Balance Your Insulin For A Balanced Menopause Transition

Ritamarie Loscalzo, MS, DC, CCN, DACBN

I am so excited to be here. And Yes, I rarely meet people with whom I say I’ve never had a hot flash, and if they’re under 40, they can agree with me. But most people who have been through menopause do not have that experience. So it’s so nice to meet a kindred spirit.

Sharon Stills, ND

But I know that I don’t think I’ve ever met anyone either. It’s like when I go to environmental conferences and they’re like, Who here has never had a mercury amalgam? And, like, I’ll be in a room of 600 with my hand and maybe one other up.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

I have a job and I had a mouthful.

Sharon Stills, ND

Of a yes. So we are the never-had-a hot flash committee. So it’s great to have you here, and I’d love for you to just introduce yourself and tell us your story. Like, how did you get involved, and how did you become so passionate about teaching about hormones and all of the good stuff?

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Oh, Yes, Yes. Long ago and far away. You know. When I was in my twenties, my health was falling apart, and I did the traditional things like go to the doctor and get a prescription, get another prescription, go to another doctor, and go to a specialist after a specialist. And I had amassed a bunch of specialists because I had problems and headaches, and I had sinus problems, and they scraped out my terminates, which are little membranes. Yes, they thought that was going to help. In fact, they didn’t talk at all about diet. And at one point, they told me I didn’t have an ulcer, but they wanted me to keep taking the ulcer medication after tons of other medication that I was on, including Valium, which put me so out that I couldn’t wake up in the morning if that was for the headaches, stress-related headaches. So they gave me Valium. And why didn’t they talk to me about stress, meditation, and heart medicine? No, they didn’t. So at that point, I just went, Can it be my diet? My diet is pretty bad. And they’re like, No, go, honey, diet has nothing to do with how? And I’m like, Really? Okay. I can believe that about the headaches because I didn’t know much about them at that point.

But my stomach, like the food, goes right through here, and how is it to have affect me with the M&M’s, Cheetos, Diet Cokes, and all that? Then I’m drinking. So that started me on my journey, and I discovered that indeed it was my diet, that I wasn’t sick as much as I was toxic, and that my whole life I had been toxic. And I’ve been; my body just couldn’t keep up with the garbage. I was feeding it; I didn’t have the right nutrients, etc., etc. I was able to turn my own health around, and I said, Okay, I have a great mind for problem solving. I’m a computer scientist with a master’s in computer science and a job in the computer field. I’m like, Okay, what if I just change the hardware and the software? So instead of this computer and this software program, what I’m looking at solving problems with is this human body and all the stuff that goes on inside of it. Little did I know then what I know now. It’s been such a journey, and I’m so passionate about it because it gets results. Because when you look at the hormones, which are the master controllers, they control everything, right? Everything. It’s not like EENT; it’s like here. No, it controls everything. So I’m like, Okay, if we can help the hormones, if we can affect hormone balance through nutrition and lifestyle, wouldn’t that be great? So that’s why I coined the term nutritional endocrinology. And I’m like, Okay, that’s got to be taken. Somebody has done it. Somebody went online—an institute of nutritional endocrinology, nutritional endocrinology, nothing. So I found a whole bunch of URLs related to it. I got a trademark on the term once. I’d been using it for a while. And so that’s what I teach. And I teach my clients who are coming to me. In menopause, a lot of my clients are actually peri- and postmenopausal women; we get men, we definitely get men. But, dealing with energy and just like lack of motivation and brain fog, it’s so rewarding when you can talk to people and get them to change a few things and get them to get things in balance since suddenly they have their life back. And that’s why I’m so passionate about it.

Sharon Stills, ND

I love that. And I always say when I’m talking to patients,  they’re like, Oh, should I go to the endocrinologist? And I’m like, No,  I’ll be your endocrinologist because I don’t know what the endocrinologist did in med school. I’m like, They were there for so long. What were they doing.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

It like learning about metformin. They were learning about T4.

