Dr.

DeRosa,

welcome to the show.

Thank you for joining True Hope Cast.

How are you today?

I am doing fabulously and delighted to be talking

with you.

Thank you so much for having me,

Simon.

Of course,

it's a very funky chair you've got there as well.

As a redhead,

I'm obligated to have funky things around me,

but I love all things animal print.

I love the obligation.

That's great.

Just as an introduction,

can you just tell our audience who you are,

what you do?

I am an internal medicine physician by training,

but I have managed to carve out a pretty

interesting niche in my career of being a hormone

specialist,

in particular women's health,

but certainly we love the men as well.

All of this didn't come by accident.

I'm sure you've looked over my bio and my story,

but for your audience,

it's always amazing to me.

It's always those professional and personal

collisions that often lead to your biggest missions

in life.

I know specifically what mine was.

When I was 35,

I went through full-blown menopause,

but I didn't really figure out what was going on

to me in my 20s when I was in medical school and

residency when I was having a whole host of

perimenopausal symptoms and completely dismissed by

my colleagues and medical profession as a whole.

In fact,

it was deemed crazy or it's all in your head or

all those hedonistic things that we love to do,

but here I was smacked up in the middle of it.

It became my personal mission and I vowed to

never,

ever let a woman ever have to undergo the care

that I received and the total dismissive tone and

demeaning nature of medicine at that time.

It became really an interesting goal to really be

able to take an internal medicine,

which is very conventional training,

and meld it with all my understanding and learning

of hormonal health over the last 30 years now.

It has been quite a journey,

but one filled with love and a very distinct

passion.

This is not something I dabble in.

This is something that I've gone to great lengths

to be able to become an expert in.

How amazing that you used that terrible experience

to fuel yourself into such a passionate project

because so many other people would have probably

just gone a different path and got themselves out

of there and maybe even quit and done something

differently.

Thank you.

Honestly,

I knew that I couldn't continue down the path of

internal medicine the way I was going because I

also realized that I was becoming part of the

problem that creates that scenario.

It's really a new way of thinking and not only

dismissing hormones and the role they play in

women,

and also looking and really delving deeply into all

the symptom complexes that go with that,

but also really fully understanding the way hormones

affect chronic disease state development and how we

can prevent that.

?????????? is essentially giving them a D.S.

and like,

Slowie or Foot Relaxation.

hundreds of medications like anti opressantsleep

pills anti anxiety pills,

plus all these different meds that we give patients

every single day that stem from root cause hormone

deficiencies that we completely ignore and women in

particular hormones and,

hormone health.

So,

so,

so dismissed in the in the conventional model it's

mind-blowing.

Well,

I think there is,

and I always hate to be the conspiracy theorist,

but in this regard I'm going to be because I've

also had firsthand experience in the pharmaceutical

industry - I worked 10 years at Procter and Gamble

to help them develop a testosterone patch and also

a female osteoporosis drug.

And I saw the inner workings of big pharma,

and I'm going to say this caveat right up front:

is that I'm not against big pharma what I'm

against is excluding other therapies that could be

highly beneficial to patients and not just going

down one path where you always have to put people

on medication.

But hormones are largely dismissed because there's a

very lack of great understanding related to it,

but they also don't make pharmaceutical companies a

boatload of money because bioidentical hormones are

something that cannot be patented and therefore

companies cannot protect the patent and therefore

can't make billions of dollars off of those

patents.

It is actually,

they make a ton of money by selling us drugs to

control symptoms of hormone deficiencies and they

want to keep us sick.

The whole medical system is designed at treating

illness.

And giving people medication,

again,

it's not we shouldn't give people medication.

We should give people medication when appropriate,

but they shouldn't be a quick go-to when hormone

imbalances can often lead to problems that lead to

chronic illness.

So to give you an example,

testosterone deficiency in both men and women will

lead to insulin resistance because when we eat a

meal,

everybody takes that glucose that we just consumed.

Everything we eat converts to straight up glucose.

Now if you eat a chicken breast,

it's going to be a slow glucose uptake versus a

candy bar which is going to be a rapid increase

immediately,

which is harder.

For the body to deal with,

but either way it still converts to glucose.

Well,

where does it go?

Well,

it has to move into the muscle to burn for clean

energy and fuel the body.

Well,

if you actually think about it,

people don't realize it's testosterone's job to

sensitize that muscle so it can uptake it in and

burn it clean for fuel,

which is why you guys burn energy can lose weight

way better than we can.

We're biologically behind the eight ball because you

have more muscle to begin with and you have more

testosterone.

So as we get older and women but we don't talk

about testosterone is our most abundant hormone and

it's actually made in greater daily amounts.

-day than we do estradiol and men are predominantly

testosterone,

even though you guys don't have testosterone,

but you guys make a little estradiol too.

But that testosterone,

we start to lose in our 30s and men start to

decline in their 40s.

And what happens is when you lose that hormone,

we don't burn glucose effectively anymore.

So what happens is the pancreas kicks in now uses

insulin to deal with that glucose which first loves

to store it as fat right in that midsection,

which we all dread and hate.

