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May 13, 2019

The hormone fix with Dr. Anna Cabeca

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If you're not managing your hormones, your body probably won't get the signals that your lifestyle changes were intended to send. Today, Dr. Cabeca and I discuss her new book, The Hormone Fix.

Allan: 01:18 Dr Cabeca, welcome to 40 plus fitness.

Dr. Cabeca: 01:20 Hi, it's great to be here with you, Allan. Thanks for having me.

Allan: 01:23 I'm a fitness guy, personal trainer and whatnot. But one of the things that I've come to recognize is that we can only do so much in the gym or on the beach or in our homes doing exercise and things like that. If we're not managing the other aspects of our lives, particular hormones, we're not really going to get to the point of health that we want to go. So I was really excited to be able to feature and talk about your book, The Hormone Fix.

Dr. Cabeca: 01:49 Oh, I'm glad. I love talking about it. And you're absolutely right. And even in my practice, right? It takes more than hormones to fix our hormones. So these are all important components that work together.

Allan: 01:59 And that's where when I got into your book, I was thinking, okay, we're going to talk about testosterone. We're going to talk about estrogen. We're going to talk about thyroid. And that's where most of the time when you start this hormone conversation, particularly for people over 40, that's the direction that conversation goes. And there's just kind of an expectation that those were going to solve everything. But you have a very different view, in my mind, of how we can fix and manage and balance our hormones.

Dr. Cabeca: 02:27 Yes, absolutely. You know, it's so true, especially as a gynecologist, I'd love to say it's all about progesterone, estrogen, even testosterone and data. But the truth is it's not. And through my own personal journey and just working with so many patients through menopausal transition, we have to get to the underlying reason, the underlying major players and those major players are insulin, cortisol and oxytocin.

Allan: 02:53 And I want to dive into each of those because I think on the show I've talked about insulin a good bit when I talk about Keto a lot and they understand that Keto is a way to manage insulin, to manage insulin resistance, so we've talked about that a good bit. I've talked about cortisol lot because that was kind of my last thing that I've been working on trying to get myself as healthy and well as I can as the stress relief of moving to Panama, having a slower pace of life, not having as many moving things that are going on you know, getting rid of a house that could get hit by a hurricane.

And then the oxytocin is kinda the one that, I know what it is, I guess, but we don't talk about it a lot. And I'll say this, I define wellness as being the healthiest fittest, happiest you can be. And this really kind of fits in that notch of that third one. But could you just kind of walk through each of those and talk about what they mean to us and our health and how getting those balanced actually kind of juxtapositions us to get the rest of them in order?

Dr. Cabeca: 03:55 Yeah, absolutely. And for so many people we don't really understand oxytocin. It's a hormone. It is the most powerful hormone in our body. At least that's my point of view. I call it the crowning hormone, the real light of hormones, and it is the hormone many women first come into contact with externally with oxytocin during labor. It's the hormone we give or we inject in women during labor and delivery to increase the amount of contraction strengths to help the baby come out and be born.

And that is that hormone, whether we've had injectable oxytocin or not that really that contracts the uterus, but that forms that bond that really defies all words, right? We can talk about this bonding with the infant, our babies, but when we feel it, when we look into that baby's eyes and we feel this imprinting, this connection, it's undeniable.

That's oxytocin. That's the power of oxytocin, the feeling of love, happiness, and I love your, I love your pillars that health, healthy, fit and happy, right? So happy is oxytocin, that happiness hormone and we can't have high, crazy stressed cortisol levels and burning ourselves out then depleting cortisol or suppressing it and healthy, happy oxytocin at the same time. It doesn't work. Not Without a lot of discipline, practice meditation and I think maybe the Dalai Lama's got it down, but for most of us, certainly for me, we feel that we find that we have that suppression oxytocin is low and cortisol's low at the same time, especially if we've been under stress for a long time and now we have this burnout phenomenon which is when we feel disconnected.

