Latest / The Body Pod / Menopause, IBS & Gut Health in Midlife Women: What Your Doctor Isn't Telling You with Dr. Mary Pardee

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Menopause, IBS & Gut Health in Midlife Women: What Your Doctor Isn't Telling You with Dr. Mary Pardee · The Body Pod

• 0:00
  Speaker 1: Yeah, I mean, the more that we sell those supplements,
• 0:02
  Speaker 1: the more that they tell women they need to get
• 0:04
  Speaker 1: lightpo for it, the more we're perpetuating that whole loop
• 0:08
  Speaker 1: that we need to keep fixing the normal female body.
• 0:13
  Speaker 1: And like the overpathologizing that we see in the wellness
• 0:17
  Speaker 1: industry is insane to me. Hi.
• 0:22
  Speaker 2: Everyone, my name is Haley and this is Laura, and
• 0:25
  Speaker 2: welcome to the Body Pod. Welcome doctor Mary, party to
• 0:31
  Speaker 2: the Body Pod.
• 0:33
  Speaker 3: Thank you. I'm excited to be here, super excited to
• 0:36
  Speaker 3: have you.
• 0:37
  Speaker 2: And I'm really as I've been diving through information about you,
• 0:41
  Speaker 2: I want to know what made you start and kind
• 0:44
  Speaker 2: of get into your profession and start modern met because
• 0:47
  Speaker 2: that's really intriguing to me.
• 0:50
  Speaker 3: Yeah.
• 0:50
  Speaker 1: So I think why I started my own business versus
• 0:54
  Speaker 1: just you know, joining a practice is I had a
• 0:57
  Speaker 1: pretty good idea of what I wanted to do and
• 1:00
  Speaker 1: I didn't see a model that was exciting for me
• 1:03
  Speaker 1: already just to be a part of. And I knew
• 1:07
  Speaker 1: I wanted to treat a couple of things, but I
• 1:11
  Speaker 1: didn't want to just choose one of them. I feel
• 1:12
  Speaker 1: like sometimes you know business coaches that are always telling you, like,
• 1:16
  Speaker 1: pick your one thing, and I'm like, but I have
• 1:18
  Speaker 1: two and I like really want to do the two things,
• 1:22
  Speaker 1: and so I treat chronic GI issues and then I
• 1:25
  Speaker 1: also do preventive medicine with more of a performance edge
• 1:29
  Speaker 1: to it because of my background in nutrition, and I
• 1:32
  Speaker 1: did a really brief background in exercise science and I
• 1:36
  Speaker 1: love performance. So just me personally, one of my hobbies
• 1:40
  Speaker 1: is exercise science and geeking out on performance and optimization
• 1:44
  Speaker 1: and things like that. But I wanted to do both
• 1:46
  Speaker 1: of those things, and they're obviously very different and require
• 1:49
  Speaker 1: different hats. But that's what I've done, and I really
• 1:54
  Speaker 1: love it.
• 1:55
  Speaker 2: I know that you've talked a little bit about menopause
• 1:58
  Speaker 2: on your site, and that's kind of that's all our
• 2:02
  Speaker 2: entire audience is pretty much midlife females. I assume that
• 2:06
  Speaker 2: you work with anyone as a physician, but what, like,
• 2:12
  Speaker 2: are you getting more into the menopause space, do you
• 2:15
  Speaker 2: have just an interest in it yourself, or what does
• 2:17
  Speaker 2: that bring into your practice? Are you getting more women
• 2:20
  Speaker 2: coming in asking about it?
• 2:22
  Speaker 3: Yeah?
• 2:23
  Speaker 1: So my scope is primary care and that fits under
• 2:25
  Speaker 1: the bucket of preventative medicine, right, So I see women
• 2:29
  Speaker 1: all the time in midlife going through perimenopause into menopausal transition,
• 2:35
  Speaker 1: and I take care of those women. I prescribe MHD.
• 2:38
  Speaker 1: I'm a Menopause Society certified practitioner, so I've done that
• 2:42
  Speaker 1: whole training and it's definitely a part of what I do,
• 2:47
  Speaker 1: and I think it's a really important part of the
• 2:50
  Speaker 1: primary care aspect too.
• 2:53
  Speaker 2: Do you find that women come in that may have
• 2:55
  Speaker 2: been dismissed from other doctors that come to you for
• 2:59
  Speaker 2: any reason, they're too young for hormone therapy, they might
• 3:03
  Speaker 2: not be getting the same information.
• 3:07
  Speaker 1: Yeah, I think the space is getting better overall, one
• 3:11
  Speaker 1: hundred percent. I always hear like the one off stories
• 3:15
  Speaker 1: of you know, my doctor said I shouldn't go on
• 3:19
  Speaker 1: hormones and they cause cancer or something like that, and
• 3:23
  Speaker 1: these are kind of like the signals of the our
• 3:27
  Speaker 1: system is broken. Doctors don't have enough time to spend
• 3:30
  Speaker 1: with patients to really break down the numbers with them,
• 3:35
  Speaker 1: and so that's why I like the model that I
• 3:38
  Speaker 1: have where I'm going to spend an hour with a woman,
• 3:41
  Speaker 1: if not to visits, so like two hours talking about
• 3:44
  Speaker 1: risks benefits. What are the numbers look like in terms
• 3:47
  Speaker 1: of breast cancer risks? What are the numbers look like
• 3:50
  Speaker 1: in terms of you know, or what are we actually
• 3:52
  Speaker 1: trying to treat too. I think there's a bunch on
• 3:54
  Speaker 1: social media where like every woman should be on menopause
• 3:57
  Speaker 1: hormone therapy, and I don't think that's true either. I
• 3:59
  Speaker 1: think any extreme you hear is probably just that an extreme,
• 4:03
  Speaker 1: and we need to figure out individualized therapies for women.
• 4:08
  Speaker 1: And that's what I try to do in my practice
• 4:10
  Speaker 1: and say, you know, is it right for you right now?
• 4:12
  Speaker 1: And that answer may be different in ten years, that
• 4:15
  Speaker 1: the answer may have shifted from a yes to a no.
• 4:17
  Speaker 1: And that's when we transition women off of four months.
• 4:20
  Speaker 2: Are you willing to keep a client on that is
• 4:24
  Speaker 2: over that has been on it for longer than ten years?
• 4:26
  Speaker 2: Because that question always comes up if someone has been
• 4:30
  Speaker 2: on it for longer than ten years, or if somebody
• 4:32
  Speaker 2: wanted to start it for whatever reason in their sixties.
• 4:36
  Speaker 1: Yeah, starting in your sixties. If you haven't been on
• 4:39
  Speaker 1: it is a different discussion. There's a higher risk associated
• 4:42
  Speaker 1: with that. So you'd want to really go through that
• 4:44
  Speaker 1: woman's family history, clotting history, personal history, that whole thing
• 4:50
  Speaker 1: and make a really informed decision for that woman because
• 4:55
  Speaker 1: the risks are higher, but I also believe that women
• 4:58
  Speaker 1: need to have quality of life, and so quality of
• 5:00
  Speaker 1: life is really really low, and this is the thing
• 5:03
  Speaker 1: that would change the quality of life despite the increased risk.
• 5:07
  Speaker 1: And she knows the increased risk, then you can have
• 5:09
  Speaker 1: a discussion about what that looks like. The easier question
• 5:14
  Speaker 1: was the first one, which is keeping women on it
• 5:16
  Speaker 1: past the ten years absolutely, and every year you should
• 5:20
  Speaker 1: be having a discussion with your doctor about do the
• 5:23
  Speaker 1: benefits outweigh the risk still?
• 5:27
  Speaker 3: And if the answer to that is yes.
• 5:28
  Speaker 1: Then you can continue with MHT beyond that ten year mark.
• 5:33
  Speaker 1: Sometimes the answer is going to be know though, and
• 5:36
  Speaker 1: so then we want to transition off of it.
• 5:38
  Speaker 3: But this is a.
• 5:38
  Speaker 1: Conversation with a doctor. This isn't the doctor talking at you,
• 5:42
  Speaker 1: not asking you questions. This is them asking you what's
• 5:45
  Speaker 1: your comfort level? Here are your risks? Are you comfortable
• 5:48
  Speaker 1: with these risks? Should we try to.
• 5:50
  Speaker 3: Go off at maybe you don't have symptoms anymore?
• 5:53
  Speaker 1: And so it's all about the patient doctor relationship and
• 5:56
  Speaker 1: really having a discussion about it versus being talked at.
• 6:01
  Speaker 2: What do you think about DEXA scans and the recommended
• 6:06
  Speaker 2: age of sixty five.
• 6:09
  Speaker 1: Yeah, that one I don't go by, so I do
• 6:12
  Speaker 1: dexa scans much younger for a lot of different people.
• 6:17
  Speaker 1: But there's also there's a dexa scans that do body
• 6:20
  Speaker 1: composition right, and then there's the bone density dexas scans,
• 6:24
  Speaker 1: And unfortunately, the ones that you can just go into
• 6:26
  Speaker 1: on your own, they're just going to give you a
• 6:28
  Speaker 1: total body bone density. They're not going to be diagnostic
• 6:31
  Speaker 1: for osteoporosis and osteopenia. So the ones you're referring to
• 6:34
  Speaker 1: are you going to a hospital and you can get
• 6:36
  Speaker 1: a diagnosis of osteoporosis and osteopenia. But for those, I'm
• 6:40
  Speaker 1: much more liberal in using those in women at much
• 6:43
  Speaker 1: younger ages. Especially if a woman is just on the
• 6:47
  Speaker 1: thinner side, her likelihood of having frail bones is much
• 6:52
  Speaker 1: much higher, and I'd rather catch it early.
• 6:54
  Speaker 3: You know.
• 6:54
  Speaker 1: I had a woman come into my practice who's twenty
• 6:57
  Speaker 1: years old, normal body weight, but on the low side
• 7:00
  Speaker 1: of normal. I think she's like twenty five or something,
• 7:03
  Speaker 1: and we did this scan on her and there was
• 7:04
  Speaker 1: no standard of care that told me to do this
• 7:06
  Speaker 1: scan on her, and she's very very low bone density.
• 7:09
  Speaker 1: But I'd rather find out at twenty five and do
• 7:13
  Speaker 1: something about it, then wait till she's much older and
• 7:16
  Speaker 1: have not done something about it.
• 7:18
  Speaker 3: So we can do a ton for this person. And
• 7:20
  Speaker 3: I'm really glad that we did it earlier.
• 7:24
  Speaker 2: Do you find that insurance will cover it?
• 7:30
  Speaker 3: Depends on the insurance, sometimes sometimes not.
