Home · The Dr. Axe Show · Ep. 328
Episode 328 · The Dr. Josh Axe Show

Why Women Are Exhausted, Inflamed, & Hormone-Dysregulated | Dr. Austin Lake

Why are so many women doing everything right: eating clean, exercising — and still feeling exhausted, inflamed, and hormonally off? If your labs look “normal” but your body doesn’t feel normal, this episode uncovers what’s being missed. Dr. Austin Lake joins Dr. Josh Axe to reveal the root causes behind fatigue, weight resistance, infertility, and hormone chaos — and what actually helps women heal.

78 minwith Dr. Austin Lake
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Transcript

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Josh

If a doctor is putting a patient on a statin, yeah, for them not to immediately put them on Coenzyme Q10 is an easy thing to do. Yeah, yeah, yeah. Or metformin, vitamin, you know, B12, right? I mean, we know clinically that your body's completely depleted of those nutrients when you're on those medications. Study after study's proven it. That's not happening. And so what are medications actually doing to the body versus if you're getting somebody on a vitamin, a mineral, herb? How is the body responding differently to those?

Dr. Austin Lake

A lot of medications that we are currently using, we found the natural form of that in in nature, and then we've patented it and created it synthetically so that we can sell it and make money off it, right? And make a bunch of money off it. So when you start to see, you know, like metformin, and the comparison would be like berberine, like having a natural substance that will help to improve insulin sensitivity but not necessarily reduce CoQ10 or vitamin B12, like you were saying before with metformin. And so there are examples of that where we've taken something that God has created created a synthetic form of it that now has consequences for its use and patented it and made money off it. And that to me is where I'm like, that feels beyond irresponsible.

Josh

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Dr. Austin Lake

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Josh

When I first got into clinical practice, there The single biggest thing that surprised me was how many women are struggling with hormone-based conditions. Everything from hypothyroidism and Hashimoto's, PCOS, endometriosis, infertility, menopausal symptoms, and so much more. And today I'm bringing on one of the world's leading experts in women's hormones, Dr. Austin Lake, and we're gonna be talking about how to heal and overcome the root causes of hormone-based conditions. Hey, Dr. Austin, welcome to the show.

Dr. Austin Lake

Hey, man, I appreciate you having me.

Josh

Well, hey, we had a great time hanging out in London. I know that that was a great trip. I had actually one of my favorite interviews I've ever done. We had Barbara O'Neill on and she was amazing. And I know I got to hang out with you and Ben Greenfield and Dr. Chris Motley and Gary Brecka, Will Cole, so many people. And it was really a great event. And I really enjoyed getting to know you and hear more about what you do as a practitioner. And I know today that when I'm— practicing and seeing patients, one of the biggest conditions or group of conditions we see are women struggling with hormonal issues. Yeah. And today I want to sort of center the conversation around what's causing these hormonal conditions. How do you practice specifically to get to the root causes? And what are some of the results you see? And just get really practical today on helping women heal their hormones.

Dr. Austin Lake

Yeah, I think it's something that rightfully so we need to talk more about, you know, even looking at research, research isn't being done on women as much as it is on men. And so you start seeing these discrepancies whenever it comes to treatment to actually help solve problems. I think when we think about women, we think that women just are complex because they are a more complex than male physiology and, and technically their hormones are very fluctuating, right? Like they have a lot of diversities with each day, with each month. And so I think whenever we're thinking about women's health, we have to kind of start to look at them from a more, uh, you know, in-depth perspective. And it takes time to do that, you know. And I think a lot of practitioners— at least my initial experience getting into women's health was not because I had necessarily a passion about it. It was based on a need of needing to solve a problem for my patients, right? Like, they come in, they have low energy, they're gaining weight, you know, they feel terrible. They're told that it's just part of being a female, or it's just part of their— that time of the month. And yeah, It's a lot of language that puts them into a box to where they immediately feel like, well, I just got to tough it out. Yeah, I just got to be— I got to put on my, my brave face and just kind of prevail on. And I think as practitioners, we have to kind of appreciate what they're dealing with. And a lot of us, at least I never did fully, you know, at that time. So that was kind of my initial kick, uh, kickstart into women's health and seeing that there were root cause problems that were driving their health issues that weren't just, you know, because of these random hormonal causes.

Josh

Yeah. And one of the things I think people start to discover as practitioners when you're dealing with women's hormone issues is that cookie-cutter solutions don't fix the majority of women. A lot of times today, if they're in the conventional medical model, of course, this doesn't fix it. It's just like, "Hey, here's a drug like birth control or metformin or something like that." I mean, that's what a lot of the treatments are around versus— And then sometimes you get in the more holistic space and it's, Hey, let's reduce inflammation, right? Or, you know, let's go gluten-free or even keto or carnivore, some other sort of extreme diet versus saying no. You know, the way that I look at it is I, I remember in science class, this was when we were probably in high school. Yeah. They talked about how every snowflake, not one single snowflake is the same. Right. And it's the same with women. It's the same with men. I mean, there are very, very specific, now there are some, similar patterns that are associated with certain conditions, but it's really critical to go and look at each individual patient, look at their unique bio-individual needs, and really customize a protocol to meet those needs.

Dr. Austin Lake

Yeah. And I think if you have that perspective going into it, you can then evaluate, okay, like with this particular woman in front of me or man in front of me, like what, what challenges are they facing in their environment, in their day-to-day, in the relationships, financially, you know, when it comes to what they're consuming, what they're not consuming. And if you don't have that perspective, I think it's impossible to really help somebody solve a problem. And if anything, you can actually create potential shame by saying like, hey, you know, you're really inflamed, or like, you need to eat better, or you need to sleep better. But then you're like, well, how do I do that, right? Because I have this busy life, or I have a bunch of kids I got to take care of, or I got to manage the household and provide financially. Like, how do I actually change these things? Because if you don't provide a solution, that's practical, like, what are they supposed to do with it except feel like it just adds more stress and more shame potentially?

Josh

Yeah, well, again, I would hear this constantly in practice as patients would come in. And typically, it was funny, early on in my career, I was always like the 10th or 20th doctor that they would see. And now sometimes it's the first because people are starting to be aware of, I don't want to go this conventional route, I want to use food and herbs and lifestyle medicine to heal. But, um, But again, it happened so often where they saw another practitioner and they said something like, you need to eat better and reduce stress. And that's it. And it almost is more stress because then you're trying to figure, well, how do I reduce stress? Am I stressed out? They start overthinking and sometimes it just actually makes it worse. And that's not to mention some of the other issues with, they'll go in and get blood work done and their doctor says, hey, your blood work's normal. You're good.

Dr. Austin Lake

Yeah. It's like, well, now, okay, yeah, now I've done the work and I did these tests and I'm still not seeing what I'm supposed to be seeing. So I guess it is just me. I'm just being a hypochondriac. I'm a hypochondriac or I'm exaggerating my symptoms. But I think when clients or patients figure out that, oh, maybe we didn't look at the lab work through the right lens or maybe we didn't add enough specific panels to this to kind of get a better perspective, I think it helps patients to feel some relief to know that like, hey, I'm not a crazy person, especially women.

Josh

Well, you know, one of the things I've talked about, started to talk about pretty frequently is that a lot of these blood tests today, number one, they don't test for the right things. The right markers. And number 2, a lot of this blood work, it shows that you're in normal range, but not that you're in optimal range. Somebody could be at a 30 level of vitamin D and their doctor will tell them, "Hey, you're normal. You're good." But really 50 to 80 or so is really where optimal function is happening. So even at 30, and if you have multiple markers like this, let's say your vitamin D is borderline, zinc is borderline, even iron. We know that your immune system is not functioning at full capacity and your body isn't healing at the optimal rate. So this is something I think that's really important. Is this— do you run blood work with patients ever?

