Hormone Specialist Dr. Leslie Brocchini, MD

[00:00:01]Hello everyone. It is Sunday once again.

[00:00:04]We're coming at you on a beautiful day here in Texas. And I'm assuming it's beautiful out there in California since I see Mike smiling real hard. And the bottom line is, ladies and gentlemen, we have a special guest, uh, hormone specialist, Dr. Lesie, who's going to sit down and explain everything to us.

[00:00:23]So, if you got your pens and paper and if you don't have it, you might want to go grab it while Mike introduce everything and we can kind of go from there and move forward. But we'd like to welcome you, Leslie. And hello, my friend Mike. How you doing, brother?

[00:00:35]Hey, man. Everything's great, man. On my end, man. It's not hot today. It was a nice sunny day, man. And in in Northern Cali, man, and I appreciated the weather, man. You know me, man. Every time God allows us to put our feet on the ground and I get outside a little bit, I will do that. But yeah, I'm excited, man. And I'm excited as well, man. Um, our special guest, man. You know, we always talk about, you know, with some of these topics that we're she's going to be talking about today.

[00:01:00]But we always put that disclaimer.

[00:01:03]>> We are not doctors. [laughter] >> We Hey, we two old guys that you know that got some experience, but we not doctor. But hey, we bought you a doctor today.

[00:01:13]>> There we [laughter] go.

[00:01:14]>> We bought you a doctor today. And just want to let you know that, hey, uh, I call her a friend of mine. I call her a workout partner every now and then. You know what I'm saying? Every now and then I get out there to where she's at. I call it God's country because it's beautiful when we out there working out.

[00:01:27]But um she's a hormone specialist, man.

[00:01:30]She's Stanford. She's got Stanford background, man. So this Hey, so she's not one of those BS people, one of those BS doctors. She's got some background behind her. She's got a lot of experience behind her and also a sports background. So she can tie in a lot of stuff. So hopefully if you got questions out there, ask them. I want to introduce my friend, my doctor. Not my doctor, but she's a doctor. [laughter] Dr. Leslie Bkini. How you doing, Leslie?

[00:02:00]>> I'm good. How are you guys? Thank you for having me. I'm so happy to be here.

[00:02:04]>> Absolutely.

[00:02:05]>> Good. Good. Before we start, man, asking you questions and everything. I always ask, you know, uh, your your IG handle is Soul Strength Medicine. Now, how did you come up with that before we get into anything about you?

[00:02:21]>> Yeah, I mean I I I went through a lot of years training in medicine and uh you know, we all go through challenges in life and there was a time where I kind of felt like I had some young pre-teen kids and I was practicing medicine, but it wasn't fulfilling me and I didn't think it was fulfilling my patients and I felt honestly like it was soulless, if you will. I didn't have time. I had 10 or 15 minutes to hand out prescriptions and you know I would say there were there stories that people tell you and I had a patient one time that I was struggling with her weight and I had been seeing her for a couple of years and prescribing medications and and at one visit she said I'm never going to lose the weight and I said why and she said because every night at 10 o'clock when my dad used to abuse me is when I eat a pint of ice cream and that's probably never going to stop. So at that point I realized there's just the elephant in the room like I had never had time to talk to her about like the real like the deep stuff right the soul stuff like her soul was not well and so I had thought I was practicing you know evidence-based the best medicine but I wasn't practicing soul soul medicine so uh I you know and then struggles in my life as well I realized that there are times where I was doing everything right physically hormonally uh but my soul wasn't right and so decisions I was making were the best for me. So, I I just think you have to be strong in your soul. And I think that we always have to get to the root cause and find kind of the basics and then we can build upon that. But if we don't have strength in our soul, we're not going to get very far.

[00:03:55]>> Excellent. Got it. Got it. I thought it was like James Brown stuff with, you know, you got soul, but [laughter] >> Well, we can do that, too. I like that, too. You know, I'm good with that. But it's more I think we have to have a balance of everything and and the mind body part of it I think is critical and I think that's a lot of I didn't learn that in medical school. I I learned that in my integrative medicine fellowship but that was after medical school.

[00:04:22]>> Awesome. Awesome.

[00:04:23]>> Well, let's jump right into it because I I have shared with people that I know about we're going to be talking about peptides and things like that. So, I know that there's people online right now listening to all of that. And uh I actually have a client and her and her husband actually owns uh a health clinic and including peptides and every all the other things that come along with it.

[00:04:48]And I've learned some things and I'm [clears throat] always willing to be open to uh hear some other things too.

