Cavewomen Don’t Get Fat with Esther Blum: Rational Wellness Podcast 226
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Esther Blum speaks about Why Cavewomen Don’t Get Fat with Dr. Ben Weitz.
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1:09 Esther had mercury toxicity in her 20s, which damaged her thyroid. She gained 20 lbs and developed terrible IBS. It took several years to find the right doctor who diagnosed her mercury toxicity and put her on a detox protocol that included Captomer, a binder from Thorne, lecithin to protect her brain, omega 3s, trace minerals, and liver support like Spanish black radish. It is important to see a Functional Medicine doctor and to make sure to heal the gut and to protect the brain while removing the mercury. As a child, Esther was frequently sick with ear infection and she was placed on antibiotics almost every month. They also took her tonsils out. She ended up with Epstein Barr and/or Lyme and she did a plant-based diet to help kill it off, along with a bunch of supplements. She took silver, lysine, barley grass powder, spirulina, trace minerals, Cat’s Claw, and Lauric acid. Esther had a lot of neuroinflammation and insomnia. Esther also had some mold problem, so she did a few rounds of cholestyramine, along with binders like GI Detox and Saccharomyces probiotics along with glutathione, either liposomal or patches. She had a moisture issue in her garage.
15:09 What is the best diet? It should start with real food, which are foods on the outer aisles of the grocery store. Fruits and vegetables. Things you can grow in your garden. Chicken, eggs, meat, pastured, grass fed lamb, buffalo, elk, and venison. If you tolerate diary, you can have cottage cheese or yogurt. If you have a lot of gut problems, you may have to limit certain vegetables and be on a low FODMAP diet. Root vegetables, potatoes, sweet potatoes, and winter squash are all nutrient dense foods. If you tolerate beans and other legumes, eat them after soaking and sprouting and properly cooking. If you tolerate grains, then rice and quinoa can be great foods. It depends upon the person and their tolerances and their condition. There is no universal best diet. Esther noted that she personally needs at least 140 gms of carbs per day or she cannot sleep. She has found that most women do best with about a cup of fruit a day and anywhere from half to one and a half cups of cooked starch. The best fats are coconut oil, olive oil, avocado oil, butter, and grass-fed butter. Man made seed oils like sunflower oil, sunflower, safflower, soybean, canola, grape seed should be avoided entirely.
21:20 Some of the simple ways that women can change their diet to promote better health include adding things in that are good to displace the less good. Esther will often have women add in some protein so that they can maintain or gain some muscle. Protein also sustains your blood sugar for 4-6 hrs.
Esther Blum is a best selling author, integrative dietician, and health coach. Esther beat mercury, mold toxicity, battled Epstein-Barr virus, and debilitating insomnia in order to get her health back and to build a successful practice. She is the best selling author of Cavewomen Don’t Get Fat, Eat, Drink and Be Gorgeous, Secrets of Gorgeous, and The Eat, Drink, and Be Gorgeous Project.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss and also athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111. Dr. Weitz is also available for video or phone consultations.
Dr. Weitz: Hey, this is Dr. Ben Weitz, host of the Rational Wellness Podcast. I talk to the leading health and nutrition experts and researchers in the field to bring you the latest and cutting edge health information. Subscribe to the Rational Wellness Podcast for weekly updates. To learn more, check out my website, drweitz.com. Thanks for joining me, and let’s jump into the podcast.
Hello, Rational Wellness Podcasters. Today, we will be speaking with Esther Blum, who’s a bestselling author, integrative dietitian, and health coach. Esther beat mercury, mold toxicity, battled Epstein Barr virus, and debilitating insomnia in order to get her health back and to build her successful practices. She’s a bestselling author of Cavewomen Don’t Get Fat, Eat, Drink, and Be Gorgeous, Secrets of Gorgeous, and The Eat, Drink, and Be Gorgeous Project. Love that gorgeous word. Welcome, Esther. Thank you for joining us today.
Esther: Thank you. Thank you so much for having me.
Dr. Weitz: So please tell us a little bit about yourself and your own health challenges and how you overcame them.
