Coffee, Menopause Education, A Tiny Rant and A Big Apology

hi everybody good morning it's Dr Mary Claire Haver and I have spent the last couple of hours writing for the new menopause the new book I'm creating um to help my followers and patients navigate this menopause journey in the healthiest way possible and um so I'm taking a break a mental break because the research is thick um and I thought you know what let me con come on live answer some questions the recent chapter I've been working on is about abnormal lipids and elevations in cholesterol and how that relates to menopause so if anyone would like to discuss that just drop your questions in the um comments below and um let's see and also Vonda is watching Dr Vonda Wright hey do you want to go live with me are you still here um she is an orthopedic surgeon who's a Mobility specialist and does a lot of incredible education around the changes of our musculoskeletal system associated with menopause including osteoporosis and musculoskeletal pain and what we can do about it from a practical standpoint and not end up in her or with a hip fracture and so um Vonda if you are there drop me a comment and let's see and let's go live together request to join hang on for a second all right how to get a doctor to understand this and get off statins so there are absolute definite things that you can do to help your cholesterol outside of statins so one of the things and I'm not saying that you never need to go on a Statin but statins for women do not crease your risk of death from cardiovascular disease they just lower your cholesterol levels make sure you understand that um so um the women who hear trends that we know from a nutritional standpoint on this is just what I was writing in this chapter on what you can do to decrease your risk of having cholesterol elevations in a level that is going to put you at increased risk for cardiovascular disease so not all elevations of cholesterol are linked to cardiovascular disease risk and so number one the lower your vitamin D the higher the level of the LDL cholesterol so 80 85 percent of my patients and at least 60 to 80 percent of all menopausal women have very low vitamin D levels and there's multiple reasons for that so vitamin D supplementation is one of the things that I do recommend for almost everyone I check a vitamin D level of serum vitamin D level um on absolutely all of my patients who come in it is that important it is involved in multiple it is an enzyme and is involved I mean a hormone and it is involved in multiple enzymatic processes through the body to promote health so if you have don't know your vitamin D numbers um you can probably safely give yourself over-the-counter vitamin D um up to like four to five thousand I use per day so for my patients I formulated a vitamin D I'll show you I'm going into my pantry right now to grab it so here is one example if you are taking one that has the same stuff in it fine okay I'm not here to sell you this just to talk about so this has omega-3 which is another important so diets rich in omega-3 fatty acids so rich in foods that contain omega-3 or supplementation have much more cholesterol levels D3 levels that are excuse me um LDL levels that are less likely to be associated with increased cardiovascular disease risk so the other is a diet rich in probiotics now I have not formulated a probiotic those are a little tricky for my patients if you're eating something rich in probiotics every day kombucha miso yogurt uh but be careful they can put a lot of stuff in yogurt that'll take away the healthy parts of it then you don't need a probiotic supplement you're getting it through food I mean most of your nutrients should come from food we only supplement when there's a gap so most of us have a gap in D3 if you can't take your you know if you're Dairy allergic or dairy sensitive and you can't do yogurt every day and you don't have a great source you know I don't like kombucha or I don't eat a lot of the things that are rich in probiotics naturally um so I do take a probiotic supplement omega-3 I try to get as much fatty fish in my diet as I can but right now I'm landlocked I'm in Colorado not easy to do and so you know I do combine these two together and the K is for increased absorption so um yes so it's I'm sorry it's backwards but it's a three DNK so anyway if you're already taking that great keep doing what you're doing you can take probably up to four thousand a day but over that you really need to get your levels checked because there can be toxicity with vitamin D so so the big nutritional things and the other one is berberine if you're going to do a berberine supplement you want to do something that is liposomal liposomal berberine when I have patients who come in with elevated cholesterol and we've done you know I'm like they're already getting this in my office so that's that's done but then I'm telling them to go find a liposomal bermarine to help bring that cholesterol level down um and a Diet that's rich in antioxidants naturally so you know those of you who follow me know I talk a lot about an anti-inflammatory diet and that is basically avoiding things that are very pro-inflammatory and that can look like different things to different people and filling your diet full of things that are naturally anti-inflammatory nuts seeds legumes you know probiotics you know foods rich and probiotics foods rich and vitamin D food leafy greens vegetables fruits um so um I'm just reading the question so I found one from a berberine that I'm going to try I've just ordered it from so active um I don't I have borderline cholesterol it's not bad at all it runs in my family so even with perfect nutrition some women are going to struggle it and then of course hormone replacement therapy does help okay it's better at prevention than at helping to reverse and and you know estrogen is a powerful antioxidant in your bloodstream and women who are on HRT have less atherosclerotic plaques we've known this okay especially if they start early so you know all things to consider when you are considering hormone replacement therapy so um uh couldn't handle progesterone so there is there's a an HRT option called duavi d-u-a-v-e-e it is you know something you have to get my prescription and it does not have progesterone in it but it is protective for the lining of the uterus it has something called it starts