221-SYNCPodcast_PaigeQ&A

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[00:00:58] Jenny Swisher: Welcome friends to this episode of the Sync Your Life podcast. Today I’m sharing with you a small clip of a recent live Q& A that I hosted alongside Dr. Paige Gutile. Now, Dr. Paige and I have been partnered up for several months now. She and I offer virtual health consults for the women who take my Sync Digital course.

[00:01:16] Jenny Swisher: So I asked Dr. Paige to come live with me into my Sync Digital course Facebook group, which is all the women who’ve taken my course, to offer some insight and to answer questions. Now, this was, she literally was an open book. She was willing to answer anything and everything that these women had to ask.

[00:01:31] Jenny Swisher: And I thought it would be beneficial for you guys to hear her perspective on a lot of things. We talk about proper testing, we talk about gaslighting and women’s health, we talk about what you should really be advocating for when you’re working with your doctor. She herself is an osteopathically trained family physician.

[00:01:45] Jenny Swisher: I’ve actually interviewed her here on the podcast before. I’ll make sure that I link that up in the show notes as well. But I’ve really enjoyed and loved our partnership. I really loved getting to know the women who come in our door, our virtual door, for these health consults. I’ve loved learning from Dr.

[00:01:59] Jenny Swisher: Page. I’ve learned so much, just in the last few months on how to really help women live with their maximum energy. So, you’re going to find in this small clip . that we could basically finish each other’s sentences because we we drive on so many levels as it pertains to the fundamentals of hormone balance being sleep, supplementation, fitness and nutrition.

[00:02:18] Jenny Swisher: And those are the four things that we focus on in our health consults. But like I said, this was a small clip of just a session that we had one night where we went live into the Facebook group simply to just answer our course takers questions. A lot of times women will apply when they know the why. So when they’re able to ask questions and they’re able to really.

[00:02:36] Jenny Swisher: dig deeper and have a doctor in front of them that they can trust and they know knows her stuff. They can learn so much. And that’s what I’m hoping for you. So sit back, relax, listen to a small clip of our recent live Q and a, and here we go.

[00:02:49] Jenny Swisher: All right, ladies, here we are. Hopefully, this is working for you. It looks like it is, at least on my end. So, welcome to our Monday Night Live Q& A.

[00:02:57] Jenny Swisher: I’ve got a special guest with me, as promised this week, Dr. Paige is here. Um, some of these ladies are getting to know you through our virtual consults and some of them are excited. Been awaiting their consults and others. This is the first time they’ve heard of you. So, um, yeah, so I’ll just do a brief introduction and then we’ll just dive into the questions because I want to make sure we’re mindful of everybody’s time.

[00:03:17] Jenny Swisher: If you guys have questions live, please comment on the Facebook live stream of this right now. So I will check that at the end. I’ve got too many screens up here trying to do this through through zoom.

[00:03:28] Jenny Swisher: Okay. So Dr. Page, um, I’ll let her introduce herself, but I’ve had the pleasure of working with her now for, um, I don’t know, we’ve done probably maybe 10 or so consults with different women from the sync group. So if you’re not familiar, if you’re new to this group, welcome to the group. I usually do these live streams solo on Monday nights, just to answer questions that you guys have as you go through the course.

[00:03:50] Jenny Swisher: Um, but recently in the last couple of months, Dr. Page and I partnered up to be able to offer you. Virtual consults with a true doctor, um, and to be able to Be a one stop shop for you so that you’re not only going through the course and becoming your own best advocate and learning about your body and asking the right questions, but this is my way of saying here.

[00:04:08] Jenny Swisher: This is who I recommend. Um, let’s do it all here. So I know that that can be half the journey for a lot of women. It can be half the journey to finding a doctor who will listen, finding a doctor who. Looks beyond just, um, the basics. So it’s been an honor to work with Dr. Page and actually I’m working with her on a, on a health basis as well.

[00:04:28] Jenny Swisher: As I navigate this recent journey with migraines coming back, I keep telling her if we can figure out my migraines, we can rule the world. I totally believe we can. I just, we’ve got to figure that out first. That’s a small hiccup. So anyway, so Dr. Page, welcome. These are the ladies taking the course.

