Speaker 1: 0:03

Welcome to Hormone Heroes, where I share testimonials from real people who have experienced bioidentical hormone therapy. Men and women share the symptoms they have experienced and the difference proper hormone replacement has made. I'm your host, dr Kelly Hopkins and I have been in the functional medicine space for over 30 years, with a focus on hormones for 20 years. Please keep in mind this podcast is for educational and entertainment purposes only. Please consult with your physician or practitioner for medical advice. Let's get started with today's guest. Hi and welcome to the podcast. Today we're excited to have Pam Mahone. She's a physician assistant and she's the owner of Youthful Med Spa in Port Vedra Beach, florida. And with her we have Hope Honisberg. She has her doctorate, she's a nurse practitioner and she's originally from Maryland. So welcome girls.

Speaker 2: 1:06

Thank you for having us.

Speaker 1: 1:07

So let me just Pam, you're originally from where.

Speaker 3: 1:12

I'm originally from New York, but I moved here when I was very young, so I kind of consider myself a Floridian.

Speaker 1: 1:18

Yes, and you're beautiful and blonde and tan, and so you definitely look the part. How long have you owned Youthful Med Spa?

Speaker 3: 1:26

Well, we're very happy to say this is our 20th year, so we're excited about that.

Speaker 1: 1:30

Oh, wow. So have you seen lots of changes within your med spa. What did you start with and where are you now?

Speaker 3: 1:38

Well, my background was in primary care and then bioidentical hormones with a gynecologist, and then moved into plastic surgery, working with someone like that, and then opened the med spa and so, yeah, when we first started, I mean Botox was just, you know, coming to fruition. And there's just been so many changes with the technology and different lasers and then just all the different treatment modalities and this whole wellness is just explosive.

Speaker 1: 2:06

It is, and the hormone piece really does add to the aesthetics that many med spas have offered, and I think a lot of people are joining that bandwagon, thank goodness. But you had mentioned when we spoke before we started the podcast that you have moved more into a wellness aspect. Can you describe that for us?

Speaker 3: 2:29

Well, we've been doing pellets for quite some time and we're really happy with that. But we knew that there was more out there. We just didn't have the expertise. And then we were very blessed to have Hope join our team about a year ago and she just has so much of a wealth of knowledge and certifications in functional medicine, wellness, peptides, hormone optimization that she's kind of allowed the practice to move into those directions where we felt comfortable with her being you know what we consider in our practice the guru.

Speaker 1: 3:03

That's great. So, hope, dr. Hope, give us a little bit of your background. You're originally from Maryland, and then what?

Speaker 2: 3:11

Yeah, so I'm from Maryland and, as Pam had mentioned, about approximately a year ago relocated to St Augustine and started working here with Youthful Med Spa. So I've been practicing for approximately 16 years and my degree was originally in traditional medicine and then, as I started to advance in age, like I like to call that, I started noticing some things about myself that I found were very unusual and couldn't seem to get a good answer from my beloved primary care providers which some of them happen to be some of my preceptors while going through my clinicals. And then I found a nurse practitioner very much like myself that specialized in functional integrative medicine and hormones, and she really changed the trajectory of my career at that point. And then I went on and continued to educate myself and receive certifications through A4M, Georgetown Medical, the Heather Hirsch Academy most recently. So I'm certified in peptides and hormone replacement therapy and functional integrated medicine. So it's been a lifelong love of mine keep doing this type of longevity medicine.

Speaker 1: 4:26

Yeah, and everything you just mentioned really elevates youthful med spa probably above most medical spas that do aesthetics and even that just do hormones. Everything you mentioned takes it all a step further and delves deeper into wellness and anti-aging and all that good stuff. And A4M, for anybody that doesn't know, stands for Academy of Anti-Aging Medicine and it is a it's sort of the cream of the crop for anyone that wants to advance their medical knowledge past what you learn in medical school and residency and things like that. So that's great, dr Hope. Youthful Med Spa is very lucky to have a practitioner like yourself. So let me just start with. We'll go back to Pam for a second. Pam, you are a hormone patient, correct? Yes, I am. And when did you start to notice symptoms of hormone deficiency and what were they?

Speaker 3: 5:27

Well, it's been quite a few years ago. I had an ablation, so periods stopped so shortly. Probably after that, in my 40s, probably mid 40s, they said I was going through some early menopause and I started having the hot flashes. I think that was pretty much the first sign and I really didn't want to at that time do something like on a daily basis. So that's when, after having some labs drawn, that I started on pellet therapy.

Speaker 1: 5:57

So your symptoms were? What did you say?

Speaker 3: 6:01

Hot flashes, hot flashes. Okay, while they were tweaking it, you know I also started noticing especially as I started advancing into more full-on menopause, you know, the skin laxity, creepiness of the skin, dryness, you know, lack of libido. Intercourse wasn't as comfortable mainly because of, you know, decreased lubrication, dryness and those types of things. So it was kind of all of those things that just kind of started happening. And, you know, once I started on the hormones, things improved and then they've been kind of tweaked through the years.

Speaker 1: 6:35

So what was the initial type of hormone therapy?