with a Biz b-e-z B something um and and forgive me for not knowing it off the top of my head because I rarely prescribe it most of my patients can take progesterone do really well in it but it's not for everyone and so that is something I reserve for someone who is not tolerating progesterone at all and they still need the estrogen so we'll give them the Dew of e option there so in my clinical practice okay how do you know what dose of estradiol to do you got the patch so the patch is one of my favorite ways it's cheap it is effective I know that 93 chance of what they say is in the patches in the patch most people tolerate it well not all and so it depends how badly so if you have severe symptoms like a severe hot flashes all that I will start at a higher dose if you are early in your perimenopause journey I will start at a lower dose if you you know I it's it's a lot of trial and error again one size does not fit all for hormone replacement therapy and you have to be patient your doctor has to be willing to go there with you and realize that it may take some tweaking um to understand what dose is going to work better for you um Chimera Pro is has the progesterone built into it's not my favorite um I'm pretty sure it's the pro is Provera which is medroxy progesterone acetate when you know the studies were stratified in France looking at Breast Cancer Association with the type of progestin that women were taking the mpa had the highest risk and oral micronized progesterone had no risk so I rarely prescribed climera Pro or prime Pro though it does work and you get the benefits but it is a little more risky as far as possible association with breast cancer so for most of my patients I do a generic estradiol patch with the oral micronized progesterone again no one's paying me to say this I make no money by giving you this information you know I do make money off of this but whatever you do you go find one that works for you um let's see thank you for all your knowledge and experience you're so welcome um uh okay I just answered that question what about wild Liam's you can eat all the yams you want that's great yams are healthy they have lots of fiber they're a phytoestrogen but um as someone's prescribing you a wild yum cream there's no evidence to support its use it doesn't have it's it it just no I wouldn't do it guys it's not it's not safe it's not going to protect the lining of your uterus bless your heart um your doctor said you can't start hormone replacement therapy until you're in full menopause that is not true that is absolutely a misunderstanding that is misinformation and miseducation and I apologize on behalf of the medical system for that you do not have to be in full menopause to begin hormone therapy you do not have to wait and suffer unnecessarily for seven to ten years until your period stops before you are a candidate for hormone therapy the minute you have the first recognizable clinical symptom of perimenopause you can start hormone replacement therapy and benefit from it okay um so um let's see you are 52 on hormone replacement therapy and just got diagnosed with high blood pressure so well-controlled hypertension on medication is not a contraindication hormone replacement therapy if you are on only oral estrogen not transdermal not transmucosal has been associated with elevated blood pressure risk Okay so switch so if any of you are on oral and suffering from you know blood clot risks or you need to not be on an oral form okay not all estrogens are ew ready uh we got on the wrong side of this live there's some um somebody blocked that lady um okay I'm going so if you have questions we have the little question never had high cholesterol in your life and you do eat well exercise your gyne refuse to acknowledge you need HRT what can you do so you're gonna have to find a new provider there's no getting around this um and it can be tricky to find a menopause educated menopause friendly menopause you know for better for so many of us our OB gyns were amazing at delivering babies did great middle you know early life care took care of our kids all that and then all of a sudden once your reproductive life is over they tend to be clueless because they're not trained OB GYN traditional menopause training is severely lacking and there's a lot of misunderstanding that goes along with that so I would try to find someone we have a list of providers on our website that have been recommended by my followers I get no money for this okay I'm going to begin to train healthcare providers in kind of my way of doing things so get ready for that and then the menopause Society it's menopause.org has a list of certified providers on their website that at least have taken their certification course doesn't mean that they're perfect doesn't mean they're going to absolutely give HRT I have a whole guide on my website on how to prepare yourself for your visit for hormone replacement therapy the questions to ask what I have the Articles to bring in and hand to the healthcare provider because you may be educating them that is all for free and it's all on my website under the blogs at galvestondiet.com I have tremendous amount of Education in my blogs all free go and check it out um I just wrote the chapter on heart palpitations why they are increased in menopause why they happen and the things that you can do about it um let's see your pain is unreal unbearable bless your heart bless your heart bless your heart um so if it's pain due to vaginal atrophy vaginal estrogen is your best friend that is the gold standard that is where you need to start skip out I mean you still probably need lubricants I'm a huge fan and hyaluronic acid but the root cause is that vaginal atrophy and pain is the lack of estrogen and we need to get that back in your system to help you so um let's see uh estrogen does and most women does tend to lower the lipid profile I'm reading questions guys hang on so please drop your questions in the question segment down here below um and um hang on one second okay can you stay on an estrogen patch at 64 with coronary artery disease that's a little bit tricky so if you have been on estradiol and you're doing well in your 60s and you have no evidence of cardiovascular disease we don't have and you don't have a contraindication we don't have a compelling reason to take you off okay however with women with existing coronary artery