[00:04:53]And uh if you could just share with us uh why is it when you're on a peptide that you have a tendency to lose muscle?

[00:05:04]Is it because of lack of protein and not working out while you're on the product or is that kind of part of it because it's actually another florine uh medication that going into your body?

[00:05:18]>> So you're talking about GLP-1 peptides or weight loss peptides specifically.

[00:05:22]Um, I think that, you know, there's lots of peptides. Uh, but but that one, you know, of course, is is popular and is all over the place. I think the, >> um, I think if they're super beneficial as a longtime internal medicine doctor, um, for years I didn't really have the best tools to treat diabetes and met metabolic dysfunction, obesity, uh, fatty liver. Uh, these medicines are game changers. Uh, but they are powerful. And so they do, there's several things they do on the body. Uh, one of the things they do is they make you feel full and they slow down food uh, transition through your gut. And so people tend to not eat as much. Uh, and so you really have to push yourself to eat the protein, get the amino acids, or you could be, you know, doing your resistance training, but if you don't have the the building blocks and you're not going to build muscle. So the the risk of these medicines is that you could lose muscle and you could lose bone. And obviously as we get older uh over 50, we're at risk of doing that anyway. And so we have to be really careful. So you have to really, you know, make sure you're getting your protein mark uh even though your appetite shut down.

[00:06:33]>> Yeah. So when your appetite is shut down, uh and and like you said, it slows down the deposit of the foods and stuff like that. So being regular and going to the restrooms and stuff like that, should a person uh take something to enhance that movement or we just kind of let your body move forward? How do that work?

[00:06:51]>> No. Uh you definitely want to make sure so I always tell patients you want to have one to two softs serve bowel movements every day no matter whether you're on the medicine or not. Uh I think that that's part of our looking at the whole picture that's part of detoxing, right? So we don't want inflammation is kind of the bottom line.

[00:07:07]We really don't want inflammation in our body. If we have inflammation, then we're in a fat storing mode, not a fat burning mode. So, our goal is always to try to be in a fat burning mode, fat burning mode, and a muscle building mode. And if we're inflamed and we're toxic, uh, because we're not having bowel movements every day, then that's going to impede that. So, I tell people, it's like taking out the kitchen garbage. Like, you don't just leave your garbage in the kitchen for a week, right? You you you got to take it out every day. You got to keep things moving through. you have to be more aggressive with that when you're on GLP-1 peptides because it is slowing motility. So sometimes I have patients use uh specific forms of magnesium. I have sometimes people using Mirillax. I I always want people to optimize their fiber. Uh I want them to have 10 grams of fiber with every meal. Uh I like squatty potties. Uh you know all you have to have all the things you know that's part of your whole body function.

[00:08:00]So, if there's anything you're doing to optimize your health, but you're slowing down a bodily function, that's a problem.

[00:08:07]>> I I got a qu I got a question. So, I'm coming in for the first time to visit you, doc, and you know, I may I'm I'm a little overweight and everything and I'm like I'm and I want to get on the GLP.

[00:08:20]What kind of program, you know, just like a sample program would you would you put me on? Uh because I know there's people out there that just say, "Hey, they give you GLPs and and and wave you by." They don't do anything. No follow-ups or anything. What What kind of program would you be putting me on?

[00:08:37]>> So, uh with my patients, I do a full kind of metabolic assessment. So, I usually have them do labs before they come in. So, the things I like to do are checking for inflammation. I like to check for glucose intolerance. I like to know if you're insulin resistant. I like to know if you have fatty liver. So, I check labs before you even come to just see how your body's functioning. I'm a functional medicine doctor, so I like to know how your body's functioning. I didn't mention in the beginning, my bachelor's degree is in biochemistry, so I'm all about pathways. So, I measure a lot of things and get a sense of what your body is doing. I also do a lot of talk about what your lifestyle looks like. Are you sleeping? Um, you know, I actually even ask questions about childhood adverse events because I want to know the entire person that's sitting in front of me and what are the obstacles we're up against and what things are influenced how their body's functioning before I start throwing any medication at them, including GLP1s. So, I measure a bunch of labs. I come in, I spend about 45 minutes to an hour with you. I measure your body composition. I measure your waist circumference. I want to know, are you carrying most of your fat in your belly? uh and that raises your risk for other things that I might look for. I might send you for coronary calcium score to try to assess if you have any met any heart disease. Most of my patients are um you know over 50. I do have some younger ones. If I'm strictly doing obesity medicine, then it wouldn't it would be a little less complicated than that. But I also want to know like what your family history is. Like it does everyone in your family struggle with obesity? Because there's genetic components, there's lifestyle.