But then the pancreas burns out,

which leads to pre-diabetes and then ultimately

diabetes and then cardiovascular disease.

and then diabetes and then cardiovascular disease

and then diabetes and then cardiovascular disease

but instead of thinking about that role of that

hormone we tell patients to go eat better go

exercise which they're fighting a losing battle if

their body doesn't have the tool to deal with it

although those activities are helpful but then we

put them on metformin and then they don't get

better and then ultimately we add more medications

they end up on insulin and they go down this path

and we keep piling on more and more meds and they

never get the proper tools to properly correct the

underlying root cause and they end

Up with cardiovascular disease,

heart attacks,

and strokes,

and it could,

could all be stopped,

or at least mitigated by starting testosterone

therapy.

But think of all the drugs that those patients get

put on,

and the profits that go into the medical industry.

Do you see a way out of that patented model?

Oh,

absolutely.

And what's the good news with all this,

although it can be very depressing when you start

to think about it,

is there's a lot more docs who are going into the

field of what we would call integrative medicine,

or functional medicine,

or holistic medicine,

or hormonal health,

so there's a whole slew of us that are saying

enough is enough,

and we're seeing that medicine isn't getting any

better.

And in fact,

in the last 20 years,

I've seen a decline in preventative strategies on

the conventional side,

people being put on more and more medications,

and doctors and nurse practitioners and other

providers losing autonomy and practicing for their

individual patients.

And a lot of us are just saying,

done,

we don't want to do that anymore.

We want to work on a model that we know can be

helpful,

get our patients living better,

more optimal lives,

and we're going into those specialty fields.

But unfortunately,

we're getting a lot of bows and arrows flung at

us by the conventional folks.

Yeah,

absolutely.

Soon we're going to be the majority.

Yeah,

I mean,

you see,

I mean,

you can go to kind of anywhere in the world these

days,

to most cities,

and you can look up a functional practitioner or

an integrated practitioner,

and they've all done incredible training.

And most likely gone through a similar experience

as you did,

went into the conventional model,

looking to help people,

noticed there was some big,

big things going wrong there.

And you know,

you genuinely really wanted to help people and

you're able to find that niche,

find that passion.

And usually,

you know,

you've gone through something personally as well,

which obviously usually helps.

Well,

it's interesting; one of my colleagues,

she's just,

she's probably one of the most brilliant women I've

ever met.

She's a triple-boarded and intensivist,

trauma surgery,

and ER,

and also does various other things in the medical

field.

And she's also an ultra-marathon runner.

So,

I mean,

she's highly underrated.

She's an ultra-marathon runner,

and she's a triple-boarded and intensivist,

trauma surgery,

and ER,

and also does various other things in the medical

field.

You know,

but here she said enough,

I don't want to be constantly opening people up

and amputating limbs and all this stuff for people

who aren't taking care of themselves in a medical

profession that doesn't really help them.

She quit it all.

And she was making a killer salary.

And she's starting a functional medicine practice.

And I'm just so proud of her.

But then those are the things that finally people

get fed up and they want to really,

we really want to help people and conventional

medicine doesn't do a lot of that.

I've had an experience in the last year of working

with children,

like pediatricians,

and people who work with kids who have

unfortunately,

you know,

genetically been born with something.

And the the motivation and the energy and the

passion and the love around that type of doctor,

and then somebody who is treating the same person

with the same issue,

who's not going home and doing the work,

you know,

to get better.

There's a completely different energy and aura

around those two,

two types of practitioner.

And that's obviously what we want to see within

any model,

it is that that level of that level of care and

passion,

because I'm a practicing nutritionist.

And it's very,

very difficult when I have a client who keeps

coming back to me and keeps paying me money to

come and sit with me,

but is not ready yet to go home and really put

the work in.

And it's,

it can be it can be quite frustrating.

Well,

and also,

and I and I try not to berate my patients right

out of the gate,

because I always tell my patients,

it would be absolutely absurd for me to sit here

and flagellate you and say,

go diet and exercise,

when let's say their thyroid metabolism is low and

not helping them or their testosterone deficient,

and they can't properly burn sugar.

So until I give those tools back for them to

properly functioning,

they're going to continue to beat their head

against the wall.

And they could even institute the right activities,

and they're going to struggle and not get anywhere.

So I always tell them,

I give them a pass until I get their hormones,

then they got to get behind me,

because then their body is going to be optimized.

And often when you think about testosterone,

not only with glucose metabolism,

but it affects motivation,

and it affects libido,

it affects our overall how we feel about ourselves,

it affects so many other things,

our muscle energy,

our endurance.

So if you're missing those things,

you may go work out and you're going to feel

horrible afterwards.

Or you just don't have the energy or motivation to

do it.

And if we can kick those in biologically,

through natural substrates,

we should give our patients the tools before we

sit there.

So I mean,

when someone's coming to you,

they're probably not going to be able to do it.

But if you're going to do it,

you're going to be highly motivated,

unless they have those things already fixed.

And as I said,

traditional medicine,

so depressing,

because nobody gets better.

But when you start to give back the body the

tools it needs itself,

it's just like the osteopathic principles,

the body has the innate ability to heal itself,

you just have to give it the proper tools.