[00:04:45] Jenny Swisher: Obviously some of them brand new and joined this week. Some have been around for three years. So I would love for you to just give us a brief introduction and then we’ll dive into the questions that we have.

[00:04:53] Dr. Paige Gutheil: Awesome. Yeah, I’ll try to keep it short. But basically, my name is Paige Gutile. I’m an osteopathic family physician in Columbus, Ohio.

[00:05:01] Dr. Paige Gutheil: And so I trained in a very integrative model and then found myself kind of graduated into the healthcare system where they tried their best to train that. integrative medicine, um, nature right out of me. And so I found myself on a personal and professional journey to kind of come back to that in the past decade with added training and lifestyle medicine and life coaching and functional medicine.

[00:05:31] Dr. Paige Gutheil: So my goal is to really bring together the best of science because we know We need science and the best of the most natural approaches and my favorite, favorite, favorite people to work with are those that find themselves mostly women. Let’s be honest, we’re the fun ones to work with. And we find ourselves doing all the things often stressed, tired, overwhelmed, overweight, and generally feeling older than we should.

[00:06:02] Dr. Paige Gutheil: That is my specialty. Um, I’ve yet to really coin a name for that, but no doubt it’s a syndrome in and of itself. And, um, so I tell Jenny all the time, like you ladies are so fabulous. Like if I could wipe my medical practice clean and just help women deal with hormones and all the implications, it would be so fun.

[00:06:29] Dr. Paige Gutheil: So happy to be here with you. It’s Yeah. What questions do we got?

[00:06:36] Jenny Swisher: Yeah. I’m excited. Okay. So we did get some in advance and I got some privately as well. So I have a list here to go through. So I’m just going to dive straight in. Um, okay. So Amy says, I have a question on how to deal with menopausal emotions.

[00:06:51] Jenny Swisher: I am full of rage one day. And then the next I’m crying for two hours straight help. I need to book an appointment with you as I’m lost on how I have gained 25 pounds and nine months. So let’s talk perimenopause into menopause transition and emotions.

[00:07:06] Dr. Paige Gutheil: Yeah, I think it’s a delicate topic because in my estimation, fill in the blank society, the healthcare system has been very quick to kind of write off women as, Oh, it’s just, you know, hysteria, normal emotions.

[00:07:24] Dr. Paige Gutheil: We just have a higher risk of anxiety and depression and all of that. And it’s just something about being a woman that gives us that higher risk. And that’s, of course, a bunch of. Now, there are a lot of things about society that put us at risk for that, but we don’t probably have time to cover all those things.

[00:07:45] Dr. Paige Gutheil: But during the perimenopause transition, there is no, and menopause, um, which, just to clarify, I’m sure all of you ladies know this, but when we use the term perimenopause, that’s The time leading up to menopause when I use menopause or postmenopausal, um, to me, those terms are kind of synonymous and it’s the birthday.

[00:08:06] Dr. Paige Gutheil: What I usually say, we’ve, we’ve spent a year without having periods so we can wave the menopause flag at that point. Um, but by nature of fluctuating hormone levels, which Honestly, even that term kind of doesn’t do it justice because our monthly cycles, as you all know, when we look at that famous chart of the hormonal fluctuations that happen month to month, estrogen, progesterone, FSH, LH, When those are superimposed on each other, it looks like four roller coasters just going to town every month.

[00:08:43] Dr. Paige Gutheil: So, it’s not that we can’t deal with the fluctuating hormones because, you know, that’s our deal, right? We, we do that quite well. But when they start becoming unpredictable outside that normal pattern, we absolutely, um, find ourselves just not feeling like ourselves and being a little, having different emotional reactions.

[00:09:05] Dr. Paige Gutheil: Progesterone is a huge part of that. That probably oversimplifies it a little bit, but progesterone has a very calming effect. Um, and it’s the one that tends to kind of tucker out a little bit, sooner than even estrogen. And so that’s when we might find ourselves being more emotional, um, more anxious, palpitations, trouble sleeping through the night.

