This is a segment of the conversation with a hormone specialist from the UnCut podcast, “Hormone Optimization with Dr. Alexandra Mayer” about busting some common myths and misconceptions around hormone-related treatments and health.
“My best piece of advice is that you don’t have to live with it. There is somebody out there that’s going to run your labs and do a good job. It’s going to be worth your investment to go and get that done.“
– Hormone Specialist, Dr. Mayer
In this blog post, Dr. Tom and Dr. Alexandra Mayer of Ethos Integrative Medicine continue their conversation about hormone optimization. This is the third part of their conversation. In the first part, “Hormone Optimization: When ‘normal’ isn’t good enough,” the doctors discuss where lab work reference ranges come from and how getting “normal” results doesn’t mean optimal and that there’s nothing to improve. In the second, “Hormone Optimization: How to know you’re getting good labs done,” the doctors discuss how to find out if your provider is giving you the full story that your labs are telling and what to do if you’re still not getting better.
In the third and final part of this series, the doctors discuss common myths and misconceptions around hormone treatment and care, and the difference in treatment plans from a GP and a hormone specialist.
Dr. Tom
Your healthcare should be a partnership between you and your doctor, right?
Dr. Mayer
Yeah, everybody needs to be involved in it.
Dr. Tom
I share that sentiment, that patients should be highly involved in their own care. To be an active participant. We’ve been more passive participants in the past. That was always how it was, you just do what the doctor says. And then that’s supposed to make you better. And we’re looking at what’s happening in society in this day and age with all the different metabolic and hormonal disorders and just orthopedic taboo, right. And we’re kind of seeing the consequences of that.
Dr. Mayer
I also think that there’s this aspect of idealism in medicine.
Healthcare That Works With Your Lifestyle for Attainable Health
Dr. Mayer
One of the things that drives me the most crazy in medicine is when you get these super idealistic treatment plans. My favorite patient is a patient like me. They’re kind of impatient, they’re really busy, they have a lot going on in their life. The majority of my patients are business owners or high-functioning business women, and they’re also juggling life and things like that. So my treatment plans reflect that because they can’t do these crazy-hard treatment plans.
It drives me bananas when I see offices that are like, every single person has to be vegan, and every single person has to be on 27 supplements, and every single person has to do these things and whatever. Because you have to meet your patient where they’re at. And I think there is this aspect of idealism that doesn’t work in medicine, because life happens. This week, for example, I am personally moving my house and renovating my house. I macro track. Do you think my brain has the ability to macro track this week? God no! It’s like, “Uh, no.” And I know I should be macro tracking, but my brain is just at zero, like, “I’m not doing it. I refuse.” You have to give yourself grace in those kinds of moments. There aren’t enough providers that are like, look, let’s meet you where you’re at and let’s move forward. It’s a partnership.
Most Common Misdiagnoses and Symptoms of Hormone Imbalances Hormone Specialists See
Dr. Tom
Absolutely. What are some of the most common problems that you see? And then let’s get into the least common problems that maybe people aren’t aware of or that you didn’t know when you first started that you would be seeing so much of?
Dr. Mayer
Yeah, so the most common problems that I see would be low energy, trouble losing weight, and menopausal symptoms. So hot flashes and night sweats, and with that comes mood disorders. We don’t talk about this, but women have a high rate of depression in menopause. And there’s actually a rise in suicidality that happens around menopause that we don’t talk about in women. Hormones change this, not antidepressants. So hormone specialists see a lot of that.
Sr. Tom
Do you find that people have been prescribed antidepressants when hormone optimization could be the solution?
