The Keto-Green Diet for the Female Brain at Any Age

Introduction and Speaker Background 0:00

Welcome back to the Reverse Alzheimer's Summit. I'm your host, doctor Heather Sanderson, and I'm so thrilled to have Doctor Annika Rebecca here with us today. She and I are very much aligned on what's best for an aging female brain. Lots of greens, a ketogenic diet, and been very mindful of hormones and making sure we get the right nutrients to support optimal brain health. Doctor Annika Becker is a doctor and Ob-Gyn who's triple board certified and a fellow of gynecology and obstetrics, integrative medicine and anti-aging and regenerative medicine.

She has special certifications in functional medicine, sexual health, and bioidentical hormone replacement therapy. For the past 20 years. She has served over 10,000 women in her private practice, plus millions more through her books, online videos and articles. When her own health took a troubling turn during menopause, she sought out the wisdom of healers around the world. She learned that modern medicine and time tested natural remedies are not at odds. Working together, they create indisputable results for true well-being, using delicious healing foods and simple lifestyle changes.

Doctor Anna reclaimed her health and her life, and now she can share that with you. Fueled by her belief that every woman deserves to be empowered and in control of their health and life, she developed the keto green lifestyle, which has helped thousands of women opt out of menopausal misery and experience a joyful transition to the next stage of their lives. You can breeze through menopause and into your second spring feeling the best you ever have. I can't wait for you to share with our listeners what this looks like.

Welcome! Thank you so much. It's great to be here with you, Heather, and really, I've enjoyed everything you're doing in this. This summit is amazing. I mean, women's health and brain health go hand in hand. Physical health, mental health. And, Yeah, I'm glad. And hormonal health and our menopausal brain and what that means for the rest of our lives. It's, I'm thrilled to be here to talk with you about this, but we both know that women are affected by Alzheimer's so much more than men. Not only are they diagnosed with Alzheimer's more frequently, but when a man in a woman's life has Alzheimer's, she's the caregiver.

She ends up being that provider for that person. So we women kind of get it on both ends as the patient and as the caregiver. And caregivers also have higher risks of of ending up with dementia. And so I really want to dive into how we can fully support women and understand, you know, why is it that there's maybe this difference, what are the hormonal changes that affect memory? Yeah. And I think this is the really it's really beautiful to understand this because, when I was going through my own perimenopause, how I didn't understand this.

It's not taught. It's not well, explained and it's really not well understood. It's not well understood. And I'm really excited for more women, especially. And, and, women's health go understanding their own transition through menopause. And it's going to change. We are disrupting menopause, disrupting the standard of care what people are being put through just because with the best, you know, the best we have, we just don't know. And so, so you know, my experience at 48 was this brain fog, memory loss, irritability, you know, like where's this monster coming from?

My patients would say that I didn't I wasn't the monster for my patients, but my patients would come in and say, Doctor Anna, I have this monster within me. She's like raging sometimes. And I don't know why I'm acting that way. Well, when I was 48, going through this, hormonal hell, I understood that. And that's why what led me to write my first book, The Hormone Facts. It takes more than hormones to fix our hormones. And while menopause is mandatory, every one of us will go through it. And natural process suffering is optional.

Suffering is optional. We do not have to suffer through this. We have to transition. Transform just like we did in puberty, right?

Menopause, Brain Fog, and Ketones 4:17

Just like we did in puberty. So this is a transition and a transformation into the second spring is about the second spring of our life. How do we get a gorgeous second spring? We have to have good soil. We have to have a good foundation. We have to have good seeds, right? We have to have good care and nurturing. And this is this is true especially in perimenopausal menopause. As for the rest of our life, it doesn't matter how old we are. Women in their 80s starting a new with creating a healthy brain body libido.

I mean, it's amazing. I could hear my inspiration. I'm like, wow, I helped you do that. Thank you. Like they're my like, I want to do what you're doing. We're doing what you're telling us to do, you know, I mean, this is it's beautiful. It's a beautiful transition. And so, you know, you asked about, you know, why are women having so much difficulty in these hormonal changes, this neuroendocrine, vulnerable time period that we go through between 35 and 55 is one of the key reasons. And then again, it doesn't stop. It doesn't stop.

But during this transition it's really important to understand that for the rest of our lives, the way our brain is designed, our brain will use glucose for fuel as a preference and circulating glucose levels. There's that maintenance level, but above and beyond the use of glucose for fuel in the brain and gluconeogenesis in the brain is hormone dependent. Is estrogen dependent specifically most likely progesterone dependent? Now, you know, unless you're studying brain neurochemistry, you might not have ever learned that.

Or unless you're suffering with brain fog, memory loss, and you used to have a perfect, darn perfect memory. And you're like, I can't remember my kids names, you know, let alone, you know, want to have energy to do anything right, let alone be calm and feel. You know, responsive versus reactive. And so so that took me on this journey that took me into the keto lifestyle. And and that's where I came with my keto green approach. Because keto alone is very a masculine keto green is a very feminine, very combined feminine masculine a really that yin yang, health beyond, you know, perimenopause and beyond.

