Latest / The Menopause Disruptor Podcast / Menopause Weight Gain, Muscle Preservation, and Long-Term Health with Sharon Lemoine

Transcript

Menopause Weight Gain, Muscle Preservation, and Long-Term Health with Sharon Lemoine · The Menopause Disruptor Podcast

• 0:00
  SPEAKER_00: Let's stop looking at social media and trying to get into those skinny jeans and really focus on the reason we want to take care of our bodies.
• 0:06
  SPEAKER_00: And that is God gave us this body by choice.
• 0:10
  SPEAKER_00: How are we going to steward this?
• 0:12
  SPEAKER_00: And once you come from that perspective, there's your motivation to get out of bed and go do your workout.
• 0:18
  SPEAKER_00: Get your hydration, take your supplements because you've got that purpose.
• 0:22
  SPEAKER_00: And there's no other purpose out there that's going to be more fulfilling than using that as your motivation.
• 0:28
  SPEAKER_00: And again, I'm telling you, patients want that.
• 0:32
  SPEAKER_00: They they relate to that.
• 0:35
  SPEAKER_00: And so we're addressing physical, emotional, and spiritual health.
• 0:39
  SPEAKER_00: And I can't speak enough on that.
• 0:41
  SPEAKER_00: And I tell my providers, speak out, open your own doors, speak of your faith, and it will build.
• 0:46
  SPEAKER_00: It will grow.
• 0:49
  Mary Lee: Welcome back to the Menopause Disruptor Podcast.
• 0:52
  Mary Lee: This is the platform where we explore the science, the lived experience, and sometimes the spiritual side of navigating midlife and beyond.
• 1:00
  Mary Lee: And I am your host, Mary Lee.
• 1:03
  Mary Lee: My work in menopause coaching brings together menopause science, neuroscience, trauma-informed coaching, lived experience, and spirituality.
• 1:13
  Mary Lee: And with this podcast, featured guests and I are not simply educating individuals about hormones.
• 1:19
  Mary Lee: We are exploring what happens when midlife changes how we understand ourselves, our bodies, and our purpose.
• 1:27
  Mary Lee: And today, we're talking about something that reaches far beyond menopause: taking ownership of our health before we find ourselves in crisis.
• 1:36
  Mary Lee: My guest is Sharon Lemoyne, a nurse practitioner with more than 25 years of experience in emergency medicine, who has since built a practice focused on primary care, women's health, hormony, medical weight management, and wellness.
• 1:53
  Mary Lee: And at the heart of her practice is faith, faith in the Lord, which to some might simply be a source energy that is far mightier than any of us alone.
• 2:03
  Mary Lee: After years of seeing people arrive in the emergency department with conditions that might have been prevented or better managed earlier, Sharon became increasingly passionate about prevention, education, and helping people understand the choices available to them.
• 2:19
  Mary Lee: Her own experience living with type 1 diabetes and navigating significant health challenges have also shaped her approach to patient care.
• 2:27
  Mary Lee: And in this conversation, we explore why so many women feel overwhelmed by the growing volume of information about hormones, supplements, and now GLP1 medications, and how to begin separating useful information from the noise.
• 2:43
  Mary Lee: It's no surprise my last episode touched on this very same topic, the role of peptides in addressing menopause weight gain.
• 2:52
  Mary Lee: We will get into that topic, and I'm particularly passionate about lifestyle choices to address the midlife belly fat.
• 3:00
  Mary Lee: One in particular, muscle.
• 3:03
  Mary Lee: Why should we be paying attention to muscle mass, strength, bone health, and brain health?
• 3:08
  Mary Lee: And how do we approach weight management in a way that supports long-term health rather than changing how we look?
• 3:15
  Mary Lee: But this conversation goes beyond peptides, weight gain, and longevity.
• 3:19
  Mary Lee: Sharon also shares how her faith informs her work and why she believes caring for the physical, emotional, and spiritual well-being can give us a deeper sense of purpose.
• 3:30
  Mary Lee: As always, this podcast is about opening up conversations, asking bigger questions, and empowering you, the listeners, to be an active participant in your own health journey.
• 3:40
  Mary Lee: So let's get into it.
• 3:41
  Mary Lee: Please join me in welcoming Sharon Lemoyne to the Menopause Disruptor Podcast.
• 3:46
  Mary Lee: Welcome, Sharon.
• 3:47
  Mary Lee: So happy to have you here.
• 3:49
  SPEAKER_00: Well, thank you so much.
• 3:51
  SPEAKER_00: I love the opportunity to speak with like-minded providers and doing the same work.
• 3:56
  SPEAKER_00: So it's an honor.
• 3:57
  Mary Lee: Absolutely.
• 3:58
  Mary Lee: Well, I always like to start off with the guests' story, how they transition into their specific line of health care today and focusing on menopause.
• 4:09
  Mary Lee: You spent 25 years in emergency medicine.
• 4:11
  Mary Lee: And tell us what did you experience about what happens to people in crisis before they take their health seriously?
• 4:21
  SPEAKER_00: Well, that certainly is a process.
• 4:23
  SPEAKER_00: So, like you said, I spent 25 years at the bedside in emergency medicine, part of that time as a nurse, and the rest of the time as a nurse practitioner and a provider in that space.
• 4:35
  SPEAKER_00: And the big message that I saw repeatedly is seeing patients come in with diagnoses that were completely preventable.
• 4:48
  SPEAKER_00: And I saw the lack of education and prevention discussions that was happening on the corporate healthcare side.
• 4:57
  SPEAKER_00: And I would have these brief little moments at the bedside in emergency medicine to maybe have that discussion on how to reverse type 2 diabetes or how to reverse cardiovascular risks and risk for dementia.
• 5:11
  SPEAKER_00: And when that setting is very difficult, you're putting out fires and moving on to the next patient.
• 5:16
  SPEAKER_00: And as much as I appreciate that experience, as I stepped out of that, I live in the state of Washington.
• 5:23
  SPEAKER_00: And once I was up and running as a nurse practitioner and provider independently, I had the ability to broaden my skill set and I opened up a small little aesthetic uh business on the side, just me learning some simple skills and treating my community.
• 5:40
  SPEAKER_00: And it was, again, a great skill set, but I quickly realized my passion was health and wellness.
• 5:46
  SPEAKER_00: And since then, the practice now is a full clinic primary care specializing in women's health, hormone optimization, weight loss, and wellness and longevity.
• 6:00
  SPEAKER_00: And the timing is perfect on so many levels because we are now in a trend right now, a great trend, that there is light being shined down on the need of hormone education, correct education.
• 6:17
  SPEAKER_00: We're rewinding a lot of misinformation that has been out there for such a long time.
• 6:24
  SPEAKER_00: There are some great providers and influencers out there doing great work to advocate for women's health.
• 6:31
  SPEAKER_00: And so the timing for me in my own personal life going through menopause at the same time building my business, it certainly was a personal experience as well as professional.
• 6:43
  SPEAKER_00: So, you know, for me, again, another motivator is my personal story as a type one diabetic for the last 25 years.
• 6:52
  SPEAKER_00: It certainly has given me appreciation for my health and to pass that forward to my patients to make them understand there is so much we can control.
• 7:06
  SPEAKER_00: And I don't believe that's been the narrative in corporate health care.
• 7:10
  SPEAKER_00: So I am in a position now, I am very grateful, very blessed to be in good health myself and teach my patients that they actually do have so much uh control and options for treatment.
• 7:23
  SPEAKER_00: And we have to think outside of the box of what traditional corporate health care has been trained to uh to educate and treat.
• 7:31
  SPEAKER_00: It's a great space to be in at this time.
• 7:35
  Mary Lee: You mentioned there's the the spotlight is shining down on menopause.
• 7:40
  Mary Lee: Do you find now that there is such a plethora of information that women are not only going from feeling a little bit more informed, but completely overwhelmed by the amount of information.
• 7:53
  Mary Lee: And some of that is conflicting.
• 7:57
  SPEAKER_00: That is a great point.
• 7:58
  SPEAKER_00: And I agree 100%, and I see that every day in my clinic.
• 8:02
  SPEAKER_00: Women are coming in.
• 8:04
  SPEAKER_00: Number one, they are desperate to be heard and validated.
• 8:08
  SPEAKER_00: Awesome, because they're doing all their homework.
• 8:10
  SPEAKER_00: I learn from my patients every day.
• 8:11
  SPEAKER_00: They're bringing in tons of information and options for treatment and want to talk about every avenue that pertains to their health.
• 8:21
  SPEAKER_00: And that conversation does have to occur of where are you getting the information?
• 8:26
  SPEAKER_00: What's the right treatment for you?
• 8:28
  SPEAKER_00: What is appropriate in our setting?
• 8:32
  SPEAKER_00: And so it can be very difficult to navigate all the information out there.
• 8:39
  SPEAKER_00: There's some, again, great leaders out there that if you lock into those that are giving accurate information, I would say kind of hone it in a little bit and make sure that you get, you know, coupled with a provider yourself where you can have these conversations and say, okay, I'm hearing all this on the internet.
• 8:57
  SPEAKER_00: Are these options, are these accurate?