[00:09:31] Dr. Paige Gutheil: But when you then couple lower progesterone with these peaks and valleys of estrogen, sometimes that big, peak and drop of estrogen that adds to that emotionality too. So it’s like you don’t have your coping hormone and your estrogen is going crazy. So I don’t want to boil it down to, you know, um, menopausal hormone therapy being the answer for everything.

[00:09:55] Dr. Paige Gutheil: Um, but it is the root cause for a lot of those changes. And so those women who don’t have a contraindication to hormone, um, we’re kind of getting away from saying hormone replacement therapy, the kind of term that, um, menopause experts are using are mostly, you know, menopausal hormone therapy. But that’ll take a while for me to break, break that habit.

[00:10:23] Dr. Paige Gutheil: So any woman, not every woman needs to take menopausal hormone therapy, but every woman should be given that honest conversation of what are the pros and what are the cons? Because we now know with updated research, there honestly are very few cons. There still exists some situations, but very few cons.

[00:10:47] Dr. Paige Gutheil: So Um, long story short, I would say, you know, consider menopausal hormone therapy. But then there are some, a lot of other things from a supplement basis, from a lifestyle basis. Sometimes this is the time of life as women out of necessity and out of the wisdom that we’ve gained that we learn not to take as much shit as we have taken for, you know, 10, 20, 30 years.

[00:11:14] Dr. Paige Gutheil: Because sometimes that emotionality, it’s not that everything. Is like setting us off, right? It’s that we all have a threshold. And if we’re skating around right here, any little thing, yes, is gonna, you know, maybe throw us off, but it’s because we need to deal with all of this under here. We’re expecting too much of ourselves.

[00:11:34] Dr. Paige Gutheil: We’re not sleeping. Our cortisol’s through the roof. We’re working on a, you know, 24 hour man’s schedule that does not respect our own needs. For, um, rest and fluctuations and resting our brain, resting our emotions, resting our bodies. So there’s a lot involved in that answer, but yeah, no, that’s good.

[00:11:56] Jenny Swisher: That’s really good. Yeah. And I mean, so these ladies know that I’ve been tracking my cycle through the mirror wand. And, uh, so what they don’t know is that I don’t send page my mirror wand very often because every, every time I do, I get the same answer, which is I’ll say. Oh my gosh, like my estrogen dropped today and this happened today.

[00:12:15] Jenny Swisher: What do you think’s going on? And every time she’s like, oh, perimenopause, the answer, there’s really no true answer. And so it’s, it’s not, you know, I know it’s not funny. I know that it’s, it can be an emotional rollercoaster, but, the one thing that I would just contribute to that is just, I would say, this is why we talk about those four fundamentals of hormone balance in the course, because as we’re going through these transitions, I know, Dr.

[00:12:38] Jenny Swisher: Laura Bryden calls. Um, perimenopause 2nd, puberty, right? As we go through this sort of roller coaster again, a formal transition. It is the best time to really prime ourselves for what the rest of our lives our next 30 years or whatever are going to look like nutritionally strength wise.

[00:12:55] Jenny Swisher: You know, I know you guys are that you’re aware that I’m a fan of Dr. Dr. Gabrielle Lyon and her research on skeletal muscle. So it’s a good time to focus on like, you know. Exercising in the right ways and dialing in that nutrition so that you’re not maybe dealing with awful side effects of menopause, like hot flashes or whatever, that there is a, still a lot that is within your control and it has to do with the fundamentals of your lifestyle.

[00:13:19] Jenny Swisher: Like how well are you sleeping? How, you know, what does your nutrition look like? What does your exercise look like? And, and then that supplementation piece can play a role too. So I just wanted to throw that in there. Yeah.

[00:13:29] Dr. Paige Gutheil: Supplementation piece. I don’t want to under, um, undersell that honestly, because even though it, it may not be the exact, you know, root cause like hormone therapy can provide, there’s a lot that we can do when it comes to omega 3s and B vitamins, folates, some Herbal based, like mushroom based adaptogens that really can positively influence mood, even without hormone therapy.

[00:14:00] Jenny Swisher: Yeah. Cool. Okay. Let’s see what question. We’ve got a lot of questions, amanda says, is the current, Oh, she’s wanting to know, is the current plan to continue taking appointments into the new year? I’m trying to work with my OBGYN on some testing prior to my appointment with her.