• 7:33
  Speaker 2: So are you Let's move on for sticking with the
• 7:38
  Speaker 2: menopause theme here, I want to talk about IBS, as
• 7:42
  Speaker 2: I was just sharing before we started this podcast. I
• 7:45
  Speaker 2: have many people in my family that have it. I don't,
• 7:49
  Speaker 2: but I know that my mother, who never struggled with
• 7:53
  Speaker 2: it at all, and tel postmenopause, it began and it
• 7:58
  Speaker 2: has been such a hard transition for her to even travel.
• 8:05
  Speaker 2: I think she's on top of it now, but at
• 8:07
  Speaker 2: the first it was it was severely holding her back.
• 8:10
  Speaker 2: So do you see that IBS those symptoms kicking up
• 8:14
  Speaker 2: postmenopause or even in perimenopause.
• 8:19
  Speaker 1: Yeah, your mom's story is interesting. What I do see
• 8:22
  Speaker 1: is perimenopause can be a time when symptoms flare. So
• 8:27
  Speaker 1: if a woman has IBS and she was doing pretty well,
• 8:30
  Speaker 1: perimenopause sometimes can create more flares and irritable bowel syndrome symptoms.
• 8:35
  Speaker 1: And when we talk about IBS, we're talking about diarrhea
• 8:39
  Speaker 1: constipation alternating diarrhea constipation, but the keynote being abdominal pain
• 8:43
  Speaker 1: and cramping with IBS also can get floating in distension.
• 8:48
  Speaker 1: But with hormone fluctuations in perimenopause being so erratic and
• 8:53
  Speaker 1: up and down, your home hormones, progesterone and estrogen have
• 8:58
  Speaker 1: effects on the GI track. Strone actually slows the GI
• 9:01
  Speaker 1: tract down. That's why in cycling women much more likely
• 9:06
  Speaker 1: to be constipated right before your period when progesterone levels
• 9:09
  Speaker 1: are at their highest and estrogen talks to serotonin receptors
• 9:14
  Speaker 1: and help can help reduce pain signals for people with IBS,
• 9:18
  Speaker 1: And so that's why some women with IBS will feel
• 9:20
  Speaker 1: better in their follicular phase into their ludeal phase where
• 9:24
  Speaker 1: estrogen levels are a little bit higher and perimenopause kind
• 9:29
  Speaker 1: of everything goes out the window and we see fluctuating
• 9:31
  Speaker 1: levels up and down, and that erratic changes in the
• 9:35
  Speaker 1: hormones can cause flair in IBS symptoms.
• 9:39
  Speaker 3: But what's really interesting is that.
• 9:43
  Speaker 1: After the age of like forty or fifty, because IBS
• 9:48
  Speaker 1: is twice.
• 9:48
  Speaker 3: As common in women as it is in men.
• 9:51
  Speaker 1: But by the time women approach the age of seventy,
• 9:54
  Speaker 1: the rates of men and women are actually the same
• 9:57
  Speaker 1: at that point.
• 9:58
  Speaker 3: So after that.
• 9:59
  Speaker 1: Perimide apostal menopausal transition, the rates start to converge down
• 10:03
  Speaker 1: because we don't have those hormonal differences in men versus women.
• 10:08
  Speaker 1: So what I was saying was interesting with your mom's
• 10:10
  Speaker 1: case is typically, and again there's always exceptions to this
• 10:14
  Speaker 1: one hundred percent, but a lot of the times we'll
• 10:16
  Speaker 1: see improvements in IBS symptoms postmenopausally.
• 10:20
  Speaker 2: So if we're just focusing on IBS, what causes it?
• 10:23
  Speaker 2: Because I know you have a lot of information on
• 10:25
  Speaker 2: your socials about IBS, and it's always been intriguing to
• 10:30
  Speaker 2: me because I have many family members with it, and
• 10:33
  Speaker 2: I would say that some of them are more extreme
• 10:37
  Speaker 2: than others. But the extreme is like we plan our
• 10:41
  Speaker 2: vacations around everything, knowing where a bathroom is, flights, buses,
• 10:48
  Speaker 2: if you're doing a tour in another country, if the bout.
• 10:51
  Speaker 2: I mean, all of these things have to be taken
• 10:54
  Speaker 2: into account, and I feel like the advice that they
• 10:59
  Speaker 2: have been given over the last maybe fifteen years is
• 11:05
  Speaker 2: kind of like, well, it's IBS. Here's a drug, but
• 11:08
  Speaker 2: most of these work for women. Do we see a
• 11:11
  Speaker 2: difference in the drugs that work for women and men?
• 11:14
  Speaker 2: And what what would you say causes ibs? Is it
• 11:18
  Speaker 2: in the gut? Is it all of the foods that
• 11:22
  Speaker 2: they're eating? I mean, what is the pattern there?
• 11:26
  Speaker 1: Yeah, so the first part of the question, like what
• 11:27
  Speaker 1: causes it? This isn't what I think. This is like documented,
• 11:32
  Speaker 1: So it's it goes along a biopsychosocial model. So several
• 11:37
  Speaker 1: conditions in medicine go with a biopsychosocial model, and what
• 11:41
  Speaker 1: that means is it has biological or physiological components and
• 11:45
  Speaker 1: those are things like changes in motility, sensation changes. So
• 11:50
  Speaker 1: visceral hypersensitivity is one of the keynotes of irritable bowel syndrome,
• 11:55
  Speaker 1: and that's a big fancy word for people with IBS,
• 11:59
  Speaker 1: they're in Heston's become more sensitive to pain and discomfort
• 12:04
  Speaker 1: compared to somebody without IBS. And so if somebody has
• 12:08
  Speaker 1: a little bit of bloating and IBS, they're going to
• 12:10
  Speaker 1: feel it much more prominently than somebody without IBS. Now,
• 12:16
  Speaker 1: what this can get mixed up with is people say, oh,
• 12:18
  Speaker 1: so you're telling me it's all in my head. I'm
• 12:20
  Speaker 1: making it up. That's not what we're saying at all.
• 12:23
  Speaker 1: This is a known physiological change called visceral hypersensitivity, where
• 12:27
  Speaker 1: the nerve endings in the gut are sending heightened pain
• 12:31
  Speaker 1: signals to the brain. The good thing about that is
• 12:34
  Speaker 1: we actually have ways that we can turn down those
• 12:37
  Speaker 1: pain signals so that the person isn't experiencing as much discomfort.
• 12:42
  Speaker 1: So like there's a physiological changes, we also add in there,
• 12:45
  Speaker 1: like the gut microbiome we think is probably involved maybe
• 12:49
  Speaker 1: some degree of low level inflammation, but not the degree
• 12:51
  Speaker 1: that we can actually check on blood work more just
• 12:53
  Speaker 1: from like a research setting. And then we have the
• 12:56
  Speaker 1: psycho so the psychosocial factors, so like mind social components
• 13:01
  Speaker 1: to it. Stress is a well known contributing factor for
• 13:04
  Speaker 1: IBS psychological state, so we know that people with IBS
• 13:09
  Speaker 1: are more likely to have a neurotic personality type that
• 13:11
  Speaker 1: worry more and may contribute to symptoms in some degree.
• 13:15
  Speaker 1: And then also just ineffective coping strategies can potentially play
• 13:19
  Speaker 1: a role in IBS too. And then we also have
• 13:22
  Speaker 1: the early life events like genetic factors, so you can
• 13:27
  Speaker 1: see higher rates of IBS if your parent had IBS,
• 13:30
  Speaker 1: there may be a genetic component to it as well,
• 13:32
  Speaker 1: and then some environmental factors in terms of potentially early
• 13:36
  Speaker 1: childhood trauma and things like that. And so it's not
• 13:40
  Speaker 1: a clear this is the cause. It's multifactorial. There's many,
• 13:45
  Speaker 1: many things that look like they're playing into irritable bowel
• 13:47
  Speaker 1: syndroma as we know it right now.
• 13:50
  Speaker 4: So childhood trauma, it would be when you say it's
• 13:53
  Speaker 4: a result of childhood trauma, would it be because of
• 13:57
  Speaker 4: an extremely stressful situation that then they are carrying all
• 14:03
  Speaker 4: of this stress.
• 14:05
  Speaker 3: We don't know.
• 14:06
  Speaker 1: And not everybody with IBS had any childhood trauma, so
• 14:09
  Speaker 1: you can see people, I mean, we have post infectious
• 14:12
  Speaker 1: ibs too, right, So that's like when somebody goes usually travels,
• 14:16
  Speaker 1: they get travelers diarrhea, they come back and they develop
• 14:20
  Speaker 1: irritable bowel syndrome based on just an infection. But trauma
• 14:26
  Speaker 1: is believed to be one of the potential kind of
• 14:28
  Speaker 1: causes into the bucket of irritable bowl syndrome. But every
• 14:32
  Speaker 1: single patient is different. You know, I have people come
• 14:34
  Speaker 1: into me they're like get started after I got a
• 14:36
  Speaker 1: divorce or somebody's like, I don't know, but my mom
• 14:39
  Speaker 1: had it, like everything else was really good. So it's
• 14:42
  Speaker 1: always kind of a mixed bag in terms of why
• 14:45
  Speaker 1: we think it happens.
• 14:46
  Speaker 3: And I like, I.
• 14:49
  Speaker 1: Always want to give people an answer, but a lot
• 14:51
  Speaker 1: of the times we will never know why it developed
• 14:53
  Speaker 1: in one person because of all these factors that can
• 14:56
  Speaker 1: play into it. And we really want to focus on
• 14:59
  Speaker 1: how do we you better? Like, how do we get
• 15:01
  Speaker 1: you feeling better?
• 15:01
  Speaker 3: Is the big thing?
• 15:03
  Speaker 2: Yeah, and how do you I mean, is medication the
• 15:06
  Speaker 2: number one or is the more diet combination? I mean,
• 15:09
  Speaker 2: I know not everything's going to work for everyone, but
• 15:13
  Speaker 2: it's kind of a doozy. There's not like an easy fix.
• 15:17
  Speaker 1: There's not an easy fix, and in my experience, is
• 15:21
  Speaker 1: a combination of medications and behavioral changes, sometimes including diet
• 15:28
  Speaker 1: changes as well. So if somebody comes in with IBSC,
• 15:31
  Speaker 1: they're constipation predominant and they have bloating, the first thing
• 15:34
  Speaker 1: I'm going to do is get that gut moving faster,
• 15:37
  Speaker 1: and most of the time I'm using medications or magnesium
• 15:39
  Speaker 1: to do that in that person. But if they also
• 15:43
  Speaker 1: are like really bothered by the abdominal pain and cramping.
• 15:46
  Speaker 3: We have meds for that.
• 15:47
  Speaker 1: But we also have really effective strategies that target the
• 15:52
  Speaker 1: gut brain axis. So IBS is now classified as a
• 15:57
  Speaker 1: disorder of the gut brain interaction.