disease you have atherosclerotic plaques your yoursterio level is higher you've had a heart attack systemic estradiol especially oral can make that worse so this is an intense conversation with a menopause friendly cardiologist who really understands how estrogen works in the body and I cannot tell you at 64 with coronary artery disease that estrogen is of benefit to you right now remember any medication any intervention that you do has risks and benefits that are individual to you and for some of you this requires an intense conversation so like for me I by the grace of God was able to start hormone replacement therapy well before any of these disease processes started and I am not going to take that patch off until I have a contraindication and if death comes before that I will die with my estrogen patch on there's too many benefits for me but I cannot say that for everyone I have intense conversations I spend an hour with every single new menopause patient going through the risks and benefits of this and I hope you can find a menopause provider that will do the same for you um I would never ever ever prescribe a compounded progesterone cream if any of you are being prescribed a compounded progesterone cream you are not getting enough the molecule and progesterone is huge and it does not pass through the skin well okay so it's never been shown to get to blood levels high enough to protect the lining of your uterus from endometrial hyperplasia or cancer the reason the number one reason we give progesterone to a woman in menopause with the uterus is to keep her from developing endometrial hyperplasia and cancer and transdermal progesterone in the form of compounded has never been shown to be effective now the combi patch and the and the climera pro those FDA approved ones yes those are fine I have other issues with those with breast cancer so I am literally do not if someone is giving you a transdermal compounded progesterone you're not getting protection of your endometrium and I can show you multiple studies to document this I have no Financial benefit of saying this and I am not trying to scare you but there are people out there who don't know what they're doing okay and God bless you okay um all right how can your provider know if your heart palpitations or anxiety or pre-menopause um that's a tough one and so the perimenopausal palpitations are almost a diagnosis of exclusion a lot of women think that they're having anxiety or the anxiety is getting worse because they're having palpitations that is a difficult thing to entangle and we never may get to the bottom of it okay um um okay uh let's see um so I'm reading the questions in the little question box down below if you have a uterus and a Mirena IUD do you still need progesterone going on estradiol no for the protection of the lining of the uterus the Mirena or progestin containing iuds are all that you need I do have a few patients you've had a hysterectomy or have a Mirena that are still struggling with sleep even with good HRT still having a little bit of racing thoughts at nights and some anxiety and progesterone oral micronized progesterone can be protective so there are some women who are benefiting from progesterone outside of the protection of the lining of the uterus hope you're following that again can androgenic alopecia get worse on HRT certainly if you're taking testosterone absolutely yes but estrogen tends to make that better if it's androgenic uh hair loss so um is your fiber okay if allergic to grains no we have several grains in the Galveston diet fiber we wanted to have a source of grains outside of just psyllium husk we wanted to have and so we do have Amarth and so read on the back of the package to see if you are specifically allergic to certain grains but if you're allergic to all grains you don't want to use our fiber that's not going to be your best bet let's see wood would a patient who had a 50-year post hysterectomy and a 40 percent risk of breast cancer family in atibia so absolutely estrogen alone does not cause breast cancer I hope you guys realize this it might feed a pre-existing breast cancer we know that but it does not cause breast cancer your estrogen levels are highest in your life in your 20s and 30s and when you're pregnant there are five times your Baseline level when you're pregnant you don't get breast cancer it's rare it can happen but you know pregnant women don't get breast cancer as a rule right estrogen does not cause breast cancer it can feed a breast cancer there is a difference and so family history of breast cancer and even genetic mutations does not exclude you from especially if you've had hysterectomy in the Whi it was medroxyprogesterone acetate that causes the breast cancer you know that was linked to the increased risk of breast cancer the women who were on estrogen alone actually had a decreased risk of breast cancer so much misinformation out there so um let's see I'm reading questions guys as fast as I can uh okay put them in the little question box what about taking the probiotic Karma drink I have no idea I don't know anything about that drink but you know probiotics are great try to get them from food supplement when you can I get my probiotics mostly from yogurt I take a probiotic supplement on in the form of a pill that works for me on the days that I'm not having yogurt um let's see can you eat grapefruit while on HRT I got a couple in my fridge right now it's not hurting me so um rheumatoid arthritis is not a contraindication to hormone replacement therapy if you're being told you can't take hormone you shouldn't take oral you should only do transdermal or transmucosal that's it okay um I don't know what an estrogen diet is so I'm sorry you're asking me about an estrogen diet and that is not you know I wrote a whole book on menopause and nutrition and wellness and lifestyle in the Galveston diet and I've never heard of an estrogen diet so I I'm not exactly sure what you were referring to when is it too late to ate to take HRT when the risks outweigh the benefits the end and that is going to mean different things to different people so when is it too late to HRT when the risks outweigh the benefits the end okay um Jen said no to copy patch because the progesterone is synthetic the progesterone Combi patch is synthetic I you a couple of my patients take it it is not my first line it is not my first choice um if