Speaker 3: 6:37

you tried the first thing that I did was an estradiol pellet with a low dose testosterone pellet and then taking the progesterone capsules in the evenings.

Speaker 1: 6:49

Okay, and do you take your progesterone nightly, every night, or do you cycle?

Speaker 3: 6:54

it Definitely take it nightly because I don't have periods and I never did have periods from when I started on hormones because of the ablation.

Speaker 1: 7:02

Yes, yeah, and ablation is the cauterization of the uterus, so it's helpful for people that have heavy bleeding and things like that. So are you only doing testosterone, estrogen and progesterone now, or have you added anything else to your regimen?

Speaker 3: 7:19

So currently I am doing those three things, but since Hope joining our practice, she's really turned me on to a lot of the other things that are adjunctive, like the DHEA I feel like that helps all of the hormones. She's also turned around to like oxytocin, which has also helped, and then within the practice I've been doing Thermiva, which has helped with the vaginal experiences and things like that as well.

Speaker 1: 7:46

And that's a laser correct.

Speaker 3: 7:47

It's a radio frequency device. Okay, it kind of increases the blood flow, increases the tightening, helps with the nerve sensations. So, unlike a laser, you don't have like a lot of bleeding or discharge, you don't have any downtime from it, you can work out, you can resume intercourse the same day and it's really not painful. So to me that was like an easy adjunct.

Speaker 1: 8:11

Absolutely so. Have you had any side effects to any of your therapies?

Speaker 3: 8:16

Nothing. I don't think that wasn't expected. I think that's real important to let patients know what you can anticipate. Good side effects I had was, you know, the increase in libido, increase in energy, decrease in the hot flashes, better laxity, improvement in the skin. I would say the only I wouldn't even know if I'd call it negative side effect is maybe like a little more peach fuzz. But you know, for me that's a no-brainer. You can just do a little Dermaplane and you've taken care of that and it's so well worth the positive pros of it.

Speaker 1: 8:52

Yes, that I would have to agree for myself. A little extra hair on the face can easily be remedied. So, Dr Hope, are you a hormone patient as well? Yes, ma'am, I sure am. Ed. How old were you when you started to notice symptoms of deficiency?

Speaker 2: 9:09

So I was 38 years old and I was a primary care provider and my symptoms started off very different than what most women know about, because we know about these common symptoms, we know about hot flashes, we know about insomnia, we know about decreased libido. So mine started with brain fog, started losing my words. You know telling patients I'm going to take your you know the thing squeeze your arm, your heart. You know where it's like blood pressure, you know I was losing the normal things. And then my phone started to burn and then the top of my ear started to burn and I was like what is happening? And then I would cry for no reason and then the libido came and then the insomnia came. And you know the insomnia was happening. I could fall asleep and then I would wake up like around you know that magic hour 2, 3 am. And. And then I would wake up like around you know that magic hour two, three am. And I'm laying there and I'm redoing the NSYNC song that I used to listen to when I ninth grade. You know this forever going and earworm couldn't get rid of it. And then I would go grocery shopping and oh, I got to do this. And then I would ruminate. You know, did I say the right thing to this patient? Oh my goodness, did I read that lab room? The right thing to this patient? Oh my goodness, did I read that lab room, you know?

Speaker 2: 10:25

So it was this constant, like I kept getting these unusual symptoms that most people, they don't peg them as those perimetopause, metaposal symptoms. They don't understand that there's a plethora of them and we're so unique. You know, each part of us, even our symptoms. So when I went to my gynecologist, who I absolutely adore to this day, she was like oh hope, you know, you're just getting old. Wrong answer, wrong answer, brilliant, but didn't like that. So then I went and I saw my primary and he says, oh, I think you might be depressed, you need some sleeping pills and you should see a psychiatrist. And so you know this whole time and you're so close in the box. You know, and you know the right answers. You sort of know because they teach you this much in traditional medicine school or traditional nurse practitioner school. But then I met a colleague and I said you know, I'm losing my you know what. Right now. I don't know what's happening to me, but there's something wrong and my labs are normal, right, right, normal for your age.

Speaker 2: 11:20

Yeah, I wait. I saw this MP, MP and I remember sitting in her office with my lab slip and I had this lump in my throat and I just looked at her and I was like, look, if you're just going to tell me I'm normal, my labs are normal or that I'm getting old, I just don't waste your time. And she said I'm not going to. And she sat with me for like an hour and a half, read my labs like nobody's business, made me feel like I was a person, listened to me, let me know that my tongue was not going to fall off and that my vagina was not going to be dry for the rest of my life and I was going to be able to remember all this education that I had before. And I left out of there and like two weeks later, I felt so much better and my first prescription at that time was a progesterone pill and vitamin D because I was normal on my labs. But you know, my vitamin D level was 35. Low end normal is 30, according to the lab core in the quest that I've ran across. So I was eating on vitamin D. She put me on DHEA, she put me on progesterone at night before bed. Within two weeks it, like the sky opened and I lit up.