• 16:00
  Speaker 3: That's the umbrella that it.
• 16:01
  Speaker 1: Falls under, and that's because we believe that IBS is
• 16:05
  Speaker 1: in part due to the fact that there's a miscommunication
• 16:08
  Speaker 1: between the gut and the brain when they're trying to
• 16:10
  Speaker 1: talk to each other. This is what I was talking
• 16:12
  Speaker 1: about with the hypervigilance and hypersensitivity specifically. And so because
• 16:18
  Speaker 1: there's this kind of kink in communication between the gut
• 16:20
  Speaker 1: and the brain and they're not sending signals like they
• 16:23
  Speaker 1: should be sending signals, we can actually work on that
• 16:25
  Speaker 1: communication from a CBT cognitive behavioral therapy standpoint and get
• 16:31
  Speaker 1: the gut and the brain communicating more effectively together.
• 16:36
  Speaker 3: So this is one of the main things that I
• 16:37
  Speaker 3: do with people.
• 16:39
  Speaker 1: The American Gastro Association recognizes how important this is for
• 16:42
  Speaker 1: people with IBS.
• 16:43
  Speaker 2: We don't have a.
• 16:44
  Speaker 1: Ton of resources for it yet. There's not a lot
• 16:46
  Speaker 1: of practitioners who are trained on it or who understand
• 16:49
  Speaker 1: it or have the time to do it. Because this
• 16:51
  Speaker 1: is not something that can be done fifteen minutes. Seeing gastrentrologists.
• 16:55
  Speaker 1: We're usually meeting for like hour long sessions several times
• 16:59
  Speaker 1: over the course of a few weeks, and really what
• 17:02
  Speaker 1: we're doing there is we're analyzing how somebody's thoughts, beliefs,
• 17:06
  Speaker 1: and behaviors could be actually acting as maladaptive behaviors that
• 17:12
  Speaker 1: are worsening somebody's GI symptoms. I'm gonna give an example
• 17:16
  Speaker 1: because otherwise it just sounds like a bunch of words.
• 17:20
  Speaker 3: So you were talking.
• 17:21
  Speaker 1: About like family members knowing where every bathroom is, right,
• 17:24
  Speaker 1: That's a super common trait of somebody with IBS is
• 17:27
  Speaker 1: if they've been there before, they know where the bathroom is.
• 17:29
  Speaker 1: They kind of like map out the bathrooms where are they,
• 17:32
  Speaker 1: even if they don't have to go to the bathroom yet.
• 17:36
  Speaker 1: That alone can change areas in the brain that go
• 17:40
  Speaker 1: into a fight or flight state because they're not thinking
• 17:43
  Speaker 1: they're safe if they're looking for bathrooms and they're actually
• 17:46
  Speaker 1: probably releasing adrenaline nor apenephron, putting the body more into
• 17:50
  Speaker 1: a fighter flight state. When you're in more of a
• 17:52
  Speaker 1: fighter flight state, you're more likely to have diarrhea because
• 17:55
  Speaker 1: adrenaline speeds up the GI tract example of it makes
• 18:01
  Speaker 1: sense to do that, but actually could be perpetuating the likelihood.
• 18:05
  Speaker 3: Of needing to use the bathroom.
• 18:07
  Speaker 1: One step further, I'll have people that are more diarrhea predominant,
• 18:11
  Speaker 1: and I'll ask them, Okay, when you're out in public
• 18:14
  Speaker 1: and you think you have to run to the bathroom,
• 18:16
  Speaker 1: what's the first thought that.
• 18:18
  Speaker 3: Comes to your mind?
• 18:20
  Speaker 1: And almost everyone is like, oh, oh shit, I'm going
• 18:24
  Speaker 1: to have an accident.
• 18:24
  Speaker 3: Like it's a fear of like what's going to happen?
• 18:27
  Speaker 5: Right?
• 18:28
  Speaker 1: And what your body does with that thought is it
• 18:31
  Speaker 1: sends out the oh shit, we're going to have an
• 18:33
  Speaker 1: accident hormones, which is again adrenaline. You go into a
• 18:36
  Speaker 1: fight or flight state. You're starting to scan your environment,
• 18:39
  Speaker 1: what do I do? And unfortunately, those hormones cause more
• 18:43
  Speaker 1: of a dumping reaction in the gas room and testinal tract,
• 18:46
  Speaker 1: and it's more likely that you'll actually need to go
• 18:49
  Speaker 1: to the bathroom and have urgency. So if we can
• 18:52
  Speaker 1: train people, this works super well. But if you can
• 18:54
  Speaker 1: train people that, hey, whatever your sign is, maybe it's
• 18:58
  Speaker 1: like a stomach grumbling that usually take you off, or
• 19:00
  Speaker 1: like a feeling in your stomach instead of going into
• 19:04
  Speaker 1: the oh no, what's going to happen mode? I want
• 19:07
  Speaker 1: you to go right into diaframatic breathing, calm your nervous
• 19:12
  Speaker 1: system down, and then I want you to replace the
• 19:16
  Speaker 1: oh no, what's going to happen with a coping strategy
• 19:19
  Speaker 1: or coping thought, which is I'm totally safe right now.
• 19:24
  Speaker 1: I've actually never had an accident in public. Most people
• 19:26
  Speaker 1: who are afraid of accidents haven't actually had an accident
• 19:29
  Speaker 1: in public. If they have, we can go through that
• 19:31
  Speaker 1: and be like did you die? Like would you die
• 19:34
  Speaker 1: if it happened again?
• 19:35
  Speaker 3: You know, it's not.
• 19:35
  Speaker 1: Ideal, but we often see people catastrophized to like if
• 19:41
  Speaker 1: this ever happened, I would die, I could never live again, right,
• 19:43
  Speaker 1: And it's like, well, no, you could, like we would
• 19:46
  Speaker 1: be actually okay. So if we can really completely change
• 19:50
  Speaker 1: how that whole process goes, this is the coolest one
• 19:53
  Speaker 1: to die. Formatic breathing with urgency.
• 19:55
  Speaker 3: People will come back to my office and be like,
• 19:57
  Speaker 3: it worked. What else do you have?
• 19:58
  Speaker 2: Like?
• 19:58
  Speaker 3: What else can I do?
• 20:00
  Speaker 1: And they're really excited because they're like, wow, like I've
• 20:03
  Speaker 1: never had something that I could actually put the brakes
• 20:06
  Speaker 1: on that it doesn't mean that you won't go to
• 20:09
  Speaker 1: the bathroom eventually. But people aren't worried necessarily about going
• 20:13
  Speaker 1: to the bathroom. They're worried about not making it to
• 20:15
  Speaker 1: the bathroom or that urgency and like the whole stress
• 20:18
  Speaker 1: around it that's there. So it's really focused on quality
• 20:21
  Speaker 1: of life and changing that. But we see huge improvements
• 20:24
  Speaker 1: in people's IBS using these gut brain techniques.
• 20:29
  Speaker 2: Okay, I need to work on this with my kids
• 20:31
  Speaker 2: because I feel like the one that does. I'm like, well,
• 20:36
  Speaker 2: you're eating at your college kid, eating at Taco Bell
• 20:39
  Speaker 2: every day. I would have IBS too. What are we doing?
• 20:46
  Speaker 2: Where does the diet? Well, first of all, what dietary
• 20:51
  Speaker 2: changes can show to be helpful, But then is there
• 20:54
  Speaker 2: more of the population that has with constipation or with diarrhea?
• 21:00
  Speaker 1: And do somehow we have IBSC, which is constipation predominant,
• 21:04
  Speaker 1: We have IBSD, and then we have IBS M, which
• 21:07
  Speaker 1: is a mixture of both of those. I believe IBSC
• 21:11
  Speaker 1: is more common, but I actually forget the stats on
• 21:14
  Speaker 1: those in women. I bs C is more common for sure,
• 21:18
  Speaker 1: but you can see either one of those. And then
• 21:21
  Speaker 1: diet does play a role in irritable bowel syndrome, but
• 21:23
  Speaker 1: people are often surprised it's less of a role than
• 21:26
  Speaker 1: you think. What we know from a nutrition standpoint about
• 21:30
  Speaker 1: IBS is it's really looking at the fermentable carbohydrates that
• 21:34
  Speaker 1: can exacerbate symptoms. So if you've heard of a low
• 21:37
  Speaker 1: fod map diet, that's really the kind of first line
• 21:41
  Speaker 1: that we'll pull in from a dietary perspective for people
• 21:44
  Speaker 1: with irritable bowel syndrome. You have to be really careful
• 21:48
  Speaker 1: about dietary changes, especially a low fodmap diet, which is
• 21:51
  Speaker 1: pretty restrictive in the beginning, and you need to do
• 21:55
  Speaker 1: a really thorough screen of somebody's health history mental health history,
• 21:59
  Speaker 1: because the last thing you want to do is put
• 22:01
  Speaker 1: somebody who either is still or has a history of
• 22:05
  Speaker 1: disordered eating patterns on a restrictive diet, because then you
• 22:08
  Speaker 1: can flare back up the disordered eating patterns, which is
• 22:11
  Speaker 1: way worse than going down the pathway, because you can
• 22:14
  Speaker 1: actually treat IBS without these diets as well. But if
• 22:18
  Speaker 1: somebody has no history of restrictive eating, they feel really
• 22:21
  Speaker 1: healthy around food, then we sometimes may do a low
• 22:24
  Speaker 1: fodmap diet trial, and that's the key piece I have
• 22:27
  Speaker 1: people come in and they're like, I've been low FODMAP
• 22:29
  Speaker 1: for seven years, and I'm like, no, we don't want
• 22:34
  Speaker 1: to do a strict low FODMAP diet ideally for more
• 22:38
  Speaker 1: than like six seven weeks. And after we do the
• 22:43
  Speaker 1: trial of low FODMAP, we want to introduce each of
• 22:47
  Speaker 1: these groups really methodically because it's not just one group.
• 22:50
  Speaker 1: We have many different types of FODMAPs. Each letter of
• 22:53
  Speaker 1: that word stands for a different type of carbohydrate, and
• 22:57
  Speaker 1: so we want to challenge each of these because for
• 22:59
  Speaker 1: some people it may just be like, oh, I just
• 23:01
  Speaker 1: can't do the lactose piece, I just can't do any dairy,
• 23:05
  Speaker 1: but I can put all the other ones in and
• 23:06
  Speaker 1: then I feel great. Or for some people it's like
• 23:08
  Speaker 1: I can't do onions and garlic, but I can do
• 23:10
  Speaker 1: all the rest and I'm cool. And so that's the
• 23:12
  Speaker 1: ideal situation as we find just a few of the triggers,
• 23:15
  Speaker 1: keep those out, put all the rest back in so
• 23:18
  Speaker 1: they have a really diverse diet.