[00:10:11]So I need to figure out is this your lifestyle? Did you do this because your lifestyle because you have four businesses and you're eating McDonald's multiple times a day or are you doing all the things you possibly can and genetically your family just struggles with the disease of obesity? Um, in which case I would move a lot sooner to the GLP1 because I think they're made for that.

[00:10:33]And then those people, I'm I'm checking on what they're eating, what their protein intake is, and I'm uh they're on the phone with me or my nurse every four to six weeks, and they're measuring body composition. And if I'm not getting that, or if I see people losing bone and losing muscle, then I take them off of med.

[00:10:49]>> Awesome.

[00:10:49]>> Wow. Awesome.

[00:10:50]>> So, with peptides, how many Well, I can't guess you can't tell me how many, but I'm going to ask the question anyways.

[00:10:58]Over the amount of peptides that are out there, how many have actually been FDA approved?

[00:11:04]Well, I mean, I think the ones that are FDA approved are the GLP ones. So, the semiglutide, the tzepatite, there's a lot on there that are on the FDA ban list. I think that's probably going to change. Um, you know, the BPC57, the growth hormone, um, the insulin growth factor stimulants like simoralin or tesmoralin or, um, you know, CPC, those ones. Um, I some of those I don't really know. I think it's kind of a moving target with the current administration, but some of them um are are moving off the FDA ban list. Some of them are still on there.

[00:11:39]>> Okay. Because I know a lot of people uh including myself uh Yes. And talking about me out there, people, but um the uh Tessa Marlin and the uh BP BPC 157, I I'm utilizing that. Uh and I was just curious on uh you know the effects of that because you know they said it's it's for diabetics people who have inflammation I mean age patients people got inflammation in their intestine area and also fat carrying body fat within an area that testes motor is supposed to be one of the main effects that will help that is that fact or is that just my >> uh I think that that's uh based on very small nonrandomized control data mostly animal studies. So, I think that that's still a very gray zone. I think it's when you go in some of these areas in the gym and online, it looks like it's it's just fact, but it really isn't. The data is really not there. So, I'm not I'm a biochemist, so I love uh peptides.

[00:12:38]I love amino acids. I think it's just a string of amino acids. So, I I don't think they should be any on any sort of ban list, but I do worry a little bit about the gray market and where they're coming from. There's been a lot of compounding pharmacies um across the country and you know beauty clinics and chiropractic offices places where there things aren't being monitored uh that have made the news where there's been contaminants. I haven't really personally seen anything that's like super scary but I think that uh it it's a risk and I you know I don't have any judgment on that. I think people have the right to optimize their body however they want to. My goal when a patient comes to me as a medical doctor is to try to follow evidence-based medicine.

[00:13:21]>> Right.

[00:13:23]Good. Good. I got I got a question. Um and it's kind of maybe a little bit off of that, but you know, people always talk about women and menopause, but uh do men have like premenopause type things or something like that going on with them um hormone wise as they get older? Yeah, I mean I think I think recently people have talked a lot about parmenopause and menopause. I think historically men's hormones have gotten way more attention. Uh but I I think it's I think it's I think both people have things to look out for. I I would say both sexes really start to lose muscle after 50. Both people start to lose bone, cognition, um you know, hormone start dropping. Melatonin is a hormone. People start sleeping not as well. Uh so you know I think there's definitely more inflammation and hormone decline in both sexes. Uh and it's not just testosterone. I think for men I think the talk is always about testosterone but really you know I look at cortisol stress you know men carry a huge load a lot of times in the families they're providing there there's a there's stress that that I think is a little more silent. uh which I think I have a lot of you know I spent eight years working for the VA so I had a lot of post veterans that I was working with uh so there's a lot of cortisol issues and inflammation issues too that I don't think tend to come up as much as the testosterone conversation does >> interesting so um you said but 50 and older you start losing muscle you start losing bone um I can agree to that but sometimes I can disagree to that meaning that if you've been working out for a long time as myself, I I don't think I've lost that muscle, but I think I've lost that the hardness that was natural, if that makes sense. Like, is that part of a unbalanced, you know, hormonal unbalance, meaning that my the strength and all that kind of start to decline, but you still have your shape that you've always had?