Sharon Stills, ND

And Nat T3

Ritamarie Loscalzo, MS, DC, CCN, DACBN

And Nat T3. What else were they learning? They were learning about Premarin depending on when they went to medical school, but they were also learning about supplementing women going through menopause with pregnant male urine; it’s mare urine, not male urine. It might not be the right approach, but yes, that’s just a worry. And it’s just that they’re off base. They don’t understand metabolic health. They don’t understand that insulin resistance really starts 30 years before it actually does; they’re really using the techniques they learned to diagnose it when they can actually diagnose it years before. It is so exciting to me that people are finally getting into CGM. So I’ve been talking about that for years, and now everybody’s like, They know what CGM to use, and look at my arm. I have one on my arm here. Well, which kind is that? Instead of what the heck is on your arm? Are you diabetic? Now they go, Oh, what kind do you use? I’m looking at those, right? So it’s getting to the forefront.

Sharon Stills, ND

I don’t have mine on right now, but I’ve had people say to me, Are you diabetic or are you just curious? And I’m like, Just curious.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

It’s just wanting to prevent diabetes. I don’t want to go down that rabbit hole. So I learn what I can eat, how I need to exercise, and when I’m going too far or not when I’m not sleeping enough because it tells me.

Sharon Stills, ND

Yes. So let’s actually that could you just give us a little tutorial on CGM for those watching that aren’t familiar? Very familiar, Yes.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Yes. So a CGM means continuous glucose monitor, and it’s basically a little device; you can see it there. This one is called the Dexcom. It’s a big one. They’re new ones. The Dexcom G7 is actually smaller, and then the Abbott FreeStyle Libre, which is the newest one, is really tiny. That’s why I started with the Abbott FreeStyle Libre. The first one was for ten days, and then they went to 14 days long. Anyway, it’s a little device that you put on, and it has a little filament, like thinner than an acupuncture needle, a really thin filament. And it goes into the subcutaneous, the interstitial space, and it’s measuring your glucose constantly, and people say, Does it hurt? It’s a needle. No, it’s not even a needle. And when you take it out, you see it’s a little flimsy filament. And the way it gets in there is through a little device that gives it a quick push. So it goes in, even though it’s tiny and flimsy, and it’s measuring and feeding back the information. So you know what? Your glucose is 24/7. So if you decide you’re going to eat a Hoho, a cookie, or drink a Coke, you know exactly what that does to your glucose because it’s just giving you that meter, and you’re allowed to poke your finger.

Years before that, I started my first online blood sugar balancing program about 12 years ago, and I had people get the meters and prick their fingers every 15 minutes because we wanted to see how everything was affecting them. And after a few days, people start to complain that my fingers are bleeding. So when these came out, I tried to think of when I first got one, at least five years ago. I don’t remember when they became more publicly available, and it’s a game changer, a total game changer for people, and they go, Oh, my peak is at this, and how I ate that and it did this, and I’m making a change here, and I’m like, Oh my goodness, I had no idea that lack of sleep had that impact on my blood sugar. Right? So it really helps you to be empowered to take charge of your health and your diet. The foods we want may make my blood sugar go up. Doesn’t necessarily make your blood sugar go up, right? And I have to limit myself to five blueberries, and maybe you can eat two cups of blueberries and nothing happens, right? We have to figure that out for ourselves. And no one diet fits everyone. And the diet that they’re giving you—unfortunately, the dietetic dietitians and all that you’re giving people—is horrific, right? Oh, and you could have four pieces of candy every day, but not five. We don’t go to three because then you have to adjust your glucose somewhere, like, Give me a break. Really, we need to have better control. I mean, we’re empowered, and we can empower our patients to take charge of their health. Oh, my God. It’s a game-changer, right? 

Sharon Stills, ND

I love it. And it really, like you said, is realizing and seeing the data that sleep, meditating, not meditating, and stress really impact. So for someone listening, do you have like, what do you like to see the levels out and after you eat? What should it spike to? What’s too high?

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Yes, that’s a great question. There’s so much misinformation out there, like in the medical realm, right? An endocrinologist would say that as long as your fasting glucose is under 100 and it doesn’t go higher than 140–150 after a meal or 2 hours after a meal, they’re even saying you’re fine. And I’m like, No, no, you’re not. No, you’re not. So I like to see fasting glucose in the 80s or even below for somebody on a ketogenic diet. If they’re doing intermittent fasting, we’ll even see the fasting glucose below. I like to see mine in the 60s to 70s, and then after a meal, within about a half hour to 45 minutes, there’s a peak. So for some people, it’s a little sooner. For some people, it’s a little later. It might depend on what you ate. If it were like if you just ate a bowl of pineapple, it would peak at 15 minutes. If you had something that had more fiber but had some slow-releasing sugar, it might peak later. So you figure that out.

