Women should recognize that chronic fatigue, unintentional weight loss, persistent night sweats, blood in stool or urine, and debilitating period pain are red flags requiring medical attention, not normal symptoms; active women should understand that missing periods (amenorrhea) can indicate Relative Energy Deficiency in Sports (RED-S), where the body suppresses reproduction when energy expenditure exceeds intake, and that strength training is essential for long-term bone health, muscle preservation, and reducing fall risk, with benefits starting at any age.
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Doctor Tells The Truth About Women’s Hormones, Labs & Hidden Health Red FlagsAdded:
If you're interested in medicine, then listen up. Today's guest is Sasha Hadad, and she is a boardcertified family medicine physician, and we're having a conversation that every single woman, especially my gym girls, should hear. We start off the episode by being broad about health in general, her experience as a physician, and then we dive a little bit deeper into women's health, especially gym girls and their health, and how to just be a healthy person overall. This is an episode that blends real life with medicine. So, I introduce you Dr. Hadad. Dr. Sasha Hadad, thank you so much for being here.
Please let us know how you got into medicine cuz you're so young and beautiful and I'm just curious.
>> First of all, I just want to say I'm so excited to be here. So, thank you for having me and you're an inspiration to all women including me. So, that's the way I want to start with you first. Um, the way I got into medicine is a long journey. It took multiple long resumes and application telling people how I got in but um it's a long journey. So I was initially I was born here in California.
I grew up in Lebanon and then around 18 I came back to the states. I pursued my bachelor's degree in biological sciences up at UC Davis after which I went to Arizona for med school. Finished up and I completed my residency in family medicine here in uh Los Angeles which led me to you currently here.
>> Very honored to have you.
>> Thank you. No, it's been a struggle. So are you. So are you. Absolutely. It's been a struggle. It's been a lot of uh determination, uh exploring new waters, and >> I think my parents sacrificed a lot to bring us here. And it's been a lot of experimentation, especially when you're trying to sign up for courses, college, trying to figure out what you want to be. And there were no examples or role models. It was a lot of experimentations, failures, trying to figure out how to do things, gap year, MCAT. And I will say once you love something, when you're passionate, you automatically put in like the time, determination, the effort to get where you want to be. And after multiple attempts and experimentation, it led me here.
>> Beautiful.
>> Yeah. I'm really excited to have you here because I feel like there's so much misinformation online and people are just so curious to get the correct information from someone who is credible and obviously you're a doctor, you have the credentials and the wisdom and you know everything. And I just want to pick your brain just starting off by general questions for the general public before we become a little bit more specific.
But what are the most common health issues you have seen in your practice today? Mhm. So I would say a baseline I see a a variety of different patients from different uh age groups but the most common I would say bread and butter of the conditions that we see is things like hypertension which is high blood pressure, hyper lipidmia which is high cholesterol, pre-diabetes which means you are at the risk of becoming diabetic if you continue on this lifestyle and the route that you're going on. uh things like anxiety and depression, mental health is a big one and of course sleep disturbances. I would say those are the most common things that we see uh from all different age groups and in practice in general.
>> Okay. And then talking about the mental health aspect of it.
>> Do you think there was a spike recently or like have you seen like a growth in recent times?
>> That's a great question. So I think a lot of my colleagues and I were having this conversation because when I was in residency I was also working inatient with the pediatric BHU which is the psychiatric unit and uh we've had so many admissions regarding mental health and we've had a lot of patients come in and schedule mental health concerns and appointments and I would say I I think there's two ways to think about it. I think I'm proud of our generation because it has uh broken the stigma of it being taboo and I feel more people are comfortable sort of addressing their mental health as a true condition as something that they're struggling with and I feel like back in our parents generation I feel like if I go up to my parents even my grandparents' time I think it's a a topic that everybody struggled with but not a lot of people came forth with so I think it's the community and the generation being more woke and that probably led to the increased numbers of visits that we see and I think that's the theoretically I think that's what's happening more so I think the conditions and the quantity of the patients struggling with mental health I feel like it's always been there and yes could there have been a potential spike given social media and the pressure on top of everything else absolutely but I think people being more comfortable to say hey I'm struggling it's no longer taboo and I want to address it Well, I like that.
>> Yeah.
>> What are the biggest preventable health mistakes people make today?
>> I would say the biggest mistake that I see is people not showing up for their preventative screening or their health.
Um, what do I mean by that? That means you have the luxury of seeing your doctor and making sure everything is up to date before people get sick and before something goes unchecked. And the biggest thing that I see is that people wait and I think it's normal and I think it's sort of human nature to do this that you don't slow down and you don't necessarily go to get care or seek help until something hits the fan. And when something hits the fan, that's when people come in. And I feel like if people sort of are up to date on their general screenings and their their physical appointments, I don't think we'd be seeing the sort of like last minute crisis that come in. I'm guilty of that. I hope you're not bad at me.
>> I'm not the best.
>> I know.
>> I need to be better though.
>> We should all be better.
>> After this conversation, I will be booking my appointment.
>> Okay. I'm going to be seeing you.
>> Yes, 100%.
If someone wants to be more proactive about their health, what labs should they get yearly?
>> Okay. I think when it comes to lab work there are universal screenings and guidelines especially for certain age group but I tell my patients I tell everybody that everything needs to be individualized in what sense so for example Nona you're young you're overall healthy thank god not going to wait on okay but let's say if I were to go through your family history your medical conditions your childhood development things that are significant to you that may be not be, you know, relative to somebody else. It needs to be tailored to your risk assessment, right? Someone who is exposed to a lot of secondhand smoke, someone who has different genetic risk factors that put them at a high risk to getting different things. Um, each person needs to have an individual assessment. So, that's the biggest thing. There's no one universal set of uh specific lab work that people should get but there are common layouts for example um your blood work which is things like your hemoglobin for anemia depending on the person your cholesterol checks your blood pressure especially when you go to the offices you may not notice but your vital signs are being checked in so I would say those are key factors and for example your sugars pre-diabetes risk But ideally it goes back to the person and their story, what they're exposed to and what risks they have and that's how you go through in terms of lab work and screenings.
>> So very like individualized.
>> It should be individualized. It should be individualized. There are universal things for age and gender and we can talk about that too but ideally it should be individualized to each person.
Yeah.
>> And then talking about a little bit before to this about like screening.
Yeah. How often should like a healthier person get screened?
>> So, in terms of the data, there isn't like a certain uh there isn't like a magic number in terms of how much a healthy person should be screened, but ideally based on the USPSCF guidelines and things that we have said, it's ideal to have like an annual screening, which is at least go in for your physical exam once a year to check in with your doctor and be up to date. A lot of things are changing, right? there's new diseases, there's new vaccine updates, there's new blood work, and as you grow, you're growing into those milestones. Um, so you may not have had to do, let's say, your pops at 20 before 21, but now you turn 21, right? Things are changing. Um, and it should also be different because let's say you had an injury, although you're young and healthy, but something happened. That means you probably need to be following up with your doctor for that condition more closely. That's what I would say.
>> Beautiful. What are some symptoms that people tend to ignore that shouldn't be ignored that you've seen especially in like girls in their 20s?
>> Yeah. So, I think we're in this generation of hustle, you know, um being like a boss babe, which is incredible and a lot of things, but I think there's a there's confusion regarding burnout and a lot of things that I see that are red flag symptoms that a lot of people need to be pay attention to. It's not normal to feel chronically fatigued. It's different. Let's say if you stayed up late, you had 3 hours of sleep, you woke up tired, maybe it could be expected.
But if, let's say, you're sleeping early, you're eating healthy, you're working out, and you're constantly feeling exhausted, you're never feeling like your battery is being replenished, that's a red flag. Unintentional weight loss where you're not trying to lose weight, you're not trying to diet and exercise, and you feel like you're dropping over the past few months.