• 8:59
  SPEAKER_00: Is there research to back it?
• 9:00
  SPEAKER_00: When should I be concerned?
• 9:02
  SPEAKER_00: I mean, that's true for anything, but I think especially with the menopause movement and hormone optimization and GLP1s and peptides, they can be phenomenal choices in our health care, but you have to do it correctly with anything.
• 9:20
  SPEAKER_00: So, you know, I don't have the right answer to say, how do we all navigate this?
• 9:25
  SPEAKER_00: Because even as a healthcare provider, I'm constantly getting information coming at me with recommendations, with new treatments, um, with new outcomes.
• 9:36
  SPEAKER_00: And so I have to really learn to navigate.
• 9:39
  SPEAKER_00: And what I have found personally is in my career, I learn every day.
• 9:44
  SPEAKER_00: I'm constantly seeking out opportunities to learn.
• 9:49
  SPEAKER_00: And I have to figure out who are going to be my people, who are going to be my resources.
• 9:53
  SPEAKER_00: And I try to keep it somewhat narrow because I know they're out there doing the proper work and bringing me the correct information.
• 10:03
  SPEAKER_00: So I would say, you know, start small, find your people and build on that slowly.
• 10:08
  SPEAKER_00: But don't try and understand it all right now because I can't even do that.
• 10:13
  SPEAKER_00: It's a lot of information to dive into.
• 10:16
  Mary Lee: It certainly is.
• 10:18
  Mary Lee: As you mentioned, have your core team.
• 10:20
  Mary Lee: Start recruiting those people who are going to be on your team to guide you, to help you feel, as you said, heard and validated.
• 10:28
  Mary Lee: And so with that in mind, when should a woman start talking with her healthcare provider or looking for a GP who will listen to her about hormone therapy, no matter where she might be in perimenopause and the menopause transition?
• 10:44
  SPEAKER_00: The big message there is number one, I think as women, we have this intuition that something is not right.
• 10:59
  SPEAKER_00: Something feels like you can't put your finger on it, but you know how you feel now is not what you felt like a year ago or five years ago.
• 11:07
  SPEAKER_00: And to validate that, don't dismiss it.
• 11:10
  SPEAKER_00: We are all very dizzy women with careers and families and you know, all the things.
• 11:17
  SPEAKER_00: And it's so it's very quick.
• 11:18
  SPEAKER_00: We're hard workers, we we don't complain a lot.
• 11:21
  SPEAKER_00: And so it's hard to really take the time to stop and think, okay, wait a minute, this is a valid issue.
• 11:28
  SPEAKER_00: So listen to that voice.
• 11:30
  SPEAKER_00: And then, secondly, get your right provider when to start looking at hormones.
• 11:37
  SPEAKER_00: What's very interesting is there are some very broad ideas out there.
• 11:42
  SPEAKER_00: When you go through menopause, when does perimenopause start?
• 11:45
  SPEAKER_00: And what I have found, and I continue to learn, every single patient is so different.
• 11:52
  SPEAKER_00: I could take the same age woman at the same weight with the same medical history and give them the same treatment plan, and they will respond completely differently.
• 12:05
  SPEAKER_00: So if I say, hey, when you hit 35, start having your hormones tested, well, I can tell you I am treating patients in their mid-20s with significant hormone deficiencies.
• 12:18
  Mary Lee: Right.
• 12:18
  SPEAKER_00: When I first started uh educating in this hormone space, of course, I'm using my adult children and my nieces and nephews and everybody.
• 12:27
  SPEAKER_00: I'm like, let me test everybody.
• 12:28
  SPEAKER_00: I want to learn on everyone.
• 12:29
  SPEAKER_00: They were all deficient.
• 12:31
  SPEAKER_00: And they're all living pretty darn healthy lives.
• 12:34
  SPEAKER_00: So that was a big eye-opener.
• 12:37
  SPEAKER_00: Simple things.
• 12:38
  SPEAKER_00: For example, I have a handful of patients in their mid-20s really suffering from anxiety and depression.
• 12:44
  SPEAKER_00: And that alone could be a podcast and all the concerns and stimuli that are coming at these young patients, and we can rationalize why this is happening.
• 12:55
  SPEAKER_00: But when they go to their primary care doctor in that corporate health setting, number one, they're limited on time.
• 13:03
  SPEAKER_00: And the first option is an SSRI or an antidepressant.
• 13:07
  Mary Lee: 100% true.
• 13:09
  Mary Lee: Yes.
• 13:10
  SPEAKER_00: Now, do they feel better?
• 13:11
  SPEAKER_00: Sometimes, sometimes they don't feel better, but I can guarantee you they're gonna have one or many side effects.
• 13:18
  SPEAKER_00: So when they're coming into me, I have to look a little bit deeper.
• 13:24
  SPEAKER_00: So commonly for that group of patients, they the trend, they the trend shows that they have low testosterone.
• 13:33
  SPEAKER_00: And the link of testosterone in both men and women, low testosterone and the correlation to mental health is unbelievable.
• 13:44
  SPEAKER_00: It was shocking as a practitioner.
• 13:47
  SPEAKER_00: And so for me, when I treat these patients and they're open-minded to say, like, I want to be well, I don't want to have to take this medicine.
• 13:55
  SPEAKER_00: That's step one.
• 13:57
  SPEAKER_00: When we give them a small sprinkle of testosterone, and they all of a sudden have motivation and they're sleeping better, and their libido goes up and they're out, thriving, living lives, being social, motivated to go get a job, go back to school, whatever it may be, they come off these antidepressants.
• 14:17
  SPEAKER_00: We have optimized what once was their normal levels, and we've eliminated a long-term dependency on an SSRI and avoided all the side effects.
• 14:28
  Mary Lee: I'm so glad you said that.
• 14:30
  Mary Lee: For the listeners who can't see me, I am nodding my head that I almost have whiplash.
• 14:35
  Mary Lee: What you've just described has been my journey and how what landed me in this work as a menopause dual up is that I was first met with misogynistic attitude.
• 14:47
  Mary Lee: Um, unfortunately, my daughter was away, so I had a locum, and he just naturally assumed looked at my date of birth, which at the time was about 46, and just assumed, well, you're at that ripe old age that my mother was at, that you are depressed, and therefore an SSRI will solve everything.
• 15:05
  Mary Lee: Well, I knew that my experience was far different and not related to any depressant mental health concerns.
• 15:14
  Mary Lee: In fact, later on we discovered it was a gut health concern, which is in itself a podcast episode, is the gut brain aspect.
• 15:23
  Mary Lee: Fast forward to having a recent concussion approached my doctor.
• 15:29
  Mary Lee: This time I had my GP.
• 15:31
  Mary Lee: And her first reaction was maybe an SSRI, when I asked her, approached her to see just prodding.
• 15:39
  Mary Lee: What is your thoughts on testosterone?
• 15:42
  Mary Lee: In the end, she says it's your decision, but I have to caveat that the research out there is not compelling enough.
• 15:50
  Mary Lee: So I went on and wrote a big long Substack article.
• 15:53
  Mary Lee: I will link it in the show notes.
• 15:55
  Mary Lee: I was enraged and I thought our healthcare system is still lacking the education around so many things with hormonal health for women.
• 16:05
  Mary Lee: But testosterone now enters arena.
• 16:08
  Mary Lee: When I said there's a lot of conflicting information, this is one of those areas.
• 16:11
  Mary Lee: Dr.
• 16:12
  Mary Lee: Susan Davis, or allegedly the pioneer in testosterone, versus the other school of thought where we've got the Kelly Kaspersons, for example, Vonda Wright, and they're all pushing for lived experience must outweigh a doctor's response to want to prescribe SSRIs.
• 16:33
  Mary Lee: You have to listen to your patient.
• 16:35
  Mary Lee: You have to listen to what she's experiencing.
• 16:38
  Mary Lee: And at the end of the day, it's a little bit of trial and error.
• 16:41
  Mary Lee: And as you said, of all those patients that you treat, no two women will have the same experience.
• 16:47
  Mary Lee: Absolutely.
• 16:47
  Mary Lee: Yeah.
• 16:48
  Mary Lee: And that the lack of education which comes to advocating.
• 16:51
  Mary Lee: And that's where I would love to take the conversation, Sharon.
• 16:54
  Mary Lee: How can a woman still feel empowered enough, even brave enough, to broach her healthcare provider and have those conversations that might end up being difficult?
• 17:06
  SPEAKER_00: You know, I've heard so many women come in telling me their experience with their provider.
• 17:10
  SPEAKER_00: And I never talk badly about providers in the sense that they've had significant training and years of education.
• 17:17
  SPEAKER_00: And I believe they really do want to do right by their patients.
• 17:21
  SPEAKER_00: But what agenda are you going to subscribe to?
• 17:25
  SPEAKER_00: And man, I would love to get into those medical schools for a day and just lecture on listening to the patient and think outside of the box for the love of God.
• 17:36
  SPEAKER_00: Everything is not one recipe.
• 17:40
  SPEAKER_00: So I would say to those women that are going in to talk to their provider, understand that a lot of these providers, whether it's their specialty or primary care, they haven't had the education on it.