When like that person that we've loved and wanted to spend our whole life with, we no longer feel love for them and I heard my patients say that so many times and I felt and I experienced this myself, post trauma. This disconnect, this feeling of not loving the things you always loved and not wanting to do the things you've always loved doing. So that's the power of oxytocin. We also associated with joy. It's a natural pain reliever. It's a natural appetite suppressant and even studies in age, elderly, we have shown an increase in muscle growth. So this oxytocin hormone is one that we can for free, increasing our body through some great principles and practices and managing cortisol as well.

Allan: 06:28 One of the things that really, when I was reading through that, I was thinking, this makes so much sense because if you've read the blue zones or Dr Day's, The Longevity Plan, they talk about how the longest lived people on Earth have these social bonds and they're spending time socially with their family and their meals. They're sitting down together and they're having this time together where they're having that joy. They're having that laughter and that fun, and that's what's creating this hormone in circulating this hormone and it's keeping them alive longer.

Dr. Cabeca: 07:03 Yes, absolutely. That sense of community, that connection, that energetic bond. And one of the things I always tell my clients to give them a real perspectives, you know, we always talk about resveratrol right? Beautiful Antioxidant, powerful superfood resveratrol found from grapes, right? Red Wine. So we talk about have your glass of red wine, you'll get your resveratrol and that's heart healthy. But is it really? I believe that it's the community that we have that glass of wine with, the laughter, the joy, the celebration that makes that a medicinal food, right? Versus if we're drinking glass of wine by ourself tonight. That's not medicinal

Allan: 07:41 Or in your or in your pantry eating dark chocolate.

Dr. Cabeca: 07:46 Right. But I always say I love dark chocolate. I love red wine. I love coffee. And I as a researcher, I have researched thoroughly the benefits of my three vices.

Allan: 07:58 I do too. So now, you got into a concept in the book, which I've read a little bit about but not a lot. So I'm going to profess ignorance on this one and I'm going to ask you to take me down the line because we talk about having a diet that's alkaline versus acidic. And what I've known before I read the book and you kind of confirmed in the book was that our body has a pretty good mechanism for making sure there are blood acidity or ph is at a particular range and it's a very, very tight range. And if it gets outside of that range, we've got some major health problems.

Our body is very protective of making sure that we stay in the range. So I just, I guess I was confused to say, okay, if I eat the wrong foods, and obviously the foods you named as acidic, I was like, okay, well you shouldn't need a whole lot of those or any of those in some cases, the things that are alkaline, like yeah, you should be eating a lot of those where you can and it all kind of made sense. But I was wondering if I eat something that's acidic, does it affect my body that much? And in the book you kind of explain how it does.

Dr. Cabeca: 08:59 Yeah, it really does. And over time it's the wear and tear phenomenon that we experience, especially as we're getting older. So one of the things that, you're absolutely right, our blood Ph is maintained as a doctor, as a physician. If someone came in my emergency room crashing, I pull a blood arterial blood gas and I'm looking at the Ph of that blood gas. And that's from the artery in the wrist pumping, right? Blood fresh from the heart. So that's what we're talking about. That ph is so well maintained slightly offline at approximately 7.4 and it doesn't shift very rarely at all, but now the question is how do we maintain that very exact ph when the conditions are not optimal?

When we're under stress for a long time, maybe dehydrated for a long time, maybe in starvation mode for a long time eating inflammatory foods for a long time. How do we maintain that blood ph and we have to maintain it from our electrolytes, right? Our minerals and nutrients our muscle or bone and they were seeing the results of that because that's kind of like a standard American diet. So we see Osteopenia, osteoporosis in 30 year old women. I thought that was a disease of 65 year olds, you know? That's what I learned, right?

Allan: 10:20 Osteopenia typically for a healthy person, wouldn't start until they're 30 35 years old. When you go get a dexascan, the actual increments they use to base you as a 35 year old woman.

Dr. Cabeca: 10:36 As the optimum, right?

Allan: 10:37 You shouldn't be losing a lot of bone or muscle mass before the age of 35.

