253. Dr. Jessica Shepherd: On Menopause, HRT, and Longevity Tips for Women

21:57What does it do for preventing chronic disease? What does it do for brain health or bone health later on in life? Those are the conversations that we really should have focused on when looking at the benefit of hormone therapy. Yeah, I wholly agree with you.

22:13Gary Brecka:Listen, there's what I share on this podcast and then there's what I share with my inner circle. If you've been following me for a while, you know how I hold nothing back here. But my VIP community, that's where the real magic happens. Picture this. You're struggling with energy crashes, brain fog, or just feeling like you're not operating at your peak, and you don't know where to get real answers. But here's what really sets this apart. You're not just getting my insights. When I have incredible guests on the podcast, VIP members get to submit questions for a private podcast segment. So that world-renowned expert we just interviewed, you get exclusive access to their knowledge tailored to your specific situation.

22:51Gary Brecka:This section is under the private podcast section in the Ultimate Human Community. And speaking of exclusive, you're getting my personal protocols, the exact tools I use for water fasting, gut optimization, and morning routines that have taken me decades to perfect. This isn't theory. This is what works in the real world. The community launches challenges throughout the year where you get direct access to me and my network of experts. It's like having a personal health advisory board for less than$100 a month. Your health is your wealth, and this investment pays dividends for life. Join the VIP community at theultimatehuman.com forward slash VIP and step into your ultimate potential.

23:26Gary Brecka:Now let's get back to the Ultimate Human podcast. I think a lot of women, you know, they're getting into this too late. And I've heard you talk about target timeframes where, like, there's a good, better, best, right? There's never a time where there's no hope, but there's a time where it's good, a time where it's better, and a time where it's best. And relative to hormone therapy, what does that look like for women? That was one of the things that the WHI did get wrong in the study because the ideal fundamental of the study was cardiovascular risk. And what can we do to decrease cardiovascular risk because heart disease is the number one killer of women.

24:05So that, you know, when we're looking at a study, we're like, this is good. Good. We're going to look at something that has great outcome. Unfortunately, who they used hormone therapy in in the study were not the best. And we're talking about good, better, best of who we should have been using. These were women who were on the average older than menopausal age. So they were way in their elder 50s into 60s. Smokers, people who had history of heart disease. So again, that's not ideally who you want to start hormone therapy in. who you do want to, for anyone who's listening, is in that late perimenopause into early menopause transition, which could mean if you wanted to put a tag on it on the age, maybe 45 through 55.

24:46And that is when we start to see the flux in hormones and perimenopause, you're still having your cycle into that early timeframe, probably within the first five to 10 years of not having a cycle is the ideal time. Do you want to know why? I think you want to know why. He's like, well, I kind of already know.

25:02Gary Brecka:And my audience wants to know why. But we're dealing with symptoms, so we're minimizing and resolving some of those symptoms, which can make a woman's life very frustrating. But the other part and benefit of estrogen and progesterone and testosterone is that it has such stark relationships that are beneficial when we think of glucose metabolism, brain health, decreasing inflammation. Estrogen really is one of those robust hormones that is an anti-inflammatory, right? We know that inflammation is one of the main causes of disease. The root of all evil, yeah. But it is. And then we talk about glucose, right?

25:38So sugar, like how is it manifesting in a way where it's going to control your glucose better?

25:43Gary Brecka:And then the last thing is your organs need estrogen. There are estrogen receptors all over. So we're losing muscle mass. So when estrogen is lost, we're not able to kind of get our lean muscle mass like we like. Our gut health. Gut health is imperative for future and disease prevention, but also heart muscle and brain. So bones even. So I could go on and on about the receptors that are needing estrogen. So when you lose it, your body is like, what do I do now? So I really think that timing is important, that 45 through 55. And that's loose numbers. That's not saying if you start after the age of 55 that you're not gonna get the benefit.

26:19But we want to get you before the body starts to have the inflammatory response. Now you've been exposed to your heart muscle not being optimal. So you're increasing atherosclerosis and things that are going to cause heart disease.

26:31Gary Brecka:You know, I think too, it's important to talk about the impacts on hormones that are not directly related to hormones. Things like stress, like, and we're going to get into diet and lifestyle choices, but hormone mimetics, you know, cosmetics, microplastics. I mean, these things that don't make their way into the mainstream discussion and mainstream academia. But we've seen mold and mycotoxin infections, severe heavy metal toxicity, and just the overburden of microtoxins, you know, between the glyphosate and the paraquat and the microplastics. And individually, maybe individually, these things are not catastrophic on their own.

27:18Gary Brecka:But at some point, you're just overstressing the system. Yeah. And women, I think, in general, have a tendency to develop things like caregiver syndrome where they put the needs of everybody else before the needs of themselves. You know, they're used to raising a family or taking care of a spouse or kids or co-workers or their career or their, you know, any number of things. And they sort of start slowly putting themselves into the backseat. They are usually at the bottom of the list and the back of the line. And that's why I was saying earlier, this timeframe to focus on you is very hard for someone who's put everything else ahead of them or in front of them is to now being like, what?

28:00I have to pay attention to me and pay attention to my symptoms and what's really bothering me. and then being able to come back and say it to someone is actually a leap from what they have done for so long. So there's a little bit of like uncomfortableness with kind of guiding women in the sense of, I actually want you to pay attention to you and actually then come back and be able to tell me how you're feeling. And they're like, say what? Like you get to be selfish.

28:29Gary Brecka:You need to talk to my husband. Tell him, write me a script for this. Yeah, because, and I think this is why it starts to give us, shed some light into why there is such a prevalence of autoimmune disease in women. Because where does autoimmune prey? It preys on the weak. And what makes you more susceptible? You know, anything that degrades the immune system, chronic stress, being in a sympathetic state for too long. I think women very often don't feel safe in their own bodies. That makes sense. They are taught that. to feel safe in their own bodies. And this is where I go on like my emotional kind of like landscape.

