Episode Transcript
[00:00:02] Speaker A: Welcome, my outside the box thinkers to the anti aging Unraveled podcast, where I am your host, Dr. Lori Gerber. In this podcast, we will explore the fascinating world of personalized anti aging medicine that considers the whole person inside and out, and how all systems are interconnected to each other. In today's world of modern medicine, we often find ourselves like just another number in a system that prioritizes quick fixes over sustainable and more natural solutions. Well, let's get ready for a paradigm shift in health and beauty. We look far beyond treating symptoms and aim to get to the root cause of our health and cosmetic issues. This podcast is your go to source for all things natural, outside the box, and innovative in integrative medicine and cosmetic dermatology. So sit back, relax, and get ready to dive deep into the world of functional medicine and aesthetics. With me, Dr. Lori Gerber. Let's take a trip down the real skin revolution pathway together.
So, hello everybody, and it's been about a week and a half since my last recording, so I'm kind of excited to be back. Welcome back to antiaging unraveled. And I am so excited to talk about our new platform, if you will, which is our new real three health Genesis program. And what that is is our wellness and weight loss journeys. And we are kind of rebelling against the word antiaging. I think that's pretty safe to say. I think most of us don't like the term antiaging, but we use it for lack of a better descriptor. But we are talking about what we call successful aging and aging your way, aging the way you want to age and basically the things that matter to you most. For me, it's one thing, and for some of our patients, it's something completely different. Is it losing weight? Is it being active? Is it being able to travel with your family and retire young? Or is it just like you want a better libido and have a better quality of life? So this is our age your way platform and we're starting off today. I'm really excited to have one of our patients to tell us her story. Her name is Krista, Krista Windsor. And she's nervous, but we're going to calm her down, right? We're going to keep her in check. This is really easy. You guys know me, super low key. We're just going to talk about experiences and really just tell you about what is possible with some of our programs and a lot of us poo poo the wellness space and that they think, oh, we're just getting older. This is part of the natural aging process. I'm just tired, but really, there's a lot of things that we can do to take the health into our own hands and really go after what we want. So I'm really excited to have you, Krista. You're welcome. So what I'm going to do is just briefly describe kind of her intake, guys, and just give a little patient overview, especially for my clinical providers that like to kind of listen in and do some cases with us. So Krista came into us from Utah and see you were born in 72. Yeah. So we're not going to dwell on that too long, but basically, as many of my listeners will identify, middle of life, we're having all these changes, some of which are mood, some of which are hormonal night sweats, hot flashes, and some of which are weight related. So when we first did her intake, she said that she had put on weight over the past two years, about 15 pounds. Even though, and I hear this a lot, I didn't change anything about my diet or exercise. And I always say I put air quotes on that because if it were working, it would have worked. So, yes, you didn't change anything, but our metabolism slows down as we age, so we do have to change some things. So I hear that quite frequently, lots of headaches, which she wanted to get under control, hard time with focus, especially at work, and struggled to work out, but she wants to work out. So getting out of bed and going to the gym, that was her kind of initial complaints and just tired a lot more, fatigued and wanted energy back. So again, this is a really common scenario. Right. We hear this at least as what I do. We hear this all the time. So really we teased apart some of her symptoms and then we started to get lab work. And anxiety too. Right? That was worsening. Irritability, mood swings, headaches, fatigue, some indigestion, which we can kind of attribute some gut issues to brain fog and memory loss. So see if there's anything else that I'm missing. Some nonspecific joint pains and visual stuff. But for the most part, that was her big ones. So what did we do? We got labs. What did we find? We knew she was going to be a menopause, but lo and behold, guys, she's a menopause. So what happens? All of your hormones tank, your progesterone goes down, your estrogen goes down, the testosterone goes down. Her thyroid function was low functioning, which means she had not hypothyroid, but just low end t three and t four, some cholesterol, like I always say, like, nonspecific sticky cholesterol, a little bit of insulin resistance, which was not necessarily demonstrating on her sugars. Her insulin resistance score was high because of her cholesterol. We kind of look at the cholesterol and the sugar numbers, and we kind of come up with a score. That's insulin resistance score. So she wasn't losing weight, because now, all of a sudden, her body hasn't been able to metabolize carbs, and her hormones are not there anymore. And she actually came up positive for some cells for fighting infection, which we can talk about, too. Where do we start with someone like her? And I think for her, her main thing was, I want the weight off. We need to get this weight down. It's time. So we started with things that would optimize her hormones, optimize her thyroid, and kind of step two was getting on some stuff to optimize her insulin levels so that she could actually break down carbs efficiently. So I guess, Krista, I'm going to end up starting to turn this over to you. I'm going to have you just tell me how you started this process. What were you thinking in your head? Like, how fed up were you, and where were you at when we kind of started?