And actually I really I have girls from age 14 to 33, my own daughters, and it's perfect for each of them as well. And I'm 55 now with a 14 year old. So brain health and clarity is even more important at that time. At 48, I had a teenage daughter in high school when in middle school, and we one in elementary school, so that brain fog led to mass manipulation. So we can't afford that as women, right? I mean, they were manipulating me, right? I'm like, I don't remember you saying that. I don't remember what I said or whatever.

And so this gluconeogenesis factor is hormonally dependent is it's that's key. But use of ketones for fuel in the brain is not. Got it. So if we can switch the fuel from sugar to fat, then we don't rely as much on the need to have plenty of estrogen and potentially progesterone around in the brain. So as we're going through this transition of menopause, where there isn't as much estrogen and progesterone around, it might be easier is what you're saying for our our brains to burn ketones for fuel.

And we'll get back that mental clarity and that mental energy that we're lacking. Yes. Yeah. Absolutely. How exciting. Okay, so what else is going on in terms of like mental health and memory and menopausal changes with our, with our brains? And I am going to make it, I'm going to switch so the doctor and I can share her screen real quick so that everyone can see what it's planning to. Yeah, I definitely feel like a picture says a thousand words. And I want to explain that because it's such an important area to understand.

And I'm very visual in learning and then and then teaching. So, thank you for that. And, one of the things is that, you know, in this whole transition and like, what makes it easy, what makes it complicated with this transition in menopause is certainly the hormones and where it relates to Alzheimer's, because that's what we want, right? We want we you know, I very I have a strong belief that, you know, we have a certain number of days to live out the many purposes of our lives. And the quality of those days is within our control.

The quality of those days are within our control. And having seen the ups and downs of being a caregiver, of a father with a diabetes, heart disease, you know, consequences of diabetes and him going into brain fog, you know, foggy brain areas, but able to with the what I'm going to teach everyone here today and what you're teaching is snapped him out of it. So maybe it will help for me to share this story first. Heather. So people can come along with me and understand where I'm coming from as a physician, because I always say I never, you know, I never wish any physician the journey I've been on to learn what I know.

Right? It's so true. My doctor bag is full from out of desperation, from being empty out over and over again. And so, so I, you know, my mom passed away. I was 16, coming home from school, and my mom was 52, undergoing her first heart surgery. The first day I'd come home to my mom, not being at home to an empty house. I'll never forget that day. And I just understood the gravity of her undergoing heart surgery, being in a hospital and recognizing the research that her clinical care was based on was research performed on men.

There were no 50 year old women in any of those studies. And that was a big moment for me at 16. And that led me to be passionate about women's health. And then I, you know, I went into ObGyn and and my mom passed away in my first year of residency, undergoing her second heart surgery at the young age of 67. She passed away. And I wasn't able to help her with the best of leading standard medical care that I could. My mom was my mentor in life and in death. And so then, you know, a decade later, my dad's come and visit in August.

He's 79 at this time, and diabetes again for 20 years, and on 120 units of insulin a day on 11 medications and, on, you know, just like struggling, feeling cranky and irritable.

Personal Family Health Journey 10:43

He flew from Philadelphia, which is where our family home was, Philadelphia, and flew to, us in Georgia. But he had to take the wheelchair and be pushed through the airport. And my dad was World War two. He was he went into World War Two, served 20 years in the Navy. And I applaud all veterans. And you know, all of our active and retired military. I'm telling you, this is hard work. And this is also where the brain comes in post. Trauma on the brain can create this neuroendocrine vulnerability in both sexes with specially women.

So so my dad, you know, was 79 at this time. And he's you know, my mom had passed a decade earlier and I was in private practice in Saint Simons Island, Georgia. My son, was a toddler and crawling around his ankles. And my dad was here. He was, you know, kind of irritable. And he sat on the couch and watched two and a Half Men all day in and day out, if anyone saw that show. But, you know, so after his medicine. So that's okay. But he I said, dad, what's going on? Why aren't you. You know, he goes, you know, and I just don't feel good.

I mean, it's not like him to snap or to be forgetful or, and, and so I said, well, let me do you want me to call your cardiologist? And so I called his cardiologist, who I knew very well from our hometown in Doylestown, Pennsylvania. And, you know, I said, doctor, you know, dad's, you know, A, B, and C, and these are finding these are his, you know, blood test results, blah, blah, blah. And he said, you know, and your dad's 79 years old. He's lived a good life. And I could just hear in the back of my mind, you know, like him washing his hands of my father.

And I waited for him to say something else, and he did it. And I said, oh, I understand. Well, do you mind if I intervene? You know, I'm a guy in from Emory, so would you mind if I intervene? And he's like, you know, do do whatever you think. And so I went to my father, you know, a 79 year old retired naval attaché. And I said, dad, you know, are you done living? Your doctor's done with you. And he's like, well, I'd like to see 80 years old. Like, okay, it goes and I'll do whatever you say because I just don't feel good.

