Jackie Wicks: Hi, it's Jackie Wicks with PEERtrainer, and I am here today with Dr. Sara Gottfried. I have to tell you how excited I am. Let me give you a little background. She runs the Gottfried Center in California. She's had over 20,000 patients. She graduated from the Physicians Science Training Program from Harvard Medical School and MIT, and then she completed her residency at UC San Francisco, where she actually still serves as a faculty member.
She's an integrative physician, so she blends alternative medicine with the state-of-the-art women's health, and she's part of the PEERtrainer network of health experts.
But here's why she's here. Her new book, called "The Hormone Cure," is going to be published in March 2013, and she's the leading authority of helping women get their hormones under control. But I know this interview is going to help you, because it's literally about all of us, how we're all overwhelmed, how we have no idea how to get our lives back. Sara's personally helped me, or Dr. Sara.
Dr. Sara, it's so great to have you here.
Sara Gottfried: Jackie, I'm so excited to be with you and with everyone who's listening to us today.
Jackie: Today, again, we're talking about this epidemic of overwhelmed women, who are treating their symptoms, when we were talking about this, with the wrong things, when we crave wine at five o'clock and almost can't get through, or we crave chocolate, or even you were talking about the medications. This hits me. This hits so much of our community and so many people I know that it's some of just the most important information that we've shared, and obviously, how it affects your weight loss and moods and everything.
Sara: No question. We definitely have a crisis of hormone imbalance, and it's being treated with exactly the wrong things. I just want to change the conversation that we're having about hormones, because the truth is, if you figure out the reason why you're feeling fat, cranky, or don't want to have sex, or overwhelmed, if you go to the root cause, you're going to have a sustained benefit. You're not going to be craving that wine, hearing jungle drums telling you that you need to eat chocolate. It's going to make your life so much better.
Jackie: That's so interesting, because I didn't even mention the sex part. I know a lot of people just feel like they have no energy left for some of the things that they used to, including me, including so many of us. I don't know anybody who doesn't really feel this way.
Sara: Well, I think that's absolutely true. For some people, it shows up as no sex drive. It can really cause problems when you're in a marriage, when you're in a long term, committed relationship. And so, I really feel like my job is to help women understand why it is they're feeling crummy and like they're old at a young age, like they're aging fast. I want to reverse that for them.
Jackie: I hear hormones. I've heard hormones. I've heard "change your hormones." I hear about it all the time. But can you just explain what it is, what the importance is? Why am I paying attention to this?
Sara: Well, hormones are chemical messengers. I think of them almost like email in your body. They drive what you're interested in. They drive your ability to focus on making a lunch for your kid in the morning. Or for women who don't have children, they help you with figuring out how you're going to crank on your mission that day. They drive your interest in sex. They are supportive and can amplify your mood, or they can totally make your mood tank. They're involved in all these different parts of your body. And -- maybe we can talk a little more about this later -- there's all this crosstalk between your hormones and your brain chemicals, especially the happy brain chemicals, like serotonin, which has its hand in mood, appetite, and sleep; dopamine, which is that neurotransmitter of pleasure and satisfaction. It's involved in all these different things.
What I find is that, for women who are overwhelmed, if you start talking about hormones and biochemistry, you can go off the deep end pretty easily and just feel like, "Oh my God, my eyes are glazing over. Let me do something else..."
Jackie: I'm already spacing out. [laughter]
Jackie: The first thing I wanted to know was, is this affecting me? Is this everybody? Because most people are glazing over and starting to think about the errands they need to do while they're listening.
Sara: That's a symptom. Let's start with symptom number one, where you can't focus for more than a minute or two, unless it's something really compelling. Here's the deal. I want to make this astonishingly simple. One of the ways I do that is through stories, because I think stories really help us. Brene Brown said stories are "data with a soul." I'd love to maybe share a patient story with you.
