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    139: The Neuroscience of Health, Hormones, and Happiness w/ Dr. Sarah McKay

    Emerging research shows that our early years have a lasting impact on not only our mental and physical health, but our health, wellbeing, and lifespan. I’m joined byDr. Sarah McKay, a neuroscientist based in Australia, to discuss the intersection of nature, nurture, and a woman’s brain.

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    About Dr. Sarah McKay

    Dr. Sarah McKay sums up her research with the words, ‘Nature, Nurture and Neuroplasticity’. Sarah is a neuroscientist and science communicator who specializes in translating brain science research into simple, actionable strategies for peak performance, creativity, health, and wellbeing.

    As the director of The Neuroscience Academy, Sarah offers training in applied neuroscience and brain health for ‘helping professionals’. Sarah has authored the popular science book, The Women's Brain Book - The Neuroscience of Health, Hormones, and Happiness, which explores women’s health from 'womb to tomb' through the lens of neurobiology. In 2019, she hosted an episode of ABC’s flagship science TV show Catalyst exploring biohacking, brain health, and longevity. 

    In 2020, Sarah will take part in Homeward Bound, a women-in-STEMM leadership expedition to Antarctica. Sarah grew up in Christchurch, New Zealand, and after completing her neuroscience degree at Otago University, won a scholarship to Oxford University for her Ph.D. training. After 5 years of medical research in Sydney, Australia, Sarah hung up her lab coat to build a science communications business.

    Sarah combines a wry sense of humor with an uncompromising mind, and whether she's writing or speaking on the TEDx stage she tells science stories in a fun and compelling way. She features in print media such as The Wall Street Journal, The Guardian, and Sydney Morning Herald. Sarah is also on SBS Insight, ABC Radio National, ABC Catalyst, and Channel 7 Mornings.

    Sarah lives on the Northern Beaches of Sydney, Australia with her Irish husband. Together they're raising two boys and a cocker spaniel, and they spend time sailing, surfing, mountain biking, or skiing.

    First of all, Sarah explains what neuroplasticity is. It’s a relatively new avenue of neuroscience that Sarah’s dedicated her studies to. She shares how her studies brought her to start her own science business.

    While there is increasing evidence that the first few years of our lives impact our health and wellbeing, Sarah provides evidence of how the love and care of someone outside your immediate family can help turn your life around. This gives a strong argument to the nurture side of the debate - and how important activating with love and kindness to others has such a lasting impact.

    From a family first point of view, we talk about how new mothers and new families need to have support systems put in place immediately. As opposed to returning to work just weeks after giving birth, an emphasis on connecting and building love within the family unit will help solidify that new baby’s positive mental health later in life.

    We discuss the links between puberty and perimenopause and how girls and women should have support during these times in their lives. Our brains and bodies are undergoing some intense transformation that should run as naturally as possible. 

    Sarah explains what actually causes the hot flashes that women experience during perimenopause. While there could be an argument for taking artificial hormones to suppress these and other effects that come with perimenopause, I believe it’s important we don’t suppress our hormones during these incredibly changing times.

    How can you show love and support to those around you at all times? How do you manage your perimenopause symptoms? As always, you can ask me anything and let me hear your thoughts in the comments below. If you have questions, email team@drannacabeca.com.

     

    In This Episode:

    • What neuroplasticity is
    • How the love and care of one other person can turn someone’s life around
    • What support systems we need to put around a new mom and family
    • How the social constructs around a child impact their mental health throughout puberty
    • How puberty and perimenopause are biologically linked in the brain
    • What causes hot flashes during perimenopause
    • What happens when we suppress the hormones present during perimenopause

     

    Quotes:

    “Now we have very clear evidence that, yes, what happens in those first few years of life are a strong determinant, not the only determinant, but they are a large determinant to your mental and physical health, and loosely, health, wellbeing, and lifespan.” (19:56)

    “A lot of the culture with managing emotions that we see in young people is just a bit of a mental mishmash between the emotional part of the brain developing faster than the top-down control part of the brain.” (36:05)

    “There’s more that we don’t know than what we do know. Really it’s about being educated and informed and working with a healthcare provider that will help you make the right decisions for you.” (53:23)

     

    Resources Mentioned

    Buy The Women's Brain Book by Dr. Sarah McKay

    Get The Applied Brain Science Toolkit

    Find Dr. Sarah McKay Online

    Find Dr. Sarah McKay onFacebook |Instagram |Twitter |LinkedIn

    Join the KetoGreen Community on Facebook

    Buy Keto-Green 16

     

    Transcript: 

    Dr. Sarah:
    You've got kids going through puberty and experiencing the hormones of puberty for the first time but the largest determinant of their mental health is social context, which puberty is happening not just hormones switching on or off. I think at every stage I went through in the book, I was just so blown away that hormones were kind of opening a window but what was the most important thing was other people. That's always the determinant of health.

    Dr. Anna:
    Hello everyone and welcome. It's Dr. Anna Cabeca and I am the girlfriend doctor. It is my mission and my passion to help women live better lives before, during, and after menopause. Welcome to the Girlfriend Doctor podcast, an intimate place for intimate conversation, and hey, I'm here for you. You can ask or tell me anything. I've received some great questions in, and remember that this is a safe place where we can pull back the curtain on all things related to sexual health, libido, PMS, menopause, you name it. We are talking about it.

    Dr. Anna:
    We are shining the light on overall wellness, mind, body, and spirit and it's so important that we do this together in community because community is life-giving, community is oxytocin building and community is empowering healthy community, but where does it start really. Healthy community starts with you. It starts with you putting your oxygen mask on, getting healthy, knowing that you are worth it, and you are so valuable and plus you, wherever you are today, you can be better tomorrow. Without a doubt, you can be better tomorrow.

    Dr. Anna:
    Now, we've gone through some trying times right now and we may have had some experiences with fear or maybe a loss of self-control, of relapsing, of flashbacks. I mean, the list goes on, right? I know because I get it right. Will power issues, stress, fear, depression, and we may feel like the world just doesn't look or feel safe anymore and so that is a sentiment that we are completely aware of and here to combat because our bodies are resilient and as we awaken to our own reality, as we become more aware with how much potential we have and what works for us, so discernment, what works for us and what works against us. How we set our minds in a direction with goals and lights and dreams that help us succeed.

    Dr. Anna:
    Our brain is incredibly neuroplastic, and so that's what I really want to talk about today with you here on the Girlfriend Doctor podcast. I have a beautiful guest that's joining me today. Her name is Dr. Sarah McKay. She is about nature, nurture, and neuroplasticity. She's a neuroscientist and a science communicator who specializes in translating brain science research into simple actionable strategies for peak performance. Today we're going to talk about how women, men are different, and what makes our brains different as well as how our hormones affecting our brains, turning on our emotions and our behaviors and how we can be powerful over them. I'm excited about this. We're going to get into some neurobiology and some great neuroscience and here we go. Dr. Sarah McKay, how are you? Thank you for joining us today.