[00:14:14] Jenny Swisher: So the answer to that is yes. Um, we also have women that we’ve met with who will be doing followups. Early next year as well. Her other question is, if I can’t confirm ovulation through my scope, would you say that basal body temperature is the best best method of tracking? I’ve been tracking through mucus for years.

[00:14:31] Jenny Swisher: I’ve been working with my scope just for a few months and I barely. Oh, no, I at best. I see transition. So she’s seeing like. The transitional pattern on the saliva, but she’s not seeing the full transition. So all I would say, just because I am the scope person is, um, like, your, your ovulation window is very fleeting.

[00:14:51] Jenny Swisher: Right? So I know for me, like, I will really only see firms on my scope for like, 12 hours. And I’ve tested that just to see. And so. It’s really less than most likely less than a 24 hour window that you’re going to catch those firms. So you can, you know, you can assume like, okay, I was in transition. I had fertile mucus.

[00:15:09] Jenny Swisher: You know, these are the things I’ve been tracking. I can assume that ovulation occurred. But. It’s sometimes hard to catch. So if you’re testing in the morning and you don’t see anything or you see that transitional, I would test again, like 4 or 5 hours later or 12 hours later and kind of stay on top of testing that.

[00:15:25] Jenny Swisher: But otherwise, do you recommend basal body temperature for tracking ovulation?

[00:15:30] Dr. Paige Gutheil: Yeah, and I guess it’s always hard because I, I’m curious to know. Um, what we’re going for, as far as are we going for cycle awareness, are we going for fertility, are we going for, um, changing cycle, because that, you know, obviously will influence how Into this.

[00:15:51] Dr. Paige Gutheil: We want to be, um, Jenny might get sick of me saying this, but we’re always trying to balance that, like, we’re all type a scientists over here, like trying to figure everything out, but then that we can go too far in all this tracking, right? Um, we have to have kind of a lightness and awareness of it because just the stress of tracking sometimes is enough to throw things off.

[00:16:15] Dr. Paige Gutheil: So, um, there is this, you know, it’s, it’s sometimes nice if we can. Use just a curious nature to put together a few data points. The, um, looking for your burning patterns. I’m a fan of basal body temperature. If you are wearing the aura ring, you know, using aura ring temperatures, just because I think it’s easier than, you know, adding that like, okay, now I got to check my temperature every morning, you know, I feel like a robot and then really that cervical mucus.

[00:16:51] Dr. Paige Gutheil: I know, I mean. We’re all where we go. Yeah, right. We do. Um, uh, to me is when you gain confidence and knowing what your body’s doing based on, vaginal discharge, cervical mucus changes are very Like very what’s the word I’m looking for? I’m very reliable.

[00:17:16] Jenny Swisher: Yeah, that’s good. I have a feeling the majority of these women are tracking because they’re cycle syncing.

[00:17:21] Jenny Swisher: So they’re just wanting to make sure like, did I ovulate? Did I not ovulate? Because 1 question that I get often, um, I think almost every live stream, somebody asks this question of like, well, it doesn’t seem like I’m ovulating, right? They’ll say I’m tracking with my scope and I’m tracking my temperature.

[00:17:36] Jenny Swisher: I wear an O ring or whatever. They’re doing 2 of 3 things, right? Okay. And I, I don’t think I’ve populated the last couple months. And then usually the question I get is, how do I customize the calendar that Jenny’s created around an ovulation to which they don’t like my answer, which is why are we not ovulating, um, you know, ultimately, if population is our 5th vital sign, and it really is a predictor of overall health and hormones, then we need to understand why that’s not happening as opposed to.

[00:18:05] Jenny Swisher: Pushing you through workouts, which may be counterproductive to that ovulation. So I don’t know if that, you know, I’m not saying that that’s what Amanda was asking, but I just want to say that for anybody listening, because if you’re wondering, like, well, I don’t know if I’m ovulating or maybe you’ve had recent blood serum draw, that’s kind of indicating maybe an ovulation or something.

