The Gut–Hormone Connection Most Doctors Miss

Opening on Gut Health and Wellness 0:00

If your gut is not healthy, your body cannot be healthy because everything starts in the gut. Almost 90% of that is made in your gut. A lot of times I tell people, you don't have an SSRI deficiency, you have a gut issue and that's what's causing your mood instability. Health is not owned, it's rented and the rents do every single day. You have to participate every day in order to be healthy and stay healthy. Like if your kitchen sink has a leak in it and you put a bucket under the kitchen sink and shut the kitchen sink door and never come back to the bucket, You're going to have a problem eventually, right?

Same thing with medications. You're going to be calling me later because your sink's going to have mold under it. We're going to have so many issues. If you're overwhelmed with chronic health symptoms and still don't have answers, you're not alone. I'm Dr. Javin, and on redefining wellness with Dr. Javin, we'll be exploring root causes like Lyme disease, mold, and parasites, and I'll guide you with simple and practical steps towards real healing. Welcome back to the redefining wellness podcast here.

I'm excited today. We have Dr. Cassie Smith. I'm excited to have her cause she, she probably has more licenses as a doctor than just about anybody else by herself running her own practices. She's not some big corporation, some venture capital or anything. She's doing this to be able to help people with their endocrine system. So thanks for joining me today. Thanks for having me. So we've talked before and I'm going to give you her bio so you can see what she's all about. And then we're going to be talking about gut and how to help heal the gut and how that affects hormones.

Because what I run into on a daily basis is people coming in, their hormones are way out of whack. They're crashed. They're, they're not feeling well. I can't tell you the number of women I've talked to in the last week that are in my practice that are 38 and 39. And they're like, I'm in menopause. I'm like, not because you should be. but because of something else. So I'm gonna dig into that with you a little bit today, but let's get into that bio. So Dr. Kat Smith is an MD, founder of Modern Endocrine.

She's dual board certified in endocrinology, diabetes, metabolism, and internal medicine.

Introducing Dr. Cassie Smith 2:00

She completed her education in the University of Missouri, Kansas City. Go Kansas City, that's where I'm from. And a fellow at Harold Ham, diabetes senator, named top doctor in the magazine 405 in 2022, a national speaker, a member of a lot of physician societies. And since she founded her practice in 2020, it has been rapidly growing in holistic medicine, specializing in gut thyroid hormones and weight loss, which everybody's dealing with one of those problems it seems like these days. So Dr. Smith is also an expert in bioidentical hormone replacement therapy and emphasizes holistic and preventative care.

And this is why she has 46 licenses so she can serve you all over the place from wherever you're listening. How in the world did you motivate yourself to get 46 licenses? Well, Dr. Moore, you know that when you start practicing medicine, like I came from traditional medicine, right? It's very disheartening and we don't make people better in the traditional space. And so I got into functional medicine in 2020 and it's kind of grown. And what I found was the people who really need functional medicine maybe don't always live in Oklahoma, right?

And I have this passion for educating people, patients, and providers. And so it's kind of just grown into this. I educate for a couple companies. I just started working for another company called Avexious Health Solutions, but they're developing, they're a hormone company, but they're developing a whole gut health program for physicians and patients, which is like my passion. And so in doing this, I just became, you know, I would meet all these people in different places that needed help and I couldn't help them and it was very frustrating.

And so I just decided, I think it was like 18 months ago now, oh, I'll just get a few license, like I'll just start here and start here. And, and now we're like, we're actually 46 deep now because we got three in the last couple of days. So we're almost completely licensed in every state so that the people who, you know, want an option to be helped, we can help provide them that. which is always the goal. I know that so many people come into my clinic and are just looking for help, like you said.

The standard Western insurance-guided, everybody fits into a tiny little box system, just doesn't help so many people. It gives you a band-aid, you might feel better for a moment, but the long-term it is not getting you there. And one of the reasons why that happens, which is your expertise, is gut. There's really no talk of gut. Western medicine from anyone that comes to see me from you know, that's just not something that they do so Can you help people to understand why the practice your practice name modern endocrine would be so concerned about gut?

I would love to. I actually have a book coming out in April that's going to talk all about this. But what I found as an endocrinologist, you know, I did a whole training, like two years worth of fellowship on just hormones, right? And with that training, armed with that training and all the functional medicine stuff that I knew, I still had about 30% of people whose labs look perfect.