[00:05:52] Speaker B: All of that makes it sound like I was a complete mess. It was crazy because I felt like all of it sort of happened overnight. Like I said, I was gaining weight, and I've always been very active, and I want to go back a little bit. Back in 2015, I had gained a lot of weight, and I decided, I'm done. I'm going on a weight loss journey, change of life, everything. And I really started exercising, eating right, doing all the right things, and I lost 30 pounds, and I kept that weight off pretty well within maybe 510 pounds every once in a while until 2021. And all of a sudden, I'm just like, what is going on? Like you said, I was doing all the same things, eating the same, exercising the same, and the pounds were coming on, and they just kept coming on. And then all of a sudden, I started to feel the night sweats and the tiredness. And I'm thinking, okay, there's obviously something going on. And I was nearing my 50th birthday, and I thought, okay, there's something up. And then I started to have a conversation with my really good friend, who is also a patient of yours. And we just got talking, and she was telling me about all of the great things you've done for her. And she said, just try. Just give her a call and just see. And so I was like, okay, I'm done. I'm done because this is not working for me. And I was getting very frustrated with how hard I was trying to lose the weight and feel better, and nothing was working. And so that was it. So that conversation with my friend, and then I went to your website and did the intake for him, and I spoke with you, and you hadn't even done anything. And I immediately felt validated.
This is really happening. All of the things I'm experiencing, the weight loss, the brain fog, the irritation, all of it, this is not in my head, and there's a reason for it. And I was so grateful to know that there could potentially be something that would help me. And then when we did the lab work, I couldn't believe how many vials of blood they took. And I'm like, oh, my gosh, this is fantastic. Because you go to a medical doctor and you're not going to get that same. They try. They do what they. But I just was like, okay, and now they've taken all of these vials of blood. This is great. She's going to dig. She's going to really find out what's going on with me. And you did. And from there, we started the hormone treatment and all of the other things. And I'm so grateful that I talked to my friend because I feel so much better.
[00:08:21] Speaker A: That's amazing. I think you're right. Unfortunately, as a trained, traditional physician, we're taught to look in certain ways or at certain things. And I get this a lot where a doctor will say, I only order labs that I know what to do with. And to some degree, I understand that. But also, patients that are frustrated and desperate are looking for answers. You might not always know what to do with that result, but you can sure as heck find someone that does. Right? So they're a little bit constrained by basically the malpractice and the insurance company dictating what methods of care that they can actually provide, which is unfortunate. Right. When you started your journey. I'm trying to remember. I'm going to look back a little bit. We started initially, we did some supplements, and we worked on your thyroid with, like, what I would call a glandular thyroid, and kind of sped that up a little bit. And we started working on your hormones, too. So how did you find the hormones? Because we gave you some testosterone lozengers. We call them trophies, guys under the tongue and then a little bit of progesterone at night to help with sleep and that kind of thing. How did you find them to help you, and how quickly do you think that they started to work for you?
[00:09:25] Speaker B: I would say probably two months in. I started to feel my energy levels started to get better. And then there were some adjustments made because there were still some headaches. Not as bad. I would say everything was getting better, but I wasn't to a spot where I said, oh, my God, I feel great. And so we upped my testosterone a little bit, and we upped my progesterone so that I was taking one in the morning and one at night. And I would say once we leveled up a little bit on the testosterone and the progesterone, I probably felt it was probably a month. And I thought, and it was really interesting because you take your health for granted when you feel good. And one day I was just like, I feel good. I feel not as tired. The irritability is better, the headaches are better. And I was just thinking, wow, I wish I would have done this five years ago. And that's the thing that I want to tell people that I talk to who are much younger than me, don't wait. And I've got some friends that I've had these conversations with because I feel like you're kind of behind the power curve a little bit when you're already in it. And anyway, so I would say from the time we started my treatment, I would say by about month four, I was feeling really good.
