Speaker 1: Earlier this season, I spoke with several experts about cosmetic
Speaker 1: dermatology and the science of skincare. The response was terrific
Speaker 1: and thank you very much. Today we're going to continue
Speaker 1: to explore medical topics, discussing the latest research, innovations and
Speaker 1: health recommendations. Today I am at Newsstand Studios right in
Speaker 1: Rockefeller Center speaking with doctor Elizabeth Poynter, a gynecologic oncologist,
Speaker 1: an advanced pelvic surgeon, and an expert in midlife women's health.
Speaker 1: I've known doctor Poynter for several years and I am
Speaker 1: so impressed by her depth of knowledge about women's health.
Speaker 1: And just to clarify the situation, she has also been
Speaker 1: my gynecologist for several years and I have been extremely
Speaker 1: happy with her treatment and with her consultations. So many
Speaker 1: are very hesitant to talk about menopause. Many doctors, many
Speaker 1: women are hesitanted to talk about a very natural occurrence
Speaker 1: in every woman's life. But I firmly believe it's important
Speaker 1: to learn as much as possible and to understand how
Speaker 1: the changes associated with menopause can affect physical, emotional, mental,
Speaker 1: and social well being. Doctor Pointer, welcome to our podcast.
Speaker 2: Thank you so much for having me today and allowing
Speaker 2: me to talk about to speak with you about.
Speaker 3: One of my favorite subjects, women's health.
Speaker 1: Well, it's so much more than about women's ability to reproduce. Elizabeth,
Speaker 1: I've heard you say that we need to go beyond
Speaker 1: bikini medicine. Can you tell me what you mean by that?
Speaker 2: So women have distinct physiologies from men, largely dictated by
Speaker 2: fluctuating hormone levels throughout the month and throughout our lifespans.
Speaker 2: So we know, and we've known for quite some time
Speaker 2: that women are not small men. However, there hasn't been
Speaker 2: a lot of work devoted to this or a lot
Speaker 2: of research relating to this, And now we're just at
Speaker 2: a pivotal moment where we're beginning to realize the importance
Speaker 2: of specific female physiology and it needs to be studied
Speaker 2: and entreated and looked at very differently through a different lens,
Speaker 2: a hormonal lens.
Speaker 1: And you, as an expert, know a lot more than
Speaker 1: most of us, because for the record, I've been on
Speaker 1: hormone replacement since I was like forty years old. That's great,
Speaker 1: and you want to know something, I think it is great.
Speaker 1: I think it has kept me more vital, more healthy,
Speaker 1: more my bones stronger. If that's true, I'm not sure
Speaker 1: if that's just genetics or if it really has been
Speaker 1: helped by my hormone replacement.
Speaker 2: Definitely for women, when hormone replacement, usually consisting of estrogen
Speaker 2: or estrogen plus progesterone, started within a few years of
Speaker 2: menopause or in that perimenopausal transition or before the age
Speaker 2: of sixty, you're really going to get great benefits from it.
Speaker 2: You're going to get cardiac benefits, cardiac protection, bone health protection,
Speaker 2: of course, maybe even brain protection.
Speaker 1: That data I certainly hope. Yes.
Speaker 2: So it's great that you started early and had physicians
Speaker 2: who were engaged and who actually did that foil years.
Speaker 1: It was because I had a lower abdominal hysterectomy after
Speaker 1: the birth of my daughter, I developed fibroids or something
Speaker 1: like that. I don't know, I can't you know. That
Speaker 1: was a long time ago, and the doctor said, oh,
Speaker 1: it'd be best if you just had this procedure and
Speaker 1: then but he started me immediately on hormone replacement. It
Speaker 1: was primarily progesterone and a little bit of justeosterone. I think, so.
Speaker 2: Before the Women's Health Initiative study that was very standard.
Speaker 2: Kind of the advantage of being an older physician is
Speaker 2: you get to see the history of medicine and the
Speaker 2: history of trajectories and how we treat people. And when
Speaker 2: I first started in surgical oncology, when we would remove
Speaker 2: ovary's or do a hysterectomy with ovaries, we would always
Speaker 2: recommend hormone support to protect the heart. The Women's Health
Speaker 2: Initiative Study was published and came out in two thousand
Speaker 2: and two and really took that off the table for
Speaker 2: a lot of people, and a lot of doctors then
Speaker 2: became very scared to provide hormone support for their patients
Speaker 2: before well the study was the interpretations of the study
Speaker 2: were prematurely released, right.
Speaker 3: We looked at the Women's.
Speaker 2: Health Initiative Study included one hundred and fifty thousand women
Speaker 2: who were as young as in their forties and as
Speaker 2: old as seventy nine, and they were randomized to either
Speaker 2: be on hormone support or no hormone support. And what
Speaker 2: we found is the risk of cardiac disease and breast
Speaker 2: cancer was higher. But remember we were starting women far
Speaker 2: after the transition of menopause. These were women who were
Speaker 2: in their sixties and seventies, who were more than twenty
Speaker 2: years for some of them probably after menopause. But when
Speaker 2: we did a subset analysis, meaning we took and we
Speaker 2: looked at specific populations or groups of women within that study,
Speaker 2: we found that if hormones were started early in that
Speaker 2: perimenopausal or menopausal transition, that you actually did gain significant
Speaker 2: cardiac benefit from paramant support and decreased our death from
Speaker 2: all causes actually other than breast cancer, which was slightly
Speaker 2: elevated in this study.
Speaker 1: And not all surveys are the surveys that we need.
Speaker 2: We need to interpret studies the appropriate way just because
Speaker 2: something is published and we need to look at how
Speaker 2: to interpret it, and we have to be intelligent about
Speaker 2: how we interpret it.
Speaker 1: Now I'm looking I had a very beautiful, slender, chic,
Speaker 1: short skirted, long leggage, high heel wearing Guya colleges.
Speaker 3: Kay, I'm coming back here more often.
Speaker 1: When I first met doctor Porter, I thought she was
Speaker 1: maybe the office assistant on a summer break from college
Speaker 1: or but here here I am sitting next to a
Speaker 1: very beautiful female doctor with long black hair. How do
Speaker 1: you keep in shape like this with your horobably difficult schedule.
Speaker 2: Well, I practiced what I counsel my patients. I started
Speaker 2: on hormones when I was forty three. I had some
Speaker 2: new mood issues actually around the age of forty three,
Speaker 2: and I was doing very large surgical oncology cases and
Speaker 2: kind of hand ringing a little bit and developed some anxiety.
Speaker 1: Was your son born then?
Speaker 2: Note he was born. He was about a year or
Speaker 2: two after he was born. And it was my mom
Speaker 2: who said, oh, I think it might be your estrogen.