Why Gut Health Drives Hormones 5:00

They were doing what they were supposed to. They were checking all their boxes and they still didn't feel good. And so I was so frustrated because I was like, well, your thyroid hormone looks perfect and all these hormones look perfect, so why don't you feel well? And so then I started doing research and you would see in these people like they would have inflammatory markers, right? They would have elevated CRP levels, their insulin would be a little high. And it's like, well, where is that coming from?

Because they say they're eating well, they're sleeping, they're exercising. And so then I started looking at the gut. And what you find is if your gut is not healthy, your body cannot be healthy because everything starts in the gut. We have almost a hundred times more genetic material in our gut than we do in our entire body. and our gut is talking to our entire body all day long by way of our vagus nerve. It's kind of like our Wi-Fi router of our body, right? And so it makes sense that if we have gut issues, the rest of our body is not going to function optimally as a unit because that is driving you know, issues, inflammation, we have, you know, if we have infections in our gut, if we're not digesting our food, if we have a leaky gut, then all that causes cascades of, you know, interleukins and our immune system to be activated.

And basically then our body thinks we're under attack or something's wrong. And so then our hormones don't convert correctly. And I mean, I'm sure you remember from medical school, our estrogen metabolism, almost 100% of it, well, I mean, it happens in our liver, but there are things that have to happen in our gut in order for our estrogen to be metabolized and to leave our body. I also think it's very interesting that cancer rates are growing in this country, like astronomically, as gut health deteriorates.

Because again, hormones, I don't think are always the villain that they get. Well, they are not the villain that they get. You know, people say, oh, hormones cause cancer. It's not the hormone. It's the way the hormones metabolize. So all these things tie back to your gut. And so until you understand gut health and you understand what's going on, you know, as a whole and a person, I don't know that you're going to be able to fix them, right? Especially if all of our hormone metabolism is happening in our gut.

So that's kind of where the basis of all this started. And then with our practice, we see so many people, we follow labs. And I can tell you, you know, these women that are coming to you that are 35 and 40 that are in perimenopause or menopause, they have issues with their gut. And when you fix their gut, then their gut can metabolize their hormones better. And a lot of times these things can get better. So that's where I got so passionate about it. I love it. I've got questions for you that I know you know the answers to, but, you know, I talked to my dad, I talked to my mom, I sit and have these conversations with them and I say words like gut.

And they're just like, and they kind of just nod their head. What does gut mean? Yeah, I think that's a great question. So we're talking really about the microbiome, which the microbiome are bacteria, fungus, parasites, not viruses, bacteria, fungus, parasites that live in our GI tract, right? But they're there for a reason. We have these bacteria for a reason. They help us digest our food. They help us extract nutrients. They help us make things like fatty acids, which we need to make proteins and hormones.

And so we have this bacteria for a reason. Some of it actually helps with driving our immune system. And so it's just our gut is a system, our gut, our microbiome is there to help protect us and help utilize food and different things to help our body function. as a whole. The problem is when there are more of a bacteria that shouldn't be there or there's a bacteria that gets in that shouldn't be there and overgrows, we get this imbalance of what's there and what should be there. And then the bad bacteria can release things, things called lipopolysaccharide, LPS, which are very destructive and inflammatory to our body.

And so if the balance is wrong, it's kind of like, you know, if the wrong person gets invited to a teenager's party. Like you got a teenager's party going on and everything is good. For the most part, the kids are being good doing what they're supposed to. If the wrong person gets to the party and brings things we don't want at the party, brings drugs, brings alcohol, whatever, then the party gets a little chaotic. It's the same thing with your gut. Like you have to have the right amount of the right bacteria there or things don't function correctly.

And so that is kind of what I think about when I think about the gut, right? So gut is not just your stomach. It's not just your small intestine. Although it includes those things. I mean, technically, gut in the way I explained is like, it's basically from where you enter food into your mouth, right? So your mouth all the way down your esophagus into your stomach through your digestive tract, which is your small and large intestine, and kind of sort of involves your gallbladder and liver a little bit, not necessarily by definition, but in my mind, it's a part of it.