[00:18:23] Jenny Swisher: Um, the better question to ask is why are you not ovulating? And yeah, for sure. Yeah.

[00:18:28] Dr. Paige Gutheil: And so. You know, when you’ve had kind of the baseline blood work that doesn’t show any signs for, you know, reasons for anovulation, and if you’re getting, even if you’re not getting perfect answers, like Jenny said, you, if you’re noticing transition, but you’re not seeing the ferning, but.

[00:18:46] Dr. Paige Gutheil: After that transition period, you’re noticing cervical mucus at my default would be like, I am ovulating, but I’m just not catching that, you know, in that 12 hour period. The other thing I would mention about our consoles is if you are comfortable at one, yes, we will do it throughout the year. But, um, if you’re comfortable with A lot of women that we’re meeting with, we’re kind of on a little bit of an extended schedule, right, like they’ve sent us their information, some blood work, but then we’ve kind of given feedback to get more blood work and then put everything together.

[00:19:27] Dr. Paige Gutheil: So if you feel like, you know, I’d like to kind of send you my information, I may not have all the blood tests together. I would say like, go ahead and do it and give us all the information because then we may have some guidance, to help you get the information you need through blood work, through your local physician, like don’t put it off.

[00:19:46] Dr. Paige Gutheil: Yeah.

[00:19:47] Jenny Swisher: And that makes, that’s a great point because I also think that what I have seen happen frequently with women is that they will go through, because I mean, if you get into the right doctor’s hands, you can do all the tests, you know, and so it’s not, not all the tests are really necessarily what you need.

[00:20:04] Jenny Swisher: Um, so, you know, that’s what I also love about Dr. Page is she’s going to look at you and say, this is what we really need to know about you. Right? Like. Maybe you have a breast cancer history. Let’s look at your estrogen metabolites. But like, you know, like we can look at different things that are more focused on you as an individual, which is a great point.

[00:20:20] Dr. Paige Gutheil: And even our most like the, really the most comprehensive testing, which would include the Dutch test that gives us deep dive on sex hormones plus cortisol response, and then what I call kind of our foundational blood work that’s done through serum. You know, that’s blood counts, kidney, liver, electrolytes.

[00:20:39] Dr. Paige Gutheil: Looking into glucose metabolism, looking into thyroid. Um, I think the total on that, if you want to order through us, is about 400. Um, and I don’t know. And the foundational blood work, the Dutch is 300 of that. The foundational blood work is 100. Yeah, that’s a really discounted price. Sometimes a lot less than even you would pay going through insurance.

[00:21:07] Dr. Paige Gutheil: So yeah,

[00:21:09] Jenny Swisher: that’s I’ve never. Yeah. And I mean, even even before you came on board here with us, you know, I was giving people the 100 off. Dutch code and that was just for the Dutch test and that was bringing it to like 600 for the Dutch test. So yeah, for the Dutch for the Dutch test. It was 600. I think it was might even been 650 and I don’t I’m not an affiliate for Dutch.

[00:21:29] Jenny Swisher: So I’m not even getting there’s no kickback. Nothing like it’s just a code that they gave me. Um, as an influencer and that’s as much as I can help. So taking advantage of that opportunity is, is great too, to be able to get more bang for your buck and be able to see the data that you really need. Right.

[00:21:45] Jenny Swisher: Which is a great lead into this, to Courtney’s question. She asked how effective and or reliable is allergy testing through blood work. I had food and environmental allergies tested, and I feel somewhat crazy as there are things that came up negative, but I know that they cause me issues.

[00:22:01] Jenny Swisher: Um, so, but that the reason I asked this question and then I’ll let you answer is this is why, right? We talk in the course about blood serum testing versus urine testing versus saliva testing and what is best for what, what type of data you can gather from each, right? And so rather than just going to a regular piece, no PCP or OBGYN, but most of the time, Um, so, so, Their baseline lab work is still not really taking a super functional approach.

[00:22:29] Jenny Swisher: So I don’t want, I just don’t want you guys to waste your time and it doesn’t have to necessarily be with, with us, but that’s why I put the course together the way I did so that you’re not spending all the money on all these tests. And then you feel like six months later, you’re not getting anywhere, you know?