But at the peak, I believe that’s the healthiest. It shouldn’t go above 110. Maybe, in that window, 110 to 120 will give you the margin of error of the device and all. But I really believe it, and based on the studies I’ve seen, I was reading something somewhere recently that said exactly that. And I’m like, Oh, good, because people think I’m being a little too extreme. But when you look at the studies, there are studies that show that when the glucose goes above 100, there’s some damage happening to the beta cells in the pancreas that produce insulin. When sugar goes above 120, like in the 120 to 140 range, we’re starting to see the peripheral neuropathies down there, and the retinopathy is up here, right? We’re starting to see that at that barely elevated level, according to endocrinology, right? So, no, we don’t want your glucose to be at 140 two hours after the meal. Two hours after the meal. I want it back at 85. I wanted it to go up and down the way it should. And when you do predict, when you have sugars that go too high, you’re producing too much insulin. And that’s one of the tests that most doctors aren’t doing. I’m sure you do it on your people, but with insulin, we could be testing insulin levels on everybody. I mean, as soon as they get to be 18 years old, right on there, we should be testing their insulin. And if it’s good, maybe five years later you’ll test it again, like with a colonoscopy when people get to be 50, or a mammogram, or whatever. You’re just okay; everything’s fine. Let’s test it again in five years.

But there are so many people who have elevated insulin for decades, which is causing damage to the insulin receptors on the cells, which causes insulin resistance, but which is also causing constriction of the blood vessels, which is causing the sugar-coating glycosylation of the red blood cells, which makes them more prickly and like taffy. When you were a kid, if you heated, you had this stuff. And basically, that’s what the red blood cells do, which then damages the lining. So a lot of people have been creating havoc in their systems for decades by having these high-sugar, high-insulin drops. They’re always at 85, 95, and 95. It’s not healthy. But we can talk about that in a moment. But doctors think it is, so they’re always told, You’re fine, you’re fine, you’re fine. But they’re not testing insulin, and the insulin is causing all kinds of damage. We had a guy who came to see us, and he was learning, right? And he had always had fasting glucose levels in the mid to upper nineties, and he was having trouble with weight, energy, and a lot of other stuff. He heard about hemoglobin A1c and just went and got it tested. It was ten. Yet he’s fasting on glucose while still in the 90s. What was that doing? That meant that on average throughout the day, his glucose was way high, like 240 or something, which means that all that damage was happening. Well, it turned out he had retinopathy. He had never been diagnosed with diabetes, but he had the biochemical manifestations of diabetes, and he had diabetic retinopathy. And he wondered if he also had neuropathy. His feet were getting tingly. And they heard, and he said to the doctor, I’ve heard about diabetics; could this be related to my blood sugar? And the doctor said, No, no, no, you’re not diabetic. So we’ve got to manage this. And what gets measured gets managed, is the saying. And if you’ve got a glucose meter on, you’re going to find out what he would do if he was wearing a CGM. Right. He would have seen this. Oh, my God. My blood sugar is going up to 240. But then I’m producing so much insulin that it crashes back down. So my glucose when I wake up in the morning is fine.

Sharon Stills, ND

So you’re a CGM wizard. So other than running fasting insulin in the blood, which yes, I agree, And I run, I see a lot of my patients bring their kids, grandkids, or whatever. And, unfortunately, like our kids, they are getting to be obese. It’s almost just commonplace these days.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Right.

Sharon Stills, ND

And so you do see this insulin resistance and this metabolic syndrome happening and it’s sad sometimes. Nine year old.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Oh, Yes.

Sharon Stills, ND

It’s so sad. So that so but other than running fasting insulin in the blood and like you said the hemoglobin A1C because one fasting glucose does not tell a story. But is there a way to use the CGM to know what your insulin is doing as well?