Dr. Mayer
Yes, I wish that I could tell you no, but yes. And there’s this false aspect of people being scared of hormones. And I think that people being scared of hormones honestly comes from a provider who’s not a hormone specialist and isn’t educated or up on the research in the field. Research really does show that there’s a major decrease in issues like this when treated with hormone replacement. People used to think that there was an increase in breast cancer. Well, what we found is that it’s progestins that cause an increase in breast cancer, not progesterone or estrogen. Actually, there’s an interesting research study that just came out that was saying, even with using progestins, which are like the crappiest version of progesterone, you could see that the rise in breast cancer is nominal and doesn’t even actually have an impact. They’re saying that the rise in breast cancer is more related to lifestyle factors than replacement. So the risk-reward benefit is there. There’s a huge reward for very little risk, but people aren’t giving the patient the option to weigh that themselves. It’s not based in good science right now.
The Surprising Sports Medicine-Hormone Connection
In terms of things that I see that I wouldn’t have thought that I would see as a hormone specialist is on the sports medicine side. My husband, who’s my business partner, treats sports medicine issues like ligaments, tears, partial tears, things like that.
What we find is that a number of patients who aren’t optimized hormonally and nutritionally won’t heal. And so he’ll have patients who he’s treating, for example, patients with things like golfer’s elbow, and he’s treating it all the time, and he’s getting great results. And then we’ll have a number of patients where they’re struggling through it. And oftentimes, it has to do with lower levels of testosterone, or lower levels of thyroid.
So for example, frozen shoulder, thyroid is greatly indicated in frozen shoulder and women. The rates of frozen shoulder in children and women in menopause actually go up a lot, and it’s due to hormone deficiency. Those kinds of things are things I never would have thought that I’d be seeing.
Another example of this, I co-treat a patient with Dr. Morgan in our office, she’s having back pain. I’ve optimized all of her hormones for back pain. And finally, I was talking to Dr. Morgan one day, and her back pain is just chugging along so slowly. And we realized that it’s actually because she’s vegan, and she’s not getting enough protein.
It’s all of those things together. And that’s the piece that I didn’t think that I’d be treating. Sports medicine is not my jam. Like, honestly, when patients come to my office, I’m really grateful that I have good sports medicine physicians that I know who are in my office, or like you guys who I refer to, because people start talking to me about their pain and my brain just goes, “Sure, sure. So tell me about this, I will refer you to a great person.” But the hormone piece is the piece that I think is often missing in those treatment plans that he didn’t realize was going to be such a big piece.
Dr. Tom
Yeah, I mean, especially when it comes to testosterone and the ability of the body to recover and rebuild and do all that kind of stuff. You’ve mentioned nutrition a few times now, is that something that you guys do in the office, too? How do you recommend that somebody gets into optimizing their nutrition?
Dr. Mayer
I can’t think of very many women that don’t need to optimize their nutrition. And no, we don’t do it in the office. So start with macro tracking, that’s my recommendation.
The biggest lesson that I learned I actually had to learn on myself some years ago. I couldn’t lose weight to save my existence, you know. I went through medical school, obviously, kind of stressful. And when I got out of school, my body was just a little different than when I went into school. Actually, a lot different. And no matter what I did, I couldn’t lose weight. And I would do all the right things. And I swear to God, my husband and I would start a program. And I would gain 10 pounds just to lose 10 pounds and be net zero, and he would just magically lose 10 pounds.
I was like, first of all, I’m going to kill him. Second of all, this is unfair, he actually met this nutritionist and started talking to her about macros. And what I learned is that the majority of women are severely under-eating in calories. And that was actually me. So my average calories per day were like 1200, the “magic number” that “every woman” is supposed to be at is like 11 or 12 and I was hitting those daily.
Dr. Tom
Blanket recommendations are the best.
Dr. Mayer
One hundred percent. They’re my favorite. But for the majority of women, that’s not where they need to be. And what I tell them is that there is this aspect of metabolic safety. Your body is designed to keep you alive and safe. And it will make all of the choices every single day to do that. So, for example, if you’re under-eating, it needs to use its resources. So, for example, it’s going to dial down your thyroid because your thyroid is your powerhouse of metabolism so that it can say she ate and keep your metabolism at a safe level. It’s unsafe for you to have a high metabolism if you’re under-eating.