[00:15:28]>> Yeah. So I I think there's a difference between someone who has I when I say we start to lose bone and muscle I I mean if we if we don't do anything about it like just in the natural aging process we start to lose bone and muscle ideally we are not doing that we are are you know doing our strength training getting our protein maybe using peptides keeping our hormones balanced to so that we don't and I would say that we do it's it's more difficult over 50 to build muscle for because we're kind of going against what's naturally happening. Uh for sure we want to maintain and ideally build. I mean I have uh osteoporosis patients who come to me and they're already in full-blown osteoporosis and their doctor says, "Well, you're just going to have to be careful the rest of your life. You don't break a hip." And I sorry, I call BS on that. I put people on 70-year-old women on testosterone. I put them on estrogen. I teach them how to re weight train and resist do their resistance training and check their bone density again in a year. And often times it says uh you know improvement and a lot of times their doctor will have said >> wow that's not typical. Well it's not typical in our traditional medicine. It is typical if we actually get to work.

[00:16:40]And and same with my my men. I mean some of my men are at risk of that too. And trying to fight insurance for bone density for men is near impossible. So you're right that there are some things where like women can get a bone density no problem. But some of my men need that too and I can't for the life of me get it for them. But luckily a cash pay is not that expensive. But yeah, I think that your bo your body composition changes. So you might still have your muscle but the myines and the things that are released from healthy young muscle are a little different than our 50 and over muscle.

[00:17:12]>> Yeah. And and ladies out there who's listening to this, you did hear her say that you can get on some testosterone.

[00:17:19]Most most women you mentioned test, they don't want to get big. I don't want all that muscle. That's just not going to happen. So, if you can if you can dig into that a little bit more with the ladies knowing that they can have because I tell everyone when they come on board with me, I go, "Look, get your test levels checked, get your uh estrogen levels checked, and get your thyroids checked." That's my most important things that I tell them to do.

[00:17:40]So, if you want to dig in a little bit more about how the amount of testosterone and stuff like that that they should take.

[00:17:46]>> Yeah. I mean, I think that a lot of times, you know, people think of testosterone men, estrogen women, but the reality is that both sexes create both hormones. Like we, you know, we have it's a little different of an orchestra and a different percentages, but actually we we all need those things. Women need testosterone.

[00:18:03]Unfortunately, we've been, you know, the FDA has made it a controlled substance, which is dumb in my opinion. Makes it really hard for women to get testosterone. I I every week I'm fighting with pharmacists trying to get them to give my patients the testosterone that I ordered. I can get it from a compounding pharmacy very easily, but then the patient my women patients are paying $50 or $60 a month for testosterone when really if they could get it from the regular pharmacy, it's going to cost them pennies a day.

[00:18:32]So there's really um that's all kind of legal stuff that I I I think the current FDA commissioner is somewhat on board, but women need testosterone, too. Um, but even it's it's an uphill battle.

[00:18:44]Pharmacists, uh, most doctors won't prescribe it. I I will prescribe it, but I'm fighting the pharmacists who are gatekeeping it. And then I'm trying to convince the women, come on, you do, we just got to try it. But I think there there also are places that are not regulated. There are people that are not educated that put pellets in women, do all kinds of crazy stuff, and get super physiologic. And that's the problem, right? It's all should be about a balance. We don't really want to go super physiologic. We want to replace what's naturally declining because we don't, you know, I tell people it's like an orchestra. We our hormones are conducting this orchestra. We have all these individual organs that, you know, everyone can play really good on their own, but how can they play well together? And if we just blow you out of the water with testosterone, guess what?

[00:19:28]We're throwing off your cortisol, we're throwing off your estrogen, we're throwing off your progesterone, we're throwing off your brain hormones. So, we don't want to do that. And so, there is a a way to do it and a way to monitor it. And unfortunately, not a lot of people are trained how to do that.

[00:19:43]>> Yeah.

[00:19:43]>> So, what is what is out there for estrogen blockers for men to keep your test levels from estrogen estrogen blockers for men? Is there anything out there for that?

[00:19:54]>> Yes, there are there are natural herbal things and there are medications. Um, I actually check check my patients that I have, my male patients that I have on testosterone. check how they're how they're metabolizing it because what you don't want again is for you to give testosterone and have people converting it to estrogen. Obviously that you that's not going to help you. So there are um blockers um to do that. Uh there's a whole pathway that I show patients and I say okay I want you to eat more of this. I want you to drink this tea. I want you to take use this herb in your cooking. If you are still doing it then we'll throw you know medication at you. But a lot of time you know I'm integrative medicine trained too. So, I like to use plants as medicine uh when I can. But yeah, we want to know, we want to make sure men are not converting testosterone to estrogen. We want to make sure that women aren't converting their testosterone to cortisol, you know. So, I think there are p you can actually do urinary metabolite tests and assess what these people are doing biochemically with the hormones you're giving them.

