Then we don't know what to do about it. And anything we try to do doesn't really seem to work. Can we talk about belly fat cuz I have to imagine with the work that you do, that has got to be one of the the top symptoms women come in there very emotionally about. Definitely. And you said nothing has changed of what they do, but everything has changed around them, right?So, the surrounding environment is not the same as it was before. And not necessarily us doing something different, eating more, or exercising less. It's just the environment that we are on physiologically and socially also, right? So, in midlife we encounter many changes in our life and hormonal changes happen parallel to social cultural changes at the same So, it's the combination of those things that I feel puts us in a place that we're almost at a failure, right? Definitely in perimenopause, we're seeing the shifting of hormones, the chaotic hormonal changes that we're going through that promotes visceral fat, right?So, the fat that we had in our fertile years where they tend to be more in the hip and the breasts goes centrally. So, our body composition changes. And then on top of that, we start losing muscle mass easier. When you lose muscle mass, you're losing your burning calorie machine, right? So, then you it promotes also the accumulation of body fat.And because of perimenopause, the accumulation happens centrally. And then also, if we're symptomatic for perimenopause, we're not sleeping. The lack of sleep has a lot of rippling effect. The not sleeping is going to make us tired, irritable, we won't want to work out, we may not be following a healthier nutrition diet, right? The lack of sleep can increase insulin resistant, the insulin resistant is going to increase carb craving, sugar craving, right?So, it's just in a vicious cycle. And in top of that, socially things or familial things are happening. Our parents are aging, our we're losing our parents, our kids are growing, professionally we may be in changes professionally or a peak of our career. So, it's all of this is multifactorial really what is happening in a woman's life in midlife. As you're saying that, I'm like, yes, okay, and then that happened.
And I can really remember those different times in my life and how it just kind of all one thing layered on top of the other. Yeah. Things have changed in all different areas. It's not just the hormones, but hormones do play a big role in all of that, right? Definitely, the the drop of estrogen causes us to change our body composition.
We lose muscle mass easier to gain body fat. So, it just becomes a little bit more difficult and and I hear women saying, "Everything I did is not working." Or even some say, "I'm doing more. I'm exercising more. I'm being more cautious about my diet, and it's just not happening." A lot of women feel like they're they're being told like their levels are normal, they're pretty normal, but they're not feeling normal at all. How do we define that?
Yeah, so I think that's a misconception that we going to see it in your blood work, right? But many times, like let's just as an example, perimenopause. We know that estro- the drop of estrogen from premenopause to menopause doesn't go from 500 to zero. It's more of a fluctuating period of 8 to 10 years. So, depending where we check in that time of the month, your levels may be at a different level, right?
So, let's say your estradiol level is normal, that doesn't mean that you're not in perimenopause, that doesn't mean that you're not symptomatic. It only means that at that time, that period of time that we checked, the one point, your levels were normal. They're they're clinical diagnosis and that chemical diagnosis. So, any woman that they tell them, "No, your symptoms are not real because your blood work shows something different," they really have no knowledge of what the hormone physiology is in midlife. Because we know going in there how we feel, and that's what you listen to.
Exactly. That's what you listen to. I want to go back to fat and inflammation and some of the other dangerous kinds of fat. I know you mentioned visceral already. When we talk about fat and we talk about inflammation, can we talk about the difference between those two and how they show up in the body?
So, we have subcutaneous fat that is basically what's under our skin. So, if somebody has liposuction, what they're going to remove is subcutaneous fat, right? That is not a bad fat, that is not a pro-inflammatory type of fat. Then we have intra-abdominal fat, which is inside of the men that attaches to your internal organs, to your liver, to your gut, to your pancreas. That's what we call the bad fat.
Was that one called again? That's visceral fat. Fat. So, this can cause And visceral fat is a pro-inflammatory tissue. So, in that fat tissue in the adipose tissue, there's cytokines, which are inflammatory cells, right?
So, they promote inflammation in your body. This is the fat that can promote different types of cancer because of the constant state of inflammation that the visceral fat is on. Now, if it surrounds your organs, it can lead to in your liver, fatty liver, right? In your gut, in your pancreas, can cause insulin resistance. So, that's the fat that we want to target whenever we're talking about weight loss, we're really targeting visceral fat.
That's why somebody, let's say with that overweight and they have high subcutaneous and high visceral fat, if they go with plastic surgery and they have liposuction, it's not going to touch the visceral fat. So, they're still at risk of disease. So, they'll have the vanity part might be somewhat there. External part, but the metabolic part is not touched. So, how do you target both of those things?
