Straight Talk From A Pharmacist: What You Need To Know

Lindsey Elmore, PharmD, BCPS

It’s always such a joy to get to talk with you, Sharon. I’m so excited.

Sharon Stills, ND

Me too. Before we talk about some really important topics, I just, typically, when I meet a pharmacist, it’s like they think one way and I think a very different way. And so it’s such a joy when I meet someone who is like, What now? They’ve come to the dark side, and so I’d just love it if you could share with us briefly how that happened for you. Was it a personal health issue, did something happen with patients, or was it just how you became this holistically minded pharmacist?

Lindsey Elmore, PharmD, BCPS

It was a longer journey for me. There was one final straw, but there were a lot of hay bales on top of the camel. So, when I was a first-year pharmacy student, I tore my ACL. When you tear your ACL, your leg gets locked out in a leg brace. So while you’re recovering, and as I was walking in this leg brace, you end up hiking your hip each time that you walk. So my hips were out of alignment. That landed me in the chiropractor’s office for the first time. At that appointment, I told the chiropractor, Doc, I think I am just really struggling to sleep. I’m not doing well. I had been taking some sedative hypnotics at the time, which are not the safest of medications. I wanted to move on from that. She recommended that I go to the acupuncturist, who will introduce me to Chinese herbs. I started going to integrative medicine conferences. I met my first kind of wacky pharmacist, who is also a shaman who practiced shamanic medicine at the University of Minnesota for a long time. I started to get this reputation that I knew as much about herbs, supplements, and alternative healing modalities as I did about conventional medications, and as I have become more learned about the history of the pharmaceutical industry, the way that patients are treated by Western medicine, as well as the way that specifically women are treated by Western medicine, I just said, Hey, I’m looking for something very different. I’m looking for something very different here. So I started going further and further down the rabbit hole, and I went, all the way from one side to the other. 

Then, as I have again just continued to study and really taught with more people about where I am in my life and in my journey, I have come to recognize that there are certainly times when medications are 100% appropriate. There are times when they are absolutely lifesaving. I just like to teach people that if we’re going to use medications, let’s use them appropriately. Let’s be sure that you know what to look out for to know if your medication levels are too high or too low. Let’s make an intentional effort to mitigate the risks that come along with medications. Even as I’ve matured even further, it’s like, Okay, we also need to mitigate the risk that comes with some of the more assertive wellness practices. I mean, you don’t want to sit in an ice bath for 30 minutes. We need to be pragmatic. That’s where I’ve come to: I want to be able to talk about medications, supplements, vaccines, wellness interventions, new and cutting-edge therapies, and emerging therapies all in the same way. I just want to be able to say, What does the data show us? Who was the data actually collected from, and how do we create an individualized, personalized approach to each person’s health?

Sharon Stills, ND

I love that. I think one of the reasons there’s many reasons that I went to medical school was because I didn’t want to just understand the holistic side, the herbal side, or the nutrition side. I wanted to get a DEA license and have the ability to understand pharmacology and prescribe meds if I needed to, because especially if I was taking someone off the medication or to know when, like you said, there’s a time and a place for everything. Because of my training, because of my extensive training over in Europe, I have not had to use pharmaceuticals very often. I mean, I write scripts for bioidentical and LDN, and things of that nature, but I think it’s really important. I really respect and appreciate that, and you understand it because I’ve seen, as I’m sure you have seen along the way, well-meaning holistic providers pull someone off a medication and create chaos.