Dr. Cabeca: 10:42 Now ideally, but we're seeing it. And so that has a lot to do with it. So what we find is that, you know, measuring urine Ph. Urine Ph is a fabulous, easy, inexpensive way to monitor. Just like if we were checking our temperature, if or how our thermostat works on the wall to kind of maintain the good room temperature. But if we check our urinary Ph, just like the weight on the scale, it's kind of fluctuate if we've had an inflammatory food or were swollen, or for me, if I eat any dairy, I'm three pounds heavier the next day, right? So I can tell that that didn't work with my body, but I can also tell in my urine if I'm stressed, our urinary Ph drops.

So one simple thing I've had my clients do in my menopause program now, this is true for men and women because over the past several years now, I've been working with clients and working through this Keto Green concept that I talk about in my book, The Hormone Fix. And that is check, you know, test, don't guess, but check your urine because urine Ph is a marker is a guide, is an indicator of okay, bodies doing great. No, maybe is under a little bit stress. Maybe it's pulling some nutrients and urinary Ph will tell us that.

Healthy urinary Ph is seven or seven to eight and it will naturally go down after your intense workout, right? We expect to see lactic acid secreted in the blood during a workout and also cortisol during the workout and Cortisol sensitizes these receptors and the kidney, and we get a decrease in urinary Ph. So that's expected. But should it be expected after we eat, you know, depending on what we're eating. Say for example of I eat some dairy, my urinary Ph drops because it's a food sensitivity to me and it creates an inflammatory markers.

So it's interesting. It's part of just those clues, just being able to discern. Okay, this works good for me, this doesn't work good for me. And our body or cellular Ph is different at different places in our body our skin's a little acidic, the vagina's acidic, the stomach's acidic, the urine typically should be alkaline. And so different areas of our body will have different pages or saliva should be outlined. Our tears are alkaline. And so that's why when we jumped into a pool, it's slightly alkaline so it doesn't irritate our mucus membranes.

So it's interesting how we can look and see what, how our body is reacting to our nourishment and our environment. And this is true in both men and women. And so when I came across this easy and expensive marker, right? Cause I've done the guy's position, I've ordered thousands of dollars of testing and functional lab tests for my private clients and this tells us so much more. This helps the patient. This helps each individual figure out, okay, this is working for me, I need more alkalinizers in my diet, so more of the low carbohydrate. Dark, leafy green, mineral rich organic veggies as much as possible to help from that aspect. I also need to stress manage, and sleep well, and meditate. And get outside more.

Those are other things that help our body become more our urinary ph increase in alkalinity. The research has shown that when we see a healthier urine Ph that a higher urinary Ph is associated with less metabolic disease, less hypertension, less diabetes and less inflammatory conditions. So that's why I love it.

Allan: 14:13 Yeah and you got to that section and it was so interesting cause like measure for success and then you know that's kind of a standard business monitoring and I get 30 years in the corporate and it was, what you measure gets managed, the whole the tenant there. And I was thinking, okay so here's going to be a list of labs that we can run out and we can get tested and figure it out. But you took a little twist to that as well in that a lot of the stuff, a lot of the things that we can measure that they're free.

I mean how you're sleeping, how you're doing, and you have a series of almost like quizzes and tools in there to go through a series of tests as you will, that don't involve you getting pricked with a needle or going through anything kind of crazy like spitting into a tube all day long. Can you talk a little bit about some of these measurements that we can do? You talked about Ph of the urine and then you dropped the bomb on them too, as we're talking about Keto here. So can you kinda talk a little bit about some of those measures that we can do that are cost effective and will give us a lot of information about how our hormones are balanced?

Dr. Cabeca: 15:14 Yeah, This is something that I practice. When I went to medical school, I really didn't know how it was going to pay for it, but I was blessed and I received a National Health Service Corps Scholar scholarship. So after residency, my ob Gyn residency, I came to southeast Georgia, small area. So I had quite a diverse range of clients, but I was the only bilingual obstetrician. So I had very much wide range of clients and also from the islands, the Sapelo island, the shrimping area, so very low economic areas. And I had to get really creative.