I in 30 days, this 79 year old man lost 30 pounds. I took him off three of his prescription medications to start, and he went from using 120 units of insulin a day to 20 units of insulin a day. And not only like I mean, that is key. Like who talks about 79, you're going to reduce insulin. You go into your doctor. Well let's increase it here. Let's add another, you know, glycemic aid or prescription or whatever. You know, you're not looking at reducing it in a 79 year old man. But those years of, you know, I think I wish I had started a lot earlier because that, you know, that kidney, that effect on his kidneys had been profound for many years.

It ended up in dialysis the last year of his life. But, you know, I mean, it was I mean, so 79 so I've reduced his insulin, 122 to 20 units a day. And not only was the off the couch he was playing, laughing, beating us all in Sudoku challenges, which our family will xerox one Sudoku page and who does it fastest? Correct. And a beating us all in that. And he was out on the tennis court with the kids. He was out on the tennis court with the kids at 79 years old. And not only had their not only did he make 80 years old, he made 91 years old.

91 good years. He outlived all of his younger four younger siblings, outlived them all, not just in the number of years, but by decades and the quality of his life. And I want to encourage everyone to hear that story. Male, female, you know, 70s, 80s, 20s. I want you to hear that because at any stage we can change our physiology, which affects our behavior, which affects our well-being, which sets the stage for the rest of our lives and gives us back what's most important. Right. You describe him enjoying his time with his grandkids versus being crabby and grumpy about them crawling around his ankles.

You can just see these very diametrically opposed visions of what aging can look like. And that's what's so exciting is it's creating this compelling future. It's like, yes, I can be out on the tennis court, whether that means with my friends that I've had for decades or it means new friends, or it means my family or means work, whatever is purposeful and meaningful for me, I have the choice to engage in it because I feel up to it. Right? And that's I think that's really the key of what's so exciting about this.

So what did you do exactly? What was he doing? I, I think there's one other little point I want to make about insulin, and that's that I think we think of sugar as being bad, and that's what's doing all the damage. These glycosylated in products and like the damage that's done in the micro vasculature and in the brain, and yet insulin itself, when we're not only raising blood sugar but also raising insulin, insulin also signals that when we get too much of it, of course we need enough. But if we get too much of it, it's leading to more inflammation and more degradation.

And so just increasing the insulin level doesn't solve the problem. So I'm so glad you mentioned that. But now it creates more, you know, burden on the kidneys exactly like rates their route to dialysis. Just heartbreaking. Which means you're in a dialysis center for three days a week for hours on end. Yeah. And technically, if you're over 70, I believe it is your, life. I think it's 70 or 80, but I think it's 70. Your life expectancy once you start dialysis is six months. So. And I looked at that research because when we decided to put my dad on dialysis, he was on 90.

And so I was like, oh my God. It's just like in his, you know, a 90. He'd been diabetic for over oh my gosh, how many years, 40 years, 40, 40, 50 years at that point. But he was 90 when he was. And so but he made it a year and a half after starting dialysis. And he was good. I mean, you know, me still travel. He still I mean, yeah, I was just really, really good. It was really good. And he died very peacefully. So anything to see what's possible, what's possible and what's possible. When is when his cardiologist. Right.

Who deals with younger and older said this, that he's lived a good life. And that's true. And that's what I hear went over and over again. And I think this is the really big thing. It's the quality of our days that matter, but it's also the quality of our relationships. What was dad doing? And then any time in the future, like over those next 11 years, that I was blessed to have him in my life, he whenever he would start getting irritable or forgetful, it was like, okay. And you ask, what did I do?

And I've certainly refined it over the years and over the time working with my dad, I never was able to take away his scotch, so. Okay, like 91 years old, he had a scotch that day. So, you know, but it was definitely a reduction for sure. And in beer drinking and and sugar, of course, and maintaining stability and just letting him live his life to have have the, the of that, you know, he'd work so hard to get with all you know, with his children, with his grandchildren and just with his freedom.

He had freedom. He lived on his own till his last year, lived on his own till his last year. And so and that's what I want people to recognize. At 79, he would have needed full time care. He had 79, but he had another, you know, ten, 11 years of, freedom. Freedom. Absolute freedom. They turned it around. What's the formula? Okay, so this is what I teach and why I'm so passionate about. Now I focus on menopausal women because that is my niche. This works for everyone, I'm telling you. So the concept between diabetes and Alzheimer's, right?

We call and you've addressed this in your summit clearly that Alzheimer's type three diabetes. So I've turned it around in the way of my what I call my keto green approach. And I'll explain that in a minute. So and I also turned it around by reducing the polypharmacy. You have to do that very carefully with physician's guidance and and maybe a functional physician, a health coach, you know, to really monitor some of the and we got so many better ways to monitor continuous glucose monitoring. I recommend everyone do that for at least one month.