[00:10:40] Speaker A: Yeah, I mean, that's awesome.
Just to touch on that progesterone a little bit for you guys that don't know enough about hormones, and that's why we're doing this. Progesterone, I always say, is like the brain hormone. I'm going to make you calm. I'm the Gaba stimulator. I'm going to make your moods a little more even. I'm going to help the brain fog because it actually has a lot of what we call GAbA stimulation to it. So it hits the brain receptors. Progesterone, the highest place that it actually acts is in the brain. So when you start progesterone, it's actually pretty quick. I mean, you do find those receptors get saturated relatively quickly, but it also helps with sleep. It's that calming hormone. So with a lot of women, it's not always the falling asleep, it's mostly the staying asleep. With menopause, yes, a little bit of falling, mostly staying asleep. And when you don't sleep correctly and you have long term sleep disorder, essentially, because you've been going through menopause, just a cool little stat. You're basically menopause for a quarter of your life, or at least some variation thereof, right? Perimenopause hormone changes, that's a long time to suffer with mood, sleep disturbance. And we just attribute it. We love saying it's serotonin, right? Like our whole society is SSRIs and Lexapros and selexes and everything, but really, postpartum depression, hormonal, it's low progesterone. A lot of women that have PMDD, it's low progesterone for two weeks before their cycle, they go on birth control. It's suppressing progesterone and changing their mood and making them crazy. Progesterone and insulin are directly linked, so when we don't have a lot of progesterone, our insulin becomes resistant. So by definition, we go through menopause and we get squishy mushy. Right. Because that's what happens metabolically. So you're right, we should not wait until we're 50. Most of us go through some early stages of menopause, which I actually like to call it andropause, because technically, it's like when your testosterone goes down, and that's an androgenic hormone, even though that's technically for men, that word. But our hormones, testosterone, it goes down. After babies, like mid to late 30s, it starts declining, and progesterone slowly trickles itself down as well. When our periods start to get a little bit different or heavier, or all of a sudden maybe we start having migraines, that's that little bit of progesterone just ticking away. It takes a while, it takes years, and then all of a sudden you're done. Estrogen is the last thing we talk about. I mean, you and I aren't even there, really, truthfully. So estrogen is the hormone that is two to three years after your last period when you don't have anything left and you basically can't make any more estrogen anymore, that's a late finding. And then when we talk about cancer, that's really what we worry about, is the estrogen. We're not really worried as much about progesterone or testosterone. If anything. Progesterone is anticancer. It's anti proliferative. It's the balancer to estrogen. So when we get people all the time that are scared, they're scared of HRT, because HRT, those letters, gets a bad rap. We've pretty much proven the old HRT studies, to be flawed and not valid, but they were all on synthetic, high dose horse urine, very strong, crazy estrogens on extremely high risk patient populations, truthfully. And older. So the data was super flawed. So anyone that's contemplating a lot of anxiety and mood disorder, I treat, that's progesterone. I mean, easy, simple. So I love that answer. So testosterone, let me just put that out this out there, because we get lots of questions from women. Did it cause any side effects for you? No. Okay, so you're not growing hair where you shouldn't grow hair. You don't have breakouts all over your face you're not having. Okay, so this is a big question I get. And here's the other question. Do you feel like it helps you at all?
[00:14:22] Speaker B: I do. I would definitely say it's helped my energy levels substantially. It hasn't done a ton for my libido, but I didn't really have a lot of problems in that area before. So I would say testosterone has definitely helped with my energy levels and zero side effects. Nothing?