[00:22:43] Jenny Swisher: So, okay, let’s dive into how effective and reliable is allergy testing through the blood.

[00:22:48] Dr. Paige Gutheil: Yeah, so I that’s a great question and it is a little bit controversial. I’m like I mentioned earlier all about like. I see the points of view of my, you know, very traditionally trained colleagues, and then I see the points of view of a more functional medicine lens.

[00:23:06] Dr. Paige Gutheil: And so the nuance to your question really is when you talk about allergy testing, true allergy testing can be. Usually we refer to something that’s called IGE that really mediates a true allergic response, and that’s more of usually the traditional allergic response like hives, itchy, watery eyes, sometimes it’s more of like GI upset, but more like nausea, pretty extreme.

[00:23:36] Dr. Paige Gutheil: Um, in that case, the IGE testing is pretty sensitive, but a lot of allergists will still do kind of skin testing because. It works too, but then a lot of times when you’re getting allergy testing through the blood, really what we’re looking at is more like food sensitivity testing. So you’re not necessarily getting a true allergic response, but you’re.

[00:24:02] Dr. Paige Gutheil: Getting are you elucidating more of a inflammatory response those testing? It depends kind of what kind you get some of them depend on Certain immune mediators. There’s a couple that will actually kind of like not just work through the blood but Take into consideration, what is the status of your microbiome and how your body is processing that information.

[00:24:38] Dr. Paige Gutheil: So, it’s kind of confusing, I know, but, and we’re not used to, in like health class, they don’t talk to us about like, hey, You know, you have natural bacteria in your gut and you know, when we hear like viruses and fungi and bacteria, we think, ooh, but we’re a whole ecosystem, right? Like we have a very natural balance of pH and natural bacteria, viruses, fungi that are meant to work in our favor.

[00:25:04] Dr. Paige Gutheil: And so that is constantly changing. Your food sensitivities may change over time and you can have different types. So you can have food reactions I would call them based on Microbiome balance you can have food reactions based on an inflammatory response. There’s no overlap there And then you can have food reactions based on a true allergic response.

[00:25:28] Dr. Paige Gutheil: So most likely you are testing one of those three methods and the take home message ladies for most things is you’re never crazy. If you are noticing something, it is real what you’re noticing. And so just because a freaking paper does not put it in bold, do not let that paper steer you wrong.

[00:25:48] Dr. Paige Gutheil: You know, it’s just not giving you the answer. Truthfully, good allergists still to this day use an elimination diet. That will trump testing for them now. They lean on testing all the time. But the reason they Use an elimination diet is we should trust how we feel when we eat something and so One just to say, you know Obviously we could we could sit down and we can kind of go through exactly what reaction you’re having exactly what type of testing and I could probably tell you like Why you feel what you feel based on, based on testing, you know, the testing you have done or what you could have done.

[00:26:32] Dr. Paige Gutheil: But then, you know, there are ways you may be reacting to a food that it doesn’t show up as a true allergen, but it’s throwing off your microbiome. It’s creating bloating. It’s creating inflammation and, and believe it, um, now the cool thing is, especially when it comes to that inflammatory response and the microbiome response, if you do abstain from the foods that cause a reaction for a period of time and work on your gut health in general, lots of probiotic foods, natural foods, um, maybe taking a probiotic supplement, lots of anti inflammatory foods, You will heal your gut and balance your microbiome, it’s diversity and numbers to the point where oftentimes you can tolerate those foods again.

[00:27:23] Dr. Paige Gutheil: So without torturing yourself.

[00:27:26] Jenny Swisher: Yeah, that happened with me in my, in my twenties, like it came back, I think almonds were like a high sensitivity or something for me. And then now I seem to do fine with them. So, um, Yeah, interesting. But yeah, I love that, that they’re not crazy because, um, I told Dr. Page when we first started meeting for me, I’m like, I cannot hear out of my right ear.

[00:27:46] Jenny Swisher: Like something with these migraines is causing my right ear to be weird, but yet modern medicine put me through all the ear testing and the ENTs and all the ologists and, um, they’re like, your ear is fine. I’m like, it ain’t fine. There’s something wrong. And so, um, yeah. But it’s interesting because the more that I read into this histamine intolerance thing, which I’ve shared with them, is part of my journey now to see what’s going on there, which relates to allergies.