• 17:54
  SPEAKER_00: They don't have the time.
• 17:56
  SPEAKER_00: They're not offered that specific training.
• 17:59
  SPEAKER_00: And so they want to do right by their patients, but it's just a lack of special.
• 18:05
  SPEAKER_00: I don't know.
• 18:05
  SPEAKER_00: I'm not a special, a specialist in orthopedics or cardiologists, right?
• 18:10
  SPEAKER_00: Well, there's also a specialty in hormones.
• 18:13
  SPEAKER_00: And so you have to respect where they're coming from.
• 18:17
  SPEAKER_00: If you walk into that appointment, a little bit of anticipation thinking you might be a good preparation.
• 18:25
  SPEAKER_00: It's when you go in and you're like, I finally got my appointment.
• 18:27
  SPEAKER_00: I've been waiting three months.
• 18:29
  SPEAKER_00: I got my whole list of symptoms and I know what I want to do.
• 18:31
  SPEAKER_00: I want to do testosterone, estrogen, progesterone.
• 18:34
  SPEAKER_00: And they look at you and like, nope, that is going to set you down a path you don't want to go down, right?
• 18:41
  SPEAKER_00: We want to be able to find that person.
• 18:44
  SPEAKER_00: So if you go in and you have that experience, maybe anticipate it a little bit.
• 18:48
  SPEAKER_00: And if that happens, just be polite and just say, okay, I feel strongly that again, I'm listening to my body.
• 18:55
  SPEAKER_00: I feel these changes.
• 18:56
  SPEAKER_00: I want to be proactive.
• 18:58
  SPEAKER_00: I feel like the information I have so far is valid and I want to give it a try.
• 19:04
  SPEAKER_00: And if you want to meet me halfway and do the proper blood test and discuss the therapies I would like to have, great.
• 19:10
  SPEAKER_00: If not, then you are not my person and don't waste your time.
• 19:14
  SPEAKER_00: And just politely say, I've got to go find my person.
• 19:18
  SPEAKER_00: There are plenty of us out there that are leaving corporate health care because we see the need.
• 19:25
  SPEAKER_00: We want to give our patients the care they deserve.
• 19:28
  SPEAKER_00: We want to practice medicine the way we intend it to.
• 19:31
  SPEAKER_00: And don't be discouraged.
• 19:35
  SPEAKER_00: Don't be discouraged.
• 19:36
  SPEAKER_00: Start young, stay on top of it, listen to your body.
• 19:40
  SPEAKER_00: But do not let somebody tell you how you're physically feeling.
• 19:46
  SPEAKER_00: And I love, I love male providers.
• 19:48
  SPEAKER_00: They're awesome.
• 19:48
  SPEAKER_00: And some of the biggest mentors in my career are male.
• 19:51
  SPEAKER_00: But they will never understand what it's like to live in a woman's body, nor do I know what it feels like for them.
• 19:56
  SPEAKER_00: So there's got to be that understanding as well, especially with our male practitioners.
• 20:01
  SPEAKER_00: Are you sympathetic or not?
• 20:02
  SPEAKER_00: Are you open-minded?
• 20:04
  SPEAKER_00: Are you willing to have the conversation?
• 20:06
  SPEAKER_00: If you're going to a female provider and she's looks about that menopausal age, for the love of God, she probably is feeling the same way.
• 20:16
  SPEAKER_00: And maybe some of those providers aren't even open to hormone therapy.
• 20:20
  SPEAKER_00: Maybe they're just really stuck in that education that they were taught 30 years ago.
• 20:25
  SPEAKER_00: And they believe it, they feel it, they practice it.
• 20:28
  SPEAKER_00: But you have to be able to think outside the box as a provider to get the right care.
• 20:34
  Mary Lee: Yes.
• 20:35
  Mary Lee: And we have enough research.
• 20:37
  Mary Lee: One being the Menopause Society has their position statement on hormone replacement therapy.
• 20:44
  Mary Lee: And I find that that's a very valid piece of information, albeit is still catching up to the research as it becomes hot off the press, so to speak.
• 20:53
  Mary Lee: But it is still one really valid piece of information because in that document it recognizes, and it's several pages long, that age of starting hormone therapy and continuing on as long as the woman is still getting results and quality of life, there's no need to stop.
• 21:12
  Mary Lee: That yes, there is probably a preferred age for her to start, but it doesn't mean that she cannot start postmenopause, that day, that line in the sand where she's gone without amensies for 12 months.
• 21:24
  Mary Lee: So I certainly would say to a lot of women that the menopause society has some great position statements.
• 21:31
  SPEAKER_00: And even with that, I will say yes, very valid information, but you will find that every provider has a different personality and a different take.
• 21:42
  SPEAKER_00: Are they super conservative with that information?
• 21:45
  SPEAKER_00: Are they going to step out a little bit and be open to that information plus considering other options?
• 21:52
  SPEAKER_00: So it is a range of what you do with that.
• 21:56
  SPEAKER_00: So not only is it looking for accurate data and information, but how are you?
• 22:02
  SPEAKER_00: What are you going to do with that?
• 22:03
  SPEAKER_00: What is your provider going to do with it?
• 22:05
  SPEAKER_00: Again, you can get a very conservative.
• 22:09
  SPEAKER_00: Provider that maybe believes in just estrogen for women, but hasn't bought into testosterone yet.
• 22:17
  SPEAKER_00: And so are you in that same place?
• 22:19
  SPEAKER_00: Great.
• 22:19
  SPEAKER_00: If you're like, I really think I need some testosterone, you've got to weigh out the thought process of the provider.
• 22:28
  SPEAKER_00: And it goes back to there's some really great providers out there in the hormone space.
• 22:34
  SPEAKER_00: There's some looking at it more from a monetary perspective that really gives it a bad rap, that it's not done correctly, like anything.
• 22:44
  SPEAKER_00: In my practice, I'm fanatical about labs.
• 22:48
  SPEAKER_00: I want, I want to see where you're at.
• 22:50
  SPEAKER_00: I'm conservative.
• 22:51
  SPEAKER_00: I'm going to start with a small dose of whatever method of hormone replacement we start with.
• 22:58
  SPEAKER_00: I don't know how you're going to react until we try something.
• 23:02
  SPEAKER_00: I'm not going to go super aggressive, which I think in that scenario, that's where the bad rap comes from talking to somebody saying, Oh my gosh, my neighbor, she did testosterone pellets and she grew a beard.
• 23:15
  SPEAKER_00: And, you know, she's she's had this horrible experience.
• 23:19
  SPEAKER_00: And when I hear things like that, I ask certain questions, things like, did they test your total testosterone and free testosterone?
• 23:27
  SPEAKER_00: What was your sex hormone binding globulin?
• 23:29
  SPEAKER_00: What was your trough labs 10 weeks after your first treatment?
• 23:33
  SPEAKER_00: What was your starting dose?
• 23:35
  SPEAKER_00: And if they don't really know these things, that tells me, okay, somebody's out there slinging pellets or slinging prescriptions just for the for other reasons than true, truly wanting to corrupt a hormone imbalance.
• 23:49
  SPEAKER_00: So I mean you could say that about any specialty, really.
• 23:53
  SPEAKER_00: So the negativity, you really again have to weed out.
• 23:57
  SPEAKER_00: There's great people like Kelly Kasperson.
• 24:00
  SPEAKER_00: She's right up the road, um, a couple of hours from here, doing phenomenal work.
• 24:04
  SPEAKER_00: I love how she is speaking out.
• 24:05
  SPEAKER_00: Vonda Wright, Sharon Malone, uh, Mary Claire Haver, great, great providers that are really advocating for a patience.
• 24:13
  SPEAKER_00: I look up to them as leaders in the industry.
• 24:16
  SPEAKER_00: Right.
• 24:17
  SPEAKER_00: There's a couple of those also that are like, oh little pellets.
• 24:19
  SPEAKER_00: I don't know.
• 24:19
  SPEAKER_00: Well, okay, that's their practice, that's their comfort level.
• 24:23
  SPEAKER_00: Totally fine.
• 24:25
  SPEAKER_00: But with everything, there's you have to be conservative and look at the patient and consider each option, not just one, when you're talking hormone therapy.
• 24:34
  SPEAKER_00: That's right.
• 24:35
  Mary Lee: Individualized treatment and look at the patient.
• 24:38
  Mary Lee: Just like in coaching, you coach, you treat to the person standing in front of you, not to the textbook, not to your own personal agenda as well.
• 24:46
  Mary Lee: And I love the line that you've said.
• 24:48
  Mary Lee: It's going back to the core message meet me halfway, because it is shared decision making.
• 24:55
  Mary Lee: I like to say treat your yourself as the CEO of your own company and who you're going to hire out to do the job so that your company is performing optimally.
• 25:06
  SPEAKER_00: And don't feel bad about turning some options away.
• 25:09
  SPEAKER_00: If it's not the right fit for you, be polite, say no, thank you, and go find your people.
• 25:14
  SPEAKER_00: Yeah.
• 25:15
  SPEAKER_00: Don't waste their time.