And what symptoms would you say are common for people to understand? Okay. It's my gut. Because when I think gut, when I talk to my dad and he thinks gut, he's going, I got diarrhea and that's kind of where it comes to an end. I got a stomach ache. That's where it comes to an end. But you're talking about hormones. So it's so much more than that. So what would you tie to? I need to go get my gut checked. That's a great question. You know, if you are listening to this and you're somebody who has thyroid disease, right, you struggle with hypothyroidism, you're somebody who has hormone issues, and you are still having symptoms, and the main ones I think of are fatigue, weight gain and brain fog.

If you have these three symptoms and you have seen a doctor and they say your labs look normal, it's all in your head or you're fine or they give you some generic answer as to why you have these things, you're getting older, it's a part of aging, that's a problem. And so I think those are the three main things that I see in people who come to me who are like, I just can't get rid of this brain fog.

What the Gut Means and Common Symptoms 11:00

And maybe they are being treated appropriately for their thyroid. Maybe they're not. But brain fog, like when your brain is just foggy, you're really fatigued, you're gaining weight. And you're really doing what you're supposed to. You really are. You know, hey, I'm not overeating. I'm exercising. Those are three of the things that can actually be gut issues. And the reason I say that is because if your body is stressed, right? So if your body is in this chronic state of stress, which many people are, we live on adrenaline.

your gut senses that stress. And so the vagus nerve is going to know, hey, the brain is saying that the body is stressed. And so then your vagus nerve is going to be heightened. It's going to affect how you digest food. It's going to affect where your food is put once you digest it, whether it goes to your skeletal muscle, whether it goes to your fat, you know, what happens, what happens to your insulin levels. And so your gut can directly affect your mood, your energy, how foggy your brain is, your weight, all sorts of things.

So I think that's important for people to know. The other thing that I think is really important for people to know, mood and skin issues. So when you have a lot of mood issues, if you're anxious, if you're depressed, especially if you've tried medications in the past, you've been given medications for anxiety or depression and you're like, wow, those made me feel worse. Or you've tried a whole bunch of them and nothing has changed. So your serotonin, which is what keeps us happy, I mean, almost 90% of that is made in your gut.

So a lot of times I tell people, you don't have an SSRI deficiency, you have a gut issue. And that's what's causing your mood instability. Now part of that can be progesterone metabolism and estrogen metabolism, which is also a gut issue. But I think mood is another one that people a lot of times just have no ideas tied to their gut. And then skin issues. I hate it when teenagers get put on Accutane for acne and nobody talks to them about what they're eating or trying to fix their gut. So these are just a few things besides what you mentioned, right?

Bloating after you eat, you have diarrhea, your stomach hurts, you have crampiness. Obviously, those are gut issues, but it can be your skin. I mean, it literally can affect almost anything, your brain. you know, your skin, your mood. And so it's really important that people understand their gut is literally tied. Also your sleep, that's another one. If you're having really hard time sleeping and you're waking up at 3 a.m., like jolting out of bed, it can be a progesterone issue, but it could also be a cortisol adrenal issue that's stemming from your gut.

So gut is so much more than your stomach and symptoms are so much more than what we think of as our stomach symptoms that people are getting to. And, you know, one thing that really jumped out at me because now that you've explained a lot more, I feel like people are going to understand more. So many people love, I mean, it's everywhere right now, bioidentical hormones. I know you're a fan because part of your bio. But you mentioned earlier for those women that I was talking about that are 38, 39 years old being told they're perimenopause, menopause.

Why is it, and you touched on it, but I want to get just deeper. Why is it that you said if they fix their gut, that's probably not a problem anymore? This is a great question. So if you understand some of how hormone metabolism happens, then I think this makes a little bit more sense. So as a woman or a man, because men have estrogen, but as a woman, we make a lot of our estrogen in our ovaries, right? Some of our estrogen is made in our fat cell and adipose tissue, which is why it's so imperative to keep your adipose tissue at a reasonable level because we do know that when we have excess adipose tissue, we make bad estrogen in that adipose tissue and that increases our risk of cancers, of estrogen-drive breast cancer.

But as a woman, we make most of our estrogen in our ovaries and or our fat cells. Some women take estrogen. And when you take estrogen, there are different pathways estrogen can go down. There's not just one estrogen. There's actually three forms of estrogen. And estrogen is metabolized down different pathways. Now that metabolism, a lot of it happens in your liver. So there is some things that happen in your liver that help estrogen to decide, okay, am I going to go down a 2-hydroxy pathway, a 16-hydroxy pathway, or a 4-hydroxy pathway?