    Dr. Sarah:
    I am great. Thank you for inviting me to [inaudible 00:04:04].

    Dr. Anna:
    You are welcome. For everyone listening, Dr. Sarah is in Sydney, Australia. She's in the morning time. We're going to toast right now. This is the Girlfriend Doctor podcast so cheers to your coffee. I'm having a little afternoon glass of wine and we're toasting as we get started to have this really great heady, no pun intended, a conversation about women's brains, men's brains, but seriously women's brains. Dr. Sarah McKay, her book, The Women's Brain Book: The Neuroscience of Health, Hormones, and Happiness explore women's health from the womb to the tomb. Do you all see why I love this woman, why I absolutely had to have her on my podcast?

    Dr. Anna:
    Sarah, tell us about yourself. Tell us what got you started in this, and I can't wait to dig in.

    Dr. Sarah:
    Yeah, oh, thank you for the opportunity. I'm a New Zealander. I grew up in New Zealand. I've lived in Sydney, Australia for about 20 years. It's a nice part of the world to be quarantined but hard because my mom's in New Zealand, so I would love borders to open up again one day. We're recording this in mid-April 2020, just for context. I guess I was one of those kids always... I was very fortunate to grow up in the part of the world I did and we had a very, very happy childhood.

    Dr. Sarah:
    Loved learning, always enjoyed reading books and when I got to my first year of university, a psychology lecture, I was in the... recommended we read a book by Oliver Sacks called The Man Who Mistook His Wife for a Hat, which if you have read the book you will know the book, he's a neurologist and write these wonderful... an amazing writer and write these wonderful case studies [inaudible 00:05:53] very unusual things that can happen to people when their brains go wrong or malfunction and I was so captivated by this idea, and this is the early '90s.

    Dr. Sarah:
    Neuroscience as a discipline in universities is very, very new. We're still kind of pulling to give the neuro components from different disciplines but there was a pulling together the neuro disciplines from these different departments and there was a new neuroscience degree set up at a university down the road from me. Otago University about four hours down the road from where I lived in Christchurch at the time.

    Dr. Sarah:
    I hit it off to study neuroscience, and that was sort of the early '90s and it's really been kind of my north star ever since. It's such a fascinating deep broad subject. Now I was incredibly fortunate to win a scholarship to Oxford University in the UK and I did a master's and then a Ph.D. there. Taking a look really at these ideas. Back then we didn't use the word neuroplasticity even in the research lab but was really interested in what guides the wiring up of neurons in the brain cells. How do they form their sort of synaptic partners?

    Dr. Sarah:
    I was looking at the very old fashioned question now, is it nature or is it nurture? Is it kind of genetic? Is it age or is it environmental and experiential? And it's kind of a bit of both was the answer. I did move to Australia, did a couple of postdocs here and brought my Irish husband from Oxford with me. He's an economist. We thought we'd come to Sydney for a year. I thought that would be a nice place to go and live for a year, that was in 2002 and while I was working in research and the universities here, I just became... first loved neuroscience but was frustrated with academia and the trying to get papers published and trying to get research grants and I felt like everywhere I turned, it was all these gatekeepers and I couldn't really kind of... I didn't have the freedom to kind of think about what I wanted to think about because in academia and research, which is fundamentally necessary, and you probably know this, you have to become an expert on such a tiny niche.

    Dr. Sarah:
    I felt like I had found my... well, the other neuroscience [inaudible 00:08:03] and eventually after about five years of sort of soul searching, hung up my lab coat and set up my own business in science communications, because I saw there was a real gap and a thirst for people wanting to understand about what was happening in the neuroscience research lab and then... there's just been this growing interest in the brain. What do we understand? Where is contemporary neuroscience and how can we apply that to people's lives?

    Dr. Sarah:
    That's kind of what I've done since I had my boys. One of whom just walked in there and I suppose along the way, they had various opportunities open up to me and I was approached by a book publisher who said, why don't you write a book? And I went, " I couldn't write a book. That sounds like a lot of hard work, and I don't really have any good ideas." She's a very charismatic woman, [Patujan Richmonds 00:08:47], who's now my book agent and she said to me, "Well, why don't we just meet over coffee and have a chat?" And I was like, "well, okay, I can do that."

    Dr. Sarah:
    Back in the days when you could do things like that [inaudible 00:08:59] you should speak to me, what have you... I said, "I haven't got an idea for a book." And she said, "Well, what have you ever written for an audience that's really resonated?" And you'll find this interesting. I was writing a lot for the ABC here in Australia, Australian Broadcasting Corporation. I had written an article on menopause and brain fog and we had this enormous outpouring of emails of people saying, oh my goodness, that is me and the idea behind this piece was the concept of brain fog, which I guess is a colloquial term. Women going through menopause often experienced that, but often a lot of women and you probably know this.

    Dr. Sarah:
    A lot of women think it's the first sign of Alzheimer's or dementia.

    Dr. Anna:
    Right. Memory loss, brain fog.

    Dr. Sarah:
    [crosstalk 00:09:43] and forgetting everything. I'm 48 and I'm getting dementia already and really it was saying, look, this is quite normal. We don't really understand, is a bit of a chicken and egg scenario about what exactly is the cause. Is it directly related to hormones? Is it related to hot flashes waking you up at night? So you sleep deprived, all of these kinds of chicken and egg scenarios, but it was kind of like it's probably not Alzheimer's. It's probably menopause.

    Dr. Sarah:
    I was telling my book agent this, and she went, "Oh my God, you have to write a book about menopause." And at the time I was 41 and I was like, "I'm not going to write a book about menopause. I'm 41. It was something my mom once did." I'm 45 now. I have a different attitude to periods. As I sit here sweating-

    Dr. Anna:
    Well, the experience is a great teacher.

    Dr. Sarah:
    Yeah, and actually writing. Anyways, so I thought, "Well, look, I don't want to write a book on menopause." And then she said, "Oh, what about baby brain?" And she just kind of said in an offhand way, it was baby brain this thing called when you're pregnant you get a bit foggy and I was like, "Well, I'm from New Zealand. We don't do brain fog there, baby brain there because we have this wonderful prime minister who's had a baby and is clearly a superstar." But also baby brain was never a thing that I'd ever heard of. It wasn't a concept in my world.

    Dr. Sarah:
    Oh, look, I don't think there's any plausible neuroscience explanation for that and then I went, "Oh my God, I've never thought before about all of these aspects of women's lives through the lens of neurobiology. I've been a neuroscientist for going on 25 years, female. I knew of a female body and brains since I was born and because neuroscience is so broad and deep, I had never thought about puberty and the brain, periods, the menstrual cycle and the brain, pregnancy in the brain. And I thought, "Well, maybe I could write a book, taking a look at all of these aspects of women's lives through the lens of neurobiology." And we were like, this is the book idea.