Speaker 2: And so I actually started on hormone support due to
Speaker 2: some anxiety, which was I'm now in retrospect, was definitely
Speaker 2: the perimenopausal transition. And this is before anybody really reconnized
Speaker 2: that anxiety or depression was actually linked to perimenopause or
Speaker 2: menopausal transitions. So I started early on hormone support, and
Speaker 2: I think it's kept my metabolism good. And I practice
Speaker 2: what I speak about in terms of nutrition, exercise, lifestyle,
Speaker 2: healthy sleep, good outlook, all those things that helped to
Speaker 2: keep us young. So I try my hardest.
Speaker 1: There are men who will say, oh, she's in a
Speaker 1: bad mood today, she's in menopause. Probably men are telling
Speaker 1: me this and I mean, what do they know about menopause?
Speaker 2: Well, we need to educate them more. And I think
Speaker 2: you're aware. My husband is a breast surgeon, and so
Speaker 2: when I was starting on hormones, my husband is very
Speaker 2: knowledgeable obviously about breast cancers. Like, no wife of mine
Speaker 2: is going to start on hormones because of the breast
Speaker 2: cancer risk.
Speaker 3: And we can talk more about that, and I hope
Speaker 3: we do.
Speaker 2: But he went to all the best medical schools, had
Speaker 2: all the best training, knew nothing about menopause, knew nothing
Speaker 2: about hormonal transitions, and was like, this.
Speaker 3: Is no joke.
Speaker 2: And I'm like, yeah, no, it's not a joke in
Speaker 2: terms of the changes that we go through. But I
Speaker 2: think there's more conversation now. There's more out on social
Speaker 2: media about menopause. There's certainly more in the popular press
Speaker 2: about menopause, and so now individuals are men and women
Speaker 2: are realizing that anxiety or depression or mood issues are
Speaker 2: tightly linked to hormonal fluctuations.
Speaker 1: Now once on hormones, now I've been on hormones for
Speaker 1: a long time. I started like right in my early
Speaker 1: forties too. Does your treatment have to change? How do
Speaker 1: you test for hormonal balance and everything.
Speaker 2: So this is the tricky part about hormonal management. Naturally,
Speaker 2: we will need to change hormone dosing over an individual's lifetime.
Speaker 2: If you still have your ovaries and you're transitioning through
Speaker 2: perimenopause or into menopause, the ovaries don't just decide one
Speaker 2: day they're going to turn off. They naturally decline, and
Speaker 2: so we may start on lower doses of estrogen, we
Speaker 2: may start on doses of progesterone with odd estrogen or
Speaker 2: and then naturally anticipate that they will need to be
Speaker 2: escalated over a woman's lifetime and then maybe drop down
Speaker 2: a little bit when we get a little bit older. Actually,
Speaker 2: so that this is a conversation and dialogue that every
Speaker 2: woman should have with her physician or the person who's
Speaker 2: helping her manage her hormones, because it's really a communication
Speaker 2: because what works for one person doesn't work for everybody.
Speaker 2: So it's very highly personalized medicine.
Speaker 1: I don't usually talk to people about their treatments or
Speaker 1: medical treatments, but a couple of my very close friends
Speaker 1: have spoken to me like, oh, why do you have
Speaker 1: such a nice skin? And I say, I think it's
Speaker 1: because of the hormones I taken, and of course genes,
Speaker 1: but and I said, do you take hormones? And most
Speaker 1: of them, most of my friends, have never been on
Speaker 1: hormone replacement.
Speaker 2: So about that period of the Women's Health Initiative Study
Speaker 2: when it came out, and I remember this, I mean,
Speaker 2: we sent letters to our patients. At the time, I
Speaker 2: was at Slung Cattering as a surgeon, and we sent
Speaker 2: letters to our patients, you know, stop your hormones immediately.
Speaker 2: We were very couscormed about it. Stop them immediately. Well,
Speaker 2: about fifty percent of people went back on hormone support. Actually,
Speaker 2: so fifty percent has significant symptoms off of hormone support.
Speaker 2: So everything with the Women's Health Initiative Study came from
Speaker 2: a screeching halt because it was just a knee jerk
Speaker 2: reaction because there was an elevated relative risk of breast
Speaker 2: cancer with this type of hormone support that was prescribed
Speaker 2: in this study, everybody to stop their hormones. And instead
Speaker 2: of throwing out the drugs and saying, okay, these drugs
Speaker 2: might not be the safest that we could use, we
Speaker 2: actually throughout the issue. We threw out menopause and said, well,
Speaker 2: there's nothing we can do for you because this Women's
Speaker 2: Health Initiative study came out. You can't take hormones, they're
Speaker 2: not safe. But we have newer preparations now that the
Speaker 2: French have had for a number of years, longer than us,
Speaker 2: that are actually safer than our older preparations, and this
Speaker 2: is now being brought to the forefront, so we have
Speaker 2: instead of saying we can't do anything, we now have
Speaker 2: safer preparations to treat with well.
Speaker 1: Most discussions around hormone therapy is about relieving symptoms of menopause,
Speaker 1: but they must affect so many other parts of our health.
Speaker 1: I mean, they must help so much more in bone
Speaker 1: strength and good hair.
Speaker 3: Is that true? Absolutely?
Speaker 2: There's estrogen receptors all throughout the body. I mean we
Speaker 2: could talk from the tip of your head down to
Speaker 2: your toes, to the muscle, bones and joints basically. So
Speaker 2: there's estrogen receptors in the brain that are increasingly being
Speaker 2: identified as being important actually and maintaining cognitive function for women.
Speaker 3: In terms of estrogen support.
Speaker 2: It was recently published that around the time of perimenopause,
Speaker 2: estrogen receptors are those hearts of our cells that hold
Speaker 2: on to estrogen actually increase at the time of perimenopause,
Speaker 2: and there's some data out that really suggests that women
Speaker 2: who are on early hormone support within three years of
Speaker 2: menopause actually have improved cognitive function and may have a
Speaker 2: decreased risk of dementia. Overall, that's the brain, cardiac health.
Speaker 2: We know that there's a thirty percent reduction in all
Speaker 2: cause of mortality other than breast cancer with hormone support,
Speaker 2: and that's thought to be largely through cardiac risk. Skin
Speaker 2: definitely increases, collagen production, decreases fine lines and wrinkles. There's
Speaker 2: data in the literature that few people review and discuss
Speaker 2: that even with topical estrogen we can improve skin muscles. Well,
Speaker 2: of course we are muscle mass changes when our estrogen drops.
Speaker 2: It can also drop and decline as estra levels decline.
Speaker 2: Bone health has been recognized for many years that as
Speaker 2: estrogen declines, bone health deteriorates, and we can help bone
Speaker 2: health by adding back estrogen. So really and metabolism also, right,
Speaker 2: So when estrogen levels start to decline, we begin to
Speaker 2: develop metabolic disruptions. So you can look at every organ
Speaker 2: system in the body basically and have some link to
Speaker 2: hormone fluctuations in terms of the health of that organ system.
Speaker 1: So what happens to the woman who has a brisk
Speaker 1: cancer history in the family, what do you tell her
Speaker 1: about taking hormones.