So really found that the art of medicine is in listening to the patient. Right? And it sounds so simple, but it's absolutely true. So these inventories that I created, or checklists, I hope people love checklists as much as I do, but I know if I have something on a checklist, I've got to check it off. And so I created a checklist but also inventories questions like how am I doing today? How am I doing in a week, a month from now? And that's where these inventories really help at a fraction of the cost. And I can see despite what the labs are saying, cause we always say treat the patient, not the labs, right? We look at the labs for guidance, but want to treat the patient, not the labs. And that's really important because normal is not optimal and we want to be optimized.

Allan: 16:34 So let's look at a normal is not optimal. I love that because I mean, bless them. Seven minutes in and out, everything looks fine. See you next time. You know, I don't feel fine. You know, my energy level's down I'm fatigue, I've got pain, my joints hurt, you have these issues and you're normal and we are kind of taught a little bit to kind of accept that that's normal.

And if that's not going to answer for us, well here's a pill. This will deal with the pain or the inflammation. So I like that you have these kind of measures where we can look at this because most of the folks I'll deal with, I'll be honest with you, they come to me because they want to lose weight and I'll say, okay, wait is one measure, but it can't be the only measure because you're going to love yourself one day and then you're going to hate yourself the next if that's the only measure you have. So I like that you've given us these inventories so that we can go through and say, okay, how did I sleep? How do I feel? What's my energy level? What's my Ph? I like the fact that you've given us a lot of these little tools that we can measure so we can know that there's progress.

Dr. Cabeca: 17:35 Yeah, you're exactly right. Like we want to look well, right? But optimally we want to feel well in our bodies and so many of us have Yoyo Diet and over the years I was a fat kid. I struggled with my weight my entire life, been over 240 pounds and was diagnosed menopausal. Reverse that as part of my journey that I talk about in my book, but I've been there. I've struggled with my weight. The most important thing is that we feel well because feeling well gives us willpower. Feeling well helps us make right choices. Feeling well is sustainable long term. We have the clarity of thought, we have the financial success, which comes with clarity of thought and those are, those are part of living an optimal life, right?

Allan: 18:20 Yes. So your book, basically the plan or where we're going to go with this is that you said, okay, there's a place for Ketosis to help balance hormones and there's a place for an alkaline diet to help and there's evidence to support both of those. But you marry them together to come up with what you call Keto Green. Can you kind of explain the Keto Green way of eating and how it's going to help us feel better, be better and optimize our health?

Dr. Cabeca: 18:48 Yeah, absolutely. So when I hit in reality, I hit menopause a second time in my late forties, 48. And after having kept 80 pounds off for nearly a decade, watching the weight creep on, but struggling with focus, struggling with memory, struggling with relationships, all of that. But yet I knew I needed to get this weight off. And so that's when I pushed for getting my body into ketosis or doing a ketogenic diet. And however, you know, I've known about ketogenic diets, low carbohydrate diet types for decades and for my neurologic patients, Parkinson's, seizures, etc.

But whenever I would put, especially a peri-menopausal client on it, she would come back and say, I feel irritable. I don't like how I feel on it. And that's what I experienced to Allan. I call it go and keto crazy. And I talk about this in the book, but let me tell you, if you're a mom, you've got teenagers, small kids, you cannot afford to meet irritable on edge and Keto crazy, that's for sure. So I wanted to figure out what was going on. And so that's when I just said, okay, well what's happening to my body? And I just started testing my urine again cause there's a functional medicine doc I always have my clients check their urine, get alkaline. And that's something that really helped me and restoring my health in my late thirties so I started checking my urine. It was persistently five. That's the lowest Ph on my strip. It was five. Who knows what it was, but it was five or less. I'm like, no wonder I feel crappy. Right?

There's probably inflammation going on and don't have the nutrients to nourish myself. Cell function membrane, not to mention neurotransmitter support. And so it was like, okay, well let me add in Greens. It's adding the alkalinizes the Greens, and let's just bump this up, get alkaline and focus on that and then go back into ketosis. And that was a huge combination. That was a huge awakening for me. An aha moments like, wow man, this feels amazing.