That's very important to pay attention to. Uh night sweats, especially at night that's been ongoing and it's not just like a one single episode. That's also a flag. Um having blood in your stool is not normal. A lot of people, let's say if they're straining, they have constipation. Sometimes they have hemorrhoids, they may have like some spot or blood. That's different. But if you truthfully have blood anywhere, urine or your stool, it shouldn't be overlooked. Um, and mostly I think like if you are having, especially in terms of women, and I say this because growing up, I think it was sort of like normalized that oh periods, not a lot of people, not a lot of people talk about periods. It's not normal to have such a painful, debilitating period that really impacts you, impacts your day, impacts your life. Um having painful sexual intercourse is not normal. Being or getting frequently sick all the time or getting frequently injured all the time you're not able to recover is also not normal. And I would say those are the things that you have to pay attention to.
>> Oh wow. I used to have really bad cramps when I was younger. I have a lot to say about the cramps. Um debilitating enough for one time I couldn't make it to class. Oh wow.
>> And I think that's like the wakeup call.
Like we grew up thinking our definition of normal is especially to what we're going through but hey actually it shouldn't be normalized right yes having some bloating some cramping feeling uncomfortable around your period time that could be physiologically expected but for you to feel like you're so miserable you're not able to function you're not able to go about your daily activities that's a red flag >> right >> I mean does it get better as you age like >> does it get better as you age as in getting menopause. No more periods.
>> And then you deal with the other headaches.
>> Exactly. The postmenopausal life, >> the heat flashes and everything.
>> I will say I mean if you're a teenager and you first got your period, it's different cuz your body is like what is this? I'm trying to regulate. I'm trying to establish some sort of normaly. In the beginning, you expect it to be sort of >> dynamic in different ways. But as you get older and you're outside of the teenage years, you are expected to have a regular sense of period for you, right? The timing could be different, the flow could be different, and the duration of the period could be different, but you have to have some sort of consistency of that period to what you're used to. The minute that there's irregularity in those three parts, right? the the the timing of the period, the flow of the period, the duration of the period. That's when you're getting into the irregular part for you.
>> Okay, these are good factors.
>> Yeah, >> I have another question relating to the previous questions that I asked, but what are signs someone is functioning, but they're not thriving? signs that someone is functioning. I want you to imagine like a burnt out student like someone who is able to put in coffee in them probably whatever is available like a bagel or ramen show up to their class and then probably take a test. But I wouldn't say that someone who's functioning I think it's like looking human without feeling human. Right? If you're constantly stressed, if you're constantly tired, if your sleep isn't right, if your food isn't good, if you constantly are very moody, you you don't feel stable enough. That's where I would say you look human, but you're not functioning human. You're not as stable as you could be for yourself showing up every day for you. That's where it's like red flag.
>> Yeah.
>> You're not functioning. You look human, but you don't feel human. You feel dead inside.
>> Yeah, exactly.
>> You're just moving.
>> You're having this brain fog where it's like you're showing up, you're up at 6:00 a.m., but everything feels so foggy. You don't have a clear mind.
You're not able to think. You're not able to strategize. You're not able to show up for yourself the way that you want to show up.
>> Mhm. And that's so important because I feel like right now because of our hustle culture, a lot of people are just like kind of zombies, you know, like they're moving but like they're not >> feeling like they're human inside.
>> Yeah. No.
good and bad things about the hustle culture, but I think like the key >> the key to the hustle factor is that if you're not able to sort of like reset and recharge, it's like the sprint. How can you go on the sprint if you don't have like a full battery to do the sprint? If you're running on low battery all the time, at some point the engine's just going to burn up and fumes.
>> Exactly. It's not good long term.
>> No.
>> At all.
>> No.
What are some health concerns that you see women ignoring that they shouldn't other than the periods like specifically for women?
>> I think in ter I think women in general we are so strong because we deal with so much on a daily basis you know physiologically mentally emotionally um but a lot of things that I would say that women struggle with besides the periods of course when it comes to their health is bloating. I think sometimes people think that okay it's natural to feel bloated with certain food items but constantly feeling bloating and unable to dig to digest is a big factor. um mood, right? Yes, we are cyclical. Yes, we have hormones. We go through different parts of those hormones during the month. But it doesn't mean that having an instable or like feeling labile in terms of your mood, feeling anxious all the time or feeling depressed, that's unusual. Hair, I think hair is a big part of our identity and it's a very sensitive topic. When we go through having hair loss or hair shedding, there's what we call your daily physiological hair loss where you're expected to shed, let's say, 100 hair a day. But then once you start to have patches and you're losing more than normal, that starts to impact you. And that's also a warning sign for your body. It says, "Hey, something is going on. Take a deeper look within."
Feeling exhausted and I and I or weak. I would say weakness, feeling dizzy, all those symptoms. It's a flag. It's a It's part of your body telling you, "Hey, I'm not okay. Check up on me because then we go into things like your iron, your thyroid, other things are causing you to feel like this." Um, we talked about the periods, but also in terms of sexual health, going through again painful episodes of pelvic pain, that's not usual. having recurrent infections, especially in terms of discharge and urinary infections, that's also unusual.
That needs to be looked at. Anytime where you feel like your heart is racing, if something makes your heart race on how it race, be careful. But if you feel like it's racing irregularly or if it's fast all the time, you shouldn't you shouldn't let that go either. So, I'd say those are a lot of the things that I see in terms of women's health.
>> Beautiful. Yeah.
>> And then I want to become a little bit more specific.
>> Yeah.
>> And dive into gym girls, >> okay?
>> And active women in general.
>> My favorite type of girls right here.
>> I kind of want to talk about hormonal and menstrual cycle a little bit more because you know we kind of like touched briefly on it, >> but is it normal for an active woman to lose their period?
It is common for active women, when I say active, that means someone who recently decided to take on a new athletic challenge or for women who are consistently very athletic. It is common for those women to lose their period. Is it normal? It shouldn't be normal.
And that's the the light bulb that should sort of show up. A lot of women that feel if they skipped a period, they feel, "Oh my god, I'm so fit that I skipped a period." Right? However, there's something called a relative energy deficiency in sports. And we actually uh do this for a lot of our um women athletes before they get let's say cleared for a sport or to continue for the next tournament and their challenges. So there's so we talked about hormones in general and we function on hormones and there's something called the hypothalamic pituitary ovarian access.
And I know that sounds a lot. It's like HBO, but the way that I'd like to describe it, it's like brain brain signals ovaries. Ovary signals reproduction. And it's your brain basically saying, "Hey, hey, are we good? Do we have enough resources? Do we feel energetic? and do we have all the stuff we need to have a kid? And your body's like, "Nah, you need to chill.
We're struggling here, right?" And and and that's how it happens. The whole point of getting your period and going through your ovulation is sort of preparing your body to say, "Do I have enough nutrition? Do I have enough energy? Do I have enough of a build and resources to get ready to have a child and reproduce?" Now the problem with again being very overly fit is when you hit the relative energy deficiency in sports or in general it's basically saying I'm expending more than I'm intaking in terms of my energy. And the more that you're expending in terms of your energy you don't have enough for your body to sort of function on its daily sort of living. So, how can I be ready to have a child if I'm not able to function because I'm just expending and expending and expending and that's where your body's like ah okay so so we're not ready so it sort of freezes like okay we're skipping a period if you skip a period once it happens because it's relative to everything that you're going through >> but once you hit three periods right or three months where you skipped that's a red flag. That's where you need to sort of take a stop and re-evaluate what you're doing. And anything also less than eight periods in a year, that's also a red flag because you're just burning yourself out. That means you're not able to take enough energy and keep it in to be able to sort of function for yourself that now you're sort of disregulated from a hormonal and physiological perspective.
>> So, is it like a combination of overtraining and under fueling?
>> It's a combination. So you can be you can be regular weight. So it's a misconception, right? You don't have to be very like skinny in terms of BMI to go through that. You can actually be normal fit, normal BMI, normal physique.
It's actually underfueling with overexpending, right? If you're not feeling if, again, it's like what you put in and what you put out. If you're out is more than the in, it's the water is going to stay low all the time. If you're just like pouring out the water and not enough water's coming into the bucket and your bucket is always low, then then you need a certain amount for you to be able to function regularly.