[00:20:55]And I actually require that once a year on my patients that are on hormones with me.

[00:20:59]>> Awesome. I got something for you too, Doc. Um, one, I know you lead by example. You know, like I I think we had a conversation before. I said, "Hey, I've had doctors telling me what, you know, what I need to do and they're huffing and puffing and basically, you know, you know, having heart almost having heart attacks while they, you know, examining me." Um, how important is it uh for weight training, resistance training to be involved as you get older? And what is your sports background and your background doing and leading by example? H how does what does that do for your patients?

[00:21:37]>> So, uh strength training has a profound influence on our body's function.

[00:21:41]Honestly, I I think that uh I just read a study probably about a month ago and really it was kind of ranking uh different lifestyle things and and how they attri contribute to longevity and uh strength training was number one. So, you know, we have to keep our muscle and there's many reasons for that. So, metabolically we have to keep our muscle because that actually helps our hormones work better if we actually have muscle and not fat. Fat is pro-inflammatory.

[00:22:11]Muscle is anti-inflammatory. So, we want to have enough muscle for our metabolic hormones to work well. The other thing is as we get older, obviously the thing that tends to take people out and put them in nursing homes is falls. So, you want to have balance. You want to have um you know, be able to step up steps and to to hop over something like you want to be able to do that. You want to maintain your grip. Uh that's a good marker of your of your strength. Um, so I think that that strength training does so many things like but those are probably the most important I think. Um, I think that I so you know like I said my mother um always did exercise when I was growing up. So I grew up watching her do that. Um I I started probably you know after I always would go for a run in medical school but in medical school things are kind of crazy. I had my first child at 32 started running. I did five half marathons between my um you know 32 and 45. I just started running because that was the what I could do um quickly and then I also was doing CrossFit. I did a lot of CrossFit. I did a lot of master swimming um some half marathons.

[00:23:21]After 50 I started to, you know, realize that CrossFit was actually too hard on my body for a lot of reasons. I started getting more injured. I was more prone to injury. You know, things change, things changed. And so you have to, you know, switch your mindset from balls to the wall to protect. So I always nowadays I am kind of a preserve and protect. I'm careful with the load I put on my spine. I make sure I do my mobility. I do swimming because I think that helps. Um, you know, I manage my stress so my cortisol is low so that my muscles aren't inflamed so that I'm not going to injure my back when I'm lifting. So you know, I think that we we have to think about all those things, but it all evolves over time. And I think what I was thinking about when I was 35, 40 is very different than what I'm thinking about now at 55.

[00:24:07]>> Excellent. So, we have a lady come on, Melissa. Hello, Melissa. She's asking a question, doc. She's saying, "How do we help get testosterone reclassified so it's more accessible for women? It bothers me. I pay insurance and then I have to pay out of the pocket for a compound pharmacy."

[00:24:26]So, uh I would I think there are people that are trying to work on get getting testosterone uh classification change. Obviously, that's a bigger issue. There are people working on that. I think Rachel Rubin is an MD. She's a urologist. She's all over social media. Um if if you Google FDA commissioner and testosterone and like a medical panel I think it was last year there was about five doctors orthopedic surgeon urologist all talking about how much women need testosterone with this FDA commissioner. So I think there are people that are working on that. Um I agree with you. I don't think it's fair that we should have to pay for compounding testosterone. And I've been battling my localarmacies and and honestly probably for a couple years and I would say just in the last maybe month. Uh I have sent many prescriptions and I've not gotten them back. Uh so there is a way actually um and I'm happy to I don't know how I can send that if there show notes or something but there is a way to write it. Uh and you have to write that it's off label. So your doc, you need to find a doctor that knows how to do that. If they're part of the North American Menopause Society or um the IS iswish, which is like a a sexual health society, um I'm happy to provide those.

[00:25:47]Um and then you could try to find someone near you that that is uh able to write the prescription because you have to write it exactly right or the pharmacist will reject it every time.

[00:25:57]It's a it's it's really it's one of the most frustrating things because I I feel like as the medical doctor I'm writing what I want my patient to do and I don't think the pharmacist should be able to tell me that I can't do that is super frustrating for me too.