29:11Dude, rip it. Let's go. My woo-woo MD version is we have been taught that, but also the chronic stress we absorb, we are emotional absorbers of everyone else around us. And that actually wreaks havoc internally, increases inflammation. The body keeps score. If there's traumas that they've endured early in their life, How we socialize women to think is a big part of that as well. But, you know, Dr. Gabor Mate, he is an MD, but he is a psychiatrist and focuses on trauma and what trauma holds in the body. But he also understands that the trauma can then reveal itself externally as autoimmune disease.

29:52So, you know, it's all linked in how our bodies are responding internally, which sometimes we don't see externally, which is hard to capture, is that it manifests as autoimmune disease, but also estrogen is a potent anti-inflammatory. So it only makes sense that you start to see autoimmune diseases impacting women or the diagnosis of in their 40s and 50s. And so that is everything together. There's a parabolic spike. Yeah.

30:17Gary Brecka:There's a parabolic spike. And you know, what's interesting is, now you bring that up, is I was looking at epidemiological data and meta-analyses, And men and women track very closely until that sort of mid-40s timeframe. Then there's this sort of parabolic spike and they start to depart, you know, men in autoimmune disease. So if we were to go back into lifestyle choices, diet, sleep, exercise, hormetic stresses, so for the women that are listening to this what does a low inflammatory pro-hormone if you will healthy immune system lifestyle look like? What are some of the interventions that you do that are not hormone related or supplement related?

31:04I think that goes down into gut health and this is where I think this is imperative that we do a better job at creating an infrastructure where gut health is very important because the gut also has estrogen receptors And so the ability for the gut to have less permeability rather than more, which is what happens with aging alone, but also with estrogen decline, we do see that the gut takes a very big hit in what it actually allows for it to come out, which is the thing that should stay in and vice versa. And so what we need to do is focus on anti-inflammatory ways to heal our gut or keep our gut safe as possible through anti-inflammatory foods.

31:46But also, this is where you start to see more deficiencies in vitamins as well because of what our gut is kind of pushing out, which really shouldn't be pushed out. So I always say that the way to best treat the gut is to decrease, obviously, your processed foods. It sounds easy, but when you actually look at diet of most Americans and in the westernized population, processed food is still a very big part of what we consume. And then the other thing is more whole foods and protein. And whole foods in the sense of make your plate the rainbow, incorporating more less cooked, less processed foods, and then protein.

32:25we have not established for women especially how important protein is for our diet in order to sustain lean muscle mass. But also it helps with our brain, with our brain health too. So our gut talks to our brain. And so when we were talking about brain fog, it does. And clarity, a lot has to do with what we're putting into our bodies. I would say, even though it's considered supplementation, I do find a space for supplementation. The best way to get your vitamins and your nutrients is through your whole foods, what you consume. But we usually are lower than we should be. So I would say people always ask me, what's your top three?

33:03I usually say it's very individualized and personalized because when I have people come to me and I read through their labs, everyone will have a different story. But most women will have a deficiency in vitamin D, in vitamin B12. And fiber and protein are the other two that I feel need to be kind of heightened when we think of what we need to do with our diet. but really looking at things that are going to help decrease inflammation, but also substantiating the parts of our body that is like, we are really at a deficit right now. How can you help me?

33:34Gary Brecka:Yeah. And I think that protein, you know, consumption by women is woefully inadequate. You know, thought leaders like you, Dr. Gabrielle Lyon, you know, talk about this a lot. And hey, thankfully we just flipped the food pyramid upside down. I mean, literally we pulled it out over the ground, turned it upside down, set it back down again. And people went crazy. But we, you know, when I say we, because I'm aligned with the Maha action, Bobby Kennedy's Maha action. And by doing this, we ended the war on saturated fat. And we ended the war on protein. And we really began the discussion about how much of our caloric intake is just coming from high glycemic carbohydrates.

34:17Gary Brecka:you know so many people being insulin resistant and the impact that that has on your on your hormones because you know i feel like uh it's very rare in human beings for multiple systems to just break down all at once you know there's usually an early domino that starts to fall it's just like that one that like tips the line yeah right and and you know i think blood sugar is one of those oh my gosh it is like i don't even know if it's a slight tip when the glucose goes out of control. I mean, those dominoes are like going down. So how important is it for women to meet their protein equivalent and to control their blood sugar?

34:54Gary Brecka:And if they don't know what their blood sugar looks like, what does a lab test look like for them to get the data that they need? I love, so I think that blood glucose is definitely something that we are good at in labs, right? And so we're good at what is that? When we usually draw a glucose, people be like, my glucose was great. And I'm like, but that was at the time, at the time that I drew your lab, that's what your glucose is showing me. So whether you had something that had high glycemic index before or not that's what it's showing me. One of the best ways that we can do that is a hemoglobin A1c which is our glycosylated hemoglobin which really shows us retrospective analysis of what your body does in order to manage glucose.

35:33Because it's really the management of it and what your body has in reserve versus what your organs are able to shuttle glucose as a fuel into it especially your muscle and your brain and when we look at a hemoglobin A1c it's really giving us a three month kind of picture of where your body is and how it metabolizes glucose. That really is the best way for us to say this is where you are we don't want you to go into pre-diabetic phase, we don't want you to be a diabetic but if you're close to that number here's what we can do to kind of offset that. Another way to watch your hemoglobin A1c I really like a CGM

36:11Gary Brecka:So continuous glucose monitor. And the reason why that's important is because you and I will have different responses because of gender, but also maybe movement, maybe lifestyle of how we utilize glucose. Foods also in response to how our bodies do that is quite different as well. So I have people who just ethnically are going to be able to metabolize rice better than some other. And so if you don't know that information, then you are going to go by a template of what is good for you. And sometimes that's not the best way to feature how nutrition is being implemented into your body and your body is able to utilize that glucose in the best way.