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Yes and no. Okay. So we can’t measure insulin via CGM. We can’t measure insulin with a home test. There’s some special processing that has to happen with the blood. So you have to get that tested in the lab. But you can extrapolate based on what you’re seeing. So if we say we see somebody who has, for example, a really good hemoglobin A1C, like 55.1 or 5.2, but their fasting glucose is, maybe it’s in the 80s or 90s, you start to see on the CGM high levels and low levels. And that’s something if we just test the A1C and see they can have perfectly good A1C. But if we’re not testing the insulin, we don’t know that it’s going way up and way down. So if they’re overproducing insulin, when they eat that donut and their blood sugar goes up to like 150 or 160, the body’s producing tons of insulin, and it could be bringing it down too far. And then it’s going maybe down in the fifties or sixties, and that’s where they’re feeling like I’ve got to eat, but it averages to an A1C of 5.1 or so, which is like an average of 98 or something like that, which is perfectly fine. So there are ways to look at that. There are ways to look at it and say, Look, every time I eat this particular food, my blood sugar goes way up and comes back down. And you could assume that the insulin is going to go high, right? So that’s the way I always treat people. If I’m suspicious, I’ll have them do what’s called a fasting insulin, but then a postprandial insulin. I’ll tell them to go to the lab, get your insulin checked, go out to your car, eat the highest carbohydrate meal that you typically might eat, and then go back in and get tested again. And let’s see what happens.

Sharon Stills, ND

See how it looks. Yes, very wise. And so we’re going to get into estrogen and insulin. So what is this? So important? Where do you like to see in like a fasting insulin? Where do you like to see it?

Ritamarie Loscalzo, MS, DC, CCN, DACBN

I like to see it right around three. So between two and five is considered the functional ideal range. Up to 19 is considered in most labs to be okay, which is totally fine. That’s insane because the damaging effects of insulin are profound. And so I like to see it, three is nice, but between two and five ideally. Yes.

Sharon Stills, ND

And if someone has it lower, like if they’re at a one, do you get concerned. What is, what does that mean.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Yes. Yes. So if I see it at one, I say, Well, either you’re really good or you are not making enough insulin. So let’s test. That’s when I do the postprandial, for sure. And if the postprandial goes up but not, depending on what carbs they eat, if they go out and they eat a donut and it only goes up to two, then I’m concerned that there’s type one diabetes or, as with a lot of adult-onset diabetes, autoimmune diabetes. So then I’ll run antibodies, and I’ll ask them to go get antibodies checked to see if they have antibodies that are either attacking their insulin, attacking their pancreas cells, or attacking something called GAD glutamic acid. So I’ll run those tests to see what that means. But if they run it, they run the insulin, and it’s a one, and then they go and eat, and then it goes up to like eight and then comes back down. I’m like, You’re producing. The other thing you can do is run a C-peptide, which will give you an idea of how well the pancreas is producing.

Sharon Stills, ND

Great. I told you, ladies, we were going to have a good crash course. All right. So now let’s talk about menopause. So estrogen, insulin—what’s the menopausal connection?

Ritamarie Loscalzo, MS, DC, CCN, DACBN

So if you have insulin resistance going into menopause, it’ll get worse. It’ll get worse because the levels of estrogen are dropping. But they’re actually bobbing up and down most of the time. They are, however, generally declining. And estrogen is important for insulin to get into the cells. It’s part of that whole that we need the cell membranes to be sensitive. And magnesium is important. Chromium is important, and DHEA is important. Estrogen is also important. So as we see that, especially in the brain, we see that going through, and then we see insulin resistance getting worse. We also see that as the estrogen goes down right in the ovaries because the ovaries stop producing it after menopause, we’re supposed to have the adrenals pick up the slack, right? The adrenals pick up the slack. They can make just the right amount of estrogen, not to help you get pregnant but to just keep all things balanced, protecting your bones, protecting your heart, etc. If you’ve been living a stressful lifestyle for all the decades before that, which so many people have, I’m sure you see that. We will see. We’ll find that the adrenals just can’t pick up the slack now that we’ve used up all the precursors, and then we don’t have a problem, right? We have a problem where we can’t pick up the slack, and then the hot flashes, the night sweats, the inability to sleep, the irritability, and all of that stuff start to happen more. Yes, and they last longer too.

