Foreign. The name of this game is Myth or Must Know Midlife Edition. So I will give you a sample prompt and you say whether it is a myth or a must know truth, and then you can give a little explanation if you'd like. All right, first one. Calcium supplements are the most important factor for bone health.
Elizabeth KatzmanThey are not. And calcium can get lodged in our arteries where we don't want them. So supplementing with calcium when our estrogen is low can be dangerous. I like mchc. It's micronized bovine calcium. It's very bioavailable. It doesn't tend to coagulate in our arteries. So I really like mchc. And also actually, you know, vitamin D and K together is much more supportive than calcium, so. Wow.
RoxyOkay. Back in the day, you know, in the 80s and 90s, everyone's like, drink your calcium, take your calcium. You know, do that. Wow. Okay. Number two, if your labs look normal, your hormones are balanced, well, you could.
Elizabeth KatzmanAsk probably 10 different people and show them your same labs, and they would probably all have different interpretations. So that would be a definite myth that just because someone tells you they're normal, that everything is somehow balanced and balanced. By the way, balanced for one person is not balanced for another. I know women who feel amazing on really high estrogen, and I know women who feel amazing on pretty low estrogen. So. And a lot of that's genetics. So what is right for one person is not necessarily right for you.
RoxyIt's individual.
Elizabeth KatzmanIt's very individual.
RoxyOkay. The pill only affects your body while you're on it.
Elizabeth KatzmanRight? Right. Myth.
RoxyTotal myth.
Elizabeth KatzmanIt does, for a very long time, affect our receptor function and the way our brains communicate with our ovaries. And for there. There are some women who are very blessed. They get off the pillow. They get a cycle immediately. Not just, you know, withdrawal bleeds, but they're actually. They're ovulating right out of the gate, and their skin looks great and they're sleeping. There are those women. I don't want to make it seem like everyone who is ever on the pill is going to have short and long term issues, but for many women, the issues last. They could be 20 years later.
RoxyOkay. Gosh, it's like the more, you know, weight training is more effective for bone health than cardio.
Elizabeth KatzmanYeah, it is. We. We need resistance on our bone. And muscle health is a great indicator of bone health because, you know, if you are. If you're putting resistance on your muscle, you're also putting resistance on your bone, and that's how we gain bone density and cardio. Like swimmers and bike riders, for example, have really poor bone density, especially bike riders in their neck and upper back. Swimmers kind of notoriously don't have great bone density. And when you're doing a lot of cardio, you're increasing cortisol, which breaks down bone. So definitely strength training is the hero there.
RoxyOkay. Hormonal shifts are inevitable at midlife, but suffering through them is not correct.
Elizabeth KatzmanThat is true. You do not have to suffer. There are, whether it's herbs or HRT or lifestyle changes, we have a lot of tools to make sure that it doesn't. You do not have to be miserable.
RoxyThat's such a good thing. Gut health has nothing to do with hormonal health.
Elizabeth KatzmanOh, yeah, a tremendous amount. And again, a lot of it is out of our hands. If you're eating a perfect diet, but you're losing estrogen, you are losing your diversity virtue of that alone by changing nothing. So, yeah. And it affects how we metabolize our estrogens. So we could have more circulating estrogen, which would make us sick, which I really didn't talk about. But if someone is not going to the bathroom daily, they really shouldn't be taking HRT because you're going to be accumulating recirculating estrogen. So it's one of the first thing I'll ask a woman. It can also be related with thyroid function. So if you have a sluggish thyroid, you have sluggish digestion, and we really have to address that or up your magnesium. We have to get you going to the bathroom every single day to get rid of circulating estrogen. And so a lot of that has to do with the function of our microbiome as well.
RoxyWait, that's fascinating. So I did not know that. So if you do not go to the bathroom every day, it's not a good idea to pump extra estrogen into your body. Wow. Because you have to be able to eliminate what you don't need. Right?
Elizabeth KatzmanYes. You'll have a lot of estrogen dominant symptoms.
RoxyLike, what are some of those? Like, what would happen? Like, if you got the buildup, let's.