And nutrition is a huge piece of that.

But unfortunately,

we have to get patients motivated to want to go

do that.

Absolutely,

and really want to take care of themselves rather

than just wanting to give the responsibility of

their own healing.

Yeah,

absolutely.

So when it comes to hormone health,

menopause,

and all that,

you know,

you got the Dr.

Hot Flash thing going on.

I want to talk to let's talk about that for a

second.

How'd you get that nickname?

It actually came from my best friend.

It was interesting.

She came to see me as a patient many,

many years ago.

And she just quit,

she goes,

'Oh,

you're because I told her my story.' And then she

goes,

'She was dealing with all these hot flashes.' And

she was like,

'Oh,

you're not going to heal.' And then hers all went

away.

She goes,

'Really,

you're just the greatest doctor.' And she goes,

'Dr.

Hot Flash.'

I go,

'Whoa,

that just kind of stuck.' And I had to fire her

as a patient because I wanted to be your friend.

So she saw one of my colleagues continue to be

friends with her.

So she became one of my closest,

dearest friends,

but she was her her calling.

So I have to give her credit for it.

That's great.

I love it.

How uneducated are most people when it comes to

female hormone health?

We'll get on to the guys.

Yeah,

we'll get on to the guys later.

But you know,

let's talk about let's talk about female hormone

health.

Because we're not taught about in school in

biology,

really,

I don't think I don't remember hearing anything

about it.

But when I went to nutrition school for three

years,

you know,

it was extensive.

And it was amazing.

And it blew my mind.

I was 30 years old at the time.

And I was like,

how do I not know this information?

One,

it's absolutely fascinating and incredible.

And what the body does.

And two,

it's like,

I think,

you know,

if I've got a partner,

I've got a partner,

I should,

it can serve me very well in the relationship very

well,

if I actually have a basic understanding about the

biology of my partner,

you know,

so you say,

most people are very uneducated when it comes to

it.

So it's like,

you know,

that that's a problem,

right?

It's a huge problem.

And interestingly,

I'm seeing actually more of the lay population

learning a lot more than doctors do,

because they're highly motivated,

because they know something's wrong.

And they're seeking answers.

So they're finding folks like myself are doing

their research and coming across things.

But in medical school or residency,

I mean,

very little attention is paid to female physiology.

And again,

that dismissive nature,

but I think it's because people just think it's in

this kind of black box,

or it's so complicated to understand that nobody

takes the time to do it.

And they rely on,

again,

big pharma to give them the information that they

need in regards to female health,

and it's very skewed.

So it really takes a clinician to have the desire

to want to actually seek out the real information,

because nothing makes me more crazy when I hear

'Oh,

doctors say',

well,

there is no data about that.

I'm like,

No,

you're just an idiot,

because there's plenty of data,

you've just chosen not to go look at it or find

it.

And it's all there.

And it's highly compelling and very evidence-based

medicine.

But it's really a problem.

Because unfortunately,

there's huge conflicts of interest to in the

education that physicians obtain.

So for instance,

when we look at a lot of the big societies,

and I'm going to throw out one,

like,

the North American Menopause Society,

or the Endocrine Society,

or various other societies,

there's supposed to be non-conflicted organizations

that give non-conflicted advice and guidelines to

clinicians to practice in certain treatment

modalities.

And unfortunately,

with women,

we've gotten really pigeonholed into the OB-Gyne

space - that's where women's health is supposed to

be delivered.

But OB-Gyne is in particular,

and I love OB-Gyne,

my best one of my dearest friends is an OB-Gyne.

They're trained to be surgeons.

And they're trained to deliver babies,

but they get zero more education on hormonal health

than your standard practitioner.

So women are largely going to those clinicians,

and they're not getting what they need on the

hormonal side,

and they have an or they're getting really bad

information.

But back to the society.

So like the American College of Obstetrics and

Gynecology,

all these other societies,

they're putting out guidelines that are that are

based on a lot of the data that's coming from the

pharmaceutical industry,

which when you look at those organizations,

they're actually funded by big pharma.

So you until you have guidelines that are not

conflicted,

I'm always suspect of how they're making

recommendations,

and you have to take it with a grain of salt and

look at the data in total.

Because oftentimes,

they rely just on the data that their board

members who have sat on those pharmaceutical

industries are delivering autopharma,

and then they exclude,

say,

compounding medicine or other things that can be

highly beneficial,

but they don't want them to compete with.

So again,

there's a level of skepticism.

And again,

it's pharma or the FDA,

or any of those folks,

or these societies,

but there's a huge amount of conflict all amongst

them.

And you follow the money trails.

And it's,

it's impressive to see the conflict of interest

that's going on.

Yeah,

I mean,

when you when you know,

we're talking about female hormone health is

pigeonholed into in a certain category.

And the science obviously emerges,

but like to make significant educational changes

within criteria in universities that for that

aspect,

we're talking about decades,

it takes so long.

Oh,

yeah.

To go through so much red tape.

And arguably,

a lot of these universities are significantly funded

by pharmaceutical companies anyway.