Sharon Stills, ND

It’s very rare, unfortunately. I mean, just in the life we live in, the way society is set up and the variety of toxins that we’re exposed to, visible and visible, that someone’s adrenals by the time they are perimenopausal or menopause, that they’re still like, Yes, we’re ready to come to the party. Most of us by that time we’ve been through,  some significant stress or just life or not sleeping or whatever. 

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Having children and you’re raising kids, that’s a pretty significant stress.

Sharon Stills, ND

Yes, right. Stress there’s good stress is bad stress. There’s, all around. But I so for someone to know like as they’re going through this, what do you recommend? Like how can they balance their insulin? Insulin, what can they do? Obviously getting their estrogen up, like how do you approach that? What’s the.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Yes. Yes. We’ve got to start with the basics, right? What’s causing this? Yes, you’re going through menopause, and you have less estrogen. But that started a long time ago with stress and the adrenals. So we really do have to address stress. We have to teach people mindfulness practices, right? Whether you’re meditating, doing a heart map, tapping, getting a massage, or doing things that get you into the parasympathetic nervous system, the parasympathetic nervous system activates the vagus nerve. That’s another term that people are actually hearing a lot these days. Right. Years ago, if we went to school, we heard these things about the vagus nerve. So the vagus nerve exercises, right? So there are some fine ones in there and some not-so-fun ones. So what’s that one? The face, the cold water, the side effects—all right. So, Yes, you want to dive into cold water or splash cold water on your face, but there are other nicer ways that you can get that under control.

Meditation and massage certainly help to activate the vagus nerve. So things that activate your parasympathetic nervous system, that activate your vagus nerve, are going to be super helpful for having you get through menopause in a much healthier, happier way, keeping things balanced, and taking the stress off the adrenals so that they can actually chip in and do what they’re supposed to do. Right. So that’s one thing. But diet, right? If we’re talking about insulin and the insulin connection, you don’t want to do things or eat things that cause your body to need a lot of insulin. So we get off the processed foods; we get off the bread, the pasta, and all that. Yes, you can eat really good bread that is not insulinogenic right there. You can eat great pasta made out of kelp, konjac, or things like that. It doesn’t mean going gluten-free and eating gluten-free pasta. It’s the same glycemic effect, right? So we need to do things that are going to help us slow down the need for insulin, decrease the need for insulin, and increase the sensitivity of insulin.

And there are a lot of herbs and foods that are just everyday things that we can increase in our diet. One of my favorites is actually chocolate, but because it has an effect on improving insulin sensitivity, avocados improve insulin sensitivity. Green, leafy vegetables improve insulin sensitivity. I have this whole chart, which I’m happy to share with you and your folks, that I put together. It’s like a six-page infographic that has a little picture of all the different herbs and foods and how they affect insulin receptors. It’s a great thing to start looking at as you hit that perimenopausal time in your life, or even if you’re already in it, even better, right? Because it’s going to help you improve your insulin sensitivity. And of course, get off sugar. Right. I have found that avocados are great for me. If I eat something, like too much fruit, my sugar levels will go up. I just go grab an avocado, eat half an avocado, and it comes back down. Now, I’ve not tried it with M&Ms. I think it’s really bad for me. But just if I overdo on something that is a healthy food but for my particular physiology doesn’t work in large amounts, and about, Oh, that was too much pineapple, quick grab that avocado.

Sharon Stills, ND

I was going to caveat your chocolate, like I’m not talking about eating Snickers bars or Mounds bars; I’m talking about good paleo-high, dark chocolate.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Yes. And when I say chocolate, people laugh at me because I eat 100% chocolate. So I get 100% chocolate. I usually rock a cow, and then I mix it with other foods that are going to help with glycemic control. And I make these amazing truffles that are delicious, but they’re sweetened with, say, Lo Han or Stevia, and there’s no milk in them. I may use coconut, right? I may put coconut butter in there with the chocolate and make these really nice chocolates. And that’s how I satisfy my chocolate craving. And that’s how you’re going to help with your insulin. No. If you go out and buy a Snickers bar, it doesn’t work that way.