• 23:20
  Speaker 2: Okay, So, and how long does it it takes about
• 23:23
  Speaker 2: if you're doing an elimination diet of any kind, you're
• 23:28
  Speaker 2: saying you don't want to be on that ideally forever,
• 23:30
  Speaker 2: but then you want to try to add it back in.
• 23:33
  Speaker 2: But do you have to be like one hundred percent
• 23:36
  Speaker 2: strict during those say six to seven weeks.
• 23:41
  Speaker 1: I tell people aim for eighty percent, and that's usually
• 23:45
  Speaker 1: a pretty good place to be.
• 23:47
  Speaker 5: Do you ever do a food allergy test?
• 23:51
  Speaker 3: No?
• 23:52
  Speaker 1: No, allergies are totally separate for ibs. If somebody has
• 23:57
  Speaker 1: any allergic symptoms, I'm just sending them to an allergy
• 24:00
  Speaker 1: I don't do any of that in my office. But
• 24:02
  Speaker 1: with allergies, you're looking for pretty like significant symptoms, right,
• 24:06
  Speaker 1: You're looking for like lip swelling, rashes, fives. So I
• 24:11
  Speaker 1: think maybe you're referring to food sensitivity testing, which is different.
• 24:16
  Speaker 5: I was just gonna say more of a food sensitivity Yeah, yeah, yeah.
• 24:20
  Speaker 1: So food sensitivity testing is looking at ig G antibodies,
• 24:26
  Speaker 1: and I don't do any of that in my practice.
• 24:28
  Speaker 1: I actually never have. I've worked alongside of people who
• 24:32
  Speaker 1: have done it. I see zero benefit from those tests.
• 24:36
  Speaker 1: I'm actually a big advocate not to do them because
• 24:38
  Speaker 1: I think they create more food issues than they solve.
• 24:43
  Speaker 1: When somebody gets a list back of all the foods
• 24:45
  Speaker 1: they've been eating, and somebody says you're sensitive to them,
• 24:48
  Speaker 1: they freak out, they go down this like spiral, and
• 24:51
  Speaker 1: most of the time it's not the cause of their symptoms.
• 24:56
  Speaker 1: But it's really hard to convince somebody to put that
• 24:58
  Speaker 1: back in their diet when they think they all so
• 25:00
  Speaker 1: confuse it with an allergy and they're like, well, I'm
• 25:01
  Speaker 1: allergic to it. I'm like, no, it's not an allergy,
• 25:03
  Speaker 1: and we have to go through like what the difference is.
• 25:06
  Speaker 1: But I personally like, don't touch those things at all,
• 25:11
  Speaker 1: and I get great results in my practice too, So
• 25:13
  Speaker 1: there's like that caveat where it's like, if I wasn't
• 25:16
  Speaker 1: getting great results, I'd still try other things. But if
• 25:18
  Speaker 1: I don't need to use them and I don't have
• 25:20
  Speaker 1: to have people on really restrictive diets, then I'd much
• 25:23
  Speaker 1: rather stay there for sure.
• 25:25
  Speaker 2: Do you when you say the did you say it
• 25:28
  Speaker 2: was visceral pain?
• 25:30
  Speaker 1: Yeah, visceral hypersensitivity is the term?
• 25:33
  Speaker 2: Is that just in the gut? Or are they I'm
• 25:36
  Speaker 2: just thinking, I'm thinking of the people that I know,
• 25:39
  Speaker 2: not gonna name any names, and I feel like their
• 25:42
  Speaker 2: overall pain tolerance is like this big and for me,
• 25:47
  Speaker 2: I mean, every every time they're sick. It's such a
• 25:50
  Speaker 2: massive ordeal and I want to be like I walked
• 25:52
  Speaker 2: around with a broken leg for two days, You're fine,
• 25:57
  Speaker 2: you just don't have any and then I'm just sensitive.
• 26:00
  Speaker 2: But I wonder if that translates to just pain for
• 26:04
  Speaker 2: all well.
• 26:05
  Speaker 3: So I don't know the answers. I don't know.
• 26:07
  Speaker 1: I haven't looked into that, but I wouldn't be surprised.
• 26:12
  Speaker 1: But I would also bring in like this other term
• 26:15
  Speaker 1: which we use in the IBS treatment. We have visceral hypersensitivity,
• 26:19
  Speaker 1: but then we have the term hypervigilance. So hypervigilance is
• 26:23
  Speaker 1: a key kind of If you're my patient, you've heard
• 26:26
  Speaker 1: the term hypervigilance a million times because we talk. You
• 26:28
  Speaker 1: have to understand the process to be actually able to
• 26:30
  Speaker 1: treat it. And hypervigilance is when you are scanning your
• 26:35
  Speaker 1: body for sensations because you don't feel well. So somebody
• 26:39
  Speaker 1: with IBS floating, distension, cramping, they don't feel well. And
• 26:44
  Speaker 1: the last we're not gonna you know, gaslight people saying
• 26:47
  Speaker 1: you do feel well, you're fine, like they really don't
• 26:49
  Speaker 1: feel well. And what happens in the brain when you
• 26:52
  Speaker 1: don't feel well is it tells your brain to start
• 26:55
  Speaker 1: scanning your whole body, where am I not feeling well?
• 26:59
  Speaker 1: What else is it feeling it?
• 27:00
  Speaker 2: Well?
• 27:00
  Speaker 1: What's going on here? How do I fix it? So
• 27:02
  Speaker 1: your brain becomes hyper vigilant scanning scanning, scanning. We also
• 27:07
  Speaker 1: scan our environments for potential stressors, and this hypervigilance can
• 27:12
  Speaker 1: one hundred percent increase pain signals elsewhere too, because if
• 27:17
  Speaker 1: you scan enough, you're gonna find something else wrong with you.
• 27:21
  Speaker 1: The analogy I'll use sometimes, if you run, for like
• 27:23
  Speaker 1: a trail run, you're in the woods, you cut your
• 27:26
  Speaker 1: leg on something when you're running, but you don't even
• 27:29
  Speaker 1: see the cut until you get back to your car.
• 27:32
  Speaker 1: But when you see the cut, your brain puts the
• 27:34
  Speaker 1: attention on the cut and says, ooh, we should be
• 27:37
  Speaker 1: in pain now, and maybe then you can actually feel it.
• 27:39
  Speaker 1: But when you were running, you couldn't feel it much
• 27:42
  Speaker 1: at all, and you weren't paying attention to it. You
• 27:43
  Speaker 1: also had adrenaline hormones going on there too. But when
• 27:46
  Speaker 1: we put attention onto a discomfort, our brain goes into
• 27:51
  Speaker 1: survival mode and increases the pain.
• 27:54
  Speaker 3: So that we make sure that we fix it.
• 27:56
  Speaker 1: And so it could be anywhere kind of pain but
• 27:59
  Speaker 1: if we keep paying at time to it and it's
• 28:01
  Speaker 1: not a threat.
• 28:02
  Speaker 3: That's the key is pain with IBS if you have.
• 28:05
  Speaker 1: An actual diagnosis of IBS, so this isn't like if
• 28:07
  Speaker 1: you've never been diagnosed, go make sure that's IBS not
• 28:10
  Speaker 1: something else.
• 28:11
  Speaker 3: But if you know you have.
• 28:12
  Speaker 1: IBS, the pain associated with IBS is not harmful at
• 28:16
  Speaker 1: all to your body. It doesn't increase the risk of
• 28:21
  Speaker 1: other chronic diseases, it doesn't increase the risk of cancer.
• 28:25
  Speaker 1: It's a pain and we want to treat that, but
• 28:28
  Speaker 1: it's not a threat to your life. And this is
• 28:32
  Speaker 1: one that we really have to start to ingrain because
• 28:34
  Speaker 1: if we can actually start to ignore that pain using
• 28:37
  Speaker 1: other coping strategies divert our brain's attention away from it,
• 28:41
  Speaker 1: we can start to tell the brain, hey, we're actually safe.
• 28:45
  Speaker 1: You can chill out, and then hopefully it's going to
• 28:47
  Speaker 1: turn down the hypervigilance, turn down the hypersensitivity, so these
• 28:52
  Speaker 1: sensations actually get better.
• 28:55
  Speaker 2: So are you a big fan of I mean clearly
• 28:58
  Speaker 2: the breathing, which I'm a big fan of. Two. I
• 29:01
  Speaker 2: just came back from a yoga retreat not too long ago,
• 29:04
  Speaker 2: and I always just thought meditation and breathing was like,
• 29:09
  Speaker 2: oh cool, you do that, But I never ever would
• 29:13
  Speaker 2: have made time for it. I was just like, not
• 29:15
  Speaker 2: my thing, don't have time, sounds great, whatever, And then
• 29:20
  Speaker 2: when I went there, like all of this stuff came up.
• 29:23
  Speaker 2: And I'm not saying I'm perfect at all, Like I
• 29:25
  Speaker 2: was going to do it sixty six days solid was
• 29:27
  Speaker 2: what we were supposed to do, And of course I've
• 29:30
  Speaker 2: missed a whole bunch of days. But I'm telling you
• 29:33
  Speaker 2: that ten to fifteen minutes at any point during the day,
• 29:38
  Speaker 2: if you're super stressed or you just feel like it
• 29:41
  Speaker 2: is such a good reset. I cannot believe I've waited
• 29:45
  Speaker 2: forty eight years to try it.
• 29:46
  Speaker 1: I love your story and I hear it all the
• 29:49
  Speaker 1: time too, and we can extrapolate that, like the breathing
• 29:52
  Speaker 1: is incredible. The diformatic breathing is not something to like
• 29:56
  Speaker 1: just be like, oh, it's not going to work for me.
• 29:57
  Speaker 1: My symptoms are so bad, Like.
• 29:59
  Speaker 3: You really have to try it and try it more
• 30:02
  Speaker 3: than once.
• 30:04
  Speaker 1: Yeah, because I see people and then people will also
• 30:08
  Speaker 1: hear me say like, so we're just gonna talk about
• 30:09
  Speaker 1: my symptoms and they're going to get better and I'm like,
• 30:11
  Speaker 1: uh huh, and they will if you're open to it,
• 30:15
  Speaker 1: because really our thoughts and beliefs change how our body
• 30:19
  Speaker 1: responds from a hormonal standpoint. And this isn't wu wu.
• 30:24
  Speaker 1: I mean, this is cognabavial therapy. It's one of the
• 30:26
  Speaker 1: most studied things we have in psychology, and it has
• 30:30
  Speaker 1: great results for people. We're talking better results than most
• 30:33
  Speaker 1: of the medications for global symptoms. So we have really
• 30:36
  Speaker 1: great meds to slow down the gut for diarrhea, speed
• 30:39
  Speaker 1: it up for constipation. We don't have great meds for
• 30:42
  Speaker 1: the abdominal pain, cramping, distension, bloating.