And all those estrogens do different things. We want mostly 4-hydroxy estrogen because that's what does all the great things for estrogen. It protects our bones, our brain, it keeps our skin pretty, it makes us not hot, like all of those wonderful things. 16-hydroxyestrogen, that is a proliferative estrogen. It's not necessarily bad. It's also a bone protective, but we want it in smaller quantities. And the 4-hydroxy is our bad one. 2-hydroxy is our good one. So the first one that I was talking about was 2-hydroxy.

But when we are metabolizing things down the 4-hydroxy pathway, that increases our risk of cancer. And so all this stuff happens in your liver, and it is very dependent on whether there are micronutrients in our liver, which we get from our gut. So if you have a lot of gut issues, dysbiosis, and you're not able to get micronutrients out of your food, things like B vitamins, then this process can't happen right in your liver. And then once everything happens in your liver and the bad estrogen is sent into your actual gut so that we can get rid of it, right?

So we've taken in estrogen or we've made estrogen and our body's decided what estrogen we need. And it's like, hey, we need to recycle some of this estrogen and get rid of it because we know the ovary is going to make more estrogen or we're going to take more estrogen. The bad estrogen goes into our gut and is supposed to be recycled in our feces and our poop. But if our gut doesn't work and the estrogen sets in our gut too long, then it recirculates. And now we have this extra estrogen floating around that shouldn't be there.

And this is why a lot of women end up with weird symptoms, right? Like they will have no estrogen, then they have really high estrogen, they have breast tenderness, then they have vaginal dryness. They can't figure out what they're like, I have too much estrogen, I have too little estrogen, because it's the metabolism of the estrogen. And that is all very specifically like depends on what bacteria you have in your gut. Same thing with progesterone, same thing with testosterone. And so if you have a lot of inflammation, you're really stressed, you're not eating well, you're not sleeping well, you're running on adrenaline, then a lot of times your body's not able to make these hormones because again, your gut gets out of balance, right?

You have a lot of bad bacteria producing inflammation, which then causes our body to not make those hormones. And so we stop making them. Sometimes we're making too much of them and we're not getting rid of them. And so it's all a balance. Like you have to make sure that your gut is working so that when we make hormones appropriately, we can metabolize them and get rid of them. And we have to make sure that we don't have so much bacterial overgrowth that we're not able to make the hormones. So, if we fix that bacterial overgrowth balance or that inflammation in our gut, sometimes we'll be able to actually make the hormones we stopped making because our body was just kind of like, oh my gosh, there's so much going on.

There's so much inflammation. Your body is just trying to get you through the next day, right?

How Gut Health Affects Estrogen and Other Hormones 18:00

It's trying to make sure that you have enough energy to eat and breathe and it's not trying to make hormones because that's like the last thing it's thinking about. And so, this is why sometimes fixing your gut can actually help with hormone metabolism. And that's just sex hormones. You know, also your thyroid hormone, your growth hormone, your insulin, your cortisol, all those things are influenced by your gut. Now, as I'm listening to you, I'm sitting here thinking about like, man, I can make so many Instagram reels off of what she just said as an expert medical doctor, female, hormone provider.

I'm just going, okay, so like, let's, let's talk about this. So as a woman, if you come in and you're thinking, I have hormone problem, it might be your bacteria in your digestive tract is not giving the nutrients to your body to build the hormone. So you're deficient. It could be that your body's too stressed out and it doesn't want to prioritize that you have a lack of hormone because it's focused on something else. It can also be that you're dumping estrogen into your body from shampoos and conditioners and plastics and you name the stuff that's in the world that we have so you're dumping all this estrogen in plus you're still making it and now your body can't actually break it down and excrete it so hormones are not necessarily a deficiency or a toxicity of the thing Although that's there, it's more often than it's a symptom of a greater grander problem.

As you've said, a gut problem in many cases. And by the way, to everyone listening, I'm not telling you that there's no reason to take bioidentical hormones. That's not what she's saying. I'm just saying as I listen to this, I'm like, remember, we still have to make you healthy before we go into longevity or at least alongside of it. Cause sometimes you want to do both at the same time. Yeah, no, I completely agree. Like this is why I think it's really important for people to understand this. And this is why I'm so excited to be teamed up with this hormone company, because if you teach providers or patients, hey, let's take hormones and you teach them all the benefits of that, which are all true.