    Dr. Sarah:
    It was not planned, it just sort of happened. I think part of the beauty of me having no agenda going into this is, how many are assigned. Just want to understand a lot of these ideas is that I... just very much we tend taking a look at what is the latest neuroscience research say on all these different points in the lifespan and I just read them and write them and talk to loads of really interesting people and that was kind of how the book came about.

    Dr. Anna:
    I love it. I think it's great and especially you said at first thing, let's get some definitions for our audience too, is the neuroplasticity. Let's talk about that. You said we didn't have that word way back when you knew you were at Oxford, but now we see it everywhere. Let's talk about neuroplasticity and what that means, and then I definitely want to get into the stages of our brain life.

    Dr. Sarah:
    The neuroplasticity is this kind of umbrella term use now in neuroscience. Back then I was looking at brain development, the kind of the early phases of brain development after birth so those first few prenatal, postnatal sort of days, weeks, months that the brain is obviously developing and growing and being shaped and sculpted. That shaping and sculpting and developing and which neuron wires up to which neuron is now... the kind of the blueprint is laid out by our genetics and then experience the kind of experiences we have, shape and sculpted original plan.

    Dr. Sarah:
    So we're all kind of born into this world with this brain that's like, hey, well, here I am to learn about who I need to be in this world I'm living in, and then the experiences that you have in those very first years, kind of lay a lot of the foundations about how you... teaching you, adapting to the world in which you live and that ability of the brain to adapt and to be shaped and sculpted by either a knit patterns of electrical activity, very, very early in development prenatally, and then throughout the lifespan being shaped and sculpted by the events that happen, essentially, as neuroplasticity.

    Dr. Sarah:
    Now, if you want to get into the kind of neurobiology of this word, it kind of encompasses a whole lot of different terms and encompasses the birth of new neurons, which we would call neurogenesis, which largely takes place during childhood dips down in the teenage years and then if it does happen in adult humans is very, very rare. A lot of people think this word neuroplasticity is all about neurogenesis and the birth of new neurons, but it's very, very debated within contemporary neuroscience. The degree in which new neurons are born throughout the adult lifespan. If it happens, it's probably a bit very rare.

    Dr. Sarah:
    The greatest degree of plasticity that occurs throughout the life span is kind of the changes and the strength of connections between neurons. How kind of reliable is that connection? How well worn is that path might be another kind of way to think about that. How efficient is that network? And so that's kind of the level of the kind of the connections or the synapses between neurons. We could like look... zoom all the way into the brain and look at what happens between particular neurons or we could zoom out. At some points in the lifespan, we actually see structural changes take place in the brain, that we can visualize with an MRI machine and interestingly, one of the greatest structural changes that we see in women's adult brains, obviously brains are shaped and sculpted all the way through childhood, especially during the teenage years and then if we were to kind of take images of the brain, we wouldn't say many sorts of large structural or plastic changes taking place through most of adulthood.

    Dr. Sarah:
    Hopefully, when you reach later in life, you don't see too many degenerative changes, but one of the most significant changes we do see in the structure of women's brains is during your first pregnancy, which as some research, which has come out sort of in around late 2016 from a group in the Netherlands that showed that there was significant structural changes in the cortex, the kind of outer wrapping of the brain during a woman's first pregnancy and really interestingly it was the parts of the brain that are involved with social cognition, with the ability to think and understand how other people think and feel. That's a plastic change that takes place sculpted by the experience of pregnancy.

    Dr. Sarah:
    We think most likely the actual hormonal shifts of pregnancy, rather than the act of mothering in those first few weeks. We see all different kinds of structural changes taking place from like all the way down at the level of kind of like cell to cell, all the way out to being able to see changes take place. Neuroplasticity kind of encompasses all of those [inaudible 00:16:36] of the brain and that responding to the things that happen to it.

    Dr. Anna:
    I think that is fascinating and that there's so many directions I want to go with you on this conversation. Let's talk a little bit about that early brain development and bonding time period, where we are increasing... like increasing the bonding, increasing the oxytocin attachment, and how that is... I think it's so important to understand how that's important so that we don't have addictive behaviors as an adult, isolation, oxytocin deficiency, or resistance. I call it an oxytocin resistance syndrome that creates an oxytocin seeking or dopamine seeking a type of behavior, which... I think that there's certainly an interaction there, but I'm looking forward to you to help me explain and make sense of this and then we'll go into the perimenopausal brain.

    Dr. Anna:
    I definitely want to hit on that, but that early brain development and how that attachment is critical so that we can then understand why maybe we're experiencing this as an adult. I mean, just as a physician, as a women's health physician, integrative medicine, and a gynecologist, when I have a client has significant, whatever it is that she's dealing with. My history includes, like, how was your mom's pregnancy with you? How were your early formative years? I mean, it's just... whether I'm dealing with a client for just hot flashes or cancer or autoimmune disease or whatever it is, I want to know those early formative years and if there's any energetic shifts that need to be addressed there.

    Dr. Sarah:
    Yeah. I mean, the research and the space is really, really interesting and I suppose... For a long time, a lot of people working with adults were troubled for whatever reason, whether they had mental health issues or physical health issues. This idea, oh, let's look at your early childhood like is that kind of a bit Freudian, but the research now is kind of playing out thanks in large part to a lot of very detailed longitudinal studies of the life span. We've been able to take a look and study children from birth all the way through the lifespan.

    Dr. Sarah:
    I think it's really important to be able to look at how they have been done very carefully instead of just taking a bit of a Freudian, tell me about your mother and your childhood because we knew... We had these concepts, but we didn't have any good solid evidence backing them up. A longitudinal study is following large cohorts. There's a fantastic one that comes out of Dunedin, New Zealand, where I went to university called the Dunedin Study, which has followed over a thousand people who were born in 1974, every year or two throughout their entire lifespan. They're all now in their mid-late 40s, and there's been no gaps for the data to fall into and that's the beauty of those studies have come from.

    Dr. Anna:
    Wow.

    Dr. Sarah:
    Instead of relying on people's stories about their experience with their mother, we can actually look at every aspect of these kids from their... then are adults, from the dental records to the school studies to every sort of detail of their family history. They have MRI scans through to mental health kind of reports done. We're going be looking at what's their income, who are they married to? What are their children like? Every aspect of their lives has been well-established and now we have very clear evidence that yes, what happens in those first few years of life are a strong determinant, not the only determinant, but they are a large determinant to kind of your mental, your physical health and without wanting to use this word too, I'm using this word loosely sort of success and health and wellbeing throughout the lifespan, and that it appears that those early years of your life do kind of get in under your skin and affect your biology.

