Actionable Steps for Better Aging

Welcome to Menopause Rescue. I'm Dr. Polly Watson. Midlife women are often caught up in a sea of symptoms. Too often, they're overwhelmed by the lack of support from mainstream health carere They're inundated with so called experts who are selling solutions which may lack credibility. I'm a Menopause Society certified gynecologist with both traditional and functional medicine training I'm here to guide you through this transition and help you decipher the facts from the fads arrmed with credible information I hope you are empowered to rescue and restore your health Making the second half of your life your best Welcome to Menopause Rescue. I'm your host, Dr. Polly Watson, and I am so excited to bring back Kate Willis, nurse practitioner who is the other half of Hormone Wellness MD, we are going to be talking about inflammation And I am so glad to get Kate on to talk about this topic because I think that There's a lot of noise in the menopause space right now that hormones are the answer for everything. And I think if we dive into inflammaging, this is a real opportunity for us to acknowledge how hormones are helpful, but all the other things that need to be part of that picture. So welcome back, Kate, thanks so much for being here excited to be here. So we're just gonna dive right in. When we think about inflamming, this is kind of a pop culture word. We're sort of talking about inflammation as we age. and this is a really important driver in how we feel how we function how we look, all of those things are kind of coming into play. and it certainly influences a lot of the changes that we're starting to have at midlife. So today we're gonna unpack what is inflammaging, why it accelerates at midlife, especially for women And most importantly, what the heck can we do about it? So we can actually move the needle So Kate, let's just dive right in. How do we define inflammaging? So inflammating is this chronic, low grade systemic inflammation that comes as we age. And so I want to separate this from the inflammation that we get if we have a tooth infection or if we're sick or if we sprain our ankle, or even if we get a vaccine, so it doesn't have to be a bad thing that happens to us that creates that inflammation. This is that low grade sort of creeping inflammation And it's persistent It happens in our cellves. And so this is really impacting us from head to toe The biggest drivers of this is cellular senescence. and that's basically where our cells retire. but instead of dying off, they stick around and release inflammatory signals. I feel like people are talking about senesccent cells as zombie cells. Is that a term you've heard lately Absolutely. And so they're going around causing lots of problems and not contributing anything really super helpful to the body So these zombie cells, these senescent cells, they're creating noise and then The noise keeps getting louder and louder. So I guess if we're thinking about We can bring it all back home. Our teenage kid is playing video games really loud and we're trying to finish charts and connect thoughts in our head. That noise is just getting louder so it's harder to get your job done for your immune system, for all the things that your body has to do So how can you talk Kate about like how does this affect us mostly at midlife? Like let's kind of connect that back to the midlife transition Well, you mentioned, you know, perimenopause, menopause hormones And in the intro to the podcast, so I'll circle back there first. You know, I think The conversation so much recently has been about really what's happening to hormones. and I think it has given women the false hope that if you fix your hormones and I'm putting that in quotes because we don't We don't ever get back to where we were at age twenty or thirty hormonally. E with HRT, even with great HRT, that hormone piece doesn't fix the inflamm age altogether. certainly can support our metabolic health and cardiovascular health bone health and lots of other systems, but it is not the answer One of the things I will speak to hormones, you know, when our hormones are steady and regular, when they're kind of going up and down, you know, every month Estrogen does play a powerful anti inflammatory role. It's immune regulating, so it helps with those inflammatory signals that are pass you passing around. But there are still changes that are happening even when we replace estrogen with hormoneotherapy in cardiovascular system and our metabolic system in our immune system that are a result of these aging zombie cells, we can call them So we are hitting this at midlife. Number one, our hormones are changing. But number two, we're hitting this point where our cells are starting to not work quite as well as they once did. And that's where we start to see some of these changes in our body. We can feel them, we can also see them show up. as well Yeah. and I love that you kind of helped reframe kind of quote unquote balancing hormones for people. And I just wanted to kind of tag off that is that In our practice, we're not just Thinking about your sex hormones, like I think people think, okay, I'm taking estrogen, testosterone and