You know, at least one month, maybe even one month every few months and just really see how is your body interacting. It's going to change based on your stress level and your epigenetics. And it's really fascinating. So continuous blood sugar monitoring that is so anyway, so we've got so many better tools. But it would be this keto green approach with intermittent fasting. No more snacking, healthy fats, cutting out sugars, but having healthy milk, you know healthy al colonizers. And as I continue to get through, you know, to understand and metabolic syndrome and understand mitochondrial dysfunction and understand, you know, what is happening, especially with the hormonal changes as our body age, one of the key biomarkers that I have people do is check your and pH for alkalinity, to know that when we have a more alkaline urine, we have a more grounded physiology.

It's like being in nature versus being in a industrial city covered in smog. So how do how do we best operate? Obviously, as by design and but in nature. So that alkaline urine plus the work you know of higher alkaline air with lower levels of uric acid and all of these important pieces to the puzzle. But I definitely see that alkaline izing component of our, our nutrition plan mentally and physically as part of our part of our, you know, part of our protocol. So then tell me, so what are some of the things that make us more outline?

What are some of the things that make us more acidic? Like, can I just drink a bunch of alkaline water or is it more than that? Yeah, it's much more than that. It's much more than that. So the whole we know that plant, you know, diversity in our plant foods create a healthier immune system and lower risk of all the metabolic diseases. So the whole part of the alkaline izing vegetables and herbs and spices are really to add that fiber, prebiotic content as well to support microbial diversity, and especially when it comes to as women's health, they struggle, you know, and man's because the increased rate of prostate cancer right.

Keto Green Lifestyle and Meal Ideas 21:08

So detoxifying estrogen healthily that's a really important factor. So so that alkaline izing with dark green leafy is like greens spinach with herbs and spices like turmeric, curcumin, mocha. I have my mighty mocha plus formulation that has all these organizing adaptogens, you know, super oxidants. And that's that's beneficial. And the other piece is, you know, the herbs and spices. Food is medicine. And I will say that, you know, learned that the ancient physicians to the kings and they back into the Ottoman empires were where the the physicians prepared their food.

They were their chefs, they prepared their food. And these herbs and spices came from, you know, balancing the constitution of the of the royalty and of the is so fascinating to me. And then somehow we forget that in modern medicine now you can just drive through. It's just about calories. It's not about all that, you know, garbage that I learned growing up and being a student of of health and so it's fascinating to me so that alkaline colonizing but with healthy ketogenic foods, healthy fats, you know, from quality sources as well as high quality protein, you know, to continue to support our metabolism and our brain function and really restricting the carbs more and more, you know, especially as I've been doing this now since I created my Keto Green Plan in 2015.

I've been doing this now for many years. You know? I know like that I swing in between ketosis and not, and before I'm getting on a podcast or before I'm presenting, I'm like in high ketosis because I want that memory, that recall and and it's, it's it's true. It's just it's truth. It's honoring our physiology by design and the fluctuations in our 2030s can eat anything and have perfect memory. Not so true. Now I love it. You were totally ahead of the curve, right? We did. And I think personally, many of us were feeling this right.

When I get into ketosis, I feel mentally clear. And we were hearing it in clinic from our patients. Like when I get into ketosis, I feel clear. And yet there's been this refrain for so long, certainly in the 80s and 90s, that fat was bad and lots of fear around the ketogenic diet, because some people would interpret that as like cheese and bacon and sausage for three meals a day. And I think clarifying that, that you can have it what we want. And in fact, the whole purpose here is a healthy ketogenic diet, a green forward ketogenic diet.

And I just want to plug, like, you were right because now we see I don't know if you saw the recent, article out of Florida, but in six weeks they took it's a feasibility study. So a small child, but in just six weeks, they took nine participants with measurable cognitive decline, and they reversed it with a ketogenic diet with a healthy ketogenic diet. And so really impressive. And everybody who got into ketosis had reversal of their cognitive decline. So you were on it. You knew. And so that means that you have a lot more experience than most people who are kind of like on the edge of like, okay, maybe it's a paleo diet or maybe it's a mediterranean diet.

You're like, no keto since 2015. So you do green, keto, green, right? That's the thing. That is the difference. Yeah, absolutely. There's keto dirty and keto clean, which is keto green. And then also learning because right 2015 I started doing I'm putting menopausal women on this plan. And now it's reached, you know, hundreds of thousands of women. And my first book, The Hormone Picks. And then from there, Keto Green 16. And now my next book coming out is menu. Pause. Ha, I love it. I know many pods, and it's the five different eating plan so each can break a plateau.

Listening to your body again, we get we get into a certain way of doing things and we just think that's the way. But just the same thing with exercise routines, we have to change things up. We have to change things up. And that is really important to remember that variety and, you know, just not a stuck way. And it's just the same thing with some clients. I've had it in, you know, even doing keto green for a long time. So sometimes you need a feasting day. Sometimes you need a fasting day, you know.

So so we have to change these things up and you have to test. Don't get so getting into ketosis and checking your amp levels. It's the combination is magic. It really the combination is magic. And that is honestly the best place that I could live in that zone. It's hard. Stress takes you right. Stress is going to make you more of create an acidic urine. Cortisol. Cortisol creates an acidic urine by, you know, increasing hydrogen ion secretion across the renal tubules of the kidney. We see that. So you can be eating perfectly and be acidic because mentally you're stressed, but you're the only one who can upset yourself.