    Dr. Sarah:
    Now, you talk a bit about oxytocin. I think that that's really important, but I don't think it's quite as simple as there being one hormone that's kind of client playing a role in there. It would be great if that was the case but-

    Dr. Anna:
    Totally agree.

    Dr. Sarah:
    ... children are kind of, as I said, we're kind of born into this world and you kind of might remember from high school biology. Animals adapt to the world in which they live in and humans in our little brains, when they're born, are no different. A baby is born into a world that must kind of listen in and learn about the world in which it's born into, particularly in those first few years of life and go, well, this is who I am. This is the world I live in, and this is how I must shape and adapt to be.

    Dr. Sarah:
    If you are born into a warm, loving, nurturing family with a lot of interaction with caregivers, whether or not that's a birth mother or not, it doesn't really matter as long as there is a lot of interaction, a lot of attention, a lot of what we call serve and turn reactions every time a baby makes a kind of... not, but it's possible every time but when children look at you and smile, someone smiles back and as they learn to kind of go, ga ga you would make noises then there is serve and turn interactions and that baby is communicating, [inaudible 00:21:36]. Well, that's quite that child understands what kind of world it's born into. What is when children are born worlds of which they are neglected and which there is a great degree of what we might call toxic stress and the child was born into a highly stressful environment.

    Dr. Sarah:
    Now that's when we kind of see the neglect or the toxic stress of the early years getting kind of in under people's skin. Now, what is the reason for that? It would be nice if we could say, oh yes, it's like the child wasn't... the lack of interaction with a warm caregiver meant that the oxytocin system didn't grow and develop and therefore that's what they're seeking for the rest of the lifespan. I don't think it's probably as simple as that. I think this whole brain, body physiological systems involved in there, which genes are switched on and off, how is the brain wired up.

    Dr. Sarah:
    In particular, the stress response system is going through this very plastic critical period of development in the kind of a couple of months before birth and in those first two years after birth, so that the entire stress response system, the autonomic nervous system, the hypothalamic-pituitary-adrenal system, which produces cortisol, that's all going through a period of development, and if that child is born into an incredibly stressful world, it's living in an environment where it's stress response system is developing in a highly stressed way so then a child, sense well, live in a pretty stressful world and will always then respond in a very kind of hypervigilant stressed way kind of going forward in the lifespan.

    Dr. Sarah:
    There's a whole lot of things going on. We're still trying to unpack the kind of the cause and effect of a lot of these. I think it's probably quite wise to point... We've underestimated the importance of the early years in kind of building the right kind of infrastructure around kids, particularly children who are born into highly stressed, perhaps a lot of neglect, perhaps extreme poverty. They grew up in these very toxic stress environments but I think it's important to point out that that doesn't mean you sort of that's that for life.

    Dr. Sarah:
    I spoke to Professor Richard Porton who heads up the Dunedin study in New Zealand, which is this longitudinal study of the lifespan. We were talking a lot about, if they can go back and look at the first couple of years of a child's life and predict with a great degree of accuracy which child will end up in prison, which child will end up with mental health problems, which child will end up consuming the vast majority of kind of social services resources, which are the ones that kind of require the kind of investment of the government and kind of social support services. They can predict with a reasonable degree of accuracy going back, looking at the early life and I was like, well, it's bench pressing. It's not really very good news.

    Dr. Sarah:
    I mean, is that always inevitable? And then he said in his very [Kiwi-waged 00:24:33], are you asking me if they're screwed for life? And I [inaudible 00:24:37] and he said, well no. He said I have seen the most remarkable things happen. Some people had the roughest start to life and these... the people who have grown up, they've had a tough childhood and every kind of point in life is better than missing. Sometimes we see this remarkable turnaround and it's just, they might have been given the loving care and the teaching of just one other person, perhaps it was an auntie, perhaps it was someone in their extended family as we say in New Zealand, perhaps even it was a therapist, perhaps it was a teacher.

    Dr. Sarah:
    Sometimes the love and the care of one other person can turn someone's life around at any point in their lifespan. He said, they aren't as he said, screwed for life. He said we just need to realize that these people are often neglected by society and they're the ones that we need to kind of pluck out and give the support and attention to so hopefully they're kind of offered a bit of hope as well, which I thought was a beautiful thing.

    Dr. Anna:
    Yeah, no, that's great and to know that this study is being done, that's... then they're able to do it is fascinating and I definitely think that... I like how in the Netherlands that when a mom gives birth, that they have a caregiver coming to her house to help her kind of do everything, take care of everything. I think it's six months now that they do it... so amazing and then the husband, the father has paternal leave too.

    Dr. Sarah:
    Paternity leave. Yeah, yeah, yeah, yeah. I think there's lots of... I know you guys in the U.S. do it pretty tough.

    Dr. Anna:
    Yeah, no, no. We're like I was back to work in three weeks.

    Dr. Sarah:
    The rest of the world is kind of, I guess, lots of countries and the rest where we approach maternal health. It's not just about the mom and it's not just about the baby. It's about their family and it's about... It's about that network and how we can build that infrastructure to support not just a newborn baby, but to support the family around that baby. It was interesting because at every point in the lifespan that I looked at in my book, whether I looked at early childhood. I mean, I looked at the research, spoke to the researchers, spoke to the health experts, whether I looked at late childhood, whether I looked at adolescents, puberty, the teenage years, whether I looked at new moms, a woman going through pregnancy, menopause going into age care.

    Dr. Sarah:
    It didn't matter at which point in life span, we were looking at. It didn't matter whether it was boys or girls, males, or females. Even research... what do you think is the key health outcome indicator here [inaudible 00:27:04] most important thing and do in supporting people through this, is it diet? Is it exercise? And it was... Every single person said the same thing. It's about the other people and it's about the social prescription. It is about putting... It's not about me. It's about way, what can we do to put the right support systems around people, new moms? What can we do for them? How can we help kids transition into primary school? What can we do to help teenagers when... young people when they're entering puberty, boys, and girls. When teenagers are going through all that kind of turmoil of teenage years, it's always about other people.

    Dr. Anna:
    It's not about me, it's about we. I love that. Oh my gosh. It's not about me, it's about we.

    Dr. Sarah:
    Like young people entering puberty for the first time that's when they often become more vulnerable to mental health issues. We often got... I've got a 12-year-old, he's turning 12 on Monday.

    Dr. Anna:
    I have a 12-year-old too. 12-year-old girl.