Cuz I know there are a couple different ways. I know there's some new ways and there's a lot to to discuss with it. But, what are some of the ways to start targeting that if you're a woman that whether you're on hormone therapy, I guess or not. Yeah, so two easy changes that don't require any medication and we want to talk about and that first is going to be strength training, right? Building muscle.
The more muscle you have, the more fat you burn for energy. Anywhere in your body, whether you're doing your arms, your legs, anywhere. But you need to build muscle. Resistance training and then strength training, right? That's one.
And the second is your diet. So, increasing protein in your diet is a must and this is for any age, but especially in midlife where we tend to lose more muscle mass, we need to up our protein intake in midlife. I spent years not knowing what was happening to my body. Menopause snuck up Is there one big mistake you see women make when it comes to eating in perimenopause? Under-eating.
I think we all are noticing, like 80 plus percentage of women notice that there's a weight change or a redistribution of fat. And I think it's very tempting to go back to our old 20s, ways and go into this major diet phase where you're just not eating enough nutrients, you're starving yourself, and your cortisol is through the roof. And so, I think when you eat the right foods and you're actually can eat more and feel satisfied, not feel like you're deprived all the time, I think that was like the biggest change. What scientifically happens to your body when you under-eat? When you say, "Okay, I'm just going to have, you know, 1,000 calories today because I'm feeling so bloated." What actually happens to your body?
When you under-eat, you have a rise in [clears throat] cortisol. A lot of people's. Now, everybody's different. For example, for the first few days when you under eat, you'll probably lose a few pounds, right? But if you try to do that chronically, that's when you see your body trying to adapt cuz your body is not going to let you starve yourself to death.
Otherwise, you could just diet yourself to, like, death, right? So, your body has all these counter mechanisms to try to get you to eat. So, any woman who's dieted in her life knows that it that will be increased cravings, that will be fatigue, that will be like you won't expend as much energy because your body's just like, "Okay, we got to save what we have, right?" And then you might like wake up in the middle of the night because your blood sugar's lower, you want to eat, your you dream, you I I don't know if you've ever had this, but you could dream about food. I dream about pizza sometimes. Yeah.
And I But I do it even if I've eaten it, so I don't know. You know you know that if you haven't, and especially if you've gone a long time. I went on this like bodybuilding thing where a lot of people are doing this now, like protein heavy and then you cut. Cut is like where you really cut your calories to kind of show the muscle. And I remember waking up in the morning and I'm like, I dreamt about food all night.
It was so weird. Your body knows that if it doesn't send you these huge red flags. It's like when you're in the wrong relationship and you get these huge red flags and you're like, "Why What's the universe trying to tell me?" The body's trying to tell you to get the proper nutrients. And when you're not doing that, it's going to send you more signals. Is it true that going on too many diets actually messes up your stomach?
I've tried everything, low carb, low FODMAP, keto, and now I feel like my digestion is worse and I can't lose weight no matter what. I do think that diet culture has an impact on our hormones and our eating behaviors. And so, I think going to a diet That's why the 30/33 when I thought about what kind of nutrition advice, I really stayed away from doing something that was like a diet per se. I don't want women have been on too many diets and yes, it does mess with your microbiome. Like you kill all the good gut bacteria when you're not eating say fiber, right?
If you're carnivore, you're not eating all those things. So, staying away from the diet fads is going to be your best friend. The 30-33 tool is in the book. It's what you've created. Can you break that down for me?
You can be on any diet, any restrictions, any you can be vegan, carnivore, paleo. Doesn't require you to buy any special things or blenders or anything. So, I wanted to do something that was like agnostic. Like I wasn't trying to sell you some kind of, you know, product or tell you that you had to buy something. I wanted to do something that everybody could do and you didn't have to do much to change your lifestyle.
So, It's a nutritional tool? It's a nutritional kind of framework that you can use. A nutritional framework to follow. Yes. So, 30 30 g of protein in your first meal. 30 g of fiber throughout the day and three probiotic foods.
So, let's start with the first one. 30 g of protein in your first meal. That means whenever you have that first meal, you're going to have a egg omelet with veggies or you're going to have yogurt parfait or you're going to have a protein shake or you're going to have, you know, something that has 30 g of protein. That is food for your gut. That is signal to your brain to have less cravings. That's evening out your blood sugar and that's setting up your gut for a great day, great decisions.