And that's great. But if you don't teach them, well, we also have to make sure those hormones metabolize correctly, then that's where we get problems, right? Because just because we give you a hormone doesn't mean that hormone is going to go to the cell and affect the cell how it's supposed to and metabolize like it's supposed to. We are giving you that hormone back, but you still need that environment in order, a healthy environment, in order for that hormone to actually be accepted into the cell to do its job and to be able to be metabolized from your body.

So that's exactly right. I love bioidentical hormones. I love them in good environments because if you give, and again, this is why I think hormones got a bad name. If you give someone hormones in the wrong environment and that person is taking those hormones and their body is converting them the wrong way, can they get cancer? Of course they can. But was it the hormones problem or the hormones fault? No, it was the way the hormone was metabolized, right? So it's very important for people to understand that.

Like hormones are not with anything, just like GLP-1s. There's no like magic pill in the world where you just get to do one thing and then like, ugh. I'm going to be great, you know? Health is, I tell people this all the time, health is not owned, it's rented and the rents do every single day. Like you have to participate every day in order to be healthy and stay healthy. It's not something that you just get to like do and then check off and like check out, you know? So when you just said that a moment ago with hormones coming in and if your body's not ready for them, then they can cause problems.

As an analogy or another way you see this, if you have food poisoning and you go and eat a big fat burrito and you throw it up, is it the burrito's fault or is it the fact that you have food poisoning and you're throwing up, right? Food poisoning is a parasite or bacteria in your digestive tract that is out of balance. So in your gut. So if your gut is out of balance, don't blame the food for react for being reacted to blame the gut. If your hormones are off, don't necessarily blame what's happening with the hormones.

Look for why the hormones are off, especially if you're not taking them. I mean, so many times I was a client of mine. I was thinking of earlier when I said the 39 year old. She's like, yeah, I think I'm going into perimenopause as my doctor told me. And we had just gotten through all this mold treatment, this parasite treatment, all this other stuff. And she's getting a little bit of a histamine response on her face. I go, first of all, you're not old enough to be in menopause. And she's just like, I'm like, you're not old.

And she's just like, thank you. And I was just like, yes, there are still some things going on. And yeah, we can probably tweak them and we can help you out and we'll get you taken care of. It's just so funny that a 39 year old has two kids. That's in great shape. That's fit. That looks young is being told you're just getting old. Well, it's, it's sort of funny. It's kind of sad though, right? Because it's just like, this is what this country has come to. It's like, oh, well, it's just part of aging.

It's just, it's almost like the easy answer, right? Unfortunately, because we weren't taught this in school, right? Like I wasn't taught in medical school or like, I tell people this all the time. I have a degree in metabolism. Endocrine, diabetes, and metabolism. And you're not taught anything about metabolism or food or gut or even in fellowship. And so it's pretty sad because, again, our gut controls our entire body. Hippocrates knew this 2,000 plus years ago. He was talking about this, the father of medicine.

And then somehow we lost that. from 2,400 years ago to now that, hey, the gut's actually really important and we should talk about that. And it's like we have been, our food industry has slowly just, you know, they give us more and more and more poison until we accept it. And then they give more poison and we accept that. And then, okay. Let's just keep giving these people poison because they're accepting it, right? Like our food is so freaking bad. And it's like, they've over time just made us like, oh, I guess I'll eat that poison.

I guess I'll eat that too. I guess that's acceptable. If you turn around and look from like 1960, it's like, what the heck are we actually eating? And then we wonder why everyone's gut is a train wreck, right? So it's just, it's really sad. I have to ask this question in kind of the bold way. So as a, Endocrinologist, internal medicine, double board certified specialist in diabetes and metabolism. When you were in school, not all the stuff that you've done afterward, how many total hours of time were you taught about diet and lifestyle changes to help affect metabolism?

That's a great question. I actually have thought about this a lot. I remember one lecture that we had about diet somewhat and that's it. So maybe an hour. Yeah. And like one hour, right? I mean, did you go to some amazing school where you were taught better?

Medical Training, Lifestyle, and the Limits of Conventional Care 25:00

No, no. I mean, he had a class that was organic chemistry three that they called something like nutrition or something like that. It was organic chemistry three. We weren't actually talking about real food. They were just saying, well, like these nutrients are needed for this process in your body. And then those chemicals that you're taught about to fix that, which is called medication. So that is basically what that became. O chem three was nutrition. I mean, I had this one. Whenever I got out of school and I was doing residency, we had this one older cardiologist and he was amazing in Kansas City named Dr.