Esther: Yeah. Well, I have no doubt in my mind that these were put in my path to just help make me a better practitioner and help more people. So in my 20s, I developed a whopping case of mercury toxicity. I was a hospital dietitian, and there was a lovely vendor who sold these amazing tuna fish pita pockets that I was eating every day for about a year and a half. Really, all of a sudden in three months my thyroid died. It had had enough, and I put on 20 pounds. Now, bear in mind, I was 5’3″ and I was 120. So for me to go from 120 to 140, I had never been that much in my life. I was lifting and very lean and working out. So all of a sudden, I couldn’t fit in my clothes overnight. I had no idea what’s happening to my body. I developed terrible IBS. I started going to different doctors and no one can help me or was helping me. It took about three years to find the right doctor to diagnose me and he was like, “Oh, you have mercury toxicity.” He put me on a detox protocol, and in six months, I lost 10 of those 20 pounds, so I joke them the girl who never lost less 10 pounds and lived happily ever after, but, certainly, my brain function returned. My gut returned to normal within two weeks of treatment. So that was really helpful, and then-
Dr. Weitz: By the way, what kind of mercury detox protocol did you use?
Esther: At the time, I was put on Captomer, which was a binder. It’s a product by Thorne. Again, I don’t advocate you do this on your own at all. I have the protocol in my first book, Eat, Drink, and Be Gorgeous, but I was taking a lot of lecithin to protect my brain as the mercury is pulled out. I was put on omega-3s. I was put on trace minerals, liver support like Spanish black radish. So that’s just what my body needed at the time. That worked very well for me, but I send people to functional medicine doctors for the detox because you really want to make sure you protect that blood-brain barrier. I see a lot of products out there with chlorella, and I know chlorella is advertised as binding mercury, but it pulls it into the bloodstream, but it can still cross the blood-brain barrier and make you feel like garbage. So you really have to be so careful with finding a protocol. You can get, I mean, now you can get IV drips. You can get IV vitamin C and glutathione, which is very important antioxidant for the body. The key is really to be put on binders, too, and probiotics and adrenal support, too, because mercury lives in the gut. So you really have to make sure you heal the gut. Then my husband and I did another mercury detox before pregnancy just to make sure that we got out as much as we could from our systems before carrying a child.
Dr. Weitz: Cool, and then you also battled mold and Epstein Barr.
Esther: Yeah. So the Epstein Barr, as a child, I was terrifically sick every month and was put on antibiotics. My grandfather was an ears, nose, and throat surgeon. So he took out my tonsils because they were just always every month. My mom joked it was like me getting my period. Just every month they put me on all these antibiotics. I had terrible ear infections.
Dr. Weitz: They’re an extra organ, anyway. We don’t really need those organs.
Esther: Yeah. So yeah. That was, again, and my parents, my dad was a physician, my mom was a nurse. So it was just full tale antibiotics, which really set me up at a disadvantage. I’m still always working on my gut because of that. So yeah. I had my tonsils out, and then after childbirth, though, that beast got reignited and I was very sick with Epstein Barr and/or Lyme. We’re not exactly sure. I’m still undergoing testing for Lyme now, but, yeah. So again, I did, at the time, I actually did a plant-based diet for quite a while to help kill off the Epstein Barr and took a lot of supplements. I took silver, I took lysine. I was juicing a lot of celery, and I took … Oh, my goodness, barley grass juice powder and spirulina, and I took lots of trace minerals and cat’s claw, and lauric acid to really kill off the Epstein Barr. So I had a lot of neuroinflammation and insomnia. So that got better, but it really just took my body a long time to ride itself after childbirth. It really did. Then mold, we’re still undergoing. I’ve done two mold detoxes. Clearly, my home still has something in it. So I just did another test this week. So it’s ongoing, but my body and my mind have become much more resilient in the process because I know where I got that from, so I don’t fear it or have anxiety around anymore. I just work with really good practitioners and know how to treat it. That’s really-
Dr. Weitz: What did you do for your mold detox?
Esther: So the mold detox, I did a couple rounds of cholestyramine, again, lots of binders like GI detox and Saccharomyces probiotics, again, glutathione either in patch forms or liposomal forms, but with mold, it’s really tricky. If you don’t get it out of your … We’re still trying to figure out is my body pulling it out and that’s why my levels aren’t budging or is it in my home. So I just did a retest literally last week where I took, it’s called an ERMI test, E-R-M-I, and you get cloth samples and you just wipe them on the surfaces. We did have a moisture issue in our garage, which we remediated, but I can tell still something isn’t right. So the question is, do we remediate again or do we move? We’re just waiting to see what happens. So stay tuned.
Dr. Weitz: Yeah. Mold-
Esther: Again, I’m doing this all with the help of functional medicine doctors. I do not treat myself ever because you can’t and it’s really beautiful as a practitioner to surrender and let someone else take care of you. That’s really the beauty of it all and to go through the experience to work with a good practitioner who listens to you, takes your needs into account, and who inspires you. Most of my practitioners have been sick with Lyme or mold or some other form and they’ve gotten to the other side. So you need to see the inspiration. In spite of my challenges, I mean, I still work. I still see my patients. I’m going to start another book. I don’t stop. I feel tired at times, and I just go and grab a quick nap and get on with my day. So you can’t surrender to what you have to keep going.