That's why I say in the AM. Should that happen before coffee? You have coffee No, you can have Dr. Dr. Amy Shah, I need to know when my coffee is around there.
You can have your coffee first thing. I I actually don't subscribe to the fact that, you know, you can't do a fasted workout as a as a woman over 40. I I honestly think everyone's different. Every day is different. Like Timpson, you wake up when you travel and you might be like, "I'm not hungry right now.
I'm just going to eat when 11:00." Great. But the next day you wake up and you're like, "I need to eat first thing." Great. Either way. So there's a lot of there's no rules around when you should eat. The rule for me is that there should be a break between your last meal of the evening and your first meal of the morning.
So meaning that eat an early dinner and then you fast for 12, 14, 16 hours and then you can have your first meal. A lot of women are dealing with belly fat right now, which there's not really weights that you can lift for that. Is that mostly attributed to diet or I mean I I know you just can't do 100 crunches a day and and hope that goes away cuz I've already tried that game. What do you recommend? Yes, so as you said you can't spot treat fat and I think that this is an important clarification to make.
If you feel something burning, people think that it's burning fat in that area. But that's just an accumulation of metabolites of chemicals in the tissue that's causing an uncomfortable sensation. That is not fat melting off right there. So we think like, "Oh, my shoulders are burning like I or my triceps are burning. I'm like burning off my bat wings or like toning, sculpting up my arms." Fat loss happens systemically throughout your whole body mainly due to diet.
However, what we're seeing is that belly fat There's two types of belly fat. There's the subcutaneous fat, which is the kind of the fat that you can see and pinch. And then there's visceral fat, which is the fat that you can't see and pinch, but it's surrounding the organs and may have a slight aesthetic component, right? You might your your midsection might be slightly bigger because of visceral fat. Typically, it's a combination of both.
Typically, it's a combination of subcutaneous fat and visceral fat. Those two are mainly and mostly impacted by diet. So, just a sustained proper diet. But, exercise can also improve how we metabolize fat. When you have more muscle mass, your fat storage goes down.
And this is across your whole body, including in your belly. When we eat carbs or when we eat food, the carbs in our food are broken down into sugar. And that sugar travels throughout your bloodstream to serve different processes of your body. It keeps us moving. It keeps us heart our heart beating.
It keeps us breathing. It improves our brain. All of those things. And then anything left over that the body did not use is either stored in the muscle, in the liver, or stored as fat. We obviously can't increase the size of our liver.
So, that is capped out. We can increase the size of our muscle. When we have more muscle, sugar has more places to go and less of it is stored as fat. So, that's one primary reason why building muscle can have an effect on your fat mass. And it's one of the reason why building muscle can help you maintain a body composition so much easier and feel like you can eat more.
I think it's so encouraging in so many ways and gives you even more reason to be doing that. Yes, absolutely. It There's so many effects that muscle has on your body beyond just like giving you that sculpted look. It really is an investment that will affect you for years to come. Well, how is muscle actually built?
Because I think that sometimes we get that wrong. Can you explain how muscle is actually built? So, muscle is built I think about four primary things. And we can go into detail as much as you want or we can just touch on them high level and then Let's Let's touch on them and then go go down go down if you want to. Yeah.
So, these are the four things that are important. And I do think that when women or or men or anyone focuses on these four things and kind of blocks out all the other things, you will see your body change. You will see muscle development. So, it's reps, r e p s, easy to remember. So, each letter stands for a different component of building muscle.
The r is repetitions. So, getting close to failure in 30 repetitions or less. You can do anywhere from about four repetitions all the way up to six repetitions as long as your last couple reps are to failure or near failure. And failure means your arm is kind of shaky, you can say you can't I just can't do anymore. Yes, failure means you physically cannot complete the rep.
It's not [snorts] burning, it's not shaking because you can continue going through burn and shake. It's hard. It doesn't feel comfortable, but that's not true failure. And that's why a lot of people do Pilates and they confuse the fatigue and the shaking and the burning and the quaking with true failure. Is Pilates getting a bad rap these days?
Or Pilates is polarizing, I would say. What do you mean? Like either you love it or hate it? I think there's so many different facets of this because like the true Pilates people will say mainstream workouts that are marketing themselves as Pilates aren't really Pilates. It's just you're lifting light weights and you're doing combination moves and sweating and whatever.