Bogart. He was probably in his late 70s, 10 plus 15 years ago now. But I remember we would do rounds with him and he would make comments like, I can't believe we feed people in hospitals food like this. Or he would make comments like, you know, back in the good old days, when you came in a hospital room, people were eating real food. And he would just make comments about how medicine had changed so much. Now, he also was the doctor who went and actually put in his stethoscope and listened to people and did physical exams, like laid them back and pushed on their belly and looked for JVD.

And it was very interesting because we could go examine a patient in the ER and he'd be like, oh, their EF's 30% and they're in diastolic heart failure. And we'd look at him and he's like, Remember when I started medicine, we didn't have echoes and all these fancy things you guys have, right? So like he probably taught me more about lifestyle and things than anyone, but in school, no. But it was just funny because when I was thinking like, did I learn about this? I remember him making comments like that all the time.

He would be like, well, this is why everyone's sick because we eat crap and like that's not even real food. But other than that, no, nobody. Yeah. So if you're listening and you're wondering like, why isn't my doctor know all this? That's why. Yeah. Dr. Cassie here has spent years. going into more education after you already went through medical school, which I like to refer to as brainwashing because it's the perfect storm of like, I'm going to put you in a group. I'm going to make you learn stuff and then be tested on it.

And I'm going to have the stress level through the roof for years. And then we're going to put you through sleep deprivation. And by the time you actually get out to being able to practice on people, you're so tired and burnt out and all you've heard is the same thing, the echo chamber. That's what you do. So I don't even blame docs when they get out for being the way some of them are. But at the same time, I'm like, there are so many good ones like you out there that have the heart to just say, what we're doing isn't working.

Let's do something different. Thank you. I agree. And that's why I love people like you as well. You know, we need to, I just say, we need to like, I don't know, form a group and like, just there needs to be some really good functional medicine training that like as soon as doctors get out of school or any sort of provider, they can actually go get like the real education, right? Like we call it the real doctor training. What you really need to do to make people better, right? For sure. I don't know.

I don't know how you fix it, because I've thought about that a lot, too. How do you fix it? You would have to completely change all of medical school education, because we're never taught about any of that, which is so very compartmentalized, like boxes. I don't know about you, but in school, we, we did everything in systems, right? Like we're going to just talk about the cardiovascular system. We're going to just talk about the, the gut system, the GI system. We're going to just talk about the lung system.

And nobody ever like, had you step back and be like, we're talking about a person here who has symptoms and feelings. And maybe we should listen to the person and actually, you know, care and believe what they say. It's just, it's, it's a novel thought, but I don't know. Anyway, I know we just hired a guy on our team and he's been a pediatric pulmonologist for. 15, 20 years, something like that. And he went to his first IFM course. He was just like, there's so much more to health. He was so excited about what I considered to be 30 years ago information.

And I was just like, amazing. Like I'm so happy for him because he's just like invigorated that he would be able to be able to bring this information to the people he's working with. He's invigorated by the opportunities to be able to help people in a different way, which is interesting. But to get back to- I remember that feeling. I remember that feeling. It's awesome when you realize that, right? It is. Well, getting back to this hormone situation and gut situation, we've talked about what gut is and how hormones relate.

What are you doing for people? What is it that everybody's different? Like you said, everyone's unique. You want to listen to them. You want to see them more than just their gut. But when people are coming in with these, likely by the name of your practice, I have hormone symptoms and you're saying, okay, let's check your gut. What is a common path forward? Yeah, that's a great question. And this is where it makes it kind of difficult. Like you said at the beginning, I'm not this huge company, right?

We're trying to keep things very individualized. But I think when people come in, we have a general intake that we do where we kind of just listen to them. And I want to know what brought you here. I kind of want to know a little bit about your history. What have you tried in the past? And then I want to know what are the three top things that are bothering you, right? Because I feel like, I want to know what's bothering them. And then we do this comprehensive lab panel, which some people are just like shocked.

And it's not even that comprehensive for you. I mean, you know, it's like we do a CBC and a CMP and lipids and a lipoprotein A, lipoprotein B. We look at inflammatory markers like insulin, CRP, ESR. We look at, you know, uric acid levels, all their hormone levels, a full thyroid panel, micronutrients, cortisol, and then IGF-1.