So it's actually start reeducating doctors and

practitioners,

dietitians,

you know,

whoever,

it's a very hard process to crack.

So yeah,

you should say a lot of people,

a lot of a lot of patients are going to be a

lot more knowledgeable than the average GP,

especially when we've got this incredible world of

loads of people.

And,

you know,

diving off the conventional track and and creating

content and creating information for people to grab

a hold of because there is just this,

especially within hormone health,

there is this,

this urge to understand because it is complex is

fascinating,

but like,

everybody experiences hormonal imbalances.

And we have this massive chronic problem across the

Western world,

when it comes to hormone health.

So yeah,

it's,

it's tricky when it comes to I mean,

look at and if it's like the guidelines too,

by the time they come,

out,

they're already 15 years out.

I mean,

problem,

you're,

you're way behind the eight ball when it comes to

innovation.

So that's,

that's also,

yeah,

it's a big,

that's a big issue.

So when it comes to like the actual medical

school,

what,

how much because we hear about,

like,

how little nutrition is focused in medical school.

And there's,

you know,

like,

yeah,

you can get to so many different things like that.

But like,

when it comes to like hormone health,

for example,

what would you say?

It's minimal,

because like,

it's minimal,

is it because like,

the it's complex,

or it's not important?

Or most GPS?

I think that you learned the basic endocrine

system,

but I don't think they really teach folks how to

apply it clinically.

Other well,

in particular,

well,

that's not a such as they do it for various

disease states.

But for some women,

for some reason,

the female ovarian system and that particular

endocrine site has been completely dismissed.

So what's interesting is men: Men walk into an

office with testosterone deficiency symptoms and low

testosterone.

They're going to get absolutely treated with the

testosterone products that are out there.

They have erectile dysfunction drugs.

A woman actually exhibits the same symptoms as men

do with testosterone deficiency.

But we walk into an office,

we have zero commercially available testosterone

products.

So we have to compound it,

which everyone's against,

but it's highly safe in the right environment.

And we have no drugs to treat low libido other

than like,

again,

they give us antidepressants.

So every recommendation on the menopausal side is

give us like Prozac for God's sakes.

So we get,

you guys get the drugs you need.

We get psych drugs.

So the gender bias is just mind-numbing,

but it's also interesting.

And everyone says,

oh,

isn't menopause a natural state?

We should just ignore it.

But no,

biologically we shouldn't.

To give you an example.

And I just,

and I,

forgive me if this gets a little complex,

but it will illustrate the point so beautifully.

When,

so there's a hormone called TSH,

thyroid stimulating hormone.

And a lot of you,

for the listeners out there,

when you go to a doctor and you complain of

thyroid symptoms,

so you think you're low thyroid,

gaining weight,

constipation,

losing your hair,

dry skin,

dry hair,

all these various things that,

but most often people get fatigued and gain weight

with thyroid disorders.

But hair loss is a big part of that as well.

And you're sitting there clinically with all the

hypothyroid symptoms.

We do the exam.

They look like they're hypothyroid.

Well,

clinicians in your conventional system are going to

send off the blood work TSH and T4,

and that's a standard blood work,

but it's not the only stuff that we should be

looking at.

We should be looking at active hormones and other

things that they may understand.

But back to the original point,

if your TSH thyroid-stimulating hormone is high,

it's telling us it's actually an inverse

relationship.

So I,

I called.

Thyroid stimulating hormone,

the whip,

it's the whip that the brain puts out when it's

really ticked off with the thyroid,

it's going to beat the thyroid,

make it to make its thyroid hormone.

So the higher the whip goes up,

the more upset the brain is and wants the thyroid

to work.

So when it goes over four,

we diagnose people with hypothyroidism.

Well,

we see patients all the time with TSHs of 40,

60,

100,

they're markedly hypothyroid.

We jump all over that all the time.

Endocrinologists do.

I mean,

even your conventional doctors are going to jump

all over that thyroid because the body's telling us

that the thyroid is low and it's problematic.

Well,

why is it then the ovary does the same thing?

So when the brain senses that it stopped making

its hormones,

so the patient goes into menopause,

the estrogen levels drop,

the testosterone drops,

the brain does the exact same thing.

It pumps out a hormone called FSH,

follicle stimulating hormone.

So the more upset the brain is,

the more upset it is.

The more upset the brain gets,

the more it secretes this hormone.

So it will go up 40,

60,

80,

100,

illustrating that it is highly upset with the

hormone imbalance from the ovary at that given

time.

And it physiologically wants to fix it.

Well,

if the brain didn't want that to normalize,

why would that hormone stay elevated to the day we

die?

Because just like thyroids,

but we don't ignore thyroid,

but for some reason,

our brain and our body is physiologically telling

us it has missing a very high hormone.

It's a very dire hormone that is not being

produced and it's trying to attempt the body to

fix it,

but we ignore it medically and it's wrong

physiologically.

So understandably that we were never meant to have

babies after our fifties,

it would be ludicrous to get pregnant at 60,

70,

80.

And that's why mother nature shuts down that ovary.

So we don't get pregnant because we want to be

able to care for our babies into our old age and

not die before their adulthood.