Lindsey Elmore, PharmD, BCPS

Absolutely. I mean, medications are not benign, right? Therefore, I think it’s critically important. It’s almost unethical to say I’m going to be in a practice where the first thing that happens when somebody comes into my office is they go from taking six medications to nine. That can be a very dangerous situation for lots of people. If we don’t discontinue medications appropriately, it can lead to withdrawal, even for medications that we don’t typically think of as addictive. And it is also really not good for a licensed health care professional to be making rash decisions. And so I would much rather see somebody who comes in and says, Hey, I’ve been taking this statin medication. I really don’t want to be taking the statin medication. And I say, Okay, well, let’s get a three-month plan together to work on a slower discontinuation, working on the diet and exercise, and assessing some of the more intricate markers that help us to understand so much more of, Okay, is your cholesterol level actually dangerous or is it just high? There’s a lot of debate as it relates to cardiovascular disease about how overinflated the value of LDL is as a standalone marker for cardiovascular disease.

Sharon Stills, ND

Good, good point. Yes. And the myth of cholesterol it’s so permeated societal thinking. Even with my patients all the time, I do 30 vials and pages and pages of blood, and a lot of time goes by. What’s my cholesterol? And I’m like, That’s like the bottom of the totem pole. Let’s look at what your inflammatory markers are. Let’s see what’s actually going on in your body, which is so much more important. I think this is such an important conversation because, if you’re in perimenopause or going through menopause, you might actually be on some medications at this point in your life already. Or maybe you’re being told you need medications to mitigate cardiovascular disease or osteoporosis risk. So I’d love it if you would just educate us a little about the medications that are out there and what are the dangers. Are there any points that you see as beneficial? I want to, and obviously I’m not a pharmaceutical pusher, but I’m a believer in telling all sides of the story. I once had a patient who was on antidepressants, and usually patients come to me because they’re on antidepressants and they’re not working, and they want help getting off them, and they want a natural solution.

But for this patient, it was so long ago—this is like 15 years ago. So I don’t even really honestly remember why she came to me. But she was on antidepressants, and she they were helping her. Sure. And she really felt good on them. And I was like, Look, let’s just look and make sure, like, the nutrients it’s depleting, let’s test and make sure you don’t need them. Supplement it back in. And if you do, we will. But stay on your antidepressant. If you’ve been struggling a long time and you finally got meds that are working for you, like if it’s not broke, don’t fix it kind of thing, and I remember colleagues and friends were like, You have a patient stay on an antidepressant. I thought you were a naturopath. And I was like, Well, I’m in the business of helping people holistically. And she didn’t ask to come off it, and it’s actually really helping her. She was suicidal prior to that. So, like, Yes, I’m going to leave her with antidepressants. 

Lindsey Elmore, PharmD, BCPS

I think it is an interesting piece of medical history in this country to see how it has been a strategic and manufactured narrative that the acceptance of alternative and natural medicine and food is the diametric opposite of drugs and surgery. Whereas both you and I are sitting here going, Nope, they’re both just tools in the tool bag. But that’s actually a very historically well-documented part of medical and pharmaceutical history. There was a guy named Stanley Flexner, and he wrote this document called The Flexner Report. Prior to the publication of the Flexner Report, medical schools had personalities, right? So you could go to one school where they are saying, Okay, yes, we’re going to teach you medications, but we’re also going to teach you a little bit about herbs, or we’re going to teach you pharmacognosy, where you actually learn to take herbs and convert them into medications. You might go to another school that has a huge emphasis on chiropractic, dry needling, or hormesis. So, what happened is that after the Flexner report, everything that was not drugs and surgery was villainized and pushed to the side, and schools began to lose their accreditation if they did not adopt the new guideline-based, medication-focused, and symptom-focused, You think about an infant coming to the pediatrician these days for a, well-baby visit. Still, the first question that we ask is, What’s the chief complaint? And it’s like, What’s a well-baby?