• 30:46
  Speaker 3: That are there.
• 30:47
  Speaker 1: And this is where like the CBT and the gut
• 30:51
  Speaker 1: directed hypnotherapy, but all these things that are not medications
• 30:55
  Speaker 1: work really well for those symptoms and quieting them down.
• 30:59
  Speaker 2: I love it. I'm doing it for till the end
• 31:01
  Speaker 2: of time.
• 31:03
  Speaker 4: I feel like I always say, there's nothing three deep
• 31:06
  Speaker 4: breaths can't solve, Like in a stressful moment.
• 31:10
  Speaker 5: It doesn't even have to be ten to fifteen minutes.
• 31:12
  Speaker 4: But if you ever just like stop in those moments
• 31:15
  Speaker 4: and take three super deep.
• 31:19
  Speaker 5: Breaths, if you can fill the physical change.
• 31:23
  Speaker 2: Yeah, I'm a fan. I will continue to be a fan. Okay,
• 31:27
  Speaker 2: So moving on, if when we look at finding a
• 31:32
  Speaker 2: good physician like yourself, I guess when people when people
• 31:39
  Speaker 2: come to you with a variety of different issues that
• 31:43
  Speaker 2: you're your training or you're answering, what, how do you
• 31:52
  Speaker 2: do you ever maybe dissuade someone from going back to
• 31:57
  Speaker 2: a physician if they're getting really doodle. I mean, I
• 32:00
  Speaker 2: feel like our healthcare system, there's great physicians, there's incredible physicians.
• 32:06
  Speaker 2: There's physicians that are probably good, but they only have
• 32:09
  Speaker 2: ten minutes and so you can't really get a lot.
• 32:11
  Speaker 2: So there's a whole different bag here that goes into
• 32:14
  Speaker 2: finding a really good physician. But what should someone look
• 32:17
  Speaker 2: for in finding a really good physician that they need
• 32:22
  Speaker 2: to go to?
• 32:24
  Speaker 1: Yeah, for IBS specifically, I.
• 32:29
  Speaker 2: Would say for IBS, for menopause, the things that we've
• 32:32
  Speaker 2: been talking about today. I mean, can't possibly cover everything
• 32:36
  Speaker 2: totally totally.
• 32:37
  Speaker 1: I mean what I would say is you want to
• 32:39
  Speaker 1: interview your doctor like you would any other kind of position.
• 32:44
  Speaker 1: You want to come at it a different way. I've
• 32:46
  Speaker 1: heard stories and like that they're not going to respond
• 32:49
  Speaker 1: well to that, Like they're going to get really defensive
• 32:52
  Speaker 1: if you're just kind of berating them, right, but you want.
• 32:56
  Speaker 3: To ask questions in a kind way.
• 32:59
  Speaker 1: And I would also really push people get a specialist. Like,
• 33:03
  Speaker 1: if you're looking at IBS, get somebody who knows IBS
• 33:06
  Speaker 1: in and out. I'm a naturopathic doctor, so like I'm
• 33:09
  Speaker 1: not a gas terentrologist, but as a naturopathic doctor, I've
• 33:14
  Speaker 1: then sub specialized in chronic GI issues, mostly irritable baloisan drume,
• 33:20
  Speaker 1: chronic constipation. Then there's many gis who also really specialize
• 33:26
  Speaker 1: in IBS, even more so than other GI conditions. But
• 33:30
  Speaker 1: that would be my biggest thing, is like, get somebody
• 33:32
  Speaker 1: who really specializes in what you're looking to treat.
• 33:36
  Speaker 3: Some things you don't need a specialist.
• 33:37
  Speaker 1: It's like even for MHT, you want a practitioner who
• 33:40
  Speaker 1: prescribes a bunch of menopause hormone therapy. But if you're
• 33:44
  Speaker 1: if you've never tried it, you may do great with
• 33:46
  Speaker 1: like the standard kind of first line things, so you
• 33:48
  Speaker 1: can see an obgyn or sometimes your primary care doctor
• 33:51
  Speaker 1: for that. But if you've been working on something and
• 33:54
  Speaker 1: having gotten good results, like most people with IBS, you
• 33:58
  Speaker 1: really want to find like a specialist who really understands
• 34:03
  Speaker 1: that condition. And that's where I see people going awry
• 34:06
  Speaker 1: in like the functional medicine even like the naturopathic medicine space,
• 34:10
  Speaker 1: is that you have people who, if you look at
• 34:12
  Speaker 1: their website, they treat everything. They treat autoimmune conditions, they
• 34:16
  Speaker 1: treat ibs, they treat mold, they treat lime, they treat
• 34:20
  Speaker 1: I'm like, I don't know how you can be a
• 34:22
  Speaker 1: specialist on that many conditions. That feels really strange to me.
• 34:28
  Speaker 1: So it's also why I only do preventive medicine and
• 34:31
  Speaker 1: chronic GI issues. I don't see anybody for anything else.
• 34:34
  Speaker 1: People come to me with autoimmune all the time. I'm like,
• 34:35
  Speaker 1: I'd send you to a rheumatologist. I don't actually treat
• 34:38
  Speaker 1: that myself.
• 34:40
  Speaker 2: So preventative medicine. And if we go to heart disease
• 34:44
  Speaker 2: still being the biggest risk for women, which everyone thinks
• 34:47
  Speaker 2: it's breast cancer, where how many is how big of
• 34:53
  Speaker 2: a deal is that to you? Do you see a
• 34:55
  Speaker 2: lot of patients coming in and what's the treatment or
• 34:58
  Speaker 2: what's the recommendation that you're giving there?
• 35:02
  Speaker 1: Yeah, heart disease is still the number one cause of
• 35:04
  Speaker 1: death for both men and women, and women are more
• 35:08
  Speaker 1: likely to be undertreated compared to men, so it's a
• 35:12
  Speaker 1: huge focus in my practice. I'm going to do a
• 35:15
  Speaker 1: advanced lipid panel, so I'm gonna actually run Lplytlea on
• 35:18
  Speaker 1: all my patients, a bob full lipid panel, and then
• 35:21
  Speaker 1: all the metabolic and inflammatory markers that could be fueling
• 35:24
  Speaker 1: the fire with cardiovascular disease as well. We're also going
• 35:28
  Speaker 1: to look at blood pressure more in depth than most
• 35:30
  Speaker 1: primary care offices would, So we want to do a
• 35:33
  Speaker 1: full risk assessment of where somebody stands from a cardiovascular
• 35:37
  Speaker 1: disease point, men and women. And then I always will
• 35:41
  Speaker 1: sit down with people when we have their results, and
• 35:43
  Speaker 1: I'll do a risk assessment with them and basically just
• 35:47
  Speaker 1: ask them, how risk adverse do you want to be?
• 35:50
  Speaker 1: Do you want to completely take the ability to put
• 35:54
  Speaker 1: down plaque in your arteries off the table? Do you
• 35:57
  Speaker 1: want to go with the American Heart Association guideline, which
• 36:00
  Speaker 1: actually just kind of shifted. Do you feel good about
• 36:03
  Speaker 1: like staying within their guidelines and just being really, you know,
• 36:05
  Speaker 1: regimented about being in those levels Where do you stand?
• 36:10
  Speaker 3: And people are all different.
• 36:11
  Speaker 1: Some people are like, no, I'm good with the standard
• 36:12
  Speaker 1: of care, let's get my level down to a seventy.
• 36:16
  Speaker 1: And then I have other people that are like, I
• 36:17
  Speaker 1: want to take it off the table, Like I don't.
• 36:19
  Speaker 1: I want to get my level down to like a
• 36:21
  Speaker 1: fifty five LDL.
• 36:23
  Speaker 3: We're docking.
• 36:24
  Speaker 5: So what are some.
• 36:25
  Speaker 4: Of the things you do for that patient when they
• 36:29
  Speaker 4: say they want to be totally risk at first?
• 36:32
  Speaker 1: Yeah, so first we're running their levels, see where they stand.
• 36:34
  Speaker 1: So we're going to look at their LDL cholesterol level
• 36:36
  Speaker 1: and LP little A. If LP LITTLEA is high, they
• 36:40
  Speaker 1: automatically go into the high risk category. And we want
• 36:42
  Speaker 1: to get their ld level closer to forty for those individuals.
• 36:46
  Speaker 1: And we're using diet changes, reducing saturated fat in the diet,
• 36:50
  Speaker 1: making sure they're eating a lot of fiber in the diet.
• 36:52
  Speaker 1: But then also most of the time we're going to
• 36:54
  Speaker 1: have to take put in a medication.
• 36:56
  Speaker 3: To get people's levels that low too.
• 36:58
  Speaker 1: We have a shlew of metations that we can use
• 37:00
  Speaker 1: at this point to reduce cholesterol levels. And so there's
• 37:04
  Speaker 1: a lot of people that are still scared of statins.
• 37:07
  Speaker 1: I try to get people not scared of statins because's
• 37:09
  Speaker 1: one of the most utilized medications that we've had that
• 37:12
  Speaker 1: been studied forever. We have really good safety data on them,
• 37:15
  Speaker 1: but we still have other options if people want to
• 37:17
  Speaker 1: do another class of medication to use.
• 37:21
  Speaker 2: Yeah, it's always interesting to me. And I mean people
• 37:24
  Speaker 2: are coming from all over the board. But I mean
• 37:27
  Speaker 2: I know some people that I love who have had
• 37:32
  Speaker 2: this blood work comeback that's not great. And a lot
• 37:37
  Speaker 2: of diet and exercise would solve some of these issues,
• 37:41
  Speaker 2: but it doesn't ever like the behavior never and the
• 37:44
  Speaker 2: habit never changed to actually implement that. Do you see
• 37:49
  Speaker 2: patients that come in that are like, Okay, cool, got
• 37:52
  Speaker 2: the news, Just give me a drug and I'll go
• 37:56
  Speaker 2: that route.
• 37:57
  Speaker 1: And you know, I think this is where I see
• 38:00
  Speaker 1: different group of people. Like I think once you look
• 38:03
  Speaker 1: at my website and I always get on a screening
• 38:05
  Speaker 1: call with people and I tell them what we're going
• 38:07
  Speaker 1: to do, and I think I scare everybody away who's
• 38:10
  Speaker 1: not going.
• 38:10
  Speaker 3: To do behavioral stuff.