• 25:16
  SPEAKER_00: Don't waste your time.
• 25:17
  SPEAKER_00: You've got to find the person that's going to match.
• 25:20
  SPEAKER_00: You know, sometimes I can be very energetic and outspoken.
• 25:22
  SPEAKER_00: Well, maybe that's not the right fit for some of my patients.
• 25:27
  SPEAKER_00: But we we agree, like, this is who I am, this is my approach.
• 25:30
  SPEAKER_00: Let me hear what you think.
• 25:32
  SPEAKER_00: This is the plan I have for you.
• 25:33
  SPEAKER_00: How does that sound?
• 25:35
  SPEAKER_00: And usually it's a great match, and we can come up with something we both agree on.
• 25:39
  SPEAKER_00: If they walk into my office and they're like, oh my gosh, I saw the best, this best peptide or this best GLP, I want to be on it tomorrow.
• 25:46
  SPEAKER_00: I'm like, okay, well, let's talk about it.
• 25:49
  SPEAKER_00: And we usually will come up with a combined agreeable plan.
• 25:53
  Mary Lee: And go slow, start, start slow, go low.
• 25:55
  SPEAKER_00: Exactly.
• 25:56
  Mary Lee: But I do, and you mentioned it, lab testing.
• 25:59
  Mary Lee: Just like in any decision-making process, whether you are building a home, you're in a company, you've got to make some core decisions, you're looking at the data in front of you first and foremost, rather than just winging it.
• 26:11
  Mary Lee: And the same must go for healthcare.
• 26:13
  Mary Lee: So let's talk about the role of lab testing.
• 26:15
  Mary Lee: What are key lab tests to take and how often?
• 26:20
  Mary Lee: And again, going back to the importance of a woman advocating, asking for those lab tests.
• 27:13
  SPEAKER_00: So the basic lab panel, basic in this setting, should be a basic blood count, a metabolic panel, which looks at kidney, liver function, electrolytes.
• 27:23
  SPEAKER_00: These are simple tests that you would normally get at your provider's office.
• 27:26
  SPEAKER_00: In addition, a full thyroid panel, low-functioning thyroid can also mimic a hormone low estrogen, low progesterone.
• 27:37
  SPEAKER_00: So we got to make sure we're treating the right thing.
• 27:39
  SPEAKER_00: We're looking on a thyroid panel.
• 27:41
  SPEAKER_00: How many of us have gone to the doctor and said, oh, I'm so fatigued.
• 27:44
  SPEAKER_00: I'm gaining weight.
• 27:45
  SPEAKER_00: I have a thyroid issue.
• 27:46
  SPEAKER_00: And you go get your labs done, and they're like, no, you're fine, go home.
• 27:50
  SPEAKER_00: But they haven't looked at T3.
• 27:53
  SPEAKER_00: That's the active thyroid hormone.
• 27:56
  SPEAKER_00: So if you're the normal range for that would be two to 4.4 per the lab.
• 28:01
  SPEAKER_00: If you're hovering in the low twos, you might feel horrible.
• 28:06
  SPEAKER_00: You might have to get up to a three or a four.
• 28:09
  SPEAKER_00: And that, and so you have to look more specifically at a thyroid panel.
• 28:14
  SPEAKER_00: You're also looking at TPO antibodies that can be an indicator of gut health, which relates to Hashimoto's.
• 28:20
  SPEAKER_00: So again, it kind of brings into that gut health piece, which really every patient has some form of gut issue.
• 28:29
  SPEAKER_00: So full thyroid panel.
• 28:30
  SPEAKER_00: Then we're looking at vitamin deficiencies, vitamin D.
• 28:32
  SPEAKER_00: Everybody in their mother that comes into my office is deficient.
• 28:35
  SPEAKER_00: Yes, we are in the Pacific Northwest.
• 28:37
  SPEAKER_00: However, it is a very small piece of why we are not absorbing enough vitamin D.
• 28:44
  SPEAKER_00: So, and then again, on that piece alone, I have studies showing that if a normal range per the lab, what we call normal, is 30 to 100, if I get my women and men to 80 or 90, I am reducing breast cancer, MS, and colorectal cancer significantly with just vitamin D, because as we know, that acts as a hormone.
• 29:09
  SPEAKER_00: So if they're not checking vitamin D and trying to optimize you on the higher range of normal, that's a problem right out the gates.
• 29:19
  SPEAKER_00: We also look at ferritin levels, especially in women with having heavy menstrual cycles.
• 29:23
  SPEAKER_00: They're coming in, barely can get out of bed.
• 29:26
  SPEAKER_00: They're so exhausted, and their ferritin is in the toilet.
• 29:30
  SPEAKER_00: We have to look at those iron stores and replenish them.
• 29:33
  SPEAKER_00: And again, normal labs does not mean optimized.
• 29:37
  SPEAKER_00: So if they're normal sitting at a level of 15, I want them a minimum over 40.
• 29:45
  SPEAKER_00: And so these are again layers to the treatment outside just hormone therapy.
• 29:50
  SPEAKER_00: Then we look, of course, at all the hormone levels.
• 29:53
  SPEAKER_00: And again, these are all basic labs that should be included in a very basic hormone workout.
• 29:59
  SPEAKER_00: That includes your obvious estradiol, your FSH, follicle stimulating hormone for women, you know, total and free testosterone.
• 30:07
  SPEAKER_00: That's a big one.
• 30:08
  SPEAKER_00: How much do we make?
• 30:09
  SPEAKER_00: How much do we convert to use?
• 30:10
  SPEAKER_00: Those two numbers are very important.
• 30:12
  SPEAKER_00: If you make a bunch, but you can't convert it to use, well, then we got to look at why.
• 30:16
  SPEAKER_00: Ah, interesting.
• 30:18
  SPEAKER_00: Okay.
• 30:18
  SPEAKER_00: So free tea, if someone's like, oh my gosh, I'm doing all this testosterone, it's been a horrible thing.
• 30:22
  SPEAKER_00: What's your free tea?
• 30:24
  SPEAKER_00: And they don't know because they're not running it.
• 30:26
  SPEAKER_00: So free tea is big, a really big one.
• 30:28
  SPEAKER_00: The other one is sex hormone binding globulin.
• 30:32
  SPEAKER_00: And if this is elevated, it's gonna bind up with all that testosterone floating around, and you're not going to feel it.
• 30:39
  SPEAKER_00: So that could be for various reasons, and we have to start troubleshooting that.
• 30:43
  SPEAKER_00: So as you can see, it's multi-layered, multifactorial.
• 30:47
  SPEAKER_00: Those would be the basic labs.
• 30:49
  SPEAKER_00: So I call that my hormone workup.
• 30:52
  SPEAKER_00: What I have done now that we're really encompassing primary care, because we were kind of doing the work anyway.
• 30:57
  SPEAKER_00: Now we can officially say we're primary care.
• 31:00
  SPEAKER_00: I want to see metabolically what's happening with our patients.
• 31:02
  SPEAKER_00: If you're brand new to me, let's do that hormone panel.
• 31:05
  SPEAKER_00: But let's add on a lipid panel and an A1C and an insulin level.
• 31:10
  SPEAKER_00: Because if you're super insulin resistant, you're going to be super inflamed.
• 31:15
  SPEAKER_00: And if you have low estrogen, yes, you're going to be putting on 20 pounds and you're going to feel like you got hit by a truck.
• 31:21
  SPEAKER_00: So let's optimize everything and look at the root cause of what's causing the insulin resistance.
• 31:27
  SPEAKER_00: So that is my personal general easy minimal workup.
• 31:33
  SPEAKER_00: I have recently added more to it for people that are coming in saying, do everything.
• 31:39
  SPEAKER_00: We can do more looking at epigenetics and genetic testing.
• 31:43
  SPEAKER_00: We can do very complicated lipid panels looking at cardiovascular and dementia risks, where you're at in the range of insulin resistance.
• 31:51
  SPEAKER_00: So there's quite a bit you can ask for.
• 31:53
  SPEAKER_00: It just depends on how aggressive.
• 31:55
  SPEAKER_00: But at least you know what the minimum is to ask your provider for.
• 31:59
  Mary Lee: And not in all places that the this is covered by healthcare insurance.
• 32:03
  Mary Lee: Certainly in the United States, I can't speak for that, but I can say in Canada that some of those lab tests will be covered, but many of them are out of pocket.
• 32:14
  SPEAKER_00: That is a great point.
• 32:15
  SPEAKER_00: And so typically in the US at least, testosterone treatment and testing is not typically covered by insurance.
• 32:24
  SPEAKER_00: It's not accepted as an approved treatment in women, although we make more testosterone than we do estrogen.
• 32:30
  Mary Lee: That's true, three to four times more, yes.
• 32:32
  SPEAKER_00: So why are we not looking at that?
• 32:35
  SPEAKER_00: And I think there's work being done as we speak to change the approach to that.
• 32:39
  SPEAKER_00: But so yes, when my patients are coming in, sometimes we have to kind of break those labs apart and try and get insurance to pay for some of them, but they typically are paying out of pocket for that, at least the testosterone portion in females.