Same thing: I’m going to see my OB-GYN in a month or so. And there’s nothing wrong with me. I feel just fine. Yet the first thing that’s going to get asked is, What’s your chief complaint? I’m like, I’m here for preventative health screenings. I’m here to be sure that nothing is going awry. I’d like for somebody else to look at labs other than just me. We have to get out of this mindset that the two things are opposite. The fact of the matter is that I love both. If I have a patient sitting in front of me who says, and I’ve heard it from my friends, I’ve tried for years to get off my antidepressant; I’ve gone from 30 milligrams down to five, and I simply can’t get off of those last five, You can either say, Okay, stay on the five, or work with a specialty compounding pharmacist who can make you doses of medications that do not otherwise exist. I interviewed Dr. Ellen Vora on my podcast, and we were talking about a very interesting concept: this whole thing of I can’t get off of this medication. If that is in fact true, then what we are dealing with is a physiological addiction to the effects of the medication.

Addiction has been so villainized, but it’s a disease just like any other. We need to be able to talk about all health care conditions in a down-to-earth, meaningful way, be it menopause, addiction, or mental health disorders. We need to be able to talk about these things because otherwise, as we create victims and villains out of our patients, I look at the work of an author who wrote a book called Insane, talking about how we villainize and demonize mental health disorders. Well, there’s nothing wrong with somebody who says, I really think I want to stay on this medication. There’s also nothing wrong with somebody saying, Okay, I understand that I have a physiological addiction. It doesn’t drive me to do bad behaviors, but my body is addicted to the effects of this. And therefore, I’m willing to go through a six-week taper while also increasing the amount of herbs that I’m taking that can help elevate mood and modulate mood. And both are completely valid approaches to health.

Sharon Stills, ND

And then it’s a bad yes; it’s really that I love that. I didn’t know what or where a conversation was going to go. But I love because I hope for those of you listening that I think sometimes when you get on this health journey and then you beat yourself up, that you’re on medication. And if that’s what the tool was at the time for the person you were working with, if that was the best tool they had, then that was the best tool they had. And there’s a time and a place for a lot of different things. In my career, I have studied continuously for over two decades, and I very rarely need to go on antibiotics. I know how to do it; I don’t need to go on osteoporosis drugs. I don’t need to use cardiovascular drugs or diabetic drugs because I have all these tools. But that’s not always where we’ve been. So if you’re on medications and you’d like to get off of them, that’s a very fine thing. And if you’re on medications, I think it’s really important to understand, and I think we could talk a little bit about that now, like, what is the detriment? Because you don’t really learn about that. And a lot of medications were meant for short-term use. You’re depressed because you just lost your spouse, and you go on an antidepressant for 30 days to get you through. But people get put on medications and they just get left there, and that can really lead to some detrimental effects. So I’d love it if you could talk about that. I think that with the osteoporosis drugs, a lot of the women I believed were being told that they needed to go on these drugs, and I’d love for you to speak about them.

Lindsey Elmore, PharmD, BCPS

Yes. And so if this is a concern of yours, especially if you have a medication list that’s six or eight medications long, I think one of the most important things that you can do is sit down with a local pharmacist who practices in an area called medication therapy management. Medication therapy management is when a pharmacist sits you down. They will, depending on how they interview. I like to ask a lot of open-ended questions, so I’ll pass my patient a bottle and say, Tell me what this medicine is. Tell me how you take it. Tell me what you notice when you take it. How long have you been on it? A pharmacist can really help you identify overlaps and therapies. Potentially dangerous therapies, potentially contradictory therapies, therapies that are causing massive nutrient depletions, like the statin medications, for example, cause massive depletions in COQ10, to the point where in Japan, pharmacists are required by law to dispense COQ10 alongside a statin medication. And you may think, Well, why does that matter? Well, if you don’t have enough COQ10, your mitochondria can’t clean up their waste material like they need to be able to. Guess what it causes? The buildup of toxins that leads to muscle pain. While muscle pain is one of the most common side effects of statin medications, if we’re going to use medications, let’s at least give them a fighting chance to work appropriately. Osteoporosis medications are an interesting class of medications; aside from vitamin D and an appropriately dosed amount of calcium, most of what is used are bisphosphonate medications. Then we have some more assertive medications for people who are further down the line that are called anabolic medications. These are medications that actually increase your bone growth. So I think it’s generally good advice for most women to be on a vitamin D3, a vitamin K2, and an appropriately dosed calcium supplement, because I see these women coming in with, like, 2000 milligrams of calcium once a day. Well, calcium reaches a maximum absorption capacity of around 500 milligrams. So if you’re taking more than 500 milligrams, all you’re doing is causing constipation, and constipation alters the microbiome. It alters your metabolism and makes you feel sluggish. It doesn’t help you eliminate toxins from your body, etc.

