Balance Hormones & Blood Sugar: Women’s Wellness Guide

Introduction and guest background 0:00

Hey everyone, welcome to this episode of the Reversing Type 2 Diabetes Summit 2.0. I'm your host, Dr. Beverly Yates, and it is my distinct honor and joy to interview my colleague, Dr. Tabatha Barber. Dr. Tabatha Barber is an expert in women's care. Obstetrician Gynecology is her primary work and her focus, her lens is on functional medicine and making sure women have the health care that they so richly deserve and need and understand how their bodies work and what can be done to make them feel better.

So, Dr. Tabatha, would you please introduce yourself to our audience? Oh, thank you, Dr. Yates. I'm so excited to be here. This is such a passion of mine, because honestly, coming through, you know, conventional medicine, training, trying to practice as an OB gyn for a long time, I was frustrated that I could never make my patients well. You know, I was able to control their symptoms and give them some reprieve sometimes from their complaints. But nobody ever felt well, including myself. And it wasn't until I went on this healing journey of my own and found the world of functional medicine and went on to become certified and then anti-aging medicine and all the things that I realized, like there's a whole world of health and wellness that's ours for the taking, but we just don't know about it.

And so it's so exciting that you're bringing this truth to people because otherwise it's just not available from their doctors, you know? And here I'm the first to admit, like I was a doctor, I just didn't know. And once you know better, you got to do better, right? Absolutely. So well said. Know better? We do better. Right. Those will be like the words for humanity going forward for forever. Yes. And I want to say that was Maya Angelou. That was not me. So super, super. That's how we learn. I'm sure she's smiling.

Okay. So with that in mind, will you kick us off with this discussion? Because it's a rich, nuanced discussion, right, when it comes to women's health as we go through our various life cycles, you know, we go through puberty, our young adult years fully formed, fully formed adult years, and then into midlife transition, menopause. And then beyond approaching our elder years, what are three myths that you might. Let's start with one myth that women may have around, let's say, blood sugar and diabetes and their health specifically as a woman, because I feel like there's a lot of missed opportunity to make sure that we can stay well during those times.

Yeah, unfortunately we were sold the lie that we should eat every couple hours to maintain a stable blood sugar.

Myth of constant snacking and fasting benefits 2:51

This was actually pushed. This narrative was pushed by the American Diabetes Association, American College of OB-GYNs and it really set us up for metabolic dysfunction. And unfortunately, it took a good 10 to 15 years to see the effects of this eating every couple hours. Make sure you're snacking in between your meals. And there's a lot of women still out there being told this lie and that they're trying to be, quote unquote, be healthy and live this way because they don't realize that is actually a myth.

So what is happening is when you eat every couple hours, your pancreas is working overtime. Every time you put something in your mouth, your body has to produce insulin to go out and regulate that sugar in the bloodstream, that glucose that you're breaking down and absorbing. And it's exhausting for the pancreas, it's exhausting for the gut, for the liver. And so we're diverting resources and we're constantly in this digestion mode, which actually requires energy. And so it's not a healthy state of being.

And this is one of the biggest things that really prompted me to study fasting. So as a surgeon, you know, the first thing I was taught in residency was that you write MPO orders after surgery and that is telling the nurse, do not feed my patient, my patient is not allowed to eat because they are in a healing process and we don't want the digestive system to be active and using all of our resources. So, you know, I had that training. It was in the back of my mind. But then this new trend of eating all the time to regulate your blood sugar came out and we kind of forgot about that.

But when I go back and I do the research and I go back 2000 years and read the Bible because that's where I stem from, God actually created our body with this incredible innate intelligence to be able to fast. Fasting is actually a tool that helps us heal, helps us get back into, you know, a balanced homeostasis. It clears our mind mentally so that we can reconnect and nourish our soul. But I want women to realize that we actually our physiology was not created to eat on a regular basis. There were not grocery stores on every corner thousands of years ago, millions of years ago, when man, you know, started to walk this earth.

We were created to have feast famine cycles. We should be able to go periods of time without eating, have a nice meal, and then go without. Again, that is how our body is designed. But because we got into this society of eating every couple hours, we lost our metabolic flexibility, we lost our ability to get into ketosis and regulate our energy production from other foods like fats and proteins. We've become dependent on carbohydrate foods. And so that is why we have fatty liver insulin resistance, polycystic ovarian syndrome, diabetes, all the problems and infertility is at an all time high and this is one of the drivers of that.