Speaker 2: So a family history of breast cancer without a personal
Speaker 2: history of breast cancer is not an absolute contra indication
Speaker 2: to hormones. Even with our highest risk individuals in terms
Speaker 2: of genetic mutations, we will many times speak with them
Speaker 2: about hormone support after ovaries are removed and recommended. Actually,
Speaker 2: so I think every individual in every situation is to
Speaker 2: be personalized, but a family history of breast cancer is
Speaker 2: not a contraindication to hormone support.
Speaker 1: Are you writing about this too?
Speaker 2: Oh yeah, oh yes, yes, So we're working in a book. Definitely,
Speaker 2: we're writing about this.
Speaker 1: When is that book available, Probably.
Speaker 2: Within the next eight or nine months. We want to
Speaker 2: offer you solutions and how you can age beautifully and
Speaker 2: be vibrant just as you're doing.
Speaker 1: I have so many friends who need this book, so
Speaker 1: good luck with it. I can't wait. I can't wait.
Speaker 1: Thank you. You'll have to come back on the podcast
Speaker 1: to talk about the book. So what innovations are you
Speaker 1: seeing about when it comes to the science of managing
Speaker 1: and treating the symptoms of MENOPAUSEA when do you know
Speaker 1: that you're in menopause? When? How do you know?
Speaker 2: So menopause is really defined as being postmenopausal as you
Speaker 2: don't have I haven't had a period for a year.
Speaker 2: But that's an antiquated kind of definition, right, because that
Speaker 2: definition was before we had laboratory testing. Everybody kind of
Speaker 2: forgets you know, one hundred years ago we weren't able
Speaker 2: to check for these levels of bollicle stimulating hormones and
Speaker 2: asterrodial level. So menopausemeaus you haven't had a period. And
Speaker 2: when your post menoposamis you haven't had a peer in
Speaker 2: one year. Perimenopause is that time leading up to menopause.
Speaker 2: And then perimenopause really can start anywhere between eight and
Speaker 2: ten years prior to your final menstrual period.
Speaker 1: So women, that's an elongated right in a bad mood? Well,
Speaker 1: I mean that's what you hear. Everybody is in a
Speaker 1: bad mood.
Speaker 2: Think everybody reacts differently, right, I mean, I think everybody
Speaker 2: has their own different types of issues as their hormone
Speaker 2: levels fluctuate. And that's actually an interesting question is in itself.
Speaker 2: Why are some individual symptomatic and others not right?
Speaker 1: And could that be also because if they were taking
Speaker 1: hormones maybe that would prolong good health or of course,
Speaker 1: and that's when I phone the actual menopause.
Speaker 2: Right, that is one of the big questions that I
Speaker 2: have actually just as a practitioner. If we start hormones earlier,
Speaker 2: can we stave off some of these cognitive changes that
Speaker 2: we see because right at the time of perimenopause and menopause,
Speaker 2: we see real changes in the brain. The brain size changes,
Speaker 2: the blood flow changes, the metabolism change them. You can
Speaker 2: see it on scans. So if we start hormones earlier,
Speaker 2: especially at women who maybe elevated risk of cognitive issues
Speaker 2: and that type of thing, if we start earlier before
Speaker 2: fluctuations really set in, can we actually stave off these
Speaker 2: issues even better? And those are big questions right now
Speaker 2: that are not just now being asked and beginning to
Speaker 2: be answered based at a basic science level and at
Speaker 2: a clinical level also.
Speaker 1: So are you giving brain scans to women now on
Speaker 1: a regular basis?
Speaker 2: There are research protocols where people are beginning to do that,
Speaker 2: looking at MRIs of the brains, looking at brain size,
Speaker 2: brain processing, this type of thing, and that's very kind
Speaker 2: of elevated testing.
Speaker 1: What about physical tests physical.
Speaker 2: Test Well, certainly in terms of cognitive testing, there are
Speaker 2: definitely physical testing. But by the time you have manifested
Speaker 2: any of these physical symptoms, and I'm just talking about
Speaker 2: brain health as an example, we could talk about every
Speaker 2: organ system. But the time you've manifested, you are transitioned
Speaker 2: into a disease state. So we want to keep you
Speaker 2: from transitioning into a disease state. We want to cut
Speaker 2: we want to prevent anything.
Speaker 1: Early detection, early examination is best.
Speaker 3: Yeah, and early prevention.
Speaker 1: So like what age would you say a woman and
Speaker 1: should start really considering this?
Speaker 2: So I think you know, women between the ages of
Speaker 2: thirty five and forty can begin to see significant hormonal
Speaker 2: fluctuations and really need to pay attention to their symptoms.
Speaker 2: Right now, we don't have great laboratory testing. Again, this
Speaker 2: is an area that I'm super interested in, is can
Speaker 2: we really begin to define when estrogen levels start to
Speaker 2: fluctuate or progesterone levels start to decline with our current
Speaker 2: testing that's really well accepted. We're not really there yet,
Speaker 2: and we have to listen to narratives, And this is
Speaker 2: why doctors need and physicians and healthcare providers really need
Speaker 2: to listen to the patients that they're caring for about.
Speaker 2: You know, may have a little more anxiety, like some
Speaker 2: of the earliest symptoms of actually hormone changes, a little
Speaker 2: bit of anxiety, maybe a little shape shifting. You don't
Speaker 2: even have to gain weight, you just get a little
Speaker 2: thicker in the waste. That may represent an accumulation of
Speaker 2: what we call visceral fat, which happens as estrogen levels
Speaker 2: start to decline. May have a little new anxiety, libido
Speaker 2: issues actually or early worn early symptoms of estrogen fluctuations,
Speaker 2: vaginal dryness at certain time points of the month, actually
Speaker 2: a cycle maybe, So we need to listen to our
Speaker 2: narratives of our patients to really kind of determine where
Speaker 2: they are in this transition. And then it'd be great
Speaker 2: to have some laboratory testing too.
Speaker 1: And women should be a little bit more open with
Speaker 1: their doctors. I would say, are women are still a
Speaker 1: little shy? I think sometimes I think so physical being.
Speaker 3: I think some that's changing.
Speaker 2: I think thanks to social media and the internet and
Speaker 2: more conversations. You know, I realized during COVID actually that
Speaker 2: when we were having these kind of anonymized zoom meetings
Speaker 2: and things like this with patients and speaking groups, that
Speaker 2: women talked a little bit more freely. And now they
Speaker 2: can get information a little bit more easily, so they
Speaker 2: might become a little bit more open. And this generation
Speaker 2: of women now who are transitioning through menopause are very
Speaker 2: open about it. And that's great because that's bringing all
Speaker 2: of this conversation to the forefront and helping women to
Speaker 2: open up about it. But still you still have to
Speaker 2: elicit and ask questions, do you have pain with intercourse?