Sharon Stills, ND

I think we’re all coming to Dr. Ritamarie’s for snack time.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

I love making food. Go to my YouTube. I’ve got to put more on my YouTube channel. But I have all these videos that I should pull out of my membership site and put on YouTube of me making healthy chocolates and healthy pizza. They call it the flour crust and things like that.

Sharon Stills, ND

Because Yes, you don’t have to feel like you’re missing out on things. It’s true. How are you? And I love that you brought it up. I just want to reiterate that going gluten-free can be beneficial if you need to get gluten out of your diet. But then, just by replacing all the gluten with gluten-free pasta, gluten-free bread, or gluten-free cookies, I still had that glycemic load. Yes, it’s worse.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

It could be worse.

Sharon Stills, ND

Than throwing all this stuff at it to try to make it taste good. So to be conscious of that, there are lots of things, like you mentioned, and you can get pasta made of lentils and black beans. And every time I go to the store, I feel like there’s a new form there.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

A new variation, and it’s just to test them. No, because black beans and lentils, for some, might raise the sugar because they’re high in carbohydrates. So you just watch it. But the ones I found that don’t are konjac, which is a root that grows in Asia. But it’s amazing that you can get miracle noodles, and then kelp noodles are really amazing.

Sharon Stills, ND

They’re also, like, zero calories. Zero calories! You’re like, How cool is that? They taste good. It’s like having zero calories. Whatever.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

So your favorite sauce is on it. But then there’s also zucchini. You get a little spiralizer machine. I mean, that used to be like a novelty years ago. Like 20 years ago, I’d be talking to people. They go, Huh? Now, everybody, there’s the Spiralizer cookbook and the Spiralizer this, and there are like 20 different kinds of spiralizers you can choose from. And you just take a cylindrical vegetable and stick it in. And it’s either this way or this way, depending on the machine, and spaghetti comes out.

Sharon Stills, ND

Exactly. And I mean that you can see that at Whole Foods, you can even buy prepackaged items like spiralized squash or zucchini. If you’re in a rush and don’t have time to spiralize,

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Yes. You don’t have the 30 minutes it takes to spiralize it and the 2 minutes it takes to clean up. Yes.

Sharon Stills, ND

Right. And I want to just go back to what you are talking about. I just hope everyone will really digest that, like the use of the CGM and what Dr. Ritamarie is saying, like how she knows that she needs an avocado. That’s the power it gives you because, really, your body is the laboratory, and you’re really getting the data on your body because we say, Don’t eat white potatoes; they spike your glucose, even with a sweet potato. And I have had patients where it’s totally the opposite.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Opposite, right? Yes.

Sharon Stills, ND

We know that knowledge is power. And when you have that personal knowledge of what your biochemistry is doing, it really is like, Oh, that is such a great and powerful thing to have, and I mean to have it any time. But certainly at this point in time, when things can change and maybe you will be able to eat what you want, it doesn’t matter. And now that’s changing a little.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Yes, absolutely. Absolutely. Yes. I call in a study. You say that the laboratory, the bodies, the laboratory, and our membership sites are called labs. So we have the body freedom nutrition lab and body freedom, meaning that when you do the right things, you’re free to do whatever you want. I can if I want to go out for a run right now, but it’s dark out, so I don’t really want to. But I’m calling out for a run right now after a long day of work. I’m going out for a run right now. Right? I have the energy to do it. I can go down to the living room, which is my weight room, and lift weights if I want to at 10:00 at night because I have the ability. Brian calls up and says, Hey, I want to go do something. Yes, let’s do it right. That’s the freedom of having a body that’s working properly. So our lab is called our nutrition lab because we teach you how to figure out what the best foods are for you and your particular needs.

Sharon Stills, ND

And sometimes, that even changes—like, as you see, dangerously, it can change. Stress levels can change as you age, and certain things can change. So in.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

So.

Sharon Stills, ND

It’s good to understand that your body is allowing you to be. I want to ask because we think about insulin and exercise. So what tips do you have as far as when you’re trying to keep your insulin at the right level, like how does this play a role in that?