So women need to really pay attention and that's a really important thing for them to understand. That's a great way to phrase it. I'm glad you shared this because, you know, I've always thought that it's so interesting. Like you look around the world and you look at the different cultures, you look at people, spiritual beliefs, their religions, the things that they do. And what is one of the things that has the pop out, if you would pay any attention? It's fasting. It's in every religion. It is a core of every religion because it is a part of how we stay healthy in our physical body.

Absolutely. Yeah. Yeah. And that physical body and its interaction with the spiritual body, you know, nourishing one and then also giving a chance like you talk about with this metabolic flexibility concept, it makes sense, right? I feel like it gives us more spiritual dynamism, ability to be dynamic in our spiritual life as well as our physical life. And I agree with you 100%. We've lost that ability because of this 24 seven access to food. We haven't yet really adapted to that. You know. We have it.

And when we are eating, we are creating more cravings and we're responding every time we feel a little twinge from our ghrelin, our hunger hormone, we're like giving in to that urge. And we really get over indulgent in feeding all of our cravings and all of our urges. And we really should not be living that way. We need to have some discernment and we need to actually tell our body no sometimes and go through that feeling of, okay, this is a little uncomfortable, but I don't need to give in to every craving and every whim.

That's what people who end up with major problems like addictions and things have is they're not stopping themselves. They just give in to every feeling. And this is part of why we have so much emotional eating and dysregulated eating because we are listening to our urges as opposed to eating for nourishment and for the reasons of eating right. Yeah, definitely, Definitely. So with that lens from functional medicine and with your original training in conventional Western medicine, what are your thoughts about that transition that leads into menopause and post-menopausal years?

Because for a lot of women, this is where issues with insulin resistance pop up. Maybe they if they didn't historically have weight struggles, they might now suddenly, suddenly it seems like it happens. They might start their problems with their sleep. Their ability to handle stress may change. They may have more feelings of anxiety full on panic attacks, that there's a lot of dust up that can happen for some people during this time, all of which is a set up, an absolute setup for type two diabetes and pre-diabetes.

Absolutely. And here's something I did not learn as a conventional OB-GYN, but it's key like it is key estrogen protects our body and keeps it healthy. So we have hormone receptors all throughout our body for estrogen and progesterone and testosterone. And when we are in a balanced state of estrogen during our reproductive years, our immune system behaves, it usually acts appropriately and protects us and protects our cardiovascular system. So our blood pressure can stay regulated. It keeps our everything healthy.

When we go through this menopausal transition and we go into a state of estrogen deficiency or decline that's permanently low, you're just not going to make that much estrogen like you did ever before. Everything shifts not only in your uterus and in your ovaries, but your entire body, the way your brain functions, the way your cardiovascular system functions, the way your liver functions. And so what we know is estrogen deficiency or menopause is a state of increased inflammation. And so we see those diseases come about.

We see the increased risk of developing pre-diabetes and diabetes, insulin resistance, heart disease, all of the things and this is what I see in my practice every single day when a woman goes into that transition, her blood pressure increases an average 10 to 20 points because the arteries that pump your blood throughout your body and your heart

Menopause, hormones, and metabolic changes 10:48

are relying on estrogen to stay elastic and pliable and mobile. And so when you no longer have that estrogen supporting those cells, your arteries get stiff. They turn more into like pipes. And so you have to pump your pressure harder to get the blood out throughout your body. And so I see it every single day. Women are like up. I just got told I have elevated blood pressure. Well, yeah, You went into menopause six months ago. The same thing happens with cholesterol. You're going about your life.

Your liver is making a certain amount of cholesterol. Here's the thing. Cholesterol is the main ingredient to make your sex hormones. So we use cholesterol to make testosterone, estrogen, progesterone, DHEA, and even cortisol, our stress hormone. So when we stop making all these sex hormones because we're no longer reproductive, that cholesterol sits in our liver and it's not being utilized, it takes a minute for your liver to go, okay, I don't need all of this cortisol production or cholesterol production anymore.

Let me down regulate. So women get told, you have elevated cholesterol, here's your statin and here's your blood pressure medication. When those are honestly normal changes that your body is going through because it's transitioning into a hormone deficient state. So we just got it all wrong. We're just not understanding that the body is incredibly smart, like it knows exactly what it's doing. And here's the other thing that women are surprised about weight gain is inevitable with menopause, at least £5, maybe ten.