36:52Gary Brecka:If you want protein to build lean muscle, but without the caloric impact or need to cut, you need Perfect Amino. It's pure essential amino acids, the building blocks of proteins in a precise form and ratio that allows for near 100 % utilization in building lean muscle and no caloric impact. So we build protein six times as much as whey, but without the excess body fat we normally get during bulking. This is the new era of protein supplementation, and it's real. If you want to build lean muscle without having to cut, you need perfect amino. Now let's get back to the Ultimate Human Podcast. And so once we have this information, you start to, I think the CGM is a great idea because I wore one for a while and I was surprised by a lot of things.

37:39Gary Brecka:I did too. Really surprised. I was fascinated. There's one thing. I love telling the story. What your body does in response to lifestyle. I had a CGM on and I did mine for just two weeks. Yeah, that's about what I did. I'm not the one who like wears it 12 months a year. It's like a whooping. It can sometimes be paralysis of analysis. I know. I know, I know. I'm like, take it off. Take it off. I had a good night's sleep. No, you didn't. It's like you're on the line of like looking too much at it. I had a CGM on and I did a cold plunge. And it went down within, it brought my glucose down significantly after doing a cold plunge.

38:15So imagine if we know, yes, your body was responding to that stressor in the best way possible. So imagine we had that data in order to know not only the food that I'm intaking, but maybe if I take that 10-minute walk after I eat a big meal, what if I'm able to do sauna and cold plunge every day? What is that going to do to my glucose? So I think it's just a great way to see how you can instill every part of your lifestyle and nutrition into what's keeping your glucose maintained at the level that you need it to.

38:42Gary Brecka:Yeah, I think, you know, I had a group of people that put these on for a couple of weeks and I think most people were astounded that after fasting all night and sleeping, getting up in the morning, they would start to move around and all of a sudden their blood sugar would start to rise. They're like, how's this possible? I haven't even eaten. I'm like, well, that's your liver actually. You know, going to work, there's a good sign. You know, it's taking the glycogen, the stored sugar, and creating glucose and throwing it into your blood. They're like, don't pass out. Yeah, yeah, yeah. It's fascinating.

39:11Gary Brecka:The body's a beautiful machine. It's such a beautiful machine. If we treat it right. The more I study it, the more I believe in God too because I just don't think this whole thing happened by chance. I don't think you and I or even, you know, as many thought leaders in the world could have put it together better than... The greatest team of engineers give it all the AI you want to give it, you're still not going to figure it out. I mean, this is such a beautiful design, so architected so incredibly. But, you know, I was very surprised by that. And I think the group that I was doing this with was really surprised by that.

39:40Gary Brecka:And then also, like you said, you know, looking at higher fat, higher protein, high fiber meals versus high glycemic meals and the duration of the elevation for a lot of these timeframes after meals, It just gives people a really good way of saying, I now have a roadmap for how I should be eating and the positive impact that just a 15-minute walk after a meal. Do you know how key this is, what you're saying right now to when we would bring people in and give them diabetic counseling, right? So now it's on paper with some messed up food pyramid that is not even relevant anymore. and I'm trying to explain an educational way, like this is why we need your glucose, the glycemic diet does this to it.

40:29But it was never a picture of what they're actually doing in real time. So now for someone to see it is only incentivizing them to being like, oh, I want to keep it there. I want to keep it at that good level. That is the best way for me as a high research, evidence-based physician to bring something to someone and being like, this is you at its finest. What do we do from here?

40:53Gary Brecka:So I want to bring it back to the autoimmune discussion because it's such a prevalent challenge in society. And a lot of times when I do stage talks or lectures and I've got a big audience out there, I'll say, raise your hand if you or someone you love has been diagnosed with an autoimmune disease. 75, 80 % of the hands go up. I'll say, raise your hand if you or someone you love has been diagnosed with more than one autoimmune disease. That's the part that really astounds me. At least half the hands that went up go up again. And it's purely anecdotal and subjective, but I've done this all over the world in very large audiences.

41:37Gary Brecka:And it is astounding to me. I didn't go three, four, five, but how many people have compounded chronic conditions. And I think that one of the areas where there's a lot of paucity of information is what does a lifestyle or a morning routine look like that really empowers the immune system? Like how do we, women especially, strengthen our immune system? How do they feel safe in their body? What are some of the lifestyle practices that they can engage in? Oh, I love this question because I think, and not to kind of throw shade at male biohackers. hackers. Well, you're on a male biohacking podcast, so be careful.

42:17Gary Brecka:I know, right? But for females, like we said before, you're like, and cut. Thank you for coming, Jessica. And we're done. But they take on so much that sometimes they don't find the time for themselves. So going back to that, that really was the point I was making is teaching women to take time for themselves. Even if it's just 10 to 20 minutes a day, these small implementations in their daily life can do outstanding work. So some of those things are, I'm a firm believer in some form of meditation. So good. Because when you have mind body, if we think about autoimmune in general, it is literally the body cells attacking its own, right?

42:56Yeah. So we know that there's inflammation. We know that there's some type of attack going on. So when we think of mind body medicine is really regulating the mind in order to kind of tell the body what to do. The body is just a vehicle of what is going on in the mind. So true. And so if we look at it, just like if someone could just take a step back, whoever's listening and saying, wow, I never thought about it that way, that your body is literally just doing what the mind is telling it. So if we can find a way to quiet the mind, there is a lot of data that shows that meditation in some form of mindfulness can actually help with disease process.

43:33Decreasing chronic progression of a disease. So starting with that, firm believer in that, and it can just be 10 minutes, 15 minutes a day. The other part is what you put in your body. Really taking a good look at food log, right? What have I done? I challenge my patients to do this. I'm like, just give me two weeks of what you're eating. Don't try and eat the healthiest things just give me like raw data. I just need to know what's going on from that. I can make adjustments to being like, this is not serving your body well as far as inflammation, because that's the fuel for autoimmune diseases.