Speaker 2: Do you have vaginal dryness? People don't always volunteer that information.
Speaker 2: We have specific questions that we ask our patients.
Speaker 1: So it's up to the doctors as well as the
Speaker 1: patient's Absolutely we have overt and uh open about all this.
Speaker 1: There's so many other questions to ask a guidecologist of
Speaker 1: your stature. What is the current guidance on frequency of mamograms?
Speaker 2: For example, most professional societies actually recommend a yearly mammogram.
Speaker 2: Still AI is going to help that, I hope actually
Speaker 2: in terms of in terms of looking for pattern recognition,
Speaker 2: I mean, AI is like so great looking at pattern recognition, Like,
Speaker 2: we're at a point now where we can look at
Speaker 2: an EKG and this was just brought to my attention,
Speaker 2: and that AI group can look and that the machine
Speaker 2: learning can look and say it's a male or female EKG.
Speaker 2: There's no physician who can do that. So now we
Speaker 2: have all this great pattern recognition. So this is really
Speaker 2: going to contribute to our screening. But most people still
Speaker 2: recommend a yearly mammogram and of course a breast ultrasound
Speaker 2: if you have dense breast and if you're at elevated risk,
Speaker 2: consider a breast MRI.
Speaker 1: And what about pap smears.
Speaker 2: Pap smear is a little bit less on the guidance
Speaker 2: in terms of the frequency is recommended now every two
Speaker 2: to three years if you haven't had an abnormal pap
Speaker 2: smere or HPV negative testing every five years if you're
Speaker 2: over the age of thirty and HPV negatives.
Speaker 1: So I used to be every visit right.
Speaker 2: But there's guidelines are for population health, right, and so
Speaker 2: it's always like I always, I think it's a conversation
Speaker 2: between the individual and the person who's taking care of them.
Speaker 1: Of course, copies seems like everybody is prepping for a kolonoscopy.
Speaker 3: Well, so colonoscopy.
Speaker 2: We've decreased the age of recommendation of kolonoscopy down to
Speaker 2: forty five. That's because we're seeing aggressive colon cancers and
Speaker 2: younger people. We're not quite sure why, but definitely colonoscopy
Speaker 2: has remained the gold standard. But there's also there's liquid
Speaker 2: tumor biopsies looking for fragments of tumor DNA in stool
Speaker 2: samples and such, and also in the blood. And so
Speaker 2: these screening modalities are also poised to contribute.
Speaker 1: To mail order stool samplings. That right, I mean you
Speaker 1: could just you can just put some poop in a
Speaker 1: in a tube and send it off in the mail.
Speaker 3: Right.
Speaker 1: Are those accurate?
Speaker 3: They are very accurate.
Speaker 2: They are not well accepted for an individual who is
Speaker 2: known to be at elevated risk, such as.
Speaker 3: A family history or a pre do that, you know,
Speaker 3: they're extremely accurate.
Speaker 1: They're a little scary to me.
Speaker 2: The easier that we can make a screening test for
Speaker 2: somebody and the less invasive that it will be, the
Speaker 2: more acceptable that it will be. Overall, and so, and
Speaker 2: I think again we're moving as we get as we
Speaker 2: have more molecular diagnostics.
Speaker 1: And I always worry about the temperature, and if it's
Speaker 1: one hundred degrees outside, well, any symptoms disappear, you know,
Speaker 1: That's what I think about if it's in the mail.
Speaker 1: For us, ever, are sitting in a hot truck for
Speaker 1: four days, right.
Speaker 2: We're looking at fragments of DNA and such, and so
Speaker 2: that's pretty stable.
Speaker 1: Actually that's stable. Yay? Stable? So can you break down
Speaker 1: by decade? This is a this is a kind of
Speaker 1: a hard question. How should women adjust their medical routines
Speaker 1: and health habits. Let's just say in their late thirties forties.
Speaker 1: What do you do then?
Speaker 2: So, for for many women in their late thirties, they're
Speaker 2: completing child bearing if they've chosen to have children, and
Speaker 2: are focused less on reproduction and more on now focusing
Speaker 2: attention a little bit to their own health. And some
Speaker 2: of us need attention, need to do that, and because
Speaker 2: we all have busy lives or we're taking care of children,
Speaker 2: or we're taking care of our families, or we're working.
Speaker 2: But this is a time after child bearing, right to
Speaker 2: really begin to focus and focus on health. And that
Speaker 2: is healthy exercise, making sure that you move every day,
Speaker 2: healthy nutrition, staying socially engaged, stress management, paying attention to
Speaker 2: sleep for a lot of people, which is also very difficult.
Speaker 2: But you know, late thirties early forties time to just
Speaker 2: establish your patterns and patterns of good health and also
Speaker 2: listen to your body. What's your body telling you? You know,
Speaker 2: we don't talk as physicians about this enough. Like your
Speaker 2: body will speak with to you a little bit. Sometimes
Speaker 2: it whispers, but it'll tell you when things are a
Speaker 2: little bit of wry or not wrong. So I always
Speaker 2: try to tell women, you know, if you feel like
Speaker 2: something's not right, bring it to the attention of your physician.
Speaker 2: So thirties and forties are where you're started to listen
Speaker 2: to your body and establish good health habits and get
Speaker 2: into the to the routine of making sure that you
Speaker 2: get a yearly exam. See you see your physician once
Speaker 2: a year, have your lipids checked, have your hemoglobin A
Speaker 2: one seed checked, find out what your baseline is and
Speaker 2: where you're starting from, and then grab onto some good
Speaker 2: health habits to age with strong and what you do.
Speaker 2: So fifties are a time where really estrogen levels are
Speaker 2: really declining, and so thirty five to forty to to
Speaker 2: the late forties, right, we're starting to we see estrogen fluctuations,
Speaker 2: but we really see estrogen levels start to decline in
Speaker 2: the early to mid fifties. And so again that's paying
Speaker 2: really close attention to your symptoms. Knowing your family history,
Speaker 2: know your family history of cardiac disease, know your family
Speaker 2: history of dementia, speak to your health care provider's hormone
Speaker 2: support right for you. Paying attention to maybe not feeling yourself.
Speaker 2: I always as my patients, you know, do you have
Speaker 2: you lost your JOI de v You know, you might
Speaker 2: say I'm not, I don't have anxietyor depression.
Speaker 3: But you might say, you know, I don't feel like myself.
Speaker 3: I don't.
Speaker 2: I don't have the same confidence when you while I
Speaker 2: walk into the boardroom, Am I having any word finding difficulty?
Speaker 2: It's really about how am I enjoying my life?
Speaker 3: You know?
Speaker 2: These are all just very subtle things that we as
Speaker 2: physicians don't always ask, but these are important things to
Speaker 2: ask yourself. And then if you have any of these
Speaker 2: issues and they're new for you, something that's new or
Speaker 2: different from you needs to be addressed. Actually, sixties sixties
Speaker 2: that's a time to really double down. I think on nutrition, exercise, mindset,
Speaker 2: stained socially engaged, making sure you have a great sense
Speaker 2: of purpose.