I am a megadose of vitamins kind of person, and it is very important when it comes to calcium. The other thing that we need to know about the anti-resorptive of medicines is that they are bisphosphonates. The bisphosphonates in medicine almost stick like magnets to the top of the bone. The risk of that is that if you’re not on a bisphosphonate and you break a bone, the bones tend to just break, right? There’s one hairline fracture, or there’s one break that’s a little bit jagged that just kind of moves the bones apart. Okay. When you are on bisphosphonate drugs that act by sticking to the surface of the bone and preventing our osteoclasts from coming in and eating the bone away, what happens is that the bones become artificially hard, initially so hard that they actually become rigid. We don’t want rigid bones. We need our bones to flex. We need it when we bump into something too hard for the bone to be like, Oh, ouch, not to break. So what we see are some much more dangerous spiral fractures that become more common in people who are on anti-resorptive medicines. These are Fosamax, Actonel, Boniva, and even the I.V. Therapies like Reclast and monoclonal antibodies are in this class.

This is also where estrogen replacement therapy comes into play. Estrogen is an anti-resorptive agent. Estrogen has a hugely protective effect. So if you’re not currently on bioidentical hormone therapy, women, we used to go through menopause and then die, right? Our life expectancy was very, very short compared to now. But now that we’re living decades postmenopause, our bodies are not meant to live without the signaling of estrogen, testosterone, and progesterone for decades upon decades. So this can be a role for bioidentical hormones versus an osteoporosis agent. And friends, take care of your bones. Like, go lift some weights, stop smoking, and don’t drink alcohol. If you have balance issues, be sure that you’re including balance exercises on a daily basis and then really eating a diet that is low in things like phosphorus and oxalate. Don’t get me started on all of the phosphoric acids that are in dark colas that literally leach calcium out of our bones. And so the bisphosphonates there are not my favorite class of drug, but they’re not my least favorite class of drug either. They’re not as dangerous as some classes of medications.

Sharon Stills, ND

What’s your least favorite? I want to know your least favorite.

Lindsey Elmore, PharmD, BCPS

My least favorite class of medications is debatable, depending on the day. But the proton pump inhibitors come very close to the top of the list. Talk about a medication that is only intended to be used for two weeks. The original label, say, two weeks or less. We have people who are placed on these medications, and they have been on them for 20 years. And it’s causing magnesium depletion, multi-mineral depletion, and multiple vitamin depletion; it’s causing your bone health to decline. It’s causing you to be more susceptible to infectious diseases because your stomach acid is not killing off viruses, bacteria, and parasites as it was designed to do. So the proton pump-inhibiting medications really come to mind, especially because you want to talk about medications that cause a physiological addiction. Coming off of those medications, there are two different ways that medications can work. They can either, so if you remember back to, say, sixth grade biology, the lock and key method of how something binds to a cell, turns it on, or turns it off, Well, we have receptors, and some medications will stick to the receptor and then move away. They’ll stick to the receptor and then move away. 