[00:26:14]>> Yeah. Interesting. So, um, when there's when there's a medical issue with your license and everything to approve something, do you have to go above the rim to, uh, besides what you're sharing with us now, is there like another level that you can reach to that you guys can reach to to go, hey, look, this needs to be clarified at some point, >> you know? No. I mean, I think that there the the California pharmacy board. I'm in California, so I think different states have different rules. I don't Texas I don't think is bad. Florida is like you could do whatever you want in Florida I think there so there's a whole variation. New York is even more strict than California. So I think it's kind of varies state by state. So which is also unfair, right? I mean this should be federal. We shouldn't have women that are in New York that can't get testosterone but a woman in Northern California can. Like it just really it there there's definitely obviously more at play than just medicine here.

[00:27:09]I I got a question. I'm trying and I want I'm you know asking um with mental health and hormones and somebody that may be having struggling and on medication with mental health, do you and hormone therapy and stuff? How does that does that work or how does that go in? Because I know people have mental health issues and taking medication and they're depressed and and but they and they're gaining weight but they want to work out and stuff. So if they come to you, what what what would that be about?

[00:27:42]>> So yes, it's all connected, right? It's all part of the orchest part of the orchestra. So the hypothalamic, pituitary, adrenal axis is is kind of what I'm looking at all the way. So I start with the brain. So you know, what is the, you know, what is your serotonin, what is your dopamine, what is your norepinephrine, what is your GABA, like why are you not sleeping, why are you depressed, why are you having panic attacks? So I as a biochemist look at it from a pathway perspective and so I start by measuring that in the urine.

[00:28:12]Again I'm not doing a brain biopsy so it's not 100% but it it often times I would say that's the thing that moves the needle the most that I do that a lot of people don't do and my interest in that started because I was working with veterans [clears throat] and and they had such bad PTSD. So yes I hormones very much affect the brain. Serotonin is very connected to estrogen. Progesterone is very connected to GABA. So when they come to me, I try to assess, is this hormonal? And if it is, I treat it hormonally. I don't treat it with SSRIs and anti-depressants. I'm not saying that I don't use those. Sometimes I do, but a lot of times I don't have to. Uh I would say 9.5 times out of 10 I don't have to because I look at I fix the inflammation. So if your brain's not inflamed, your brain hormones are going to work better. If your brain hormones are working better, then that's going to send the signal down to your gonads. So, your ovaries and your testies and your testes and and all your hormones are going to work better. So, I try to get to the root cause of what the problem is rather than just putting you on a medication that's going to block the reuptake of serotonin and just blast you with serotonin, which can be helpful.

[00:29:21]Those are very important medicines. They can be helpful, but I think they're they're handed out too much.

[00:29:28]Huh. Wow. So, I'm I'm I'm listening to everything you're saying and it see it doesn't seem simple. It's it seems very difficult [clears throat] in your position to have to uh fight for what your degree allows you to do. [laughter] You know what I mean? It's like someone telling me, "Yeah, I know you have a degree, but you can't tell me what to eat." You know what I mean? It has to go to another level. And so, uh, is there now this is a little deeper than I probably need to talk about, but I just I'm just curious because I'm curious is the fact that is there, uh, a board like with your medical board that people are fighting for you or is it just you as an individual?

[00:30:09]>> So, um, yes, there are people that are trying to expand this way of medicine. So, there there are big groups. There's the Institute of Functional Medicine.

[00:30:20]There's anti-aging for medicine. So, I would say that um you know, obviously I was trained at Stanford, very conservative, very much evidence-based.

[00:30:29]I thought it was the end- all beall when I left there. Once I started practicing, especially in a complicated group like veterans and then I myself started going through pmenopause and was just getting dismissed and I was like, "Wait a minute, I actually know there's a problem." And I was just, you know, getting dismissed. And I started thinking, okay, I don't think I learned everything I need to learn. So then I sought out these bigger organizations who are practicing the medicine that I believed in. I did another fellowship, have taken more board certifications trying to get to where I have all the tools to help my patients. But unfortunately, after 13 years of medical school, a lot of people don't have the time, the money, the energy um to to want to go on and do more training. And so they just practice what they learned and then you know that's just their job.