Root-Cause Testing and Personalized Treatment 31:00

seems very comprehensive to some people. They're just shocking to me how many people don't know what their fasting insulin level is, how many people have never had a vitamin D level. And so we do this about 35, 40 different lab tests, and then we sat down with them for an hour and we go over, this is what we see. And this is, you know, I try to explain to them big picture, like, this is what I'm seeing in your labs. These are all the issues that, you know, I would like to address. This is how these things are causing your symptoms.

And then we try to go back and say, okay, what is the root cause of all of this? And most of the time it is in their gut. And so I just like to give them all that information. So then it's like, okay, are you all in? Do you want to fix this? Do you just want to take a medication? Because you also have to meet people where they are, right? And sometimes people are just really sick and they want to feel better. And they're like, I don't care. Just give me a medicine. I want to feel better. But I want people to realize how complex and deep it is.

That's why they're still sick. So if you're listening to this and you're like, man, I've tried everything and I've been on medicine for 10 years. It's complex and that's why you're still not feeling well. But I think it's really important to educate people and help them understand how the three symptoms that brought you to your clinic could relate back to their gut or their sleep or their lack of exercise. And so that's what we try to do as a company. And then we just say, okay, You know, this is our, this is what we would do one, two, three.

What do you want to do? And we just work with them. You know, we meet people where they are and we have a health coach. But a lot of times we do end up looking at their gut because again, if you have five, six, seven different issues and you have, you know, three or four pretty significant symptoms and you really want me to get to the bottom of it, I can patch it up. by giving you hormones and giving you micronutrients and giving you whatever to feel better. But is that going to make your environment conducive to all those things I'm giving you and make you be better a year from now?

Probably not. And a lot of people tell me I have a really bad business model because my business model is you come to me really sick, you get a lot better and you don't have to come back to me. But it's a really, really fulfilling business model, right? But that's not what hospital systems and most traditional medical clinics want. They want you to come to them sick, stay sick, and need them every three months. Well, hey, with the change in longevity and hormones, your patients are going to stick around for the optimization piece.

So that'll be the business model because they'll actually trust you and want to come back and see you. You know, when you're saying something, I always like to try and break things down and make it really understandable and make it to where people can own it. And you said something to the effect of, if you've been 10 years on a medication and you're still searching for feeling well, it's because, well, one, maybe the medication does shift you a little bit at the beginning and you're like, okay, I feel a little bit better.

The problem is, is if you don't, because meds don't solve problems in most cases, they solve symptoms. And if you have a problem of an overgrowth of GI bacteria and this is leading to blood pressure and they put you on a blood pressure medication, or if it's leading to tiredness and they put you on a thyroid medication, that solves the momentary symptom. but it does not solve the problem and if you don't deal with the long-term problem it gets worse so if you have a hole in your jeans and you don't sew it up and it keeps getting hooked on things and it keeps getting bigger you're going to keep on getting a bigger and bigger and bigger hole over time until it's not good at all.

And that's what's happening with a lot of medications in today's world is they stick a bandaid on it. They help you to get a little bit of relief momentarily and then you don't get fully better. And you start, you continue to have the real problem getting a little worse, a little worse, a little worse. And then you go back and they stick another Band-Aid on and they repeat this process. And then you end up like my mother, who at one point was on 40 medications and they're just like, well, I don't know what it is.

And I'm like, well, yeah, no, no kidding. You don't know what it is. Like. There's one too many side effects of medications to manage, much less whatever the real problem was. And here's the crazy thing as an endocrinologist, this is going to drive you nuts. She got in a car accident while on the 40 medications, not severe, just enough to get a fender bender in a snowstorm. And she went to the ER. And the iridox said, are you diabetic? And she said, no. And he went and ran her blood two more times through.

They come back and they're like, you are diabetic. She was just simply missed for diabetes and her whole body shut down basically. So what I'm saying is if you miss the real reason, which I don't even think that diabetes is the real reason for her. I think there was complex stress problems from working in corporate America. She had just gotten her wisdom teeth removed and had an infection in her jaw. Those were the real reasons. that created the insulin resistance through the inflammation and stress that led to the 40 medications that were mismanaged instead of getting to the root cause like you were talking about.