Dr. Austin Lake

So, yeah, I mean, we— it's an online practice. And what we do is if our clients already have blood work, you know, we want to look at that. We want to evaluate that. Oftentimes our clients won't have any blood work at all. And so—

Josh

and for us, it—

Dr. Austin Lake

all the information we can get is always better, right? Like, we want to take as much as we can. What I've started to do and recommend is looking at like a total toxic test or total toxin test through like Vibrant Labs. Yeah, places like that. Yeah. Because I think it's a good way to kind of give 'em a different perspective on what could be challenging their immune system and can be challenging their mitochondrial health. And when they start to view it through that lens, they can see like, okay, I had a, I had a thyroid panel done and my TSH was at 3.5 and My, my T4 is at 0.7 and my doctor said these are normal, but yet I don't feel normal. But when we can look at it and combine it with these other components of, hey, it turns out you have some heavy metal toxicity or there's some mycotoxins present or there's some, you know, PFAS in your, in your, in your system, like that will complicate these numbers and make it more challenging for your body to actually heal and feel optimal. Mm-hmm. And when also when you're talking about labs, having the understanding that as you were saying before, like normal doesn't mean that it's it's normal physiology. It means that it's common within society, right? Like those are common ranges that we will see for the population, right? And so a, a vitamin D, like you're saying, of 30 is what we'll typically see. That's a non-pathological state, you know, for, for the common person coming in. But the optimal state, as you were saying, is 50 to 80, you know, like that's where we wanna see people. And so when our clients come into us, when we're working virtually online, we always wanna start with as much information as we can get. If their doctors have already run, you know, thyroid panels or, um, you know, hormone panels, which is rare, rare to see that. I mean, most doctors aren't doing that. But if they're doing a common CBC or CMP, you know, we'll take that information, we'll look at it and do the best we can to help them create a game plan. But our job is always to help them get off of medications if that's what is wise and the best course of action and in alignment with their doctor. More times than not, their doctors aren't necessarily opposed to getting off medication, but they're not usually for it either.

Josh

Yeah, I found a lot of doctors, they're just not, they're indifferent. Yeah, they're non-helpful.

Dr. Austin Lake

Right.

Josh

Yeah, they're not. And I've told patients this for years that, hey, if you do, if you had a doctor prescribe medication, I can't take you off that. That's something you have to work with them on.

Dr. Austin Lake

That's not my responsibility.

Josh

But also if they're unwilling to do it, find a different doctor who's willing to work with you and weaning you off and getting off of it. 'Cause I don't think that most people fully grasp how bad being on most medications is long-term.

Dr. Austin Lake

What— when have you ever seen a medication— medications aren't designed to heal or fix anything. I mean, really, in reality, if you look at most, most of them have a consequence to them, not a super positive benefit from them. Like, it may keep you alive a little bit longer, you know, like if you have a heart attack, taking a nitroglycerin is going to be very helpful in saving your life. But taking a long-term statin drug there have been no real benefits. If anything, there's a lot of consequences to doing that long-term, specifically what it does to your mental health and seeing things like Alzheimer's and dementia rise drastically. So I think, again, not to say that all medications are bad all the time, but long-term chronic use, rarely do you see that it actually fixes anything. It creates more problems.

Josh

I mean, there are, every medication that I can think of has, depletes your body of something. And so if you're on it long-term, and I actually consider this generally, I don't know that malpractice is probably too strong of a word, but I would say being irresponsible, that if a doctor is putting a patient on a statin, for them not to immediately put them on Coenzyme Q10 is—

Dr. Austin Lake

It's an easy thing to do.

Josh

Yeah. Yeah. Or Metformin, vitamin B12. I mean, we know clinically that your body's completely depleted of those nutrients when you're on those medications. Study after study's proven it. That's not happening. And so what are medications actually doing to the body versus if you're getting somebody on a vitamin, a mineral, herb, sort of how is the body responding differently to those categories?

Dr. Austin Lake

Yeah, I mean, well, if you think about it, all, most, I shouldn't say all, but a lot of medications that we are currently using, we found the natural form of that in nature and then we've patented it and created it synthetically so that we can sell it and make money off it, right? And make a bunch of money off it. So when you start to see, you know, like metformin in the— and I guess the comparison would be like berberine, like having a natural substance that will help to improve insulin sensitivity but not necessarily reduce CoQ10 or vitamin B12, like you were saying before with metformin. And so there are examples of that where we've taken something that God has created, created a synthetic form of it that now has consequences for its use. And patented it and made money off it. And that to me is where I'm like, that, that feels beyond irresponsible. You know, when we start thinking about that long-term and we start to extrapolate that over the course of all these other different forms of medication where, and I don't wanna open a can of worms on this topic, but where you look at how they use a lot of different, you know, different, they call 'em peptides, but a lot of 'em are actually venoms from different you know, snakes and different, you know, like the gila or the gila monster, like it's a lizard, you know?

Josh

Yeah, there's a couple.

Dr. Austin Lake

There's examples of that, you know? Sure. But we're like, we're using these different mechanisms of action to create a suppression of symptoms within the human body that, again, maybe it's yielding the result that you want for that particular symptom, but what are the other consequences that then unfold from that?

Josh

Well, I think the other sort of philosophical reality here is that, The dose determines the medicine or the poison. What's happened a lot of times with medication is they have taken that extract from the plant, and so it's an isolated compound now, so it's no longer, curcumin from turmeric as an example. That's a good one. Okay, so now you have this, and then we're gonna take that, and we are going to do an ultra-high dose of it. And so, and it's gonna be synthetic, so it's the difference of having, raw honey versus high fructose corn syrup now. I mean, it's an ultra-processed thing that's isolated where the dose is incredibly high. And I'll say this, and a lot of people aren't aware of this, and people in the natural health community don't speak about this much, but if you do certain herbs in an ultra-high dose, which your general supplement, it's almost never an ultra-high dose ever. So it's almost something you don't have to worry about. But if you took something in a very high dose, like I'll give you an example, berberine If you did really high doses of that, in Chinese medicine, it's known to really cool your nervous system, and it's actually going to start causing some issues with your GI and your bowel movements if you did a really high dose long-term. And so a very similar thing, metformin is a very high dose. I believe metformin actually comes from lilacs. French lilac, yeah. Yeah. But all that being said, the dose and what it's accompanied with is incredibly important.

Dr. Austin Lake

Yeah, I mean, they always say the dose makes the poison, but if you look at, you know, these different examples of how, you know, fluoride, for example, like, you know, they, they'll look at the different doses of this and saying, if you consume this, it's not a big deal. If you swallow more than this, like, you need to call, you know, hazmat control or, you know, your doctor and get, and get help. But I think the dose makes the poison analogy, I think, you know, I think, I think we're seeing a, a compounding effect that happens when we have a little bit of this, a little bit of that, and we, we start to have all these environmental poisons, toxins that get into our system. And by themselves, in isolated form, maybe not a big deal. But when you start to consume a lot of it, or you combine it with other environmental toxins, you start to see a, a toxic soup that can—

Josh

well, yeah, there's no doubt that doses every day for a long period of time and multiple of other things that can be harmful are going to add up and cause issues, to your point.

Dr. Austin Lake

Yeah.

Josh

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Dr. Austin Lake

Yeah. And so again, I think, I think the medication thing, like, again, I'm not, I'm not a, you know, I'm not a physician. I'm not one of the people that would say I'm an expert on pharmaceuticals, um, nor do I want to be. But I also think, um, it's important for the public, the, the, the general public to understand that you know, there are other natural forms that God created that are healing and, and don't maybe have the consequences that a pharmaceutical patented synthetic form of that same thing can have on the human body. And I always try to first focus on those things. And if you are on a medication and if we're seeing changes in your lab markers and your doctor's on board, like, we can start reducing that dose and maybe get off it, you know, safely.

Josh

Yeah. One of the things I've always sort of described to people is, is that when you look at medications and a lot of cases, they're kind of forcing your body to do something that it doesn't want to do. I mean, you're forcing your body into something rather than kind of gently nudging it or creating an environment where it can thrive in a better way. You know, herbs, what they should be doing in most cases is just creating a more friendly environment. I mean, that's how it was used in Chinese medicine and Ayurveda and throughout history is, you know, for instance, if you're doing bitter herbs like gentian, it creates a more, a drier environment, getting out dampness and Candida and bad microbes. You know, a lot of those herbs that get rid of Microbes are very bitter. If you've had like wormwood or black walnut, I mean, they're very bitter, and bitter is drying. So now parasites and a lot of these things can't thrive as well when you move it out of that sort of damp, microbe-rich environment. So really herbs are meant to just help change your environment so your body can better function in a better environment. Just like a plant will grow better in an environment with sun and water. And then vitamins and minerals, very different thing. It's just giving your body what it needs to function optimally. Optimally.