Once you're under that mark, once you're under that minimum line on that bucket of water, you're in the expenditure phase. So, it's all about how much you're expending in terms of how much you're fueling.
>> So, balance.
>> So, balance.
>> You need the yin and y.
>> Balance. You don't need no doctor to tell you that. Balance.
>> Balance is key.
>> All departments of your life. Exactly.
What are the early signs of hormonal imbalance in women who train a lot?
>> In women who train a lot, um, it goes back to the things that we sort of talked about in the front. Your periods are a big one. The minute you start missing your periods, that's a red flag.
The minute that you feel you're constantly exhausted, you're not able to recover. Another sign, if you're having frequent injuries and you're not able to heal and recover before you have your other injury, that's another flag like, "Hey, hey, we need to sort of like take a chill pill here because you're not having enough recovery time." Um, if you feel like you're faint and you feel on on edge of passing out, that's another flag. It's like, "Hey, you need to stop when what you're doing. You need to re-evaluate." and of course skin and of course hair. But those are usually like the external signs of what's going on within. So whenever something happens within yourself, your body's sign for you to pay attention is your physical appearance. That's how things sort of show up, especially autoimmune stuff, right? You start having rashes, you start to have like you're pale, your hair is falling out, you're having heat or cold intolerance, your nails are brittle. All those are signs like, "Hey, you need to take a deeper look and what's going in on the inside because you're not feeling it until I start showing you on the outside."
>> I think that's so important because in today's day and age, I feel like people like see something wrong with their skin and they go to the market and like buy something like a moisturizer for their skin, but they don't realize that like internally it's like yelling for you to like pay attention.
>> Everything on the outside is a sign to say take a look within cuz it's from the inside. But you don't listen to me. So the only option for me left to do is to show you on the outside.
>> And we're so like dismissive sometimes about it, too.
>> Yeah. We're like, "Oh, it can wait. It can wait. It can wait." And then you hit a wall.
>> Literally, God forbid. God forbid.
>> Can overtraining show up in our blood work?
>> So that's a tricky question.
Usually you can have normal labs and you can overtrain and it may not show up in your blood work.
>> Now are there certain lab works that can show that you're overtrained or on the path of like more injury than recovery? Yes. Hormones is a big one. an estradile, your free T3 is one of those things, but those aren't the things that you we would usually uh order or check for. We go by symptoms clinically and how you're feeling. Now, are there uh are there certain conditions that tell us you're actually injuring yourself and let's say you're putting yourself through AKI, kidney injury, you're going through rabidomiolysis, like muscle breakdown.
Absolutely. You're going through electrolyte derangements, right? You're sweating so much. you're not hydrating now. Your electrolytes are fluctuating like your potassium, your sodium, possibly yes. But in terms of specific blood work, no. We we don't usually go for that unless there's a certain reason to dive into it.
>> I see. How common is iron deficiency in active women?
>> I would say iron deficiency in women who have periods are actually common and I think they're under reportported. Um, usually there's common causes of having low iron. One of them is actually losing blood. Of course, a shark biting your leg off, you automatically lose a certain amount of blood, but not enough to sort of do fluctuations or changes.
But having periods, which is consistent amounts of bloodshedding in a in a month, over time that could uh result in iron deficiency. But uh in terms of uh women who are active, it's also it reflects in terms of symptoms. People who are tired, people who appear pale, people who actually have changes in their heartbeat or they feel like they're anxious or having palpitations that could show. So usually in like women in general, we don't randomly do iron checks. We do check hemoglobin and that's on a CPC panel. But for women who are very active, we start to take a deeper dive into things like iron deficiency because it is under reportported and we do look into other factors sometimes thyroid especially in those who actually have difficulty with with losing weight or are bloating or they're having hair loss. And another one that's been sort of on the debate side is vitamin D level because low vitamin D is also common especially in terms of different populations where you are in the continent. Low vitamin D is one that a lot of physicians there seem to be debate about but in terms of athletes and people who are active or women who are active they do check for low vitamin D and they do tend to replenish it if women are deficient in vitamin D as well.
>> Perfect. And then you said women who are active, what level is it like the everyday gymgoer that a doctor should be taking a you know deeper level of looking into their blood work or is it like the Olympian? Like what is that level?
>> No, that's a great question. So this is what I would say. If you're someone who is actively or or who works out on the daily and I would say um let's say the American Heart Association recommends at least 150 minutes of moderate intensity exercise per week for your heart health.
So if you're someone who at least gets a 30 minute to 1 hour workout every single day. I would say that's someone who's overall you know young healthy you should check with your doctor for annual physical and the annual blood work that is due for you. Unless again we go back to the individual risk assessment. If you have a history of any medical conditions or genetic risk factors or parents or upbringing and of course the type of diet, the food that you eat based on those you'd usually do blood work. For example, things we check for, we check, of course, for anemia if it's relevant. If you're having fatigue, if you tell us that, hey, you know what, we're having uh hair loss, unintentional weight gain, just feeling off, thyroid problems in the family, would probably check that. We'll check a lot of your sugars for pre-diabetes and diabetes. We check your electrolytes for any discrepancy, your liver health, your kidney health. Um, I'd say those are the the things that you would usually check other than your prevention screenings, things like your past smears, your vaccines. Um, those are things that need to be up to date on on according to the uh age and and frame that you're in.
>> Mhm.
>> Should we be testing thyroid regularly?
>> No.
>> Okay. Why?
>> Um because there's false negatives and your thyroid fluctuates. Like if you're sick, things are transient in state. So things sort of fluctuate according to what you're going through. Like if you're running a marathon, if you got sick, if you're exposed to something, things tend to find its homeostasis.
Like your body wants to always establish a sense of balance. We go back to the word of balance. So the minute that you're kind of offbalance in any department of your body, your body really puts an effort to sort of establish that. The reason why we don't check check things just to check things um is because sometimes there's a lot of abnormalities and you don't want to necessarily one create panic that's unnecessary and two sort of overtreat things when usually it sort of resolves on itself because that's what your body does unless you have symptoms and we go back to how the person feels as a whole and of course their family if someone in their family has certain conditions that predisposes, for example, you to be at higher risk to have thyroid problems.
Only then do we start to look into things that are more specific, such as your thyroid. Your thyroid is one that does normally fluctuate. So unless it's causing problems or there's a reason for us to check or if there's a nodule that you feel on physical exam, that's when you have to dive deeper in and check your levels.
>> Good to know. So don't just check it every single time.
>> No, don't check things and cause a heart.
>> Don't randomly do things when you don't need to do.
>> Yeah. and panic yourself and can't sleep cuz you don't know what it means.
>> Yeah.
>> What screenings or lab work should women actually be getting in their 20s and 30s? Or like is there a difference between your 20s versus 30s?
>> So, I would say in your 20s and 30s again, other than the individualized risk assessment, when you do walk to your doctors, they're checking your blood your blood pressure. That's number one. Uh two, we go back to pre-diabetes and diabetes checks. We uh go into cholesterol, which is lipid screening checks. And of course if women according to your period sometimes we have to look into your anemia and see if there's any need to check iron deficiency vitamin D in certain situations can be checked and then we go into papsmearies which start at 21 years young 21 years old as well and then you do them every 3 years if everything's normal until you hit your 30. Your 30 is when you have some leeway with at least the paps which is cervical cancer screening. you get the chance to uh co- test for HPV and you will do your cervical cancer screening every 5 years instead of three. But a lot can change from your 20s into your 30s. A lot of things like stress. Um sometimes people get pregnant. Sometimes you have a new sexual partner. So STD screening is a big one. hepatitis C at least once during your lifetime and other things as well according to what you're exposed to um should be looked into. So yeah, 20s and 30s is usually like the best time of your life unless your parents had given you something that would cause you to have to do different types of lab work and screening to follow up on genetically and autoimmune conditions and things like that. Okay, that makes sense. That I was going to say like do things show up more like at a specific age in your life?