• 38:13
  Speaker 1: But before, when I worked in you know, more like
• 38:16
  Speaker 1: the insurance model one hundred percent, every day I would
• 38:19
  Speaker 1: see people that they just want the men. They don't
• 38:22
  Speaker 1: even want to know why, and they don't want to
• 38:24
  Speaker 1: do any of the behavioral thing. If I can get
• 38:27
  Speaker 1: enough time with somebody who's somewhat open minded and go
• 38:30
  Speaker 1: into the education around it, that's when I can really
• 38:34
  Speaker 1: see people who just wanted the med go do oh,
• 38:36
  Speaker 1: I get it now. There's a lot of people who
• 38:40
  Speaker 1: think exercises just to lose weight, and they're like, I
• 38:42
  Speaker 1: don't really care about that. And then when I talk
• 38:44
  Speaker 1: about okay, do you know what happens actually physiologically when
• 38:47
  Speaker 1: we exercise, and that your muscles are more of an
• 38:51
  Speaker 1: organ system that's secrete anti inflammatory and cardioprotective chemicals to
• 38:56
  Speaker 1: improve your physiology.
• 38:58
  Speaker 3: If I go through all that stuff, we're like, oh.
• 39:00
  Speaker 1: Interesting, this is much more than just weight loss or
• 39:04
  Speaker 1: body composition optimization. It's really around heart disease prevention, diabetes prevention,
• 39:10
  Speaker 1: cancer prevention.
• 39:12
  Speaker 3: Yeah.
• 39:14
  Speaker 4: Interesting there, What else do you do for longevity?
• 39:22
  Speaker 3: That's a big question.
• 39:27
  Speaker 1: How do you keep people alive longer? Yeah, I mean
• 39:31
  Speaker 1: cardiovascular disease. That's one of the big ones, because that's
• 39:33
  Speaker 1: the number one. But then we also go into cancer prevention,
• 39:36
  Speaker 1: so what do we know our risk factors for cancer?
• 39:39
  Speaker 1: And we start to talk about nutrition exercise. For sure,
• 39:42
  Speaker 1: exercise is a huge topic. That's not even one appointment.
• 39:45
  Speaker 1: For me, We're talking about exercise almost on every single call,
• 39:48
  Speaker 1: but I'm doing a ton of education about Okay, resistance
• 39:52
  Speaker 1: training versus cardio, high intensity cardio versus steady state, lower
• 39:56
  Speaker 1: intensity cardio. I'll geek out as much as something he
• 40:00
  Speaker 1: wants in that. That's the most common one where people
• 40:02
  Speaker 1: like I'm.
• 40:02
  Speaker 3: Good now, like we're good. And then sleep.
• 40:08
  Speaker 1: You can't talk about longevity without talking about sleep. If
• 40:11
  Speaker 1: somebody's not sleeping, you kind of throw away the rest
• 40:13
  Speaker 1: of it. Like that's got to be one of the
• 40:15
  Speaker 1: biggest priorities there. Bone health, we have to look at
• 40:18
  Speaker 1: that because you don't want to break a hip men
• 40:21
  Speaker 1: or women. The outcomes for breaking a hip or not great,
• 40:26
  Speaker 1: so we really want to focus on that. It's going
• 40:28
  Speaker 1: to come back to exercise and diet as well, though,
• 40:31
  Speaker 1: and then there's some environmental things that we'll look at
• 40:34
  Speaker 1: in terms of like air quality, water quality, and then
• 40:38
  Speaker 1: relationships and mental health huge factors on your longevity. Social interactions.
• 40:45
  Speaker 1: People who feel lonely but versus people who feel supported
• 40:48
  Speaker 1: and like surrounded by people they love and can count
• 40:51
  Speaker 1: on very different outcomes from a longevity perspective.
• 40:55
  Speaker 2: What about peptides so we know peptides are everywhere. And
• 41:00
  Speaker 2: I'm not just talking about GLP ones, although that is
• 41:03
  Speaker 2: part of the conversation for sure. But I think that
• 41:07
  Speaker 2: some of these peptides name it, a lot of them
• 41:12
  Speaker 2: don't have this massive background of incredible results and information,
• 41:19
  Speaker 2: but they are. People are buying them left and right.
• 41:23
  Speaker 2: And just today I was scrolling on Facebook to answer
• 41:27
  Speaker 2: a message and this ad got popped up that was like, Oh,
• 41:31
  Speaker 2: you want to know why everyone looks great in Hollywood,
• 41:34
  Speaker 2: it's this it's this one specific supplement. I'm like, they've
• 41:40
  Speaker 2: all had whatever they want. I don't think it's the
• 41:46
  Speaker 2: one peptide that you all know.
• 41:49
  Speaker 1: I mean, if we look at longevity, socio economic status
• 41:53
  Speaker 1: is one of the leading indicators of how long and
• 41:56
  Speaker 1: how well somebody is going to live. How much money
• 41:59
  Speaker 1: you have matter in terms of health. And I don't
• 42:01
  Speaker 1: say that to be rude or dismissive. I say that
• 42:04
  Speaker 1: to really highlight that people are People are telling you like,
• 42:09
  Speaker 1: it's this one peptide, right, or it's this one other thing.
• 42:12
  Speaker 1: And it's like when people have access to personal trainers,
• 42:16
  Speaker 1: to good healthy, whole food sources for the time to
• 42:20
  Speaker 1: exercise because they have financial freedom, the access to see
• 42:24
  Speaker 1: doctors where who can.
• 42:25
  Speaker 3: Spend more time with them.
• 42:27
  Speaker 1: I think it's really important that we realize that socioeconomic
• 42:30
  Speaker 1: status has a huge influence on it, and that we need.
• 42:33
  Speaker 3: To improve.
• 42:36
  Speaker 1: Other people's ability to access good care, food and exercise
• 42:41
  Speaker 1: as well, because that's where we see big discrepancies that
• 42:45
  Speaker 1: are affecting the health of our nation.
• 42:48
  Speaker 3: That's just a tangent.
• 42:49
  Speaker 2: Oh no, I I was just going to go there
• 42:51
  Speaker 2: and say, I remember watching and I really don't watch
• 42:56
  Speaker 2: TV all and haven't for I don't know twenty years.
• 43:00
  Speaker 2: I can't even I don't think I've had channels for
• 43:03
  Speaker 2: twenty years. But I remember I must have been somewhere
• 43:06
  Speaker 2: where I saw this interview of someone talking about it
• 43:11
  Speaker 2: was somewhere in the south, more of a lower economic area,
• 43:18
  Speaker 2: and they were like, well, of course I have to
• 43:20
  Speaker 2: go to McDonald's and feed my family. I can feed
• 43:23
  Speaker 2: them for fifteen dollars. I can't get anything. I go
• 43:27
  Speaker 2: to Whole Foods and I walk out with two pieces
• 43:30
  Speaker 2: of fruit for fifteen dollars, Like I have to feed
• 43:33
  Speaker 2: my family of five or six with this food, and
• 43:37
  Speaker 2: so that, I mean, that could take a whole other podcast.
• 43:39
  Speaker 2: But if you had one message to send about just
• 43:46
  Speaker 2: the healthcare system, I know that you're a concierge doctor,
• 43:50
  Speaker 2: what would it be.
• 43:52
  Speaker 1: I don't know, and my expertise is not in public health.
• 43:56
  Speaker 1: I'm really interested in it at some point I would
• 43:58
  Speaker 1: love to learn more and get in more in it.
• 44:01
  Speaker 1: But public health is very different than one on one medicine,
• 44:05
  Speaker 1: and I think actually that's what we're seeing politically kind
• 44:07
  Speaker 1: of go awry here is you can't necessarily insert what
• 44:12
  Speaker 1: works with one patient to a public health standard because
• 44:18
  Speaker 1: that's not how it works. But I would be misspeaking
• 44:23
  Speaker 1: if I kind of commented on it, just because it's
• 44:24
  Speaker 1: not my expertise, So I'll leave it for the public
• 44:26
  Speaker 1: health people.
• 44:28
  Speaker 4: What about other myths I've heard you talk about colostrum
• 44:33
  Speaker 4: and how it is not linked to longevity.
• 44:36
  Speaker 3: It's not linked to like improved immune health. It's not
• 44:39
  Speaker 3: linked to longevity.
• 44:41
  Speaker 1: Yeah, I have an Instagram real on colostrum taking down
• 44:44
  Speaker 1: like a very very common colostrum company who have nothing
• 44:48
  Speaker 1: against I just think when you start to use sales
• 44:51
  Speaker 1: tactics that are completely out of integrity, I have no
• 44:55
  Speaker 1: problem calling you out because there could be somebody there
• 44:58
  Speaker 1: who has in the lower suo economic status, who would
• 45:01
  Speaker 1: be way better buying fruits and vegetables for their family,
• 45:05
  Speaker 1: but they may get coerse into buying this frickin colostrum
• 45:08
  Speaker 1: supplement that's I don't even know how much money.
• 45:10
  Speaker 3: I'm going to do nothing for your health.
• 45:13
  Speaker 1: And so you can tell it like gets me fired up,
• 45:15
  Speaker 1: because you have a responsibility when you have a platform
• 45:20
  Speaker 1: and you have a product too. Yeah you can sell it,
• 45:23
  Speaker 1: but you got to be integrity with your claims, Like
• 45:26
  Speaker 1: your claims better be actually true, and if you're trying
• 45:29
  Speaker 1: to trick people, like I'm not for it, and I
• 45:31
  Speaker 1: just yeah, I have zero patients for it. I've also
• 45:34
  Speaker 1: like this is kind of how I came to be
• 45:36
  Speaker 1: where I am. As I was the girl in her
• 45:38
  Speaker 1: twenties getting tricked by all this stuff. I was super naive.
• 45:41
  Speaker 1: I was from a small town in Massachusetts. I thought
• 45:43
  Speaker 1: anybody who was on a podcast must be telling the
• 45:46
  Speaker 1: truth and was good intentioned. And then I got out
• 45:49
  Speaker 1: to the West Coast and I started to like meet
• 45:52
  Speaker 1: some of these people and like the curtain fell for
• 45:54
  Speaker 1: me and I was like, WHOA, some of these people are.
• 45:58
  Speaker 3: Just trying to make money.
• 45:59
  Speaker 1: I'm like, I was a girl listening to the podcast
• 46:02
  Speaker 1: believing everything they said, buying every digestive time and probiotic
• 46:07
  Speaker 1: and like doing all the things because I thought that
• 46:08
  Speaker 1: they said that I was going to get better and
• 46:10
  Speaker 1: they sounded so sure about that, and I didn't, and
• 46:14
  Speaker 1: I spent thousands of dollars that I didn't have on
• 46:17
  Speaker 1: these supplements. And so I'm just really protective of people
• 46:19
  Speaker 1: now where I'm like, I want to help be a
• 46:22
  Speaker 1: signal amongst all the like the super noisy stuff of
• 46:26
  Speaker 1: social media, a lot of which isn't going to get
• 46:29
  Speaker 1: people the outcomes that they're they're hoping for.