And in so many cases it is gut. So I'm just glad that you're out there doing this. And if you're listening right now, she's licensed in 46 states. The likelihood is you live in one of them. I do a math problem for my team and all the licenses that we have. And I'm like, all right, we're covering this percentage of the US population. And that's just like the math problem I've done. I'm like, we're up to 200 million. So if you're listening, she probably can support you. And as you can tell, she's got a passion for actually getting the root cause.

And then once you get there, I love the statement you said earlier, either you're working toward health or you're losing it. There's one way or the other. That's it. So true. Yeah, that's really sad. Your mom was on 40 medications, and that's what happens, unfortunately. And we're not taught any different in school. We're taught, find the symptom, treat it with the medication, and move on. And I think what we need to demand as a society, as providers, and as patients is, maybe I'm going to take a medication for that symptom for a week or two or a month, but let's uncover what's causing that symptom and let's fix it, as opposed to continue to just throw things on top of it, right?

And I think that we just, we have to change that mindset. Like what is causing it and let's go to the root cause. Because, you know, I like the kitchen sink analogy. Like if your kitchen sink has a leak in it and you put a bucket under the kitchen sink and shut the kitchen sink door and never come back to the bucket, you're going to have a problem eventually, right? Same thing with medications. You can't do that. And you're going to be calling me later because your sink's going to have mold under it.

Mold? We're going to have so many issues, right? So yeah, and so it's just, I don't know. And it's, and I love meeting people like you and chatting with people like you, because again, like we have to stick together and we have to help people

Medications, Band-Aids, and the Need for Real Healing 38:00

realize You deserve better care than this. You just have to keep looking. And we really need to change what is expected in this country as far as health care comes, what is expected as far as educating providers, what is expected as far as educating patients, and just how we treat people. And so that's, I mean, if we can do that, the world would be a very different place. It's just a big, big issue that needs to be addressed. But I'm here to help you do it. Yeah, we'll do this together. We'll continue to get our friends together, get more podcasts, get more doctors out there, get more people getting better.

And, you know, one mission I have with my team is like, get testimonials, get as many testimonials as we possibly can so that the proof is so overwhelming when somebody doesn't feel well that they know where to go. They know that there's these possible to be well. Well, Dr. Cassie, I'm so thankful that you put your time together today. Hormones are not my number one expertise. I do a lot with gut, but not as much from the hormone side. So I'm glad that you connected the dots for so many people, especially so many women that are searching.

Not that it doesn't apply to men. It does. It's just, it seems like women are just more on top of their game of like, Hey, I don't feel right. Fix this. Men are like, eh, I'll get to it later. And then their wives are bringing them into us. So I just want to thank you for your time and how do people get ahold of you? Well, thank you for having me. So I'm active on social media at Modern Endocrine. Our website is modernendocrine.com. I think it's modern-endocrine.com. But you can find all of my stuff on social media, the website, and then I would say, you know, my book that's coming out on April 6th.

So it's called Fix Your Gut, Fix Your Hormones. There's a nice little tagline under it talking about how if you still feel bad and have normal labs, this is the connection your doctor's missing. I would say get that book and read it. I never thought I would write a book. It was not a fun process. I wrote it sheerly for the fact that I want people to have a really good information source. I actually thought about selling it to a big publisher, but they wanted me to rip it apart and sell it in like three books so they can make more money.

And I was like, no, I don't want to do that. People don't need three bucks. They need one book that, you know, and so I'm really excited because I think it's just hopefully going to teach people like, why is this important? And so I think, you know, keep advocating for yourself, keep learning, keep following people like yourself. And yeah, I mean, we're here to support you in any way that we can from an educational perspective. And don't give up on yourself either. If you're a woman listening to this and you've been told you're 39 or 40 and all these symptoms that you're having are normal or part of aging, they're not.

Not sleeping, being moody, having painful periods, being bloated, none of that is normal at 40, okay? So don't let somebody gaslight you and make you think that, like find somebody who can really help you, like Dr.

Where to Find Dr. Cassie Smith and Closing Advice 41:00

Moore. I mean, honestly, 40, even 50, yeah, sure. You're going to be going through some hormone changes. They do not have to be brutal or hard if your body is aligned with health. So look her up, Modern Endocrine. Until next time, until I see you at the next conference. I know. Take care. Thanks. Thanks for having me. Thank you for tuning in to redefining wellness with Dr. Javin. If this episode spoke to you, please follow and share this podcast with someone who is ready to take control of their chronic health symptoms.

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