Other medications do what’s called irreversibly binding a receptor, and that is what the proton pump inhibiting drugs do. They irreversibly bind the hydrogen potassium ATPases, which typically pick up a hydrogen ion and throw it into the gastric cavity, creating lower and lower PHs in your stomach acid. Well, guess what happens when you take the medicine? You irreversibly bind all these ATPases; they’re basically just little shuttles that move ions across the lining of the gut. The problem is, let’s say you stop taking the medication and you’re doing good for a little while, and then three, four, five, or six days later, all of the receptors start dying off and new receptors are getting generated. And now you have been exposed to low stomach acid. Now all of a sudden, you get a horrible rebound: heartburn. That’s one of my least favorite classes of medications, and I could go very long and detailed into the criminal history within the pharmaceutical industry of misbranding, mismarketing, or overinflating data as it relates to medications. But that one really comes to mind because they’re so common, they’re over-the-counter, and they’re generally considered to be safe to use every single day. And they are simply not. They cause massive problems throughout the entire body.

Now, back to osteoporosis medicine. I’m actually a huge fan of the anabolic medicine teriparatide, or Forteo; I’ve used it on lots of patients. I see it really working well. The downside is that if you stop taking it, the anabolism is going to go away. So it is one of those things where it’s like, All right, you can build the bone, but if you take away the influence of the medication, the influence of the medication is going to be gone. I just think it’s so important—don’t start lifting weights when you’re 45 or 50. Like, really start investing in your resistance training, not only because it’s going to help support your bones and keep your bones healthy, but because it’s going to keep you insulin sensitive, which, in my estimation, if you took 100,080 year-olds that were all walkie-talkie healthy, people would be up and about. They would all have one thing in common. They would all be insulin-sensitive. They would all still respond to the signals of insulin, and insulin and cortisol are kind of like the baseline. If those get out of alignment, everything else starts to trickle out of alignment as well.

Sharon Stills, ND

I remember when I was making my deck of red cards and I wanted to do cards on hormones, but it’s so individualized talking about progesterone and estrogen. I said, Let’s just talk about the Masters. Let’s just talk about insulin and cortisol. So then, I totally agree. We all want to replenish and balance our estrogen, progesterone, and testosterone, which is what I’m all about. But we can forget about insulin and cortisol; they really are the overarching umbrella.

Lindsey Elmore, PharmD, BCPS

Yes, and I think that we need to be teaching patients so much more about the nutrient depletions. Because I have a feeling lots of women go to their PCP and get their DEXA scan. They find out that their bones are a little bit thinner, and they say, Okay, it’s time for you to go on your bisphosphonate. But nobody sits back and says, Hmm, well, you’re actually on three different medicines known to deplete calcium, so we may have to do a more assertive calcium repletion protocol. You’re on two different medicines that decrease vitamin D and decrease magnesium in various significant ways. We simply don’t, number one, teach clinicians this, the quintessential textbook of drug-induced nutrient depletions. It’s almost like you’ve got to find it on the black market these days. It’s been out of print for so long, and I never knew it existed until a colleague of mine showed me, and I was like, Am I really going to pay 40 bucks for this, like, little, tiny textbook? And I was like, Yes, I am. Because it is so important that we teach people that if they’re going to take medications, at least give them a fighting chance to work and mitigate the risks. When talking about more of the master hormones, people who are menopausal think about estrogen, progesterone, and testosterone. But if you’ve got estrogen, progesterone, or testosterone problems, chances are, under that, there’s something going on with the thyroid. I am frankly horrified on social media when I talk about the appropriate administration technique of thyroid hormone medications and supplements. I’m like, Who are these pharmacists that are letting their patients walk out the door not knowing how to take their medication? It is just unconscionable to me. 