>> I would say um it's natural that the longer that you live things mutate, things change, >> but ideally it's really how you take care of yourself. I can have someone who is 80 years old feel and look like they're in their 50s. And I can have someone who's in their 50s who generally feels and looks and has all the medical conditions as that of an 80year-old. So I would say the best thing that you can do, you can control the things that you have control over. Things like your exercise, your lifestyle choices, your diet, your mental health, your sleep, what you're exposed to, your job, that's a big one. What you're exposed to on the daily is is very important. And then the things that you cannot control, you can be angry about, but early detection and early screening and sort of trying to sort of stabilize it and control it so that it doesn't flare out or get worse later on.
>> That's what I would say.
>> Okay.
>> Yeah, >> good to know.
>> Yeah.
>> So, taking care of yourself is very important for the long term, not even for the short term.
>> It's an investment. It really is. It's an investment >> with a high return. pirate.
>> How important is muscle mass for long-term health?
>> Very important.
>> Um there has been multiple studies and there's one article that came out uh by JAMAMA which is one of the journals that says that building and sort of having muscle strength or strength training and muscle mass has been shown uh in terms of improving like the all cause mortality in terms of almost many conditions especially in women. The the the thing is is that the older that we get, especially as women, when we hit menopause and we become post-menopausal, we have lower estrogen, we lose muscle mass and our bone density also struggles, so we have weaker bones. The problem is is that if we don't have a good base to start with, for example, if I try to maximize my muscle mass now and get up, let's say to 80%. Well, if I were to have a drop, let's say to 60%.
That's okay. But if I'm already starting with 60% and I'm drawing down to 40 and 30%, then you can imagine what that would look like as we get older. So, this is an example of what exercise does. If I were to go and work out strength training wise, okay, you have your bones, you have your muscles, you contract your muscle, the muscle is going to pull on that bone. When it pulls on the bone, that's causing stress on the bone. And the bone is like a living tissue. A lot of a lot of people think like, you know, it's common bone is just like this object, this thing.
>> It's like a stone.
>> It's a living tissue. It really is. So when the muscle pulls on the bone, it causes that stress, the healthy stress.
Certain cells osteoblast get activated, right? And it creates better bone and it creates stronger bone. So the biggest thing that I tell women is that your independence is so important. The stronger you are, the less frail you'll become, especially as you get older.
When I tell them about independence, everybody seems to be holding on to the idea because nothing is worse than feeling helpless and weak. And God forbid the last thing that you want is your fall risk patient to sort of the minute that you barely fall or barely do something and break a hip, break a bone.
It's not ideal. It's not ideal for yourself. It's not ideal for the people around you. Another important factor is cognitive health, right? the risk of dementia, >> cognitive health, cardiovascular health, um almost everything health and it all goes back to strength training and muscle mass.
>> I didn't know strength training helps with dementia like helps prevent it.
>> Not necessarily. It's by association.
There's a lot of studies showing that um and and there's a lot of studies that are ongoing about its relationship in terms of long-term dementia risk and other risk factors.
>> And then I have a question. So let's say I know like the person who strength trains today is helping like the future them. Yes.
>> The like 70-year-old them, but let's say someone who never strength trained and is 70 years old. Do you think they could reap the benefit if they start later in life?
>> Absolutely. Because in the end of the day, it doesn't matter how old you are.
It's the same thing as smoking. If you sp if you stop if you start developing your muscles and working your muscle strength now, every day after is a win.
You can't necessarily lose. You can only win and have more positives moving forward. Now, in terms of the bone density, could that necessarily is that different than when you start younger? Of course, it's better to start younger for all of those benefits and cardiovascular health. But I will say if you do start older, let's say my grandma decided that she wants to do strength training with a professional, it will help her balance. It will help her gate uh her gate. It will help her from being and feeling more confident, more independent to not need us the minute she wants to go and make her breakfast.
and god forbid she falls, at least she has the balance and the stability to prevent her fall risk. Um, so although we may think, okay, the long-term benefits of the bone health, the cognitive health, the cardiovascular health, if we feel like that's such a long-term reward, even starting later, it's still a reward to at least strengthen your gate and your stability to not fall and to be able to feel at least more strong and functioning and not break a hip, you know?
>> It is.
>> It's so important.
>> It is.
>> So, it's never too late to start. It's never too late.
>> I love that.
>> In all in all ages, it's never too late to start.
>> Exactly.
And then I know we kind of talked about bone density.
>> Yes.
>> What are other ways that we could help with like our bone density as we get older?
>> Yes. So, of course, a lot of things are intertwined with hormones, with what you eat, with um of course your muscles.
However, uh one thing that I will say is a vitamin D deficiency. Your health is important and if people will have certain nutritional deficiencies that will cause a lot of bone thinning. Now for us as women unfortunately as our estrogen decreases that places us at a higher risk to sort of have uh osteoporosis in terms of like bone health. But the best thing that you can do is going back to your nutrition, to your exercises, to everything that you can support in terms of young when you're young. Um, I will say certain diets, when I say diets, I'm not talking about like losing weight, but for example, um, some sort of like foods may not have ideally the things that you need to build your bone. So, if you're very strict in terms of what you eat, that could impact the deficiencies that you have and that will impact also your bone health. Um, not to say there are different conditions that are not by choice that some people get that can lead to thin bones and that's something that of course the earlier you catch the better is long term.
>> True.
>> Yeah.
>> But I just want to emphasize this to everyone who's watching, strength training is key, right?
Oh god, there's like a huge debate going on. Tik Tok right now.
>> What's the debate?
>> Skinny talk.
>> So like they're like, "Oh, I don't want to like weight train anymore because I'm getting bulky and looking like a man. So like I want to just like become as thin as possible." And I'm like, "That is so toxic."
>> Yes, I agree. Um I will say though, I will say, and this is a very important point, cardiovascular health is very different, right? So for someone to be doing let's say moderate intensity exercise that that's more uh um like let's say you're doing more cardio, you're doing more running, it's really good for your heart in general like your blood pressure, everything regarding like you know getting a heart attack and a stroke, it's very different. But when it comes to actual bone health >> and of course muscle health and the rest, that's strength training there. So if you want to protect your bones, you want to protect your muscles, that's where strength training comes to play.
And I think it's very important to recognize and it goes back to balance because if you do one without the other, you're missing the benefits of each.
>> So like for example, do your weight training, but maybe add cardio to it, too.
>> It's so important to have a mixture of exercises. If you're not if you're not moving your body and making your heart work at a certain level, then you're missing out the benefits of what you can do now to protect your heart health long term. But if you're also not building up your bones and your muscle from now, you're also losing the benefits that you could be, you know, creating at a young age. So the best thing that I would say is that having a program that sort of incorporates both the cardio and the strength training in a way that optimizes you and also limits your ability and limits your ability to get injured because the last thing that you need is you're also like overtraining and overdoing trying to balance it all but then you're just injuring yourself and you're not able to recover and then you lose both.
>> True.
>> You do.
>> Then you're done.
>> You're done.
>> Oh yeah. Yeah. Okay. I want to dive into supplements because obviously I feel like >> there's a lot of misconception.
>> Yeah.
>> And like good and bad things on the internet.
>> But what are some supplement trends that concern you right now?
>> There's a lot of trends that concern me.
>> Supplements.
>> Our doctor is tired of this. Give her a break.
>> Not trends. I'm I I just see them in the urgent care. Okay. Don't do something now.
>> But I would say this. I think the thing with supplements, there's a lot of great things that come with it and a lot of bad things. And that goes back to why you're taking it. What is it doing? What is the source of the supplement? Did it go under enough testing and safety? And also, is it is it do you trust the seller? You know, is there other contaminants in this supplement? Do you know how much dosing you're having from the True Clean product? So overall, in terms of the supplement world, I feel like a lot of people feel the need that they need extra things to optimize their health, but supplements were really created to sort of fill in a niche where there's a deficiency. Now, >> I will say this, I've been seeing a lot of things are like these detox and cleansing supplements. a detox supplement, especially for liver detox and kidney detox.