Speaker 3: Of course, having all of your testing that.
Speaker 2: You would normally have with blood test, I failed to
Speaker 2: mention a coordinary calcium score. But know your family history
Speaker 2: of cardiac disease super important. But consider advanced testing in
Speaker 2: terms of more advanced cardiac testing in the fifties and
Speaker 2: early sixties, pay attention to that, of course. Also the
Speaker 2: sixties are where we have to, I think, make a
Speaker 2: real concerted effort, Like I am going to exercise every day.
Speaker 2: I'm going to do one hundred and fifty minutes of
Speaker 2: zone two cardiac. I'm going to do strength training three
Speaker 2: days a week. I'm going to make sure that I'm
Speaker 2: eating enough protein because we tend to lose muscle masses
Speaker 2: we age, so we want to make sure we ramp
Speaker 2: up the protein, decrease the carbohydrates. Maybe a little bit
Speaker 2: in nutrition a little controversial with that, yeah, but definitely
Speaker 2: ramp up the proteins. And how you adjust that with
Speaker 2: your carbohydrates, that's your choice, but.
Speaker 3: Definitely ramp up on protein.
Speaker 2: And then I think it's really like I said, sleep
Speaker 2: is really important, becomes a little bit more difficult to
Speaker 2: sleep as we age, and so what.
Speaker 1: Should one do about that? I mean, this is so
Speaker 1: many people are talking about, Oh I can't really sleep.
Speaker 1: I can't.
Speaker 2: One thing that's really important is realize that sleep is
Speaker 2: an active process. Realize that it's something that's really important.
Speaker 2: It's not like you just go to sleep and your
Speaker 2: body's not doing stuff. It's doing really important stuff, right,
Speaker 2: So scheduling sleep, making sure and we all know sleep hygiene,
Speaker 2: you know, turning screens off, giving yourself an hour of
Speaker 2: wind down, you know these things. But also I think
Speaker 2: it's really important just to get in that mindset of
Speaker 2: training your body to realize that sleep is important. And
Speaker 2: also I just recently got an aura ring. You're supposed
Speaker 2: to wearing a four PingER. I get data on my
Speaker 2: ring finger. But what that showed me which was really interesting.
Speaker 2: I mean I have a million degrees from all these
Speaker 2: Ivy League educations, and I didn't realize that being in
Speaker 2: bed does not mean that you are asleep, that you
Speaker 2: are sleeping exactly, or a ring gives you or any
Speaker 2: of these wearables whoop or any of these give you
Speaker 2: insight into if your sleep is disrupted.
Speaker 1: Or by the way is, Oh, you are a and
Speaker 1: I just got one. It was too small for me.
Speaker 1: So I'm waiting for my new one to come because
Speaker 1: i want to wear it on my forefinger. It is,
Speaker 1: and I want to I'm dying to see what my
Speaker 1: horrible sleep habits.
Speaker 2: It will give you a lot of insight and then
Speaker 2: you can see, like, you know, does a little bit
Speaker 2: of wine the night before does it disrupt my sleep?
Speaker 2: And you'll be amazed that like two ounces of wine
Speaker 2: will actually lead to some sleep disruption or you know,
Speaker 2: I'm always amazed at the heart rate variability actually correlates
Speaker 2: with my stress.
Speaker 3: Actually, it's really so. It gives you good insight into
Speaker 3: when you sleep better? What did I do the day before?
Speaker 1: What to do correct exactly? That's what I'm looking forward
Speaker 1: to to really determining with mine. So what should we
Speaker 1: do in our seventies.
Speaker 2: I think similar to the sixties. I mean, you just
Speaker 2: you really want to make sure that you are really
Speaker 2: focusing non nutrition, exercise, sleep. I think even more so
Speaker 2: sense of purpose and social engagement becomes really important in
Speaker 2: the seventies. I think that we need to you know,
Speaker 2: we live in I always say it's a great time
Speaker 2: to get being getting older in our society right now,
Speaker 2: because I love all the older Instagram accounts, I love
Speaker 2: the older the magazines that are for individuals post fifty.
Speaker 2: I think it's really great. In the past, we wouldn't
Speaker 2: have seen these.
Speaker 1: Public AA and what else.
Speaker 2: Yeah, oh, there's there's a few others actually that don't
Speaker 2: have retired in the.
Speaker 1: Title because AARP is like that retired shouldn't be there,
Speaker 1: because yeah, I encourage people never to retire.
Speaker 3: I'm not retiring. No, yeah, don't Yeah, I'm not retired never.
Speaker 2: But I think that's why that sense of engagement and
Speaker 2: purpose becomes really important, because a lot of us will
Speaker 2: exit the working fields, and I think that we have
Speaker 2: to really focus on community, sense of engagement, sense of purpose.
Speaker 2: These are all if you look at the common denominators
Speaker 2: of individuals are centurions, and they are people who have
Speaker 2: a great sense of purpose, a great sense of optimism.
Speaker 2: They remain socially engaged. So got to do all the
Speaker 2: other good stuff with nutrition exercise. Protein exercise becomes even
Speaker 2: more important because you want to really maintain muscle mass
Speaker 2: and don't want to become frail, and because that has
Speaker 2: its own set of issues. But that maintaining of that
Speaker 2: social structure is so important and sense of purpose is
Speaker 2: so important, and then eighties, same thing, really the same thing,
Speaker 2: and I think, you know, just really maintaining that all
Speaker 2: those great health abb is that you established.
Speaker 1: It's harder and harder to find doctors to take care
Speaker 1: of you as you get older. Being involved with the
Speaker 1: Center for Living at Mount Sinai, I learned that geriatric
Speaker 1: medicine is a medicine that for a while fill out
Speaker 1: of favor because doctors didn't want to deal with elderly people.
Speaker 1: But now with the aging population, it's starting to become
Speaker 1: a more interesting field of endeavor for doctors. So I
Speaker 1: hope more and more go into geriatric medicine because we
Speaker 1: need to really deal with all of those as we
Speaker 1: get older and not feel bad about getting older.
Speaker 2: It's great to get older. You want to age strong.
Speaker 2: You want to be you want to age with strength.
Speaker 2: That's the title age strong. You want to be strong
Speaker 2: as we because you're getting older. The opposite is no good, right.
Speaker 2: You want to get older. You want to be chronologically
Speaker 2: older and biologically fit and a little bit younger. And
Speaker 2: I think that this is a great time. I'll always
Speaker 2: say it. I think we're aging with more optimism now,
Speaker 2: and I think we're on the cusp of really changing
Speaker 2: that whole approach to medicine for older individuals.
Speaker 1: When it comes to longevity medicine. Are there specific considerations
Speaker 1: for women that would be different from men.