progesterone. I've got something to treat geniturinary syndrome and menopause, and I'm done. And I think those are all really fantastic helpful tools and they're just the beginning, right? Because I know you did a work on and glucose regulation and you did a whole class on that. we want to think about your insulin. When we're thinking about inflammation, that's going to be a big part of it. How is your thyroid working? Fat is an indocrine organ, Are we in metabolic disease, right? So when we're thinking about balancing hormones I think it's It's an ongoing process. It's something we strive for every day, but it is a journey in and of itself. It's not a destination. It' so And one thing that you know, I think sometimes in the functional medicine space, there's this idea that we need to order lotots of very expensive labs to understand what's going on and everyone needs to be on a million supplements to support their bodies You know, the truth is we can actually, you know, use some fairly maybe maybe not quite as basic as you get at an annual You know, check up. but we can work through a panel like lab forore reQests that are commercially available labs You can run them through your insurance. There are some specialty labs that we can use, but we don't require those of people nor do most people need those to see this sort of inflammation? We'll use a glucose monitor, which is aap relatively cheap option to help someone understand how metabolic issues blood sugar are then driving this aging process and how what they can do to really support that So Definitely Hormones are wonderful for many women, but we really aim to look beyond hormones to assess what's going on in all the body systems so that people really actually start feeling better and start seeing the improvement in this you know yourselves And I love that you're kind of talking about this transition am mid life. So hormones were changing. We can certainly replace those, but there's still things going on in the background. When some of the things we might see, you are mentioning some really simple labs, when a C reactive protein, right? That's a four dollarars test at lab or it's not a super expensive lab We can see a lot of immune system behavior where as estrogen levels are going down, we often see autoimmunity start to go up And I think this is a really even more interesting conversation in the light of kind of post COVID and how a lot of folks are sort of dealing with long COVID while they're having this hormonal shift that is also affecting their immune system And then as hormones are changing, as these immune and inflammatory markers are changing, we see the risk of cardiovascular disease and metabolic disease go up, which leads to heart attack stroke diabetes, dementia. So you know some of our colleagues might say, why are you ordering a CRP? Why are you ordering some of these things Because they have tremendous early flags to kind of let us know when we need to be worried about things that really can affect someone's longevity and their health spans. They are. and then there are things like a basic comprehensive metetabolic panel, which is many times ordered to at an annual visit. The ALT is one that I'm always looking at because you can tell if there are some maybe inflammatory or maybe fatty changes in the liver. So that's very sensitive marker that is probably on labs you already have Think about Ferriton two, which is an iron storage marker Veriton will go up because it is a reflects acute inflammation as well as iron stores. and so That's one again, these are, you know, maybe a little beyond basic labs, but not labs that are going to cost someone an arm and a leg really to understand where the inflammation is happening, how to address it Right. And then I do think when we see markers like Ferritin and C reactive protein go up, it doesn't tell us where the inflammation is in the body. That's where the magic happens, right? That's where we have to put on our Nancy Drew hat and really start asking good questions and partnering with a patient I had a patient last week where her CRP was high and I was really surprised because I'm like, I know she exercises, I know she eats clean. I know she manages her stress. And so I started asking questions and I said, you know, we know there's a lot of information about oral health and how that affects our cardiovascular health and our neurocognitive health. And I said, you know, is there any chance you have like a root canal that's gone bad or what's going on in your mouth? And she said, yeah know every time I floss my teeth, it bleeds, they've been telling me I need to get some deep cleaning done. and I'm like, okay, it's showing up in your blood work. Like this is This needs to get done and so It can really lead to some interesting conversations where you wouldn't be thinking at the gynecologist, you'd be talking about your oral health, but hey, it's all connected, right? It is all connected, Yes. So we've been kind of talking about these shifts, these shifts that happen with our inflammatory state, these shifts that happen with our immune health Talk a little bit more about Kate, what's happening beneath the surface. Why does inflammation