And again, it's your body's innate intelligence. We make estrogen in our fat cells. So when we go into an estrogen deficient state, our body says we want enough estrogen to keep protecting our bones in our brain. So it makes your fat cells more metabolically active to make more estrogen. That is a normal process, unfortunately, of going into menopause. We don't like it because we don't like how it feels or looks. Right. But your body is not betraying you. Your body's not failing you. Your body knows exactly what it's doing.

And if you want to combat that, you can get on bioidentical hormone replacement and stop your body from trying to do that. But I love explaining to women like you got to work with your body. It's not failing you. It's not betraying you. Honestly. Like as soon as you shift your mindset around that, everything can change going forward. Beautifully said. Absolutely true. These are normal physiological shifts. Here's what was true before. And now. Here's what's true in this stage of your your life. Your season is changed.

And now the reason for these things is changed, right? Yeah, absolutely. Yeah. Super, super. Thank you for that. That was a clear explanation. A great job here. Okay, so what's another myth that goes on around the idea of blood sugar regulation and risks for type two diabetes pre-diabetes as a woman's life unfolds, whether she's in her reproductive years, that window or she's transitioned to menopause, and now the reproductive window has closed. And that energy, a life energy, is available for other things now.

So that's a tremendous shift. That's a lot of energy there. Yeah. So let's take that in two parts. Or the reproductive age woman who's trying to get pregnant or be healthy in that stage of her life. There's a new myth going around that you should not fast you should be eating all of the time, essentially because it's not good for your hormones. Again, I'm going to say that is a myth. That is not true at all. Our bodies do not want that food. Like I mentioned, 24 seven, because the more that you are relying on insulin to come into the picture, the more your hormones get disregulated and polycystic ovarian syndrome is probably the number one cause of infertility in this country.

So what's happening is it's not really an ovary problem. It's a metabolic dysfunction problem, it's an insulin resistance problem, and we're trying to tackle it with hormones when really we have to regulate your blood sugar and stop all that insulin production. That's how you reverse PCOS. And when I run my fasting programs, I don't use fasting with all my one on one patients. People get pregnant every time they start getting back to this healthy lifestyle, fasting is not a fad. It's how you were created to function.

It's a lifestyle. And so once you get back into using fasting in your life, your ovaries will finally feel safe and comfortable to produce the hormones when they're supposed to. And you'll get into a regular cycle. Because remember, and you know this Dr. Beverly, that your body does not want to procreate and be reproductive and grow another human being if it's in survival mode, if it's struggling, if there's infections to kill off, if there's stress, they think they have to run from a tiger or any of these stressors externally or internally, they will signal to the brain and the brain will shut down that hormone production with the ovaries.

That communication will go offline because it's a protective mechanism yet again. It's not that your body does not know what is doing. It's actually protecting your unborn baby by not allowing you to get pregnant at this time. And I think we don't talk about that enough. And the cool thing is I find that very empowering because women can be like, Oh my gosh, I actually have so much input in, say, into whether I'm reproductive or not. I actually can affect my fertility with my lifestyle choices, with my diet choices.

And that feels really empowering as opposed to going to an RBI, like a reproductive endocrinologist and being told that, well, you just need IVF because there's no bringing your ovaries back to life. I promise you that's a lie. It just is. That's a great point that you're bringing up here. So when we talk about, you know, that rejuvenation and letting the body restore and repair and do what it's supposed to do and removing those obstacles to cure, that's how we would say it. Naturopathic medicine, where we completely overlap with our functional medicine colleagues, right.

You know, root cause issues. You know, you think about today's world in the constant snacking and the advertising of food, and it just looks so glimmering and it's like this food never looks like that. But are you all even showing Right. Hits our dopamine and serotonin and the next thing you know, people feel themselves compelled to do things that their rational self knows doesn't even make sense. But here we are, right? So then in this moment for women's health care, as we go to look at healthy aging and having our health span equal our life span, because people on average are living longer and in part is because we don't have the same really high rates of infant mortality.

Like if you look at the numbers, there's a way in which it gets put out that's not quite accurate. But the bottom line is you want to be healthy for however many years you are blessed to be on this earth, right? So if we're looking at doing that and we're thinking about women's

Stress, caregiving, and blood sugar dysregulation 18:30

healthy journey and going through menopause, you know, the reproductive window, preserving that fertility. And for those of you listening to the summit, if you're a younger woman, please listen carefully. Rewind if you need to, and take notes. Because what Dr. Barber is saying right now is absolutely true, that Dr. Tabatha has given you the goods here. If you are an older woman, share this with younger women. Okay. So now we're going to talk about for older women, we're going through menopause. We've hit that transition.

