me one of the most beautiful men on this planet. Yeah. And my husband Elise Clark, FNP-C: is beautiful. Why wouldn't you look at him? Crissy Florio: knows that I know I believe this. So all is well there. I'll have to look Elise Clark, FNP-C: Yeah, yeah. Crissy Florio: for it. Elise Clark, FNP-C: Yeah, so you said you were gonna get tested for the gene, right? That's what you were talking about. Yeah. Crissy Florio: Mm-hmm. Yeah. Yeah. Yeah. I'm gonna do it next week. It's I've been on the fence back and forth. So my dad's dad had it and his was fast, fast decline. And then my grandmother on my mom's side had it and they put her on what did they put her on? I guess what are the meds? Not a memantine or Elise Clark, FNP-C: I don't write them, so I don't know, to be honest. Crissy Florio: Yeah, I forget it's gonna come to me. No, I'm kidding. I don't know it at all. I was like Gosh. And it kind of just like stopped her in her like in her stage of development, which was already developed. Elise Clark, FNP-C: Yeah. Crissy Florio: Like she was already advanced. And it just kept her there for a long time until and then the doctor said if you pull her off of it, she's gonna have this rapid decline, which please pull me off of it. Okay. I do not want to hang out that way for a long time. Yeah. But Elise Clark, FNP-C: Yeah, at a certain point, yeah, mm-hmm, yes. Crissy Florio: but yeah, so I'm you know, I I probably do have it and I probably have a greater risk, probably fifty percent. But I like Elise Clark, FNP-C: Yeah. Crissy Florio: the book that this doctor's writing because I know that with optimizing my hormones and my thyroid and stuff and then doing all Elise Clark, FNP-C: Mm-hmm. Crissy Florio: the other things, the things that we know, the blue zone things, like eating right and exercising and keeping a healthy Elise Clark, FNP-C: I know. Crissy Florio: BMI and making sure we don't have insulin resistance, all those things will really set you up to be preventative. Yeah, his program called Recog or Recode has pulled people out of it. Wow. And that's super encouraging to me. Elise Clark, FNP-C: Yeah, it's really cool. And I agree, I think there's so much to be said for the prevention aspect. I don't know that I wanna know if I have the gene or not, I haven't decided. It doesn't really run in my family too much though. But either way, I think that what we do in the functional space, especially with hormones, is so proactive and people don't realize that estrogen in particular is so important for preventing brain decline as we get older and that's one of the Crissy Florio: Mm. Elise Clark, FNP-C: biggest reasons to do it. Because I'm sure you get this when you first meet patients, they're like, well, I don't really have hot flashes and night sweats. I don't really think I need hormones. And I'm like, do you Crissy Florio: Mm-hmm. Elise Clark, FNP-C: want your brain? Do you want your bones? Do you want your vessels to Crissy Florio: Hard. Elise Clark, FNP-C: be elastic? Do you want your cholesterol? to stay down and so I explain all of those things because my first goal with patients is always I want you to feel good and then my second Crissy Florio: Mm-hmm. Elise Clark, FNP-C: goal is how are we going to prevent diseases Crissy Florio: Mm-hmm. Elise Clark, FNP-C: and I think that they can definitely go hand in hand. But I can't tell you how many times I have the conversation and if we could just get people to eat well and exercise, like how much better life would be all around us and how much Crissy Florio: Ninety percent of what I do. Elise Clark, FNP-C: disease we could prevent. And I mean, I'm not perfect, right? I'm not saying I have it all figured out, but. Crissy Florio: Yeah, nobody is. Right. Yeah. Elise Clark, FNP-C: I just drives me bonkers, especially when people have the means and the access and they just don't prioritize it because we're so busy. We're so stressed. We're doing, we're going, we're being, and we're just Crissy Florio: Mm-hmm. Elise Clark, FNP-C: never still and we don't regulate our nervous system. you Crissy Florio: Yeah. Elise Clark, FNP-C: know, it's almost like exercise even is