[00:31:19]I'm super passionate about it and I also am passionate about it because I want my family to be healthy. I come from a family that's that struggles with a lot of diabetes and obesity and so I've always wanted to be able to try to fix that and I as a biochemist I knew I could. So there are bigger organizations. I don't I don't nec I think it's really going to be a mindset change and in medicine it takes years. I mean the women's health initiative in 2002 was very wrong uh the way it was presented in the media and we are just now coming back from that 25 years later. So it it does it takes a long time, but I hope that someday we get to a point where there's more precision medicine and where it's not when we're trying to get to the root cause and trying to focus on food is medicine, hormone should be balanced, inflammation, like those have to be in in place before we start piling on medications. I think we'll get there, but it'll probably be another 25, 30 years. there are some medical schools, some newer medical schools, um, that are really starting to to open and bring in this focus of whole body medicine. And so what I'm doing won't seem it was seen as super out there. I think it still is to some of my traditionally trained colleagues, but I I don't shy away from that. I mean, I always just fought for what I thought is right, and I will continue to do that. And you know obviously there I do have to stay within the confines of you know protecting my medical license. Uh but I but I think much of the stuff should be basic medicine. So uh I'll just you know keep doing it. When I opened my own office in 2014 I thought I'm either going to leave medicine because I don't believe in this anymore. I don't believe in the way that this is going or I'm going to open my own practice and we'll see. We'll just see if it goes. And it just it took off.

[00:33:09]I mean, I haven't been open to new patients for several years. So, I think >> Hey, hey, she's booked up to booked up to be booked up.

[00:33:17]>> Yeah. Yeah. So, patients want it. So, I think it's it's really patient demand.

[00:33:21]So, I encourage my patients like write your congressman, write your people, write them and say, "I should be able to get testosterone like my husband gets it. Why do I have to pay for it separately?" So, it's going to take all of us >> Yeah.

[00:33:33]>> to change.

[00:33:35]>> Okay. So, we're going to um drop this power story that you're sharing, which is a lot stronger than stuff that Mike and I talk about. So, I want you to reach out to some of the people who listen to us on a Sunday basis, and that is we talk a lot about how you should always go get your levels checked at some point in time.

[00:33:55]When would you say be the first age coverage that a guy should go and go and get his test levels and everything checked?

[00:34:06]Well, I mean, I think uh I think it depends on the patient. I think it depends on the symptoms. So, I I definitely have had 20 year olds come to me and my initial response is, "Oh, your testosterone is probably fine." But they're complaining of, you know, different symptoms that seem kind of similar, so I'll check them. And I have had some of them actually be low. And then I start talking to them. I actually had one probably a month ago. I had a 21-year-old who had all the symptoms of low tea and I thought that's so strange and so I started talking to him about um his life and it turns out he wasn't sleeping. He was on he was gaming all night and so he was sleeping from 3 3:00 a.m. to till 11:00 a.m. It was when he was sleeping. So then I had to go back to okay listen at 10:00 at night to 2:00 a.m. that's when you're building your testosterone. You missed that window. So look at your blood level. It's like 200 your total tea and you're 21 years old.

[00:35:05]That's not good at all because you're supposed to be building your bone and muscle like to your peak right now. So this is a real problem. So I don't know if there's just one set. I listen to the patient and their symptoms. I would say everyone over 50 I usually check u maybe 45, but I it depends. I'll check it sooner if I feel like there's a need to.

[00:35:25]Sleep apnea is a really big problem that causes low tea. So if they're if they have risk for sleep apnnea then then I I look at that sooner.

[00:35:34]>> Yeah. I have a couple of clients that I train that are either wear the mask or they don't wear the mask and they talk about how tired they are no matter what.

[00:35:43]So that I'm sure that low I was telling that your test got to be low and that they should get >> Yeah. The problem with them the problem with them is giving them testosterone does not help them. They really have to treat the sleep apnnea.

[00:35:57]>> Yeah. Yeah. So, do you say that the would you say that the mask and all that stuff is topnotch or is it second compared to the in insert?

[00:36:07]>> Uh, I would say the data we have is with the mask, but the mask is a pain in the rear. So, it's really hard to get people to be compliant. So, I just tell people whatever you can do to be compliant and then let's check your testosterone levels. Let's check your levels and see if it's improving. If it is, then then we found our our answer. If not, then you have to go for the full face and you have to really give it three, four months and try really hard. And most of the time, if they do that and they can get over that hump because it's a pain and it's not very comfortable. But the patients that do 6 months later feel like completely different people. And it's not just their testosterone like their insulin's down, their inflammation's down, their weight comes down, their because their energy is better, their focus is better. So everything changes. I mean, if you think about depriving yourself of oxygen all night when you're supposed to be sleeping, like that's gonna have like farreaching ramifications, right?