Dr. Austin Lake

Yeah, yeah. And again, I think I always tell my clients, I want you to get your— I want your food to provide that as much as possible, you know, whenever, whenever you possibly can. But understanding that our soil is depleted, you know, like it's not the same that it used to be when you have, you know, a vitamin or like an orange. The amount of vitamin C has probably been depleted up 30, 50% compared to what it used to be. And so there are plenty of examples like that to where people are— I was one of these people 10 years ago. I would be like, why do I want to have expensive urine? You know, it's like I'm just buying all these supplements for expensive urine. But the more I realize that we're not getting as much through our food as we, as we used to, and we're not getting as much through our, through our soil. So vitamins and minerals and supplements take a very, very important role in our bodies getting what our bodies need to actually not just to survive, but to actually get into a thriving state. And a thriving state for those who haven't experienced it since they were a kid is an amazing place to be. You know, when you have mental clarity, you have energy, you heal and recover quickly. Your body can't do that unless it's meeting its nutritional needs on a daily basis. You know, you talk about like daily bread from a biblical perspective. There's a daily need that, that has to occur. And again, if you get chronic states of deficiency, people call it, you know, it's just part of getting older. But I, I, I really think that aging is just a, you have more time in a state of deficiency. Like you're spending more time in this environmental world that's full of toxins and then your body's deficient and you're trying to, You know, you're trying to solve a problem that your cellular health can't solve because it doesn't have the raw materials that it needs. But if you give it the raw materials, you give it plenty of oxygen, our bodies are designed to thrive for a long time, I think. But society, we've kind of lost sight of what that looks like because we've gotten so used to it.

Josh

And hence, you know, this is one of the main causes that we're seeing that causing female hormone issues. Yeah, absolutely. You know, in general and male as well. When you think about what the biggest root causes are, some of the biggest things you're looking for and you're seeing these patterns of this is causing the female hormone issues today. What are you seeing?

Dr. Austin Lake

Well, not to be too generalized, but inflammation is the biggest driver, I think. When you look at things like PCOS and endometriosis and subsequently infertility, which is a lot of what the hormonal female issues are, inflammation is the main culprit there. So then the question is, what is inflammation? For somebody listening, I'm sure your audience is pretty well aware of that, but for most people, they think of, I sprained my ankle, it gets swollen. It's inflamed for a few days and maybe a few weeks, and then it starts going back to normal. But chronic inflammation is this destructive, repetitive cycle, right? Like that we get caught up in. And so for a female or for anyone listening, male or female, when you have inflammation, typically what you're going to start to have is, is higher insulin. You know, you have more of this insulin resistance problem that develops. And for females with endometriosis and PCOS, high insulin is, in my opinion, the biggest driver of that. And again, there is a genetic component that can make you more susceptible to those types of problems, especially with PCOS, where you have more follicles in your ovary that are not being, you know, they're not maturing to a certain point. So they start to get immature and they start to kind of create some ovulatory problems. But for a lot of women, the main driver of that is higher insulin chronically. And then in my opinion, the driver of that is usually a high level of inflammation chronically. So That's what I see as like the primary driver for females. And then you add on top of it, you know, the source of that inflammation can be, you know, emotional stress, like having too much on your plate, you know, managing too much at home or at your workforce or having poor sleep patterns or circadian rhythm, um, under eating, you know, like that's a stressor, overexercising stressor. Um, so I, I always try to tell my clients like, it's not just like you have You know, you need to take some curcumin, phytosome curcumin, like that's gonna fix all your inflammation. It's like, well, what if the source is coming from what's happening up here? Or like what's happening in your relationship with your spouse, or what's happening every night before you go to bed and you're watching, you know, something on your phone, you're getting blue light stimulation and then you're not sleeping as deeply that night. And then you wake up and you drink a bunch of caffeine, you maybe skip breakfast, you go to the gym and then you go off and do your work. That's a huge source of stress and inflammation that I think drives Not, not like a, not like a dysfunctional pathological state, but actually an adaptive state. And what I mean by that is when women have, let's say PCOS, what's happening is you're taking this progesterone that would normally help you to fertilize an egg and you're creating androgens, right? Those androgens are gonna be the result of that. And those androgens are essentially making you more male-like, like, and to me that's, that's actually. An adaptive thing that happens by design to help you survive the stressful situation that your body thinks you're in. Mm-hmm. Yeah. So making a baby is not gonna be productive, but maybe having more androgens or testosterone will help you to survive whatever the stressful situation your body thinks that you're in. And so again, I like to kind of give the body the benefit of the doubt more times than not, because about only 5 to 10% of, of hormonal issues are truly genetic. Right. And so we have 90, 95% of these things that are lifestyle epigenetic type factors that are influencing how your genes are being expressed. But we can't always blame these hormonal issues on genetics. We just can't.

Josh

Yeah. Yeah. You know, I, uh, I did a genetic test recently. I had my 5-year-old daughter do it too. Oh, smart. And, uh, it was, it was really telling, you know, that there, most people at this point have heard of MTHFR. Yeah. Okay. And that's a methylation specifically looking at methylfolate. Yeah. And seeing how well your body converts into methylfolate, which is needed for methylation, thyroid function, a number of, a number of things. But there are so many other gene variants you can have. You know, one that I used to see a lot in practice, still do today, is HLA. And that's really tied to your body being able to detoxify mold specifically. So a lot of times, you know, there's about 24% of the population where if they go into a moldy building or home, it just keeps cycling through their body because their body isn't good at binding to it and releasing it. And so But there's such great value in knowing, hey, maybe what gene variant do I have? And sometimes you just don't even need a test. You just know, hey, I took this, I felt better, or anytime around mold, I have a problem, and you just generally know. But yeah, genes are, as you and I have talked about so often, they have to be turned on. There has to be a switch there, and you can switch them back on or off based on, to your point, Lifestyle, you know, the things we're doing on a regular basis. Something else you said, it made me think of this when we were— you were talking about inflammation being a big driver and then what was causing that and related to insulin and then stress and those types of things. But there is a, uh, in Japan they operate— now this really started in their, uh, uh, motor vehicle division. Okay. But they would say, okay, if there's a problem with a car vehicle, we're gonna practice something called the 5 Whys. Okay. And we're going to keep asking why, why, why, why until we get to this was the actual root of it. And so, for instance, with what you're saying, if you have a woman with endometriosis, maybe the first thing is, well, why does a woman have endometriosis? Well, there's inflammation of this lining. Okay, well, why is there inflammation of this lining? Well, it's because insulin is spiking. Well, why is insulin spiking in this person in particular? Well, sometimes on blood work or looking at lifestyle, It's actually because cortisol— it's not you're eating too much sugar because your diet's perfect. It's actually cortisol's high. Well, why is your cortisol high? Well, because you're really, really busy. And sometimes this is where we always end up with a lot of these conditions. Why are you so busy all the time? Well, because I feel the need that I have to please people and say yes to everyone. And then it goes to childhood trauma because at one point in my life, my parents taught me that my worth and value was in how much I got done and checking off a task list. Yeah, something like that. But my point there is when we're doctors of root cause, we're looking at why, why, why, why, why, why. And the further you can get to the why, the bigger results you're going to see long term with, with, with, with patients.

Dr. Austin Lake

And so, absolutely, I think, I think I couldn't have said it better myself. I think it— but again, having that perspective in your mind, you would think, well, that's going to take a lot of time to, to ask those 5 whys and to kind of dig with your patient, but Once you do, and if you do that upfront and you prioritize that, like the amount of work that can be done that can be expedited after that is exponential, right? Because now you're no longer like tiptoeing around like all these potential problems. You're actually getting right to the meat of the problem. And I think for practitioners, I'm not sure how many practitioners listen to this, like I can't express how important it is just to take some time to like ask. I've never thought of it that way, those 5 whys, but I think that's a perspective I've always taken. But that's so important to actually get to the root, the true root of it. And it's not, it's not always just like, you know, if you obviously, if you have mold in your house, you wanna get rid of that. You wanna get rid of the source of that stuff. Yeah. But how many of those people have, especially, again, this is why I like, I like working with women. How many women have been told that they're just little men? You know, like they're, they're, they're the same. They're just little men. They just have like smaller physiques. But the reality is like in God's design, they're totally different. Creatures, right? Like, women are— have a— they have the role of bringing life to this world and nourishing that. And men have this role of like protecting that whole thing, right? At least in my opinion, from a biblical perspective. And so if women think that they're supposed to be little men, that they have to just like toughen up and like, you know, pull their bootstraps, you know, up by their bootstraps, they're gonna go through life maybe telling their body to like be quiet and like not listen to their symptoms and kind of just put on a facade of like, I may have this ovulation pain or I may have this like this severe cramping that's like actually debilitating, but I have to be tough. I have to be a little man and kind of like push through and I have to, I have to kind of like overcome my own body's communication that's trying to communicate with me. And I think if we don't acknowledge what women are actually going through on a day-to-day or monthly basis, we're going to encourage this, this masking of their symptoms that then perpetuate the hormonal dysfunction that can exist after that. And I think men, especially as a husband, you know, part of the reason I got into women's health was my mom and my wife. And then now that I have daughters, it's just made it me even more passionate about it. But when you see, like for my mom, for example, you know, she has autoimmune disorder, adult onset Still's disease, that I think was, you know, expressed after my brother had cancer. So her son had cancer when he was 14. He survived and all that, but it was extremely tough, you know, very, very challenging. Um, after that, my dad had several heart attacks, and he went through all the stress that— because he was working 80, 100 hours a week and trying to provide for everybody. And so my mom took on a lot of emotional stress and a lot of stress of taking care of the household, and she starts getting, you know, these symptoms coming out of nowhere and turns out it was an autoimmune condition. Um, in hindsight, looking at it now, it's like, it makes a lot of sense to me. At the time, didn't make much sense to me at all. But the whole point of all this is that she took on all these extra responsibilities and worry and stress and anxiety and all these things of just trying to keep your son alive that I think, you know, some women just go through more than they're supposed to, you know, like they carry more weight than they're, they're supposed to carry. And especially single mothers or, women who are working and taking care of the household, running kids all over the place and feeding them, all this different stuff. I think that's why God created a husband or a spouse, a partner to balance that responsibility out. Take off some of the load. Yeah. And women don't get that. A lot of women don't get that offload because I think they think they're supposed to be something that maybe they're not. It's like they're supposed to be able to take on all these responsibilities and just like, tough it out. But the reality is, when you tough it out, you're just inducing the survival mechanism that we're talking about. And I think this is where we see infertility, uh, it skyrockets. Because why would your body want to make another human when you're trying to just keep yourself alive?