So biologically.

It makes sense,

but there's this indirect consequence of us also

losing the hormones that the ovary made to sustain

the quality of our life and not developing that

chronic illness and disease state and aging rapidly.

So,

but we ignore FSH,

but we treat TSH.

And I always,

when I lecture to physicians,

I say,

explain that to me.

Why is that one important?

And that one,

not the body's still telling you the same problem,

but it's just a different organ system.

But biologically,

it's a problem.

So what are the responses when you tell this to

practitioners,

like,

why are we not?

It's like kind of dumb looks at first,

like what?

And then they kind of start to process it.

And all I'm hoping is that I'm driving home a

biologically simple point that any other endocrine

system in the body that does that exact same

feedback mechanism,

we get all over and treat,

but the only one that we ignore is the ovary and

with women.

And we obviously have this from,

from the brain.

Yeah.

We have the same thing,

whether it's FSH or TSH,

there's a,

there's a cascade that happens throughout the body.

And we have this.

And we have other cascades in our adrenals.

We have them in our pituitary,

the exact same thing happens to a man.

We treat them,

but with women,

why do we ignore that for women?

I don't know,

Angela,

I wish I knew it's the conundrum of the day.

I know if someone's going to figure it out,

it's going to be you.

I'm trying.

I'm trying to fight the fight.

When it comes to men.

Yeah.

And like hearing the actual words,

hormone health,

I feel that,

um,

a lot of them feel that hormones is a female

thing in my experience anyway,

with,

with chatting with guys about this,

this type of thing,

but how kind of wrong is it?

And how would you advise more men to learn about

hormones?

Cause obviously,

well,

I think more men should learn about their own

hormones,

but I love that you're an evolved male and you've

learned about your,

their wife's hormones too,

because it's really important for relationships,

for each side to understand what the other side is

going through.

And I always encourage men to read my book as

much as I encourage my patients because it's

important if they can understand what's happening,

they will take it.

They won't take it as personally,

and they may be more invested in the outcome,

but also men struggle and we're seeing it more and

more.

And when I started my practice,

men very rarely came to the office,

but we're seeing a large influx of men into our

practices.

And with,

I,

and I believe like when you look at men,

women,

for instance,

the average age of menopause is certainly getting

earlier.

I believe women are starting their period sooner,

and they're going through menopause earlier,

and it has to do with environmental factors.

I mean,

antibiotics in our food,

God knows it's in the water,

various other stressors that our body undergoes,

but I'm also seeing a shift in men where younger

men are also struggling with hormone imbalances

where say they may start having them in their

sixties before now we're seeing it regularly in the

forties and scarily we're seeing them in the

twenties and thirties,

and a lot of men.

And a lot of it can be impactful.

We're seeing more and more recreational marijuana

use,

and the men seem more predominant there to engage

in that activity,

which leads to testosterone deficiency and estrogen

excesses or a lot of men; just like women,

they struggle with body dysmorphia and image

problems now too.

And they're jacking up on anabolic steroids and

putting all this crap in their bodies to try to

get big.

And it just killed their testicles and ability to

produce the hormones they need.

And they start to struggle very rapidly with it;

they get the hormone deficiency symptoms.

I mean,

again,

when you look at testosterone deficiency in both

men and women,

it's the low libido,

migraine headaches,

lack of muscle energy,

that lack of killer instinct,

new onset mood disorders,

panic,

apathy,

glucose intolerance.

I mean,

a whole host of things,

infertility,

men can't get women pregnant.

And that's often when we identify some of those

things or they get,

if they get weight gain too,

then they get the estrogen excess,

which can lead to weepiness.

The man.

The man boobs,

uh,

prosthetic hypertrophy and prostate cancer and,

um,

erectile dysfunction and impotence.

So,

I mean,

there's a whole host of things that are men we're

seeing them come in now.

And the good news is,

I mean,

men are talking about it more readily,

whereas you never talked about it before.

So,

that's certainly a positive.

And I think,

yeah,

I see the issues coming from a very young age

with men in regards to how,

um,

we are within a society in regards to,

you know,

being kind of being very dependent on our screens.

Not being dependent on interacting with,

with,

with other people and,

you know,

having the kind of like normal biological cues that

we would usually have.

Um,

and obviously there's so many factors that come

into it,

nutrition,

being inside all the time,

not moving your bodies.

Yeah.

It's a,

it's a big,

big,

big,

big issue.

But yeah,

absolutely.

It's,

um,

we see these things coming,

coming forward in age as well throughout the years,

which yeah,

it's a,

it's a concern when you,

you obviously have,

I'm presuming you,

you have new patients come in,

they,

they might know a little bit about hormones like

on like or none at all.

So I kind of wonder how do you introduce the idea

of hormones?

What are they?

Because I'm interested to like know,

how can we introduce the idea of hormones to kids

in schools correctly from a young age?

Well,

you're,

you're so right is that the sooner we can educate

people,

the better.

And just to,

again,

illustrate the problem is like,

we put a lot of young women on birth control

pills without any regard to what they do to their

bodies and all those women are going to become

testosterone deficient,

which is going to lead to all the symptoms.