you're taking estradiol and you have a uterus and you are not taking Progesterone in an oral form you are running the risk of endometrial hyperplasia in cancer your provider should have known this that is malpractice if anyone has given you estrogen without progesterone and you still own a uterus you do not have a Mirena IUD that is malpractice that is a lawsuit because they're they're deliberately putting you up because either they don't understand or they don't know enough or they're trying to get into the menopause game without really understanding the medical implications of what they're recommending um you do not have to stop hormone replacement therapy at a particular age never there's no age at which you must stop it is when the personal benefits risks outweigh the benefits that is when we stop that's it okay um what do I think about biased I don't know why people prescribe is or Trieste that's a compounding thing there are no studies there are no randomized control studies versus placebo on biased and tris they're giving you astrone and estriol as well as estradiol estradiol is what your ovaries made that's what you're always make I'm just giving you back the water you were drinking estrone is what is peripherally converted in fat cells from you know from androgens and estriol is what we make in pregnancy why someone would give you a fat storage hormone or a pregnancy hormone is not well studied and there's not enough evidence for me to recommend that my license and my reputation is on the line here when I say these things out loud on the internet and to date there is not enough evidence to support me recommending giving those the end so um viosa vieoza works viosa is 550 wholesale per month that's what I think about it I think this is a it does not work as well as estrogen and for the rare patient who as an absolute contraindication to estradiol which is rare yozo could be a great option but no one can afford it okay 550 550 a month that is big Pharma I you know I hate to demonize all big Pharma but to me that is not somebody else to try to help you that is somebody else to make money off of you and demonize estradiol to make you take their product that should be illegal illegal um trust me it cost him 20 cents to make that medication I promise they're doing it with insulin they're doing it with with the um the freaking as uh epipens the cost of an EpiPen that is life-saving and they're charging hundreds of dollars for an EpiPen I mean that should Congress is trying to make that stuff illegal I mean look drug companies they're not perfect they're trying to make money um let's see okay so let's review the cholesterol stuff again remember HRT goes a long way but check your vitamin D level the higher your symptoms your um your vitamin D the lower your cholesterol tends to be the higher your dietary intake of omega-3 fatty acids the lower your cholesterol tends to be okay the higher your intake of dietary probiotics the lower your cholesterol tends to be and I can't say enough about berberine here okay I would do all of that before I tried a Statin because statins have not been shown to decrease the risk of death from cardiovascular disease hormone replacement therapy has absolutely true and Men it has but we're not men we're not men and yes I'm in my pajamas and we're all having coffee together okay um I'm going back to the questions drop your questions in the little question box down here below um okay let's see let's see I'm reading the questions guys give me a second I do not have any information about CMOS and menopause um the Galveston diet okay will hormone uh will hormone replacement therapy help with losing belly fat Okay um will hormone replacement therapy help with losing belly fat women who are on HRT have less visceral fat accumulation than women who are not so in order to lose so to stop the shunting of fat to the viscera HRT can can help attenuate that but you still have to do the work you still have to change your diet you still have to change your exercise habits we cannot get around that when I talk about menopause care with my patients it's not I wish I wish there was one pill that I could just give everyone HRT and they go off into the sunset and be 25 forever okay HRT is a poor substitute for our 25 year old ovaries I hope you guys realize that there are things in my own life that are not better even with HRT I still don't sleep like I used to I cannot tolerate alcohol like I used to my joint pain is better but it's not perfect okay I have to do the things I have to do the work so when I talk about menopause care it is a tool kit that works synergistically together hormone replacement therapy and other pharmacology is just one part of the kit okay it's like like those caboodles when we were kids you know you put all your makeup in and stuff your hair stuff and um nutrition should be the number one thing nutrition okay and I had to go back to school to understand this and really learn because they didn't teach me in med school all right nutrition nutrition nutrition in the form of food not supplements okay nutrition number one an anti-inflammatory pattern of eating that is consistent consistently avoiding things that we know promote inflammation that's all part of the Galveston diet I wrote a whole book about it you can go read it there's an online program it's all that information is available on my website all right number two movement you must move your body stop focusing on cardio do more resistance training you should be lifting weights you should be pushing and pulling things that are heavier than you you should be consistently trying to do that on a three to four times a week basis because the our muscle mass determines our longevity and strength and functionality and resistance to disease and diabetes as we get older no way around it and aging and menopause are stripping away our muscle and calorie restrictive diets are stripping away our muscle we are seeing dramatic protein losses in taking certain medications for weight loss be very very careful that when you look at taking any medication you are looking at the risk and benefit profile for you guys stop focusing on the number on the scale as a measure of your health stop it's not doing you any favors I used to have the most ridiculous number I did it I did it for years my social currency my value of myself of my health was always that I was thin I