    Dr. Sarah:
    Yeah. They get cranky, and you go oh, it's hormones, it's hormones, it's hormones and there's a very interesting study done here in Australia, looking at children entering puberty and the development of kind of emotional turmoil and mental health issues. If you have a little girl entering puberty early but normal, say she starts developing brace and maybe gets her period at like 19. Early, but it's not normal and the beginning of that kind of curve. She's far more vulnerable to develop mental health issues than a girl who goes through puberty at the same age as her friends who may be a little bit later, but you look at the boy who enters puberty before his friends early but normally a sort of... What happens to when boys go into puberty. They grow tall, hairy, and bigger muscles, and they rise in social stature.

    Dr. Sarah:
    The boy who goes through puberty earlier than his friends is protected against mental health issues versus... and everyone had that little guy in their class who still hadn't even started growing when he was about 15 who's still like little, and so you've got kids going through puberty and experiencing the hormones of puberty for the first time, but the largest determinant of their mental health is the social context, which puberty is happening not just hormones switching on or off.

    Dr. Sarah:
    I think at every stage I went through in the book, I was just so blown away that hormones were kind of opening a window but what was the most important thing was other people. There's always the determinant of health, been studies of PMS, we can talk about that. Perimenopause, all of these, the social context is the key indicator of health.

    Dr. Anna:
    I think that I can see that and just from early through every stage and how the community helps with these times of transition. This is Dr. Anna Cabeca the girlfriend doctor. Author of bestselling books, Keto-Green 16, and The Hormone Fix. I quickly wanted to share with you that my new book, Keto-Green 16 is finally available. Look inside these pages, beautiful recipes, a 16 day clinically proven effective fat loss, adrenaline-boosting, an anti-inflammatory plan that will make you feel great quickly.

    Dr. Anna:
    We have used this plan in clients, in menopause and postmenopause as well as some gentlemen that have joined us along the way. I love it when men are joining alongside their ladies and taking part, and what we found is an increase in fat loss, a decrease in Symptom Scores and a decrease in waist. We'd like to see these changes, in fact, we have one client who's a 67-year-old woman who has tried many things. She was diagnosed in the past with breast cancer and had felt that she had hit a wall and she was just going to have to power through or struggle for the rest of her life.

    Dr. Anna:
    Just within one cycle of Keto-Green 16, she not only felt tremendous, but she said she was happier than she's been in forever that she could remember and she was no longer feeling like when is the next shoe going to drop as far as waiting for another diagnosis. She felt empowered over her own body and that she has taken this control back, not to mention losing some weight, improving her blood sugar with a decrease in hemoglobin A1c, as well as some other really important health markers.

    Dr. Anna:
    Now we've had a gentleman in the plan. His name is Daniel, at 57 years old with 80 pounds to lose, on blood pressure medicine at risk for starting blood sugar medicine. He did one cycle of Keto-Green 16 with his beautiful wife and within 16 days his symptoms dropped tremendously. His blood pressure improved so much that he has to be weaned off his blood pressure medicine and he lost 30 pounds. I know. Crazy, right? And what other clients have told me, especially during the quarantine is that they felt like they were doing something good for their body. They could focus on their health and their resilience, which made them feel much stronger and healthier and so I encourage you to check it out, Keto-Green 16, and I am pleased to be on this journey with you.

    Dr. Anna:
    One thing that I caution in my work and my practice is certainly in the prepubertal girl or in that transition, I often would see girls coming to me at age 13, 14, 12, even on birth control pills and we're like, okay, we can not suppress this transition. There is a rewiring that is happening neurologically and I see there's no difference in the perimenopause menopause. We can't suppress and we can support, but we can't suppress the transition. I could talk about the wiring. I mean, we go through... like puberty is not a disease. Menopause is not a disease, and there's a necessary hormonal transition here and I wanted to just kind of compare and contrast these two major life transitions in the brain.

    Dr. Sarah:
    I mean, I guess, one way that's kind of what we would call like kind of a biological clock in our brain, which sort of switches on, which is the indicator that it's time to kind of kick-start puberty and it's that... We don't really know what kind of determines that biological clock in our brain, just sort of switch on and send message to the ovaries to kind of start developing and maturing and to kind of kick off menstrual cycles in girls and to kind of kick-start the testes to produce testosterone to kick-start puberty in boys.

    Dr. Sarah:
    It's interesting because the brain kind of switches the gonads on, the other end of the lifespan for girls when... look the other way, hopefully halfway through your lifespan. It is the kind of the ovary sort of kind of running out of steam, which then have the effect on the brain. This is kind of a bit of a nice shift and I guess all the way through, from puberty through to menopause, pregnancies aside and whether or not you choose to take hormonal contraception there's a nice kind of chit chat between the brain and the hormones and they're kind of going back and forth but as I say, I certainly, from my research, don't believe that hormones are the loudest voice in the crowd of a people which play a large role in influencing a lot of our health outcomes and our expectations and how it all kind of plays out.

    Dr. Sarah:
    Of course, we've got to be... support that, support our biological health, but it's like things going on. If we look at how things kind of go through the big transition through puberty in the teenage years, that it's most likely a lot of sort of the changes that we start seeing happening kick-started by the hormones of puberty. We think we don't know or whether the two just kind of channel along together. We see that if you were to look at a thousand girls and a thousand boys, the girls' brains start developing about a year or so before the boys and that's kind of typically what we see girls into puberty a year or so before boys. Boys eventually catch up.

    Dr. Sarah:
    Of course, there's always people at either end of that normal, and girls and boys but later, but what we see is that a lot of the subcortical structures, the structure that kind of sit a little bit deeper in the brain, which is involved in things like interpreting what is happening in our body, kind of regulating our emotional responses. These kind of start developing earlier in the adult-like state earlier than the prefrontal cortical part of the brain, which is a part that sits in behind our forehead, which is involved in kind of all sorts of things from being able to do algebra to social cognition, to judgment and planning and reasoning, and being able to kind of to pay attention to and importantly being able to regulate emotions.

    Dr. Sarah:
    A lot of the cruelty with managing emotions that we see in young people is just a bit of a mental mismatch between the emotional part of the brain kind of develop faster than the kind of the top-down control part of the brain. I think it's important to realize though, that in particular, this prefrontal cortical part of the brain is [inaudible 00:36:27] very this exquisite period of heightened plasticity, a critical period of development in much the same way that pets', infants' and toddlers' brains go through when they're learning a language.

    Dr. Sarah:
    Brain goes through this exclusive phase of plasticity kind of around [inaudible 00:36:44] in which they absolutely require learning a language to wire up in the appropriate way to set you up for being able to speak a language for the rest of the lifespan. Teenagers' brains are also going through this exquisite phase plasticity in which they are learning how to regulate emotions. They are learning how to understand the thoughts and feelings of other people. They are understanding that there's a shift from the kind of family of origin through to friends and family.