just another thing to check off the to-do list. And it's like, no, it's supposed to be rewarding. It's supposed Crissy Florio: Yeah. Elise Clark, FNP-C: to be this like increase in activity followed by this rest. We just go, go, go, go, go. Crissy Florio: Yeah. And I and and our bodies don't I mean, yes, the strength training is good, don't get me wrong. But when we look at like the blue zones, it's not the hardcore working out. It's just Elise Clark, FNP-C: Right. Crissy Florio: walking. It's being able to be mobile enough to get off the floor, right? And do things and they're doing it all day long. They're working in an office. Right, exactly. They're moving with purpose. Elise Clark, FNP-C: Right, never, yeah, they don't stop for long periods of time either. know, it's Crissy Florio: No. Elise Clark, FNP-C: like that's just integrated in their lifestyle. And this weekend, my husband and had this moment where we were both like, we just wish we lived somewhere where we could even walk to go get a cup of coffee. You know, Crissy Florio: Yeah. Elise Clark, FNP-C: like our cities are just so spread out and like we're in a neighborhood Crissy Florio: Mm-hmm. Elise Clark, FNP-C: inside of Dallas and we have a lot available, but there's such big roads that you can't even walk where you want to go because there's too much traffic. So, Crissy Florio: Yeah. Yeah. Elise Clark, FNP-C: I appreciate that about like those blue zones. It's like their lifestyles are just built on being active and unfortunately with how our cities are set up we have to be so proactive with it. It's Crissy Florio: Yeah. Elise Clark, FNP-C: not our lifestyle to farm and raise kids outside. That's true. Crissy Florio: Or or in Florida you get dehydrated on the way to the coffee shop because it's so hot in the summer. I walk to the mailbox and I Yeah I gotta change my clothes. Yeah. Elise Clark, FNP-C: Yeah, we have that problem to a lesser extent here in the summers, Crissy Florio: Yeah. Elise Clark, FNP-C: but you're right, yeah, weather is a big factor for us as well. Crissy Florio: Yeah. Yeah. But I think it's important for everybody if if you are not one that typically loves to work out. But Elise Clark, FNP-C: Yeah. Crissy Florio: when you do it, you recognize immediately you feel better when you're done. I always try to tell my my clients, like, think about the after. Like if you're sitting on the couch, you're like, I just don't feel like working out. Think about when you're done, how you always feel better and let that be the driver, right? Let that be Elise Clark, FNP-C: Yeah. Crissy Florio: your your, in excitement to get up and go, right? I mean, because the truth of the matter is, yeah, we we live in a world where everything is at our fingertips, right off the bat, right? Like we can sit on the couch and watch TV for hours and hours on end. We don't have to get up anywhere and have dinner delivered to us. And Elise Clark, FNP-C: Yeah. Crissy Florio: We don't have to the library anymore. We can just chat GPT something and have the information. Yeah. we need to simplify. Yeah. I think there's something in Elise Clark, FNP-C: We need to bring back encyclopedias for the kids. Ugh. Crissy Florio: opening it up and smelling it and using a highlighter. Cause I I'll hear something and Elise Clark, FNP-C: I love the smell of bugs. Crissy Florio: then I'll forget it. And I'm like, I literally just read or I heard it, or ChatGPT told Elise Clark, FNP-C: You Crissy Florio: me it yesterday, and why can't I remember it? And I could be getting Alzheimer's, okay? I most likely have the gene. However, I think it's that instant in and out. yeah. I got the information. It's just Elise Clark, FNP-C: Yeah, well, it's only engaging one sense. to your point, if you're getting a book, you're touching it, you're smelling it, you're seeing it, Crissy Florio: Mm-hmm. Elise Clark, FNP-C: whereas on your phone, you're already holding it, so you're literally just seeing it, and it doesn't compute. But I remember Crissy Florio: Yeah. Mm-hmm. Yeah. Yeah. Elise Clark, FNP-C: thinking that the kids that had all the encyclopedias in their house were like so rich, because