44:03It's like inflammation. If it's got it, it's like, I'm on.

44:07Gary Brecka:Fire is lit. There's something called the immune system there, right? So there's diet. And one of the best things that you can do in the morning is because that's when your cortisol is really high is not to create more cortisol, right? And so what are the things that you can do? I think that having something as simple as water with lemon is a way to kind of neutralize and get your body ready for what you're going to put into it for the rest of the day and not eating a high glycemic thing first thing in the morning, right? So we're really trying to keep inflammation down. And you can have more sustainability throughout the day with energy if you start with protein.

44:41And the last thing I would say is always exercise, right? So however that can look. It does not need to be a full out hour. A lot of people don't have time for that. So I always appeal to, I say this even in medicine, if we're talking about disease progression, is if you can take care of the person who has the least resources, then you're reaching everybody. I completely agree. So I can't always, great, I want all the gadgets and all the things, but I got to go to work. Unfortunately, I still got to go to work. So I'm like, if I can take care of someone who has all of these responsibilities and taking care of all these people, then I know I've reached everybody.

45:18So that could be, again, it could be jumping rope, right? It could be taking a walk for 10 minutes. Imagine if you did that routine for every day, getting up a little bit earlier in order to give yourself this 30 minutes, 45 minutes of self-care, you will show up a better person at 70, 80, and 90. And that's what we're trying to accomplish.

45:40Gary Brecka:You'll not only show up as a better person then, you'll show up as a better person almost right away. You know, I made a choice about six years ago that I would schedule all of my meetings and travel around sleep and exercise. And there's exceptions to this sometimes. I like that. Scheduling-wise. But, I mean, if you open my phone right now, you will see, I mean, my morning is blocked in there. And I won't make exceptions to this, but by and large, I mean, you could go three months out of my schedule right now and see, okay, well, if I'm in London, the meetings don't start before then. If I'm traveling, rather than take the red eye, I spend the night and leave the next morning at a reasonable hour.

46:23Gary Brecka:Just that small little shift and then realizing that self-care is not selfish. It's actually the best way to be selfless because you take this time for yourself and then give the rest of your day away. Yeah. You can give so much more when you are filling your reserve. We were even talking about that earlier. When someone falls ill or is sick or is not feeling their best, a lot of it, you can't ever evade that, right? But the goal is what have I invested in myself or given back in self-care that when these things happen, I have reserve and I have recovery. Yeah. You know, being affiliated with this Maha committee, we looked at some of the broad statistics of healthcare spending, pushing about$5 trillion a year, healthcare outcomes.

47:08Gary Brecka:we essentially lead the world in morbid obesity type 2 diabetes which is isn't that weird it's it's really fascinating that that's that's our we're number one in that like that's not what we're trying to be number one in but somehow we've gone there but um and then there's a lot of evidence that you know we lead the civilized world in um infant and maternal mortality that one brought me to a full stop yeah right because all you have to do is walk around disney world to realize why we're leading the world in morbid obesity. But, and I've heard you talk about the crisis in black women. Yes. Which are three to four times more likely to die at childbirth, which is astounding to me.

47:53Gary Brecka:You know, and when we look at when disease and pathology seems to be selective, like autoimmune disease in women, we have to take a step back and say, okay, what is happening there? because mortality is not sexually selective either. And it's also, I wouldn't assume, racially selective. So what is the impetus? What is the backstory? You know, Gary, that is the million-dollar question. Well, I do have several answers. One is a black woman myself, but also an OBGYN. So this is something that I'm seeing like every day in my training and seeing where we're missing the mark in such the gap. And I said it earlier, unless everyone takes a step back, and I'm glad you framed it that way, that it should be surprising and it should cause pause in everyone.

48:38It's not just only the people who are involved that it should cause pause in because until we take care of a community that has the least resources and access, then everyone's not okay. So until we choose to make choice, everyone has choice, but make that choice where we're invested in people who don't have as much access, then we're not taking care of everybody. And so the reasons that that happened is it's systemic. I mean, I think that, you know, I always just like to say it like it is because I don't think it's offensive. And the more that we can talk about it, the less people will be offended.

49:12There's systemic racism. It is what it is. I see it. I've lived it. So once we understand that there's that and we can be like, huh, what do I need to do as an individual, an organization, an institution to address that? Then we're actually going to get somewhere. Instead of us kind of like being like, oh, that's not me or I'm offended or, oh, I don't want to talk about it. It's too dicey. No, just say what it is. And then how do we make change? The other part of that is, again, going to diet. Typically what you'll find in communities that have lack of access and resources are the foods that are not the best.

49:48And so when you have increase in inflammation, then you're going to have increase in diabetes, which just gestational diabetes is a big part, but also cardiovascular disease. So when we think of preeclampsia, which is another reason why we see these morbidity and mortality rates that high. It's a vascular issue, which is because we have increased risk of heart disease. So all of these things, it's the domino effect. Once you kind of start the domino moving, then everything else is going to fall. So I think we need to all take a step back and say, where do we start with this discussion? Because the discussion that we've been having is not getting us anywhere.

50:27And so I think the discussion needs to change between all stakeholders. It's all stakeholder conversation, not just one. I think you have now some of our governmental elites, I'll say in a positive way,

50:40Gary Brecka:I believe are well-intentioned about this Maha movement. Like how do we get the toxins out of our food supply? How do we improve the nutritional foundation for our children, especially our public school programs? and I think the, you know, women's health in general is where there's a lack of understanding of kind of what to do but I will tell you emphatically, I know these statistics are making their way into the right ears. Yeah. As long as we make sure that the people who need to understand or are being impacted by it rather understand what's being done and changed. So we have to make sure that the message is going all the way downstream to the people who really, really need it.