    Dr. Sarah:
    Actually, they're at the kind of their peak for learning how to plan and judge and reason. It's not that they are really bad at it, they're actually explicitly changed to learn how to do that. We see a lot of those processes started off by pubertal hormones, but the hormones almost kind of open the window then for the outside world and the experiences we have to wire the brain up in the appropriate way. Now, when we go to the other end of sort of the female reproductive lifespan, we do see some changes take place, but they're nowhere near as significant as shift as what we see when we're into puberty.

    Dr. Sarah:
    What we see is when you got... you start going through kind of perimenopause the kind of the ovaries sort of in some months and will carry on as normal. Your hormonal fluctuations and shifts will carry on as normal and other months there'll be heaps of hormones in X amount they'll be hardly any, and what we think has happened, we don't completely understand the effect that it's having on the brain yet. It's a very, very new area of neuroscience research, but we know that the brain has receptors for estrogen. We think it has probably a similar distribution of receptors for progesterone, but we don't really actually know an adult human woman yet. We only understand what rats and mice from the research lab have, but we know that there's estrogen receptors in the brain and when the estrogen sort of starts that kind of stilted conversation, sort of a nice flowing back and forth conversation, we say the brain is going to react to this kind of drop or kind of sputtering of estrogen levels.

    Dr. Sarah:
    Now, one of the most significant changes that we see, and one of the few that's very well understood from the perspective of neurobiology as changes that take place in the hypothalamus. In particular, the part of the hypothalamus which is a part of the brain buried quite deep down, which is involved in temperature regulation, so thermoregulation. One of the most common symptoms, if women are going to have a symptom, going through perimenopause and into the menopause is hot flashes or hot flashes, whatever you call them wherever you live in the world.

    Dr. Sarah:
    What we think is happening is that in our hypothalamus, we have kind of like a thermostat. [inaudible 00:39:29] with a lower level and an upper level and what we think happens is when you're going through perimenopause with this kind of unreliable influence of estrogen, is that the thermostat kind of gets a whole lot narrower so your kind of seek point is kind of a whole lot narrower so you don't have to get that much hotter or get that much cooler. Your body temperature doesn't need to increase that much until suddenly a signal has been sent to your entire physiology. Oh my God, it's really, really hot in here.

    Dr. Sarah:
    The thermostat, the kind of the top level's gone down and the bottom level has gone up a bit and that we think maybe part of the reason why lots of women then experience hot flashes and night sweats. I certainly, from my own personal perspective, after writing the book and thinking on menopause, it's something that it's a long way off in my future. I'm now 45, about a year ago started getting night sweats. It's driving me absolutely bonkers, and I'm pretty fit, pretty healthy, ate a pretty good diet and I was like, well, here we go.

    Dr. Sarah:
    Now you probably might disagree with this. However, I eventually met and talked to my OB/GYN, which is not really an obstetrician when you reach this age anymore, they're more of just a GYN/OB. Forget about the OB bit, and I went back on an oral contraceptive pill, which I had been on for many, many, many years all the way through my 20s and 30s, up until I had my kids and had a very... I'd never had any side effects as always. Suited me very well. We went back on that because I did what I know a lot of... the jury's kind of out, but certainly for me and from my research, instead of dealing with these kinds of fluctuations just tramline them and put in a bit of synthetic estrogen, which I know a lot of people might... quite uncomfortable with that but the synthetic estrogen then just tramline my hormone levels. Within a month the night sweats went away. I went back to... I can sleep. I can win the gold medal Olympic for sleeping. Sleeping really well and everything just kind of settled back into place.

    Dr. Sarah:
    My hairdresser said to me the other day, my hair has changed. It's got thicker again. My skin has improved and I'm like I love this synthetic estrogen business.

    Dr. Anna:
    Oh, man. All right, well, we're going to argue about this there. We are going to argue about that because it's-

    Dr. Sarah:
    Yeah, personally for me, that was my choice to manage the fluctuations because I couldn't see knowing my personal health history and how I lived my life that any improvements I could make in my lifestyle there'd have to be... My lifestyle is pretty good, so where was I going to see a gain and certainly the scientific literature shows that for someone with my personal history, that it's not causing me any damage and I'll tell you what, no night sweats which is a great thing.

    Dr. Anna:
    I know. No night sweats are great. Let me tell you, this is though my area. This is certainly my area of specialty and the estrogen... Usually in birth control pills, we typically... it's more of bioidentical estrogen, but the progestin, not bioidentical progesterone is what the problem is. This is my concern with this perimenopause. Let me just stop your symptoms. If we did that at puberty, what happens to the nervous system of the aging child, and why would that be any different now? And I see this suppression of the ovarian production of its own natural hormones as potentially doing more harm than good.

    Dr. Anna:
    When we want to treat the symptoms we do, if we need birth control, I mean, let's do an IUD, nonhormonal IUD for birth control if we need it. At this stage in our life where we really do want to decrease any toxic hormones in our body and allow this transition naturally, but support that bottom line becoming insulin... I'm going to send you my book, The Hormone Fix, because I would say it takes more than hormones to fix our hormones but look, I am on bioidentical hormones. I do a [troche 00:43:39], a submucosal of a combination of tiny little bit of estrogen, a little bit of bioidentical progesterone, but I use my pure balance progesterone and pregnenolone cream because I want to support from the top down and a little DHA and a little testosterone to support me.

    Dr. Anna:
    I'm 53 right now. 53 with a 12-year-old. I'm ahead of you a little bit on this one, but that shift makes a difference and we get a good night's sleep. We get restored and we also get this clarity back because many people don't realize the neuro... There is a neurologic consequence to progestins and of course, oral birth control increases inflammatory markers, such as our hsCRP so if we can do this through herbs and nutrition, I'm going to send you Mighty Maca too, an adrenal adaptogenic blend of over 30 superfoods. Some of which I learned about on my travels around the world in New Zealand and Australia, as well as other places in the world but when we... I support the adrenal glands and support the ovaries, then number one, then our natural hormone levels improve and so we get that communication system.

    Dr. Anna:
    What I am concerned about and when I've seen in this perimenopause, whether it's high dose bioidentical hormones or high dose birth control pills, when we suppress that natural ovarian production, we're interfering with the hypothalamic-pituitary-adrenal gonadal access, and we're also increasing thyroid dysfunction and so that's increasing sex hormone-binding globulin, increasing TBG, thyroid-binding globulin and then next step is hypothyroidism.

    Dr. Sarah:
    Do you think that this is just a problem at perimenopause or would you not think that any woman at any age should be on the [crosstalk 00:45:22] pill?

    Dr. Anna:
    Birth control pill? I am an obstetrician and gynecologist. I would still prescribe it for the patient that that was the best choice for them at the time, right? With my daughters for a short time as needed that was prescribed, but again, never without supporting detoxification, never without supporting methylated B vitamins and magnesium for sure. There are some reasons, but in our family too and with myself, not hormonal IUD. I feel pretty strongly about the body's communication system because there's more to this brain hormone connection because when I have women who have had their ovaries removed, right? They go through an immediate like castration, right? They go through this early menopause, but yet they hit this time period, 45, 50 in this age range again and all of a sudden they're getting hot flashes again. All of a sudden they're experiencing something again.