Josh

Yeah, I think, I think, I think there's something to that, is that a lot of women are just trying to tough it out, right? They're just trying to tough it out and do more and more and more versus sometimes do less, or take a pivot of do something really specifically in alignment with what God's called you to do. And this is true for men and women. If we're operating outside of God's design and what he's uniquely called us to do, and it can be different for one woman versus another, one man for another, but I think that's an important thing. I think anytime you're operating in the lane that God's designed for you, there tends to be not always an, I mean, I was going to say the word ease, but maybe a peace of knowing this is where I'm supposed to be. This is what I'm supposed to be doing. And that's so life-giving. I wanna talk about some other conditions specifically. So we talked about endometriosis a little bit. Talk to me a little bit more about the root cause of issues like, in your mind, of hypothyroidism and Hashimoto's.

Dr. Austin Lake

Yeah. Well, I mean, again, when you look at the research, 80% of autoimmune issues are autoimmune or not autoimmune, hypothyroid issues are autoimmune driven, right? So autoimmune thyroiditis and women are accounting for most of autoimmune conditions. I can't remember the stat. I mean, I think, do you know the stat off the top of your head?

Josh

No, but it's much higher. It's like, it's much higher. Yeah.

Dr. Austin Lake

It's like, you know, it's, yeah, it's a ton. And so I think when we, the big thing that really triggered me back in the day when I started looking at this was like, okay, why are women, you know, proportionally more having issues with autoimmunity in general? Not even just hypothyroidism, but autoimmunity in general. Like why are women more subject to hormonal imbalances? And you know, why do women perceive stress 40% more than men? Like, you know, these are all things that really got me thinking about how can I help women truly solve these problems instead of just like, Hey, you have a problem. Good luck dealing with it. It was like, I have to, I have to provide the implementation or help them implement this stuff to be successful. And so I need to understand like what challenges they face on a daily basis. But when it comes to hypothyroidism, you know, you mentioned MTHFR, that's a huge connecting point. When you look at the inability to methylate very well or take in meth, you know, meth or essentially folate and, and use it for essentially creating glutathione and detoxing and creating energy. Like all these things are, are, you know, if you're burdened by mold, if you're burdened by heavy metals, if you're burdened by parasites, if you're burdened by, you know, just existing in a stressful world, if you don't methylate well, your thyroid is now, because it's a master gland, is having to compensate to kind of just keep you, again, to keep you alive. And I think when we start looking at, you know, obviously iodine deficiency can be a big role. It can also be a problem in thyroiditis, you know? Yeah. We're making it worse. But there's a, there's a balance there, especially if you, protect your thyroid with selenium. And there's some good ways you can do that. But for a lot of women, I think if you look at the HPA axis, which is your, you know, hypothalamus, your pituitary, and your adrenal glands, and then you look at your thyroid, they're all working in conjunction with each other. And so if the brain is interpreting this stressful environment and again, trying to prioritize cortisol just to kind of get you through, naturally you're gonna have some suppression of that T4 to T3 conversion. Mm-hmm. And it's gonna long-term, it's detrimental. You know, it's, it's called hypothyroidism. Short-term, it happens all the time throughout your day. Like if you were to look at a live, you know, analysis of your thyroid, you'll see it fluctuates all, all day long. Mm-hmm. And that's normal. But when you see a trend of TSH and T4 and T3 and reverse T3 and all, and, and all that, you'll start to see that, yeah, we're trending in the wrong direction. That's becoming more, you know, in a, a low functioning state. And in my opinion, again, it's just, it's protective. It's kind of like insulin resistance where your body is like pushing back against the potentially benefits of insulin. If it's chronic, it starts saying like, hey, we can't keep doing this because we're, we're not going to survive this if we keep allowing insulin to dictate. So we're going to become resistant to your, your effects. I think cortisol does the same thing, like there's cortisol resistance, and so you start seeing that affect the thyroid. So a lot of women, I think, are in that state where there's deficiencies, there's environmental toxins, there's there's food sensitivities like gluten and dairy that can, that can interfere with your thyroid, especially if it's autoimmune-based. And then there's just the chronic state of circadian rhythm disruption and all that stuff.

Josh

You know, the way you started that, and this is where I want to just— I want to, I want to piggyback on this, and that is that why do women have more autoimmune disease than men? Yeah. And I believe it's because women are more emotionally driven. Yeah. You know, if you think about it like this, I mean, I mean, you know, this is typical. If you're a woman or man, you know, everybody listening here, you'll recognize this. I mean, I know for myself, you know, Chelsea is thinking, thinking, thinking, thinking constantly. And sometimes when I get home, it's easier for me to just shut my brain off and not think. Yeah, right. I think about my mom and dad growing up. My mom was always thinking, always worrying, whatever. And my dad was just watching TV. Yeah. We're waffles. Or, or, or. Yeah, exactly. And so there's a lot more of that. And in Chinese medicine, it's known, and this is the reality in all of our scientific community as well, is that when you're worrying and thinking constantly, it starts to drain energy from organs. It's draining your— it's causing cortisol to stay up because you're having to be alert while you're thinking like that. It actually then impacts insulin. So all those hormones are affected if you are worrying, analyzing, obsessive, if your brain is on more and you're thinking. So I think that's a major driver. I mean, one of the greatest things women can do is try and turn their brain off, go for a walk, play pickleball, do lunch with a best friend. Yeah, just, just really, because I think a lot of women, what's happened is, and you see a lot of women like this in your practice as well, it's like they have something scheduled from the moment they wake up to the moment they go to bed, and they're a full-time— a lot of them full-time mom, full-time chauffeur, right? Sometimes they're working as well, making food. I mean, there's so many things, and their whole day's packed. Yeah. And so it's like there's just no downtime. Yeah. You know, and so I think they're, you know, prioritizing rest and just doing things that you love, like scheduling peace just throughout the week. You know, that, that'll kind of— that'll, that'll get you out of it. The average person applies over 100 endocrine-disrupting chemicals before breakfast just from everyday personal care products. That's why I want to spotlight a business that's taking a totally different approach: Primally Pure. It's one of the first brand that treats the skin like the microbiome it is. Instead of formulas loaded with synthetics, Primally Pure goes back to what humans used to do for centuries—real, recognizable ingredients from plants and animals, including grass-fed tallow. Tallow is incredibly skin compatible. Its fatty acid profile mirrors your skin's natural barrier, helping restore balance, support the microbiome, and deliver deep nourishment without any endocrine disrupting chemicals. Their less is more approach has earned a massive following, especially their deodorant and tallow-based creams and balms, which actually work with your body, not against it. If you're ready for skincare that supports your health instead of adding to your toxic load, you need Primally Pure. Your skin and your whole system will feel the difference. Use code AXE15 to get 15% off your purchase. At primelypure.com, because when your skin thrives, so does your health.