[00:14:39] Speaker A: Yeah. And she's on a pretty low dose. So women make about two to four milligrams on average of testosterone a day. So we usually replace about 1 mg, maybe two, depending on how we're treating somebody orally. But if you think about men, they do ten times that. So when we talk about side effect profile, we need to really boost that dose pretty substantially, or you need to be really sensitive to testosterone to have that kind of problem. I would say the most common complaint is some hair thinning, but that's mostly with our pellets, or if we're doing an injectable, not necessarily with a lozenger, which is what she's doing. And as far as libido, I find if you don't really have a problem with libido, it doesn't do much for libido. If you've already tanked and your libido is like trash and you're like, oh, my gosh, I don't even know what to do. I can't even think about sex. It's not even on my radar. That is the people that, generally speaking, we can help pretty effectively with testosterone replacement. And let's be honest, why shouldn't we want to have sex, right? This is a natural part of life. We should want that. Just like men will call up and be like, listen, I need my libido back. Women should too, right?
At least I think so. Yeah. So what things did you try and fail before? This started working.
Did you do supplements or anything like that? Did you try, like, dietary stuff for hormones? No. Okay.
[00:16:01] Speaker B: Didn't do anything at all. I just tried to work harder when I was at orange theory and try to go more days and was more careful about what I was eating. But no, I didn't try any other kind of supplements at all.
[00:16:15] Speaker A: Yeah, some people try some soy based products or there's a lot of herbal type products on the market. Most of those are meant to block estrogen or, sorry I lied to you, stimulate estrogen, meaning when your estrogen is gone, we're trying to give you a little bit of moisture back, essentially, and stimulate estrogen. So therefore, usually for late menopause. So a lot of those actually can make them worse in the beginning because all you're doing is raising that estrogen level, which you're already having trouble balancing out to begin with. I always say it's a seesaw. Progesterone goes down, and then we're stuck with all this extra estrogen. Estrogen is not fun for women. When it's unopposed, it's the hot water balloon, it's the squishy mushy. It makes us miserable and weepy, and it changes all of our body composition. So when we don't have that progesterone, I call that the savior hormone, really. We're in this kind of seesaw where we're stuck at the top and we can't get it to come down. It's like someone heavy sitting on the other end. So a lot of people try supplements first and they just don't cut it. But there are some supplements that help, like a methyl green or dim, which is what you are on. And that's a great broccoli extract to balance out estrogen and testosterone. So we do use a lot of that. So let's see. Are there any milestones that you're proud of during your journey? This is kind of an interesting one. Like maybe a weight loss milestone or, I don't know. You wake up ten days in a row and you're like, I'm not tired, and I could just go work out or whatever.
[00:17:43] Speaker B: Well, should we talk about the semiglutide?
[00:17:46] Speaker A: Go for it.
[00:17:46] Speaker B: So I did not even know this was a thing. I must have been sleeping for the last year. Two years. I did not even know this was a thing. Ran into a friend who is also a patient of yours who I hadn't seen in a long time, and she had lost so much weight. And I'm like, what are you doing, because I need to be doing the same thing. And she told me she was on semiglutide, and she told me all about it. I literally came back to my office, and I called you immediately or texted or whatever I did. I need to do this too. And I started that in August of this last year, and I'm down 19 pounds as of today because I weighed myself this morning, and I am so excited because I feel like with the hormones or with the treatment and the semiglutide, I feel like I'm, like, back. My brain is back. My body is coming back. My energy level is back. Everything is good. I was really kind of getting depressed about my weight, and I've never really had any kind of mental issues around that. I've never been much to say. Well, whatever. This is me. It was really bothering me because I had worked so hard several years ago to get that weight off, and I was still doing all of the same things. It was really bothering me. So I would say it's a culmination of everything, the hormone replacement and now the semiglutide, and I'm in a really good spot, and I am seven pounds away from my goal weight, so I'm very excited about that. So I would say there's my milestone. I feel good mentally, and I like the way I look physically.
[00:19:21] Speaker A: Well, that's, like, all of it, right? I just like the way I look. Like being happy in who you are and happy in your own skin and not being tired and having a zest for life. It's everything. So did you have any side effects of the semiclutide or not too bad? Okay.