And we don't clue them into that.

And unfortunately they end up with the depression

and then they put on antidepressants or you start

having issues in school or memory problems and all

that.

And we'd slap them with Adderall.

So,

I mean,

it's like all these different things that we need

to educate our younger population and we need to

educate the medical profession to educate them.

But if we can introduce the concept of what these

hormones are.

Or the symphonic instrumentation of our body,

if it all goes awry,

nothing's going to work right.

And how,

how we implement that,

I mean,

it's going to be a challenge.

I mean,

they're trying to start to get a reading and

arithmetic and all those things,

and we're eliminating physical education and all

those things and nutrition in school,

which is just leading to a further obesity

epidemic.

So I think it's going to be a struggle.

And in particular,

if we don't even have doctors educated in these

regards,

but you're absolutely right.

I mean,

it's so important.

But nobody's talking about it,

but again,

it's like you look at,

they'll get financial education,

how to manage personal finances,

how to manage a checkbook,

how to save money.

How do I mean,

we avoid practical things in schools that could be

really helpful down the road,

including health and nutrition.

Yeah.

I think a lot of the solution comes with parents.

I'm not going to expect it coming from school

curriculums,

especially the public sector.

Yeah.

And not from teachers who seem to just have more

and more restrictions and restrictions.

Yeah.

Yeah.

They're not really focused on what they can and

can't teach.

They're not really focused on what they can and

can't teach.

So I think there's a lot of responsibility on

parents to discuss things not necessarily biological

but also like day-to-day things that are very,

very important to learn that you either figure out

on the way by making mistakes or you do have

somebody or a mentor in your life that does have

the foresight to recommend those things as a

discussion topic because kids are 12,

13,

14 years old,

they're young adults.

They're there to learn and they're there for the

learning.

And they can be,

and you know I was never interested in biology or

health or the microbiome when I was how it

affected puberty,

I'm sure no one would.

But when I was...

I got to 30 and 31,

I look back and like,

oh my god,

there's so many of those years I just wasted

messing around with my friends,

even though it's a good time,

but you know,

and there's a lot of time that we could be um

teaching our youth a lot more helpful things that's

for sure,

and hormone health would be absolutely one of them.

How is your um how's your practice looked in the

last couple of years considering what's happened?

Well,

we've been fortunate because we've had a pretty

stable patient base,

and obviously with COVID and everything,

some people didn't want to come to the office,

and we just kind of switched to telephonic uh um

care,

but it's been interesting.

We've seen a lot more interest in kind of health

and wellness,

and how to keep your immunity up,

and the role that hormones plays in that,

and vitamins and nutrition.

So,

I think with COVID,

a lot of people took a refocus on kind of things

that mattered,

family,

and health,

and how do you address it because I mean one of

the things we often don't talk about - I mean

there seems to be this push to talk only about

vaccines,

which certainly in high-risk patients and vaccines

can be very helpful.

But nobody talked about what this epigenomics that

the majority of the people that were dying - I

mean again,

there's always the younger People in the cases that

they always want to throw out,

but the majority of the folks who were dying were

obese and had multiple complications from obesity

and lack of proper nutrition and health.

And um,

so it's nice to see that there seems to be a

focus on it.

But nobody wanted to talk about its direct impact

of the lack of those things on Covid versus and

again it comes down to everything in medicine I

think there's always this focus on the illness and

the end effect versus how do we get ahead of it

in the first place.

And I think it's really important to talk about

the impact of the disease so that people don't get

sick,

yeah,

the the.

Comorbidities and obesity was was known really

early,

right from the get-go.

Yeah,

but nobody nobody's sitting there addressing that.

It's like,

how do we get a healthier patient population?

Do we want that though?

Yeah,

well certainly big pharma doesn't,

no course.

And even just like not even recommending simple

things like vitamin D.

Oh yeah,

vitamin D!

The data is powerful for COVID and I mean you

look at all the different data around that and

multiple other things from inflammatory issues and

things like that cancer prevention,

osteoporosis.

Vitamin D is simple,

but gosh,

it's so powerful.

So in regards

To different patients coming in to see you,

you have this client base.

But,

like,

is it not that there been a rise of any

particular condition that you've seen throughout the

last couple of years?

It's obviously been very stressful for a lot of

people,

yeah.

Well,

I think when you look at the stress component of

it,

we're seeing a lot more people.

Stress does dramatically affect hormonal health

because it it really messes with the adrenal

glands,

which then can indirectly mess with ovarian and

testicular function and various other things.

Um,

and then also weight gain and things associated

with high cortisol level secretion from.

I stress,

so I think that and also,

we're seeing a lot more anxiety and mood disorders,

and various things that are impacted by not only

hormone imbalances but the stress that affected the

adrenal.

So not only the patients that we've been treating

successfully,

we're seeing more issues with them and trying to

have to rebalance things to some degree.

But then we're seeing a lot more new patients who

are paying more attention to some of those things

that may be driving them to us because they're not

getting the answers on the conventional sides.

Do you work with um teenagers,

young people?

We do um depends on the age so typically.