Dr. Austin Lake

Yeah. And I think, I think as husbands, you know, there is this challenge and I did it with my wife one day where it's like it says something on the screen of like something that men can do that, that women can't. And it's just like this, this guy like staring at the camera and the woman's staring at the camera as well. And the guy is just sitting there quietly, just like turned his brain off. You know, you can tell. And the woman's like, like, what? Like, what? Like, what are we doing? Like, what is it? Like, what are you talking about? Like, I don't understand it. And it's just like, I did that with my wife, and, you know, I think it's the same thing. Like, when you're driving with your wife, like, I'm not sure if you have this experience, but they'll gasp a lot. They'll kind of like, like, they're gonna crash into somebody, or— yeah, you know, they're just kind of like that kind of—

Josh

here, let me say this. Chelsea now knows that it bothers me. Yeah. And by my, my wife, of— and compared to other women, she's much more even-keeled emotionally. I mean, it's really like, I'm like astounded that she is so like that. So I have a wife that's less like that than probably others. Yeah. But I definitely have— I'm thinking of my mom and sister more. They are, you know.

Dr. Austin Lake

Yeah. But like, and my wife, we've talked with my wife and she's pretty good about that. But there's— I've noticed, like, I don't do that ever. Like, that doesn't— I don't do that kind of stuff. But I've noticed with her and other women, their— yeah, their nervous system is just upregulated, right? Like, and— Yeah.

Josh

And I think there's a greater level of women, and this is such a gift. Yeah. But it also can be used too much of just that awareness. I mean, and that's, you know, it's a form of emotional intelligence. I mean, emotional intelligence is such a gift. It's such a blessing to be able to know what's going on in your own heart, knowing what's going on and perceive what's going on in the heart of others, reading the room, feeling the room. It's such a gift. But it's like, you know, if you ever had the music on full blast, maybe you can listen to a song or two like that. But if it's like that all the time and you're listening to that, it starts to just— you get brain fog. It's a form of stress. Well, when you think—

Dr. Austin Lake

so again, with women, there's a lot. So, you know, my wife's had 4 kids. You know, your wife has had 2 kids. Like the stress and toll it takes to make a human and then provide care for that human for the first— like, that's a 2-year process, right? Until you're kind of out of the woods a little bit and you're sleeping a little bit and you're more consistent. So many women I've talked to, they start saying like, yeah, like I was on— I was on birth control. For, for 5, 10 years. And then I got pregnant and then I had a baby and then I didn't sleep for a year or two. And then now, like, I had another baby and then it's just like now they're in their 40s and perimenopause hits and they're like, I don't know what happened. And doctor wants to cut out my uterus. And it's like, you know, like, holy cow. If you, if you start to look back on, on all the things that led them there, it makes a lot of sense why their nervous system's dysregulated, you know, why they have deficiencies that haven't been met yet. Why their circadian rhythm is playing a huge role in their ability to heal and control their nervous system and control their absorption of these nutrients they're taking in. And then you start to add on like, yeah, you got to eat healthy. It's like, well, of course you do, but you also have to fix those other things that happened before all that.

Josh

Yeah. Can I tell you something that happened recently too, just as an example of this to a degree? So Chelsea and I, we are, you know, we were in Puerto Rico for a time. We lived in Nashville for a long time before and then moved back to Nashville. We were in a home renting. While we remodeled a home. Okay. And then in between, we ended up going and having to like do an Airbnb and live with family because we thought it was going to be done. Of course, all construction, you think it's going to be done on time. It's not. So we had a period of about 2 and a half months where we were not in our own home. And Chelsea and I wear Oura Rings when we sleep at night. And one thing that's tracked is HRV. Yeah. Well, Chelsea, we went and tracked like she went from being in a home that we're used to, HRVs, she has great HRV in the 50s. Stable. We go there, it's in the 20s. Oh, wow. I mean, we cannot get it. I mean, it's in the 20s for 2 and a half months. Finally, like, get comfortable in a home. And it took about a month after getting in there. And then, oh, now all of a sudden it starts creeping back up and gets balanced again. But like, my HRV didn't change. Yeah, one bit. Made absolutely no difference.

Dr. Austin Lake

Isn't that amazing? Yeah, I think I've always said I got told this in college, like men are like trailers. We're, we're made to pull a heavy load. We pull straighter with the heavy load. And for anyone to pull a trailer, that makes sense. But, you know, for women, I think, again, as a husband listening to this, like there's important things you have to consider. If you don't know, first of all, your wife should know. If you're a female, you should know your cycle. Like you should know what a consistent cycle looks like for you. A lot of women I've talked to, they don't even know what a regular cycle is for them. Right. And so they don't know if it's supposed to be 28 days or 25 or 35 or whatever. And so you want to get a good idea of where your cycle is supposed to be consistently. Ideally, you know, day 28 is what would be referenced as optimal, but a day or two plus or minus is fine. But for men, I think we should also understand our wife's cycles. Like we should know like, hey, she's in the beginning of her cycle, she's menstruating, or she's, she's about to ovulate. Like she's in a really good time of her cycle where we can be a little bit more intense, a little bit more intimate. You know, we could have more— be more of these intenser conversations even. But if she's at the end of her cycle, beginning of her cycle, um, understanding how to love her well is something that I think men should take a class in because it's one of those things that it's not only going to benefit her, it's going to benefit you and how you can kind of analyze that she's not like you. Like, you have a 24-hour cycle, you're very consistent. She's up and down all throughout her day, all throughout her month. And again, when your body isn't able to make a human and you're trying to thicken the uterine lining and then thin it back down again. And then if it doesn't, you know, if you don't implant an egg and fertilize it, then you don't make a baby. Then you start the whole cycle over again. Like, your body is not— for a female, it's not going to be able to take exercise the same way at the beginning of the month versus the middle of the month versus the end of the month. It's not going to be able to take, you know, fasting maybe as well as it could at the beginning of the month and vice versa. So there's all these variables and factors that men have to understand about their woman. And And again, for me, it makes sense as a provider. I view myself as the head of the household, not in the sense of I get to have authority and dominate and rule over my family and dictate as like a ruler, but I have the responsibility of providing protection and providing whatever nourishment or, you know, safety I can for not just my kids, but my wife. And when we had kids, Every time my wife would have a baby, she would just like protect them like a mother bear and just like have this like supreme level of protection. But the way I looked at my wife is like, I have the same protection over you so that you can protect our kids. Yes. And I think viewing it that way and telling her this is how I view you and this is how you are viewing your child, like I view you the same way, so how can I love you well? Because sometimes I think if we just ask the question like, what can I do for you to love you well? Like, what do you need? It provides a huge sense of relief to where the female doesn't feel like she's being a burden to you and she feels like she can get loved properly.

Josh

You know, there's this— communication is so key to great relationships. And I think there's this element of, you know, I think what women want is for men to ask that question. And most men, it's hard because there's such a lack of awareness in most men due to, due to just never being you know, brought up that way and in the way you were fathered and not learning these things. And so a lot of men just don't know to even ask. But then a lot of women know it and they should probably ask, but they don't want to because they want the men to ask them and take the initiative there. It's a cycle. And that's such a challenge. But I do think a message for all men here is that one of the greatest things you can do— I mean, you know, I'm thinking about the book of Ephesians right now where it's saying submit to one another. Thinking about Ephesians and Corinthians where it's like, you know, love your spouse. And part of loving them is getting to know them, getting to know them. Like, what are their needs? What are their heart's desires? What makes them feel safe? And you don't get to do that by asking them. I think most men just assume, hey, I'm providing, right? You know, or I'm doing this and I'm here, right? You know, and that's enough when typically, Women want more. And sometimes just you asking and them knowing that now you know. Yeah, there's such value there. So I think that, you know, when we're talking about, you know, this conversation about women's hormones, it's about getting the root cause of women's hormonal issues. There is an element of you need to eat these foods, right? These supplements can be beneficial. But there's also such an element of awareness of the woman and knowing her cycle and her needs. The man becoming more aware and loving his wife and protecting her. In that way too. Yeah. That just is, is, you know, it's, it's so important.

Dr. Austin Lake

Yeah. And I think again, it doesn't need to be, it's not a drastic change. It's just like you said, the awareness I think is the key word there. Like if you have the awareness of where she is or the awareness that maybe she's taking on more than she should, at least for me, like when I get outta my little compartmentalized brain and I step into this other compartment of, caring for my wife, I'm like, oh, obviously I want to, I want to do whatever I can to love you and support you. Like, tell me what I can do. Like, I want a task to get done. But having even the ability to ask that question or the awareness to ask it, and then having your wife reciprocate and tell you specifically what she needs, um, I think is a game changer for marriage, for marriages.