Speaker 2: 12:24

I woke up and then, you know, a year later, I added some testosterone and probably, like I would say, early 40s, I started adding estrogen. I added by Bell dot, and then I, you know, in between I did some things with pellets, only testosterone pellets, which I loved. But because we know that in perimenopause, you know so the book says this is your hormones, this is your month, you're going to go up a little bit, it's going to go down, they're going to go up. And then you have perimenopause, and perimenopause looks like this, Right? So you're like I'm up, no-transcript, you know, nobody's the same, Right, You're not a cookie cutter establishment.

Speaker 1: 13:35

Tell us more. The Viveldot is an estrogen patch. Walk us through a little bit. What might be good for one type of patient versus another? Give us a brief summary of how you choose your therapies for patients.

Speaker 2: 13:50

So, first and foremost, what's most important to me is how they feel. What are your symptoms? I like to treat based upon symptoms. Labs always super important. Keep everybody safe, know what's going on with the whole body. But first I listen to the patient and find out what their symptoms are. Once I know what their symptoms are, then I find out what their lifestyle is like.

Speaker 2: 14:10

Are you a busy career woman who's hopping on a plane once a week and you're just like you're doing it all right? If you're a mom that has little kids that are hanging on you all the time, you may not be a cream kind of person. Right Right To know that those little ones they want to come in and be with you when you pee and when you shower, and they're always so we don't want to transfer any creams to them. Are you a gal who is? You're just kind of forgetful?

Speaker 2: 14:40

You know you may do better with a pellet, or you may do better with a patch, or you may do better with, you know, a dual cream, an estrogen progesterone cream, rather than taking your progesterone at night before bed. Or maybe we found your sweet spot and you're like I want to put everything together. Then I'm OK, you know let's do that, but I think it's very dependent upon the patient and it's not necessarily the age, it's not necessarily are you pre-metaposal or are you post-metaposal, because we know menopause is just one day of your life. It's really based upon their lifestyle and what we're trying to achieve at that time.

Speaker 1: 15:17

Yeah, that's awesome. So what's your current regimen now For?

Speaker 2: 15:22

myself, yeah, so I am on a 0.0375 estradiol patch twice weekly. I take 100 milligrams of progesterone at night before bed, and I'm doing 20 units of 50 milligram per mil testosterone siponate injection twice a week as well.

Speaker 1: 15:42

Okay, we'll talk about that for a second. So injectable testosterone you like to use that for women as well? Yes, ma'am, I do. You microdose it twice a week instead of once a week, or once a month or whatever?

Speaker 2: 15:55

I like to microdose it twice a week. You know, throughout my career have I had women that I did it once a week or I had to microdose it a little bit less? Yes, absolutely. But normally I like to do it twice a week because I feel like, you know, especially us gals that are perimetopausal, we're a little bit more finicky. So I take them up they're getting ready to come down and I come in and catch them and bring them back up so they're more stable. You know that peak and trough is more. They have more of a stable testosterone level throughout the week.

Speaker 1: 16:25

And is that why you prefer it for yourself as well?

Speaker 2: 16:28

Right now, at this point in my life, I do yeah, yeah.

Speaker 1: 16:32

Have you gone through menopause or had a hysterectomy or anything? No, ma'am, so are you still having a period?

Speaker 2: 16:39

Yes, ma'am, every month, every 28 days.

Speaker 1: 16:47

And do you change how you use your progesterone according to your cycle or do you just? How's that working for you?

Speaker 2: 16:51

So I used to change my progesterone based upon my cycle. However, what I found was that I did not sleep well when I cycled it. And then I thought well, based upon beautiful evidence-based research, you know that has happened within the past 10 years there's really no reason for us to cycle off of our progesterone. Are there risks with progesterone? Well, yes, of course you know there's risks with Tylenol, but with progester, out of all of our hormones, I would say that it's probably our safest right and it makes me calm. It gives me my nice deep REM sleep, which helps my cortisol levels go down, which helps me with maintaining my weight and my energy and my brain health. So at this time, I do my progesterone every night before bed.

Speaker 1: 17:43

And it doesn't interfere with your cycle. It's still pretty regular because that's a challenge we've had in our offices. You know we try to cycle it days 14 through 28. If you're still having a period, we'll work with premenopausal women that way for a while and then you know once the period starts getting wonky, you know it's just easier to take it every night. So I was just curious what your experience is.

Speaker 2: 18:08

That's what I'm doing. But when I have had perimenopausal women in the past that they like taking it every night but it does make the period wonky I will decrease the progesterone by 50 or 25 milligrams. So if they're on 100 milligrams you know 1 through 14, then I'll decrease it a little bit for the rest of the month and that seems to fix it.

Speaker 1: 18:29

Okay, good, good, let's talk a little bit about the adrenal hormones. You've mentioned DHEA and cortisol. Just give us your expertise on treating men and women. Do you treat men in the clinic as well? We do yes, okay. Okay, just walk us through a little bit about the benefits of treating the adrenals.