So you have to learn these pauses, these controls, letting go of what no longer serves us. And that's also, a chapter in menopause, too, is is to let go of some of the things, pause things that no longer serve us, and practices that don't serve us, that don't benefit us. That may be, you know, media promoted, but they're detrimental and toxic to our bodies and our minds, and that's what's really important. So the constant education, the constant learning, the constant exercising of our mind, it's a critical piece of of healthy aging.

And we can't do that without healthy physiology and physicality. So it's a combination of things. And that's an important piece that you certainly physicians don't have time to address in their medical practices. So what does a typical meal, on a menu pause menu or a keto green menu? Yeah. So one of the things that I love, certainly keto green smoothies, a lot of times people and especially converting women from making their morning smoothie that typically had a lot of fruit or a banana or something in it.

It's like cutting that stuff out. And instead it may be a zucchini and avocado and some celery, but protein. And I use my keto green protein powder, which is a, a seed and, vegan based protein. You can do collagen peptides. I love using those two sometimes and different proteins, but you want to make sure you got zero grams of sugar. So and healthy fats in there. So adding that avocado or that MCT oil or something like that can really benefit. So healthy fat, high quality protein and some fiber.

So some fiber and greens. And that's a really great way to have a keto green smoothie. And again still be incredibly delicious. Satisfying. You're not going to have cravings in an hour or two. And then another like keto green plate, like I love smoked salmon allows for salmon because I can buy it and I can keep it in my fridge and it's always there if I need it. But smoked salmon with capers, red onion served on a bed of arugula drizzled with olive oil is a keto green meal, and you're not going to be hungry in a few hours.

And I like a a keto green sorbet. Do it your own sorbet. So, I'm a single mom with kids, and I'm I've been living in a small condo in Dallas for the last couple years and finally decided I was going to stay, and I bought a house here. But, you know, like cooking in one, all your food in one pan and having one pan to clean like this is how I think. And these are how I create many of the recipes that are in my books. But, you know, so like I would saute up some onions and beet greens and saute that, drizzle it with, you know, in ghee, probably sauteed in ghee or some olive oil and, you know, prepare that at the end.

Just put in some chicken or some beef and, you know, saute that cook that right there in the same pan. And yeah, one pan meals. And I love that. And that is a beautiful keto green meal. You're adding healthy, high quality protein from ideally, you know, non-GMO veggie. You know, organic free range sources, your, your green leafy greens and, and spices and herbs, like, I love sprouts. And I also recommend fermented vegetables as a crucial part for helping our hormonal balance and gut microbiome. And so that I mean, that's like that's a perfect meal right there I love it.

What we do in my house is we we travel around the world so that we can in our, in our kitchen so that we can keep it fresh. Because I think some people say like, oh, are you having like turkey every night or are you having ground beef every night? Or like I, you know, there's three ways to mix it up, right. You can do chicken thighs and then and broccoli and then green beans and cauliflower. There's so many things when you start thinking about it. But I for a lot of people who aren't used to this, it feels restrictive.

And so one of the ways to keep it exciting is to say, okay, we're going to use Indian spices when they add Moroccan spices another night, and Asian spices like ginger and maybe some coconut aminos or some, the rice vinegar or something like that to make it taste different, even though you're eating some of the same basic ingredients. I love that. And then the other piece I, we do exactly the same thing. And that's what we did last night for dinner. The one great big cast iron skillet that's full of all of the grains and all of the protein that we're going to have.

The other thing we do is roast it, so put it in the oven, and then it's so much easier. It's like fast food essentially, because you just put it in and you don't have to think about it. And then it's one thing to clean crock pot. So the instapot is another way to like simplify. I know I love like we I'm going to get hungry talking to you here. I know I love it, but it's so good. And in my new book menopause, like after I wrote Keto Green 16, my goal is to do menopause around the world. Wow. Pandemic had hit right at the release of Keto Grain 16, and so I didn't get to travel around the world, but I've already traveled around the world quite a bit.

And so I love when you say that, but I do menopause. I have, you know, but topics on, menopause around the world and how we use those foods to help with balancing hormonal symptoms. And I think it's just a beautiful thing to integrate and a fun thing to do with your family. Another trick is there is gardening guidance cards. I don't know if you've seen these garden guidance.com, but it's like all kinds of vegetables in here. You know, some of the most common ones. And some like the red for example, red sweet potatoes or, you know, like the different like purple onions or whatever it may be.

And, you just draw a few cards and incorporate those foods into your vegetable mix for the, the day. And I think that's a fun, a fun thing for the kids to do to, to get involved in that class. And I get stagnant some time and I'm like, I'm going to the grocery store, let me choose three cards and see what I can create with it, or incorporate those into a casserole or something. Yeah, fun to keep that inspiration. One of the questions we get a lot is you're suggesting ketosis am I going to be in this forever?