know so many of us have done that and I eroded my long-term Health by not focusing on my muscle mass when I was a kid and when I was younger when I go back and I could tell 25 year old and 35 year old Mary Claire get stop it stop trying to be skinny stop you're not doing anything you're not doing anything to promote your long-term Health you're gonna end up like your mom okay who cannot watch she's walking with a Walker okay she's miserable in her body and I don't want to be that and by me just focusing on a stupid number on the scale which means nothing doesn't talk to me about muscle doesn't talk to me about where my fat is or what type of fat that I have so it's just we're not helping ourselves we're not to do this unrealistic gain when you looked at the supermodels on the cover of Vogue everybody saw it's been all over my social media of Cindy Crawford and Naomi Campbell and and Chris Turlington and Linda Evangelista absolutely gorgeous right they were photoshopped to near Oblivion okay now look at the Vogue covers of all these men in the last two or three years who are 50-ish okay not photoshopped craggy lines they looked rugged they looked handsome why why are we having these unrealistic ideals it's it's not helping our long-term health and so stop focusing on the number on the scale and what that means to your health it means nothing to your health think about your muscle mass your functionality your longevity I can't tell you how many women come to my office now I have a body scanner that measures muscle mass and visceral fat and I get to look at a woman who has beaten herself up for 10 15 years thinking that she had to get to a number that was 20 30 40 pounds away and I'm like you are carrying more muscle on this body than 80 percent of the women out there you you are strong you are healthy I will try I will take 10 of your pounds of body fat and trade you I'll up you this and trade you that and we laugh about it because this is what's important to me when patients come to my office and they are like I just want to be skinny and it happens it's not not that often I had to completely redirect the conversation and re-educate them as to what is healthy and what do they want but when the patient comes in and she said listen I don't want to be my aunts and my mother they're not happy they're not functioning I want to climb a mountain at 80. I want to be running that Marathon or whatever you know I'm not running more marathons trust me um I want to not have my children my loved ones worrying about my health worrying about my functionality worrying about my longevity we're all gonna die okay but watching my parents other people's parents that generation suffer so horribly and the last 10 years of their life with chronic illness and disease no thanks I am doing everything in my possible and creating plans for my patients to get them to that I weigh right now it's 129 pounds this morning okay 117 used to be my goal that was rocking the house I look like a skeleton I had no muscle mass and I weigh more now than I did when I started the Galveston diet because I felt like I was gaining too much weight with menopause and yes I did decrease my visceral fat and that's great but the moist that I have gained is muscle is muscle thank God and it's so freaking hard I'm constantly chasing protein now I'm constantly thinking about muscle mass I'm constantly having to battle a war in my head about cardio versus muscle training because I still live by those you know 40 hard years of trying to be thin and now trying to be strong it's tough It's Not Easy every day and so okay I'm gonna go back to the questions all right sorry for my rant but y'all are all still here estradiol is considered hormone replacement therapy yes um you had a hysterectomy and still have ovaries what hormone replacement therapy options are available and is midi Health a good option so there has been an explosion of Telehealth options for you guys for menopause hormone therapy now these are businesses okay I have a business full disclosure so there are there is a gap in what is available for menopause hormone replacement therapy and the education of our OB gyns we did this to ourselves our American College of OB gen is down this to ourselves so this has been recognized as a problem and now with the uh since the explosion of telemedicine since covid some very Savvy business people were like hey women need HRT they're not able to get it through the traditional routes what can we do to help so several companies several have exploded I have looked at multiple have talked to their medical directors you know I don't make any they don't pay me to say this I there are some that I believe in their Mantra I've looked at their protocols I think they're following guidelines and I wholeheartedly recommend them there are some I would not go near with a 10-foot pole but because of lawsuits I don't talk about them so if I don't mention them then believe me I've looked at all of them I would not use them so here's who I recommend you guys ready midi health midi Health not being paid to say this they don't send me any free stuff I talk to them all the time I do nutritional counseling for their followers or whatever um for their Healthcare Providers I talk about the Galveston diet and how nutrition and menopause interact okay so many Health midi takes insurance I love that for them it is like a traditional doctor's visit you meet with your health care provider through telemedicine they have some questionnaires you don't need blood work to diagnose menopause by the way you don't you might sometimes but you don't have to for most people okay then they make recommendations they give you a regular prescription that is sent to your Pharmacy and you go pick it up just like traditional medicine okay love that for them they take insurance they're not in every state yet but they're getting there they're also starting to work with these big Healthcare institutions our big um Hospital Systems to offer menopause care for their um constituents whatever I'm really loving kind of where they're going with us they're really expanding menopause care so midi Health go check them out there's two others I would recommend ever now and um alloy Health okay so ever now and alloy Health operate a little bit differently they're more like a pharmacy they have FDA approved options that they sell through their own Pharmacy