happen So inflammaging is definitely multi factorial and multis system. So number one, we think about mitochondrial function. These are our energy factories. If you remember back to high school science, these are the powerhouses of our cells H mitochondria over time just become less efficient. So they make energy less efficiently. This creates more fatigue, more oxidative stress, which is cellular stress at the cellular level We also see again, these immune shifts and our immune system tends to be more reactive and less precise. And so that's where we may get that rise of autoimmune diseases. Hormone fluctuations also can add to that. So perimenopause, we think about that as a prime time for This certain immune dysregulation We also, you know, over time as we age, we are accumulating these senescent cells and remember, they release these inflammatory cytotkines or mediators. and so this sort of like, you know, little signal of inflammation keeps getting pumped out of these. There are some additional like more maybe slightly more expensive labs that you can draw to look at those. Again, in my practice, I'm not firstirst line drawing those if I see someone with an elevated C reactive protein, I say what you said is we put on our detective hats And we look through your labs and we talk about your history and we try to identify Can we find out where the inflammation is coming from? Do we need to look at your heart, you know through Cneary argtery calcium score. Is this a blood sugar issue is this more an issue of inflammation related to visceral fat? So we're trying to play detective and figure out where those drivers were coming from And then finally the gut microbiome. I know the gut has also gotten a lot of attention lately. There are know a million probiotics and prebiotics on the market. But the truth is we get changes in our gut microbiome as we age, our good bacteria goes down. so we're less diverse in our good bacteria We also have more pro inflammatory species that grow in our gut as well And then those changes can lead to increased gut permeability. And always say, you know, our gut was made you like we want it to be made of these tight junctions. And so it's like picking up water with your hands. you might drip some water through, but you're able to hold some water ed in your hand. and gut permeability is when those, you know, if you pull your hands apart and try to pick up water, that water is going to flow through. So we want nice tight junctions where nutrients and things can move through appropriately We're not getting like lots of immune triggers and proteins going through to the rest of our system because that just pushes inflammation out of our gut and into our bloodstream So lots of systems involved here, lots of processes involved here, but those are some things that we'll, you know, you and I will both look at with patients is can we identify their a specific thing that's going on in one of those systems that we think might be driving this person's inflammation I love that you're talking about the gut and I just want to kind of I know as the longer I've been doing this, I feel like the less gut testing I'm doing. and so What I'm often doing is taking a good history. We have people fill out three days of food before they come in, to get kind of an idea what someone's dietary habits are like. Oftentimes we're starting with some really basic things before we even do gut testing, right? So if someone's coming in And they're coming in on you a standard American diet. They're having very low food diversity, they're having very low fiber, they're having very low plants We might be saying, okay, before we do any testing, we know that you need more fiber We know that you mean more diversity in your diet. We get those foundational things in and then see how people are doing, right? So before we order a three hundred dollars gut test, we might be saying, okay, let's do these dietary changes first. and sometimes we don't even need to do the testing because just the lifestyle intervention is helped And so I think that's one thing that I'm really proud about of our practice is that We're not starting with all of the fancy testing. We're often doing it when when we need more information and we've already done the basics or I will say, I think there are some patients that do not have the same level of engagement on changing their behavior unless they see it on a test result And so sometimes that's also a conversation of How do you find motivation for behavior change? Because I think sometimes people when they see that their CRP is high, they will all of a sudden start going to bed earlier and meditating, right I do think we to our patients a great disservice if we Jump to comments or ides or you know, fancy therapeutics when the foundations are still not really in place. You know, if you put something on top of a weak foundation, it's not going to work very well. And so always going back to diet. and I'd say diversity is really part of a healthy diet protin is Awesome. K eating protein. but if you're doing process protein, you know several times a day and eating very few plant foods, then your microbiome is probably suffering. know so