So the person we refer to does reverse dieting, which is this act of slowly adding in more carbs, fat, and protein in a very specific way and gets great results with patients. The calorie thing was the most eye-opening thing for me.
Always Find A Specialist – A Hormone Specialist, Nutrition Specialist, Orthopedic Specialist, Whatever It Is
My second most eye opening thing is that when I started macro tracking, I told Kelly, the person that I refer to for nutrition, that I eat a lot of protein because I had protein with every meal. It turns out I wasn’t eating a lot of protein. I would eat under 100 grams of protein in a day.
I remember the day that I got to 110 grams of protein. I messaged Kelly and I said, “Kelly, this is ridiculous.” I said, “I can’t eat this much protein, this is ridiculous.” And she messaged me back and she said, “Alex, you are my lowest person in protein that I’ve ever had. Suck it up and eat your protein.” And I was like, “Okay,” and now I cannot not eat protein, like a normal amount of protein. But I grew up in a family where we would make chicken breasts, and I would eat half a chicken breast. Those kinds of things are ingrained in us with nutrition.
That’s why I think you need to refer to somebody who’s a specialist. Especially here in Arizona. This is my soapbox that I go on with all my patients. Here in Arizona, you do not have to have a nutrition degree to give nutrition advice, which means that I’ve had a lot of patients who have spent a lot of money on nothing. So just so you know, if you’re here in Arizona, you should be looking for somebody who’s good and has an actual background.
Dr. Tom
Awesome. So, you’re hardly ever going to get that type of exact advice from a GP. Like what you should do every single day, this and that, they should have somebody that they refer to in their wheelhouse. I think a lot of people are frustrated at certain points where the general advice is eat better. Okay, how? Or exercise more. Okay, with who? How? And it’s just these blanket pieces of advice that are given to people. So I think another key that you’ve mentioned to finding a good provider is also finding a provider who has a network of people that they refer to and they don’t just give you open-ended advice.
Dr. Mayer
Yeah, a specialist, whether that’s a hormone specialist or any other kind of expert, won’t give you open-ended advice. But they also don’t hoard it in-office. Because I think that there are a lot of providers who’ll come up with these, quote, unquote, programs. This is what I mean by the blanket advice where everybody’s gluten free, everybody’s dairy free, everybody’s vegan, everybody’s whatever. That’s not going to work for you. I’m sorry. And so when it comes down to it, you want somebody who has a good network and is openly ready to refer to people that they genuinely trust and think are really good at their job, and then collaborates with those people. That’s where you’re gonna get the best care.
Dr. Tom
Awesome. I love it. What’s the best piece of advice that you would give to someone about their health, and perhaps their hormones overall?
Dr. Mayer
My best piece of advice is that you don’t have to live with it. My best piece of advice is that there is somebody out there, probably a hormone specialist if that’s what you’re looking for, that’s going to run your labs and do a good job. It’s going to be worth your investment to go and get that done.
Dr. Tom
Awesome. Worth your investment. I love it. Thank you, Dr. Alex, for being on today. Where can people find more information about you and your practice? It’s ethosscottsdale.com. But I also have a YouTube channel. And on my YouTube channel, I talk about all things hormones, and I dive into all of these topics. And so that’s Dr. Alexandra Mayer on YouTube. You can follow me for new content. And if you have questions as a viewer, that would be a really great place to put your questions because I always love to know what people want to know about.
Dr. Tom
Awesome, we’ll definitely link that in the show notes and I hope you’ve enjoyed today’s episode and learning from hormone specialist, Dr. Alex Mayer, about hormones and all things hormone optimization. If you or someone you know needs this information, make sure that you share it with them or send them the podcast. Our mission is to help more people realize that just because it’s common does not make it normal and there are things that everyone can do to optimize.
Thanks, Dr. Alex, so much for being on today’s show.
Dr. Mayer
Thank you for having me.
Dr. Tom
Until next time, get out there and live life today.