If we’re going to take thyroid hormone or thyroid supplements, you can basically get the same stuff that’s in the arm or thyroid in just a generic porcine or bovine form of thyroid hormone. We must teach patients to take it first thing in the morning without any food because thyroid hormone, the way that it’s built, has four big iodine molecules or three big iodine molecules sticking off the side of it. Iodine is very negatively charged because there are two on each side. When you get a molecule, or sorry, when you get an atom that’s got a positive two-charge, something like zinc or something like calcium, it sticks to it, binds it all in the gut, and then you just poop it out. We don’t teach people how to appropriately take their medications. It becomes dangerous because people come back in, they’re not getting the results that they want. What’s the solution? It must be that the dose is too low, as opposed to if you sit down with the pharmacist who does medication therapy management and they ask you the key questions: Tell me what this medicine is? Tell me how you take it. Tell me what you experience. They may uncover that you need a radically lower dose of a medication. It’s just that you’re not taking it appropriately. We also don’t educate people that some medications are better absorbed in an acidic environment. In a basic environment. We don’t teach people that some medications and supplements are much more highly absorbed when you take them with a fat-based meal or with a no-fat meal. Again, don’t waste your money on supplements either; we need to be taking those appropriately as well.

Sharon Stills, ND

Mm. Yes. I was thinking that, as you just started to say, and absolutely, I see that all the time. I’ve had patients over the years who are well-educated and came in on the right supplements, but they weren’t taking the right therapeutic dose. They weren’t taking it with food, without food, or whatever was best for absorption. They weren’t buying a high-quality brand. So the label said it was the right supplement, but it wasn’t actually bioavailable. Yes, when we’re talking about pharmacy and medications, it definitely goes over to serious supplements because, to me, the supplements are my medications, and so they have to be utilized appropriately. Taking them the wrong way is like taking them with food when they should be taken on an empty stomach. These all then make you think, Oh, but I’m taking the curcumin or the fish oil or whatever, but it doesn’t work for me. And often, it’s not that it doesn’t work for you; it’s that it’s not being administered or ingested properly. So that is huge. I’m so glad you brought that up. Yes.

Lindsey Elmore, PharmD, BCPS

Well, and  let’s talk a little bit more about the risk of not using supplements from a reputable company. Just last month, a study came out where 25 different brands of melatonin were analyzed. Do you know this study, have you heard of it?

Sharon Stills, ND

I don’t know if I know this specific one, but I know plenty like it.

Lindsey Elmore, PharmD, BCPS

I mean, it’s just like melatonin number one: the melatonin industry has gone psychotic over the past five years. I don’t know what they were thinking. The average recommended dose of melatonin is about half a milligram (M to a milligram). I was at the grocery store the other day, and they had a 50-milligram capsule of melatonin. And all you are doing is asking to be groggy and hung over the next day from taking megadoses of melatonin in the same way that if you take the crazy B vitamin supplements that have 15,000% of your recommended daily intake of vitamin B12, which will likely be cyanocobalamin and not methylcobalamin like we want to be taking, you have a much higher risk of getting a headache. Yet, in this study that came out last month, analysis of 25 different melatonin supplements revealed that 22 of them did not have the dose that was disclosed on the label. What’s horrifying is that the doses ranged from like 50% of what was stated on the label to more than 300% of what was stated on the label. There are really great supplement companies out there, and you can look for USP labels. That’s one group that helps to certify. It’s unfortunate that these certifications on these labels used to mean much more than they do now, as they’re often just bought. I mean, I hate to burst everybody’s bubble, but I don’t know that organic really exists anymore. You can pay. I think it’s upwards of a thousand agencies at this point to certify that your food is organic or your supplement is organic. If we just think logically about a hundred-year history of just willy-nilly dumping chemicals and medications all into our groundwater, the average municipal water sample has upwards of 15 to 20 medications in it. It’s not benign stuff, like, yes, it’s the antidepressants, but it’s opiates, beta-blocking medications, and anti-anxiety medications. And so, you may not be able to understand exactly why you’re not feeling good, but it could just come back to the environment as well. We can look for good manufacturing practices. You can look for the labels of the USP-certified products, or if it’s the National Pharmacopeia-certified, you can look for those, but it’s not 100%. But I do think that doing a little bit of due diligence and looking for companies that have ethics, have integrity, and aren’t owned by a larger parent pharmaceutical company is important. So do some research because we do need to ensure, again, that if you’re going to take supplements, give them a fighting chance to work and work appropriately.