that, I think about screen time, especially in the evenings, close to bedtime, I think about circadian rhythms. I think about sunlight and movement All of those basics we go back to and we want to make sure we can give the best support possible for patients to really engage there so their foundations are solid. and anything we add on top of that is going to work better, be more efficient and maybe be better tolerated even And I just want to maybe give a shout out to anybody that's a midlife person out there that's feeling overwhelmed with all of the things to do to be healthy these days. So I don't know that food diversity has to be super compable One One of the good go tos at our house is Cuciferous Crunch from Trader Joe's, right? It's a bag of shredded brrussels sprouts and shredded cabbage and maybe there's some broccoli slaw in there. And I'll throw a handful of that in with a bag of arugula and put some pumpkin seeds on it and all oil and lemon juice dressing. and I've got like five or six different plants right there So It doesn't have to be super complicated. You can literally grab a bag of coleslaw mix, grab a bag of broccoli slaw, grab a bag of cruciferous Cunch, mix it together with a little vineaigarette and you've got Throw some nuts and seeds on it. You've got a lot of fiber, you've got a lot of plant diversity, you weren't shopping all day long. And so yes, would it be fantastic if it were local and grown in your front yard? Yes, but I think a lot of us are, how can we get through the work day and do the best we can? And so I just kind of wanted to give a shout out for people who are feeling overwhelmed This doesn't have to be super c I found a salad this wee at Costco that is a One of their pre madeade things and it had quinoa and chickpeas and kale and cabbage and I think some carrots and a few other veggies thrown in And I've been having it every day for lunch and it is, you know ed feeding me all week long. So I agree. I think even brainstorming sometimes with patients on like So I'll recommend. I'll say, hey, you know, why don't you start with breakfast? Let's figure out two or three things that you like to eat and you can rotate through those and you know you're getting some plants, some fibers, some protein, you know, some healthy fats and you're really, you know, nourishing your microbiome, fueling yourself well for the day. but all for making it. as simple as we can. I'll just shout out one more little hack and some people may think this is high maintenance, but it's so easy. There's a company called Ha Mama H A M AM A. and they sell these little seed mats and they make broccoli sprouts. So broccoli sprouts are super fantastic. They're super anti inflammatory, kind of like five hundred times more than broccoli And so you just literally drop the seed mat in a casserole dish, fill it off halfway with water and ten days later, you have broccoli sprouts And so if you have a kid that's like romaine lettuce or nothing, and you're like, oh, come on You could throw some of those on top of your salad and really boost the nutrient density. We throw them in a smoothie if you're having a wrap or something like that, but it would just be a way to have a huge head of nutrient density pretty easily Because you can buy broccoli sprouts at the store, they just go bad really quickly. And so if you have them growing on your countertop, they're also just suring. So Hama, a seed mat, check them out no financial relationship. We just like them. Okay. so so I think are you are we talking about metabolic health now I think we I don' think we really covered the gut immune hormone connection. Okay. I think there's probably a little more to say there so. Okay, so let's go back. So Kate, can you talk a little bit about the gut immune hormone connection? because these all are so intimately connected Why is the gut such a powerful driver for inflammation So, you know, I think we often don't connect the gut in our immune system. So if someone has an autoimmune disease and you go see a rheumatologist, you probably We're not going to have a conversation about the gut But Especially when it comes to preventing the immune system from going off the rails We really want to tend to the gut. You know, the gut regulates immune signaling. I mean, I think that's a pretty powerful part of our gut is the immune signaling. So we want to keep not only good fiber going in to just support that the tight junctions in the wall but to even be influencing the signals that it's sending to our immune system to keep it regulated. You know, there's that gut immune connection and it's also signaling our things about our mood, things about our cognition. importanton again sameame basic things that we just finished talking about, but wanted to complete the circle that The gut really influences, you know, that immune system function And then even beyond and things like mood as well Yeah, absolutely. So like, you know, if we're having a diet that's more processed food, sugars, refined carbohydrates, those are going to promote inflammatory bacteria whereereas things like fiber, polyphenols, whole foods are typically supporting a more anti inflammatory response. They're pushing