    Dr. Anna:
    There's more to our hormonal clock, which I'm fascinating, the brain hormone gonadal connection. The adrenals are probably doing something there, but there's something more to this connection than just the ovarian signals and that fascinates me and what we do know too from research, when a woman has her ovaries removed before age 65, anytime, 35, 45 and, and shutting down ovarian production, not much different than they're at increased risk of cardiovascular mortality and morbidity. Cardiovascular disease, over 50% increased the risk of cardiovascular disease if we remove ovaries before age 65 compared to others so even our postmenopausal ovaries are still part of this communication network.

    Dr. Anna:
    Whether we do this transitional hormonal support now, or when we eventually remove the birth control pills at some point we switch from birth control pills to buy hormones, only bioidentical hormones at this point, bioidentical progesterone, DHEA and then we support that individual at that time. I think that does make a more physiologic sense. It does make more physiologic sense and I think that's where I really would love to... I'm with you. I'm just trying to figure it out. I'm trying to understand what is the best way to transition, just like with puberty, like the best way when I have prepubertal girls or girls struggling.

    Dr. Sarah:
    Yeah. I mean, I guess there's lots of different ways to approach this in lots of different parts of the world and certainly that's my... My personal approach has been to manage it that way and it's working really well so far. In my conversations with my OB/GYN here, we were looking at what is my personal risk? What do we understand about my experiences on the pill thus far in life? And so far, I'm feeling pretty well. I'm feeling pretty healthy.

    Dr. Sarah:
    I mean, I don't know why a girl going through puberty would necessarily have to be on the pill or not, but I don't think that most people make these decisions willy-nilly but as I said, what we understand is that when you go through puberty that kind of opens up, that kind of kick-starts the brain going through that phase of development and it's not... The greater determinant is not just hormones, it's not just our biology. It is the experience we have and all of the other things that are kind of going on in the world.

    Dr. Sarah:
    I suppose there's always a lot of controversy around the use of hormones and hormone replacement from whether it's from the oral contraceptive pill or from some other type of source when we go through perimenopause and menopause and that goes back to the kind of the fear that came out of all of the women's health studies.

    Dr. Anna:
    Right, right. What's happening to our brain in the menopause creating that brain fog?

    Dr. Sarah:
    Well, this is what the chicken and egg scenario as we call it, the chicken and egg scenario because we don't necessarily know is, and what we tend to see is, in women who are feeling foggy and fuzzy, and like, everything's kind of like, they're sort of struggling. It's hard to know whether that is directly attributable to hormones or is it because they're getting night sweats and so they're waking up on and off all through the night and so they're not sleeping well.

    Dr. Sarah:
    Once you're not sleeping well and when you only have to have one bed not sleep to feel pretty rubbish, if you're not sleeping well consistently for months and months and months what are all of the kind of the knock-on effects then are happening because without a good night's sleep, you're disrupting a whole host of hormones and you're probably not going to be eating well. You're not going to be exercising well. You're not going to be able to manage your emotions. Your social connections are going to start coming down.

    Dr. Sarah:
    This is what we understand from the perspective of neuroscience and the research has been done because we don't know... we can't say the hormones are directly impacting emotions and certainly if we look outside of the menopause and when we look at other points in the lifespan where hormones change and fluctuate, for example, taking a look at experiences of woman experiencing kind of premenstrual irritability and emotional kind of turmoil, lots of women experience before their period is that solely attributable to hormones. The research from the neuroscience perspective is kind of out on [inaudible 00:50:43] and as I said, it's not necessarily always the loudest voice in the crowd.

    Dr. Sarah:
    To make the assumption that hormones are the driving factor at every point, I think narrows our focus too much.

    Dr. Anna:
    And especially if our focus is on the wrong hormones. If we're looking at estrogen and progesterone instead of insulin and cortisol if we're looking at... I think to the interaction, especially in the transition of menopause, how important neurotransmitters are, so looking at our hormones, and this is where I think I'm a gynecologist and obstetrician. I trained at Emory University. I learned the hormonal pathways in and out. I had to memorize them and recite them. Okay. I know these hormonal pathways and what was missed were these major hormones, insulin, cortisol, and oxytocin, We know oxytocin.

    Dr. Anna:
    Looking at all the reproductive hormones, right? That's important, but if we don't look at the effect of these other major hormones to a degree that we understand the reproductive hormones, I think that does put us at certainly at a disadvantage, but also the fact that we need estrogen to produce serotonin, estrogen assists in serotonin production. Progesterone is necessary for GABA production, and testosterone is necessary and assists in dopamine production. So we look at the neurotransmitters, right? The hormonal communication between our-

    Dr. Sarah:
    They're all very intimately entwined. Absolutely.

    Dr. Anna:
    Yes, and how when we do manipulate one, we're affecting another and that cascade, so I think it is. It's such a beautiful and... I love it because I love now that the work of Dr. Lisa Mosconi, your work looking at the brain and women and now imaging the brain and looking at how the transitions affect us. There's so much more, and I know there's so much more. We're out of time, but I want to... I wish we could delve in. I'm looking forward to sharing your book with our audience and just all your work.

    Dr. Anna:
    Sarah, please share where people can get The Women's Brain Book and how they can follow your blog, what you're doing and connect with you too and again, for our audience, I want to thank you guys for being here and it's so important, we learn and we open our minds and just to continue to learn and educate. This field is evolving, especially as it comes to women's and women's brains and again, we love that we are mysterious. Don't you all?

    Dr. Sarah:
    Yeah. I think that's the thing, there's more that we don't know than what we do know and I think that there's lots of parts.

    Dr. Anna:
    Yes.

    Dr. Sarah:
    ... that we can [inaudible 00:53:27] to follow and really it's about being educated and informed and working with a healthcare provider that'll help you make the right decisions for you in not a fear-based way, but quite a calm... just take into account a lot of the influences and as I say, I think that the loudest voice in the crowd is the people that we can have around us to help support us through whatever kind of is happening and I think that that's pretty clear on a global level. At April 2020, we're being told to stay physically apart and everyone's really struggling with that and I think that that's pretty clear. I always say, I think the social prescription is the one that we should be writing, and I think we're learning that, and we're in a little boot camp to learn that at the moment globally, but yeah.

    Dr. Sarah:
    If people want to kind of follow my work and learn a little bit more about what I do, so my website is drsarahmckay.com. If you go to drsarahmckay.com/toolkit, you can download an applied brain science toolkit, which just has lots of sort of tips and ideas about health and wellbeing covering things like, can I sleep and exercise and all of the kinds of important good things we should do as well as a social connection for supporting brain health and I'm on Instagram, on Facebook, and really always enjoy sharing kind of the latest contemporary neuroscience and how we can make that useful and practical and applied in all of our lives.