Sharon Stills, ND

Absolutely. And it is sad that some of the brands that I used to think were acceptable; have been bought out by the larger pharmaceutical parent companies as investments. And to me, that’s a hard no. It is sad about the organic. I still am a big believer in eating organic, and I hope that the placebo effect, if there is contamination in there, outweighs it, because it’s just that you bring up a real sobering point. It’s just a toxic place out there. And so we’ve got to do our best to avoid it where we can and make sure our body is processing what it’s receiving. Because unless you are living in a plastic bubble, and you are, even in the plastic bubble. The plastic bubble is toxic.

Lindsey Elmore, PharmD, BCPS

Yes, I know you’re in the plastic bubble, just breathing BPA all day. I will also say, I don’t tell these things to be gloom and doom. I think a lot of people think I’m just a straight shooter, and I also very well researched in the history of the relationship between big pharma, big government, and big agro, and in the end, the manipulation of doubt within data. So I don’t say it’s gloom and doom. I say it to remind ourselves that we do our very best, and then we just forget the rest. I don’t want you to walk away from this summit going, Well, I’m screwed. I’m going to be honest. I thought I was doing well. Eating organic. You are. You are. So take what is meaningful. But we also have to live joyful lives. If we’re going through life and there comes a day where you’re like, You know what? I’m eating the hamburger and a cookie. You know what? Do it with joy and gusto, and then come back to eating kale and carrots the next day. Because I think one of the worst things we do as women, especially since I’m an eighties baby and like the women in the seventies, eighties, and nineties, is that in that super toxic diet culture, we have villainized so many foods when really I love the work of Dr. Dawn Shearling, who wrote a book called Eat Everything, and it’s about, just eating as best as you can all the time. Yet, it is simply too stressful to think about every little thing all the time. Give yourself flexibility because life is meant to be enjoyed.

Sharon Stills, ND

You’re being flexitarian right.

Lindsey Elmore, PharmD, BCPS

As being flexitarian. I know. I love that. 

Sharon Stills, ND

It’s what you do most of the time. and I so agree. Like, if it’s eating the cookie, if it brings you joy, maybe not all day long every day. But it’s how we are—it’s who we are when we’re doing things—so much more than what we’re doing at times. I often tell people that I love that you said that we totally share this belief. I often tell people that if you’re just going to eat broccoli and kale and be angry about it and stressed out about it, you’d be better off going to McDonald’s and biting into a Big Mac with joy. Because you remember being there with your grandparents and having happy memories. And I’m like, I’m not saying you should eat at McDonald’s. I don’t eat at McDonald’s, but it’s just to drive the point home. It’s like how you do things—whether you beat yourself up or are kind to yourself—goes a very, very long way. So that is just to me; that’s a mic drop. Listen.

Lindsey Elmore, PharmD, BCPS

Yes, I completely agree. I love the work of Janine Roth. Janine talks about how our love for ourselves is actually right there on our plate. It’s right there. You’re going to love yourself so much. One day, you’re going to eat spinach soup, and you’re going to love it, and it’s going to be the greatest thing. And then another day, you’re going to love being at your two-year-old’s birthday party or your grandchild’s birthday, and you’re going to eat the crappy white cake mix because that’s where you are. So, Yes, do your best and just forget all the rest.

Sharon Stills, ND

Listen to yourself. When I go eat a cookie or cake for myself, it’s still gluten-free. It’s dairy-free because I suffer. If I didn’t suffer, maybe I would eat it once in a while. But to me, it’s not worth the suffering. But I still go eat the paleo brownie or the one that my granddaughter and I had at the health fair when we started eating gluten-free and dairy-free foods like ice cream cones with this chocolate on top. We’re like, Yes, it’s having the flexibility to realize that food is not just something that nourishes you; it can also be a source of enjoyment and really being honest with yourself. Are you acting in addictive ways? Are you using food as a drug, or is it where you are with your food? That’s a whole other conversation. We’ve kind of spend a lot. So we have a few minutes left. I just want to kind of go one other quick place because, before we were talking, you said you loved herbs for sexual health, and you named a few that I love too. I don’t know how much time we have. Like five minutes. I know you have to go. A teach. Could you share one or two? Just because we might as well go from cookies and cake to sex?