Dr. Weitz: That’s actually, I think, really important. I think there are some patients that do surrender and end up owning their condition.
Esther: Yeah. You can let it define you. I did that early on. I mean, when I have the Epstein Barr issue, I mean, I couldn’t even get out of bed. I had such severe insomnia. I was getting maybe two to four broken hours of sleep per night. I was in a very bad state of brain fog. So I took a little time off work because I just physically couldn’t get out of bed. Once I could and then I took the ball and ran with it, and I also decided at some point, I was like, “I don’t give a crap if I’ve had two hours sleep. I’m moving on with my life and my day,” and I’m ignoring it until my body catches up. So the mind is the most important thing in your healing journey because people can live with all sorts of stuff going on their bodies, but it’s how much power we give to our illness. If you surrender to it and let it overtake you, it’s very dangerous. There’s two types of patients, right? There’s the kind that totally handover their diagnosis and say, “Oh, I’m sick. That’s it,” and then there’s the other kind that say, “No. This is not going to own me or take over, and I will let my body lead me and tell me what it needs, and I will treat my body with love and kindness, and plant medicine, and herbs, and pharmaceuticals when necessary, and a clean diet, and good rest, and take care of my spiritual and emotional health, and that’s it.” You move on with your life and-
Dr. Weitz: So how do you help your clients with the mental, emotional aspects of their conditions?
Esther: I do not let them fall into that victim mentality and I keep questioning the narrative that they have in their head. This is even for people who are … I treat many individuals who are very obese and think that they can’t exercise or they don’t make time to exercise. I’m like, “This is absolutely not true.” We go through their day and we find that, “Oh, no. They’re just lying around in the evenings. Oh, they have plenty of time to exercise and watch Netflix and be on Instagram.” So no. So I call them out on it, but also I help get them really connected to their why, why they’re doing it, “Why are we here? What do you really want? What’s that carrot that’s going to dangle in front of you?” So one of my clients was like, “Well, I want to retire in the next five to seven years.” I’m like, “Well, guess what? If you don’t lose this 100 pounds, you’re not even going to be around to do that.”
So she’s type two diabetes, which her own doctor didn’t even pick up on. I picked up looking at her labs. So I have her wear a continuous glucose monitor. I have her exercising. I have her text me every day her workout logs and her blood sugar and her eating. She sees on the glucose monitor readings, we have seen a dramatic shift in her blood sugar just since adding in 20 minutes of elliptical every day. I said, “This is just another dose of metformin for you. Just think of your exercise that way.” I’ve been working with her a long time and it’s taken me this long to breakthrough to her. It’s a long, long … She keeps renewing with me, but wasn’t making progress. The other thing I did was I finally got her to switch to a functional medicine doctor. Man, I was like, “You see now. You have a team supporting you versus just a regular doctor,” who didn’t even diagnosed her diabetes. I was like, “Has she even looked at your glucose or your A1C?” It was medical malpractice in my opinion. So I really fight and advocate for my patients. They know they have a partner and they know I’m with them the whole way. So I think just having that level of support and emotional support, and not in a judgmental way, just celebrating their victories along the way and getting them to clear out their stories and excuses is paramount.
Dr. Weitz: Isn’t it a shame that the typical way type two diabetic patients are treated is they’re simply given a prescription for metformin or metformin and another drug or eventually insulin, and there’s no serious attempt to get them to change their diet, and their lifestyle, and exercise, and get proper sleep, and all the things we know that is why they have type two diabetes.
Esther: Oh, well, it gets even better. She wasn’t even prescribed metformin. I’m the one who told her to get some from her doctor. She wasn’t even prescribed it. Nothing, nothing was done. I was like, “This is so unacceptable.” So then she began to realize, “Okay. I need to go to another doctor.”
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Dr. Weitz: So I think this is a good segue into the next question, which is, what does a healthy diet consists of, and in particular, which are the macro nutrients that we should be emphasizing? I’d like to make a comment before we start this discussion. It seems to me that there’s a lot of issues with what our diet should really consist of, and it seems as though emphasizing any one of the three macronutrients can have potential problems. So we have fats, carbs, and proteins. If we consume too many carbs, we tend to have metabolic blood sugar, insulin resistant problems. If we consume too much protein, especially animal protein, we may see our IGF-1 levels rise, which some data indicates reduces longevity and increases cancer risk. If we consume too much fat, we may have increased risk of cardiovascular disease. So what do we do?