And I looked in literature like half the world, over half the world fast, regularly Orthodox Christians fast, 250 days a year. Catholics on general, if they're following it fast or some type of fast every Sunday to have breakfast after communion, there's fast and lint, 40 days of fasting. There's fast built into traditions over the millennia and tied to spirituality. Because what I experienced was this, I call it energized, enlightenment, this real clarity. This spiritual connection, and from going to a place where I used to have excellent memory, a hundred percent visual memory, to having brain fog, losing my memory, losing my focus to regaining that at a higher level was incredibly enlightening as well.

And that led me to look into the research and say, surely I'm not the only one who's put these two together, but there was one paper published in 1924 out of Cambridge that looked at combining alkalinity or alkalosis with ketosis and it was an Aha moment for me. It's like, yes, this is the key. This is how we really can create a healthy cellular and hormonal balance and it helps to modulate cortisol. If we're looking at our urinary Ph, a healthy or urinary Ph is associated with a healthy circadian rhythm or healthy cortisol levels versus high cortisol is associated with low ph and we know, again, high cortisol over time burns us out, does not give us that happy feeling and kind of fights with oxytocin on the battlefield, so to speak.

Allan: 22:16 Yeah, and the fact that you're in Ketosis means you're managing your insulin at a relatively low level, you're making and potentially fixing insulin resistance, so it's a kind of a win win.

Dr. Cabeca: 22:27 Yes, exactly. That insulin sensitivity with the Ketosis, the green component, helping with cortisol management, and then bring in oxytocin, the principles and practices to create a quality, happy, joyful life. Then we have your healthy fit, happy mantra.

Allan: 22:44 Yes, I'm sitting back and I'm on social media and I'm following a lot of people and seeing what people out there doing to kind of get an idea of what the trends are. And one of the kind of the trends that I'm really, really struggling with right now is this carnivore diet and its keto, but it's just meat and eggs and it's kind of a scary because I don't know what that train wreck is gonna look like when they're done. You need nutrients from vegetables and fruits at some level. Now, not a lot of fruits necessarily, but you do need things from those. If you're not getting those, I just don't know what the long term ramifications are going to be.

Dr. Cabeca: 23:19 I agree with you and believe me, I speak at KetoCon and will be speaking there in the summer at the end of June again. And I love those guys. And Brian, the Creator of KetoCon he is a keto Carnivore and I was like, Brian, I don't know about your, you know, maybe we should be checking your neurotransmitter, we should we watched in your hormones. But bottom line is men and women are different, but all diets throughout millennia that have been successful have a strong plant based component.

I mean we need the micro nutrients from plants, but what could someone who is not able to get those plants, what do they do in order to nourish their body? And that's what I've researched. I'm like, well, you know, they talk that Ketogenic people talk about the Inuits, Alaskan natives that eat basically fatty fish, right? And that's their diet, but they don't only. They also have the huge bone broth going nonstop that they will sip on. That's minerals, that's fish bone broth that's rich in minerals to renourish their body. So intuitively or through necessity over time, they added in that alkaline or that green component through the mineral broth or bone broth. Isn't that cool?

Allan: 24:29 Yeah, it is. Because one of the things that I was kinda going through structurally, my mind, and I talked about this in my book, is I believe that we're opportunistic eaters and that's one of the problems with having a Mcdonald's and a Starbucks on every corner is that our ancestors would eat what was available in the season it was available. And so I could see being from northern Europe or the northern Americans, there would be whole periods of time when there wouldn't be much plant matter at all. So you are at that point relying on animal products to sustain you.

But then yes, the springs can roll around and there's going to be some foliage is gonna be some plant matter that you can eat. And I think that would just be a time when we would effectively go nuts because it was available. And so I just kind of looked at it and say, okay, maybe being carnivore for a period of a few weeks or a month, a couple months maybe. That might've been something that would've happened in our ancestors past. But it's when the plants came around again and were available because they don't fight back and they're easy to catch because they don't run or swim away. So I just think that when you look at what our ancestors did and try to look at it reasonably even talked about this a little bit about the different ways that people ate and the study that I guess looked at several of them and 87% of them were alkaline.