Josh

Yeah, yeah. And there's always kind of two steps to this, and even in health as well, in the very same way. There's awareness, and then once you're aware, taking action, doing the right thing, right? Because I mean, I see this in patients when I take care of patients. There's— if somebody sees great results, it's because of one of two things. If they don't, it's because of one of the two things. One, if they're not seeing results, sometimes it's because they're just doing the wrong thing. I see this with women a lot with hormone issues. They think, "I should be eating healthy, so that means a lot of salads and a lot of smoothies." And it's like, well, that typically is actually messing up your digestive tract. We need to do more soups and herbal teas and sweet potato. So a lot of times it's just that. They're not aware that they're not doing the right thing. And then sometimes they're aware of, okay, I need to be doing this, but I'm not going to follow through. Right. You know, and do it maybe because I don't have— I have a poor sense of self-esteem, or there could be all kinds of things there that are driving that. But again, it's so important to become aware of what do you need, what vitamins you need, what minerals, what foods, what, what do you need? And then having a plan and being able to actually follow through. With what those things are.

Dr. Austin Lake

I always call it the two I's. You know, there's ignorance and iniquities. You know, ignorance are the things that you do unknowingly that are harming you. As Hosea 4:6 says, God says, "My people are destroyed for lack of knowledge." Like, we need to know what we don't know. Very important. And then iniquities are things that we do knowing they're bad for us and we do them anyway. And I think that's a spiritual issue of not loving yourself, not honoring God with your body, not, you know, all these different elements that can go into your self-worth and your trauma and your, your childhood history, all that different things. And so I think, yeah, there's the two I's. And I think if you can have that perspective with your patients or with yourself, um, for me it's a game changer because then I can identify like, what is the problem here? Is it a lack of knowledge or is it a lack of self-care or self-worth?

Josh

Yeah, yeah. You know, one thing, it was funny because I, I, uh, as part of my— the Health Institute, um, where, where we see a lot, a lot of patients coming in and we do blood work and look at all these things, I have practitioners I've trained. And one of the things when I came in there and started training them, one of the things I think they were most surprised by is, and I had one of them say this to me, they said, when I become a practitioner, I didn't know I would need to be a therapist and psychologist as well. Yeah, and a theologian probably. Yeah, and I said to them, I said, listen, everybody needs advice on diet and this awareness pieces we've been talking about, but also people need hope. I mean, I've found this in practice, like so many people come in downtrodden and they've tried— I mean, a lot of people have been working hard. Oh yeah, they're exercising hard. They've been following diets, they've been taking— and they're just, they're a little bit worn out oftentimes mentally and emotionally. And a lot of them have lost hope. And I said, one of the, you know, what we also have to bring is we have to bring hope. We need to bring good counsel. We need to help be able to coach people in reducing stress and lifestyle. Like, one thing we do with most patients is we'll give them a list of— if, if they want to, this is optional— but, um, Bible verses to meditate on. Like, if they're struggling with worry, yeah, and that's causing GI issues, hey, here's 10 verses we just want you to meditate on daily. But, but, but it is important as, as practice— the best practitioners, they're not just recommending one supplement or one or a fad diet. They're, they're really going through more of this holistic body, mind, and spirit support for people in that way too. Another condition I want to hit on that I know that you've talked about before is menopause. There are so many women struggling with menopause. I think that before, here's what happened. For a lot of years, women would say, I'm just going to deal with it and suffer through it. And they didn't know what to do. And then there's been times where some women felt okay taking HRT. Okay. I would love to get your opinion on what's the root cause of menopausal issues from the way you see it, and then also get your opinions on HRT.

Dr. Austin Lake

Well, I think, I think menopause in a state of health is you go from a fertility state to a stability state, right? And so that's kind of cool, you know, if you go from having a lot of fluctuations to now being very stable with your hormones. The benefit is you can now be a source of stability and wisdom for the people around you, right? And I think that's That's the, the beauty and the, the optimal side of menopause that like doesn't maybe get talked about enough. And I think that's by God's design, obviously. The, the dysfunctional side of it is all these things that we just talked about, you know, that's happening in perimenopause or, you know, even before that when you're younger going into menopause that hasn't been corrected. And now menopause, what typically is gonna happen is you're gonna start, start to reduce your production of progesterone in your ovaries. Right. And so progesterone is that calming, stabilizing hormone that creates that balance between estrogen. Right. And so if estrogen is going unopposed and it's now creating an estrogen dominant state, you're going to create more of a discrepancy between estrogen and progesterone that, in my opinion, makes you more susceptible to stress and makes you more susceptible to all these environmental factors that can make you feel worse. And so for a woman who's going through menopause or perimenopause, and the gap is widening, that's a problem. But what happens when you go through— when you're postmenopausal is now your estrogen starts to go down lower, right? And so you have low progesterone and now declining estrogen. And that's where you start seeing a lot of issues with osteoporosis, osteopenia, to where your bone health is not being— your bones aren't being protected. Uh, you are more at risk for cancers. And I think that's where you start to have longer-term problems. But like while you're transitioning through menopause, a lot of women Again, they go on HRT because they never corrected anything before this. And so they have to get some relief from, from hot flashes or from the crazy mood swings they're experiencing or whatever, inability to sleep. And so if you don't make enough progesterone in your ovaries, I think what I always tell my clients is you start to make it in your, you, you only make it in your adrenal glands and your adrenal glands are now, because they're dealing with the stressors of the world and the demands of the world of like, oh, we have a stressful situation, make more cortisol. If you're gonna make more cortisol, you're gonna decrease progesterone. Yeah. And that's when you start to see an immediate, like, oh my gosh, I'm feeling really flushed. I'm feeling very like an adrenaline rush basically. Cuz that's kind of what's happening. And so for a lot of women, if they're eating foods that, that worsen that, or they have insulin resistance, or, you know, maybe they're not getting good consistent sleep or maybe they're getting, uh, you know, they wake up and they drink some caffeine and they don't eat a good protein fat rich, uh, breakfast. And now they have. Dropping blood sugar, that's going to spike cortisol even more. And so, all these things create more of a worsening of that progesterone to where you're going to be more susceptible to the menopause effect, I guess you could say.

Josh

You did such a great job explaining that too. And, one thing a lot of people don't realize is that this balance of progesterone and estrogen, it's almost like, again, this is a very different category of health, but this omega-3, omega-6 balance, right? You have to have a balance there. In a certain ratio, or there's inflammation and things are— things get off. You know, one thing I think I've noticed when I think about the women I've taken care of with breast cancer in particular, I feel like the most diagnoses— and again, I don't have a statistic on this, I'd be interested to look this up— but a lot of times it happens in the 40s. Yeah. And the 40s is this perimenopausal time too, when sometimes progesterone is dropping and estrogen might even stay a little bit higher and you get this estrogen-based breast cancer. But again, I think— and that was my mom, 41 years old. Wow. In that phase, diagnosed with breast cancer. But progesterone acts sort of as a protective buffer to estrogen as well being high. So I think to your point, that's incredibly important. You know, when I was talking to Barbara O'Neill, one of the things when we were talking, I asked her, I said, hey, what do you believe in all the women you've seen, the biggest cause of hormonal issues is from a hormone standpoint? And she really pointed to progesterone and she talked about using wild, you know, wild yam cream. I mean, this is something that's been used in Chinese medicine in Asia for a really, really long time. But I do think it's a hormone that probably needs even, we need to pay even greater attention to of how can we support progesterone in particular in that way. But I love the way you described sort of what's happening. In Chinese medicine, the way that they view it is when progesterone and estrogen both drop, those hormones are partly responsible for cooling and moistening the body. And this is why you get hot flashes. This is why you get dryness is those hormones. And so in Chinese medicine, they'll say eat more what we call yin-building foods. Foods. And so yin is more feminine, yang is more masculine, but yin tends to be, you know, bananas and even dairy and sweet potatoes are on that list and things that sort of— and a lot of omega-3, a lot of good oils because those help bring moisture to the body.

Dr. Austin Lake

Yeah, I love the way you described that. And I think when you hear that, like the cooling effect, and in my mind from like a Western medicine perspective, I mean, that's the only thing I was really trained in. Like it makes sense to me when you say cooling. And so I like that, I like that perspective of, of just how to support somebody. And I think for the, the person hearing that, hopefully it kind of resonates on what you can do, right? Like, I want people to hear this and be like, okay, what can I do to fix this? And so when you talk about, you know, fiber— is fiber something that, again, depending on your GI tract and what, what benefits you, fiber is very helpful. At least 25, 30 grams a day are helpful at binding estrogens and removing them out of your GI tract, right? And so I, this is where again, having, having a diet that you're like, okay, what does it look like to eat healthy? I always assume that like people know what that looks like, right? And I'm sure you probably do. Maybe you've been—

Josh

no, here's what I've realized. No, I don't think that at all. And the reason is, it's probably smart because it's what I talked about earlier. I think that I am so ingrained in personalized nutrition. Like, I found that, you know, somebody with cancer versus irritable bowel disease, those are, those are completely different diets. A woman that's in her 20s versus a woman that's in her 50s, that's oftentimes a really different diet. Like, like, like a woman in her 20s, I would almost never recommend they have soy, right? A woman in her 50s or 60s, low estrogen, wow, organic soy, man, that's a flax, right? Those are great foods. That's a good point. So, so no, I mean, Actually, my state is typically that the person probably is doing not the right thing dietarily because generally most people aren't. I mean, in terms of a percentage. So I do think, you know, people learning the exact right diet for their body. So when I'm customizing nutrition plans, I'm very aware of, okay, I looked at your blood work, I looked at your tongue diagnosis, looked at your history, looked at all of this. Let's create the exact ideal foods and make sure you're getting all of those in your diet. It in order so you give your best chance at healing.