• 46:32
  Speaker 2: I so appreciate that because we see it in the
• 46:34
  Speaker 2: help and fitness space too. I was at this metopause
• 46:39
  Speaker 2: conference and there was like this this cellulite removal cream
• 46:45
  Speaker 2: that was or like there was one that was like
• 46:48
  Speaker 2: an electrolyte slash. This will take away cellulite in this
• 46:52
  Speaker 2: little powder, And I was like, who's buy You're selling
• 46:55
  Speaker 2: this at a metopause conference, Like you're selling it to
• 46:58
  Speaker 2: women that are already super strong, us out and very
• 47:01
  Speaker 2: potentially very insecure about certain things. Is our bodies change?
• 47:06
  Speaker 2: They don't need a sub powder that's promising cellulate removal.
• 47:12
  Speaker 3: Yeah, so many things wrong with that.
• 47:14
  Speaker 1: And just like body shaming first, right, cellulate is completely
• 47:17
  Speaker 1: normal in women period, Like, it's not too pathologized cellulate.
• 47:21
  Speaker 1: We just have it and then not to mention it's
• 47:24
  Speaker 1: not gonna work. Cream would not work for cellulate. So
• 47:27
  Speaker 1: just like praying on vulnerable population, Yeah, I would have
• 47:30
  Speaker 1: a hard time, not kidding.
• 47:32
  Speaker 2: I did a photo shoot with this photographer who who
• 47:36
  Speaker 2: mainly like shoots physique competitors that are going on stage.
• 47:42
  Speaker 2: So these women are I don't even know the body
• 47:46
  Speaker 2: fat percentage, but minimal, not even in a healthy amount,
• 47:49
  Speaker 2: and they don't stay there. And he said, Haley, every
• 47:52
  Speaker 2: person I've ever worked with, the people, the women that
• 47:56
  Speaker 2: are winning these competitions on stage, every or what I've
• 48:00
  Speaker 2: ever shot has cellul liked.
• 48:02
  Speaker 1: Every Yeah, you can be super It's a normal thing
• 48:06
  Speaker 1: that the female body does. It's really just like structurally
• 48:10
  Speaker 1: how fat is deposited and how we have these kind
• 48:13
  Speaker 1: of fibers that trap it in and that's.
• 48:15
  Speaker 3: All it is.
• 48:18
  Speaker 1: But yeah, I mean, the more that we sell those supplements,
• 48:20
  Speaker 1: the more that they tell women they need to get
• 48:22
  Speaker 1: LiPo for it, the more we're perpetuating that whole loop
• 48:27
  Speaker 1: that we need to keep fixing the normal female body.
• 48:31
  Speaker 1: And like, the overpathologizing that we see in the wellness
• 48:36
  Speaker 1: industry is insane to me, and it's one of the
• 48:40
  Speaker 1: things that I work with patients on because people will
• 48:41
  Speaker 1: come to me and they're like, I'm a little bit
• 48:43
  Speaker 1: bloaded after some meals and I'm like, does it go
• 48:45
  Speaker 1: away pretty quickly?
• 48:46
  Speaker 3: They're like yeah.
• 48:47
  Speaker 1: I'm like, that's human. We're not treating it. But the
• 48:50
  Speaker 1: wellness industry has made you think that every little thing
• 48:53
  Speaker 1: there's something wrong with you because they want to sell
• 48:56
  Speaker 1: you something to fix it.
• 48:58
  Speaker 3: And that's really where we need to see a shift
• 49:00
  Speaker 3: in the space.
• 49:01
  Speaker 1: Hopefully, or people just start like blocking those accounts and
• 49:04
  Speaker 1: don't give them any of your attention, time or money.
• 49:08
  Speaker 4: Okay, so can you take a pill that helps with bloating?
• 49:12
  Speaker 4: Because we see this all the time, everyone trying to
• 49:15
  Speaker 4: sell us a pill that can help with that.
• 49:18
  Speaker 3: Yeah, if it's the Stufflee, I would just say, no bloating.
• 49:22
  Speaker 1: You need to get really clear about what you mean
• 49:24
  Speaker 1: by bloating. Because I have people come in they say
• 49:26
  Speaker 1: I'm bloated. The more questions I ask they mean that
• 49:28
  Speaker 1: they're holding more fat around the mid section. That goes
• 49:33
  Speaker 1: into the weight loss category, and we treat that the
• 49:35
  Speaker 1: same as any other weight loss caloric restriction exercise, very
• 49:39
  Speaker 1: different than I'm holding gas in my intestines. That gets
• 49:43
  Speaker 1: worse after I.
• 49:44
  Speaker 3: Eat meals, and then I wake up and I.
• 49:47
  Speaker 1: Have a flat stomach again. And then after I eat
• 49:49
  Speaker 1: meals throughout the day, I get more bloated and gas
• 49:52
  Speaker 1: and I'm passing gas. It feels better when I have
• 49:54
  Speaker 1: a bowel movement. That's more the intestinal bloating. And again
• 49:59
  Speaker 1: just for like coverage, always talk to your doctor about
• 50:01
  Speaker 1: this because bloating is one of the first signs of
• 50:03
  Speaker 1: ovarian cancer too, So we don't want to put something
• 50:06
  Speaker 1: in a like, you know, a safer bucket than it
• 50:10
  Speaker 1: should be in either most of the time it's going
• 50:12
  Speaker 1: to be gastrointestinal gas, and for that, you want to
• 50:16
  Speaker 1: identify why somebody has that bloating and if it's excessive.
• 50:21
  Speaker 1: So it's normal to fart up to twenty times per
• 50:23
  Speaker 1: day as a human. Most people think that's way too high,
• 50:26
  Speaker 1: and I'm like, if you're around that range and it's
• 50:29
  Speaker 1: not interfering with your quality of life, we actually don't
• 50:31
  Speaker 1: want to treat it. But then there's some people that
• 50:33
  Speaker 1: come in. They're like, after eat breakfast, I'm a little
• 50:36
  Speaker 1: bit bloated. After lunch, I'm really bloated. By the time
• 50:40
  Speaker 1: nighttime comes around, I feel like I'm nine months pregnant
• 50:42
  Speaker 1: and it's really uncomfortable.
• 50:44
  Speaker 3: Like I have like actual like pain because of the distension.
• 50:47
  Speaker 1: That's the bloating that we actually want to target and treat.
• 50:50
  Speaker 1: But first we have to identify why it's happening. You know,
• 50:53
  Speaker 1: is this IBS, is this se bow? Is this functional
• 50:57
  Speaker 1: bloating disorder? Is this just constipation that hasn't been treated,
• 51:02
  Speaker 1: because if you're constipated, you're not going to the bathroom regularly.
• 51:07
  Speaker 1: If we just treat the constipation sometimes it will resolve
• 51:10
  Speaker 1: the bloating as well.
• 51:12
  Speaker 2: So if we touch on sebow really quick, something that
• 51:17
  Speaker 2: I really don't I feel like I'm interested in knowing
• 51:21
  Speaker 2: more about it, but I don't know a lot about it.
• 51:23
  Speaker 2: But it's definitely a real thing.
• 51:26
  Speaker 3: Is that a question. Yeah, Yeah, it's a real thing.
• 51:30
  Speaker 1: It's a real thing. Cibo's an interesting one. Gas terentrologists
• 51:34
  Speaker 1: will treat cibo. I say it's interesting because we don't
• 51:36
  Speaker 1: have a great test for it. You can send somebody
• 51:40
  Speaker 1: for a CEBO test. It could come back negative, but
• 51:43
  Speaker 1: you can still treat them for CEBO and they can
• 51:46
  Speaker 1: still get better, and vice versa. We see people who
• 51:49
  Speaker 1: have positive SEBO results that don't actually have any symptoms,
• 51:54
  Speaker 1: so we wouldn't want to treat them, And so it's
• 51:57
  Speaker 1: one that I feel like we still need to like
• 51:58
  Speaker 1: figure out better testing and treatment tools for.
• 52:03
  Speaker 3: But it's a real thing.
• 52:04
  Speaker 1: It means it's small intestinal bacterial overgrowth. So you're supposed
• 52:08
  Speaker 1: to have some bacteria in the small intestines, but most
• 52:10
  Speaker 1: of your bacteria, your microbiome should reside in the large
• 52:13
  Speaker 1: intestine or the colon. And when you have an overgrowth
• 52:17
  Speaker 1: of normal bacteria in the small intestine, we call that
• 52:20
  Speaker 1: CEBO and I start to produce more gases in the
• 52:23
  Speaker 1: small intestine, which can either slow down the GI track
• 52:26
  Speaker 1: or speed it up, depending on which gas is being
• 52:30
  Speaker 1: produced at higher levels, so this can result in constipation diarrhea.
• 52:34
  Speaker 1: But the keynote of bloating a gas that feeling of distension.
• 52:38
  Speaker 3: Especially with food.
• 52:40
  Speaker 1: So if the dissension starts in the morning after breakfast,
• 52:43
  Speaker 1: gets worse as the day goes on highest at night
• 52:45
  Speaker 1: before you go to bed, but then when you wake
• 52:47
  Speaker 1: up in the morning you feel good again. That's kind
• 52:49
  Speaker 1: of a pretty consistent story with CEBO, and we treat
• 52:54
  Speaker 1: it with various different medications. We also can use the
• 52:57
  Speaker 1: low fodmap diet sometimes with cebo. Antibiotics are kind of
• 53:02
  Speaker 1: one of the mainstays with CEBO, and and then sometimes
• 53:05
  Speaker 1: we'll also use pro kinetics to get the intestines moving
• 53:09
  Speaker 1: a little bit faster to keep things flushing through.
• 53:13
  Speaker 2: So it seems like there's some similarities with IBS.
• 53:16
  Speaker 1: Then, Yeah, it's about seventy six percent of people with
• 53:19
  Speaker 1: IBS will be diagnosed with cebo, but not everybody with
• 53:23
  Speaker 1: cibo has IBS.
• 53:25
  Speaker 2: Seventy six percent of IBS that's high, Yeah, but it.
• 53:30
  Speaker 1: Doesn't mean that once you treat the cebo they don't
• 53:32
  Speaker 1: have IBS anymore. Unfortunately, they're just more likely to get CEBO,
• 53:36
  Speaker 1: like have flares of it.
• 53:38
  Speaker 2: Wow.
• 53:39
  Speaker 4: Okay, So for people like Hayley who have a lot
• 53:42
  Speaker 4: of people in their life that have IBS and it
• 53:45
  Speaker 4: really controls them, would you recommend them going to someone
• 53:53
  Speaker 4: like you that deals with the cognitive aspect they have.