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Trained muscle absorbs glucose and insulin better than untrained muscle, so it improves the sensitivity. So if we’re just doing simple bodyweight exercises, do push-ups on your knees. We have one lady in my program. She’s 82; I think 79, 82, or something in that range. And she decided, Okay, I need to start exercising, and she said, I’m going to try a pushup challenge. So she tried to do a push-up. She couldn’t do it on the floor. She couldn’t even do it on her knees. So she did it against a wall. And then she would try. How many can I do lower down? So she started against the wall, and then she started to go down to the counter in the bathroom, and she’d do a few there. Then she got down to the bathtub, and then she went down to the floor and did it on her knees. And now this woman, at 82ish, is doing, get this, 60 pushups a day on the floor—military pushups.

Sharon Stills, ND

Wow.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

But she did it slowly.

Sharon Stills, ND

That’s brilliant. I mean, sometimes the simplest things are so brilliant, like just starting on the wall and working your way up.That’s priceless information, ladies.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

It’s important to know if you’re having problems, so if you’re in your 50s and going through menopause, you can do this. You can do this, right? So exercise is important, and you start with where you’re at. If you’re going into menopause and your adrenals are wiped out, you don’t want to overexercise. And a lot of people, the way they do it, overexercise, and then they’re exhausted for three days after. So you just start slowly, do some weights, and you can do bands. One of my favorite things to do is use exercise bands because you can adjust them. They adjust to how much stronger you get. And I was away for three months, so I couldn’t do any weight training. I wasn’t going to bring weights in a suitcase. There go my 100 pounds. She’s gone, and I can’t put any clothes in. So Yes. So I brought my bands, and I just walked out. And as I’m walking out of town, wow, look at this. My muscles—I’m getting, like, sculpted arms just from doing dance. So you start that way; you start with the easy stuff, and you gradually build it up. Five minutes is all you can do. You have 5 minutes, right? And then you move it to 8 minutes, and then you move it to 10 minutes. And don’t try to push it too hard, because then you’re going to be sorry, you’re going to be exhausted, and you’re not going to want to exercise again. But if every day you do just a little bit and you keep those muscles working, if after your meal you, finish dinner, you finish lunch, you go for a walk around the block, right? It’s going to burn up the sugar you just consumed.

Sharon Stills, ND

Yes. So I was just reading something today that 315-minute walks after your meals are much more beneficial for your insulin levels and stabilize your glucose than doing like one long walk. and that’s palatable to us.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

All right.

Sharon Stills, ND

You go for a walk. Yes.  If you have a dog, you take the dog for a walk. If not, take yourself for a walk.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Right? Exactly.

Sharon Stills, ND

It is very doable. And I love traveling with the bands. I’ll also do that on my phone, where I have the seven-minute workout app. 

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Nice.

Sharon Stills, ND

That’s a great little app. If you are traveling and you can pick something like a full-body abdomen, you can mix it up and just let 7 minutes go by.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

I always fit 7 minutes in, which goes a long way towards restoring insulin sensitivity.

Sharon Stills, ND

I love that. Anything else like that—we didn’t talk about that you wanted to share about insulin, estrogen, and menopause before we started—

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Well, we can stress that sleep is super important, right? And I know that during menopause, a lot of people are getting those symptoms. You’re waking up in the middle of the night with hot flashes, or night sweats, anxiety, or whatever. So sleep is super important. So what can you do to help? And doing all the sleep hygiene stuff becomes even more important because we have other interfering factors. So getting off the screens an hour or two before you go to bed, you get yourself down doing something—relaxing, using essential oils, or things like that—to calm your system down. Keep the phone out of the bedroom; keep it away from you. Right, keep Wi-Fi out of the bedroom, darken the room, chill the room—whatever it takes to help you get to sleep and stay to sleep.

But one thing I will get you to do is get into bed, because if you don’t get into bed, you can’t have a good night’s sleep. And that used to be my issue idea. I don’t need to sleep as much as everybody else because I’m taking care of myself, and I would just not go to bed until 2:00 in the morning. I call that voluntary insomnia, you say. Oh, maybe you should take melatonin. I’m like, Why? I don’t need melatonin. Since my head hits the pillow, I fall asleep. I just have to get my head to hit the pillow a couple of hours sooner. So that’s the thing. We have to because we’re busy and you have kids, maybe you have a partner that’s aging, aging parents, whatever you might have, and you may have, Oh, this is finally my time for myself. And use that time for yourself to go to sleep, because that’s the best gift that you can give yourself. And I’ve learned it the hard way.