[00:28:10] Jenny Swisher: Um, and knowing that estrogen can sometimes, you know, there are estrogen receptors in the ear. I’m like, wait, I’m not crazy. Like, this is real. I knew I wasn’t crazy. So, yeah. All right. Let’s see. We got two or three more here. Let’s see. Kathleen says, I am 58. I hit menopause somewhere in the last six years. I went on the Leletra IUD at that time to manage horrible cycles.

[00:28:33] Jenny Swisher: They were so heavy. It landed me in the hospital with a hemoglobin count of four and numerous transfusions. There was never any mention of hormones being involved, even in the tough cycles in the years before. My question, I just had the IUD removed and my OB put me on natural progesterone micro at 100 milligram capsules.

[00:28:51] Jenny Swisher: I could go up to 200, but how do I know if I should? Blood work seems to be normal. I believe the IUD masks so much that now I’m at ground zero on figuring myself out. So disclaimer, and we should have probably said this at the beginning, none of this should be deemed as your unique medical advice. This is more just educational purposes, but I do think this is a good place to step into the topic of normal blood work.

[00:29:14] Jenny Swisher: And also, um, just get your thoughts on her question. How does she know her body? How does she know if she should go up on her dose? Yeah.

[00:29:22] Dr. Paige Gutheil: Um, thank you for doing that disclaimer. Cause I’m the least risk averse person ever. Um, okay. So We’ve been in menopause, just to clarify, we’ve been in menopause for six years, right, and we started the IUD early on.

[00:29:41] Dr. Paige Gutheil: Okay, so just to backtrack a little bit, it sounds, IUD is a super common, you know, method to, um, help during the perimenopausal craziness of period changes, periods to the point where I’m literally, I will share a personal story. So I went, I was having some bleeding after sex and literally this. I was seeing this GYN that I didn’t really know for the first time, this dude that I will never see again.

[00:30:24] Dr. Paige Gutheil: And he’s, and so I’m 47 and I’m describing, you know, and I try to like be respectful and not be like one of those doctors, right? Um, and he’s like, you don’t have IUD. I was like. Are we, is everybody doing this now? Am I like behind the times? Am I not keeping up with the Kardashians? Like what? Everybody has IUD at 47?

[00:30:45] Dr. Paige Gutheil: No, I don’t have IUD. Thank you. But anyhow, um, so when, during perimenopause a lot of times we’ll think of kind of like, um, estrogen, and progesterone changing in a couple of different ways. I’ve heard people describe it as like three types of menopause. So oftentimes you’ll have this estrogen dominance where the estrogen doesn’t go down right away, but progesterone goes down so you’re not Stabilizing the uterine lining as much and you’re growing the uterine lining more.

[00:31:25] Dr. Paige Gutheil: So then periods get really, really heavy, really, really long. Um, and your body is amazing, right? Like we can tolerate blood loss. To the point where you can be at a hemoglobin at four and still walking around and doing your thing It is amazing. Honestly what our bodies can do And also it’s just a note to other women to learn from you Like don’t put up with these crazy periods, you know, because you think oh, it’s just you know, a heavy period No, please do not put up with them.

[00:32:01] Dr. Paige Gutheil: So sometimes that happens where estrogen is still high but progesterone is low, so you get these crazy, crazy heavy periods. Sometimes it’s just erratic, and, um, you might have heavy periods, and then no periods, and then, you know, light periods. It’s just all over the place. And then the third kind is Maybe like kinder, gentler, and you just have this slow decrease in estrogen, and you know, women just kind of have lighter periods, and space out, and go away, and they ride off into the sunset, and we Bless them.

[00:32:36] Dr. Paige Gutheil: Um, we might be even a little envious of them. So you’re in a lot of ways, your IUD helped you so much because it stabilized your uterine lining and gave some exposure to progesterone to stabilize that lining. And so it would have been nice to have a little bit of hormone education to exactly what it was accomplishing at that point.