Speaker 2: Totally in terms of longevity. You know, we're just now
Speaker 2: realizing the importance of estrogen to basic issues such as dementia,
Speaker 2: cardiac disease, and cancer. Right, these are the three things,
Speaker 2: the three issues they associated with aging. Mitochondrial support and
Speaker 2: inflammation are issues as we age, right, or mitochondria aren't
Speaker 2: as strong. Those are the little powerhouses that make energy
Speaker 2: in ourselves, and we have more inflam so we really
Speaker 2: need to pay attention to ways to mitigate that.
Speaker 1: Well, how do you because inflammation, I think is a
Speaker 1: big problem. I feel it.
Speaker 2: Yeah, that is a strong foundation in nutrition, exercise, good mindset,
Speaker 2: keeping your cortisol levels lower, so managing stress super important.
Speaker 3: And then I'm going to say.
Speaker 2: It estrogen, right, because estrogen is an anti inflammatory, it's
Speaker 2: an antioxidant, so that will definitely help. There's some evidence
Speaker 2: that actually estrogen directly impacts on the mitochondria. So what's
Speaker 2: new in longevity medicine is that we're we.
Speaker 1: Are remembering that word everyone medachondria.
Speaker 3: Yeah, that's really important.
Speaker 2: They're what we're realizing is that women and men are
Speaker 2: different and and that will translate over at the cellular
Speaker 2: level also in terms of how we respond.
Speaker 1: Tot Oh, of course, that's what I want to know.
Speaker 2: I think, you know, women, so women live tend to
Speaker 2: live longer than men, but we live currently we still
Speaker 2: live in more years of being unhealthy. We have fewer
Speaker 2: years of active health than men.
Speaker 1: Do.
Speaker 2: We really have to get to the bottom of that
Speaker 2: and why that occurs. And that's you know, because we
Speaker 2: didn't have women in research until nineteen ninety three and
Speaker 2: I AGE did it and mandate at female animals until
Speaker 2: twenty sixteen. So we live more years in poorer health
Speaker 2: than men, but we tend to live longer. But the
Speaker 2: idea is to get us to get to better health.
Speaker 2: Actually for those all of those years.
Speaker 1: Let's get real about midlife metabolism and women. What happens
Speaker 1: to our metabolism as we age?
Speaker 2: So as estrogen levels go down, we do this shape shifting, right,
Speaker 2: so we begin to deposit fat in the visceral areas
Speaker 2: or the abdominal areas, so around your liver, around your heart,
Speaker 2: and your stomach. Basically, so the fat are adipocites that
Speaker 2: live in the hip region and buttock region actually begin
Speaker 2: to not migrate, but shifts into to the visceral area.
Speaker 2: That becomes an flammatory and then that leads to what
Speaker 2: we call insulin resistance, so we have metabolic disruption, so
Speaker 2: and that also leads to more inflammation. So it becomes
Speaker 2: a vicious cycle of low estrogen levels, visceral fat deposition, inflammation,
Speaker 2: more visceral fat deposition.
Speaker 1: Meno pot.
Speaker 2: I wouldn't use that term because I am a professional,
Speaker 2: but there is that term that is definitely circulating. Yeah,
Speaker 2: I wouldn't use that, but that is definitely circulating around
Speaker 2: and that does refer to our waste to hip circumference
Speaker 2: ratio increases, and that's actually a better measure of what's
Speaker 2: going on in our body because one term that we
Speaker 2: do use is called skinny fat.
Speaker 3: You can be abnormal weight.
Speaker 2: Or of normal BMI, but all of that fat can
Speaker 2: be in your abdominal area and that's unhealthy and that
Speaker 2: leads to this what's called insulin resistance and weight gain.
Speaker 1: And eat of watermelon a day. I just read that's
Speaker 1: a new hack. Just eat a watermelon a day and
Speaker 1: you will not ever get fat in your stomach. Well,
Speaker 1: that just came over the you know, that was on
Speaker 1: the Instagram the other day.
Speaker 2: But that reminds me of the old pineapple diet for
Speaker 2: the nineteen seventies, of which I ate so much pineapple
Speaker 2: that my mouth was about to fall off. So yeah,
Speaker 2: I don't think eating a watermelon a day.
Speaker 1: I don't either. But sleep habits are of ultimate importance.
Speaker 2: Sleep is really important. Sleep is really important to cognitive function.
Speaker 2: Less sleep equals worse cognitive function, it equals higher when
Speaker 2: people who don't sleep have a higher risk of dementia.
Speaker 2: It is, like I said, it is an active process.
Speaker 2: We're clearing our brain waste products. There's a whole system
Speaker 2: where the way lymphatic fluid circulates around the body at night.
Speaker 1: So you think that when you're sleeping, all that is
Speaker 1: going away.
Speaker 2: There is, there's active So it's an active process. It's
Speaker 2: like it's an active process.
Speaker 1: It's not bunk, as my grandfather would say.
Speaker 2: No, And it's really really, really important. And I actually
Speaker 2: did a course for a malpractice carrier recently, and it
Speaker 2: was all about sleep and cognition and cognitive function. And
Speaker 2: there's been a lot of studies and physicians that we
Speaker 2: make poor diagnostic when we have less sleep, and it's
Speaker 2: really so there is an activity that is going on
Speaker 2: in our brain as we sleep.
Speaker 1: Is there a connection to cardiovascular health? How lipids and
Speaker 1: cholesterols start to change at this age and beyond.
Speaker 2: Certainly in terms of there's a link to sleep in
Speaker 2: cardiovascular health because when we don't sleep, where we live
Speaker 2: in an inflame state, and that's actually bad for cardiac health.
Speaker 2: And in terms of cardiac health and lipid metabolism are
Speaker 2: extremely linked. And at midlife our lipids change in our
Speaker 2: cardiac health changes.
Speaker 1: So what are some no nos in terms of diet
Speaker 1: for anti inflammatory?
Speaker 3: Get rid of processed food.
Speaker 2: So anything that has more than three ingredients on it
Speaker 2: is probably a processed food. Shop the periphery of the supermarkets.
Speaker 2: Eat freshole food and don't use added sugars. Sugars are
Speaker 2: super super inflammatory. The sugars that you get in fruits
Speaker 2: and berries actually are fine because they come with fiber,
Speaker 2: but the sugar that's just added into something is not
Speaker 2: good at super inflammatory.
Speaker 1: So you don't eat any sugar.
Speaker 2: I really minimize it, really pay attention to that chocolate,
Speaker 2: dark chocolate. Dark chocolate's great for your brain, good antioxidants.
Speaker 2: So no, no sugar.
Speaker 1: Coffee.
Speaker 2: So there's one hundred studies trying to prove that coffee
Speaker 2: is bad for you, but no studies have shown that
Speaker 2: it's really bad for you. They tried to link it
Speaker 2: to pancreatic cancer at one point that was not successful.
Speaker 2: So I can't find anything bad about coffee, and coffee
Speaker 2: has antioxidant's good for your brain.