• 32:53
  SPEAKER_00: Now, if I do the same labs for men, it's covered.
• 32:57
  SPEAKER_00: Right.
• 32:58
  Mary Lee: Well, we're pushing the yardstick, moving it ever so slightly.
• 33:01
  Mary Lee: We're not there yet, but the more voices that we can get to champion, we'll slowly start to see results.
• 33:07
  Mary Lee: But before that happens, we can still advocate and take agency on our own.
• 33:12
  Mary Lee: And listing out all those panels that are important to get is going to be very helpful for women.
• 33:16
  Mary Lee: So, listeners, go back, get a pen, and re-listen to it.
• 33:20
  Mary Lee: Sharon has advised uh get your list, your shopping list, and take it to your GP or go see Sharon at her clinic.
• 33:28
  Mary Lee: Bone health though, DEXA scan.
• 33:31
  SPEAKER_00: Yes.
• 33:31
  SPEAKER_00: Let's talk about that.
• 33:32
  SPEAKER_00: Oh, I love DEXA scan.
• 33:34
  SPEAKER_00: Okay.
• 33:34
  SPEAKER_00: We have something locally in our town that I refer because I don't have one in my office.
• 33:38
  SPEAKER_00: We do in bodies quite a bit because we are a very strict GLP one weight loss program.
• 33:44
  SPEAKER_00: And so you got to come in, you get you on your in-body once a month.
• 33:46
  SPEAKER_00: DEXA scan is really important because you need to know your bone health.
• 33:51
  SPEAKER_00: And here's what's really interesting typically, insurance will not cover a bone scan unless you're 65 or older.
• 33:58
  SPEAKER_00: Exactly.
• 33:58
  Mary Lee: Here too.
• 33:59
  SPEAKER_00: So what if you have a patient, let's say they had a full hysterectomy, late 30s, early 40s, and have not been put on estrogen therapy.
• 34:08
  SPEAKER_00: Where is their bone health going to be by the time they hit 50?
• 34:12
  unknown: Exactly.
• 34:13
  SPEAKER_00: Right?
• 34:13
  SPEAKER_00: They were put into menopause at an early age that has given them more time for bone loss.
• 34:18
  SPEAKER_00: And you're not going to cover a bone scan until you're 65.
• 34:21
  SPEAKER_00: And then by then, they have full-blown osteoporosis.
• 34:25
  SPEAKER_00: So, you know, at least here are DEXA scans, they usually run about 120 bucks to pay out of pocket.
• 34:32
  SPEAKER_00: And it's a great body composition measurement.
• 34:34
  SPEAKER_00: It will give you your scores on your bone health.
• 34:37
  SPEAKER_00: And certainly you can see are you, you know, where you're at in that range and be very aggressive.
• 34:44
  SPEAKER_00: And two things is obviously estrogen and vitamin D for bone health and then weight bearing exercises and so forth.
• 34:50
  SPEAKER_00: But yeah, that that's a big one.
• 34:51
  SPEAKER_00: And I think Von der Wright was somebody that had pointed out, and I always love the little one-liners that I share with my patients, that number one, you have to be active to live.
• 35:00
  SPEAKER_00: And if you take a patient over 50 and they fall and break a major long bone, the chances of death in the next 12 months is somewhere like 30 or 40%.
• 35:13
  Mary Lee: And it's high.
• 35:14
  SPEAKER_00: And I'm thinking, man, I'm well over 50.
• 35:16
  SPEAKER_00: And I mean, I'm a class.
• 35:18
  SPEAKER_00: So if I fall down, that's my that's the reality.
• 35:22
  SPEAKER_00: That's scary.
• 35:24
  SPEAKER_00: The other really interesting fact, when I got my DEXA scan done, they sat down, they were going over all the results, and they see this one number.
• 35:32
  SPEAKER_00: And there's they said, that's the weight of your skeleton.
• 35:36
  SPEAKER_00: Now I'm a medical provider.
• 35:38
  SPEAKER_00: I should know this.
• 35:38
  SPEAKER_00: I'm thinking, what's my skeleton?
• 35:40
  SPEAKER_00: That's 5'10, you know, uh 20, 30 pounds.
• 35:44
  SPEAKER_00: Five pounds.
• 35:45
  SPEAKER_00: My entire skeleton weighs five pounds.
• 35:49
  Mary Lee: Oh my goodness.
• 35:50
  Mary Lee: I was not expecting that number, Sharon.
• 35:52
  SPEAKER_00: I did not expect that either.
• 35:54
  SPEAKER_00: But here's the takeaway.
• 35:55
  SPEAKER_00: You know, I'm 150 pounds, 5'10, and my skeleton of five pounds is supporting my whole structure.
• 36:04
  SPEAKER_00: So if I have osteopenia or osteoporosis and I take a fall, well, then you know for sure I'm gonna snap a bone.
• 36:13
  SPEAKER_00: They are small, thin bones to begin with.
• 36:16
  SPEAKER_00: And when they start to decay and erode, the outcomes are not good.
• 36:22
  SPEAKER_00: So you really have to think about bone health.
• 36:25
  SPEAKER_00: I mean, you hit 40, start thinking about it.
• 36:28
  SPEAKER_00: Hopefully it's better than that, but that's the fork in the road for me.
• 36:31
  Mary Lee: In fact, I think the number is by the time women hit the age of 30, they will start losing anywhere from 3 to 8% per decade.
• 36:40
  SPEAKER_00: That is true.
• 36:40
  SPEAKER_00: That is true.
• 36:41
  Mary Lee: Unless you start doing something like weight-bearing exercises and to ensure that your bone mineral density stays strong and that you're continuing bone remodeling and building muscle is actually the encouraging that to happen.
• 36:56
  Mary Lee: But here's something else that's I found very shocking, and gonna bring it back to Dr.
• 36:59
  Mary Lee: Von Debright once again.
• 37:01
  Mary Lee: When she was on recently just speaking in a little TikTok, Instagram reel about the new skinny peptides, GLP1s.
• 37:12
  Mary Lee: Yes, wanting to be super skinny and then forgetting about the bone health.
• 37:18
  Mary Lee: It's that super weight loss, quick, easy fix, take a GLP1s, I won't eat.
• 37:24
  Mary Lee: But then they're doing nothing else either, such as lifting, exercising, consuming protein.
• 37:31
  Mary Lee: So, and and you you offer GLP1 uh coaching and consultation in your clinic.
• 37:38
  Mary Lee: Let's talk about the pros, the cons, and it's certainly in light of our bone health as well.
• 37:45
  SPEAKER_00: So here's what's interesting: as my practice was growing, I was still working in full-time emergency medicine, doing some aesthetics on the side, and really I wanted to gravitate towards a medical clinic.
• 37:56
  SPEAKER_00: I brought in the use of GLP ones, and this was about four years ago, four or five years ago now.
• 38:02
  SPEAKER_00: And as I was implementing them into the practice, there was continued research and more and more popularity in them.
• 38:10
  SPEAKER_00: And when I would sit with my new patients and do a consultation, they were middle-aged women, 10, 20, 30 pounds that had been slow progressing over the last 10 years, couldn't really put their finger on it.
• 38:24
  SPEAKER_00: But their story was the same exact story over and over again.
• 38:30
  SPEAKER_00: That's what led me to going into hormone therapy because I'm sitting here thinking, okay, how am I seeing so many patients with the same exact story?
• 38:41
  SPEAKER_00: It's not just about the extra 10 pounds.
• 38:44
  SPEAKER_00: And I was pretty much going through the same thing with them.
• 38:46
  SPEAKER_00: And so, with my personal experience and then seeing this, I was like, okay, wait, what is happening?
• 38:51
  Mary Lee: Yeah.
• 38:52
  SPEAKER_00: So I am proud to say now we have learned and we've made a little mistakes here and there in dosing and trying to find the right patient and the right GLP for that right scenario.
• 39:04
  SPEAKER_00: But the more I have learned and really understood the importance of what muscle mass does for our longevity and our wellness, we are a little Nazis now about it.
• 39:15
  SPEAKER_00: Some of the doctors I work with or I look up to, they even say, and I've mimicked them, saying in their practices, their patients have to deserve the right to be on a GLP one.
• 39:28
  SPEAKER_00: It is, and at first I was like, well, is that a little harsh?
• 39:31
  SPEAKER_00: But it makes perfect sense.
• 39:32
  SPEAKER_00: If I've got somebody coming in that is maybe overweight, look at their lifestyle.
• 39:36
  SPEAKER_00: Are they sedentary?
• 39:37
  SPEAKER_00: Are they not watching protein intake?
• 39:39
  SPEAKER_00: Have they never been on a body composition scale and know how many pounds of your weight is lean muscle mass?
• 39:45
  SPEAKER_00: They don't know these things.
• 39:46
  SPEAKER_00: And they're walking in and they're saying, give me my weekly shot, and they just want to drop weight.
• 39:50
  SPEAKER_00: What's going to happen is they're going to come back six months later, they'll be down 30, 40 pounds, they will have less muscle, more insulin resistance, their metabolism is in the toilet, and they are metabolically worse off than with that extra 30 pounds.