It's it's probably one of like the biggest red flag supplement I've seen on the market because I've had a patient come in who is taking a liver detox supplement who really caused liver failure because of that supplement. So that same supplement that's supposed to sort of detoxify their liver end up damaging their liver. And I would say this, your body is beautiful. I I swear it's probably one of the coolest and most magical thing I've seen because it does a great job at detoxing itself.
That's what the liver and the kidneys naturally do. That they are the detoxifiers of your body. So when you find things are like detoxes, detox, you don't need those things. You don't want those things. And the problem is they cause more damage than good. Other things I've been seeing are hormonal cycling stuff. And it's very interesting to me because the same individuals who want to sort of stabilize their hormones are actually disregulating it because your body is trying to create and it sort of moves on a wave. So when your natural hormones are trying to do their own thing and you're just throwing things at it that are not quite safe, not clean, not tested, and they actually are hormonal dysregulator themselves because they're disrupting the normal cycle of your hormones. Um, I would say that's the second thing that I've been seeing that really bothered me because you're trying to sort of protect your patients and try to make sure they're safe and then they're being sold that they need to feel more stable or more, I would say, fixed than what their bodies are already trying to do. Mhm.
>> Um the third thing that I say in terms of supplements, um there there's many things, but there's one I think it's like the algae that people are eating.
>> Oh, this Oh yeah.
>> What is it?
>> Seamos.
>> Seamos. Oh my god. I couldn't find the name for it. So seaoss has minerals in general, but you know to me I find it very interesting because in a world where we have so much food and so much minerals and so much nutrients, we feel the need to go and get something from the ocean other than fish and we're like okay I need this to support more minerals in my body. The one thing that I saw patients who have um thyroid conditions or have or on the edge of being on the thyroid of hyper or hypo with seamos supplements um it actually has a lot of iodine and it's if it's not regulated you don't know how much quantity you're taking and how much is absorbed that could push people into either hyperyroidism or hypothyroidism.
So that's something that I would be careful about. Um, I would say those were like my top. Oh, so wait, not supplement. I'm gonna digress on that part.
>> Wait, what?
>> Please. The masks. Have you seen the the lip masks that people go to sleep with?
>> Oh my god. Yeah. So, they breathe from their nose.
>> Yes.
>> Wait, why not? We should talk about that. This isn't a supplement, but it's I think it's important. Yeah.
>> But it was such Oh my god. The amount of sales that people got over that trend or what do you call it? Mouth taping.
>> Yeah, >> mouth taping. Okay, I looked into the research. I looked into the study and I actually had a presentation about mouth taping. So there are there's good there are a good amount of theories about the benefits of breathing through your nose instead of your mouth. That's true.
However, when people come out or they came out with this mouth tape, the problem is that there's so many things that could go wrong that the overall benefit does not outweigh the risk of doing it. Number one, having it fully stuck on and not slipping and not having air leaking through it when you're sleeping, there's no guarantee, right? When you're putting a piece of tape and you're moving around and you're breathing, there's a lot of air being leaked.
You're not fully breathing from your nose. Second of all, there's a lot of people that have undiagnosed obstructive sleep apnea and they snore at night.
They don't know because they live alone and they don't have a partner that told them about it. So, in patients with obstructive sleep apnea, especially if it's moderate to severe, that would actually hurt them because you can imagine they can barely breathe at night. So, the last thing they need is to completely shut up shut off their mouth because they have no access to enough oxygenation and air. Another one is deviated septum. deviated septumins and a lot of patients may or may not know if they have a deviated septumin and also polyp and allergies. So when baseline when you have things already disrupt your breathing especially when you sleep cuz everything slows down and it's harder to breathe at night. So when you sort of like tape or seal the other access of breathing that you have there's a lot of more risks associated with that than the overall benefit. So, in theory, it has potential, but I would say if there's any issues with sleep and breathing, I say talk to your doctor about it because there's reasons why you're struggling and you should address those causes first.
>> Yeah.
>> So, do you think like the mouth tips with the little hole in the middle is okay?
>> No. Because then what's the point, right? Then what's the point? Cuz the whole point of the mouth is to force you to breathe through your nose. So, if there's a hole in the mouth tape, then I don't know. I don't know. Unless you like the look of it when you're sleeping.
>> Even, you know, taping in terms of like people do them for wrinkles as well.
>> It's just interesting to me. Wrinkles, there's two things, right? Collagen loss, skin elasticity, but also muscles dynamic features and wrinkles, right?
So, if I'm a happy person, I'm just cursed or blessed that I'm going to end up having, you know, crows feet and other happy wrinkles. Um, but when you apply these tape, which you know is supposed to sort of like stabilize the dynamic motion, you're using it at a time where you're sleeping. So, you're not using those expressionistic muscles when you're sleeping. You're not smiling, you're not laughing, you're not bringing up your eyebrows. And the whole point of theoretically of that tape is to sort of like stabilize those dynamic wrinkles and movements unless you're maybe using it every day in the day. I don't know. I think that has more theoretically has has more, you know, potential.
>> Um, but yeah, that sorry, those were some of the things.
>> Those are like good to know cuz honestly like I was curious about it, but I was like, should I talk about it? Should I bring it up?
>> My god. You know those >> there's so much so much in the world.
>> Keeps me up on my feet at night.
>> I mean, you always be busy. That's good.
It's >> not my choice.
>> Not your choice.
>> Yeah.
>> Um, let's talk about supplements that are actually helpful for most women.
Okay, I'd say this. If you did your blood work and you're truly deficient, your iron, then yes, you should be on iron supplementation if you've proven to be deficient. And of course, focus on your food sources on top of the iron supplementation. Vitamin D, if you're also shown to have been vitamin D deficient, vitamin D supplement is a big one. Um, some patients take magnesium. I always tell patients that there is a magnesium level check. It's a blood work. And if you are truly deficient then okay you can supplement with magnesium. Some people take it for cramps some muscle cramps. Some people take it to sleep. Um I would say those are uh good supplements. And there's a lot of new research coming regarding creatine. I don't know if you've heard but that's one in the the sports and athletic space that a lot of people are talking about. It has some you know uh promising studies as well that's new in the space. Um, I would say those are the the supplements that I would consider.
>> Okay, good to know. So, I shouldn't be taking like my daily vitamin D every day.
>> Unless you have vitamin D deficiency, then you should. But if you are no longer deficient, the problem is that when you overs supplement, it's just as toxic.
>> So, you have fat soluble vitamins. And I feel like a lot of maybe our older generation, not older, maybe our parents' time. I don't know if you remember, they used to go for the we I call it edok. So e d a k right vitamin A, vitamin D, vitamin. Okay. So a lot of uh our parents used to like take a lot of those vitamins. The problem is that too much vitamin A that's not that's going unchecked and not regulated will cause of course liver toxicity. If you take a lot of vitamin E has some sort of bleeding risk. uh vitamin D will have kidney stones and stones where you don't want them. So everything needs to be sort of regulated and the whole point of a supplement is because your body is struggling to have enough of something.
So you're trying to help it out a bit but you don't need to take something that's extra unless your body needs it.
Uh, another one is if you are vegan and you're not having um good B12 sources of, you know, food sources of B12. Uh, B12 usually can be uh low in those certain uh patient population groups.
And B12 is something that a lot of people end up having to supplement with if they were deficient.
>> Okay.
>> But don't take something unless your body needs it. And if you're deficient, you know.
>> Good to know.
>> Yeah.
>> I I should go get checked.
>> Yeah.
And then we talked a little bit about creatine.
>> Yes.
>> Do you think creatine is safe especially for a woman?