those germs in our gut that are making utterate and making things to kind of help heal those junctions. so I think food matters and I think fiber matters a lot. and I feel like we've gotten the protein message pretty well. What I'm seeing at least is that A lot of my folks are doing a ton of dairy. It might be conventional dairy. They're wondering where their cholesterol iss going up and they've ditched carbs. and so there's No beans, there's not a lot of like quinoa or other high fiber grains. And so really we love protein. Protein's fantastic, but we've got to have protein the fiber and we' gott to have some plants Well even you know, I think of the know automune patients I've seen that have come in to see me who have maybe eliminated gluten and then they've replaced that gluten with you know, gluten free bread and gluten free crackers and gluten free cookies and goodies. And really one of the most powerfulful things for the immune system is that low inflammatory diet, which is a plant forward doesn't mean vegan or vegetarian, but a plant forward plant heavy diet And so you know, again, laying the groundwork for a healthy gut and a healthy immune system really starts in the gut. One of the things that we learn in functional medicine is, you know, when in doubt start in the gut and you know, I think that doesn't mean we just guess and start there, but it means that the gut is so integral to so many different body systems and it is a driver of what's going on, you know, in our brain and our immune system and really all over. So gut is a great Great place to begin and a great place to focus. I love that you said that. I feel like My family went gluten free. Oh gosh. More than twelve years ago before I had really even it was sort of the beginning of finding functional medicine and all these things and I really didn't know what I was doing. And I did exactly what you're talking about. I traded one white flower for another white flower. Right? So I think it's a really good time to just sort of own that, right? It took me a while to figure out how to eat. Also, I'm seeing a lot of people who are like, oh, but it's sourdough bread. And I'm like, okay, so it's fermented white flour. It's still white flour. It still doesn't have a lot of fiber in it. And so we're looking for intact foods, right? So black rice, buckwheat grouts are a great option King wa is a great option. Sweet potatoes can be a great option, a whole intact food. Once something's made into flour, It's no longer a whole food. And so I think the food labeling is really confusing for people because they'll sprinkle some bird seen on top and they'll say, how many grams of whole grains? Well, if it's made into flour, where is the whole grain there? It's been made into flour. Yeah. Dr. Watson, why don't you talk a little bit about heart and metabolic health? Tell us why you know, how do we connect this inflammag gene with our heart and metabolic health So I think this is so important. and I think that's another thing that our practice does Well as we're often ordering a lot of cardiovascular risk factor markers. We're looking a little bit harder at people's heart health because what kills more women in the United States is heart disease, not breast cancer, right And I don't think those are unnecessary tests I think that this is the most common cause of death worldwide. It is the most common cause of death in our country. It's the most common cause of death for women Even though we're focusing on hormonal health, we're still really focusing on cardiovascular health So inflammaging and cardiovascular risk I think we often have been taught, okay, cardiovascular health is just LEL cholesterol and there's so much more that we want to talk about. So inflammation is a major drierver of heart disease or atherosclerosis. and what's happening is that Inflammatory signals are damaging that inside wall of a blood vessel. And when we get that inflammatory state, LDL cholesterol is getting oxidized, it's generating an immune response and all of this sort of forms the beginning of a plaque on the inside of a blood vessel wall. And so a heart attack is when that plaque breaks off and goes to your heart, a stroke is when that breaks off and goes to your brain And so We've seeen this a lot with as GLP medicines have become really, really popular, right? When we lower inflammation, we're also lowering cardiovascular disease. and those have been really helpful tools So We see this feedback loop between inlformmation and plquformation and as Eestrogen levels are changing. When estrogen levels are lower, we see more of a pro inflammatory response. So this is why We know that women who are treated with hormone replacement therapy between the ages of fifty and sixty will have thirty percent less cardiovascular risk of dying from heart disease. right That's huge, right? Why is that not on every billboard So we actually want people to be on hormones when they need to be on hormones, but we're also looking at all these inflammatory markers And know we have plenty of patients who are on statins. And so I would say, I don't think either one of us are anti statin in the right situation. But what a lot of the role that