[00:37:02]>> Sure.

[00:37:03]>> Sure. Interesting.

[00:37:06]>> Well, um, Mike, you got anything else, >> man?

[00:37:09]>> I think we've heard it all. [laughter] >> That's what I want people to understand.

[00:37:16]See, you know, they they talk about us talking to, you know, the two old black guys talking, but we bought you a doctor and she gave you a wealth of information. And I hope I hope that you guys now understand some of the stuff that me and me and Rob talk about is the truth that you got you gota you got to get your levels checked. You not just get your basic stuff done and you know you know make your doctors when you go for a physical tell your doctors this is what you want. These are the these the tests that you need to have because you know some doctors are cookie cutters man you know and and I'm glad that you know Dr. Lesie came on and you know the passion that you have. You don't see that with a lot of doctors. I have I've had a couple of doctors with that same passion. They they they do stuff outside of their box within the realm of of not losing their uh you know their you know being a doctor stuff and and and I've been fortunate but a lot of people man are not satisfied because people are coming in and out five minutes and getting pushing you in pushing you out and and and and it's a lot of things that's that's going on with people. And if they would have just took the time, maybe take some levels, do the stuff some of the stuff that you did, the people could function a lot better, you know.

[00:38:29]>> Right. Right. Right.

[00:38:30]>> Yeah. I mean, I think I I would just say I mean, I defend my primary care doctors because I I I I it's a hard job and it's unfortunately medicine has become uh forprofit and there is so much behind them that's pushing them to do. I mean, I think that I think that's an issue.

[00:38:47]And I think the other issue is, like I said, I mean, these are things we didn't learn in medical school. So, if you didn't have a biochemistry degree going into medical school, like if you did English or something, which is great. We want well-balanced doctors, then you, you know, you may just not have that information. And so I tell patients, you can ask your doctor for these certain things that they know how to deal with, but you're going to find they don't really know how to do some of this other stuff and then you have to seek that elsewhere. Like a lot of patients just order their own labs now online and then they they put it into chat GPT and then they'll bring it to me or then they'll try to figure it out. So I I think there's a lot of rows. What I would say to patients is don't stop. Like if you're not getting the answers and you still feel like hell, like keep keep going. It may not be through your primary care doctor, but please don't put it please don't do it through, you know, the tamalei lady. Like like let's find [clears throat] someone who actually is trained to help you.

[00:39:44]>> Man, my tamalei lady my tamalei lady is pretty pretty good. Don't know.

[00:39:48][laughter] >> We all got our strengths. We all got our strengths.

[00:39:53]Now, we we definitely appreciate appreciate you having you on there and I know you're full of patience and everything, but sometimes people may have a question or something or even questions that we might need to uh ask or whatever. So, if you want to give your information where people do can reach you on on on social media.

[00:40:12]>> Yeah, I mean I'm on Instagram, Soul Strength Medicine. Um so, I think that's probably probably the best place. I manage all of that. um that's why it's not very fancy but I do manage that myself and obviously I can't give medical advice over social media but if there's some resource or some information like the you know I think people in other states need to know like how to find doctors that have similar training uh to myself uh I think those are useful things for your patients to have or for your clients to have >> a excellent awesome awesome awesome >> okay >> well yeah well we'd like to thank you once again uh for coming on to the show um as always we try to reach out after a month or so, two months and reach out and see if you can give us some new information in case questions come to us.

[00:40:53]>> Uh you and Mike, you know, buddy buddies now. And so I will share with Mike if I hear something that people want to know and we can kind of go from there. But we appreciate your time and your knowledge.

[00:41:03]And Mike, if you don't have anything else, no, that's it. I just want to say hi to Melissa and thanks for the questions. Uh she wanted to thank the doctor too as well for the wealth of information that she handed out today. Like I said, you know, we'll bring on people, you know, we can get people like this, man. This this really kind of breaks a lot of the myths and stuff that people hear out there and you and and you get some troops and and you get somebody that has a passion. It's somebody with a sports background and it works out as well. So, it all correlates. It's not somebody that's that's passing out information.

[00:41:37]And I like because the experience that you have. We can't thank you enough, Doc. Appreciate you.

[00:41:41]>> Yeah. So you guys out there, please, please like and subscribe and leave a comment. Let us know what you think and we'll get the doctor back on.

[00:41:50]>> All right, everybody. Peace out there in TV land. Boo.

[00:41:53]>> Bye.

[00:41:54]>> Later. Peace.