Sharon Stills, ND

Yes, when I was in medical school, this was way before perimenopause. And I put myself in medical school. I was raising two kids on my own, and I was just down to, What are the non-negotiables to keep me healthy and keep me functioning and sleeping? Getting a workout in and meditating were like my three non-negotiables, and I would, the way my schedule is, go there because there just happened to be a monk living around the corner from me, and so he did it like it was like 5 a.m. in the morning. So I would have to get up at, like, 430 to sneak over there while the kids were still sleeping. So I would go to bed at, like, 8:00, and if you like, it is. I love how you put that. It’s like we want time to ourselves. And I get that you want to unwind. But like the greatest gift you can give is unwinding, being in dreamland, and yes, menacing and regenerating yourself, And, just like triaging, like knowing, This is my bedtime, and an hour before thinking, All right, you know what is not going to get done because sleep comes first,

Ritamarie Loscalzo, MS, DC, CCN, DACBN

The dishes are negotiable.

Sharon Stills, ND

Yes. Just put some water in them.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Throw some water in and do them. Three days later. Laundry is negotiable. Make the kids wear the same clothes again and wash them. And there are so many of those things that we think as parents we have to do or we’re a bad parent, right? The biggest gift you can give your kids is getting enough sleep and taking enough self-care. And I remember reading the book, and I was like, This is too much when my kids were little, because I was doing what I’m telling you not to do, which was trying to squeeze it all in. And when my kids were little, there’d be times when I wasn’t getting enough sleep, and then I’d be driving them around. So I listen to the book on Audible, Why We Sleep. And he talked about what lack of sleep does to the brain and that if you are going on sleep deprivation, it’s like driving drunk, and they have studies that show it. You’re impaired in your reaction time. You’re impaired in your ability to make discerning decisions. I just hit me. I put my children at risk by driving. I would never think of driving drunk. I don’t drink, but I did as badly by driving with them when I was sleep deprived.

Sharon Stills, ND

And it’s a danger to others, but it’s a danger to yourself. Hormones and your balance, and like sleep, you can’t; you have to be able to get into parasympathetic mode to heal. You can’t heal.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Heal from simply knowing you can’t. You can’t. It absolutely can’t happen.

Sharon Stills, ND

Oh, my God. So I’m so glad you got to come here and share with me. To sum up for the audience, where can we like? Where can we fangirl over you and find out more about you and what you’re doing?

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Awesomeness. My main website is drritamarie.com, and my practitioner website is inemethod.com, Institute of Nutritional Endocrinology Method dot com. I’m on Facebook as Dr. Ritamarie; I’m on YouTube as Dr. Ritamarie; and I’m on Instagram as Dr. Ritamarie. So you can just find me; just Google me, and you’ll find me in the places I do. I do blog posts every week. I put a new recipe on the blog. Every week I do a new YouTube video, like a live video every week, and I do that on Facebook, and I do a podcast episode every week. It’s geared towards practitioners and the geeky self-care people who write to you, not your science. If this interview didn’t blow you away, you’ll love the podcast because we talk about lots of that stuff, and Yes, that’s the story.

Sharon Stills, ND

Awesome, awesome. We’ll go follow her. She is. She’s a living inspiration. I have no doubt that we’ll meet again when you’re 77, 87, 97, or 107, and you’ll still be bubbly and passionate.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

That’s the plan.

Sharon Stills, ND

Creating and helping to make the world a healthier place.

Ritamarie Loscalzo, MS, DC, CCN, DACBN

Thank you.

Sharon Stills, ND

So thank you so much for what you do. I told you, ladies, it was going to be a great talk. So we’ve got lots of nuggets to pull out from this: insulin, your levels, CGM, sleep, and exercise. And so, if you didn’t have a pen and paper, you’re probably going to want to listen to this one again and jot down some notes. So you know what to ask your doctor, and so forth. So beautiful. Beautiful. We’ll be back with another interview. And thanks for being here.