Speaker 2: 18:50

Yeah. So before I talk to any of my patients about treating the adrenals, I like to explain to them the endocrine system almost in a way that helps them kind of understand where I'm headed. So when I think of the endocrine system, I think of each one of the organs pituitary, adrenal glands, reproductive organs, thyroid. Think of them as the gears on a clock. If all the gears are spinning, the world is good. If one in the teeth on one of the gears breaks, it affects all of it. Right, that's great. We can't. We're going to chase our tails. If we just put a Band-Aid on one thing, you might feel okay for a little while, but if we don't take care of that whole person, that whole system, then we're going to keep chasing. Yes, planes are going to change, but we have to treat the adrenals. The adrenals are so important. Cortisol that's that omega hormone, right? No, cortisol lights out the body. It's going to steal anything to make cortisol. What are some of the first things it steals? It steals your sex hormones, steals your testosterone, steals your estrogen. When the body is you know when it's running out of cortisol, it goes around and it looks for it and you know it goes to the ovaries and things like that, and says, hey, do you have cortisol? And the ovaries say, hey, I don't, but I got this thing that looks like it. I got testosterone or I got this estrogen, and then it works for a minute and then you start running low and everything else right. So my preference is to support the adrenals, support that cortisol, and that does mean with nutraceuticals. That means let's talk about your diet. What are you eating? Let's add some foods that are going to support the thyroid. Make sure you're doing your zinc, your iodine foods, you know, throw in some Brazil nuts for some selenium, you know. And then also, what are you doing that brings you joy? And most men and women will say, oh, I love my kids, I'm going to their baseball games, and I'm like, no, no, no, what brings you joy? And do you know most people, they just don't know what brings them joy. They're like bring me joy, as if I could sleep, and I'm like, okay, then this is what we need to do. I need you to. I want you to big belly laugh. I want you to breathe. If it means walking five minutes in the grass once a day, I want you to do that. I want you to take a bath. I want you to do something. I love to add things like ashwagandha, magnolia root, dandelion root. Those types of things also can be very beneficial at night along with your progesterone to help you sleep.

Speaker 2: 21:10

What does caffeine look like? Are you tapping on those adrenal glands? Is the adrenal glands throwing out a white flag, where we're seeing this reverse cortisol level, elevated DHE high, or am I seeing high DHEA and low cortisol? That kind of helps me figure out where I need to tweak you. I think that mind food, medicine, hormones. I think all of that and the relationship that you build with somebody that sometimes this is the first time they're talking about something so vulnerable All of that helps the adrenal glands. That helps that HPA access. It truly does.

Speaker 1: 21:49

So do you like to use saliva testing? Are you getting it off serum for the adrenals?

Speaker 2: 21:55

So for the adrenals, I have to tell you, dr Hopkins, I'm a little bit back and forth with the saliva versus the serum blood test. I mean, I love the Dutch test. I think it gives us extremely valuable information. However, wherever that woman is or that person is in their life, I find that even the saliva cortisol, it's not as reliable as I would like it to be. With the blood, the insurance covers it. So that obviously is a little bit of a spiff that we have to pay attention to, you know, to help afford things. So I prefer first thing in the morning before 9am. And some of our moms it's hard to do that and you know they wake up and they're off to the races, right, or folks that are, you know, just pretty much all of us we know we're just, we're up and we're going.

Speaker 1: 22:43

Yeah.

Speaker 2: 22:44

So that was a really long answer, I apologize. Mainly we're using serum because the insurance covers it, Sure, but the live is a little bit more expensive for folks. But again I go back to asking the patient are you peeling yourself out of bed? Are you able to get up? Tell me about that. What do you feel around two, three o'clock during the day? Am I looking at adrenals or am I thinking thyroid?

Speaker 1: 23:09

Right, you hit on a really good point and I love the clock analogy. I might borrow that. You know men that are going through andropause, which is a big word for when men start to lose their testosterone and they're stressed. And it goes for women who are in perimenopause or menopause and they're stressed. It's the Adrenals Act is our backup system to our sex hormones, and so it's a double whammy for people. There is absolutely nothing in the gas tank to draw from to get through your day. So we mentioned peptides in the beginning. Tell us a little bit about what you do with, what peptides you use and what they do.

Speaker 2: 23:53

So peptides are beautiful. You know they're branched chain amino acids. The body is very familiar and one of the oldest peptides and most people don't realize that they're peptides. One of the oldest peptides that we've been using for ages is insulin, you know, for diabetes so, and many medicines they originate from peptides. Even our newest ones, like our, those beautiful GLPs that we have access to now, are peptides.

Speaker 2: 24:16

Here at Youthful, some of the peptides that we use that Pam had spoke of. One of it is well, I apologize, that's not necessarily a peptide, but we do offer. One of it is well, I apologize, it's not necessarily peptide, but we do offer oxytocin, and that's coming more from our adrenals as well. But we do BPC, that's the body protective compound, 157. And 157 just tells us how many branched chain amino acids are linked together. So that's really something that we use. That is super nice for things like and it depends on how you administer it.