We probably will realistically gain about five or £10. You've done a great job of explaining that. I've always thought as we enter what I think of sometimes as our crone years, our elder years, our wisdom years, our give back years, right. My mother, one of the most beautiful things she ever shared with me before she passed away was make sure, Beverly, that you make friends with women of all ages, especially younger women. And it wasn't necessarily because the expectation was women my age or older would die around me, but rather to pass back information nuggets so that they could be well too, Right?

Like she was very much a community minded person. And so in that what will we want to tell, you know, our ourselves or our older sisters, women who are older than us, to let them know, hey, here's how you keep you this precious vessel of you put together, You know, like, what do we offer these women? Yeah. So I would say the majority of women who go through the menopausal transition, you know, women north of 40, north of 50, the biggest hiccup they have is not managing their stress appropriately.

And we hear it all the time. So the idea gets kind of diluted and we're like, well, I can handle my stress. That's not a big deal. We're we're running around trying to do all the things like have the amazing job, be the supermom, be a great partner, be an awesome girlfriend, and go out for cocktails and do all these things right and still look good. But even though those might be good stressors and then we have our other bad stressors, they still cause your body to make excess cortisol, which is our stress hormone, excess adrenaline and all of these inflammatory chemicals.

And so it can compound and become really difficult on the body to stay healthy. And here's the kicker. When you go into menopause and your ovaries are no longer making your sex hormones, the body goes to your adrenal glands. They are your backup ovaries. And they say, okay, we need some sex hormones to get us through this next half of our life. Kick it up a notch. Let's get some more production from you adrenals. But I see so many women going into menopause with tanked adrenals like hard core adrenal dysfunction.

They have, like, created such a cortisol excess that they nap their body got to a point where it says, Nope, we're done doing that. We're not going to do that anymore. And it downregulate your cortisol production and some women are even going into menopause like flatline cortisol, you know, we'll do a 24 hour saliva cortisol test and they're just not producing. Their DHEA is in the tank and so there's nothing to pull from. There's no back up ovaries to make any little residual amounts of testosterone and estrogen.

So these women are struggling to continue doing exercise. They used to do They're definitely struggling in their jobs to have mental clarity, even finish a thought or, you know, get through project X, They're feeling exhausted, all of those things. And so this is just the picture I see every single day. I know I'm stressed, but I can handle it. But I'm here to tell you it's not how you can handle it mentally. Your physiology cannot handle it. It is done with you being overly stressed and go on the go from dusk until dawn.

And so we have to shift how we're doing a lot of things. A lot of women have to shift from like high intensity interval training and heavy cardio to more of restorative practice, polarities, yoga, adding in walking, strength training, those types of things. We definitely want to strength train for our muscles, but you have to change and set boundaries and kind of get rid of a lot of those external stressors. But in addition, you're getting internal stressors. I'm seeing more and more women with chronic gut dysbiosis, so they have bacterial overgrowth where they have tooth issues, undiagnosed thyroid issues like all those stressors really are hard on the adrenals.

And then you go into menopause and you don't have any sex hormone to pull from at all. And so that is where menopause is like a make it or break it for women like it really is. It's either you're going to like take back control of your health and you're going to make the next half amazing or you're going to give in and believe that the white coats are the only ones that can fix you and you are just going to like lay down and die and I don't want any woman to do that. It's not necessary. You don't need to be on all these medications.

You don't have to look to doctors to heal yourself. It literally is in your hands to set boundaries, get into parasympathetic activity. Hopefully you guys are talking about that, like laugh more, hug more dude things to get you in a calming state. Breathwork tapping meditation, reading the Bible, all the things in shift how your body's functioning so that it can thrive in the second half of life. And let me just throw in there fasting is like a superpower for menopausal women because it's the quickest way to really reset everything.

So if you are doing fasting a alongwith, regulating your nervous system and shifting how your adrenals are functioning like your second half can be better than your first half of your life. Without a doubt. Like I'm living proof. My patients are living proof. It's it's a game changer. Absolutely. Absolutely. I agree. You know, fasting is an invitation for a massive reset button. It really is. You know, and the word no is a complete sentence. I write. Amen. I invite everyone to consider. That's one of the things I've observed in my patients.

And it's been interesting with the female and the male patients caregiving becomes a real theme for some of us, particularly in that window where we're in our forties. Our fifties are sixties and seventies, and we may be caring sometimes for two generations in our family, people who are older than us, perhaps parents that have ailing health may be children or other people that we are close to either in our household or close relationships. And the other thing that can happen then is that there sometimes it's just not enough resources, enough help, enough capacity to go around.