>> I think um so I I'll go based on the studies. So creatine monohyd creatine is like this compound of arginine of you know different amino acids your body naturally creates it. It's been shown relatively to be safe in terms of standard dozing in women with of course assuming they're healthy with no baseline uh kidney disease or medication interaction. What creatine monohydrate does it basically provides and repletes the energy source ATP for your cells. So you can imagine someone who's doing intense exercise like yourself or you're working out. You want to do more reps, more sets, you want quick recovery, you're having like quicker energy source. It's being repleted for you to sort of like recover from. So, you can you're able to do more reps, more sets, and sort of recover faster. Now, there's a lot of studies that are still in the works, but it sounds like so far it has a promising potential. Um, you're able, of course, uh to build lean muscle and of course recovery. I will say some of the things that comes with creatine you can have temporarily like water absorption and retention in your muscle and if someone doesn't know their kidney health which people should be checking baseline again we go back to the annual screenings people who do have kidney disease and kidney conditions should be careful when it comes to the creatine but if you're young healthy assuming no medical conditions no medication interaction the 3 to five grams daily dosing um could be generally safe for a woman to take.
>> Good to know. Good to know.
>> Yeah.
>> And then so like again like another supplement that I see some craze online are electrolytes. What are your thoughts on that? Should it be taken daily?
>> No. Should electrolytes be taken daily?
No. Um I think electrolytes were created for patients who have significant amount of sweating especially during intense exercise. So if you're someone who participates or partakes in exercises that have consistent sweating then yes it can be used especially for like the electrolyte replenishment. So when you watch like, you know, these soccer games, there's boxing tournaments where people are just profusely sweating.
They're not having the chance to take a break. Um it's been sort of created to help out those individuals and those athletes. But when your everyday natural gym girly goes to the gym, um she doesn't or she doesn't need to replenish those electrolytes because her body tries to sort of like stabilize the electrolytes for herself. The best thing that she can do is drink a lot of water a day to protect her kidneys and eat a lot of great food that contain a lot of, you know, rich things like potassium, but you don't need to take an electrolyte replenishment.
>> If, god forbid, you're having like over eight episodes of diarrhea for days and vomiting, those shifts, those electrolyte shifts within your body are starting to happen.
That's where electrolytes can sort of kick in and help out. But not like your daily onthe-go electrolyte replenishment.
>> The first introduction to electrolytes I had was when I was in college and my room would go out, she would drink and the next day she would take electrolytes.
>> That's my first introduction.
>> The question is, was she vomiting a lot overnight?
>> I have no idea.
>> I never went out in college, so I >> Oh god.
>> Um Oh, also protein powder. What are your thoughts on protein powder and is it safe for the long term? So, I'll say this again, going back to protein powder and supplements, again, if you know the source, if you know it's clean, if you know it doesn't have like contaminants, then most most individuals struggle to get enough of their protein goal a day, especially when they're working out. So, as an additional, you know, uh supplementation to your protein requirements that you're trying to aim for, um yes, protein can be helpful. But what I would say is that if you are able to successfully get the protein requirement you need for your day through food, through your recipes, through what you're eating, you may not necessarily reach out for the extra protein supplements. But it's really made for those who struggle to sort of like have the the protein quantity that they need out of their food during their daily meals. And so they they have the opportunity to gain that from a protein supplement. Now, I will say and there's one thing that I feel like a lot of the maybe it is our generation. We sort of went into like the sports, we went to the gym, but we also went to like the protein and the protein smoothies and like the protein world, but we forgot about fiber and we're having a lot of, you know, younger patients have colon cancer. A lot of patients have inflammatory bowel disease, IBS, so fiber shouldn't be missed. So yes, your protein goal is important, but so is your fiber intake. It needs to be equally as important.
>> Are there any like fiber foods that you like like that are rich in fiber?
>> Vegetables.
>> Vegetables.
>> Everything vegetables I'll say. Um so some things can anything that's more like of a folageage things like you know kale, cabbage, cruciferous vegetables can be more bloating in nature for some individuals. So the best thing that I would say is that maybe try to sauté them or sort of like cook your vegetables and it helps break it down in its nature so that it can prevent like the bloating disturbances that you may struggle with that may prevent you from reaching out for those sources.
But in general, I would say the more colorful your plate is, the better. And I mean it. If there's like color orange, color red, color green, color blue on your plate, the more colorful it is, the better it is for you. So, I would say make it fun. Make it fun. Have protein, have fiber, have your healthy amount of like dairy if you eat dairy as well. Um, yeah, keep it rainbow.
>> Yay.
>> Keep it rainbow, >> happy, full of color.
>> Love your food. Love your vegetables.
Love your fruits.
>> Exactly. And then actually while we're on the topic of fiber, let's say that someone needs to get like a well they're obviously going to try to get it from their food, but if they need to get a supplement, is there one that you recommend that you like?
>> I would say psyllium husk is the common, you know, like supplement that we usually recommend to patients. A lot of these fiber supplements are available as powders. Some of them are actually available as biscuits, biscuits with your coffee if they don't have the sugar. So there's different versions that you can take of fiber if let's say you don't want to take your fiber in the form of like powder, but that's the one that I would usually recommend patients to go with if they're struggling to get their fiber intake. Smoothies is another great and fast way to get everything in as well. But I always go back uh and tell people in general, if you're able to have things like whole and cut them up and eat them, it's much better than just blending it in and having like one big meal, >> you know?
>> Yeah.
>> Yeah.
>> I try to get mine from Whole Foods.
>> Yay.
>> But I try my best.
>> And the bill goes up.
>> And the bill goes up. It's expensive, but it's worth it.
>> Yeah.
>> And then I want to talk about basically advocacy and empowerment. Yes.
>> Why do so many women feel dismissed by doctors?
>> As a woman, >> as both a patient myself and a doctor, >> um, when I go in and let's say I go in because I I need help with something is because I'm struggling and I'm frustrated and I need help and finding a solution to my problem. because if I am able to solve something on my own, I wouldn't go out of my way and get time off of work to go for your help. So, I'm frustrated and I'm struggling and I'm miserable, which is why I'm reaching out to the expert. So, as a woman, I feel like when if I go in and I feel like someone is not engaged in the conversation, some if I feel rushed as a person, if I feel like I'm not being heard, like you're not hearing me, you're not hearing why I'm here, uh, it sounds like you're either busy or distracted, or also I feel like there's like the stigma and there's bias where you just assume nothing's wrong with me or you're just dismissing my complaint, then yeah, I feel unheard. I feel disrespected. I feel like my time went to waste. What a waste of an appointment. What a waste of taking time off of my job, my day to come here. Um, so there's two aspects to this and I'm going to put my doctor hat on. I think the health care system in general is flawed. I think we need a lot of work.
It's very difficult when you come and tell a doctor you have about 15 minutes with a patient. Imagine, you know, I'm here to see you and let's say you're struggling with something.
Most patients don't have time to come in regularly. So, what happens is that just like any normal human would do, I have at least more than one complaint that I'm here for because I don't usually come to the doctor a lot. So, I have a few complaints that I needed to to be addressed and yet, you know, the doctor's there. They're crunched on time. I have a total of 15 minutes. One, to get to say hi, introduce myself, get to know you, why you're here, all while also doing a deep dive. That means I'm trying to check your previous most recent blood work, your medications, anything that you stopped, risk factors, family history, all these things, and trying to figure out what's wrong and how can how can I help you. That is also like me stepping out and also you know trying to figure out what labs I need to order for you, what imaging, what's my next step. It's like I'm actively having these branches in my head of A, B, C, D, E. What options do I have to help you?
And then of course I have to come back, place those orders for you, explain them to you, make sure you understand them, sort of wrap it up and finish and complete my note and also build for the service. So 15 minutes is it sounds like okay you can do a lot in 15 minutes but it's a lot of pressure and stress on the physician and I can imagine how stressful it is on the patient because that's where miscommunication happens.