and that they send to you from their Pharmacy so you basically you pay for the prescriptions as your visit and you go into a subscription for your prescriptions you just pay every month or whatever their policies are and so I would definitely recommend those because I like what they offer I like where they're going with it and they're very very very affordable I feel like they are a price point where the basic person could afford it so ever now and alloy Health are the two non-insurance takers okay and then midi Health if I don't mention another company there's a reason and I'm just going to leave it at that like they don't follow evidence like they're just trying to sell you a bunch of okay now I'm getting caddy and I'm trying to be taste I already took a video down because I got a little icky this morning um so okay great question vintage is it okay to take nothing while going through menopause absolutely that's your decision but I want you to make that decision to not take hormone replacement therapy based on facts and not fear okay there are risks to taking hormone replacement therapy we all know this there are tremendous risks to not taking hormone replacement therapy and I want to make sure that's what my book is about that you walk into these appointments you walk into this perimenopause Journey completely prepared with the facts as far as I can understand and share them with it so um so that what's in my coffee cup black coffee baby that's it I'm just drinking my coffee I'm fasting so you know part of the Galveston diet fasting really works for me it's not for everyone but it works for most I do it for the anti-inflammatory and for the autophagy and for the little bit of stress it puts on my system therefore my body creates more resilience to disease it decreases my visceral fat and I'm a big fan of it it's all in the Galveston diet you can go read it um so but I'm just drinking my coffee while I fast today I'm going to do resistance training I have my app all ready to go because I'm not in my home I'm not in Texas I'm in Colorado and my other home and um my trainer who's in Texas sends me a little workout through our app and I go do it and then I'm going to do my hot core walk if those of you follow me so I have a Four Mile Loop that I do uh here in the mountains and it's on pavement most of it and so um it's this beautiful Loop and I can look at all the bajillion houses out here and the mountains and I put on my music and I rock out and um so that is one of my favorite workouts that I do and it's kind of my it's also I use it for self-care I do a lot of thinking on my walk I plan out what I'm going to say to you guys and um okay so everybody take a second and like this video share this video if you think it would be helpful to someone it will there's Tatiana there's my trainer morning I'm gonna be doing our workout soon um so go check her out she's amazing it's Tatiana she'll jump in here in a second um the nams website is a decent place it's not perfect to find a menopause friendly healthcare provider so North America menopause Society it's now rebranded to the menopause Society but it's menopause.org um the title of my book is not out yet but it's the new menopause it'll be coming out uh yes I will be saving this accidentally turn on Insta and here I am that's my trainer okay um you've motivated me so much that's so sweet okay um okay I'm reading questions hang on thoughts on testosterone can it cause blood clots yes only oral though um I want to say it causes blood clots it can increase your Baseline risk of blood clots in the oral form it also can increase cholesterol in the oral form transdermal estradiol and cholesterol and testosterone have not been shown to increase those risks so most people I know are doing a non-oral form but you know most people who know what they're doing generally recommend a non-oral form of of testosterone and estradiol because of these reasons so I um do and so I have everything I think I had estradiol patch and oral micronized progesterone Tab and I do a transdermal compounded testosterone for myself and my patients um is compound and vaginal estrogen better than Pharma there's no studies to suggest that and it's probably a lot more expensive um let's see uh oh I got lightheaded all of a sudden okay I'm talking too much um y'all so many of you guys are asking questions please drop them in the little question box down here below um oh how does the new book differ from the old book so the old book was about the Galveston diet and kind of my journey of how I got there and it's a lifestyle recommendations for nutrition Wellness we have meal plans and recipes it's more about you know eating and nutrition we touch on hormone therapy the new menopause is all about the medical aspects of menopause to make sure that you are absolutely armed and prepared to go through perimenopause and menopause it is a much deeper dive into the science of menopause and what I've learned in this menopause Journey outside of what they taught me in residency not only do I talk about hormone therapy in depth but I also go condition by condition symptom by symptom making nutrition lifestyle recommendations for things like frozen shoulder Dental changes dry tongue burning tongue vertigo tinnitus you know migraines like how that all is related to menopause why depression anxiety why these things are getting worse and what you can do about it what hormone replacement therapy might be able to help with and then what lifestyle nutrition things that you can do differently it's going to be amazing it's going to come out this spring guys so stay tuned we're still writing it and we're still writing it so um it's gonna be awesome I'm so I'm working my ass off so I'm taking a break from writing the book this right now so that I can come and talk to you guys um about it let's see I'm reading questions so um it how to become one of my patients well we have a waiting list of hundreds um but we are high we've hired a nurse practitioner she's going to start in October to help with the load that we have I'm also going to start training healthcare providers in kind of how I do things so I'll be recommending that but the website is maryclarewellness.com you can go and check it out call the office get on the waiting list especially if in the Houston area we have people cancel all the time and a lot of people slide into those last minute