Dr. Cabeca: 25:46 Yeah, exactly. I mean how cool is that at some point. And then you think about traditions again thinking as the fasting time periods, when are the majority of fasting time periods based in regions and the winter months? So lent is typically at the end of the winter season, so most likely fresh greens, lots of foods aren't available. The resources, stocks, stocks piles or the pantries are very, very low so to speak. And so there's a practical component.

So as you were talking, it just brings to mind that we had the keto carnivore, again, some people can do it. But I think, you know, if they can do it. Men and women are different women who are my primary clients that I work with and and suffer with and feast with we have to recognize that we are different and we can't do things that guys will do. Guys will do my program with their wife and or partner and they will do two, three times better, faster. They will lose two to three times as much weight faster they will feel better, faster.

That's just it. We are different. Men and women are different. All hormones are different, but I created the Keto Green way, the diet and lifestyle component to really optimize how we are as women as well. To really get into these little nuances, the insulin, the cortisol. And then of course the oxytocin, what really matters to us most and bring that into this place. But when you were talking I was thinking we need responsible eating, right? Responsible moderation or responsible feasting as we are as a community and as a society to be able to enjoy and indulge, but really nourish our bodies in ways that make sense. And this is when I teach physicians, I always say practice medicine that makes sense. We need to take that internally to our life. Okay, well what really makes sense? What's sustainable and how do I know what's working for me specifically?

Allan: 27:41 I couldn't agree more. And I liked what you said there, that food Keto Green way of eating is kind of the base for this program. But there is an entire lifestyle component I kind of wish we had some time to get into, but we're running low.

I define wellness as being the healthiest, fittest and happiest you can be. What are three strategies or tactics to get and stay well,

Dr. Cabeca: 28:06 Wow. I definitely, initially I would always say we want to start we want to go Keto Green, right? That's really important. I've been in this moment of reflection, just looking at my life over the past years and decades, you know, going from that struggle, dealing with to menopause as early menopause at 38 going through another transition time at 48 and struggling at that point with so many aspects of my life till I turned it around, this Keto green way.

And the first thing it came down to like this mantra for myself, this strategy is number one, pause. We have to pause, take pause, be present. Really, I'd be able to just be in the moment. So I would say pause and then pray and the third is prioritized. So pause, let's get in the moment. Let's really understand where am I right now. Be able to accept that. Pause, like let everything else that's going around to stop the busy stuff stopped the racing. And for myself, I always say I went around the world to find out that everywhere you go there you are right? So pause is a real big one for me. I had to settle, I had to stop and really evaluate.

And then the second again, pray. Just being able to meditate, pray, listen to that still small voice within you. The one that knows. Oh yeah, I thought so. Oh, you know, I've been thinking about that or, I've been wanting to do that for years. So give yourself that time to get into that space and then prioritize what means most for you in your life. What are the things and people that mean most for you and your life? Allan, I admire you for leaving everything that you had and moving to a new place, a new land so that you prioritize your relationship and the rest of your lives. And that's key. That's goes a big way. Big, long way.

Allan: 29:46 Yeah, those are great. And it was, you know, I'm here on an island and in the morning time it's really, really quiet. There's a lot of activity during the day, and you probably can hear some of that on this, on this interview, but I got up this morning about sunrise and went out and did a walk on the beach and just kind of just enjoyed nature, enjoy being there and feel really good about it. So I like all three of those.

So thank you for sharing that. So Dr. Cabeca, if someone wanted to get in touch with you, learn more about the book, The Hormone Fix, where would you like for me to send them?

Dr. Cabeca: 30:17 Well, I would love for them to take a look at my book. I really feel there are gems in there for everyone and it's at dranna.com/book and there'll be information and a free sneak peek into my book, The Hormone Effects.

Allan: 30:33 Okay, well this is episode 381 so you can go to 40plusfitnesspodcast.com/381 and I'll be sure to have the link there. So Dr. Cabeca, thank you so much for being a part of 40 plus fitness.

Dr. Cabeca: 30:46 Thank you for having me.

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