[00:19:36] Speaker B: No, none. Zero. I was so grateful. A little bit of constipation. A little bit. But when I talked to the doctor, your nurse, about it, she just said, take some magnesium, and that's been very helpful. I became a grandma or a yaya. I am a yaya.
[00:19:52] Speaker A: That's cute.
[00:19:53] Speaker B: Nine months ago, that's my why I want to just be super active so that I can be around for this little guy. And he's changed the whole trajectory of our family and the whole dynamics of our family. And so to feel good as he's growing up, it's just kind of the icing on the cake.
[00:20:11] Speaker A: So that's successful aging to you. Yeah. Is to be a positive influence and a role model and be around and be active for your grandchild. Yes. Which is beautiful. Right? Like I said, for me it was, and I did a post on I don't even know what day it was. I think it was a couple of days ago that, for me, I feel like I almost need to be able to travel and hike and be competitive again. That would be aging for me. I want to continue to be able to push my boundaries, push my limits, honestly, through travel and hiking and maybe even doing some races again. So for me, that's successful aging. Yeah. So it's different for every person, and I think it's really important. I think some of the semoglutide and terzepatides get a little bit of a bad rap. People are scared of the side effects, scared of what happens when I'm done. And what I do want to put out there is the side effects. If you go up slowly, unless you have a really bad gut and gallbladder issues and stuff like that, where it tends to be a little bit of gastrointestinal stuff, they're very tolerable, very controllable, and your body does get acclimated to, it's just like starting a low carb or a keto diet. Truthfully, if you've ever done that, the brain kind of works the same way. It doesn't always want to work carb free in the beginning. So sometimes a little dull headache or even, like, a little nausea from having low blood sugars. Right. Your body acclimates to that, and you will get much better. I think the only difference between this and doing it dietary is you can't really force the higher fat foods, which you would typically do when you're trying to eat keto or work off of fat for fuel, because the medication doesn't actually like you to be high fat, especially if you don't have a great gallbladder or pancreas involved. So that's the only difference. So when you go off of it, what do we do? We look at your numbers, we look at your calories in, calories out, your macros, and we look at where you are in successful aging. Right. Where are your numbers telling us you are? Are you insulin resistant because you're in menopause still? Guess what? You can stay on the medication. It's not like you have to go off of the medication. You just back off the time to use it. I do it maybe once every eight weeks, if that. I'm going through menopause. So my insulin stinks. I got my labs, and my insulin was like, a 13, but my sugars are low, but my insulin is high, and it's been like that most of my life. So you don't have to go off of it. It is not something that you can absolutely stay on it for maintenance if you want to go off of it. Is it maintainable weight loss? You do it slow? Yes, it's maintainable. You just have to look at what's different. And for you, I'm sure it's less food quantity and less at a meal. Each portion is smaller, like, less food overall. But you can't eat as much at a time. And you don't crave any alcohol.
[00:22:45] Speaker B: Yes.
[00:22:45] Speaker A: Crazy.
[00:22:46] Speaker B: Which was interesting, because I'll tell you, my glass of wine at night was kind of like, I look forward to that. And if I have a glass, I do. If I don't, I don't. That was an interesting dynamic that I didn't expect, and I appreciate it because those are empty calories and you don't need them.
[00:23:03] Speaker A: It's all glucose. So what do we need sugar alcohols for? But, yeah, they're studying it for alcoholism. Actually, I think they're in clinicals right now for it. It works really well. We know that it works on the brain chemistry and serotonin. So I don't know about you, but for me, and I'm not a very moody person, truthfully. But you feel very even my patients will describe, they don't feel as, like, ups and downs of mood as much. They feel like their sugars are more even. They're not crashing. So for my patients that really do have a lot of mood disorder, I find it to be fabulous. We do have to watch a little bit with, like, antidepressants and a little bit of what we call a relative contraindication. But I have plenty of patients that are on it that are on antidepressants as well.
All right, let's do a quick, fun question. So other than your physical transformation, what other positive changes have you seen in your life as part of this program?