The other thing that I think is helpful is that I describe the top three hormones as "Charlie's Angels," if you remember those crime-fighting women that many of us grew up with. That's one way to think about this and to keep it astonishingly simple. The three angels are three different hormones: estrogen, cortisol, and thyroid. We can unpack those a little. How do you feel about maybe telling a little story of a patient I saw yesterday?
Jackie: Oh yeah, that'd be great.
Sara: OK, cool.
Jackie: I'm sure it describes me. [laughs] I'm sure it describes everybody.
Sara: [laughs] I saw a super-mom yesterday. She's a recovering super-mom. 41 years old, mother of two. She's got two kids, who are six years old and nine years old, boy and a girl. She's a lawyer. What she said to me when she first came to see me a year ago was, "Dr. Sara, life just feels too hard. It's harder than it should be. I don't want to have sex with my husband. I've got all this belly fat. I've got anxiety. I'm overwhelmed. I can't sleep through the night. I'm up at two and three and four thinking about the field trip, X, Y, Z." She wakes up cranky. She wakes up tired of putting the happy face on. She's tired of the mercy sex with her husband.
What we found with her, if you go to those Charlie's Angels: estrogen, cortisol, and thyroid. Estrogen is the hormone that makes you flirty and feminine. It gives you boobs and hips. Cortisol is the main stress hormone, and it drives up blood sugar. Then thyroid is this super-cool driver of metabolism and weight. It also has its hand in your mood.
What we found with this woman, Julie, is that a year ago she had a borderline set of thyroid hormones. This is not the old-school way of defining the normal thyroid range, but the optimal range for women who are trying to rock their mission. We also found that she was really high in cortisol, the main stress hormone.
What we did was to correct those two angels. The way we did it was super-simple. We did two things to help her with cortisol, and when we got cortisol into that beautiful Goldilocks position -- not too high, not too low, which is what you want with every hormone -- then her thyroid also was corrected. We killed two birds with one stone, was super-efficient.
I saw her yesterday and she was saying, "I think I graduated. I'm done." She just was in this place where, yes, she still has the stress of two kids and being a working mom, but she's able to cope. She's got this, it's not like inner faith, and it doesn't have a stranglehold on her the way it used to.
Jackie: Are you saying that also, in this experience, is when you're craving chocolate and you're craving wine or you're overwhelmed, you don't feel like doing anything, this, really, it could just be the hormones being out of whack?
Sara: It's as simple as that. What I find over and over again in my practice is that women come to me and they have things like sugar cravings. They can't stop eating chocolate. They're having a glass or two or three of wine every night. They can't sleep. They don't want to have sex. They're gaining weight. What's astonishing is that for many of them, it's as simple as correcting their cortisol level. But the side story here, which I think is really interesting, and I'll just mention it briefly, is that your local doctor, conventional physicians are not trained to look at your cortisol level.
Jackie: Why is that?
Sara: [laughs] Well, it's kind of complicated. I'm not blaming the doctors here, because I went through the same conventional training as they did. The curious part is that, if you go to a conventional doctor, say a primary-care doctor or an internist, if you tell them, "I think I have adrenal burnout. Will you check my cortisol, please?" More likely than not, they're going to roll their eyes and say it doesn't exist. On the other hand, if you go to an alternative practitioner, in many ways I think they over-diagnose and over-treat the adrenal glands. Those are the cute little glands that are in your mid-back that secrete these hormones like cortisol, and it also secretes a few other hormones but that's the main one.
There's a lot of different reasons. But for some reason, there's this disdain in conventional medicine for looking at cortisol and really talking about how it drags down the rest of the Charlie's Angels, how it can affect your thyroid -- both high and low cortisol can drag down your thyroid function -- and also your estrogen balance.
Those pieces are really important, and I definitely see in my practice, cortisol is the number one problem. It's the unspoken problem that people are not talking about enough, and it can cause all of these symptoms that we're describing. It's very well proven.
As you mentioned...you said at the beginning that I did my training at Harvard and MIT and UCSF. Honestly, I'm from Alaska, and one of the things we say in Alaska is, "She went to Harvard, but she overcame it." I have a lot of humility about my training. But what's really striking to me is that so many women are struggling with cortisol and they don't know it. They blame themselves. They feel like there's some moral failing.