And you mentioned a little bit variety. So tell me what is your typical approach. How long does somebody get into ketosis for. What do they do. What do they do next. How do they know us? You mentioned testing. Like what's kind of the basic somebody is going through menopause with the first six months look like. Yeah. And it's so good because you think of, you know, the metabolic flexibility in one thing. And again, I won't ask anyone to do what I can't do myself.

Fasting, Feasting, and Hormone Support 32:28

But again, I'm always learning and growing. But I always say 10% fasting, 80% keto grain and 10% fasting. And sometimes maybe it's more 20% feasting depending on what season it is, etc. but the concept is does my meal look keto green? And so you're for example, you're going out to dinner, you're ordering some steak and veggies. Maybe that's what you're having, or fish and veggies and you just say, make sure there's no sugar in the sauce you're using, and don't bring the bread to the table. And something like that is very, very easy to do.

And when you think about that combination, I mean it becomes easier and easier and then say, okay, well, you know, maybe the next time we go out, you know, we'll have like and you can have a feasting meal like a healthy, gluten free, dairy free dessert or whatever your body tolerates. But recognizing that's just part of it is part of the ebb and flow of life, like using learning what's working for you. And I found a very interesting because I was interviewed on one of the cards by like, I think it was PEOPLE.com about one of the Kardashians doing keto, and she would have pancakes on Sunday.

And I was like, well, I mean, they're calling it her cheat day. That's her cheat day, and asked me what I thought about that. And I said, well, first of all, I wouldn't consider it a cheat day. I would consider it a feast day. She's getting results. She's looking amazing. She's, you know, feeling better and more amazing and depending. And that this day she will learn what she can feast on and what she can't feast on as time goes on. And so prohibiting it creates restriction, fatigue and often makes people feel like they're on the wagon, off the wagon.

They've fallen off their their failures and they, you know, are just losers and can't do this. And it doesn't work for them. Versus this is all these are all opportunities to learn and grow and experience. So I just I like I was out last night on a date or a Friday night on a date and, we, restaurant hopped and ended up at this gorgeous little cafe Madrid here in Dallas. And they had, far less chocolate torte and flan on the dessert menu. And I was like, oh, this seems like a perfect feasting opportunity.

And I looked at it that way, and I had to watch myself. Well, I'm cheating on this. I had to change it the way I'm thinking. I'm feasting on this. This is fun, you know and aware. I love this restaurant and this food, and it's good products. So, you know, like to change your mentality around and let's see how I feel tomorrow. But this is a treat. This is a feast. This is an experience. How will my body respond to this. And then I learn from that experience and opportunity. I'm not a failure. I didn't sabotage myself.

And I think changing the way we think about that is really important, especially as women. And it might also even change our results. Right. You mentioned having cortisol go up if I'm if I'm beating myself up because I'm a failure and I did it wrong and I fell off the wagon. Well now my cortisol is going up. And then now I might fall out of ketosis because of the cortisol. Not even the flour. Less chocolate cake, right? Watching that I another piece that comes up is my husband and I are doing ketosis and he seems to stay in ketosis, but I'm getting kicked out of ketosis.

Why is it different for the two of us? So what do you how do you coach women when they have that coming up? Men have ten times as much testosterone as women, right? The anabolic steroid men have, you know, more circulating estrogen in the brain because testosterone conversion to estrogen in the post menopause compared to postmenopausal women. So I think it's important to recognize that testosterone is an anabolic hormone. It builds up and maintains bone mass, muscle mass, higher metabolic basal metabolic rate.

So they have a cushion. They're neurologically women, especially in menopause. We're like a pressure cooker with off the lid off. Right. So it's all kinds of stuff. With a decline in progesterone. Again, for me, a menopausal and postmenopausal women should be on progesterone a bioidentical microRNAs topical progesterone is my preference. And as a, as a first line therapy, you know, with, with you know, taking, you know, hours they take 1 or 2 days off a week, 3 to 5 days off per month, post-menopausal.

And it's important. And men too. I've used bioidentical progesterone and pregnant alone. And it is an important factor for hormone stability, cognition, the neuro protection. And, and it enhances the results that we get. Post-menopausal whatever we're doing. But certainly when we're on a key to plan. So let's dive into the hormone piece, because I know you've been an expert in that for a long time. And there is throughout sort of this debate in the field about, is that healthy? Is that the best thing for people?

That's a big Women's Health Initiative study was stopped early because it looked like all cause mortality. So people were dying more frequently when they were on hormones. There's a ton of nuance in that, and I want people to understand, especially women who are at risk for dementia, either they have a family history known genetic predisposition, or they're already starting to feel the symptoms. What is how do you take them through sort of this cost benefit, risk benefit analysis and whether or not hormones are going to be a good idea.

Yeah. Well, I always say, post postmenopausal. I mean, the benefits are for hormones. I'm first of all, it's true. I mean, I've traveled all over the world. I've seen many amazing, women in their 80s, 90s and above that are just cognitive, cognitively clear and I'm not on hormonal therapy. And what are they doing? They're walking. They are, in community. They are in nature. They're living in often rural and polluted areas. And, and, they have a healthy attitude and healthy relationships and maintain that.