In our practice,

we like to focus on girls who at least have

started menstruation because we we want to be

careful that we don't get in over our skis and I

mean certainly um as an internist,

my background was more adult-focused where but

several of my practitioners they have family

practice backgrounds and they're more equipped to

manage the pediatric and pre-teen um so it depends

on the skill of our particular providers,

but we once we know that they're kind of in that

quote adulthood biologically where they're

menstruating for the women and for the male side

we want to make sure that they've gone through at

least Puberty,

before we will attack kind of taking on those

cases,

but we often will treat the moms and all of a

sudden they'll come in and say,

well my daughter's having issues and we find out

it's either related to their birth control pills or

they're having menstruation issues or things,

and we jump in and manage them a little bit more,

and then we're able to manage them.

But as a whole,

we want,

we try to avoid the kiddos.

This is a this is a massive question,

but like how bad,

how bad is,

how bad are birth control pills?

Oh my god,

they are the one okay,

so I gotta calm myself down for a second.

So birth control pills let me start it off,

are excellent.

At preventing pregnancy in most cases if taken

compliantly,

however we often forget in particular ob-gyn forget

that there are indirect consequences of those birth

control pills.

They're great for controlling bleeding in some

women,

they'll prevent ovarian cysts,

they're great for endometriosis,

they're great at pregnancy prevention.

But all oral birth control pills,

every single one is going to cause a 100%

testosterone deficiency.

That's how they work because they shut down the

ovary from making any of the hormones and one of

its big hormones,

95 percent of our testosterone comes from the

ovary.

Other five percent comes from our adrenal gland,

but when we take oral pills they process through

the liver and kick out a protein that binds up

that other five percent so they have to by the

sheer nature of how they work cause a hundred

percent testosterone deficiency which will lead to

low libido will lead to migraine headaches it will

lead to mood disorders glucose intolerance weight

gain and all the things we talked about so we

have a whole group of young women who are on

birth control pills unbeknownst to them are

developing a hundred percent testosterone deficiency

and quickly but we don't recognize that we end.

up putting them all on antidepressants or adderall

and various other things we're all the migraine

medications and so when the doctors say oh birth

control pills don't gain weight won't cause any

weight going absolutely they do and the other thing

is the worst thing of that category the low dose

estrogen birth control pills are even worse because

they will cause estrogen deficiency because they

don't give enough estrogen back in the pill which

will lead to all the menopausal symptoms the hot

flashes the night sweats the vaginal dryness the

dry skin the heart palpitations and all those

symptoms and oh by the way

Because of how that pill is balanced,

it has a very high progesterone or progestin,

which is a synthetic progesterone,

which then leads to progesterone excess,

which causes weight gain,

sleepiness,

and moodiness,

so you now have the trifecta of low estrogen,

high progesterone,

and low to no testosterone.

It's a mess biologically and endocrinology from an

endocrinology standpoint for women,

but we do it without thinking all the time.

Am I right in saying that it's not necessarily

always just prescribed for birth control?

It's prescribed to prevent so the main reason that

birth control is to stop the ovary from making

follicles.

Which turn into eggs,

but it also stops the ovary from producing its

hormones,

so then you're reliant on whatever hormones in that

birth control pill.

So,

it's good for things like pregnancy prevention if

you want to induce a low estrogen state for

patients like with endometriosis if you want to

prevent the ovary from making the follicles which

can cause ovarian cysts,

I mean those are indications for birth control

pills or they're good for patients with polycystic

ovarian syndrome.

But so I'm not suggesting that you shouldn't use

them but you need to know what you're creating

with the consequences of the hormones and

Then rebalance them or at least manage the

expectation of what's going to happen to that

patient biologically and work through that,

but the problem is,

is nobody thinks about the indirect consequence;

they just think about oh pregnancy,

or and that women are just breasts and vaginas,

but we're way more than that,

and you're creating significant chronic disease state

risk in those young women.

And we ask ourselves why are young women gaining

weight well,

social and anxious and mood disorders certainly

social media play a role in that,

but birth control pills are a huge component of

it,

but the good news is IUDs.

Can throw an IUD,

and then they're very very safe for women and they

don't shut down the ovary so okay you get you get

your natural hormone production and you've got

theatre and lining so you can't get pregnant.

IEDs are beautiful for women in the right I can

only imagine how propagandic the advertisement is

for the pill,

in regards to it's going to stop you getting

pregnant.

This is what this is what it's all about.

And then there's obviously nothing on the flip side

of that in regards to the dangers and you know

what,

what else might happen.

It's almost like a um it's almost like a rite of

passage perhaps within the culture which

Is a problem,

it's a very much a problem,

but we nobody talks about it and ob-gynes are

complicit,

they are the worst offenders,

but again they don't learn much about hormones and

they use them and it's not that they're intending

to harm women,

they just don't know any better.

So one of my goals is to educate and get out and

do lectures to the ob-gyn sector in particular,

right now because it's it's such an important thing

they need to understand.

Obviously a lot of patients come into you've got

different things going on but are there any like

common supplements or herb herbs that you may use

well certainly like if you look at thyroid

Function: getting someone on selenium or Brazil nuts

are a great source of selenium.