Speaker 2: 24:44

So for gut health, bpc is excellent. It's one of the only peptides that we can take orally that the body will not completely break down in the gastric acids because we make it there. So BPC is a really lovely peptide to make or to give somebody that perhaps is having some stomach upset. Or you get a patient who has been on Prilosec for years when they shouldn't have and they've got this malabsorption disorder. You can't seem to get enough vitamins in them and they're still losing it. Bpc is a nice thing to give them to go in, help to heal that mucosa, help to decrease reflux, decrease GERD, you know. Fix that stincture valve to help them, you know, really start to heal that mucosa.

Speaker 2: 25:24

Other things about BPC could be joint health. It's really nice as an injectable to help with joint health. You can do it around the joint in the tissue. It doesn't need to go into the joint. Bpc will find its way where it needs to go. There's also some really lovely research that shows how BPC works with serotonin, norepinephrine and helps with depression, anxiety. So there are thousands of peptides, but that's definitely one of my favorite peptides that we're using here.

Speaker 3: 25:51

NAD.

Speaker 2: 25:52

NAD yeah, so we do offer NAD here as well, which is another one of our loves here is longevity medicine, which we're seeing more and more of and I think it's because of our forerunners, you know Dr Peter Urtea and Dr David Sinclair. You know why we age, what we don't have to and outlive, and recently just did it went to a longevity conference in the beginning of the year. That was amazing, had like 6,000 attendees, fantastic representatives that talked about NAD, nmn. You know how that cascade of getting up into that, you know improving the ATP and supporting our mitochondria. So you know the NAD is really on the forefront.

Speaker 2: 26:35

Some folks are, you know, can be a little standoffish about it because of older research about how it can. I think words that I hear chatter on social media is like promote things to grow or promote cancers and such, and that's not necessarily the truth. I mean we have these things, we have those NMN precursors, we have ATP, we have mitochondria. We're just improving it, we're helping our bodies. You know we want everybody wants to live longer, but we want to longer healthier. You know AD really helps to support that and we can give NAD for multiple reasons as well, and longevity and health and Alzheimer's. Dr Melissa McCall wrote a beautiful book about the brain and Alzheimer's and talks about especially with women and NAD and supporting our mitochondria and helping to decrease, you know, the dementia and our memory are helping yeah.

Speaker 1: 27:27

Right, and do you do IV therapy there at Youthful Med Spa?

Speaker 2: 27:32

We don't currently, but we do have other modalities that work just as beautifully. So we do NAD oral, we do NAD nasal as well, okay, let's talk about.

Speaker 1: 27:42

Let's go back to oxytocin for a second. This might be a new one for some people. Tell us what it is and how you use it.

Speaker 2: 27:49

Yeah. So oxytocin is something that you know we make in the body. A lot of moms will recognize the word tostin because of puttostin, so they're like, oh, I don't want to do anything in my cervix. I'm like it's not that I promise.

Speaker 2: 28:01

Oxytocin can be used for a couple of different things. Again, we all have it. We lose it as we advance in age and, depending on how I dose it or the method of delivery, it kind of depends on why. So we offer it here two ways one nasal and the other is the atrogy, so a little something that you a little more trochee. The trochees are scored. A trochee is a square and it's really tiny and they're scored and each one I'll say you can start with a corner, with a colder a bit, and if it doesn't seem to work, then you can add and you can take up to one as needed daily and you let those melt under the tongue. Let them melt under the tongue. They're usually like a minty, refreshing flavor. So, okay, mint.

Speaker 2: 28:54

The other thing is oxytocin is known as our love hormone. So it makes us all nice and fuzzy and cozy. I read once that if you did a big bear hug on your dog, that you could give yourself a shot of free oxytocin. So the other thing is, you know, if you're going to be having an intimate evening with your sweetheart and you've got your hormones on point, but you just want to feel a little bit more, a little bit more, you know, soft or sassy, then taking some oxytocin can help give you that little bit of extra edge or oomph that you need to make sure that you're showing up the way that you want to.

Speaker 1: 29:30

Gotcha, and does it help with orgasm?

Speaker 2: 29:33

So oxytocin will help with orgasm and again, I've read some different things that tell us why it helps with orgasm. You know it can help with, you know, getting the body prepared and getting that blood flowing. You know, down in that area where so vascular, we want everything to be nice and fluffy and stimulated and sensitive. But I think libido is hugely brain, hugely brain. So oxytocin works well on the brain. So that's the other thing is, you know you can use the trochee to help with the orgasm, right, if you're not really getting so, if somebody comes to me and they're saying I'm having a hard time orgasm, oxytocin isn't my first thing to go to, because we have some other things that we need to look at. Right, we need to look at those hormones or sex hormones, and then I'll add in oxytocin as an adjunct to help.

Speaker 2: 30:32

However, another way that I like to add oxytocin is nasally, you know a nose spray, and they can use that for depression, anxiety and just feeling nervous. Because sometimes, you know, when we are going through those andropause, menopause, perimenopause, sometimes we have those nervous, anxiety feelings. Maybe we're having palpitations. Well, we think they're palpitations, maybe we're going through those things. Oxytocin is going to help to kind of bring that back down and calm you. I asked some gals that are in like administrative positions and they're you know they're used to going up and talking in front of tons of people and they're like I am so nervous I feel like I need to take a Xanax right before I go in and I'm like there's a place for Xanax but let's try some nasal spray oxytocin and let's watch you glide through and they come back and they're like I love that. That was fantastic.