    Dr. Anna:
    I love it. Thank you. With that social connection, what are the neurotransmitters and hormones that are most involved in that social connection? And I'm following you on Instagram right now because I don't think I was following you on Instagram.

    Dr. Sarah:
    I think we can be quite reductionist and look at like how does a human and that interaction with another human and change our biochemistry. I think we've got to kind of take a big picture look at it. We understand quite a little bit of social cognition and social brain networks, which go through this exquisite, as I said, a period of development during the adolescent years and then this other really newly discovered big shift during pregnancy. It's almost... and we assume it must have to do with the biochemical shift of pregnancy because it doesn't happen in the first few weeks after pregnancy.

    Dr. Sarah:
    It's almost as if it's mother nature's shortcut to try and ensure that pregnancy doesn't just prepare our body for nurturing a baby, but prepares kind of our mind for looking after a baby and then bringing in that kind of tribe of people around us now. I mean, oxytocin is kind of one part of that, but oxytocin has a sort of a sister hormone called vasopressin and none of these hormones even work in isolation. These neurohormones don't work in isolation from brain networks in our entire sort of physiology and every aspect of that but one nice kind of idea perhaps people could take away is that oxytocin is one of many along with vasopressin, many kinds of neurohormones, which is released when we connect socially with other people.

    Dr. Sarah:
    It's also interesting to know that it is also released when we are undergoing stressful experiences. When our stress levels go up, oxytocin also goes up and it kind of can have a bit of a seesaw effect. Certainly, we know it does in animals, we show in humans, but we don't know. There's a bit of a seesaw effect between one of the stress hormones, cortisol, and oxytocin, so they can kind of almost play off each other and we understand that when we're very, very stressed, oxytocin is released almost kind of like as our default mechanism to encourage us to reach out to other people, because what is the best way to reduce stress things, it's to think about instead of me, it is to think about us because no one's story... likes stories about themselves. It's about other people.

    Dr. Sarah:
    When we are stressed it's almost that we automatically want to reach out and connect with other people. That's why people are in a real sort of difficult struggle right now because everyone's a bit stressed out about this pandemic and we want to kind of connect with other people but at the same time we're being told we can't, we have to be physically [inaudible 00:57:50] from each other. It'd be really interesting to have a look. We could do some kind of study on what is happening in Australia but I also think that there's... Like I say, these things are all linked and kind of connected so how to unpack... it's very hard to kind of be really reductionist and unpack everything separate from each other.

    Dr. Anna:
    Yeah. So, so true. Thank you Dr. McKay for joining us today. I want to thank all our audience for listening. That was Dr. Sarah McKay, a neuroscientist from New Zealand living in Sydney, Australia. I've enjoyed our conversation together. You guys know how passionate I am about hormones, how I am about physiology, and enhancing our body's natural ability to balance and it certainly does. It certainly is complicated and not simple and we all do absolutely have to look into all the ins and outs of what is working for us and what is working against us and understanding that.

    Dr. Anna:
    I am just thrilled to share with you this information, open your minds to dig in more into brain science, into neuroscience, as well as into each and every one of your potential because of this... I mean, that's it. We have unlimited potential and we have so much going on in our world that we can do right now, so much that we have in our control, that will make a difference in our life. I want to share with you a testimonial that I received from a long-time client, [Angie Rial 00:59:31].

    Dr. Anna:
    She shared that regards to Mighty Maca greens, we were talking about this for stress management and she's been my client probably for over 15, maybe longer years. She wrote in to read this to you, as a lifelong endurance athlete, and with 23 years in orthopedic and performance medicine, I know how important recovery is to training and overall wellbeing. The ability to recover or not between workouts can be a determining factor in how hard and how frequently one is able to train, how susceptible one is to injury and whether training has a positive effect and builds a body up, or has an overall catabolic effect, both physical load as in training for something, having a highly active lifestyle or a physically demanding job and mental stress can cause excessive acidity in the body which can make you feel tired and cause a whole cascade of unwanted reactions in the endocrine and immune systems, as well as the musculoskeletal system.

    Dr. Anna:
    She writes I have enjoyed using Mighty Maca Plus to manage excessive acidity levels produced from long training and thus accelerate recovery. I also enjoy mixing up a glass in the afternoons if I'm experiencing an energy dip. I feel like I'm feeding my body the nutrients it needs to balance acidity and energize my systems without stimulants that eventually lead me to another energy dip later. An unexpected benefit has been noticing better digestion with regular use of the product. The single-serving packets are easy to travel and pour into any water bottle, great product, and always only the purest ingredients. Thank you, Dr. Anna, thank you for giving me this tool approximately a decade ago, and I love you and I love you work.

    Dr. Anna:
    Well, thank you to Angie Rials for writing in and sharing that. I also want to remind each and every one of you that again, empowering yourself is key and with that celebrating my new book, Keto-Green 16, we have a number of pre-order bonuses, a number of order bonuses that you receive, plus a gift code to the store, so a beautiful generous discount code to the store and some great stuff on our resources page when you pre-order or when you buy Keto-Green 16.

    Dr. Anna:
    I'm excited about that and sharing my latest work with you and all was just based on our discussion today, how important it is to understand our hormones as they shift and as what we can do through a lifestyle and natural approach as much as possible. Of course, always understanding what we need to do and with appropriate informed consent, making the best decisions for us with the information. I do also say when there's... One thing that I'm so strong about is getting in tune with my intuition, getting in tune with what is right for me and being able to discern what is right for me may not be right for someone else, but what is right for me? What is right for you? And what is the best information that we have in order to make the best decision for us? And if we're hesitant, not sure like as my friend J. J. Virgin says, if it's not a hell yes, it's a hell no.

    Dr. Anna:
    We need to listen to that. We need to listen to that voice and also know when sometimes maybe that's a fear-driven voice and we need not to listen to that voice. With that, be sure to get Keto-Green 16. I'm excited to share that with you. Support your adrenals with Mighty Maca Plus. Support your life with a lot of oxytocin and again, creating a social community. This is Dr. Anna, thank you for being here. I am here for you and I'm so happy to be your girlfriend doctor. Bye till next time.

    Dr. Anna Cabeca

    Dr. Anna Cabeca

    Dr. Anna is a Triple Board Certified OB/GYN, Anti-Aging Medicine expert, and author of the best selling book, The Hormone Fix.

    Dr. Anna helps women heal the 9 most dreadful symptoms of menopause with natural, safe solutions. Follow her for content on hormonal imbalances, vaginal dryness, menopause (and more) that are medically backed, and created to empower women — not just treat them.