[00:32:58] Dr. Paige Gutheil: But nonetheless, you know, it did its thing. Now that you are. Six years after menopause. I’m curious. I would assume that you’re also on estrogen, but you didn’t mention that. That would be my first question to say, like, at this point, six years after menopause, just replacing progesterone is going to stabilize the uterine lining.

[00:33:25] Dr. Paige Gutheil: But you probably, unless you’re on estrogen, you don’t need a stable, you don’t need to stabilize your lining. Uterine lining because you’re not gonna bleed most likely. Yeah. So that would be my thought is, um, the question really isn’t, isn’t like, do I go up from 100 to 200? The question is, where’s the, what’s the status of the estrogen?

[00:33:51] Dr. Paige Gutheil: Mm-Hmm, . And what are, what’s the status of your overall symptoms? Whether it’s dry hair, dry skin, dry nails, mood, hot flashes, sleep, palpitations, all the, all the things. Did I miss one? Was there a

[00:34:06] Jenny Swisher: two part question? No, that was no, I think that’s it. And I think that’s a good, a good answer. I’ll just chime in and say, you know, I, my question would be, what is your testing showing?

[00:34:15] Jenny Swisher: I had the same question about why not estrogen too, if you’re in menopause, um, but also coming back to this. And I know these ladies are not, they’re like broken record, Jenny. So while we’re here, but when, you know, she said that, and I quote, she says, blood work seems to be normal. Okay. So I questioned that sentence.

[00:34:34] Jenny Swisher: Bye. Every time because in my 20s, I was told that my blood work was normal, but I was not normal. I was having chronic migraines. Lots of issues, right? Same thing for now. People are like, oh, well, you’re in the normal ranges. I’m like, no, normal is not optimal. So again, let me repeat. Normal is not optimal.

[00:34:54] Jenny Swisher: The normal range reference ranges on lab work is determined by the total pool of people who have that lab done, whether it’s healthy people or unhealthy people. It is a wide range, which actually I have a question about that later on. But, um. But just know that there is a window of optimal where you want to be, and it’s not just siloed numbers either.

[00:35:15] Jenny Swisher: I mean, in menopause more. So, but for cycling women, right? We also are looking at the estrogen to progesterone ratio and looking at what that looks like too. So a lot of traditional and P. C. P. is they just look at is she in the normal range? And I like to say. Traditional medicine takes more of a is your house on fire approach like, oh, my gosh, your house is on fire.

[00:35:37] Jenny Swisher: We need to put the fire out as opposed to functional medicine approach, which is what I teach in the course, which is, you know, we found some matches in your basement and laying near some paper. It seems, you know, it seems like this might be a fire, you know, like, so that’s what you want, is you want to take the more, the more functional approach and, and just know that normal is not optimal.

[00:35:56] Dr. Paige Gutheil: Yeah. Okay. And, and I would also add to that, you know, to make it even more confusing, there are no well established, and this is sad, really, this, this honestly should make us infuriated at the state of healthcare research for women, but there are no widely accepted normal ranges like target ranges for estrogen and progesterone during menopause because it’s extremely variable.

[00:36:24] Dr. Paige Gutheil: Um, so you will, that’s why you’ll hear, um, with decent rationale, physicians both say, Hey, I never test. I don’t need to test. I talk to women. I know the symptoms that are associated with menopause. I do testing to rule out other conditions, autoimmune conditions, thyroid, vitamin D, glucose metabolism to rule out overlapping conditions that might confuse the picture.

[00:36:54] Dr. Paige Gutheil: And then I treat. Based on symptoms to get my patients feeling better. I think that rationale has a lot of yeah to it But then also sometimes it’s nice if the picture is a little cloudy To get blood work and say it’s a lot of times once we start hormone replacement therapy We may get to a point where we say, Hey, I feel really good, but I don’t know, could I feel better?

[00:37:23] Dr. Paige Gutheil: I don’t know. So then it’s nice maybe to, to do a little check and say, Oh, well, your estrogen is 30. Like, we can’t, we can’t increase that a little bit more hair estrogens, you know, 150, like. You know, we’re probably pretty good. Let’s look for other ways that we could feel better.

[00:37:41] Jenny Swisher: So good.