Or,

you look at Ashwagandha root for adrenal problems.

Um,

you can use Mexican yams,

Black Cohosh,

and various other things for um hot flashes and

night sweats.

So there are several things that you can use.

But unfortunately,

on the testosterone side,

there's not really a whole bunch of good

supplements.

Other than I mean you can induce energy with

vitamin B12.

Obviously,

the vitamin D we talked about is really good,

but you can use it for a lot of other things

like you can use it for a lot of other good for

immunity,

cancer prevention and various other Things so um,

there's select ones that it can be really helpful

um,

but if a woman's in menopause those nutritional

supplements are going to help,

but it's you need a bazooka when you may be

hitting it with a fly swatter when if you're not

giving hormones,

but I use the hormones as the foundational base

and then you can add things all around that

amazing,

and do a lot of people come to you because they

have had such poor care with the conventional

model.

Oh,

I would say about 80 percent of the patients that

come through our doors,

they've attempted to get the care things they need

from their conventional doctors and they've failed.

And they're just miserable,

and they're seeking answers.

And finally,

they hear a voice that they can relate to.

I mean,

I can't tell you how many times patients just sit

there and cry because they're so frustrated that no

one listened to them,

and then all of a sudden they're validated,

and they're hopeful again.

Well,

and that's just an absurd failure.

Oh,

it is.

It's it's it's it's really,

really sad to hear about yeah,

and I mean,

again there's all these attacks that I mean,

there's so much gender bias.

And it's important to note that doctors and

clinicians like myself,

we're relying largely on the compounding pharmacy.

Industry side,

I know,

um,

we're getting close to running out of time,

and I could do a whole dissertation on that,

but it's important for patients to realize that

there's a huge attack going on to eliminate

compounding.

They want to say they're unsafe,

but they're very safe when they're made out of

highly regulated 503B pharmacies and um,

and ones that have an underutilized pathogen,

which are blender-controlled.

It basically means we're doing our best so they

have designed through several ways to eventually and

should develop their own that's available,

and then we're really going to be sold and um,

I encourage Folks,

go to save-my-compounds.com that website and learn

more about what's trying to be pushed through at

various levels to eliminate compounding which we

desperately need so not only educate on yourself on

the role of hormones but also protect them because

God forbid you need them one day and they're not

available.

Thank you for that note,

absolutely that was a very interesting point I'm

going to check that website out myself and make

sure that's in the show notes.

Can you um,

we've got a couple of minutes left,

can you plug my book and let us know how people

can connect?

Well,

thank you for letting me plug my book,

I love my book.

it's a women's hormonal health survival guide how

to prevent your doctor from slowly killing you and

the title was meant to be a bit inflammatory and

also attention grabbing and again i i love my

colleagues and i no means do i think doctors are

intentionally trying to hurt people um most of them

by the way uh however they they may not be

knowledgeable in this area and unfortunately they're

going down a clinical a pathway of that

conventional thinking of putting patients on more

and more medications and the front cover of it

you'll see has my hand surgeon's hands filled with

medication and unfortunately that's the medical

Profession,

we want to dump all these medications which are

toxic to women and men that could be largely

managed with just hormone balancing.

So the book is designed and it's written for the

lay person.

It goes through all the different um different

hormone imbalances kind of how it occurs.

It's a very quick read; it should take people

about an hour,

if that,

to read.

But the more important thing is there's checklists

on how to look at your symptoms and see if you

have any of the symptoms.

There's things what you should be looking for in a

clinician,

red flags for reasons you should run out of a

physician's office if they're telling You're certain

things,

and also I even put a letter in there that you

can share with your doctor saying,

'Here,

I suspect I have hormone imbalances.

If you don't want to help me,

can you at least support my decision to go down

that path and help me with that journey?

So,

um,

so there's various tools and resources,

and then also how to find clinicians that do what

we do.

And if you ever run into trouble,

check with your local compounding pharmacies; they

know who the folks are in the areas to that do

this and do it well.

Amazing!

Thank you so much,

and it's drhotflash.com - right,

all roads lead to drhotflash.com.

We have...

we have all kinds of educational

Materials there access to buying the book,

and then also there's links for medical

professionals so if there's clinicians out there

that want to learn how to do what we do,

it will take you to my other company called the

Hormonal Health Institute which we train clinicians

globally how to do this.

So wonderful,

I'm glad you're out there doing what you do.

Thank you,

Simon.

I really appreciate you being a highly evolved male

who is highly educated helping with the fight.

We need more of you so wonderful.

I'll go home to my wife tonight and tell her that

I am a highly evolved male.

That's great!

I appreciate that.

Well,

thank you very much.

Again,

Dr.

De Rosa,

thank you for your time; oh,

it's my pleasure!

Thank you,

Simon.

Beautiful,

well,

for any information about the things we've spoken

about in the show and how to connect with Dr.

De Rosa,

I will make sure that the information is in the

show notes.

Don't forget to subscribe if you haven't yet.

Thank you so much for listening; this is True Hope

Cast,

the official podcast of True Hope Canada.

We'll see you next week.