Lindsey Elmore, PharmD, BCPS

I mean, I’d be. After the cookies and cake comes the sex, or maybe before; who knows? So, I mean, when I think of the classic Ayurvedic herbs for his or her sexual health, I think of Shatavari, which is the queen of all the herbs, and then you have Ashwagandha, which is the king of all the herbs. So Shatavari is an adaptogen, and Ashwagandha is an adaptogen that helps support healthy hormonal balance. It has been used for thousands of years to increase fertility and vitality. Shatavari can be used by women of all ages; it is something that teenagers who are having problems with their periods can use and something that women can use while they are fertile. It can be used in this final stage of sexual and reproductive maturation, which is menopause. It also helps to support mood. It can help you become more calm. When it comes to sex, there is a very delicate interplay between sympathetic and parasympathetic inputs that makes it to where, Okay, you’ve got enough sympathetic to where you’re getting blood flow and all the good places, but then you’ve got enough parasympathetic to where you can actually relax into it. I interviewed Dr. Jolene Brighton, and she said, Men are so funny how they talk about how they want everything to be a tight, tight vagina.  And she’s like, You know what a tight vagina is? A scared one. One that says, No, I’m in danger. I’m in danger. So we need to be using herbs that also improve this parasympathetic tone. Wild Green Oats can help support blood flow to all of the sexual organs; they also support healthy sexual desire. It’s a nootropic, and some nootropics impact our brain and our cognition, and this helps to stabilize the mood. Fenugreek is another one that women use while they are breastfeeding. Because it’s an adaptogen. It can either increase or decrease breast milk output. It also supports sexual health and vitality and can really help improve sexual desire. For guys, a lot of the time, women who have been through menopause also benefit from herbs that are traditionally thought of as men’s health herbs because it’s not just your estrogen and progesterone that’s gone off a cliff. Testosterone has as well. So we’ve got something like Tongkat Ali, which helps to support healthy testosterone levels. Rhodiola is one of my absolute favorite adaptogenic herbs. Helps to maintain endurance and performance, as well as relaxation and mood. Cordyceps mushrooms are something else that can help with stamina, vitality, and overall sexual performance. There are other ingredients, like beetroot powder, that can help improve blood flow. So the list goes on and on. Lemon balm is another good one to really help you stay calm throughout the experience.

Sharon Stills, ND

Great, great list. You’ve got some great jumping-off points there. Well, I could talk to you all day, but this has been, I feel like, just like a girlfriend’s fireside chats, chewing out some real good things. So for everyone listening, there are just a lot of things to think about. Go back and listen to some really good conversation starters to get you thinking. I really appreciate you taking the time to be here and being a part of the summit. As I said in the beginning, I follow you on Instagram to see where it can work and where the ladies can find you. I don’t know if you’re on other platforms as well.

Lindsey Elmore, PharmD, BCPS

Yes. So I am @LindseyElmore on Facebook and Instagram, @DrLindseyElmore on Tik-Tok and Pinterest, and then you can find me at Lindseyelmore.com, and my functional medicine education website is wellnessmadesimple.us. Please go and like and subscribe to the Lindsey Elmore show, anywhere you listen to podcasts.

Sharon Stills, ND

Which I have been a guest on. So you can absolutely hear that. That’s great. So she’s prolific. She’s out there. You’re doing such a great service and a great gift to the world by educating. I just love you for that and all that you do. And I told you I would not disappoint and that this would be a good conversation. So definitely some things to think about. Thank you, everyone, for being here. Go follow Lindsey to continue the conversation, and we will continue our conversation with another interview coming up.