Speaker 3: Especially teas are okay. Also same thing.
Speaker 2: You just have to watch out for your caffeine content,
Speaker 2: especially with teas. Also, you just want to drink a
Speaker 2: tea that's caffeinated too close to sleep because that can
Speaker 2: really be a disruptor for your sleep.
Speaker 1: Diet coke, oh.
Speaker 3: So yeah, that would be a processed food.
Speaker 1: More than three ingredients. Those are the things that people forget.
Speaker 1: They think that that's just water.
Speaker 2: Yeah, and you have to look at artificial sweeteners and
Speaker 2: the impact that they have. A lot of physicians, especially surgeons,
Speaker 2: have big diet coke habits. And I stopped diet coke
Speaker 2: a while ago, and when I was actually stopping drinking it.
Speaker 2: I actually had like some mood issues and I was like,
Speaker 2: this is so weird. I'm like, everything's great. I shouldn't
Speaker 2: have any mood issues. And then I start reading about
Speaker 2: I was like, oh, I'm withdrawing from all the aspartame.
Speaker 1: When I read about artificial sweeteners or actually, my daughter
Speaker 1: pointed it out to me. She had listened to an
Speaker 1: interview with the man who invented an artificial sweeteners, the
Speaker 1: most popular one, and he said that if he could
Speaker 1: do it all over again, he would never invent it. It's
Speaker 1: interesting because it's so dangerous for the human health. But
Speaker 1: I don't use a lot of sugar, but I do
Speaker 1: like dessert.
Speaker 2: So there's a ninety percent rule, right that we have
Speaker 2: got to enjoy life, right, you know, just don't need
Speaker 2: a lot of chocolate cake or eat a lot of
Speaker 2: cake all the time.
Speaker 3: You know, but what do you use? It's nice to enjoy.
Speaker 1: Every now and then. So how do we deal with
Speaker 1: mental health and mood and women's health.
Speaker 2: I think that we need to be really attuned to it.
Speaker 2: And this is where as health providers and specialists in
Speaker 2: women's health, we really need to key in on that
Speaker 2: that so just can be a simple question about how
Speaker 2: are you feeling? Are you feeling any different? How are
Speaker 2: you feeling? That goes back to those JOI de v questions,
Speaker 2: And I do think that we need more mental health
Speaker 2: providers that are keyed into midlife women's health and really
Speaker 2: understand these changes that occur because estrogen and progesterone really
Speaker 2: do affect the neurotransmitters. I mean, there are real issues
Speaker 2: that are medically happening in the brain as estrogen levels
Speaker 2: are fluctuating. We see that also in women before midlife
Speaker 2: with PMS and PMDD and postpartum depression, and the treatments
Speaker 2: of these issues and recognition of these issues definitely warrant
Speaker 2: further study and for their higher numbers of individuals involved
Speaker 2: in these specialties.
Speaker 1: Is it true that women are at higher risk for dementia?
Speaker 3: Yes? Two thirds of Yes, totally.
Speaker 2: And this is one area that I'm super interested in
Speaker 2: actually and is gaining in popularity in terms of interest,
Speaker 2: And because why is that? Is it hormone fluctuations? Is
Speaker 2: our lifestyle what makes us more susceptible intimasions? A lot
Speaker 2: of individuals are looking at the role of hormones on
Speaker 2: the female brain, and we are moving in that direction.
Speaker 2: Lifestyle factors are also being looked at, but that research
Speaker 2: is really accelerating and it's super exciting. And this leads
Speaker 2: us back to, you know, can we identify women who
Speaker 2: are at high risk and then get hormone support or
Speaker 2: lifestyle support initiated earlier?
Speaker 1: Are there lifestylent interventions that one a woman can take?
Speaker 2: Absolutely anti inflammatory nutrition, making sure that you have your
Speaker 2: homoicystine levels checked, which is inflammatory for the brain and
Speaker 2: the heart.
Speaker 1: Good stress who does that? Who?
Speaker 3: Generalists can do that? Check? You can add what is
Speaker 3: it's a blood test?
Speaker 2: There?
Speaker 3: These are blood tests and is what do you ask for?
Speaker 2: I would ask for just a general metabolic panel. I
Speaker 2: would ask for homoicysteine levels and that's not all generalists
Speaker 2: will do a homicistine level but super important, super and
Speaker 2: I think that we are at elevated risk for dementia
Speaker 2: and cognitive issues, so we need to be a little
Speaker 2: bit more aggressive in our female population. But definitely early
Speaker 2: identification of individuals who may be at elevated risk and
Speaker 2: warrant more intensive interventions. And then for individuals who are
Speaker 2: not deemed to be at risk. We are all at
Speaker 2: risks because we're all women, you know, so, but just
Speaker 2: paying attention close attention to lifestyle factors and those subtle
Speaker 2: hormonal issues that you know. And one of the first
Speaker 2: signs of perimenopause is like word finding difficulty. Sometimes I'll
Speaker 2: ask people, you know, is your memory off, and they'll say, no,
Speaker 2: it's not really often. So are you having any word
Speaker 2: finding difficulty?
Speaker 1: Oh?
Speaker 2: Yeah, I can't remember names the same way. So what
Speaker 2: we what we call associative memory or coordinating like like
Speaker 2: things or faces and names and such starts to go
Speaker 2: off a little bit and word finding goes off a
Speaker 2: little bit, and that can be correlated actually with real
Speaker 2: changes in the brain structure. So these are active areas
Speaker 2: of research and are just.
Speaker 1: What can one do about that?
Speaker 2: Again, review it with your position. Maybe are your healthcare providers.
Speaker 2: Speak to your provider about maybe starting on hormone support
Speaker 2: earlier if you're considering it. And I think this is
Speaker 2: one one thing that I'd recommend to people. Also kind
Speaker 2: of get your opinion on hormon support. Are you going
Speaker 2: to go in that direction?
Speaker 3: Yes or no? Right? And then you know, educate.
Speaker 2: Yourself early, be reactive to it, be proactive actually and then,
Speaker 2: of course, lifestyle interventions. We know that lifestyle interventions in
Speaker 2: terms of stress management, nutrition support, supplement, targeted supplement support,
Speaker 2: and exercise can help with brain health. Interestingly, when we
Speaker 2: move skeleton muscle, we release a hormone called a risin.
Speaker 3: Actually, so when we just move.
Speaker 1: Skeletal muscles, I don't even know, so.
Speaker 3: It's a myokine. Of course, it's a myokine.
Speaker 2: So it's a substance that's produced by the muscle that
Speaker 2: when you just move muscle, it's a substance, a chemical substance.
Speaker 2: It travels throughout the body into the brain and increases
Speaker 2: your brain function and structure.
Speaker 1: Actually, I did my pilates today. Why did I move some.
Speaker 3: Yeah, that's piloates.
Speaker 2: Great, Just moving skeleton muscle will help your brain. And
Speaker 2: we're getting the scientific so to provide context to it.