That's how burnout happens and the last thing that you want is for a patient to feel dismissed and unheard and you want to help your patient. Now, what I tell women in general is when you do walk in to your doctor's office, the best thing that you can do is sort of have an agenda, right? Like today, for example, when I came to see you, I was like, "Okay, we have topics that I want to talk to you about. You sort of have a game plan. You have something that you want to address." Number one, I'd probably have that and I'd have a minute, one minute of no interruption that I would want the patient to sort of say, hey, I am here because I'm struggling with this, this, this is why I think it's not normal for what my baseline is and I would be interested in knowing what options I have. Now I will say it is the physician's responsibility to sort of take a step away from the computer and sort of be present especially for the the first initial time you're building that connection with your patient that trust. It's perfectly normal for a doctor to say hey I don't know enough about the topic. I don't know what's going on. I need to review your stuff. I need to do more research. I need to look into it. I'm human. I may not have all the answers now for you, but I'm going to help you through this and we're gonna figure this out together. Okay? And I think what the patient wants to hear, they want to feel heard. They want to feel like I feel like I can trust you. Even if there's no solution now or ever, which is not ideal, but I want to have some sort of game plan. I want to have I I want to feel like this is a teamwork. You should never feel like you should never feel like oh I walked in this is what the doctor told me and I left. I always tell someone it should feel like a dance. It takes two people to dance. It's a tango.
And ideally as a patient you are the captain of your ship. No one would know what's wrong with you except you. You know your body best. So when something doesn't feel normal for you and you're the one who's struggling with it. You're the one who's being impacted by it.
You're the one who your job, your life, your family, everybody around you is being affected by it. You are the captain of the ship. And you should never leave your appointment without looking back at your doctor and basically wrapping up what you understood because a lot of times you may not understand what the doctor just said, especially if they went on like a tangent of like smart words. But really, you have to stop before you leave every single appointment. And I tell every person to do this. I tell my patients, tell me what I just told you everything.
Tell me what you understood for me.
>> I wish everyone did that because I go blank sometimes when my doctor speaks >> in a very genuine way because I want to make sure that you and I are on the same page. And if there's any and if there's any like discrepancy or I feel like there's something missing in our conversation, I need to find a different way to explain it so that you walk out understanding what we discussed and what the plan is.
>> There has to be some sort of like plan.
So you feel like you walked out of the appointment. You feel like I felt heard.
I felt like I understood. You need to walk out learning something from this appointment that's going to benefit you in any way. It doesn't mean a guaranteed solution, but you have to walk out being able to wrap up what your discussion with your physician is or was and what your next step is going to be. What's your plan moving forward before you see your doctor next? What's your homework?
What's your homework? And a lot of patients don't do their homework. And that's that's an accountability. And I tell people, you need to have accountability of your health. We're here to remind you, yes, your thing is due, your physical is due, your papsmear is due, but ideally, you need to be captain of your ship. If something's bothering you, if you need to be up to date on the things that you need to be screened for, you need to be responsible for your health. If you have homework and I hear that you come back and you didn't do your homework, I'm not going to mind it, but I will be upset for you because this is your body, your health, your investment, and you need to put in the work for yourself, you know?
>> Exactly.
>> I can't do it. I can help you get there, but I can't do the work for you.
>> Exactly. You can't be like the miracle worker and just like in your magical eyeish. Literally, >> what's one thing you wish every woman understood about her body?
>> I would say it's okay to be boring. It's okay to be boring.
>> If you feel boring, like you're not having weird spikes in both a very positive or very negative direction, it's okay to be boring. Um, things like, for example, having regular sleep, sleeping early if that's what you need to do. Just because your friends sleep at 1 a.m. doesn't mean you have to sleep at 1:00 a.m. Um, eating a healthy diet, being consistent, feeling like you have a boring sense of routine. Being boring is actually good.
>> When you feel like you're being pushed and pulled into extreme dynamics, that's not good. You shouldn't feel if you're very anxious all the time. If you're down all the time, if you're working so hard that you're always fatigued, or if you're just sleeping in that you're not even moving and you're just like limpless on a couch all the time, you need to find a happy boring medium and fluctuate around that. Um, that's what I would say to >> Boring is boring is boring is an investment. Having a boring stable routine now in terms of your workout, in terms of your food, in terms of your sleeping schedule, in terms of your choices, the boring routine now will really save you and bring you that strong independence and that confidence and that health in the future.
>> I love that.
>> Yeah, >> I think that's so important, especially for girls in their 20s, too. Like here.
>> Yes. And then what does healthy actually look like from a physician's perspective?
>> Remember when you talked about looking human but not feeling human? You need to feel human.
>> And when I see someone functioning, I feel like a lot of people, and I think we're all guilty from this, is that we expect that life is just going to be like this. You know, we're going to wake up. We're going to get a six-pack by tomorrow. I'm going to sleep at this time. I'm going to wake up at this time.
We have these unrealistic perfection standards that we try to meet. And the reality is that life is supposed to feel like this. You oscillate. It's like a wave. But overall, your stability of flying should be here. It's okay to challenge yourself and bring that baseline of a line a little bit higher, but your dayto-day should function and oscillate around this. When you feel like you're able to function, that means I feel well rested. I'm able to think clearly. I'm able to have a creativity, a sense of imagination. I'm able to show up for myself. And also, am I able to show up for other people and the people I care about when they need me as well?
>> Do I look myself in the mirror and say, "I'm going to have a great day." Do I go to sleep thinking, "What a beautiful, blessed day I have." Is my mind as clear and as peaceful as how I feel from the outside? So to be able to function is to be able to show up for yourself and feel proud that you know what it is not perfect and life isn't perfect. I may not be having the sixpack that I want today. I may not have the hair length that I want tomorrow. I may not have this beautiful flawless skin.
But you know what? I feel good from the inside. My mental health is at peace. I actually was able to make my favorite breakfast a day. I skipped out on lunch.
Okay, I'm not perfect, but you know what? I don't hate myself. I love myself. And if I'm able to show up for myself, I'm able to be functioning very well. And if I'm able to show up for the things that excite me and the things that add on to my life and the people around me, that's when I would say you're function. You're doing actually pretty great if you're at that level.
>> That is so lovely.
I love that.
>> Sorry.
>> I really do love that.
>> I love that you love that.
>> I feel like everything you say I'm like, "Yes."
>> What is one common myth, health myth that you have seen spreading online?
There's a bunch, but one that really like, you know, irks you.
There's so many.
I'll say this. um having and I'm going to go back to the period section. Just because you have a bleed every month doesn't mean your periods are normal.
>> If you are overall if your ovulations are not normal, just because you're having a bleed doesn't mean that that's normal. Um that's one thing. Skipping a period because you're very fit is not normal. It should never be normalized.
Um, taking things unnecessarily like biotin for hair health and skin supplements. No, that's a health myth I really dislike. Um, there's so many.
Which ones do I actually hate more?
>> I don't know. Which ones did you see?
Tell me. Which ones have you seen that you're curious about? Which one brought out the Oh god, the eye roll.
>> I'm like going through the list in my head right now.
>> Yeah, cuz I feel like you've been saying more of them. I know from the eyes. the eyes don't lie.
>> Well, I think I've talked about this so much that I think they're sick of hearing this, but there's like a rise on like the whole GLP1 oz epidemic that's going on right now.
>> And it's okay medically, if you need it, do it, right? But I feel like it's gotten so mainstream that like unfortunately like people are selling dupes of them on TikTok.
>> Oh, wow. So, and like people who are in high school are like, you know, leaning towards it. People who don't need it are taking it, you know. So, I think that's an epidemic that I'm just like, h >> I will say in general, regardless of the gener the generation, the time and the science and the advancements, >> I feel like as as human society, they're always going to try to sell you the easiest way to look good and look hot.
Mhm.
>> And it doesn't matter the price of the person. Now, I will say this, >> having resources and tools available >> is pretty great. It's fantastic that science, you know, could be able to progress and advance in different ways.