Esther: Well, A, it depends on what kind of fat and protein you’re eating that is going to lead to inflammation and disease. So first and foremost, you want to start with real food, and what is real food? That is food that has one ingredient in it or I say five or less ingredients, but foods on the outer aisles of the grocery store or just shop the produce section, right? Your meat-
Dr. Weitz: It doesn’t come in a box or a package or a container.
Esther: That’s right or that you can grow yourself in your garden, you can produce chickens. So chicken, poultry, eggs, meat, ideally pastured, grass-fed, lamb. Some people like pork. You can have buffalo, bison, elk, venison. If you tolerate dairy, you can have cottage cheese or yogurt. Those are all quality proteins that are nutrient dense that your body can understand and break down into proteins, sugars, carbs, fats. So also produce. Again, it depends on what you read, right? For some people with severely compromised gut function or severe autoimmune, you have to be careful with veggies, certain veggies. I have a lot of clients I treat with SIBO. That’s small intestinal bacterial overgrowth. So they have to be on low-FODMAP vegetables that are easy on the digestion. If someone has a lot of bloating, I have them have more cooked vegetables than raw.
In terms of fats, well, let me actually circle back to starches. I love root vegetables. They’re very grounding and easy to digest. So potatoes are actually tubers, which are easy to digest, then there’s sweet potatoes, butternut squash, acorn squash, spaghetti squash, right? Those are all nutrient dense. If you tolerate beans and legumes, they don’t give you gas and bloating or if you tolerate them soaked and sprouted, then those are all a great form of resistance starch, which takes a long time to be broken down. Any starches that are cooked and cooled like white potatoes, potato salad, very high in resistance starch, has a much lower glycemic index. Again, if you tolerate grains, then rice, brown rice, quinoa, which is a seed not a grain, but not all my clients have to go gluten-free. I have some people that tolerate gluten and dairy and do absolutely fine. Then I have others that need to be on an autoimmune protocol and really don’t do well with gluten and dairy or can tolerate some dairy depending on the age, more aged cheeses where the lactose is broken down.
So there is no universal diet. I have some clients that are plant-based. I have some clients that are hardcore carnivore, some that are paleo, in between. I personally do well on more carbs. If I don’t eat about 140 grams a day, I don’t sleep at night. So, I mean, who would have thought, right? So it’s really individual. I can’t say exactly what every single person should eat, but I can tell you this, real food that’s nutrient dense, low sugar. I mean, really, sugar is not something anyone should be eating a lot of. You really have to earn your carbs. When I wrote Cavewomen Don’t Get Fat, I wrote it because it’s a paleo diet book for women. Most paleo diet books speak to men. Most research on paleo diets are done on men and intermittent fasting and keto, all done on men.
So with women, I really teach them to find their own unique carb tolerance, and I do this by doing a two-week cleanse where you get your carbs from fruits and vegetables, and then slowly adding in half cup of cooked starch per day from, again, potatoes, sweet potatoes, winter squashes, and then slowly ramp up. So what I’ve found over 26 plus years of practice is that most people tolerate about a cup of fruit a day and anywhere from half to one and a half cups of cooked starch. That’s the way it goes per day, and they can divide that up or they can have it all at once. Then fats, again, you want fats that are low in inflammatory compounds, so coconut oil, olive oil, avocado oil, butter, grass-fed butter. The rest, sunflower oil, sunflower, safflower, soybean, canola, grape seed are usually manmade oils. They’re very high in inflammatory compounds and should be avoided. They’re seed oils, so they should all be avoided. They’re not safe to consume.
Dr. Weitz: Okay. So what are some of the simple ways women can change their diets to make strides towards better health?
Esther: Yeah, by adding things in, adding in the good to displace the less good. So adding in protein is where I start because for women, the women who come and see me are mostly in the perimenopausal to menopausal range. I do treat men and I do treat younger women, but primarily, those are my people. So as we age, we lose muscle mass. It’s called sarcopenia, right? It’s age-related muscle loss. So you want to make sure that you are building muscle or maintaining muscle, especially through menopause when your estrogen and progesterone drop. I see a lot of weight gain happen in a very short period of time. So you want to make sure that you’re getting … I have people aim for one gram per pound of body weight, of ideal body weight.
Dr. Weitz: Look at all the weight gain that happened in the last year because of stay-at-home orders.
Esther: That’s right, and people not going to gyms.
Dr. Weitz: Not going outside.
Esther: Not going outside, yup, which, by the way, can I also-
Dr. Weitz: Working at home right next to the refrigerator and ordering junk food in.