• 40:05
  SPEAKER_00: Because what happens is they lose the 30 pounds, they've not made lifestyle changes, they come off the GLP1, they put 10, 20 back on.
• 40:13
  SPEAKER_00: Now they have less muscle than when they even started.
• 40:17
  SPEAKER_00: So metabolically, they are a hot mess.
• 40:20
  SPEAKER_00: And so we have learned from the research and um just everything out there that it is all about not the number on the scale, forget about it.
• 40:31
  SPEAKER_00: And what is how many pounds of lean muscle mass do you have?
• 40:34
  SPEAKER_00: And what is your body fat percent?
• 40:35
  SPEAKER_00: And that third one, if you really want to know, is your visceral fat, because that's really the indicator of risk for type 2 diabetes, hypertension, all the things.
• 40:42
  SPEAKER_00: Again, I was guilty.
• 40:44
  SPEAKER_00: I put myself on a GOP one.
• 40:45
  SPEAKER_00: I wanted to lose 10, 12 pounds.
• 40:47
  SPEAKER_00: I did.
• 40:47
  SPEAKER_00: I was skinny fat.
• 40:49
  SPEAKER_00: I was at my lowest weight, but I also was not at my lowest body fat percent.
• 40:54
  SPEAKER_00: And over the last couple of years, I've made huge adjustments.
• 40:57
  SPEAKER_00: And when I got on the in-body, I was like, oh my gosh, I am 15 pounds heavier than I normally am.
• 41:03
  SPEAKER_00: But I am in the best fitness level I've ever been in with more muscle and less body fat percent.
• 41:09
  SPEAKER_00: I'm stronger, I'm more energetic, less inflammation, all the things.
• 41:12
  SPEAKER_00: And it's so rewarding to see my patients come in over time and they're like, I don't even care what the scale says.
• 41:18
  SPEAKER_00: But I put on five pounds of muscle and I drop my body fat percent by five, 10%.
• 41:23
  SPEAKER_00: I'm like, that's huge.
• 41:25
  SPEAKER_00: And they're like, my clothes fit great, and I feel confident that is what we're going for.
• 41:30
  SPEAKER_00: And quite honestly, a large percentage of our GLP1 patients have completely eradicated their hypertension and their type 2 diabetes.
• 41:40
  SPEAKER_00: That's the message.
• 41:41
  SPEAKER_00: That's the control people have and they don't realize it.
• 41:45
  SPEAKER_00: The GLP1s, and not even for weight loss, so many patients report back better gut health, less inflammation, less joint pain.
• 41:53
  SPEAKER_00: So there's something to this, you know, better vessel wall health is what they're finding in the most recent research, which lowers cardiovascular disease.
• 42:02
  SPEAKER_00: I'm not a big advocate for big pharma, but I will say in this setting with the GLP ones, I'd much rather have a patient on a GLP1 that's keeping their body fat percent down, their lean muscle mass is remaining the same, and their inflammatory markers are down, which long term keeps them off of hyperlipid, high cholesterol medications, hypertension medications, type 2 diabetes medications.
• 42:26
  SPEAKER_00: If I have them off all of those and really they're needing a small micro dose of GLP1, I don't know, every other week or once a month, whatever it may be, I'm okay with that.
• 42:35
  SPEAKER_00: The side, the risk profile, if they're doing it correctly, that's the if.
• 42:40
  SPEAKER_00: You have to be managed by a provider, you have to watch a protein intake, you should not be losing muscle.
• 42:47
  SPEAKER_00: Or we stop our patients immediately.
• 42:49
  SPEAKER_00: That's losing muscle.
• 42:50
  SPEAKER_00: You have to put in the effort just as much.
• 42:54
  Mary Lee: It's 80% effort, 20% GLP1.
• 42:57
  Mary Lee: Just like we used to say about 80% in the food you put in your mouth, 20% effort in the gym.
• 43:03
  Mary Lee: But now, yes, it's so important.
• 43:05
  Mary Lee: 80, 20.
• 43:06
  SPEAKER_00: You know, and another interesting point is I've had a few patients that are moderately obese, they've got some underlying medical issues, they get on a GLP one, still making some lifestyle changes and doing the work, and they don't respond.
• 43:20
  SPEAKER_00: And so we sit down and we have to take a step back and we realize that these patients are so inflamed, meaning whether it's coming from the gut, autoimmune disease, food sensitivities, whatever the inflammation is coming from, if you think about your cells with little receptors all over them.
• 43:38
  SPEAKER_00: If you're inflamed, those receptors stop responding to a lot of things to include GLP1s.
• 43:47
  SPEAKER_00: So we have to come off the GLP1, we have to find the source of the inflammation, put that fire out, continue with lifestyle modifications, and then come back on a few months later and they start responding again.
• 44:00
  Mary Lee: Interesting.
• 44:01
  Mary Lee: But again, the key is they're being monitored.
• 44:04
  SPEAKER_00: Yes.
• 44:05
  SPEAKER_00: It makes me very nervous when I hear patients getting GLP1s off a website with no monitoring of dosing, and they have no idea what their protein needs are or their skeletal muscle mass.
• 44:16
  SPEAKER_00: I'm like, how are you even?
• 44:17
  SPEAKER_00: Are you just, you know, wanting to get in your skinning change and be sicker?
• 44:21
  Mary Lee: And that's unfortunately the messaging that women were given for such a long time that it was aesthetics.
• 44:28
  Mary Lee: It was the size of their genes, everything on the outside.
• 44:31
  Mary Lee: And the inside was completely taken for granted to the point where it was absolutely abused, misused, and abused.
• 44:38
  SPEAKER_00: Going back to Ivanka Wright, and her and many other providers are really driving that message home.
• 44:45
  SPEAKER_00: It's not skinny, it's strong.
• 44:47
  SPEAKER_00: And I don't know about your algorithm, but when I'm looking at things online, man, I see these women in their 60s and 70s bodybuilding.
• 44:55
  SPEAKER_00: They're in better shape than most of my patients.
• 44:58
  SPEAKER_00: And man, that's so inspiring.
• 45:02
  SPEAKER_00: It's just, I do believe there is this movement to educate the our patients.
• 45:07
  SPEAKER_00: And hopefully everybody's getting that message and picking up those weights because again, the control you have over your health will be evident as soon as you start looking at your muscle mass.
• 45:19
  Mary Lee: Exactly.
• 45:20
  Mary Lee: The number I tell a lot of the gals that I work with is I want to see the number of your one rep max go up.
• 45:28
  Mary Lee: That number should be increasing.
• 45:29
  Mary Lee: Don't be looking at any other number, but of course, your waist circumference is coming down.
• 45:34
  Mary Lee: That's a good sign too.
• 45:35
  Mary Lee: Sharon, let's talk about muscle and its role in our brain health as well.
• 45:41
  SPEAKER_00: It's interesting.
• 45:41
  SPEAKER_00: And I don't know if Vonda Wright had mentioned this statistic, but there was research out there showing consistent exercises that stimulate your quadriceps and your glutes.
• 45:57
  SPEAKER_00: And again, that's that one liner that I love to tell my patients when I'm trying to motivate them.
• 46:02
  SPEAKER_00: It can be a lot, it can be overwhelming.
• 46:04
  SPEAKER_00: But your brain health is huge.
• 46:06
  SPEAKER_00: Now, of course, kind of that encompasses hormones because estrogen bathes our brain cells.
• 46:12
  SPEAKER_00: And that's where the brain thought comes in.
• 46:15
  SPEAKER_00: But you know, muscle mass, a lot of it is related to the blood flow that it takes to number one, maintain each day movements with more muscle mass when you're working out and you have increased heart rate, increased circulation, you are optimizing the levels of oxygen getting to your brain.
• 46:37
  SPEAKER_00: So that correlation is huge.
• 46:40
  SPEAKER_00: You know, when you're in your 30s, are you thinking about dementia?
• 46:43
  SPEAKER_00: Likely not.
• 46:44
  SPEAKER_00: When you hit perimenopause or menopause and you consistently start having days of severe brain fog, finding the right words, it's concerning.
• 46:54
  SPEAKER_00: And hopefully that will stop you in your tracks thinking, okay, now's the time to really put this fire out and change some habits.
• 47:02
  SPEAKER_00: Because who wants to ever go down that road and lose brain function?
• 47:06
  SPEAKER_00: We're all losing brain cells every day.
• 47:09
  SPEAKER_00: How do we preserve the very most?
• 47:10
  SPEAKER_00: You know, and peptides kind of segues into that as well.
• 47:13
  SPEAKER_00: There's some great peptides out there specific for brain health and some great research that's going on.
• 47:18
  SPEAKER_00: But yeah, I cannot say enough with if you just think about the circulation, move those muscles, contract those muscles, increase circulation.
• 47:27
  SPEAKER_00: You are getting more oxygen to your brain.
• 47:29
  SPEAKER_00: Your brain needs really two things to function glucose and oxygen.
• 47:32
  SPEAKER_00: And you lower one of those, you're gonna get stuffed in your tracts real quick.
• 47:36
  SPEAKER_00: Right.