So there's always the exception. Certainly I would say when we are living in, nature, we have nature as medicine, but when we are not, we need to bring nature in. And this is where hormonal therapies can definitely help. I our modern American lifestyle is very different. I'm in in Indonesian Ubud and I'm hiking along the back volcanic trails. I'm not on any hormones or supplements at that point, right? If I'm out camping in the woods and nature even here in in East Texas or, you know, around Dallas if I'm camping because we have a horse trailer and horses.

I mean, I mean, I don't need anything else, right? I don't need anything else. Nature is medicine. In those instances, you're out of, you know, you know, out of the stress. Typically, unless you're watching a 14 year old barrel racer racing around barrels. Anyway, but, you know, those are I mean, those are good things. So I, I look at it as, you know, I use, I've used and I've used in my patients for now. I've been in medicine, you know, for over working in biochemical hormones and sexual health since the 1990s.

So, you know, in my own practice I use bioidentical progesterone, certainly perimenopause and beyond, either cyclically or in a continuous basis, with a little interruptions and a transdermal. It's the balance. Creams come my balanced cream. It's progesterone and pregnant along with try peptide for healthy skin changes and collagen production. Of course we want that if we're using a topical. And so that combination is powerful. And and using DHEA and testosterone so topical DHEA used for the most important anatomy of our body and that's, you know, clitoris to anus.

So that's my job of formulation and that, I created these things, Heather, because I needed something for myself and for my patients. That was that would work and that was high quality and didn't need a prescription. And so that's where my formula is. And and one of the things the products that I've created, have come from because my doctor's bag was empty and I found and I created these, found these found these different ingredients to help me. And, and certainly combining bioidentical hormones in prescription was a, was a part of that.

That's less than the 10%, right. The 90% cis keto green way of living. It's not just what we eat when we who we're eating with, how we're eating, you know, how how much are we chewing? You know, what's our there's so many factors to this. What's our mindset at the time of our eating that we bless our food are not you know, I mean these are factors that affect our physiology. So that's part of why it's not a ketogenic diet. It's a key to green way. And I think that's really so misunderstood and so much of standard medical practice.

And in fact, there's fear and anger when you suggest that there is fear and anger when you suggest, look, you know, it's not just in your powerful prescription pad, you know, and there's backlash for that. But bioidentical hormones have a role in bioidentical, not synthetic. And I don't care that they can be produced by pharma and a few different strains. There's an art to medicine. Allow physicians to practice the art of medicine. Pharma is restricting us in so many ways, and we really need to acknowledge that there's blessings, there's great pharma, and then there's there's, you know, there's not so, so bioidentical progesterone in a topical form, a little bit goes a long way is a great option.

Also, there is prescription bioidentical progesterone, I promise. Cream has been around for decades now. And it's a bioidentical progesterone form. And and then using estrogen DHEA for testosterone. And in Cherokee and in topical. I don't like to use oral hormones after age 55, especially oral estrogens, because oral estrogens increase inflammatory markers and, risk for blood clots. So that is known as a side effect of oral estrogen. Then we have an alternative. The only time topical estrogen is aren't working as well is if we have gut issues G.I track issues.

If you if you have any G.I track issues, the skin is a reflection of that and you will not absorb your hormones really well. And then sometimes we bypass that for a while by doing either Cherokee's or sub buccal lozenge type hormonal therapy and vaginal hormonal therapy. You can do some rectal therapy. It's not well study. There's not many people lining up for those studies. So.

Hormones, Dementia Risk, and Resources 42:58

But it's an option. So there's lots of options that I'm hearing is there's lots of options. There's lots that can make it work for you without the breast cancer risk. A lot of patients have questions about that. And I am I maybe reducing osteoporosis risk and reducing dementia risk. But am I increasing my chance of getting breast cancer. Well, you know, increasing this is where I think the anti estrogen talk is misogynistic. Whether it really is I mean it is anti women. When we talk about estrogen the focus is on estrogen. Is it really.

Well our studies. They said estrogen alone did not increase your risk of breast cancer. So why is the drama still on that. And I want to share a couple things a couple images. I know we're running close on time, but you know, one of the things that increase your risk of breast cancer and diabetes and heart disease and dementia is hot flashes. The more and longer time that you suffer with hot flashes, unrelenting hot flashes, the higher your risk is for diabetes and dementia. And I think that's important to and cardiovascular disease, according to research.

So I think that's really important because we know that if we're at risk for diabetes, we're at risk for dementia, we're suffering with it. We're at risk. And this is the, you know, and and this is the slide I want to show you. So if you're listening, I'll explain it. But, and if you're able to see this slide, this is, you know, design this is designed by me for dramatic effect of the hormones that are, fluctuating in our reproductive lifespan. So in our 20s, we have peak hormone levels. DHEA for both men and women starts to decline in our 20s.