Esther: That’s right. That’s right. Can I suggest for all of you who are still at home or just not going to the gym, there’s a lovely website called YouTube, which has thousands and thousands of free workouts that you can do with your own body weight. So no excuses there, but, yeah. So protein is where I start because protein does the following. Number one, it protects skeletal muscle and bone density. One of the largest dangers of aging is bone breaks due to poor bone density. So you want to make sure that you’re eating a good amount of quality protein, a gram per pound of ideal body weight. To just break that down into simple math, that works out to about four to six ounces three to four time a day of protein. Protein also sustains your blood sugar anywhere from four to six hours after you eat it. It’s the only nutrient that chucks off hunger in the brain. So when someone increases their protein, they actually dramatically decrease calories because they’re not hungry and they’re not craving. Their sleep improves because the sugar is balanced during the day and their insulin, so they’re not waking up with low blood sugar in the middle of the night. It also prevents that 3:00 PM crash so you’re more productive, you’re less irritable. So protein is amazing.
Dr. Weitz: By the way, I read your Cavewomen book and I need to ask you, what is goat protein powder? You mentioned that in-
Esther: Yeah. It’s protein powder made from goat milk instead of-
Dr. Weitz: I mean, I’ve seen that before.
Esther: Yeah. You can find it. It’s a little hard to find, but you can find it. Yes. Yes, or you can goat cheese.
Dr. Weitz: There’s always cricket protein powder as well.
Esther: There is cricket protein powder, yes. I’m telling you, stay tuned, people. We’re all going to be eating crickets one day. Oh, my gosh! It’s true.
Dr. Weitz: So what are some of the most important health issues that women struggle with?
Esther: I would say gut health. Again, as we go through menopause, the integrity of your gut lining, your small intestinal lining really shifts as your levels of estrogen and progesterone decline. You can get a lot more leaky gut, bloating, gluten and dairy intolerances, gastroparesis where food just doesn’t move through your system so much, constipation. So you really want to make sure you’re fueling the good bacteria and you’re cutting the inflammation in your gut and just eating a lot of real food. Something else I saw during the pandemic is alcohol intake increased so dramatically with a lot of people, and the stress of trying to balance the needs of family members, kids who are home doing online schooling, plus keeping up with the workload of jobs is tremendously stressful. So alcohol intake shot way up. I think it’s become a really big coping mechanism and people need to understand of the other ways to handle stress like exercise, fresh air, time in nature, meditation, journaling, just quiet time, even if it’s five minute a day. It’s really important that we recondition ourselves not to just reach for alcohol when we’re stressed.
Dr. Weitz: Yeah, or sugar. I remember seeing the CEO of-
Dr. Weitz: … one of the big cereal companies and he was on the financial channel. He was talking about how great it is that people are eating cereal for dinner and isn’t that a great thing?
Esther: Oh, God! Oh, God! No. Just no, people. Just no. Don’t. Kids, too. My son would always say, “Why don’t we have cereal in our house?” So I told him about this study I learned about when I was doing my nutrition training where there was a study done. I swear. It was mice and one group was given Cheerios and the other group was given the box. I swear, the group eating the box lived longer. The cereals are really heavily sprayed, especially the oats. I mean, they’re heavily sprayed with roundup and chemicals and kids are having really high levels of glyphosate, which does a number on their brains and their guts. So if you love your kids, give them overnight oats organic, gluten-free oats or give them just eggs and some bacon, and avocado and they’ll do a lot better or we give my son protein shakes or his staple breakfast with wild blueberries, which really support brain function.
Dr. Weitz: Since we’re talking about menopause, what do you think about hormone replacement therapy for a lot of these negative effects? [inaudible 00:27:43] gut and everything have to do with the falling estrogen and progesterone.
Esther: Yes. I have seen tremendous transformations in my women who I treat who go on hormone replacement therapy. I do-
Dr. Weitz: Bioidentical.
Esther: Bioidentical, of course. Yeah, I do what’s called a DUTCH Test. It’s a dried urine test for comprehensive hormones. So that helps. Even if someone is in menopause, a lot of people say, “Oh, you shouldn’t test women in menopause because their estrogen is you get surges. It’s like a roller coaster ride. You get surges and then you get massive drops.” However, I can look at your adrenal health. I can look at your methylation patterns or your detoxification patterns and make sure that your estrogen is moving down the right pathway. So I have seen-
Dr. Weitz: Two, four or 16 hydroxyestrone pathway.
Esther: Exactly right or the 4OH pathway as well. So you want to make sure. Again, I can specifically know, are they a better candidate for DIM versus broccoli extract, versus brassica family. So it really-
Dr. Weitz: Versus calcium D-glucarate.