Dr. Austin Lake

Yeah, I call it for our clients like a diagnostic diet. You know, it's like they want to figure out what, what works for them. And again, you don't really know that until you diagnostically implement something and then start to work through a progression. That's right. It looks at— and so, but, but again, I think for the person hearing this, it's like, you know, again, whether it's, you know, I, I personally like to ascribe to more of a— again, I like to kind of do a combination of either like a low FODMAP with an autoimmune protocol with something else, right? And just kinda like figure out where to start for them. Yeah. But what that looks like is if you're just hearing this, it's typically gonna be, you know, no gluten or dairy, at least definitely no conventional gluten and dairy, like where it's hybridized wheat and conventional raised dairy like that. That to me, if you have, especially if thyroid issues, so beneficial to at least eliminate that potential source, right? And get some diagnostic data on how you do without it. And so for a lot of people, I think if they don't understand how their immune system is functioning, your, you know, your immune system has memory to it, right? And so that memory has a half-life to it to where typically, you know, a 3 to 4 week time period will allow for, if you have something outta your system that's not challenging your immune system for 3 to 4 weeks, can show some signs of improvement to where it's like, if it is a dietary trigger, you should feel better by having this out at the 4 to 5 week mark. Yeah. Potentially. Right. And so that's, that's useful information for somebody to know. I can't cut it out for, 7 days, maybe I'll feel better. But if I'm not feeling better, it's not because I'm not on the right track. Maybe I am on the right track and I just haven't given enough time to start seeing that like this does trigger my immune system or this does trigger my GI distress or whatever. And so that's really important to communicate, at least in my opinion, to my clients to say like, you need more time. You gotta give it 4 to 5 weeks. But what I was saying with that, with the, with the fiber thing, you know, uh, because estrogen can get recirculated very easily in your, from your GI tract and also can get trapped in a lot of your fat cells. A lot of our clients that have gut health issues have high beta-glucuronidase, right? And so beta-glucuronidase is one of the things that helps to bind and remove estrogen from your GI tract. And so for people that are not fixing their GI tract and then just going on HRT or, you know, trying to transition through menopause and they're not actually fixing their gut, they're not fixing their circadian rhythm, their detox pathways are blocked. Maybe they had a gallbladder removal. They don't have good bile. Synthesis and, and bile flow, or maybe they have lymph stagnation, or maybe they have some kidney function, just, you know, kidney dysfunction where they don't clear out toxins from their kidneys. They're not gonna be good detoxifiers. Right. And so they're gonna be likely to recirculate a lot of this estrogen or, you know, other toxins that when they start to lose weight, which is a good thing right now, all of a sudden they, they yo-yo very frequently because they lose, they, they break down their fat cells. They release the toxins, they get circulated and they just go right back to where they were and they start to yo-yo very quickly. And so this is where I say it's— I would rather my clients— I always say first get healthy, then get fit. You know, like I'd rather you focus on detoxing well, fixing your diet, you know, removing things from your environment that would trigger your immune system. And then once you wanna start cutting fat and getting in the gym and start building muscle, like you can do it from a stable foundation. Yeah. But a lot of people, they, especially this time of year, gyms will open up in New Year's, they'll all jump in the gym. Start killing themselves in the gym, work, working out a ton, and none of the existing foundational problems have been addressed. And so now it's like they get injured quickly. They can't exercise very long. They get burned out very fast and they don't recover. And next thing you know, they're just like, I, I'm trying, I'm doing what I'm told to do with diet and exercise, but I'm not actually getting any results. I actually feel worse now. When the reality is, if you fix some of those foundational things before you get really intense in the gym, I think you have a lot more success by doing it in that order. Yeah, yeah.

Josh

I think, I think the idea is play the long game. Yeah. You know, you're always going to be more successful the further out you think, you know, thinking eternal, thinking about when you're in your 80s, thinking about 10 years from now, you're going to be better off. And so thinking about, hey, what are the habits I can create that I can actually stick to and be doing these same habits in the same daily routine in 5 years? Yeah. You know, so I think the more you can think like that of, hey, what's doable not only now, but I can do this throughout this entire school year, year, that that's going to be, that's going to be a better mindset and more successful. If you want practical, science-backed guidance for living a healthier, longer, more vibrant life, you need to check out the Biohack It podcast. It is hosted by my good friend Iman Hassan, and it brings a thoughtful, compassionate perspective to wellness that so many women have been looking for. Every week, Iman breaks down the latest research in longevity, hormones, and metabolic health in a way that's clear and easy to understand, leads to important conversations around women's health, fertility, and the steps women can take to protect their energy, balance their hormones and support long-term well-being. She talks with top doctors, scientists, and health experts about natural healing, nutrition, lifestyle choices that make a real difference, and sits down with entrepreneurs and thought leaders to explore how they stay strong, grounded, and resilient in their personal lives and their work. If you want a show that speaks directly to health challenges women are navigating today while offering hope, clarity, and real solutions. Tune in to Biohack It every Thursday wherever you listen to podcasts. It is one of the most educational and uplifting shows in the wellness space, and I think you're going to love it.

Dr. Austin Lake

I was listening to Jelly Roll. You know, you hear about him, he's on Joe Rogan and he's lost like 300 pounds. Yeah, yeah. So he was 500 pounds and I think now he's down to like 260 or something like that. So he's lost 250 pounds, half his body weight. And he said, you know, he's like, if I thought about all the weight I had to lose, it was like, It was overwhelming, right? Like it was too big of an elephant bite to take. And he's like, I started focusing on like, how can I lose 8 pounds? You know, like in this next 2 to 3 weeks and 8 pounds for a 500-pound person is not very much. Yeah. But you know, those small incremental changes, those incremental goals, I think is, is how we have to look at it. So for somebody listening to this, I would say, you know, how can I be consistent with my bedtime? Like, I'm gonna go to bed at 10 o'clock every night and I'm not gonna, I'm gonna let my body wake up naturally. If I can, you know, if I don't have to miss work and stuff like that. And then from there it's like, well, how can I, how can I wake up and consistently drink water? You know, just like get some water and some minerals added into my, my, my filter or for into my body each and every day before I have coffee. Or how can I wake up and, and have a breakfast? This is my recommendation at least, is, is eat some food before I have caffeine. You know, like how can I do that consistently? But if you start doing those little things and you have the belief that by doing it consistently and being boring with your life, like it actually yields results if you play the long game, like you were saying, because if you're trying to solve a problem in 3 to 4 months so you can get fit for a wedding or something, that's gonna, you know, be a one-time event, you're not gonna have the right— you're gonna be— you're, you're in trouble from the get-go, I think. But a lot of people, if they have the mentality of, I may be 45 right now, when I'm 55, 65, I wanna be a healthy fit grandma or healthy fit grandpa and be a good example to my kids or grandkids and how to be healthy. Um, that's my long-term goal. Like I got, 20 years to be consistent with these little incremental goals that I'm focused on. And that to me, I think creates a lot of like leeway for grace for yourself and not putting a lot of, you know, feeling a lot of shame for not meeting your goals. Because I think a lot of women that invest in their health and don't meet their goals, they feel a lot of shame for it. You know, they just told their husband like, I'm going to— I'm going for it this time. I'm going to commit to it. I'm going to achieve my goals and be healthy. And then something doesn't work. You know, they fall flat on their face. They bit off more than they can chew. And then they spent a bunch of money on their health and they never actually achieved anything. That's gonna create a propensity for not wanting to take chances down the road for your health. Like it's gonna make you a little bit scared and skittish. And so I think it really is important to identify what your initial goals should be, make 'em very small, tangible, achievable. And once you start feeling better, the bigger goals become easier to solve. Yeah.

Josh

You know, it's so, it's so true. Yeah. Give me your top foods and supplements to support women's hormones.