And when people are in those deeply intense and sometimes prolonged caregiving moments, they wind up so tapped that they start to tip over. And one of the things that can show up is Type 2 diabetes. Sometimes people are shocked at that diagnosis because they were otherwise doing all the things as you shared, and yet they don't have the result. And they're like, How did I get here? What happened? Like, they aren't the stereotype of, let's say, partying their way to Type 2, eating ice cream and chips and all these other things all the time.

Milk, they're exercising. They're trying to pay attention to the things that they know about, but yet it is still happened to them. And rather than do the blaming and shaming and disparagement that goes on, because we all know that's not helpful or curative right now. What do you do right in that moment? Yes. So I see this a lot in my programs. Women, a few years back in my programs, I would use a Quito mojo where we would measure your glucose with a finger poke and then your ketone production because we were trying to shift into ketosis and get away from all that carbohydrate use.

And inevitably these women would say, I woke up with a good fasting blood sugar, and then an hour later it spiked up. I'm not eating, I'm not drinking. What is wrong with my body? It's because they were having crazy mornings. They were stressed out. So we need to realize that every time we make cortisol to handle something, we also make glucose in our liver to put in our bloodstream because our body thinks we're going to go fight or we're going to go run and handle that stress. And so you don't even have to eat glucose or sugar or carbohydrates.

Your body will make it from your liver if you are stressed out and we have a normal little rise in cortisol first thing in the morning. It's our body's natural way of getting us going for the day. It's our natural cup of coffee, but we can really get that thing shot up way too high if we're running around like a chicken with our head cut off, if we're fighting with our kids to get out the door, if we're not giving ourselves enough time to get ready and answer all the emails for the boss, we hate to do all this stuff, or we're like, Do an intense cardio for an hour before we get out the door.

That really pushes some excess cortisol and excess glucose production in. So you could have elevated blood sugar without even eating. I mean, I was actually a living example of that as an OBGYN and I didn't eat very often, but when I ate it was poor choices, whatever was available to me at the moment. But I was pre-diabetic and I only weighed, I think I was 160 at that point. I was a little bit overweight, back down to where I should be, but it was from the stress of my job of like babies lives in my hands.

You know, it doesn't have to be that extreme. I see this in my patients who are like CPA is around tax time. Their hemoglobin A1C just shoots through the roof. Or young moms who have multiple little kids and they feel like their mornings are so crazy and they just can't get, you know, control of anything. So I find it really important for women to get centered, get centered before anybody else wakes up so that you are starting your day on the right foot. And I want you to think about like, here's a teacup sitting on a little saucer, like Ode to My Grandma.

You want your teacup to be overflowing and filled so that the saucer is full of tea as well. And that is what is feeding everyone in your life. You should not be pouring from your cup. You should not be like waiting for the last drop to come out of your cup to give to somebody else like you. Your cup should be overflowing and the saucer should be like pouring into their teacup. So that is how I think about it now. I had to learn the hard way, like most of us. But if you are not filling your cup first, you can.

It's not sustainable. You can't keep pouring into other people. You will get depleted, you will turn on autoimmune conditions, you will destroy your gut, you will tank your adrenals, you will go into premature menopause and you will end up with blood sugar, dysregulation and all the stuff we talked about. Like I just I see it every single day. So it really is in your hands like it is

Closing remarks and where to find Dr. Barber 30:30

how you're living your daily life, those little choices you're making. Am I going to get up an hour before everybody else? Am I going to sit in the world and like, feed myself and my soul? Am I going to journal and get my thoughts out on paper, or am I going to prepare the night before and know what my day looks like before I even wake up? Like so many things can set you up for success and they're free. They're easy to do like, but it takes intention. It takes getting mindful and shifting how you're living your life.

But it's so powerful. Wow, what a great way to wrap our episode. Dr. Tabatha Barber, I so appreciate you being here with us. Would you kindly let our audience know where they can connect with you? Where can they find more info? Yeah, we would love to help you if you're struggling on your health journey. We love figuring out hormones and thyroid and gut health and blood sugar, all the stuff. I have a virtual medical practice, it said drtabatha.com D R T A B A T H A No, I's just A's. That is the best place to find me or follow me on Instagram @thegutsygynecologist Tons of free content I've The Gutsy Gynecologist Show podcast, which I just talk about this stuff all day long.

And always with that grace and humility and clarity. I also appreciate you. Thank you so much for being here. My pleasure. Thank you.