Esther: Yes. It really depends on their pathways, but, again, I can really help them methylate well, and I continue to test as they’re on hormones and get their blood levels of estradiol check once they are on hormone replacement. They go from not sleeping, having complete brain fog, irritability, depression, low libido to sleeping, happy mood, they’re not crying and in tears every day or completely irritable with themselves or their family. They’re actually interested in sex again, and it corrects vaginal dryness as well. There’s so many amazing delivery systems, right?
Dr. Weitz: What have you seen that the women that you work with, what forms do you find that seem to work the best and also if you could comment about the way progesterone is administered whether in a cyclical fashion or in everyday fashion.
Esther: Yeah. Well, okay. So first of all, with menopause, you can give some hormones during perimenopause like progesterone and/or testosterone, but usually I wait until people have had a full year without a period to give progesterone and/or testosterone, but you can start with DHEA, which is oral, comes in a micronized pill. That’s a form of hormone replacement therapy. It’s very gentle. It gives adrenal support, supports fat burning and energy. Progesterone, I always give orally.
Dr. Weitz: By the way, what’s a typical dosage you might start a woman on for DHEA?
Esther: Oh, I start very low. I start five milligrams and just slowly titrate the dose up as tolerated. I don’t even have to necessarily go that high to get good results, but 20 is probably the upper limit of what I do. Now, some practitioners go a lot more intensely. I try to take a gentler approach and go with just what your body needs.
Dr. Weitz: You ever use pregnenolone?
Esther: I do on occasion, yeah. I mean, pregnenolone is amazing, too. It’s the mother load of all hormones. I do work with oral progesterone. It can be taken in a capsule. It can be taken in a troche or a troche depending on how you … It’s a dissolving form that you put under the tongue at night. If someone is still having a menstrual cycle, I give progesterone only days 14 through 28, but if they’re fully menopausal, you could take progesterone every night. So why do I use progesterone for sleep and mood? Progesterone is a precursor to GABA, which is a very calming neurotransmitter and, again, quiets the brain, quiets that ruminating, chattering brain and just helps knock you out and get more restorative sleep, helps control that nocturia that you tend to get at night with menopause also. Estrogen is wonderful also for clearing brain fog, for bone density, for hot flushes, vaginal dryness. So estrogen I like to use in patch form, but you can also give estradiol as a vaginal suppository to correct vaginal dryness. You can also give DHEA intravaginally for vaginal dryness and libido.
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Dr. Weitz: What form of estrogen have you seen is supported by the data? Does the data seem to show it’s better to use estradiol or a combination of estradiol and estriol, which is the Biest creams?
Esther: Yeah. Those are much weaker. The Biest creams are a weaker form. I tend to use a patch of estradiol, but estriol, intravaginally, yes. So a couple of different forms, but I like the fastest, most efficient delivery system and a patch is great. You only have to change it every three or four days, and it’s waterproof, so it’s great. You just slap it on. You don’t even think about it. Then testosterone-
Dr. Weitz: Right. Absolutely. Some of the practitioners who uses combination of estradiol and estriol are doing it because estriol is a weaker estrogen and maybe more protective against breast cancer.
Esther: Yes. Really, I’m not, I mean, I work with doctors for this very reason because I’m not a doctor. I refer people to hormone specialists who can prescribe because I’ll say, “This is what I think,” but, ultimately, they sometimes override or see things that I don’t see. So I always partner with a team because I’m not a physician.
Dr. Weitz: Right. Listen to the two recent podcasts I did with Dr. Felice Gersh, who’s a huge defender of estradiol not estriol.
Esther: I mean, I primarily work with estradiol for that reason. Again, after six to eight weeks, you do need to get your blood levels checked and you need to redo your DUTCH and make sure that you are-
Dr. Weitz: So actually, you do the DUTCH Test. What is it that you’re going to look for and then which changes are you going to make in their protocols?
Esther: Well, first of all, I mean, let’s just finish the hormone if we can. So testosterone also, I was going to say I use as a topical cream. This is where I differ from a lot of doctors. A lot of doctors are using pellets. What I see is in my men and women, those pellets aromatize to estrogen. So I don’t like it because it’s also really inconsistent dose. You spike up in the beginning and then it drops down. I want consistency. So creams are great. Again, you’ve got to rub them in and don’t have contact with your partner. Wash your hands after. Don’t have contact with your partner for an hour after so it’s really dissolved. Okay. So the DUTCH Test, what do I use it for? Well, I use it for, first of all, to determine your production of hormones and then your detoxification of hormones. I want to make sure that they’re going down the right pathways, okay? I use it also to determine … It helps me figure out if you’re on thyroid medication. I can look at your cortisol patterns and see if you’re blowing through your thyroid meds too early like by mid afternoon, and if so, do you need to tweak your thyroid meds? I look at-
Dr. Weitz: Wait. Hang on. So what is it that you see that indicates that as far as cortisol patterns?