Dr. Austin Lake

So foods, I, I love sweet potatoes. You know, I think I have all my, a lot of my meal plans have sweet potatoes built into 'em. My, my family, my kids like so sick of sweet potatoes cuz we eat 'em all the time. But I think they're great. There's also different types of sweet potatoes and there's like purple, there's white, there's yellow. White are typically more lower glycemic index. So like they could be a little bit better for somebody that has blood sugar issues. But overall I think a sweet potato is fantastic for stabilizing blood sugar. It's a good source of fiber, some good phytonutrients. I love sweet potatoes a lot. And you know, they're not quite the same as yams. You know, wild yams are a little bit different, but they, there is a little bit of a component of of helping progesterone production slightly. So there's, there's that benefit. Huge fan of, of berries. You know, I think berries are great antioxidants. They're great adding to your, to your meals as a little sweet treat at the end of your meal. Avocado, big fan of avocado. It's a great source of monounsaturated fat. My kids eat that. So what, what we typically eat is like ground beef, you know, grass finish, grass or grass. What am I trying to say? Grass raised or—

Josh

I mean, it's typically grass fed, grass finished. Grass fed, grass finished. Yeah.

Dr. Austin Lake

So I, Yeah, we're a big, I like most places, if you go locally, locally sourced, you can find, you know, grass-finished beef. And I think if you're buying, or like not internationally, but across state lines, there's sometimes some regulations where it's hard to do that. But I've found every place I've gone, you can get grass-fed, grass-finished beef. And that's a big staple for us. And so we'll do that. We'll do sweet potatoes, we'll do avocado, we'll do berries. Eggs are tricky. I think if they're conventionally raised store-bought eggs, you lose that protective— they wash that protective coating off the egg in order for them to be stored. One of my clients was a scientist and she studied eggs and how they're all manufactured and processed. And she said that basically all the eggs that you buy in the store, they all kind of go through the same process to end up in the stores where they're meeting their standards. And so if you have farm fresh eggs, they have that protective coating. They can sit on a countertop for weeks and not go bad.

Josh

A long time, months. Yeah.

Dr. Austin Lake

But store-bought eggs, you have to put in the refrigerator. If you don't, they go bad 'cause they lose that protective coating. And also depending on how they're, you know, raising the chickens, what they're feeding them, what they're injecting them with in terms of vaccines, it definitely can affect, in my opinion, the quality of the egg. And so for somebody consuming eggs, I really wanna figure out, again, diagnostically, how do you do with eggs? Because eggs can be a great source of nutrition, but if you don't do well with them, if your immune system doesn't do well, I'm— I don't like eggs for some of my clients with autoimmune issues.

Josh

Yeah, it just depends. Yeah. Yeah.

Dr. Austin Lake

So it depends on that. But eggs, eggs are sometimes a food that will, consume and recommend. But otherwise, yeah, it's, it's, it, those are like some of the basic foods I like for, for my clients and for hormones. I think a lot of women don't get nearly enough protein with their meals. You know, they're getting very insufficient amounts. And so if you have to substitute with a protein supplement, I like them to do that after they've consumed food personally. Yeah. I think chewing your food is really important. I think if we're only relying on meal replacement smoothies and shakes all the time, you can start seeing some digestive issues. Yeah. Potentially. So I like them to chew food first and then subsidize a little bit after that with protein powder if they need to. A lot of my clients don't do whey because it's dairy. Yeah. But if they, if they can tolerate it, that's fine. Otherwise, like a hydrolyzed beef, bovine protein source is pretty good. Some pea protein sources are good. But yeah, I think protein— I know you've probably talked about this a ton on your podcast, but I like at a minimum of 100 grams of protein per day. Yeah. Preferably, you know, it needs to match their body mass or muscle mass. And how much muscle mass they have. But overall, I think those are the big ones. A lot of women think they're eating enough protein. The reality is, like you said, they eat a salad for lunch. Maybe they have a smoothie for breakfast that's heavily based in sweets or not sweets, but like fruit, spinach, all that kind of stuff and no protein. And then they have their caffeine, then they have a salad for lunch, and then they have a big meal at the end of the day. And it's like, it's hard for your insulin to manage that. And for people to understand that insulin sensitivity is gonna get worse as the day goes on, as the sun starts to set, your insulin sensitivity gets, becomes less. And so that means you're not gonna be able to utilize the, the, the energy coming in and, and store it properly. Right. And so a lot of people are eating later into the day and then they're more likely to store that as fat. So eating with the sun is usually what I say, eat, you know, 80% of your calories before 2 o'clock is typically like a, a rule I like to give my clients, but it's not required. Um, just something for them to think about. And then when they do that, yeah, I think they start seeing a lot of energy improvements throughout their day. They start feeling like they recover faster at the gym. And it's an easy thing to do once you get in rhythm with it. As far as supplements go, you know, my, my big ones are, I love a B complex. I think B complexes are great, especially because most women have MTHFR. I think a methylated B complex can be very, a game changer for a lot of people. You know, you do get a lot of these B vitamins from, from, you know, meat sources and things like that. But I think a methylated form that's more easily absorbed and gets you the dosage that you need to kind of meet the, meet the demands of your day. Like I have MTHFR, my, my wife has it, so our kids have it, right? Like I see huge changes in my kids and sometimes I'm like, why'd I give 'em a B complex? Or they're already crazy. Like they're crazier now, but they have so much energy. They, they can run all day long. And you know, just in terms of daily detoxification, daily energy production, mental clarity, you know, even helping with your thyroid and helping with your sleep and helping with your, for anxiety, mental health, clarity, I think it's very important to have a good methylated B complex. Magnesium is my favorite mineral. Like most people, I'm a big fan of magnesium glycinate. I think it's easier on the digestive tract, doesn't cause much nausea or discomfort in your gut. You can typically take it on an empty stomach. But there's a bunch of different forms of magnesium like threonate and citrate that could be useful too. So, all those are up for discussion. Vitamin D, obviously K2. Most people are very familiar with that term now and kind of what that means. But I say typically 5,000 IU is a good place to start. Yeah. Omega-3 fatty acids, again, are another favorite. You know, I think the population is experiencing about a 20:1 ratio of omega-6s to omega-3 fatty acids, and it should be closer to like a 1:1 ratio typically. And so I think we're way out of balance there, you know, whether it's through an omega-3, you know, fish oil supplement or, you know, you're getting it from somewhere else. I'm not sure what you recommend for omega-3s.

Josh

I mean, listen, I typically like classic cod liver oil, like a good quality brand most of the time. But yeah, I mean, I think that, you know, omegas are up there. I mean, from a clinical standpoint, when you look at studies, one of the most beneficial long-term is definitely going to be omega-3s and fish oil. So yeah, I think those are— Yeah, I think that's a great list. I think the B complex in particular, because that's so important for liver function and detoxification and to your point, methylation, that that's something that when we're talking about women's hormones that a lot of women can benefit from too.

Dr. Austin Lake

Yeah. And it's hard with hormones because once you get into some specifics of like PCOS, you could look at inositol as a great supplement to take for PCOS. Yeah, exactly. If you do have endometriosis, you can look at like that anti-inflammatory, my— Phytoceramervira curcumin can be helpful for that. If you have, you know, high— if you're not detoxing estrogen very well, like DIM can be a great supplement to take. But those are all kind of specific to the, to the condition and the person to where I have a hard time making a statement about those types of supplements. And so that's where I usually don't go.

Josh

It's what we talked about earlier, women need personalization. So I wanted to get a general hormone idea, but yeah, with every one of those individual conditions there are specific supplements that they would need that are best going to help them address the deficiencies so they can function optimally. So I think there's, there's, you know, so much, so much wisdom there.

Dr. Austin Lake

But those, those first, those first ones I mentioned, I feel like those, if you're anyone, like most people listening to this can take those to some degree. Yeah, they'll find benefit, you know, tremendously.

Josh

Yeah, those are, those are foundational. Yeah, they're foundational, right? Well, Dr. Austin, I want to say thanks so much for coming on today. Yeah, I really enjoyed this conversation. You know, I have so many people that listen to the show here who want to optimize their hormonal health. So many women in particular. So really glad you were able to come on because I know you've worked with so many women and helping them with their hormones and it's just an important topic in conversation. I want to say, hey, thanks everybody for tuning in here to the Dr. Josh Axe Show. Every week we're diving deep into the science and principles of how you can heal physically, mentally, spiritually, and take your health and your life to the next level. Hey, don't forget to subscribe. It's the number one thing you can do to support the show. So thank you for all subscribing. Thanks for sharing, and I'll see you on the next episode.

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