51:27Gary Brecka:Yeah. What would you say, you know, to the administration, HHS, CDC, FDA, NIH, if they're listening, and very likely they are. They're probably listening and we don't even know it. Without us even knowing, right? What would you say, you know, in broad context, here's some of the changes I would really love to see at that level to address things like 3, 4x increase in black female mortality over the general population. Yeah, coming from someone like me who's been in the industry of women's health for so long is I think we need more representation. Representation with more women at the table, but also people of color.

52:11I think that that's imperative because you never really can understand or know the journey of a group of people if you're not them.

52:20Gary Brecka:I know. That's just inherently what it is. Sort of debate that. And then the other thing that I would say is make sure that what's being provided is understood by the group that it's impacting as well. And I can even say this for myself, you know, trained as a physician, when a lot of patients come in and see me, it doesn't matter what they're coming in for. I speak to them in doctor talk and they're like, what the hell are you talking about? And so it's my responsibility actually to ensure that whoever is in my office is walking out understanding what I said. It's not their responsibility. They can ask me questions, but if I'm just talking above their head with stuff that they're like, I don't know what you're talking about.

53:02Gary Brecka:I'm not doing anything essentially. So I would say that making sure that whatever we're changing or whatever messaging or whatever resources are being improved, that the people who it's for actually know. You know I'm all about optimizing performance and lately I've been using the ion weighted vest during my workouts and it's been a game changer. It isn't your average weighted vest. It's designed to fit like a second skin, activating your core, improving blood flow, and even helping you with recovery while you train. What I love most is that the weight is perfectly distributed. It doesn't pull on your shoulders or throw off your alignment.

53:38Gary Brecka:Whether I'm doing strength training or cardio or just taking a walk, I'm burning more calories. building muscle and pushing my endurance even further. If you're serious about leveling up your training and unlocking your full potential, check out the Ion Weighted Vest at iongear.com. That's A-I-O-N gear.com. And you can use code ULTIMATE for 10 % off and start training smarter today. Now let's get back to the Ultimate Human Podcast. You even talked about insurance coverage and workplace environments for like menopausal women because I can tell you as someone who is deeply embedded in the industry, nobody is having that conversation in the workplace.

54:20Gary Brecka:Absolutely not. And I don't think that we are addressing for women, you know, the need for management of menopausal symptoms, you know, at that level. And, you know, women when they're reaching these, the upper echelon of, you know, at least the socioeconomic echelon of, you know, the corporate hierarchy, and then they're hit with menopause, you know, it makes things infinitely more difficult. What did you mean by we need to have this conversation around insurance coverage and workplace awareness for? Yeah, I think when we think of women's health, we have seen, even outside of maternal mortality and morbidity, is when we were just to look at midlife stage of women in menopause, there are so many women who actually leave the job force because of a menopausal symptom that they're just unable to kind of cope with, factor into their work life, their family life, and they're like, I have to give this up.

55:29And many of them don't necessarily want to give it up. So obviously the conversation is not being, again, held by the person who's being impacted. and the person or the organization who can say, huh, what do I need to do as a responsible party in this relationship in order to meet women where they are? And women's health in general has not been researched. You know, women in general have not been placed in research for a very long time. We're very new to that. We have suddenly realized that women are not little men. And so we're like, oh, let's actually include them.

56:01Gary Brecka:It took me 50 years to figure that out, actually. Let's put them into research. It's like, I call bunch, you call bunch. I'm intermittent fasting, you're intermittent fasting. Exactly. And so now that we've finally gotten there, we're like, yes, women are not little men and we'll put them in research is actually saying, OK, with these outcomes and these data, especially in menopause. And I know that now it's impacting brain health. Now I know that it's impacting the ability for them to not sit at a desk or a meeting and, you know, self-combust with heat for hot flashes. literally how do I make room for this because it was only maybe 10 15 years ago that we made actionable items in the workforce to accommodate lactating mothers right so now we're at the stage where we need to approach midlife in the same way of finding ways to have coverage in insurance for whether that's getting labs whether that's getting menopausal care, like actually making a package that is adjusted to women in mid-age and providing for them in ways where they're like, I now can safely go to the doctor to talk to them about it because I also know I'm being supported through my insurance and my workplace.

57:12Gary Brecka:And I think selfishly, this is a, this will have dramatic positive financial impact because, you know, it's, it's almost keeping people out of the system, right? The system is very expensive. And once you get into that system with a chronic disease and you start that management process and you've got thyroid and hypertension or diabetes or autoimmune. These are extraordinarily expensive, costly and if we did some preventative care and sunk some of the funds into preventative care dietary, lifestyle, which you're talking about all of these subjective factors and actually found a way to compensate physicians for making these kinds of recommendations.

57:54You're speaking my language now, Gary.

57:55Gary Brecka:Good. Dude, but you see how it came back to, how do we prevent chronic disease? I don't think that it's that difficult to do. Yeah. I think what we have been messaged in society as what life is, what the outcomes and expectations are, is actually not a fairy tale. I don't want to necessarily just get old and then I can't do anything. So basically what we're seeing now is people are getting to retirement, but then they can't do anything after because they're frail. They've broken a hip. They have a chronic disease and they have to carry around an oxygen tank. So why is it that we have the best of research and the best of resources and we're not applying it in the way that people can actually live longer and live well?

58:43Gary Brecka:Yeah. And I think from a purely, just purely black and white capitalistic perspective, it would be the best thing. It would be the best thing. Because this is the largest, I mean,$5 trillion a year. is last time I checked, that's a lot of money. Yeah. And it encapsulates like the next six or seven countries combined. And we have these kinds of outcomes. And by shifting some of that healthcare spending to screenings and preventative care. And I think the jury's still out on AI. My feeling is it's gonna be positive for medicine. Yeah, how I've come to think of AI is it's an extension of. when AI, you know, kind of first appeared on the scene wide scale, I would say about four or five years ago, I was scared as a physician.