Speaker 1: 31:17

Wow, that's fantastic. So can men use oxytocin as well.

Speaker 2: 31:26

Yes, absolutely, men make oxytocin as well. Yes, absolutely, men make oxytocin as well. And then you do then PT-141 as well. Yeah, we do PT-141 as well to help with libido and erections and blood flow into those areas. But yes, men can also use oxytocin.

Speaker 1: 31:37

Do they use it the same way under the tongue or nasally before sexual activity? Or?

Speaker 2: 31:43

Yes, they can. Okay, yes, they can, and these things can be used throughout the day. I know that I said that I use them to help with insomnia or ruminating and help people to sleep, but it really is a nice, clean way to help with anxiety or, you know, trouble throughout the day.

Speaker 1: 32:00

Yeah, I could see where I could be an oxytocin junkie.

Speaker 2: 32:03

It really is lovely.

Speaker 1: 32:06

It's quite lovely, so tell us about PT-141.

Speaker 2: 32:10

So PT-141 is very similar to things that are on the market. Medicines that folks may be familiar with are things like Viagra or Cialis for gentlemen Although I have a world for Cialis for women too and for women it would be things like Allie, and these are medications that will help with blood flow and that's what we're looking for in those areas and you know, at the end of the day, the clitoris, it's a little penis right. So for women, pt-141 will help get that blood flow into that area, help with sensitivity. We do need to make sure that the vagina and you know, the clitoris, is well-moisturized and fluffy, and that's where the amoeba comes in, and hormones and even like topical estrogen. But using the PT-141 peptides in conjunction with those things is a lovely way to help with sexual arousal and sexual health.

Speaker 1: 33:02

And you do that with men and women.

Speaker 2: 33:05

Yes, ma'am.

Speaker 1: 33:06

Okay, very cool. Do you use samorelin?

Speaker 2: 33:09

So we don't have samorelin here at this office but I do love that medication. It is one of the forefront of. I think where I liked to use it was with longevity. I know that it's a great medication to help with also muscle building and athletes. It helps with joints and tendons and such. But semirelin is also very helpful for, you know, telomeres. You can put it kind of in that category with rapamycin, but again, semirelin's been around a little bit longer, so it is a nice peptide. We don't have it right now, but that doesn't mean that we won't.

Speaker 1: 33:44

Yes, it does help to increase growth hormone. We use it here for those patients that want to take their anti-aging to the next level.

Speaker 2: 33:53

It's a good way to help. You know, tap on the pituitary, make some more FSH LH. You know it does. It is a nice you know way. And you have those gentlemen who they're not quite at the point where you want them taking testosterone. At that point you give them that. You know it helps the testicles to make more testosterone. You know that whole cascade down from the pituitary, helping them to make more.

Speaker 1: 34:16

Yeah, so have we touched on the biggest part of peptides that you use, or is there anything else you want to mention?

Speaker 2: 34:23

No, I think that's what we wanted. You know, I would mention with the peptides right now. I mean, we do have some other things like JHKCU coppers and stuff that we'd like to use for skin. That's a really lovely adjunct for skin health and hair growth, and then there are other skincare products that we have that is evolving more into that peptide world.

Speaker 3: 34:45

How about, like metformin? Do you use metformin in your practice?

Speaker 1: 34:48

We do use metformin. We use a lot of berberine as an alternative, but just dealing with people that have really high fasting insulins and high A1Cs if they're not already being taken care of by their endocrinologist or don't have an endocrinologist. We will especially dealing with our patients that are on the GLP-1s semaglutide, terzepatide and we use everything in a temporary fashion, so we just let patients know this could be a temporary. This isn't a life sentence that you need to take this medication, but that is something we utilize here.

Speaker 2: 35:25

We use metformin here at this facility. It does, you know, help with weight loss. We're not per se treating diabetes. I love berberine, you know. My recommendation for that is I like to do four to 500 milligrams twice a day with food and it, you know it doesn't cause the same type of GI upset that sometimes metformin can. However, I love the longevity properties behind reverine and metformin, so I would dose metformin much lower if we weren't treating, you know, diabetes type two. Yes, but I love the TAM study that is coming out with, you know, really great evidence of metformin being that longevity pill. That is, you know, showing that we have the disease of aging and that we can treat it from a root cause analysis, and metformin is that forefront. And it's so nice that you know who would have thought a French lilac would keep us alive longer.

Speaker 1: 36:20

For those of us that may not know and may be new to the concept of metformin for longevity, can you help us with the mechanism of action of that?

Speaker 2: 36:30

So I mean, I think, simply put, it has everything to do with the way our body processes and stores insulin. You know, as we advance in age, we either have developed poor behaviors or lifestyles that are now kind of catching up with us and our equipment doesn't work as well as getting rid of the things that we're not supposed to have and that's, you know, that's that insulin.

Speaker 1: 36:53

And carbohydrate metabolism.