Jackie: Well, we're so hard on ourselves because we sit there and think, "I have to be able to figure this out. I can't slow down, and what's wrong, and it doesn't really matter because so many people need so much from me that I just need to keep charging ahead and this is a part of getting older." I think you start to explain it away to yourself no matter what you're trying. This is just a part of aging.
Sara: It's true. I would say most doctors are complicit in that. They pat women on the hand and then they say, "I know you're overwhelmed. I'm so sorry to hear it. This is what it's like to get older, and how about this nice antidepressant or sleeping pill?"
Jackie: Well, I also have to tell you that what happens is that you start to make positive changes in your diet or you start to prioritize getting a workout in. You might start to de-stress and take yoga and things like this, but the frustrating part is that you might get a little bit more energy, but one still feels that cloud that you've almost mentioned here of, "I just don't feel the way that I used to." I think what you're suggesting is the patients in your practice stop feeling this way based on what you're recommending.
Sara: That's exactly true. I've got this large client base. You can tell that I am the type of hacker who just really loves to move the needle for people. I'm not interested in spinning wheels here. I definitely find in my practice that 98 percent of my patients feel dramatically better within six to 12 weeks.
Jackie: I want to hear...like how can I feel...is there any way to feel better? For everyone listening to this, is there any way to get this small win, the seven day...What can I do for the next seven days, because I'm feeling like six to 12 weeks, that's so far away. [laughter]
Jackie: Literally, my own mind started...When we were talking about this prior, my own mind started to think, "Oh, yeah, what time do I have to pick up the kids again today? What are the activities after school?" How do you even get just that small win, that...we call it a weekly one thing. What can you do for the week that can help you feel...and just an initial charge, not solve everything?
Sara: Sure. Well, I have about 29 things so let me...It's hard for me to choose one thing. Maybe what I'll do is I'll give you an A, B, C, option. You can tell me what you want to hear about first and share with our listeners. How does that sound?
Jackie: That sounds great.
Sara: Definitely, we, as women, are wired to over provide, and that is the root cause here. It tends to make cortisol go crazy. I think about cortisol as being that bad boy in high school or college that you dated. You knew it was a bad idea. You knew it was going to end badly, but you went ahead anyway. That's what we're trying to get under control. And so, in terms of the weekly one thing, I would say let's go after cortisol first because all paths lead back to cortisol. Here's three options. Here's your a la carte menu. Do you want door number one, two, or three?
Jackie: I'll take one.
Sara: Door number one is tiara time. Door number two is a cocktail. Maybe not the cocktail you're thinking but a cocktail of supplements that I really find is needle moving, and, by the way, it's proven by randomized trials. Number three is two way tie between orgasmic meditation and heart math.
Jackie: I'll definitely take two, because the randomized trials got me the second you said it.
Sara: Oh, you are my soul sister. [laughter]
Sara: Here's the cocktail. These are three supplements very well proven to get your cortisol to the right position again. This is what I used in that first patient that I was describing -- Julie. Number one, rhodiola. R-H-O-D-I-O-L-A. This is a fantastic adaptogen. It's an herb that helps you lower cortisol. If you are a stress crazy pants like I used to be when I was 32 years old -- we can tell that story later if you're interested -- this is definitely the herb for you.
Number two, phosphatidylserine. Phosphatidylserine, proven to lower cortisol. And then, number three is fish oil, and many of you have heard this before. You've heard of omega-3. You know it's a good idea, but here's another reason to take it. It lowers your cortisol when it's too high.
There's a little cocktail. Much better for you by the way than wine, because I hear you on that glass of wine or two every night, Jackie, and here's the problem with the wine. The very thing that you're trying to get from the wine -- the soothing, the transition, the ability to cope -- it's actually stealing from you. We know a cocktail, a real one with alcohol or a glass of wine, actually raises your cortisol further.