>> But also, it's like a double-edged sword. We create things and we make things to sort of help people initially those who need it. And of course because humans are brilliant, we find ways around things. I have been on the other side of the walls of the hospital, right? I've seen side effects of a Zampeic from different angles and different directions. Of course, those who have different risk factors and different health problems, but I've had patients die. I've had patients become so obstated, so constipated, they perforated their bowel. They were in the ICU, they didn't do well. But I've also seen the different impacts, right? I think I've seen the lifestyle impacts of people actually struggling with severe nausea and abdominal cra and just vomiting that they can't really put food in because they increase their dose of certain medications like ompic. But the the benefit of being on a Zmpic which is to them the weight loss out competes their their ability to function right so when I look at my patient I'm like if you're willing to go through the nausea through the vomiting then what is the quality of life like you need to be able to to function to enjoy your food to enjoy your meals to be able to do the things that you want within reason. So I would say this I think not just in in the OAMIC world in different parts of the world I think the younger generation are easily influenced and there's a lot of pressure there's pressure to look a certain way to act a certain way to have a certain lifestyle and a lot of younger generation you know the younger generation they think that oh you know what this is what I should be or this is where I should be at this time of my life >> we're guilty I think how How many influencers do you see online where, you know, you have young, beautiful, gorgeous looking woman, you know, on these very expensive, luxurious trips, on these yachts, on, you know, these flights. And a young girl who's her age range is going to think, "Oh, this is this is what I feel like I'm supposed to be." Especially like in terms of treatment, right? They see these super fancy gifts, these super fancy things, and they're like, "Oh, but I should be getting that." And I think that's the problem. Everything in life, there's there's positives, there's negatives, and there's consequences.
Even I was in a toxicology class in college, and I'll never forget this because I think this was very memorable to me. There was this molecule that was hidden on the board and there was all these side effects about it, right?
Death was one of them, you know, coma, all these crazy things. And I was like, "Oh, what is this horrible molecule that has all of these side effects?" You know, I was so scared. I was like, "I don't know. It's going to be something I've never heard about because it's toxicology class." It was H2O. It was water. That's to show you that everything has positives. And when it's used or misused, it can lead to negative effects and consequences. Um, these medications are very helpful for patients who need them. But I can only imagine like the younger generation like your body is beautiful and what you do now, everything has a consequence. And we we don't know what the long-term side effects are going to be, right? You may look great today, but you don't know what's going to happen tomorrow or 10 years from now. Um, so yeah, >> beautiful. Well said.
>> What is one advice you would give to a girl in her 20s >> or if you could go like Yeah. Yeah. a girl in her 20s.
>> I would say, okay, it's easy. I think if you're a girl in your 20s, love yourself. I think comparison has always been a thief of joy.
We we're in the society where truthfully everybody's about trends and there's a lack of creativ lack of creativity not because people aren't creative but because other people are utilizing their creativity to sort of copy their identity because that's what's trendy.
That's what's working. So slowly everything's starting to blend in. I think the best thing that you can do is sort of be yourself because that is going to be one of the rarest things that you're ever going to find.
Everything is blending in. There is no more uniqueness to things. The best and the most unique feature and rare thing that will and I think that's going to be the future is really the uniqueness of who you are. And the sooner you realize this, the better. I think when I was younger, like when I was in my 20s, I was so harsh. I was so harsh on myself.
I blame myself. I blame everything around me, my upbringing. But everything's going to be okay. You don't have to figure out your life when you're 20. What I would say is do what you think you want to do when you're 20 because at that time that sounds like the right thing to do. Do what you think you're excited to do. When you feel excited about yourself, about your friends, about the people that you surround yourself with, about a passion that you like, everything falls naturally. Everything just falls naturally.
>> It's like the universe like rewards you.
>> Yes. The universe rewards you. Don't try to be someone you're not trying to be.
Be yourself. But also, I would say whatever you're excited about in your 20s, pour that passion, pour everything you have into it. without losing yourself. Um, and I would say, especially when you're 20, it's okay to change your mind at any point in your life. What my interests were, and I'm sure for you, too, what I used to like when I was 20, I used to love peanut butter. Now, I can't I can't stand peanut butter. I may be, sure, I love medicine. I love being physician. I thought that was my life, but now I'm a content creator on top of being a doctor. I tell people just because someone has been doing one thing and they're 80 and I'm like, I've been doing this for 80 years. That's not a ribbon of achievement unless you're really passionate about it. Humans are not supposed to be stagnant. If your growths and your passions and your interests don't grow and don't change and don't evolve, then you're just simply dead.
Dead is the definition of stagnancy. So be whatever you want to be when you're 20. And just know that you can be whatever you want to be when you're 30 and 40 and 50 and 60. But find something that provides you some sort of stability and that stability will be your investment to sort of experiment as you get older and invest in other passions.
That's what I would go for, you know, when you're in 20.
>> I love that so much. Yes. Because I feel like people just feel like, "Oh, I have to pick." Cuz again, like our parents, our grandparents, you pick one thing and you stick to it. But I feel like Yeah.
survival, right? But like now we're learning like, you know, pick one thing that like will give you good income, but also dip dabble everywhere else. You know, have fun with your life.
>> Life is supposed to be exciting.
Exactly. You know, when you pursue your education, you pursue your career, it's great. It's a great sense of accomplishment, but it also brings revenue. And you need revenue. We live in a in a time where we definitely need monetization. We need to be able to afford a rent. I don't know about a house yet, but we need to afford a rent.
We afford a lot of things. But what it'll provide you is a freedom. Freedom to say, "Hey, I'm not happy with my life. I don't like my job. I don't like where I'm headed. I actually love baking cakes. So, why not invest in learning and opening my own cake shop, you know?"
So, that's what I say. Have fun with your life. Life is so short. I've seen people and and this generally like I mean it from the bottom of my heart.
Life is a Russian roulette. I've held I've been by the bedside of you know women younger than me who didn't make it till tomorrow. And I've been by the bedside of people way older than me who had no one by their side except me. And you would expect, right? You're like 80 years old. You have a family around you.
I've seen so much at such a young age.
And I truly believe like you don't know.
You don't know if tomorrow's a blessing.
None of us know what happens tomorrow.
You may think that someone who's like 90 and fragile and frail and has all these conditions may may pass away, but no, the younger person can pass away before them. So the minute you realize how fragile, how beautifully valuable it is to have another chance at being awake and being alive and being functional, having feet to do the hike that you want, to visit the cities that you like, to have gas in your car and driving down to the beach. The minute you realize how beautiful and how vulnerable it is to be human, you'll appreciate life more.
>> I love that. I love that. dropped the mic. I was like >> that was like the perfect like closing like I feel like you just like spoke life into me like anyone else who's going to listen to this. That's so true.
>> Yeah, that's life.
>> Yeah, >> I see. You know what I see? Like for example, when I see you, I remember like when I was young and I feel like there's like that glare.
>> You say when I was young, you are still so young, >> you know, but you know, I see that glare. I see that innocence. I see that like excitement like life didn't defeat you yet. You know, you just look it's like sparkles. And I think that's the way you have to look at life like everything's sparkling because it >> the minute you change your lens and you focus on all the negative things about the world like you as a person, you change.
>> That's true.
>> That's true. Well, thank you so much for being here.
>> Thank you for having me.
>> I'm so honored that you're here with such a light in this world.
>> No, you are too.
>> Anyone who's her patient is lucky.
Literally.
I want to ask you where can the audience follow you, look for you, how can they find you?
>> Um, so they can definitely find me on social media. I'm on Instagram. I'm under Once Upon a Doctor. I'm on Tik Tok. I'm on YouTube and yeah, you can find me in clinic.
>> All right. Well, thank you so much, Dr. Had. Thank you for being here.
>> I love you. I love everything that you're doing. You're such an inspiration to both older and younger people.
Likewise. Thank you. Thank you.
>> Bye.
>> Bye.
>> The content of this show is for educational and entertainment purposes only. It is not a substitute for individual medical or mental health advices and does not constitute or provide a patient provider relationship.
I'm just your bestie. I am not a licensed therapist or professional. And this podcast is not intended as a substitute for the advice of a physician or other qualified professional.
As always, talk to your doctor, health care provider, or professional. Talk to you soon. Bye.
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