So, there's that. And I'm not here to argue what is Pilates and what's not Pilates, but I will say that if you were doing high rep workouts, whether that be called Pilates or whether that be called barre or any other type of sculpting, whatever toning workouts, if the reps are too high, even if you are burning and shaking and quaking, but you're not reaching mechanical muscle failure, it's not a very effective or potent stimulus for muscle growth. Got it. So, how to know the difference between if you are burning and your muscles are fatigued, but you're not at true failure is what I call the rest test. So, this is a really valuable tool that anyone can know whether or not you have reached muscular failure in under 30 reps.
After your final rep, let's say you're doing 15 reps of a bicep curl, just to keep it really simple. [snorts] Let's say you do 15 reps. Your final rep is like really slow, really hard. You're like, I cannot physically do another rep. Like, I'm trying and I can't do it. Okay, great.
We're at failure or we're near failure. Set the weights down, shake it off for about 5 seconds, pick up the weights and try to do more reps. If you could do three or more reps, you were just fatigued. You were not at true failure. Oh, that's a great test.
That's a great test. If you were at true failure, your muscles need longer to recover. Your muscles need at least a minute to recover before they can physically do more reps. So, you would not have been able to even get those weights moving at all. No.
And studies show you don't have to get all the way to failure, you just have to get close. So, you have to get one to three reps shy. Okay. So, what's the E in reps? So, E is exercise selection.
And this is another thing that I think people get wrong. Choose really simple exercises that target one muscle group at a time. We try to do too much in one single exercise. I'm working my glutes and my shoulders and my abs all at the same time. And the problem with that is if we go back to the R, you're not actually getting back You're not actually getting to muscular failure in any of those muscle groups because you're going to be stopped by the weakest link.
You're stopped by your your shoulder or if you're stopped by your abs or you're stopped because you're shaking and quaking. You're not stopped by true muscular failure. So, exercise selection is the E. P is protein. So, I'm sure you've had many guests talk about protein.
A lot about protein here, but I feel like we can't talk about it enough because we didn't talk about it for a long time. We talked about calories and we talked about fat and we talked about all sorts of other things and the protein conversation, you know, there's a lot of it going on, but I I think it's always important. It's so funny cuz every macronutrient has like had its moment. It has. Oh, please.
We've lived through all of them. Yeah. We're protein right now. We're going into fiber. Fiber's here.
Right. Fiber's next. Fiber's next. But protein is important because you have the stimulus in your workout, but then you need the building blocks to build the tissue back. So, registered dietitians typically recommend 0.75 to 1 g of protein per pound of body weight per day.
And that can be what's called ideal body weight. So, let's say you just have your goal body weight and you can go based on that instead of your current weight. And then that's the P. And S is structure. Again, this is something that people get wrong all the time.
We throw spaghetti at the wall and we're surprised when our body isn't changing. Your body needs specific signals continuously and enough recovery in order to change and adapt. So, I think work each muscle group in your body, so your quads, your glutes, your shoulders, your chest, your back, one to two times per week on non-consecutive days. Make sure that you're giving muscle groups 48 hours of recovery in between. What we do is we work our glutes and then we work on Monday and then we work them again on Tuesday and then again on Wednesday.
And that doesn't create adaptation or change in your body. The stimulus is from your workouts is what triggers the cascade of effects. It's the light switch that turns things on, but recovery is the repair process and recovery is where we actually build muscle. Give me a week that would be that makes sense. So, you've got Monday you're going to work back and shoulders, Tuesday, you know, can you give me that kind of week so we can so people can hear that?
So, I recommend lifting three, four, or five times per week and you can divide up the muscle work however you want. If you're doing three workouts, you would do three full body workouts. Now, you don't have to work every single muscle group in each workout. So, let's say Monday you've got glutes, quads, chest, back, shoulders and then you take a recovery day on Tuesday. And then Wednesday maybe you're hitting abs, glutes again, shoulders, quads, whatever.
Another recovery day and then Friday you're hitting all the muscle groups that you hadn't worked and then maybe one or two other ones so that you're getting for the most part you're hitting each muscle group at least once and many of them twice. What did that year look like? I'm curious what that looks like in terms of workouts and then if you've got somebody that's if there's a woman listening right now that's like I've never even lifted any weights or been to the gym. I don't even know what you guys are talking about with with some of these exercises. Where do you start with that because I think that's really important that we talk to those women too cuz it can feel it can feel intimidating really.
Absolutely. I think a couple of things that I want to hit on there. So first with the intimidation thing. I think that we're hearing right now you have to lift super heavy and you have to get underneath a barbell and you have to do all these things. And a lot of women are like wait a second.