59:30I'm like, yeah, it's coming from my job. Yeah. I got to watch my job. You know, what I've seen is there's always going to be that scare of something that's very new and unsettling. But what I have seen is the ability to be, to make physicians more efficient with their time, but also with the wide scale of research and data that we have. now it's helping me accomplish something better for the patient in a shorter amount of time and i think that the more that we're able to do that the more that i can give back to patients and also help myself not overwhelm myself and burn myself out yeah i think that you know the

1:00:06Gary Brecka:ability to take potentially trillions of pieces of independent data and create an actionable result i think that's fascinating i mean i think you combine uh artificial intelligence early detection and big data, we start to see, wow, look at these patterns that are emerging. And I think you can have really positive impact on healthcare. You know what I love about it too, now that as you're, you know, kind of putting it into that package is personalization. Personalization of how we look at longevity and functional medicine, quite frankly, is outside of the data sets that we have that traditional medicine uses and is for the greater part of it really good.

1:00:45But we still have an N of one at some times where we're like, how do we make that applicable to you as an individual? Yes. I think that that's what the AI has the, has a capability to do. And I'm, and I'm fascinated at what it's, what I'm seeing now.

1:00:59Gary Brecka:Yeah, I do too. I think it's good for my audience to know too, you, you published a book on Generation M. Yes. Yeah. I did. Congratulations. In my spare time. I did. I know how hard it is to write a book. I've been writing a book for three years. Isn't it? And it's just because you want it to be perfect. It sounds so exciting. And at some point, you know, I know some granular PhD is going to go, ah, look at that. Right. It's a very humbling experience, I would say, too. Yeah. Yeah. It's very humbling. Because you're very, you know, vulnerable, I guess, when you, you know, because this is your work and then you put it out there and then you know it's just going to be scrutinized.

1:01:36I know, to the highest degree.

1:01:37Gary Brecka:Yeah. But it's been very well received. And I know you've done a massive book tour. Yes. 24. Yeah. You launched the book. Um, what, what can women, um, expect from that? Generation M was really a love letter. I didn't know there was a generation M by the way. Yeah. There's a generation M. There's generation M and every woman gets to be in it. Cause at some point they're going to reach that M. Right. So every woman is either in generation M or is aspiring. You're heading there. I say it. I said, you're not aspiring. See what I did there? Aspiring to be in generation M. But it really was a love letter from me to my patients, myself, my friends who were going through this.

1:02:19And I wanted it to be something that they would relate to. There's a lot of kind of patient stories in there. So I think community, when women think of like what they're going through, community is very important. But also something tangible, something of I can do this. I can accomplish this. This is not overwhelming. we have really cast menopause into this light of dread and a horror story and I said what better way is to change the script and the narrative into something where someone's like I'm gonna this is a comedic love story rather than a horror movie I gotta fall back I gotta fall back in love with myself and there may be some funny moments along the way yeah by golly I can do this and And that's how it's written because it approaches libido.

1:03:05We talk about sex. We talk about muscle. We talk about brain. We talk about meditation and also hormones. That's a big part of the book, but it isn't just always about hormones. I feel that once we create an infrastructure or framework in the daily lifestyle and kind of understanding who we are and how we're going to go through this life, hormones is kind of the, I'm also going to create this kind of framework and provide the best ways for each of those pillars to do it. But if we don't have those pillars, we're not doing anything.

1:03:37Gary Brecka:I totally agree. I mean, I think, you know, physicians like you, Dr. Gabrielle Lyon, have really reframed the importance of weight-bearing exercise and weight training and how muscle is our metabolic currency. So for the women that are listening, I mean, how important is strength training, especially midlife and later in life how important is strength training is it a non-negotiable is it a luxury item how and where does it fit in your sort of scope of what women should be doing too yeah in the toolbox of uh women's lives and health and longevity it is a non-negotiable i feel that it is something that you can choose to ignore but what will happen in the end is it will come back to bite you in the ass.

1:04:26Gary Brecka:Yeah. Yeah, it surely will because muscle is our currency of longevity because that's what not only fuels our body and allows it for strength, it really is kind of pushing against our glucose metabolism. It is a sponge. It's one of the largest absorbers in addition to the brain of glucose. And we already lose muscle mass. That's an aging phenomenon that occurs. But what happens after menopause, after the loss of estrogen, is it compounds. So now we're losing muscle even more. So what are those ways that we can push back on that is through resistance and weight training and not small weights, heavy weight.

1:05:03Our bodies, don't underestimate it. Your body is able to adapt to things. Granted, you want to do it safely and adjust it over time, but never think that you were just here as a woman to lose muscle and not build that muscle back. And if you're going to do it with lightweight, that is not the category that we should be living in. And so when I see women that are older and even looking at the generation behind us, you know, or before me rather, is it's kind of like you have this view of what women are doing and it's not all their fault. I'm not blaming them. I'm just saying that they weren't given the tools.

1:05:40They don't want to get bulky. And that's not even what happens when you lift weights. It really is. I am now giving back to my body and also my bone and my brain. Right. So muscle, building your muscle mass back, one, prevents you from frailty, improves your strength, but also impacts your brain health and also your bone health. So you are getting more than bang for your buck when you do weight training. So for me, it's a non-negotiable.

1:06:09Gary Brecka:So what does a morning routine for you look like? Because my audience loves the tips and tricks. I'm going to ask you about supplementation. I'm going to ask you about morning routine. maybe even some of your travel tips. Yeah. Because talking to you about your schedule before the podcast, I was like, I thought I'd travel a lot. There's a lot of travel in there. No, I love showcasing. I definitely believe if I'm going to talk the talk, I need to walk the walk. And so weight training is a very big part of my daily regimen. Wake up and I definitely do mindfulness meditation. And what does that look like?

1:06:46So I do guided because I'm not an expert at meditation. So I use guided. I do 10 to 15 minutes. It is a muscle that you need to build as far as meditation.