Esther: Yeah. It depends on the individual, and I also look at their blood test, too, of their thyroid, but in some patients you can see if their … Again, this isn’t a blanket statement for everyone, but for some people, if their cortisol is low in the afternoon, they could be blowing through their thyroid meds early or metabolizing them too quickly. They’re maybe not in the right dose.
Dr. Weitz: When you say low in the afternoon, it’s supposed to decline over the course of the day.
Esther: It is, but if it’s lower than normal, if it’s below the curve and flat lining-
Dr. Weitz: Below the curve, okay.
Esther: … then, again, they may also need some DHEA. They may need some adaptogens and adrenal support. Licorice will raise and sustain, licorice extract not Twizzlers, will raise and sustain your cortisol to make it more even throughout the day. So it’s so multifactorial. I can’t just make blanket statements on it.
Dr. Weitz: Yeah. No. I’m just trying to get some pearls of wisdom.
Esther: Yes, yes, yes, yes. Then I also look at … Oh, my gosh! I’m having a brain blank. Please forgive me. I look at neurotransmitters. I look at organic acids and see what is your production of serotonin.
Dr. Weitz: So you’re doing a DUTCH complete test.
Esther: I’m doing a DUTCH complete, yeah, because I want to make sure, are you making your neurotransmitters? Are you making serotonin? Are you making melatonin? The interesting thing is with that is I see a lot of people who come to me on antidepressants. A lot of the times, the neurotransmitters aren’t great even on antidepressants. So I’ll say to them, “How long have you been taking these?” They’re like, “20 years.” I’m like, “You can come off them.” I work, again, with their psychiatrist, with a good amino acid protocol, and we wean them off, and they feel fine. So a lot of the times they don’t need it when we correct their nutritional hormones.
Dr. Weitz: How can a drug that’s designed to keep more serotonin in the brain work when you’re not producing enough serotonin to begin with?
Esther: That’s it. That’s it. So I really want to make sure everyone’s optimized, not on medications they don’t need to be on, and that we correct the balance because no amount of antidepressants will fix your menopause. I do see antidepressants prescribed during menopause because women are depressed. Well, they’re also depressed because they’re low in estrogen and especially progesterone. So menopause is not a Prozac deficiency. It’s really not. It’s a nutrient and hormone deficiency. The thing is a lot of people are very nervous about hormones, and not everyone is a candidate, but many, many people are. I always say, “This isn’t your mom’s hormone replacement therapy. We’ve come a long way with the delivery systems. We test. We make sure you’re methylating properly and your nutrition is good.” One thing people don’t realize is that you should not be drinking a lot of alcohol when you’re on hormone replacement because your blood alcohol levels will also raise your estradiol for the same amount of time that your blood alcohol is elevated. So you don’t want to be in this estrogen-dominant state. You want to be in an estrogen-balanced state. So that’s something I put out there as a caveat to everyone who goes on it is watch the booze. Do not think that you can still continue your lifestyle of drinking wine every night while you’re on hormones. That’s not a safe practice to do.
Dr. Weitz: Good point. Well, let’s try to get one more clinical pearl out of this DUTCH thing.
Dr. Weitz: So what do you see in hormone metabolism and estrogen metabolism that would make you recommend one thing over another?
Esther: Again, I usually partner with doctors on the DUTCH interpretation for this reason. I’m still trying to learn it myself. Before COVID, I would have gone to conferences on this, but I usually partner with a doctor on the interpretation.
Dr. Weitz: Yeah. If you look at my YouTube page, you can see the presentation by Dr. Carrie Jones.
Esther: Yeah. She’s the best. Yes, she’s amazing. I regularly listen to those. It’s usually the 4OH versus the 16OH pathways of estrogen that really help me determine DIM versus calcium glucarate versus BroccoProtect.
Dr. Weitz: Well, when will you use BroccoProtect versus DIM? DIM is derived from broccoli seed.
Esther: Yes. Again, it’s usually when I partner with a physician. I don’t always make all the calls myself. I’m forever the student and when I don’t know something, I always defer to a doctor to help me.
Dr. Weitz: Sounds good. There’s nothing wrong with staying in your lane.