Speaker 2: 36:55

Yes, absolutely, and metformin kind of comes in and gives us that extra omp to help us to get things back to running the way that we wanted them to. The other thing is, you know the benefits that aging process with metformin. You know, when we think aging we often think about decreased memory. You know dementia, alzheimer's, and you know Alzheimer's is frequently called your diabetes, type three, right, and that's where the metformin is coming in and it's being a really nice way of kind of getting that sugar brain under control. I heard that phrase at a podcast earlier this week and it made me giggle so I had to reuse it. But metformin is a very inexpensive medicine and it's showing to be able to do much more than just treat diabetes but to be able to provide us with the tools we need to help us with that, like I said, not just the longevity but the health of our longevity.

Speaker 1: 37:50

Yeah, that's great. Tell us a little bit about how you like to treat thyroid. What symptoms do you look for? What's your favorite go-to?

Speaker 2: 37:59

Yeah. So thyroid, I feel, is a very underserved organ and it's such a big player in everything. Truly it really is. So I don't treat hyperthyroidism that is definitely not in my scope and I will send those folks to the endocrinologist. But hypothyroidism, I think that most folks, when I say undertreated, is because if they don't fall in that category again we go back into those categories, those lag values, right, and most traditional medicine. We're looking at that. Tsh.

Speaker 2: 38:32

Well, you know, thyroid stimulating hormone, that's a messenger from the pituitary that tells the thyroid to make more thyroid. It's not necessarily your thyroid hormone. So I feel like by the time that number gets to a point where it's changing the body, then we're, you know, sometimes the hay's out of the barn, right, right. So I really, you know, for insurance purposes, I, you know, using Synthroid or Levothyroxine, I think you know, definitely I'm okay with using. I do like the desiccated thyroid. I think that's nice. I like a compounded T3, t4, because then I can really change a patient's doses based upon their need. And T3, t4, just for folks that may not know. You know, those are your hormones, those are the ones. We have an abundant of the other. The other one makes the other one work, so we need both of them to make things you know work and symptoms that I look for.

Speaker 2: 39:23

Typically it's that I'm having a fatigue, I'm really kind of leveling out around two, three o'clock and I'm needing more and more caffeine. That can be a side of hypothyroidism, or I've got weight gain. You notice that the patient is missing the corners of their eyebrows and they weren't born in the 80s. So where we all had lines, you know we're clipping them off right here, right, or they have. Sometimes they'll have lines. You know we're clipping them off right here, right, or they have. Sometimes they'll have issues with their skin. You can also see that in like maybe some more acne than usual. You can also find dry skin, with these folks typically on the lower legs. Loss of hair that's another one and depression. So there's been times where I've had patients that came to me on SSRIs or anxiety medication and their TPO was through the roof and they have Hashimoto's.

Speaker 1: 40:12

Tell us what Hashimoto's is.

Speaker 2: 40:14

So Hashimoto's thyroiditis is an autoimmune condition of the thyroid. It's basically that the body is attacking itself. And I know that's not the nicest way to say it and not everybody agrees with that verbiage, but it just seems's not the nicest way to say it and not everybody agrees with that verbiage, but it just seems to be the easiest way to understand. And here at Youthful, when we test the thyroid we test a full panel. So we're looking at the TPO, we're looking at your TSH and your free T3, free T4. Because sometimes people will have been having these symptoms of hypothyroidism, with the weight gain and the hair loss or depression, anxiety, the things we spoke of, and their TSH has been normal this whole entire time. But I do a TPO and their antibodies are through the roof.

Speaker 1: 40:56

Right.

Speaker 2: 40:57

So I will treat Hashimoto's and you can treat it with the medications that we talked about. But on any of my patients when it comes to the thyroid, I think it's imperative that they're well-educated on the importance of zinc, selenium and iodine. We need those minerals for the thyroid to work well. I also like to know are you gluten sensitive? Because oftentimes you will find thyroid and gluten. They're like, yes, and you got married, it's happening. So I like to make sure that they have some type of like a vitamin that has those trace minerals in it and, you know, some ACE in it. I don't work for this organization, but Orthomolecular makes a lovely vitamin called thyrotene that I really like to suggest to my patients, but then we also go through foods that are rich in those trace minerals as well.

Speaker 1: 41:46

Yeah.

Speaker 2: 41:46

Definitely important.

Speaker 1: 41:48

So have we touched on most of the components of your functional medicine approach, or are we missing anything?

Speaker 2: 41:56

No, I think that we have touched on the majority of our functional medicine approach. The one thing I would like to add is you know we talk a lot about menopause and perimetopause and that is definitely, you know, a love of mine. But the andropause I think that I just want to touch on that just a little bit for our gentlemen. We're seeing younger and younger men with hypogonadism, testosterone deficiency, and this could be oftentimes because of that cortisol and that stress that we talked about. You see a lot of gentlemen who are in the military police officers, doctors you know people that work night shifts where they're tapping, capping, capping on those adrenal glands and it's just stealing their testosterone.