they had the whole set. It's like they have the whole Britannica. Crissy Florio: You had W. Right. That's awesome. Now I want to go out and buy an encyclopedia set. You can probably find them at the Goodwill. Probably. Elise Clark, FNP-C: I know, yeah, and I highly doubt they've updated them in paperback form, but I want to get them for my kids. Those were so great. Crissy Florio: Yeah. And your kids probably be like, wow, that's really cool. This is so vintage. Yeah. Like when we just took it for granted. But now your kids Elise Clark, FNP-C: Yeah, it's so old school, Mom. Crissy Florio: would probably be like, I think even my daughter would, my son, not so much, because he probably can care less. But my daughter, Elise Clark, FNP-C: You Crissy Florio: she's 21, she probably would even think that's kind of cool. Yeah. Elise Clark, FNP-C: Yeah. Crissy Florio: because she's like 95 years old. She's an old soul. She's yeah. Yeah. She's she's very sweet. Elise Clark, FNP-C: I can appreciate that. Crissy Florio: I I was I was either talking to somebody or I saw it. on social media somewhere. And it was so funny. It was somebody said, can everybody just take a beat? I mean, we are just like sitting on a a rock that goes around and round in the middle of space. Like everybody just calm down. That's a good one. I know. Like, I'm so busy Elise Clark, FNP-C: I do, I do like that. Crissy Florio: and this and this and every problem and this. Well chill out. We're just a rock just going around in circles in the middle of the universe. Elise Clark, FNP-C: Yeah, it's not that serious. Yeah, yeah, I think we do often take ourselves and our lives so seriously too, you know? And that's part of like living well and feeling good is like actually having some fun and having some downtime. And I'm sure y'all do this too. It sounds like especially if you're a big yogi, but it's just like. Do you ever just not do anything for five minutes in a day? Like, do you ever just Crissy Florio: Yes, yes. Elise Clark, FNP-C: sit there? I'm like, when was the last time you just sat and ate your lunch without looking at your phone, without looking at Crissy Florio: Mm. Elise Clark, FNP-C: a computer, and you just like actually had a meal? And so I try to encourage my patients in that way because unfortunately our society is built to be this fast-paced thing and I don't know that we'll change that but I'm always like you aren't gonna be able to likely meditate for an hour every day when you have three small kids in your house but can you Crissy Florio: Right, right. Elise Clark, FNP-C: take like five minutes here and there to just do nothing? And it's like we have a problem being bored again I feel like. Yeah, I was a bored kid. Crissy Florio: especially the children too. Yeah. They're like, the internet's out What do we do? Yeah. We were out like bike riding till dark Elise Clark, FNP-C: Yeah, what do I do? Crissy Florio: and playing hide and go seek and tag and all the things. Elise Clark, FNP-C: Yeah, I remember distinctly in the summers telling my mom that I was bored and she's like, okay, what do want me Crissy Florio: Ha ha ha. Elise Clark, FNP-C: to do about it? And I was like, I just had to figure it out. You know, I hope to emulate that somewhat for my own kids of like, I'm not entertaining you, go do something. Yeah, well, it is kind of a book. Have you read The Anxious Generation by Jonathan Haight? Crissy Florio: Yeah. There you go. That could be a book. Just be bored. that's a great idea. Yeah. No? I haven't and I've been recommended that so many times. I'm writing that. Just so many books to read. Elise Clark, FNP-C: Yeah, it is, it basically says, let your kids be bored, let them take risks by going outside and playing by themselves. And his whole point was like, and I don't know exactly how old you are, but I grew up primarily in the 90s and we were still outside. And then it was Crissy Florio: Right. Elise Clark, FNP-C: early 2000s, everyone got really scared of predators. Or maybe it was the 90s that kind of started becoming a thing where you were worried about getting kidnapped and. Crissy Florio: Watch out for the white band.