• 47:37
  SPEAKER_00: And that's the immediate need.
• 47:39
  SPEAKER_00: But over time, as we age and we're losing those brain cells, we got to preserve as much as we possibly can.
• 47:44
  Mary Lee: Absolutely.
• 47:45
  Mary Lee: Yes, absolutely.
• 47:46
  Mary Lee: Get the brain fertilizer, BDNF, brain direction.
• 47:50
  SPEAKER_00: Yes, that's that's a great peptide.
• 47:51
  Mary Lee: Yeah, I've been reading a lot about that.
• 47:54
  Mary Lee: Which we can naturally stimulate through heavy lifting.
• 47:58
  Mary Lee: And yes, those large muscle groups, quads, and glutes.
• 48:03
  Mary Lee: Get in there but chest, exactly.
• 48:07
  Mary Lee: Yes.
• 48:08
  Mary Lee: Tell us a little bit more about your clinic, then, Sharon.
• 48:11
  Mary Lee: Let's bring it back full circle when you got your clinic.
• 48:14
  Mary Lee: So it was obviously a lot of passion and personal experience that made you decide that you needed to have this boutique clinic that dealt specifically concierge medicine to deal with all the major concerns that we're seeing now in our healthcare system for women, but particularly and for men too, with the GLP ones.
• 48:34
  Mary Lee: Tell us how that all merged together, who's on your team, and most importantly, how can they work with you?
• 48:41
  SPEAKER_00: Well, I will say it definitely was a God thing because I really did have a passion for emergency medicine.
• 48:47
  SPEAKER_00: And I really felt uh, I mean, I got so much out of it.
• 48:51
  SPEAKER_00: It fit my personality perfectly, and I felt like I was doing good work in emergency medicine.
• 48:56
  SPEAKER_00: But, you know, I went back to school in my mid-40s to get my nurse practitioner license.
• 49:01
  SPEAKER_00: My kids were getting ready to leave for college.
• 49:03
  SPEAKER_00: My husband thought I was crazy.
• 49:05
  SPEAKER_00: I had no intention of having my own practice.
• 49:09
  SPEAKER_00: And so it has evolved.
• 49:11
  SPEAKER_00: And looking back on how everything has played out, it certainly was God's plan showing me what are my gifts, where are my passions, what is my purpose here?
• 49:20
  SPEAKER_00: When I refer back to being type one diabetic, I had thyroid cancer and had my thyroid removed, those are all blessings because that gave me an appreciation for my health.
• 49:29
  SPEAKER_00: And I figured there's a purpose for this.
• 49:32
  SPEAKER_00: I am meant to learn from this and help my patients.
• 49:35
  SPEAKER_00: And so it fed that passion for health and wellness and how much we certainly can control.
• 49:41
  SPEAKER_00: So as my clinic slowly went from aesthetics and more into the medicine piece that continued to grow.
• 49:50
  SPEAKER_00: We added weight loss, we added hormone therapy, we were going into such depths of health care that we ended up bringing in full primary care and additional nurse practitioners.
• 50:02
  SPEAKER_00: And it's kind of a crazy business aspect.
• 50:04
  SPEAKER_00: I was a full cash-paying practice, which a lot of independent providers gravitate to because they are so burnt out with dealing with insurance.
• 50:13
  SPEAKER_00: I did a little bit opposite.
• 50:15
  SPEAKER_00: Some days I question that, but I was really trying to serve my community.
• 50:19
  SPEAKER_00: And a lot of these services we offer are out-of-pocket expenses.
• 50:24
  SPEAKER_00: And I did not want to exclude somebody that was paying exorbitant amount of money for insurance that could not come see me, even if it was just for basic primary care.
• 50:34
  SPEAKER_00: So last year we added in a few insurance carriers so that built our practice and we were able to reach the rest of the community that was wanting to be seen and be able to build their insurance.
• 50:46
  SPEAKER_00: So we are a privately owned primary care practice with all the extra options.
• 50:53
  SPEAKER_00: And so now we've are getting ready to bring on another nurse practitioner looking for someone that is well adversed in hormone health and very much an advocate for patients.
• 51:04
  SPEAKER_00: So you reach out to me if that might be you.
• 51:06
  SPEAKER_00: Trying to find a right team member can always be to fit your model, is um can take some time.
• 51:13
  SPEAKER_00: So we are growing by leaps and bounds.
• 51:15
  SPEAKER_00: The one thing we have really been known for in our community is known as that faith-based functional medicine approach.
• 51:23
  SPEAKER_00: So my patients come in and they are struggling, they know they can ask for a prayer and they're not gonna be judged.
• 51:31
  SPEAKER_00: And that absolutely is their right.
• 51:33
  SPEAKER_00: And if they don't want to, that is totally fine.
• 51:37
  SPEAKER_00: But I'm not gonna sit here and look over my shoulder like I used to in corporate health care and be afraid I'm gonna get fired because I'm praying with a patient who truly needs it.
• 51:46
  SPEAKER_00: And that is very empowering personally and professionally.
• 51:50
  SPEAKER_00: And I speak of that because I want to encourage other medical providers to stand up for their faith and offer it to the patients because I'm telling you, patients want this.
• 52:02
  SPEAKER_00: There's there's always a maybe a negative comment here or there.
• 52:05
  SPEAKER_00: And that is going to be the case with anything you do.
• 52:07
  SPEAKER_00: But let me tell you, we're doing God's work.
• 52:09
  SPEAKER_00: We were here put for a reason.
• 52:12
  SPEAKER_00: And that's the other message, too, is when my patients are coming in and they're really feeling defeated, and I'm telling them, go do all this work.
• 52:20
  SPEAKER_00: What is motivating them?
• 52:22
  SPEAKER_00: And the message I'm trying to get to them is let's take a step back, let's stop looking at social media and trying to get into those skinny genes and really focus on the reason we want to take care of our bodies.
• 52:32
  SPEAKER_00: And that is God gave us this body by choice.
• 52:36
  SPEAKER_00: How are we going to steward this?
• 52:39
  SPEAKER_00: And once you come from that perspective, there's your motivation to get out of bed and go do your workout.
• 52:45
  SPEAKER_00: Get your hydration, take your supplements because you've got that purpose.
• 52:48
  SPEAKER_00: And there's no other purpose out there that's going to be more fulfilling than knowing, using that as your motivation.
• 52:55
  SPEAKER_00: And again, I'm telling you, patients want that.
• 52:59
  SPEAKER_00: They they relate to that.
• 53:02
  SPEAKER_00: And so we're addressing physical, emotional, and spiritual health.
• 53:06
  SPEAKER_00: And I can't speak enough on that.
• 53:08
  SPEAKER_00: And I I tell my provider, speak out, open your own doors, speak of your faith, and it will it will build, it will grow.
• 53:15
  Mary Lee: Beautiful.
• 53:16
  Mary Lee: That is so beautiful.
• 53:17
  Mary Lee: I'm glad you added that in, Sharon.
• 53:19
  Mary Lee: And I think we could speak at great length that the power of prayer and intention setting and gratitude on our our health.
• 53:29
  Mary Lee: Science has even entered this arena with the work of Dr.
• 53:32
  Mary Lee: Joe Dispenses, that gratitude.
• 53:35
  Mary Lee: Um shifts the energy in our body, shifts our brain waves and puts us in.
• 53:44
  Mary Lee: We can literally use our vessel to heal itself, which is also what it was designed to do, but with a little bit of help along the way.
• 53:53
  SPEAKER_00: And somebody that's recently spoken out on that is Andrew Huberman, uh neuroscientist.
• 53:58
  SPEAKER_00: And he's looking at which is so fulfilling to see him speak out on this of how he's looking at the science and he cannot explain once he opened his heart to God and gratitude and that space.
• 54:11
  SPEAKER_00: He's I've heard him say many times recently, he's never felt this kind of peace.
• 54:17
  SPEAKER_00: And he can't explain it, and it's not science, and that's what is call faith.
• 54:21
  Mary Lee: You're right though.
• 54:23
  Mary Lee: It doesn't have to compete, it doesn't have to be one or the other.
• 54:26
  Mary Lee: In fact, there's this beautiful intersection with science and spirituality that they're working together and again, forward-thinking movements towards healthcare.
• 54:36
  Mary Lee: We're starting to see all aspects of the human mind, body, soul, spirits.
• 54:40
  Mary Lee: Yes.
• 54:41
  Mary Lee: Yes, yes.
• 54:42
  Mary Lee: Sharon, before before we end, I want to throw some rapid-fire questions at you guys.
• 54:46
  SPEAKER_00: Okay, love it.
• 54:48
  Mary Lee: Bring some more humanity.
• 54:49
  Mary Lee: I guess you will.
• 54:50
  Mary Lee: Well, we've spoken a great deal about being more the human aspect of healthcare, but just to learn a little bit more about Sharon.
• 54:57
  Mary Lee: So here we go.
• 54:59
  Mary Lee: All right, your favorite way to start your day.
• 55:04
  SPEAKER_00: A workout.
• 55:05
  SPEAKER_00: It sounds crazy, but I get up at 5 a.m.