Speaker 2: 42:38

And we're having, you know, they're having trouble with fertility, they're having trouble with erections, they're having trouble with anxiety and depression, they're having trouble with erections, they're having trouble with anxiety and depression, and they can also have trouble with insomnia. Or they're deciding to go and be treated by a friend at the gym and then they come to you and they're like you know, my testosterone is through the roof, but I don't have, I can't get an erection. Well, then you find out they have no estrogen Right, and then you have estrogen. Or they're not sleeping and you find out. You know they're trying everything because they're not sleeping. I ate a whole bottle of CBD gummies and I'm still not sleeping. Well, you test them and they don't have any progesterone. So you know, men letting men know that you know you have these hormones too. We all have them. We just have them in different types.

Speaker 3: 43:22

Right.

Speaker 2: 43:22

And trying to help them as well to be their best selves and letting them know that their hormones are also a part of their longevity plan. Again, it's a mental health and it's a physical health thing.

Speaker 1: 43:33

That's a good point. You treat the gym rat group and they think you know the less estrogen the better. But men truly need at least three to five percent in the ratio of estrogen to testosterone or I'm sorry, yeah, for quality erections and moods and things like that. And then we all make progesterone, especially in the adrenals. So I'll go back to you, pam, for a second. I feel like you are definitely a hormone hero. You've been in the business for 20 years or so. What would you like our audience to know?

Speaker 3: 44:10

I just think that everyone needs to realize that this whole world of wellness and functional medicine is just such a great thing that is, you know, becoming much more prevalent, and I really think that if men could become more aware that it is okay, because I think so many men they want to be strong and then that strong they think that any weakness would be going to a medical provider or, you know, just acknowledging that they're going through anything is weak, but it is just part of aging and this is part of this. Andropause and, yes, testosterone is a very big component, but there are a lot of other things, like Hope was saying, and that's a big part of it. But that's just one part of the longevity medicine. It's everything. It's the GLP-1s, it's the peptides, it's the hormone optimization, it's the gears, it's everything you know. It's the GLP-1s, it's the peptides, it's the hormone optimization, it's the gears, it's all of those things on the clock. But it also includes men, I think. For many, many years it's been focused on women and that's really unfair to the male population.

Speaker 1: 45:18

Yes, men are really well. They've always lifted weights and the testosterone piece was a big part of their world. But introducing them to these other aspects will only enhance what they're trying to, you know, benefit from when they go to the gym. So, dr Hope, you're a hormone hero, very obviously. What would you like our audience to know?

Speaker 2: 45:40

I would like our audience to know, men and women, that you're not alone and there is great strength in vulnerability. There are many, many providers out here now that have taken the time to specialize in these areas and who truly love, you know, helping people and making sure that they're living their best life. I mean that term is used very loosely, but we are out there and you know, I told Pam before you know if I could do this for free, I totally would, because I believe in medicine and I believe in people, but know that it's okay and know that there are people out there that truly, you know, want to help and want to give you this individualized plan, and we'll listen. You will listen, yes.

Speaker 1: 46:25

That's fantastic. So, pam, what is your phone number there at Youthful Med Spa in Point Vedra Beach, florida? What is your website? Give us all the things.

Speaker 3: 46:37

Okay, our phone number is 904-273-6286. And our website is wwwyouthfulmedicalspacom. I think our Instagram is youthfulmedspa. Do you know your Instagram?

Speaker 2: 46:53

I apologize, I do not know my Instagram by heart as.

Speaker 3: 46:56

I should. I think it's YMSInjectorHope, I believe I found of these, but I think you could probably find her that way, and our Instagram handle is Youthful Med Spa.

Speaker 1: 47:09

Wonderful. Do you have any other? Do you have blogs or anything like that you'd like to share? Or just go to the social pages.

Speaker 3: 47:17

Kind of. Our main area is to find out information on our website. We're doing a seminar next week which will be our first wellness seminar, and we sent out a text campaign and within less than an hour all of our seats were full. So we're super excited to be able to really promote this.

Speaker 1: 47:35

What's your seminar going to be about?

Speaker 3: 47:38

Wellness in general. I mean, we'll be talking about how the peptides and the hormone optimization are helping people, helping them get educated, because I think so many people they know little bits and pieces of this but they don't know where to get the information. And when you do a seminar and you can, you know, get the word out and a fun, you know where they can be vulnerable but they don't feel vulnerable. I think that's a great avenue for people to get the information and start talking about social care first. But you know, so far, we've just seen such a great response to it that I really foresee this being something that we do on an ongoing basis.

Speaker 1: 48:13

That's wonderful. Well, thank you both for your time this morning.

Speaker 3: 48:22

And we'll be looking for big things out of you guys.

Speaker 1: 48:28

Thanks for listening to Hormone Heroes. Take a moment to subscribe wherever you listen to podcasts so you don't miss the next episode. While you are there, help us spread the word by leaving a rating and a review. If you would like to share your bioidentical hormone story or need help finding a physician in your area, please email us at drkelly at hormoneheroesorg, that's d-r-k-e-l-l-y at h-o-r-m-o-n-e-h-e-r-o-e-s dot org. We want you to be a hormone hero.