• 53:58
  Speaker 3: Yeah, one hundred percent, it's got.
• 54:00
  Speaker 4: To be so psychological also, and the gut tucks to
• 54:04
  Speaker 4: the brain, right, it's not the other way around.
• 54:07
  Speaker 3: Both it's bidirectional.
• 54:08
  Speaker 1: It's bell talks to the brain, brain tucks to the gut,
• 54:11
  Speaker 1: and we just have better ways of interjecting at the
• 54:15
  Speaker 1: brain level. We don't have a ton of therapies that
• 54:17
  Speaker 1: interject at the gut level yet, unless you're talking about
• 54:20
  Speaker 1: changing motility patterns for IBS in terms of diarrhea constipation.
• 54:25
  Speaker 3: But one hundred percent.
• 54:27
  Speaker 1: We go in with the behavioral things that we've been
• 54:30
  Speaker 1: talking about, like the thoughts and beliefs that whole pattern
• 54:33
  Speaker 1: stress that piece, but also nutrition medications. I really think
• 54:38
  Speaker 1: the best approach to IBS is this multi pronged approach,
• 54:42
  Speaker 1: not just meds, not just the behavioral stuff, but ideally
• 54:45
  Speaker 1: a combination of a bunch is what I've seen have
• 54:48
  Speaker 1: the best results for people.
• 54:51
  Speaker 2: Okay, as we're wrapping this up. As a concierge physician,
• 54:57
  Speaker 2: what are the parting words that you would give anyone
• 55:01
  Speaker 2: out there that's kind of maybe wanting to go down
• 55:04
  Speaker 2: the path of concierge medicine. I personally know in my
• 55:08
  Speaker 2: network so many of the collaborators that I work with
• 55:12
  Speaker 2: have moved to this concierge medicine because they just can't
• 55:15
  Speaker 2: practice the way that they want to practice in the
• 55:19
  Speaker 2: normal healthcare system as it sits right now, What would
• 55:24
  Speaker 2: be your parting words if somebody's like, I kind of
• 55:26
  Speaker 2: want to look into this concierge medicine, what do you
• 55:29
  Speaker 2: offer that's different? I mean, time is one of those,
• 55:33
  Speaker 2: but what would what information that would you share with
• 55:36
  Speaker 2: them as a patient?
• 55:37
  Speaker 3: Sharing with the patient, Yeah, with the patient, got it?
• 55:40
  Speaker 5: Got it?
• 55:40
  Speaker 3: Yeah?
• 55:40
  Speaker 1: And naturepathic doctors are supposed to use the word doctor
• 55:42
  Speaker 1: and not physician.
• 55:43
  Speaker 3: It's like a whole political thing.
• 55:44
  Speaker 1: But just I just want to note that because I
• 55:46
  Speaker 1: don't want to like miscons true. And so if I
• 55:51
  Speaker 1: was talking to a patient in terms of concierge, one
• 55:53
  Speaker 1: of the biggest things is time. So the average doctor's
• 55:56
  Speaker 1: appointments like fifteen minutes long. They try to cover five
• 55:59
  Speaker 1: different topics. They get six minutes for the longest topic.
• 56:02
  Speaker 1: If I had six minutes to help somebody with IBS
• 56:05
  Speaker 1: with the cognitive behavioral.
• 56:06
  Speaker 3: Stuff, I would like barely get through.
• 56:09
  Speaker 1: The diaframatic breathing exercise, right. It would take me a
• 56:12
  Speaker 1: whole number to get through actual content with this person,
• 56:16
  Speaker 1: and so really, if you're looking for more time with somebody.
• 56:19
  Speaker 1: I also give people access to me between appointments unlimitedly,
• 56:24
  Speaker 1: so they can message me in between, and I actually
• 56:26
  Speaker 1: prefer that they do.
• 56:28
  Speaker 3: Because I want my patients to get results really quickly.
• 56:31
  Speaker 1: And if we have momentum in the beginning and you
• 56:33
  Speaker 1: start doing the exercises and you come to me and
• 56:35
  Speaker 1: be like, hey, I just did this, what else can
• 56:36
  Speaker 1: I do? You're going to get better so much faster
• 56:39
  Speaker 1: versus waiting to see me till the next appointment.
• 56:43
  Speaker 3: We can also.
• 56:44
  Speaker 1: Tinker with things between those appointment times as well. And
• 56:47
  Speaker 1: then I also provide accountability like a health coach, and
• 56:51
  Speaker 1: so if I see you're not doing your food logause
• 56:53
  Speaker 1: a lot of what I do is body composition optimization
• 56:56
  Speaker 1: and weight loss for people who need weight loss. But
• 56:59
  Speaker 1: it's really helpful to have kind of like a coach
• 57:02
  Speaker 1: on your side and not just a doctor prescribing the
• 57:04
  Speaker 1: men saying like, how's the exercise going, like any obstacles?
• 57:08
  Speaker 1: You know, how is your run the other day? Kind
• 57:10
  Speaker 1: of thing?
• 57:11
  Speaker 3: And I see that really because.
• 57:13
  Speaker 1: I used to not be concierge and when I switched
• 57:15
  Speaker 1: over that accountability piece, especially for weight loss, but also
• 57:19
  Speaker 1: the IVS stuff keeps people engaged in rolling and on
• 57:22
  Speaker 1: their journey a lot, a lot easier. And then what
• 57:27
  Speaker 1: else It's going to also be that we're going to
• 57:29
  Speaker 1: do more comprehensive testing, So I'm not going to just
• 57:32
  Speaker 1: run you know, four lab tests. We're going to look
• 57:34
  Speaker 1: at LP, LITTLEA, A, bo B cardiovascular risk markers.
• 57:40
  Speaker 3: And we also will.
• 57:41
  Speaker 1: Do some longevity testing that's not technically in medicine, but
• 57:45
  Speaker 1: it's more for my exercise background. So I do VO
• 57:48
  Speaker 1: two max testing on my patients. I do strength and
• 57:50
  Speaker 1: mobility testing on my patients, cognitive testing as well. But
• 57:55
  Speaker 1: I want to be more aggressive, more proactive to ensuring
• 57:59
  Speaker 1: that people are where they want to be now so
• 58:02
  Speaker 1: that they can also be where they want to be
• 58:04
  Speaker 1: into their eighties and nineties. And oftentimes we actually have
• 58:07
  Speaker 1: to be much healthier than we think right now in
• 58:10
  Speaker 1: our middle ages to end up at a place that
• 58:12
  Speaker 1: feels really good for us in our eighties and nineties.
• 58:16
  Speaker 2: Yeah, do you do you do tell a medicine or
• 58:19
  Speaker 2: are you just in person one on one?
• 58:21
  Speaker 1: I do tell a medicine too, and most of my
• 58:23
  Speaker 1: patients are in the LA area, but all over California,
• 58:26
  Speaker 1: and even my LA patients who live like probably two
• 58:30
  Speaker 1: miles away, preferred tell.
• 58:31
  Speaker 3: Medicine most of the time because they don't want to drive.
• 58:34
  Speaker 1: So I did a ton of telemed regardless of where
• 58:37
  Speaker 1: the people are at.
• 58:38
  Speaker 2: This is funny that you say that, because I had
• 58:40
  Speaker 2: a client in Santa Barbara area that I was training
• 58:46
  Speaker 2: and she would just like the comment was always and
• 58:48
  Speaker 2: I would fly out there and train her and she'd
• 58:50
  Speaker 2: be I just can't get to the gym. I'm like,
• 58:52
  Speaker 2: I can see it from your house. It's right there.
• 58:56
  Speaker 2: What do you mean you can't get to the gym
• 59:00
  Speaker 2: everything into the house because going to the DRAI was
• 59:03
  Speaker 2: not an option, which was just it's a different lifestyle.
• 59:08
  Speaker 2: I'll say that. Well, thank you so much, Mary for
• 59:11
  Speaker 2: being here with you. Yeah, how do women find you?
• 59:16
  Speaker 3: Yeah?
• 59:16
  Speaker 1: So my website is modernmed dot com. There's no E
• 59:19
  Speaker 1: in modern so it's m d r n me d
• 59:21
  Speaker 1: dot com. My Instagram is at dr dot Mary Party.
• 59:26
  Speaker 1: I put out a ton of free content on Instagram
• 59:29
  Speaker 1: and I also have an email list. If you look
• 59:31
  Speaker 1: at my website you should be able to join it.
• 59:33
  Speaker 1: For blogs, podcasts, thoughts that I'm having I'll send out there.
• 59:38
  Speaker 1: But there's a link on my website to schedule a
• 59:41
  Speaker 1: complimentary thirty minute call with me if you're interested in
• 59:45
  Speaker 1: working with me one on one. I did just open
• 59:48
  Speaker 1: up a few more concierge spots and we will jump
• 59:51
  Speaker 1: on a call and see if I'm a good fit
• 59:53
  Speaker 1: for you, kind of go through your goals and go
• 59:55
  Speaker 1: from there, and there's zero pressure to do anything after
• 59:58
  Speaker 1: that call.
• 59:58
  Speaker 3: It's just an intro call.
• 1:00:00
  Speaker 2: I love that because I can tell from your personality
• 1:00:02
  Speaker 2: and your vibe that you would not be a pressure person.
• 1:00:05
  Speaker 1: No, No, the last thing I want to do is
• 1:00:08
  Speaker 1: work with somebody.
• 1:00:08
  Speaker 3: It's not honestly.
• 1:00:10
  Speaker 1: That call is two part is number one, can I
• 1:00:13
  Speaker 1: do I think I can help you? If I don't
• 1:00:15
  Speaker 1: think I can help you, that call is then going
• 1:00:17
  Speaker 1: to transform to who do I think could help you?
• 1:00:19
  Speaker 1: And like I think you should see a rheumatologist or
• 1:00:21
  Speaker 1: I actually think you should start here, because it's it's
• 1:00:25
  Speaker 1: I'm of no interest working with people who I don't
• 1:00:27
  Speaker 1: actually think I can get the results that they want
• 1:00:29
  Speaker 1: or and then also just to make sure there's a
• 1:00:31
  Speaker 1: vibe and I'm their person because we all have our
• 1:00:34
  Speaker 1: different you know, people that we work best with too.
• 1:00:37
  Speaker 2: Yes, well, thank you so much for sharing all of
• 1:00:40
  Speaker 2: your knowledge today. It's been a pleasure having you on.
• 1:00:43
  Speaker 3: Thanks. Thanks so much, guys, thanks for listening everyone.
• 1:00:47
  Speaker 4: If you enjoyed this episode, please consider giving us a
• 1:00:50
  Speaker 4: five star rating and sharing the body Pod with your friends.
• 1:01:00
  Speaker 5: Yeah.