• 55:07
  SPEAKER_00: and I feel like I've started my day perfectly.
• 55:09
  SPEAKER_00: If I can do the workout, get it done, get in the shower, and I'm on my way.
• 55:14
  SPEAKER_00: Beautiful.
• 55:15
  Mary Lee: What is your favorite go-to comfort food in times of stress?
• 55:19
  SPEAKER_00: Oh my goodness.
• 55:20
  SPEAKER_00: I am a huge coffee drinker.
• 55:22
  SPEAKER_00: So I will never tell you to stop drinking caffeine.
• 55:25
  SPEAKER_00: Um, I'm totally immune to it, but hot coffee every day, any day, all day long, I go to bed with a cup of coffee on my nightstand and I sleep like a baby.
• 55:33
  Mary Lee: What's one habit that changed your life?
• 55:38
  SPEAKER_00: Wow.
• 55:39
  SPEAKER_00: One habit that's changed my life.
• 55:41
  SPEAKER_00: I think recently, it kind of goes back to what we were talking about.
• 55:45
  SPEAKER_00: I feel obliged to set an example as a medical provider for my patients.
• 55:50
  SPEAKER_00: So when I'm preaching everything, I have to do the same thing, looking at my protein and looking at my muscle mass.
• 55:56
  SPEAKER_00: And that's been a huge habit within the last year.
• 55:59
  SPEAKER_00: And it has shifted my energy, my confidence, um, my body composition.
• 56:05
  SPEAKER_00: And I feel like it's giving me even more credibility because I'm not going to sit here and tell you to do everything when I'm not in the trenches with you.
• 56:12
  Mary Lee: What is something that would surprise people about you?
• 56:17
  SPEAKER_00: Uh, I love being on a tractor.
• 56:19
  SPEAKER_00: We have five acres, and I can't get enough time on that darn thing between my husband and my son-in-law and my son when he's visiting, but I would much rather being outside digging a ditch and on a tractor than cooking inside.
• 56:33
  unknown: Beautiful.
• 56:34
  Mary Lee: I love it.
• 56:35
  Mary Lee: Oh, you're actually knocking off all of my questions as you go through them.
• 56:39
  Mary Lee: One of them was tea or coffee, and the other one was city or countryside.
• 56:42
  Mary Lee: I we know the answer to both of those now.
• 56:45
  SPEAKER_00: Yeah, yeah.
• 56:46
  Mary Lee: Um, what is one thing though that you're unapologetically passionate about?
• 56:50
  Mary Lee: And not the faith.
• 56:51
  Mary Lee: Or your faith.
• 56:53
  Mary Lee: Yes.
• 56:53
  SPEAKER_00: Yep.
• 56:53
  SPEAKER_00: Yep.
• 56:54
  SPEAKER_00: Absolutely, a hundred percent.
• 56:56
  SPEAKER_00: I don't want to ever come off judging, but I I know why I'm on this earth and I will claim it every day, every minute, and we'll never apologize for it.
• 57:04
  Mary Lee: Oh, that's so beautiful.
• 57:06
  Mary Lee: All right, one last one.
• 57:07
  Mary Lee: It's to finish the sentence.
• 57:09
  Mary Lee: Life is too short to like sit around.
• 57:15
  SPEAKER_00: Move your body, find your passion.
• 57:18
  SPEAKER_00: I you know, I've when I was raising my kids, my big thing was you want when you get to the end of the road, you don't ever want to say, I regret.
• 57:26
  SPEAKER_00: And keeping that in mind at the forefront, or I wish I would have, I wish I could have.
• 57:31
  SPEAKER_00: Do it.
• 57:32
  SPEAKER_00: Don't sit around and just do it.
• 57:34
  SPEAKER_00: You can't learn if you don't fail.
• 57:36
  SPEAKER_00: And if you don't try, you're not gonna succeed.
• 57:38
  Mary Lee: Now, Robin's the five-second rule, right?
• 57:40
  Mary Lee: 5-4-3-2-1.
• 57:42
  Mary Lee: That's why I started podcasting.
• 57:44
  unknown: You know.
• 57:45
  Mary Lee: That's my passion for empowering women to take charge.
• 57:49
  Mary Lee: Tell our listeners where they can find you, and we'll get that all in the show notes.
• 57:54
  SPEAKER_00: Yes.
• 57:54
  SPEAKER_00: So we are in Gig Harbor, Washington, which is about 45 minutes outside of Seattle.
• 57:59
  SPEAKER_00: It truly is God's country.
• 58:01
  SPEAKER_00: We love being here and serving our community.
• 58:03
  SPEAKER_00: I do have a YouTube channel, Health Hormones and Faith.
• 58:07
  SPEAKER_00: I am on Instagram at the concierge NP.
• 58:12
  SPEAKER_00: And yes, feel free to reach out if you have questions, concerns.
• 58:15
  SPEAKER_00: Of course, if you're in the area, come see us.
• 58:18
  SPEAKER_00: I really am stepping outside of a little bit of the patient care in the office so that I can make myself more available to speak and educate.
• 58:26
  SPEAKER_00: So these types of opportunities are awesome.
• 58:29
  SPEAKER_00: And it really fills my soul to just share my gifts with my patient population.
• 58:34
  Mary Lee: Oh, beautiful.
• 58:35
  Mary Lee: We'll get all those links in the show notes.
• 58:37
  Mary Lee: Sharon, this has been a delightful conversation.
• 58:39
  Mary Lee: I am so enamored with your work, with your unwavering trust and faith in what you do and bringing the Lord, source, creator, universe, whatever you want to call it, bringing in that spiritual aspect to it is very much a part of the whole person who we are.
• 58:56
  Mary Lee: So thank you for your time, your energy.
• 58:58
  Mary Lee: I've thoroughly enjoyed our time together.
• 59:01
  SPEAKER_00: Thank you so much.
• 59:02
  Mary Lee: I appreciate having me.
• 59:04
  Mary Lee: There were so many important messages in this conversation, but I want to leave you with a few key takeaways.
• 59:10
  Mary Lee: First, listen to your body and don't dismiss your lived experience.
• 59:15
  Mary Lee: If something feels different, if your energy is changed, your sleep is suffering, or you simply don't feel like yourself, investigate.
• 59:23
  Mary Lee: Symptoms can have multiple causes.
• 59:26
  Mary Lee: So the goal is to understand what's happening rather than automatically attributing everything to hormones and aging.
• 59:32
  Mary Lee: Third, look beyond the number on the scale.
• 59:35
  Mary Lee: This was one of my favorite parts of our conversation.
• 59:38
  Mary Lee: Weight is only one measure of health.
• 59:40
  Mary Lee: Muscle strength, bone health, metabolic health, and the habits that support them deserve far more attention.
• 59:47
  Mary Lee: If you're considering a medical weight loss treatment, it's important to discuss the benefits, risks, nutrition, and muscle preservation with a qualified healthcare professional.
• 59:57
  Mary Lee: While the fad these days seems to be focused on becoming smaller, which to me just looks like frailty, real power comes from building heart, brain, and bone health that supports longevity and quality of life.
• 1:00:10
  Mary Lee: You know, like being able to recover from a trip before it becomes a fall, a broken bone, or a fractured hip, reducing mobility and your odds of aging in place.
• 1:00:21
  Mary Lee: And then finally, don't underestimate the importance of purpose.
• 1:00:25
  Mary Lee: I loved hearing Sharon talk about her faith.
• 1:00:28
  Mary Lee: Whether you draw that sense of purpose from faith, spirituality, relationships, service, or something entirely different.
• 1:00:36
  Mary Lee: Having a reason to care for yourself can help connect your everyday habits to something that's much bigger, more powerful, like being a better version of yourself every day so that you can show up for others and yourself in a positive frame of mind and overall health and wellness.
• 1:00:53
  Mary Lee: Menopause can be that powerful invitation to reassess your health.
• 1:00:58
  Mary Lee: If there's one thing I hope you'll take away from this episode, is this you are not powerless in your health journey and you don't have to figure everything out all on your own.
• 1:01:06
  Mary Lee: Work with healthcare professionals and those healthcare support practitioners who have your best interest at heart.
• 1:01:12
  Mary Lee: You can find Sharon Lemoyne through her clinic, Gig Harbor Medical Spa and Concierge Medicine, on her Instagram at the Concierge NP.
• 1:01:22
  Mary Lee: She also shares content on her YouTube channel, Health, Hormones, and Faith.
• 1:01:27
  Mary Lee: All of those links will be in the description below.
• 1:01:31
  Mary Lee: Before we go, a quick reminder that this podcast is for educational and discussion, not individualized medical advice.
• 1:01:38
  Mary Lee: Hormone therapies, GLP1 medications, supplements, and other treatments require an assessment of your individual circumstances and a conversation with a qualified healthcare professional.
• 1:01:50
  Mary Lee: Some of the treatment approaches discussed today are areas of ongoing research, so please use this episode as a starting point for informed conversations rather than a prescription.
• 1:02:01
  Mary Lee: As always, my listeners, stay informed, stay educated, and stay empowered.
• 1:02:06
  Mary Lee: Until next time.