I've been doing bar classes for three decades or cardio for three decades. I'm not ready to go get underneath a heavy barbell like that and hurt myself or whatever and or I don't want to go into the gym. I don't know what to do. I'm afraid. You can build muscle from home with dumbbells and you don't have to lift super heavy like we talked about.
You can lift anywhere in that four to 30 rep range and as long as your last rep is to failure or near failure, that will be just as effective as if you were underneath a heavy barbell. So I think That's so encouraging to hear. And when you're talking about lifting weights at home, what kind of weights are we talking about? I use anywhere from I think my lowest weight right now is like 8 lb and then my heaviest weight is 50 lb. But I've worked up to that.
Going to say yeah, you're different but yes. Okay. All right, but that's encouraging. But I recommend just buying a weighted rack of 5 lb to 25 lb or 30 lb and starting there. And you can build a lot of muscle with just that and that can get you through that first year of body recomposition.
Now, what's really cool is that you'll have to buy heavier weights as you get stronger but it's almost like fun like to go on Amazon and I'm I'm ready for a heavier weight like it's fun. It's like really exciting to do that. Yeah, exactly. I'm all grown up in the A lot of women, you know, I talk a lot about menopause, perimenopause. There's a lot of frustration about belly fat, weight distribution, feeling different.
Maybe somebody that wouldn't come see you 10 years ago is sitting in your office today because they cannot manage that and and feel different. And I think there's a lot of other things that, you know, come with it, thyroid issues, all sorts of stuff that happen as you hit midlife and especially menopause. Are you seeing a lot more women in menopause talking about this, taking it alongside hormone therapy, realizing hormone therapy might not do it itself and they need something else? Yes. And I what I also do see is people come to me thinking that a GLP-1 will fix everything in menopause and I'm like, "Mhm." Like it will fix a lot.
It doesn't It doesn't fix hot flashes. Exactly. Or sleep. So, they are being used in tandem a lot more now. And can they can be used in tandem with it?
Yes. Yes. I think that it's wonderful to use these medications in menopause. I think where it gets tricky is someone who's very, very lean and then puts on a little bit of belly fat. They don't feel like themselves and they don't fit into their last size of pants.
There is a question of do we need to use this here? I the jury's out, really. I think we really need to study this population. I'm I'm I'm laughing because I'm telling this to you. You're like, "Yes.
Nobody studies this population." Please. I'm begging you. I agree with you. And so what what is the answer to that? Because I I will tell you that I talked to my doctor and I said, "Listen, the belly fat's not going away.
I'm not fitting in anything. I feel Everything feels tight and awful. And is it 5 lb? Is it 10 lb? Whatever it is, I just feel it." I do feel it.
Yes. And that was the answer to me and I said, "Oh, I don't know if that is that for me?" So, so how do you distinguish somebody that should go on GLP-1s that's in menopause and dealing with 10 lb, 15 lb, or somebody that is really at risk in terms of people you have studied and worked with? Two things. Labs. Lab has become crucial.
One of the things that happens in peri- and menopause is insulin resistance. Mhm. Insulin resistance, talk a lot about it in the book. Is the main driver of weight gain. Mhm.
And insulin resistance leads to significant disease. So, we need to be looking for that and it's often very much overlooked. So, hemoglobin A1C is a predictor of diabetes or it's it's the marker for diabetes, average blood sugar. By the time you get to an elevated hemoglobin A1C prediabetes, you've had insulin resistance for a long time. So, we need to look at the level before full-blown insulin resistance.
We need to look at early insulin resistance. And so, if that's present, that says something to me. We do need to be looking at things like thyroid. We need to be looking at overall metabolic health. The other thing is body fat.
Okay. This, we are behind the times on looking at body fat as a measure of of optimal metabolic health and using it as a screening tool instead of BMI. BMI is easy, it is cheap, it is a good screening tool. I'm not going to throw it under the bus. People hate it, but it height and weight.
Body fat. Now, that is a lot more complicated to get and I talk about all the ways to test that in the book. And there are some more affordable options. That's where we need to start going. And that, if we have a body fat percentage that is creeping up in menopause, we know that that is not going to bode well for longevity and health.
And so, maybe it's time to have a more nuanced conversation about the use of these medications. For a woman in in menopause, what is that body fat ratio percentage? So, So, there are many levels of what we consider from fitness. We want a body fat percentage under 30% for women. All right.