we play is helping patients look beyond medication. So what are the things that they can do from a lifestyle standpoint Can they reduce their dairy intake and reduce their cholesterol that way? Are there other dietary changes, the addition of fiber I'm on a big fiber kick to lower my cholesterol. so we'll see in a couple of months hopefully how well it does, but we know that some soluble fiber helps lower LDL cholesterol. Sometimes there are some strategic supplements that we can bring in that can help with pushing the pathways a different direction and can help with some of those cardio metabolic issues. So again, not antistatin, but what we are doing is trying to take a step back as functional medicine providers and really look at not just the LDL number in isolation, but all of the cardiovascular risk and lowering those risks collectively, which often is a lowering of systemic inflammation And exercise is such an important part of that too. and I think is maybe there's a little bit of nuance there as we age and we're thinking about inflammation. So exercise can be pro inflammatory, right? And so sometimes when people's inflammatory markers are really high and I know I've got a great exerciser in front of me, I'm going to be asking about sleep quality and recovery R? So if she's lifting for an hour and a half a day and then doing an hour of cardio and she's doing that seven days a week and there's no recovery That might be she's not giving herself a sant chance to heal, right? So Exercise is so, so important. and I think B medicine balance with an appropriate amount of rest and what that is is really different for most people, right? and I always say you should feel better after you exercise not worse if you feel more depleted after you exercise and something's wrong Any other tips you've got for people to sort of figure out that balance between exercise and rest I mean, I think our bodies speak to us. and so if our muscles feel heavy and tired and achy, I would consider some extra recovery days. And I'll tell people, I'll say, hey, Why don't you try this for a month? You know because I think there's this fear of I exercise less, I'm going to gain weight or I'm going lose muscle. And so I'll say, hey, why don't What if you tried this for a month? What if you pulled back on your exercise, Mbe you do three days a week of strength training and you took some walks? What if you tried that for a month Often women come back and they're like, I feel better, my slek is better and I't gain any weight and I actually feel like I've lost a couple of pounds. and that shift in that inflammation, letting your body actually recover because We don't build muscles in the gym, we build muscle in recovery. So the work that we do in the gym, we want that to really pay off and we see that ing through recovery and letting muscles actually No. So will I will recommend a short shift in their exercise if over exercise might be part of the That was that was my, I mean, two summers ago, I was swimming three to four days a week and lifting three days a week You know, I thought I'm swimming a mile. It takes me thirty five minutes. like why is this too much exercise? but I was absolutely exhausted And so now I lift four days a week and I do sprint interval training and that's my cardio and I have more energy. And I miss the swimming, I miss my swim friends. but Long cell cardio just apped me. It just it wasn't where I'm at right now. And I think it'll change, right What you need as you age changes. and we just have to listen to that So we've kind of talked a lot about the gut immune hormone connection. We've talked about these senescent cells or these zombie cells and And let's kind of dive into what we can do to move the needle. So we're all aging, it's happening, it's quietly, our cells are starting to have more of these inflammatory signals. So Kate Let's take it home. How do we land this plan and give the plane and give people some things they can do? we've mentioned some of these, I like to call them boring basics because they do feel kind of like people are like, no, give me a Give me something advance or something you know, a supplement to buy that feels cutting edge really again. Al coming back to basics. We've already talked about exercise We've talked about diet. We've touched on sleep. I mean, I think making sure sleep apne is not a problem. So that's one question. you know, I'll sort of explore like do you snore? A you feeling unrested when you wake up? you know, or there some changes Do you ever wake up feeling like you're gasping for breath? So making sure women are sleeping well, sleeping through the night, not gasping for breath and having apneic episodes. Sleep is so foundational so we can work on doing some support for that. whether her it's regulating blood sugar, regulating cortisol, getting a dental device for sleep apnea, whatever it is that they need there And then you know, we do love hormone therapy for women when it's appropriate and I would say appropriate for more women than it is not. And so you know if you're considering it, I think at least having a conversation with a a knowledgeable provider who understands not just that estrogen will