And, progesterone starts decline in a woman's 30s with declining ovarian production. And we get into this timeless period with declining progesterone from our mid 30s to mid 50s, this, progesterone decreases about 75% from age 35 to 50. Estrogen decreases 35% from age 35 to 50. The research on estrogen on the brain have been favorable, but we're ignoring bioidentical progesterone on the brain. And the one reason is bioidentical progesterone. I believe it's difficult to fund those studies since it's not a patentable, profitable intervention.

But it is critically important. And we know from research out of Emory with their project, three trials that looked at progesterone on traumatic brain injury and when they used a bioidentical form of progesterone, they had improvements and good clinical results. The synthetic forms, however, did not. So I think it's important to look at this. This period then becomes this time frame of neuroendocrine vulnerability. So we get all the Gyn symptoms, irregular bleeding, breakthrough bleeding, cramping all of that.

And you get the neurologic symptoms the anxiety, the depression, the PMS, the mood swings, the brain fog, the loss of libido that, you know, it just goes on from there. And as a physician working in this space, going through my own hell and journey from age 39, with early menopause and infertility able to reverse that at 41 and then plummeting again at 48 as a, long story right about that in my the hormone fix. But, you know, this was through my experience. I recognize that these changes, the power, the power of the keto grain diet in this time period because these are neurologic symptoms.

So as I practice this in my, you know, started fine tuning hormones, starting, putting clients on detoxification, you know, nutrition, professional detoxification plans, an early version of my Peter Green plan. And they would come back within the further six week follow up to review the relapse feeling at 90% better before I ever wrote anything on a prescription pad. And that's that's so key. Like my mom and dad, they were, you know, military. My mom immigrated to this country and they didn't have access to physicians like me. Right.

You don't have, like, thousands of dollars to spend for an initial consultation that this hormone fix. It's that for everyone. It is that for everyone. And that's the the difference. It takes more than hormones to fix our hormones. And then neurologically, this was published in, 2015. And it looked at glucose metabolism in the brain. And this is what showed that when you have, a decline in the perimenopause, you have a decline in glucose metabolism in the brain with an increase of these neuroendocrine symptoms.

In other words, your brain is starving for fuel, your brain is starving for fuel. And it's important to recognize this because we bypass this process by switching to ketones. And that's what I was talking about earlier. And, you know, diabetes, menopause and perimenopause is a single risk of diabetes. So if you're in perimenopause and menopause you're at higher risk of diabetes if you're not. So and it's the research showed, that also increased in women who had their ovaries removed. Now, no one taught me this in residency or med school.

And this wasn't part of my consent informed consent process. And of course, you know, you've talked about insulin resistance and how that relates to dementia and Alzheimer's. And that's where this keto green approach becomes powerful because we're creating insulin sensitivity. We're reducing cortisol. And where, you know, balancing our hormonal physiology as I have it is what you're describing is a testament to the foundations of health, right? The diet, the exercise of sleep, taking really good care of ourselves, managing our stressors, that that is really foundational.

There's so many people who can get all the help they need, just doing that without ever going to see a doctor, without ever spending any money on testing or hormone prescriptions or anything like that. And so I just really appreciate that empowerment. Right? It's like, go read the books and understand how you can get the most out of this without the need to make it even more complicated and more expensive. So I want everybody to be crystal clear about where they can find your books, where they can find out more about you, where they can get the support that you offer, and also the products that you mentioned where they can find access to that.

Yeah. Thank you. And I would say, like I say, go get the book and I would say do it in community. I get a small group, your your home group, your work group, your girlfriends, your book club, and do it together and community because that makes a difference. And right now, April 12th, my book menopause is released and many pause five different six day plan. So they're fun to do together. Really good. And you can get that anywhere books are sold. And I'll, I'm excited about that. And, my website doctor and i.com doctor and a.com lots of free resources and information and and information on my product, mighty Maka and Joel von balance are all there too.

And I was like, you know, I ask me anything. You can tell her, ask me anything, and I'm here to help. I've seen too many people struggle. I've lost both my parents and, and, diabetes and heart disease on both sides of my family. Confirmed by genetics. Right. Genetic, testing and I've done the extensive genetic testing. I'm like, okay, I've got all these red flags, but I'm definitely healthier now than I was a decade ago. And we can turn the hands of time back so that we can live our passionate, juicy, wonderful, intimate lives.

How exciting. Tatiana, thank you so much for your dedication to this work, to to your patients, clearly to the cause of just making sure people are healthy are out there. What are their tips you have for people? Any less insights that our listeners can take away? Yeah, and one more thing too. And then connect with me on Instagram at the Girlfriend doctor, because I'm on there more often now than ever, because I've got a new grandbaby and I'm seeing my daughter's post on her. And also that's where I keep track of my kids.

So I'm on Instagram at the girlfriend doctor and and my, my tip would be it's really like, you know, step in to the keto green lifestyle, step in to intermittent fasting, step into working with our natural design, our physiology. And with that, you know, there's, you know, the most powerful health intervention that we can make is positive connection and love with other people. So it's this friendship, it's this nurturing, it's this connection that I always found to be my best medicine. It's why I do what I do.

Thank you again for your time. And, I can't wait to get your new book. So exciting. For.