So, under 30%. If you saw somebody come into your office over over 30%, 35%, you would say, "Here's what I suggest, GLP-1." resistance. You have metabolic syndrome. And it depends on maybe where you started, too. So, if you're telling me that you went from a body fat percentage of 26 to 15 would be We were talking There are some women though that are saying when I was 26 years old, this is what I was and this is where I am today.
So, help. Well, look at 36. Let's maybe not go back as far as 26, but having a predictive body fat percentage and then if there's a significant gain of body fat, that also signals to me and this is This is the hard one, but strength training needs to be part of our education from a very, very young age and we need to stop looking at exercise for thinness because it doesn't actually work and instead looking at making us all strong and looking at body fat percentage. I know you mentioned this time of life and a lot of things all happening at the same time and I think you we talked about lack of sleep causing weight changes, but also stress. How does stress affect our weight?
So, stress, chronic stress, puts our body in a chronic flight response mood or moment and this can increase your cortisol levels chronically, right? We have a a pathological disease called Cushing's disease or Cushing disorder where our body is making too much cortisol, right? That is usually treated with surgery. This is very different than from what I'm talking of just chronic elevated levels of cortisol from chronic stress. But, it's it still can have effects in our body.
So, chronic stress with chronic elevated cortisol can promote weight gain. Right. Do you see that all Is that all over or is that mainly More centrally, again, yeah. So, if you're not sleeping, you're going to gain weight. If you're not sleeping, you're not going to build muscle.
So, everything that you do, even if you're eating properly, if you're exercising properly, even if you're taking a GLP-1, your hormones, if you're not sleeping, that can promote waking anyhow. It's so shocking that sleep was never a priority, ever. Like Like never. It is shocking, and for many people is still not. It's not, right?
Many people accept that, oh, no, I don't sleep, or or a lot of stuff is going on my life, and I don't need to sleep, or like they take it and accepted it, but it can spill into every aspect of your life. So, for me, priority for all my patients, for whatever reason they're coming to see me, is that they sleep. Yeah. And how many hours is that? Eight plus?
Seven to eight hours. Seven to eight. Yeah, nine hours is kind of hard. Seven Seven to eight hours is more enough, but the quality of the sleep, too, right? That is continuous sleep.
Not getting up in the middle of the night. Exactly. Up, sleeping down, naps, and all that stuff. Cortisol, can you lower your cortisol? If you can lower your stress, right?
So, that's Do you have Do you have a Do you have a plan for that? Definitely. I mean, exercise is one. Why would exercise your stress levels decrease? Sleeping better, right?
Meditation, yoga, Pilates, and then trying to see what in your life you can modify to decrease the level of stress. I think that, you know, we go We sometimes go and we learn about all these things, and they feel like more stress to us because we know we have to tackle them, but it's funny that it most of it comes back to the basics at the end of the day. To the basics. Whether it's, you know, insulin resistance or thyroid. I do want to talk about the thyroid quickly, and I know we we touched on it just a little bit.
It's the little butterfly-shaped Right right in here somewhere. I'm trying not to look for it just in case I have something. What do doctors miss when it comes to thyroid? Is there something in particular they miss when looking at that? Are those traditionally just blood levels?
I I think, [snorts] to be honest, I think it's quite the opposite. I think we tend to attribute many things to the thyroid. I feel like now that we're talking about hormone replacement therapy, now that we have GLP-1, the gland that is having a ball is the thyroid, probably, that is like, finally, they're leaving me alone. Because everything that happens is a thyroid, right? You gain weight, it's a thyroid.
I'm not I don't feel great, I feel tired, the thyroid. I think we attribute too many things to the thyroid that that are that can be easily explained and that they're true being caused by other things, right? Such as? Such as midlife, waking, life itself, right? Or or something else.
I think if if we concentrate just on the thyroid thinking as such, we may be missing something else that is treatable and that it may be very important in health. Nine out of 10 times, it's not the thyroid. Really? Oh, so it's stress and we're trying to It's It's life. It's our the environment, genetics, hormones, aging, right?
That's amazing, nine out of 10. Nine out of 10 times that I see patients coming attributing symptoms to the thyroid, it's not the thyroid. And it's okay. Okay. It's okay.
Thank you all so much for listening. I hope you took something out of today that you can actually use. I cannot wait to hear what you think, so leave a comment or review and let me know. It means the world to me and the team behind the scenes here. We are building this next chapter together and I promise you the best is still ahead.
Love all of you and we'll talk in the next episode.
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