1:06:56Gary Brecka:Like an app, earphones. I use an app. Calm is a good app that I use. I have kind of a meditation, I guess you could say instructor. So I use those guided meditations. And I think that there's enough out there that people can really look. Look on your Spotify and literally take in meditation and find one that's good for you. The other thing is I say, this may sound funny, but I say hello to the sun every morning. I do too. I literally say hello to it. My kids now do it too. They're like, good morning, sun. It is always there for you. It shows up every day and you get some vitamin D with that as well.

1:07:29So I do think it's important. That's a part of my routine. And then weight training. I am a person who, if I don't get it in in the morning, typically my day is so busy, I don't find time later. So I self-care will go to the gym and I I have implemented more weight training that I have in the past. I used to be runner, and now I am very big on weight training. I still do cardio, but I maximize most of my time in weight training. It does not need to be an hour workout. I am the queen of a 30-35 minute workout because I'm focal, I'm intentional, and I'm like, I'm here to get something done.

1:08:04Gary Brecka:Yeah, and it doesn't have to take up all of your day. It doesn't have to be inconvenient. So I've got to ask you about some big, big topics. you know, topping the headlines in women's health. One of them is creatine. And I've always been a fan of creatine. I too, even as a biohacker, lean towards it being a, you know, a muscle building supplement. I think when I was in high school, I was taking it, needed creatine to build big muscles. Now the data seems to be emerging about crossing the blood-brain barrier, you know, brain health, cognitive function, inflammation, maintaining muscle mass, where do you fall in the creatine supplementation for, especially for women?

1:08:48I always like to start with the concern because most people come to me as a physician being like, I don't think I can do this. I've heard this. So I'm like, let's dispel that first. People confuse it with creatinine, which is kidney function. And so I like to dispel that first is that that's something different. People who cannot or should not take creatine as a supplement are people who have really, really chronic kidney disease. Okay. So outside of that, right. Outside of that, most people are completely fine to take creatine. The reason why I think it's imperative that we do that is we do need help.

1:09:26Our body always needs help, right? So that can come in the form of nutrition supplements. And when we think of creatine in order to help muscle, right? I always think that amino acids and supplementation and proteins in order to help the muscle build, That's what you're going to find in creatine. And taking dosage, right? So five grams is where I like to sit every day. Some people, I start them out at two. See how they kind of adjust to that, go to five. When we think of brain health now coming into data sets of seeing how it's impacting clarity, how it's impacting mental capacity, this is the beauty of why we do research and studies.

1:10:04So now that we have a brain health kind of additive added to that, that's when we start to see taking maybe 10 grams and improving brain health. So you are having something that's implementing kind of all body. That's why I like that as one of the top things that you can take in your supplementation kind of toolbox. But I do take creatine and I think it's important that people understand what your body needs in order to have those optimal outcomes is it does need help. And so that's one of the ways that I think that you can do that.

1:10:34Gary Brecka:You know, it's interesting. I have a partner of mine that owns a chain of assisted care living and memory care facilities. And these are usually, you know, inpatient resident. Yeah. And they've just done some very simple, call them longevity hacks, and are gathering massive amounts of data. And I would say, you know, they are exposing them several days a week to red light therapy, sometimes even transcranial red light with the helmet on. they've added um uh the food being farm to table and all whole foods so they've gotten every ounce of processed food out of these assisted care and memory care facilities and creatine and those simple changes and a lot of these people are on hordes of medications and you know osteopenia osteoporosis the um and this is subjective so far, but the improvement that they are seeing rapidly in such a short period of time.

1:11:39Gary Brecka:They also have them getting regular sunlight. I knew you were going to say that, yeah. So they built these small little gardens. It's not like they're going anywhere. No. Put them in the sun. Exactly. Exactly. Put them in the sun. And I mean, in wheelchairs and everything. And it's, man, it's so enlightening and so exciting because, you know, these are not like massive interventions. some red light, some transcranial red light, supplementation with creatine, absolutely fixing the food supply. No more peel off applesauce, you know, with high fructose corn syrup in it. That makes my heart happy to hear that.

1:12:10Gary Brecka:It makes mine happy too. Because even in that, one, we're addressing a population that needs it, but how inspirational is that for someone to say, with these little steps, I could get that outcome? One, it's never too late to start, But the goal is when can we start so we may potentially not get there. Yeah. But even in a population that was clearly having these detrimental defaults that you can see change. Yeah. In small little steps every day. I'm telling you, lifestyle is everything. Yeah, lifestyle is everything. You know, my mother, Judy, she's 78 now. And years ago, she had bilateral knee replacement.

1:12:51Gary Brecka:and she went into a post-surgical rehab facility, an inpatient rehab facility because my father couldn't take care of her after this. And they get you up and they get you moving right away and what happened was they left her in bed. One of her knees got infected so they were going to have to replace the prosthetic. And this facility left her in bed for 45 days. Did not get her out of bed in 45 days. What was absolutely astounding to me was I flew up there with the family, all three of my kids, my wife. We flew up to surprise her. And it was on Halloween and we had like Halloween gear and balloons and everything.

1:13:33Gary Brecka:And so I walk into her room and we come around the corner and, you know, we were going to do the big surprise, mom. And I'm an only child. And my mother barely recognized me. Oh, my God. And she thought she was being held against her will. She was very confused about where she was. about what she was doing in there. It's a dementia setting. And I'm telling you, the rate of cognitive decline as soon as she was immobile, I mean, how I handled this with this facility is a whole other story. My head exploded. But the positive side of this was, I mean, she was absolutely frightened and scared, didn't know why all of us were in the room.