Even though you feel a little better while you're drinking, that's the short view. The long view is that it raises your cortisol, and it disrupts your deep sleep so you wake up not feeling restored the next morning. I'm not saying never drink wine, but...By the way, it also harms one other angel. Can I mention that?
Sara: There was a study in the Journal of the American Medical Association last year showing that more than three glasses of wine, or three servings of alcohol per week in women, raises your estrogen levels, your bad estrogen, and increases you risk of breast cancer. We've never seen it at such a low level before. Three glasses! That makes me cry. That makes me weep.
Jackie: I can't believe it. You keep hearing about this stuff, and then you...One of the issues is that you start to hear some conflicting information. You say, "Well, but don't they keep telling me wine is good for me because of the resveratrol?" You start to almost make excuses in your head and almost listen to what you want to hear, if that makes sense.
Sara: Oh, absolutely. We do the same thing when we're pregnant. You can find evidence to support whatever decision you make when you're pregnant, because there's so much conflicting information. Same thing with parenting. But, here's the story. This was proven in the Nurses' Health Study. This is one of the most rigorous observational studies out there. They have so many people in the Nurses' Health Study that they can really prove this. So yes, the resveratrol is good for your heart. But women of a certain age, 35-plus, are not so good at detoxifying with their liver alcohol.
When they have more than three glasses of wine per week, their bad estrogens go up, and they are much better off taking resveratrol as a supplement. But here's my good news here, because I actually love a good glass of wine. I want you to drink less but spend more. Have really good wine. [laughs]
Jackie: Right. But you drink very slowly. I'm glad you did clear that up, though, because I think what happens, again, how we explain things away and then just do what we want to do. It's not just about, "Oh, well, it's making me feel better." The half a glass of wine is very different than the ones that become two or three. I have a friend who says, "Oh, you think that you're only having one glass of wine. But oh, it was a hard day, so you pour a little bit more."
You're really having two glasses that are in one wine glass. Or you think you're just going to have one square of dark chocolate, and that becomes two, and that becomes five. I think it's really getting a grip on what is really going to make you feel good. The fact that you can, just as this first step, take those supplements and get that feeling that you're trying to get from the wine or chocolate but have it be the good long term feeling, I think, is one of the best things that I've heard.
I did this myself in the last week. We talked about this. You talked about the supplements. I found them and started literally taking them the next day. You said, "People really report feeling different." Now, I know that it's a long process because you were saying the six to 12 weeks.
But I said, "I want to know just a quick when of what I can have here." I did it and seven days go by. I said, "I can't believe this. I feel better." Of course, I'm still overwhelmed in certain ways. But I have had a very specific change. I know it. I know it was because of this. That's the thing. I want to talk about all the different facets now.
I want to hear everything that you can tell us to fix this because I've now had this small thing where I feel better. I'm someone who has a lot of information. I eat salads all the time. I work out. I do hypnosis. I do meditation. I sat there and thought... Because I know that you are Harvard trained, MIT, and you are having these problems.
Or you did. I'm thinking, "She's so smart. She must just be sitting there thinking, 'I've got to figure this out.'"
Sara: I think you raise so many beautiful points, Jackie. I love that you want to go for the small win. I hear that a lot in my practice, women who say to me, "Just give me the one thing. Can you make it simple for me? I'm not going to invest a year. I don't want to do a million tests. Could you just do something? What is it? Just give me the one thing." I love that you started to feel different within seven days. That's what I'm after. I think women want this when they're struggling with their weight. They want it when they're struggling with their mood, when they're struggling with belly fat. They want this. The good news is that small hinges swing big doors, when it comes to hormones.
When you start to understand how to manage cortisol, when you start to get these Charlie's Angels working for you, not against you, like you did in the past week, Jackie...What you see is that it's easier to reset your hormones than it is to live with the torment of being out of balance. I think this is a really important point. So many women come to me.
They're overwhelmed. They're like, "Oh my God. I can't do this. I just don't have the bandwidth. I don't have the time." Yet, you are going to feel so much better with a few small tweaks.
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