spots um okay uh we do talk about in the book we'll be talking about you know if you have breast cancer if you have family history of X Y if you have clotting disorders like what are the options for you and what are some of the misinformation and misunderstandings around hormone replacement therapy um let's see um itchy boobs and nipples yes we see breast tenderness and breast changes and breast itching that can be associated with perimenopause our we stop making as much oil in the skin it dries out we have inflammation of the nerves in the skin so like creepy crawling feelings fornication feeling like ants are crawling on you and different parts of your skin is part of the menopause transition um what's better for perimenopause anxiety H or t or depression those studies are being done right now but it's looking like a dirty um especially if you didn't have it before you became perimenopausal um you were only given oral estradiol I would look for something different um ask them why they did not offer you a transdermal option or transmucosal option because you have increased risk of for blood clots for some women with the trans or with the oral option um uh recurring monthly yeast infection could very much have to do with your fluctuating estradiol levels in perimenopause that if your doctor is poo pooing that I would try to find somebody else um let's see all right guys it is time for me to go and get my oh my personal HRT protocol again this is for me this is not for everyone okay so my personal like menopause toolkit you want to know what it is okay so nutrition the Galveston diet I eat that way every day it's not perfect I just went to New York I had dessert on my birthday I mean I have dessert every now and then you know but I try to refer to every day to strive to have less than 25 grams of added sugar in my diet okay I try to every day have at least 35 grams of fiber in my diet I take vitamin D omega-3 I'll show you all the stuff I take I'll go get it um I do estradiol patch and generic estradiol patch I do oral micronized progesterone and I do a transdermal testosterone for my hormone replacement um the testosterone is for low muscle mass I am beginning to show you know because I pursued thinness instead of Health for so long I was equating being thin with being healthy which was not the case um for me that I lost a ton of muscle mass that I should have been building at that age and so um but I'm going to show you my personal let me hang on I'm going in the pantry I'm grabbing all my things now again these are for me based on my blood work my needs my labs some things I'm kind of playing with and experimenting with um don't know if I'm gonna keep doing them and nobody pays me to say this so I'm not on any of these companies payroll I'm getting everything fiber uh I am in partnership with sparkle and this looks like a lot okay all right get ready I'm gonna flip it so you guys can read the front of the labels okay so I make a concoction a drink every day so and in my drink I have powders that I just mix with water so I've been using Sparkle skin Boost Plus collagen forever we co-branded with them so this is available on our website but the cut there's another study that comes so this has varosol collagen which is good for improving collagen levels in the skin this one is newer it came out it has four to Bone which was shown to decrease the risk of osteoporosis like improved bone now it was a small study but you know it's not harmful it's a decent source of protein I've also been taking creatine great studies on menopausal women with creatine when combined with vitamin D and exercise resistance training so and then I've been playing with the super greens I don't know if I'm gonna keep doing it I don't know when it runs out we'll see if I reorder it so I mix all of this together and I drink it and I I do it after I break my fast so I have these big cups that I get you know online they're 30 ounces they're big giant cups and I have the long straw and then I dump all this stuff in there so between the collagen here and the collagen here I do two scoops and two scoops that gives me 20 grams of more protein so I'm trying to increase my protein needs I add in my fiber I have the creatine and the super greens okay and I mix all that with water does not upset my stomach I do fine with it with the collagen okay all right so I think I grabbed two fibers by accident on a pill form I here is my probiotic that I travel with this guy here I am low in B12 I have chronic gastritis so I don't absorb B12 as much so I've been taking this and my I was slightly macrocytic on my hemoglobin so but that's for me okay I don't recommend that for everyone of course my omega-3 and d and K and then this is the neuromag I don't sell this they don't pay me to say this but I take this to help with sleep and relaxation at night okay and that's that's what I take all right so I do a combination of resistance training so weight training and then I do cardio my cardio I try to do hiking when I'm here can you see I'm in the mountains yeah so I'm in the hills in the mountains in Texas I'm on flat land so while I'm here I try to hike four or five days a week um combination of like really aggressive hikes so for me the hiking is like cardio plus muscle for my legs so I really have to focus on my upper body when and core when I'm doing resistance training here because I'm always working out my legs climbing these mountains I do not take a multivitamin I don't need one um it's probably not going to hurt you if you take one but I get plenty of my nutrition from food and I don't have other gaps in my nutrition so I don't need a multivitamin on a regular basis um yeah it is gorgeous here it is it's so different like in Texas I'm so lucky because I live on the bay and I get to see water every day and here I get to wake up and see mountains and it's just mind-blowing that I'm you know this is a rental property that we have and we kicked all over herself and we don't run at one so we can stay here I came here to write the book so um so hopefully this helps you guys um also I'm so focused on my sleep I like to use sleep tracking and I'm actually have become a medical advisor for a new sleep ring called the EV e v i e ring and it'll be released next month and I'm so excited because they're really wanting me to get involved on a medical standpoint um to help develop applications