Esther: Yes. Yes. Well, that’s it. I mean, I’m like, “Okay. I can meal plan till the cows come home,” but full disclosure and transparency, I’m not an expert yet. I’m forever the student.
Dr. Weitz: Right. Forever the student, too.
Esther: Yes. Yes.
Dr. Weitz: It’s one of the reasons why I like doing this.
Esther: You’re asking brilliant questions. I’m still trying to learn this myself.
Dr. Weitz: I’m not trying to put you on the spot.
Esther: Yeah. No. It’s good. It’s good.
Dr. Weitz: So talk a bit about how you treat the person instead of the illness.
Esther: I treat the person by doing a really complete history. The first appointment with a new client is an hour and a half. So I really spend time knowing who they are as a person, finding out their psychosocial standing. Did they suffer abuse as a child? What’s their relationship with food? Were they fat chained? What’s the perspective and the story that they bring to the table? Because that influences people. If they were fat chained as a child, the last thing they need is judgment. Of course, I don’t practice in judgment anyway. I really come at it from a place of education and empowerment, but somebody might need some more hand holding.
I have some clients that just take the ball and run and they’re like, “I got this. I’m measuring my body fat. I track my macros.” They know. They just want accountability, but I have other people that truly have never been educated before on the effects that foods has on their body or they’ve never made the connection between food and mood. So I help them gently but powerfully make those connection so they can really have a sense of, “Wow! You know what? I had a really stressful fight or conversation with someone who triggered me, and I went right for that bag of potato chips and do the face plan in it.”
Okay. That wasn’t helpful. So we talk through. We talk through the binges and we talk through the stress eating and the behavioral eating. For a lot of people, my clients, the hardest thing for them to give up is alcohol. It’s even harder than sugar for people. I get that. I mean, please. I always joke I’d be like a smoking alcoholic if I could. I mean, I don’t really care for smoking, but I love drinking, but I don’t really often because it’s just a big no-no for my body. It wrecks my sleep and my mood and my mental focus. I don’t even crave it really much anymore.
So that’s how you treat the whole person, and then you teach them to nourish their body with real food and to focus on what they’re putting in versus just restricting all the time. It’s just adding foods in and abundance, creating a real abundance mindset around food. Then they see like, “Oh, my God! My sleep is so much better. My mood is better. My monthly cycles are better. I lost weight. I’m getting compliments on my glowing skin.” All of those help empower someone so that they are connected to their food, they want to put good things in their body and they feel confident about their choices. They’re not afraid.
“Oh, my God! I had some ice cream the other day.”
All right. So what? So you adjust your carbs that day or the next day and your balanced and fine. The world doesn’t end. So that’s the other piece I really focus on is building pleasure into your eating and making it fun, not about restricting. People come in to see me very scared that I’m going to take away everything. I’m like, “No. That’s not it. The key is for you to figure out how you will have that chocolate cake when you want it, but how are you going to be satisfied with three bites instead of the whole thing? How will you listen to your body of whether your body even wants it in the first place?” So it’s a lot of deep programming and unlearning and then turning their direction or compass saying there’s a new way. You can actually have total freedom. It’s all in the mind, though. So much of it is in the mind.
Dr. Weitz: Right. So I think that’s pretty much a wrap. Do you have any final thoughts you want to leave our viewers with?
Esther: Yeah. I want to give your viewers a couple of gifts. A, you can follow me on Instagram, @GorgeousEsther. That’s E-S-T-H-E-R. You can receive my three-day video training on how to crush your cravings so you can eliminate your cravings really in as little as 24 hours. So if you go to estherblum.com and just enter your email, you will receive that. Then lastly, for five of your listeners, I’m going to gift, I’ve open up my calendar, for five consultations that are complementary, and they are for action takers and people who really know that they want to solve a specific problem, be it weight loss or sleep or hormones or gut health. They will receive a 30-minute consultation with me where they will be gifted with three customized takeaways to help them reach that goal.
Dr. Weitz: That’s great. Thank you so much.
Esther: You are welcome. They can go to estherblum.com/call, C-A-L-L.
Dr. Weitz: Great. Thank you, Esther.
Esther: Thank you so much.
Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. If you enjoyed this podcast, please go to Apple Podcast and give us a five-star ratings and review, that way more people will be able to find this Rational Wellness Podcast when they’re searching for health podcasts. I wanted to let everybody know that I do now have a few openings for new nutritional consultations for patients at my Santa Monica Weitz Sports Chiropractic and Nutrition Clinic. So if you’re interested, please call my office 310-395-3111 and sign up for one of the few remaining slots for a comprehensive nutritional consultation with Dr. Ben Weitz. Thank you and see you next week.
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