Elizabeth KatzmanSay, like, you're gonna feel bloated, your energy is gonna be erratic, you're gonna skin, you know, everything. You'll, you'll, you know, you'll feel it, you'll be crampy, your breast tenderness will increase. All the things a lot of people will say, well, just take more progesterone. And it's like, not if you're not going to the bathroom. It's not gonna. The progesterone. Yes. Has to be balanced with the estrogen, but it's not going to fix the fact that you're not eliminating through going to the bathroom.
RoxyWell, I'm so glad you're bringing that up too, because I feel like so many women, especially as your metabolism slows down, that's exactly what they're dealing with. I have so many friends that are like, I'm so constipated, like, I don't know what to do. I've got. And it's just. It seems like a vicious cycle.
Elizabeth KatzmanYes. And it's also one of the issues that women will have if they're on the GLP1s because it slows gastric emptying. So, you know, I know a lot of women who have gotten into problems because they haven't gone to the bathroom enough while they're on the GLP1s. So there's a lot of research that shows HRT plus GLP1s can be amazing. But you have to couch that on the fact that you gotta be going to the bathroom.
RoxyRight. Right. You have to. So that you would do that by taking upping the magnesium, upping the fiber. Is there any. Anything else?
Elizabeth KatzmanI mean, sometimes you just need a good cup of coffee. Yeah, right, Exactly.
RoxyHot flashes are caused only by low estrogen.
Elizabeth KatzmanNo. Insulin plays a huge factor, so you really got to keep your glucose in check. Honestly, the only times I had major hot flashes were. And I remember perfectly because I tried it twice just to make sure I ate honey on an empty stomach. And holy cow, honey is pretty clean, you know, But I sweat through my sheets. Woke up in the middle of the night through my sheets, and I did it again just to see. And sure enough. But yeah, stabilizing blood sugar is crucial for managing hot flashes.
RoxyWow. I just. I never made that connection at all. Because you think it's like, hormonal, like with estrogen, but not with insulin. Wow.
Elizabeth KatzmanYeah. Yeah. And again, it goes back to insulin being a hormone. And they're all talking to each other. Yeah.
RoxyAnd final one, you can only build bone density in your younger years.
Elizabeth KatzmanRight. Very false. You can definitely build it with protein weight training. I personally, I go to something called Osteo Strong. There are locations all over the place. I don't have an affiliation with them. I don't know other locations. I'm lucky enough to have one 10 minutes away, so I go once a week. It takes 10 minutes. And it is crazy there. And there's women of all ages. You know, there's 90 year old women there, there's 30 year old women there. It's 10 minutes, you don't sweat. It's resistance, but it's safe resistance. So it simulates what gymnastics would do. Like when you pound down out, affecting your joints in a negative way. It's a very quick circuit and I've interviewed a lot of women there and I've done it myself for about two years now. And it substantially increases bone density when you pair it with protein.
RoxyThat's good to know. Have you ever had a DEXA scan?
Elizabeth KatzmanI have. I do DEXA every six months. What I actually like a little bit more, but it's harder to access, but they're becoming more popular, is an echoite REMS scan. It's an ultrasound and it tells you your bone quality and your fracture risk. So a DEXA will tell you the density of your bone, but it doesn't let you know if you have a really dense bone, but it's not flexible, you have a high risk of a fracture. So you may think, oh great, I've got dense bone. But if the quality of it is too stiff, you have a high fracture risk. So an ultrasound REMS scans different areas, just like a DEXA would, but it actually lets you know the quality and it will give you a score of what your rectory risk is. So even though on a DEXA it shows that I am osteopenic, it has gotten better each time I've looked. And the whole time my REMS has always said my bone quality is really great and I only have a 5% risk of fracture.
RoxyOh, wow. Okay, that's good to know because I feel like we, we've been hearing about desk dexas for a while, but that sounds like we get more information out of it.
Elizabeth KatzmanYeah, I, I love it. And a lot of the osteostrong locations have it, and again, no affiliation with them. I just happen to really like that combo.