for the Sleep Wing specifically for women in menopause I'm just like beyond the moon about it and so um and I and I feel like wearing sleep trackers helps me be more aware of my sleep hygiene and like things that I'm doing that are sacrificing good sleep like alcohol for me and so um that's a big deal and stress reduction so I try to do mindfulness and meditation I was not a meditator I always thought that was woo-woo but it really really has helped I'm in so much of a better place now than I ever was because I have learned meditation and journaling has taught me to put up boundaries it has taught me to put up I still love the narcissist in my life um it is someone God put in my life that I'm I I'm stuck with and but I've learned how to put up healthy boundaries and to not allow her her to affect my emotional life and stability and to recognize her for who she is there's so many wonderful things about her but she has such a severe illness in her mind and I took that so personally for so long and like the journaling and mindfulness and working with a therapist really helped me step away from that and put up healthy boundaries where I can have her in my life but I'm just not gonna go down that route and to recognize her illness for what it is or whatever you want to call it and that you know I can't change that about her and so um and that when I see my parts of her and myself to recognize that grab on to that but know that I can change I can never change her but I can change and I can focus on the the relationship I have with my own family that I've created and to not allow to really break that cycle and so um so mindfulness has totally changed my life for that and if you get nothing else out of this rant that if I can give you that um so uh yeah it's hard you know I just it's funny I went to a birthday party for someone in our lives recently and it was just just painful to watch that person not be able to celebrate her sister because it wasn't about her and and that's just our whole lives but I knew she would do this going in I was prepared for it and my goal at that party like I couldn't relax and enjoy it as much because I had a Corral that person in my life who's a narcissist so that the person we were celebrating could not and you know could enjoy her day her special day even though her sister could not be happy for her because it wasn't about her anyway so but yeah that's the stuff I deal with it made me who I am today and you know a lot of therapy has helped me realize that I don't have to be like that and it's not a negative reflection on me and there's nothing I can do about it other than live the life I want to live and put up some healthy boundaries so um and not be that kind of a mother so uh uh let's see it's exhausting just join can you elaborate sudden high cholesterol and menopause yes so that's how we started the talk and that's how we're going to end it today before I go and put on some workout clothes because yes I'm in my pajamas um and talk about I started the talk today about I was writing the chapter on lipids and menopause so many of you and my patients will notice a sudden increase in their cholesterol levels despite any diet and exercise changes that they can attribute to you know oh obviously I started you know eating and um and it wasn't like the slow Trend this was like one year of their cholesterol was 180 and then next year it was 250 you know and their LDL shut up and you know and so um that's menopause estrogen is incredibly protective uh for inflammation it protects the walls of our blood vessels to keep from getting atherosclerotic plaques and it works in the liver to um with our liver Pro with our profile um so that you know keeps the good cholesterol high in the back cholesterol low and when the estrogen levels start declining we see dramatic changes in liver profiles for a lot of us like more than half of us and so what can you do about it HRT is protective it is no doubt about it and it's also protective against blood clots forming atherosclerotic plots forming in the intima of your blood vessels but there are other things that you can do one is well check your vitamin D level so a diet rich in vitamin D and blood serum blood levels of vitamin D the higher your vitamin D level the lower your cholesterol is that is the rule okay um uh liposomal berberine has been shown to be helpful okay number three probiotics uh diet rich in probiotics has been shown to be helpful so days I'm not eating yogurt I am taking that probiotic supplement I just shown you and then um omega-3 a diet rich and omega-3 fatty acids so that is why I created the vitamin D omega-3 combo for my patients to have that to kind of have that as a backup now again nothing is better than diets rich in these things and an anti-inflammatory pattern of nutrition is very powerful in helping to keep your cholesterol normal it's like you were able to kind of get away with it until menopause and then boom the hits the fan so outside of HRT there are other things you can do and it turns out those exact same things also help multiple other disease states that tend to flare in menopause as well and you'll see this reflected in the new book over and over again in the menopause toolkit um so um I am all right so I'm gonna wrap up now I had a great time talking with you thank you for all of your support all of the excellent questions go check out all the free resources we have at the Lincoln bio here on Instagram I will download this video and upload it to to um YouTube if you missed it or came late what brand are these I'd have to flip it over and it'll make me naked um so you're so welcome again I'm not perfect I kind of went off on a chiropractor this morning I had to take the video down because you guys showed me that I was being a little bit you know it wasn't just spicy it was icky and and kind of demonized the entire Chiropractic profession which was not my intention I go to a fabulous chiropractor um and so I apologize for that and I took it down and you can go in my stories today and see what I I talked about so um you're so welcome I just want everybody to be healthy and live a good life because I am and I think you can too um we will chat again soon see

Channel: Dr. Mary Claire Haver, MD

Views: 66,246

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Id: jhhFrcJULRg

Length: 59min 17sec (3557 seconds)

Published: Sat Aug 19 2023