treat your hot flash, but that it may improve some of this systemic inflammation and agent can be a really powerful tool in your toolbox to use. Supplements are also great. Again, I don't really want anyone to have to take twenty supplements a day to feel like they're maintaining their health, but there can sometimes be some strategic supplements that we add in for some very particular reasons to you know, I think of like omega three s, I think of maybe that polyphenol If someone is a little low on fiber, adding something to help with gut diversity might be a good probiotic blend, vitamin D, you know, I can think of some others there that might be really helpful. So some boring basics and then I would put sort of the hormoneotherrapy and supplements and like a little step up in terms of interventions. The last thing I would add is Sometimes it helps, you know, when you when you go to your doctor or nurse practitioner or PA and you get your labs back and they look normal I think sometimes it does help to take a little bit broader look to say H Actually is that ALT number creeping up. Does it look like you might have some early fatty liver What about your hemoglobin A one C, the ninety day average of your blood sugar? If we look at you know, someone's number and they're at five point six or maybe they're even pre diabetic, often that gets kind of dismiss conventionally because you know, you just kind of wait until someone has diabetes to do much about it. So I think getting some of these markers drawn CRP, you know Do you need a corner artery calcium score? Do we need to investigate why your body is kind of making this inflammatory signal? I do think advanced labs can help. and again, you don't have to spend an arm and a leg or get, you know, forty things drawn or do a bunch of specialty tests to see signs and signals of inflammation and to get some really great clues about where that inflammation is coming from I love that. and I love that like a lot of the labs you just mentioned are labs you can get a lab order for not a lot of money, right? A Haman Glob in ANC is like four dollars, right? And I agree with you. I think a lot of folks were like, oh, it's normal, right? or You're only five point seven. You're like you're just barely pre diabetic. Oh, you know, you just had a birthday, maybe you just whatever And I would say, you know for every tenth of a point we get that hemoglobin A one C closer to five point two, we demonstrably lower cardiovascular death rates, right? So it does matter And we are looking at these labs with a different ruler, if you will, Our ruler is a little bit more uptight, right? We're trying to think about where things are. optimized and many of these labs we can get just through lab par that aren't crazy expensive. I love that you mentioned Ferriton. I think Ferritin really is an important thing to be checking as well as Iron studies and perimenopausal women because so many women are walking around with low ferritin, when menstrual patterns start getting weird, maybe bleeding' getting a little bit heavier and everyone's like, oh, just take some neutralphol, your hair's falling out and they really have a ferritin of fourteen. They need some iron, and then obviously we need to figure out how can we help them not have such a crazy period. But Ferriton's not A fancy avant Garde weird lab. This is a lab for lab, right And then I think if we see some of these inflammatory markers and they're high, I think I'd like to make sure to say don't panic, right? So you know CRP could be high because someone went to the dentist and they had their teeth clean and they had some transient bactermia useome inflammation. So if you are getting these labs You want to get them when you're well, and you've been well for several weeks. You're not just coming off of an illness. We're not anti vaccine, but vaccines are gonna generate an inflammatory immune response. You're building up immunity to something. So you don't wna get a CRP or a ferritin right after a vaccination an illness a surgery another kind of procedure or you know, an injury. So I think that's just a really important detail. donon't panic. The first thing we usually do is maybe repeat them, right? Can I share a patient's story really? I love that. This a patient that came to see me for the first time about a year and a half ago. And she actually had pre diabetes and knew it, but no one had made that a big deal or a red flag and then she got diagnosed with fatty liver disease and that sccaary So she felt Oh, this is a big deal. And you know, we looked and her cholesterol had really crept up a lot We do something that's looks at something called particle number for cholesterol. So it's another lab for lab. It's not a weird lab, but we looked at that and she did have very high numbers. And so she has worked over that she's changed her diet to more of a Mediterranean low inflammation diet. She's lost weight, not Act just with lifestyle, which there are lots of good ways to lose weight, but she chose just to work on it with lifestyle She's changed the way that she exercised, building more strength,, changing up her cardio a little bit from just she had only been walking for exercise. and