[00:24:00] Speaker B: I mean, just the overall feeling better, obviously, that's kind of the biggest thing. But I was really frustrated with the brain fog, especially at work. I'm in a job that I really do need to be on is the best way to describe it, and I just found myself kind of. My thoughts would kind of float around, and I would lose interest very quickly in things. And I was like, do I have add? Is that adult onset add? What's going on? And I'm able to stay focused a lot better, and I need to stay focused at work. It's really important for me to kind of be 100% when I'm at work like everybody else. So I would say that I'm really grateful for that. Because that was really frustrating for me because I just couldn't stay on task and that was tough.
[00:24:46] Speaker A: Yeah. Progesterone is awesome for that. Truthfully. And I actually think. I don't know. I kind of think the semiglutide helps too. Truthfully. I don't know if you see that. But I feel like maybe day three, maybe even four after my shot. I feel a little bit more of a clarity or mental acuity. I don't know if it's just more even blood sugars. Not having them dip as much. I dip a lot in general. Especially if I eat a carb. So I tend to be pretty carb free in life anyway. But then you throw this into the mix and I just feel a lot less I guess like of a dip. So I think we'll close out with just talking a little bit about kind of future. I think the next step for her guys is. And this is probably news to her too but to start maybe working towards peptides and things for prolonged health and wellness. So that prolonged positive aging and start working on looking to make sure there's not an underlying infection there and making sure that that's not still sitting there. So for my physicians out there, my providers that are saying what about the c four a?
We've gotten her feeling really good. So most of her symptomatology was hormonally mediated. So now we'll do our yearly check. We'll go back in, probably draw some bug labs. Make sure the complement is improving. You can get compliments that are elevated just because they're fighting off an acute infection at that moment. And you just don't know they have it. So it is worth asking the patient what they're feeling, how they're feeling about those things. But I think moving towards peptides for prolonged mental health and growth hormone health are going to be where we move next. And those are a little bit controversial right now because the government or FDA has done a little bit of a banning on some of our favorite things if you will. But there's still plenty of them on the market. And that'll help her keep her long term goals and to keep her aging in a positive way. So that's our next step. Some of those are growth hormone stimulators. Some of them are called synapsin to help with brain and kind of microvasculature to make sure we don't start with any kind of like Alzheimer's type dementias and things like that. So those are things that we'll start looking towards. And we do their labs every year ish, sometimes sooner. But she's still got some pounds to go. So we're going to ride it out a little bit before we recheck any numbers. And it's really easy. We do everything, virtually a couple of nurses now I don't have to do everything myself anymore. However, we meet once a week on everybody's case. So if you've had a meeting with them that week, then we literally sit down, we powell, we go through everything and make sure there's nothing that we want to change or no questions that we need to address. So we try to make it really easy. So I'm going to ask you a question. What's your favorite movie that has come out recently?
[00:27:24] Speaker B: I would say Oppenheimer. My husband and I like history movies. And so I would say Oppenheimer is right there.
[00:27:31] Speaker A: My son just did his high school essays and he had to pick a movie that spoke to him essentially and what it meant to him. And he did Oppenheimer. It's crazy. Yeah, it is. I actually look forward to reading some of the books, to be honest. But that's a good answer. I like that answer. All right, my dear. Well, you're off the hook. I want to encourage everyone to be like Krista. Right. Join our. It's very, very easy to do. You just go online on mydoctorlori.com, fill out our wellness intake. There's a couple of them, so there's a diet one if you're just interested in weight loss. Or there's our full wellness intake or we even have a rapid prescriber. I just give you supplement recommendations based upon your symptomatology. Can fill out any of those and we can get you started in our programs. And we're going to continue to do these, you know, we're calling them real stories and it's basically the successful aging brought right to you guys. So I look forward to the next one. But for now, Krista, thank you. And it was easy and not right. So for all of our listeners, stay tuned for the next one. And you can, like I said, go right online and get your friends to sign up. You can sign up before the new year because it will get crazy at the new year. So I highly encourage you to do it before the new year. After the new year, you're going to just be in the queue, as they say, with everybody else trying to get back on track for the new year. So thank you. And from anti aging unravel, this is Dr. Lori I'm going to sign off.