1:14:14Gary Brecka:Didn't even really kind of recognize the grandkids. And for me, the only child of her not recognizing me, It was a huge issue. And over the next 10 weeks, not only did I mandate that she was up twice a day, five days a week, which they immediately implemented. They were very embarrassed to go into a whole story about why this happened, but which made me realize a lot of times, you know, we put our parents in these facilities and this wasn't even assisted care, memory care. This was just for post-operative rehab. It made me really start thinking about that next phase of life about cystic care and memory care.

1:14:53Gary Brecka:But in 10 weeks, the first thing we did, I dramatically shifted her diet, focused again on fats and proteins, put her on a low glycemic diet, had relatively little intervention. Creatine, I actually put her on a peptide called cerebral license um got her mobile got her hydrated um made sure she was out of bed at least twice a day doing occupational and physical therapy in 10 weeks she was a completely different different human being i think she was better than when before she had the knee surgery because my dad called me he's like did your mom wants to redecorate the whole house she doesn't like any of the artwork he's like can you just like dial her back a little bit what a positive story she Just bounced right back.

1:15:39Hearing that, you know, my mind immediately went to, oh my gosh, like it couldn't have gotten better, right? Oh, it got dramatically better. And imagine just implementing movement and sunlight and food and nutrition.

1:15:52Gary Brecka:Sunlight was another big one we did. Movement, sunlight, food, nutrition, four or five supplements. So anyone who's listening can see that, one, it's never too late, but we're trying to get you to start before it's too late. But also what the body can do, when it's given the right tools. Yeah, so true. And I love hearing from mainstream academia. I put you in the mainstream academia bucket that there is starting to become a greater awareness of this. I think 20 years ago, stress, mindset, mood, emotion, those were never any things that had any impact on your health at all. In fact, you shouldn't even talk about those.

1:16:35You certainly shouldn't bring them up to your doctor. and now we're realizing the impact that stress and cortisol

1:16:39Gary Brecka:and our nervous system being trapped in this sympathetic state. And I saw that with my own wife because when she was going through this menopausal time, it was really stressful. She's like, I'm not myself. She would just break down. It's frustrating. And just be so frustrated because I stopped teasing her. But she was very frustrated. I can't find my keys in my wallet. Did I bring my passport to the airport? I mean, things that would just so not. That weren't even thoughts in her head before because she knew that she could. On her game. Yeah. But now all that's corrected. So, you know, for my audience that would like to know more about you or how they can find you.

1:17:18Gary Brecka:Yeah. Where can they find you? So I am on social media. I'm Jessica Shepard, M-D-S-H-E-P-H-E-R-D. But one thing that I've done from last year into this year, especially from the book and how well received it was, was community. and so whenever I travel we travel all over the world is women really thrive on community and so Modern Menno M-E-N-O so I didn't want to use the whole word of menopause but Modern Menno No one wants to be in a Modern Menopause group No, because everyone's like I don't want to be in that group There's still that little bit of like I don't know if I want to be in that group so I'm modernizing it with Modern Menno is the community that I developed that women can come in and learn from other women, hearing other people's stories makes you feel like you're not alone.

1:18:08You're like, I'm not the only one in this, but also for me to be able to distribute information, having webinars. And then for those who want to see me, you know, through my practice, there's a way that they can do that as well. But the main goal through Modern Menno is to say, what can I do for myself that I can inch into it or I can get the information that I need? Or if I feel embarrassed to ask a question, how can I ask the question? because from the WHI and seeing the reversal that we saw late last year is that it's still not widespread. You and I know it because that's what we live, eat, and breathe.

1:18:44But for a lot of women globally, and especially in the U.S., don't know that one, maybe that happened. Two, we're still very fearful of hormones, but also doctors. Doctors may not have gotten the matter quite yet or don't know how to manage hormones and hormone therapy. Even if they want to. Even if they want to. So we're still at some time out before everyone will either get it on the consumer side and then for physicians to being like, oh, I know how to manage this. So we still have a gap. And the goal with Modern Menno is to kind of create community to fill that gap. That's amazing.

1:19:17Gary Brecka:Okay, so I'm going to link all of that in the show notes so you guys know how to find the Modern Menno. I have a VIP community too that's, you know, they're the only ones that I tell who's coming on the podcast before they come on the podcast. I got to tell you, I got it right here. I mean, the list of questions, we have never had a response. Did you hear that? They've never had this many questions. We've never had a response like this in our VIP community to a guest coming on. I mean, and we've had some very prominent guests on, but we've got a lot of questions. We actually broke them into categories, hormone basics, perimenopause, menopause, BHRT, HRT.

1:19:56Gary Brecka:um and and so we're going to go into that vip community and and and get these questions answered if you're interested in becoming a vip just go over to the ultimate human.com forward slash vip you can sign up to be a vip and very similar to your community we do q a's and live challenges and creating a sense of community but i think doing it for um women i think is especially good because there's such a paucity of places that they can go to find that that kind of community and you know interestingly in in in these big data and blue zone studies um we don't talk about it a lot but sense of community and purpose um were non-negotiables those are those in all of these locations of safety yeah it wasn't specific diet um or specific geographical region it was community and connection um and i think we're so disconnected uh from from just the humanity that we think connection comes to our electronic devices and it comes from doing things just like this.

1:20:57Gary Brecka:So I wind down all of my podcasts by asking my guests the same question. So if you've been watching my podcast, you know that it's coming. Here it comes. I'll send it up in the air. I think you're going to smack it out of the park, Jessica. But what does it mean to you to be an ultimate human? Ooh, I love that question. To be an ultimate human is to look at all aspects of your life and ensure that you're tending to it in the best way where you can serve yourself and be the best version of yourself. Show up for everyone. Show up for yourself. Well, guys, I hope you enjoyed this podcast as much as I did.

1:21:34Gary Brecka:VIPs, we'll see you in a few minutes inside the VIP community. For the rest of you, everything that we talked about, I will link into the show notes, copy of her book, her community for women, and a lot of her work and social media contacts. And until next time, that's just science. We'll be right back.