it's been Truly a joy to see her you know, work so hard. I mean, she's really done the hard work. I've helped her navigate know she's added some strategic supplements and we've talked about diet choices and but she has reversse her fatty liver She is not pre diabetic anymore. still working on bringing down that A one C. We've seen her particle number and her cholesterol numbers improve significantly. And so I just want to give this like there is hope. You know, there we don't get to mid lifeife and see these markers and just think, well, this is just the way it is. you're stuck with this. There is a lot for change with, you know these therapeutic lifestyle changes and then again, sometimes some some more advanced interventions for particular people. But we get to see this all the time. It's really fun, it's exciting. It's fun for patients to see their labs improve and then to also be feeling that these to. so This isn't just a number showing up on the lab see women get to feel better every single day I love that this partnership that you form with this patient because you sort of gave her or helped bridge the gap for her so that she's sort of owning her choices, right? So before it was like, oh, this thing has happened to you and it's not really that big of a deal And now she's really in a place of empowerment where she's making choices every day that are determining her how she's going to age. What's her health span going to look like? So You know, that that strategic partnership is so powerful because she's she's in the driver's seat now She's not just passive Thanks, Kate. Thanks for sharing that. That's fantastic. So what are some things you want folks to walk away from this podcast knowing about inflammaging So first, if you're younger than perimenopause age, if you are not yet in perimenopause, I would just say These foundations are worth investing in and making a priority. I know life is busy, but healthy eating, getting quality sleep, making time for string training and healthy movement really help set the stage for better aging. So work on it if you're free per menopause age just to lay that foundation Number two, we have said this several times during this podcast, but hormones are G, they do not fix everything. So they alone are not going to lower your CRP. they alone are not going to lower your cholesterol They alone are not going to improve your blood sugar. Now they can help with all of those numbers and help with feeling better for sure but they don't work in a vacuum. and so We can, again, if you're a candidate, great candidate for HRT, awesome. but we want to bring the other piece of how can we really address these from a whole person standpoint And then third, you know, I would say it helps to work with someone who understands inflammagia. This is not addressed with a prescription. It's not addressed with one supplement. I think if someone tries to a number on a lab. just with one of those things, they're probably missing some of the larger picture it does help to have a partner in your health who understands the powerful levers that we can really empower you to use to reduce inflamme in your body. I love that and we're not Menopause is the rest of your life, right? And so I think that the end of your life. It is it's not the end of your life. It's the rest of your life season And maybe it can be a second better half, right? And so I love that you're really emphasizing building relationships with patients that are sort of giving them their power back right? Because all of these skills to work on inflammaging are going to serve people moving forward through the rest of their life and hopefully extend the time that their brains work and their joints work and they're active and they're engaged and they're contributing and connected And that's that's what we want, right? We want to stay engaged and connected Thanks, Kate. This was so fun Thanks for having me Thank you so much for spending your time with us today on this episode of Menopause Rescue If you enjoyed today's conversation, we'd love it if you left us a five star review and share the podcast with friends or family It's one of the best ways to help us help more women find support and start restoring their health If you're looking for personalized menopause care, our clinic, Hormone WellnessMD currently accepts patients in North Carolina and Alabama Great first step is our new patient welcome course. Are we a good fit, which is linked in the show notes. It's a quick, easy way to see if our approach feels right for you. And if you're ready to go deeper on your health journey, be sure to check out our membership. It covers over a hundred video lectures, reviewing everything from bone health to libido as well as a supportive community of like minded women to cheer you on every step of the way. Before we go, just a friendly reminder. this podcast is for general educational purposes only and isn't a substitute for medical care No doctor patient relationship is formed by listening. Always, make medical decisions with your own healthcare provider and don't delay seeking care for any health concerns. Thanks again for listening. We'll see you next time on Menopause Rescue