Speaker 2: We can always tell people like what to do, but
Speaker 2: why to do it? Actually will help people.
Speaker 1: I like that. I like that. I mean, we're reasoning.
Speaker 1: My trainer did not tell me about that, but I'm
Speaker 1: going to tell her about it because there is a
Speaker 1: a reason for doing the six thirty am pilates. As
Speaker 1: an oncologist, do you have any insight into why we're
Speaker 1: seeing a rise in cancer in younger people.
Speaker 2: Why, you know, I don't think we understand that now.
Speaker 2: I mean obvious targets are nutrition, social stressures, social structure
Speaker 2: leading to increased stress, nutrition, environmental exposures. A lot of
Speaker 2: people will point to nutrition right now, but I have
Speaker 2: a lot of patients in my practice who practice excellent
Speaker 2: nutrition who have had early young colon cancers and are
Speaker 2: not a lot.
Speaker 1: But a few. Why is it something else in our food,
Speaker 1: in our environment, in our water.
Speaker 2: Well, we also have to look to our microbiome. Is
Speaker 2: our microbiome putting us at risk? Which is intimately linked?
Speaker 2: So that's all The bugs that live in the gut
Speaker 2: are really important, you know, is our microbiome at risk
Speaker 2: from our modern lifestyle. I don't think we have those
Speaker 2: answers yet, but those are kind of the targets of
Speaker 2: where people are looking right now.
Speaker 1: Good research going on.
Speaker 3: Definitely lots of good research going on.
Speaker 1: So now this is a new project for doctor Poynter.
Speaker 1: She has recently left her beautiful gynecological practice in a
Speaker 1: private office with lovely help. By the way, your your
Speaker 1: ultrasound woman was so amazing, you would go to doctor
Speaker 1: Poynter's office and you would lie down on the table
Speaker 1: and you would have your all your organs ultrasounded right,
Speaker 1: and it was I really liked that because it was
Speaker 1: such a nice way to start an examination, knowing that
Speaker 1: there was nothing to look for.
Speaker 3: Empowering, right, It's very empowering.
Speaker 1: And doctor Poynter has left to join Atria. It's a
Speaker 1: it's an organization started here in New York City. So
Speaker 1: describe Atria.
Speaker 2: So Atria is super unique and poise to I think
Speaker 2: make some really big contributions. Leaving my practice was like
Speaker 2: literally ripping my heart out of my chest voluntarily.
Speaker 1: It was such a personal practice and your offices were
Speaker 1: so personal. It was a unique place.
Speaker 2: Thank you for the compliments of the office. So Atria
Speaker 2: is a multi specialty group. So I work next to
Speaker 2: the smartest brain health people, the smartest endocrinologist, the smartest cardiologist.
Speaker 2: We have nutrition experts, we have exercise experts. We even
Speaker 2: have a naturopathic physician who has involved in integrative care.
Speaker 2: We all work together and it's a real cross fertilization
Speaker 2: of ideas and how to approach clinical issues, further research,
Speaker 2: and also we are involved in patient care, and it
Speaker 2: is the way that the world of what we call
Speaker 2: primary prevention is going to move forward.
Speaker 3: It is a private organization, so.
Speaker 2: It's not bound by many of the constraints that will
Speaker 2: happen in an academic setting. However, every physician who is
Speaker 2: there has a very strong academic and research background. We
Speaker 2: have strategy specialists all working together to help formulate and
Speaker 2: develop a new model for how to deliver care and
Speaker 2: how to deliver primary prevention because we want to be proactive,
Speaker 2: we want to be predictive. We want to get things
Speaker 2: before disease happens and before disease transitions, or pick it
Speaker 2: up at its earliest point.
Speaker 1: How does one find out about ATRIA?
Speaker 2: So we're online of course, and a R I A.
Speaker 2: We have two locations currently New York and Florida. I
Speaker 2: have to pinch myself a little bit that I'm there
Speaker 2: because I work with the smart, very smart people, the
Speaker 2: smartest people I've worked with, and it was a lot
Speaker 2: of the work that I was trying to do on
Speaker 2: my own in my private practice, and I realize that
Speaker 2: I can't do it all by myself, and I need
Speaker 2: help to further the cause. Right, And so we're all
Speaker 2: working together to further the cause of primary prevention medicine.
Speaker 2: I think you'll see more in the future. Atre is
Speaker 2: just getting started. It is just in its infancy, and
Speaker 2: we are still in it two or.
Speaker 1: Three years old. It sounds like such a good way
Speaker 1: to learn about oneself and know about oneself for the future.
Speaker 1: I mean, you know, at my age, I really need
Speaker 1: to know a lot.
Speaker 2: Right, and I think we're we're collecting the information on
Speaker 2: how to get that to everybody in the future. And
Speaker 2: how what do we need to know, how do we
Speaker 2: need to know?
Speaker 3: How do we intervene?
Speaker 2: And this can only happen with a multi specialty group
Speaker 2: that is nimble and can ask questions quickly and adjust
Speaker 2: and readjust as needed.
Speaker 1: I got very interested in blood in the last five years,
Speaker 1: so I will have a blood tist of complete you
Speaker 1: call it what do you call it? Big?
Speaker 3: You say chemistry profile?
Speaker 1: And I get a choice a year and I look
Speaker 1: at it and it's so funny how some things go
Speaker 1: up and some things go down. Accounts go down. Is
Speaker 1: that because the testing is different or is it because
Speaker 1: the laboratory is different?
Speaker 3: OK?
Speaker 1: I'm not an expert in any way, but I just
Speaker 1: like to see that I'm pretty stable and within the
Speaker 1: parameters of good.
Speaker 2: Health, there's variability. There's variability in the human body. We
Speaker 2: react to our environment, right. Our body is constantly reacting, readjusting, right,
Speaker 2: So if you.
Speaker 1: Take an iron supplement, it's going to change your iron
Speaker 1: and your blood.
Speaker 2: Correct and it's the human body is dynamic, so you know,
Speaker 2: and you have to look at trends over time. We
Speaker 2: look at trends over time. We look at not just
Speaker 2: individual components of the blood, but how they're interacting together.
Speaker 3: And this our AI is really going to help us
Speaker 3: in exciting.
Speaker 1: Wages to see that. Yeah, yeah, well, this is so fascinating.
Speaker 1: Your practice has expanded exponentially with this new adventure that
Speaker 1: you've joined. Very interesting to learn more about the challenges
Speaker 1: facing women in each of their decades. We have to
Speaker 1: pay be very aware of women listening about this, and
Speaker 1: so to men. It's a very interesting time in medicine,
Speaker 1: and I applaud your efforts. It's really great and I
Speaker 1: look forward to your book.
Speaker 2: Thank you so much for having me and allowing me
Speaker 2: to speak today. I think we're at a great time in medicine.
Speaker 2: We're about to crack through some issues.
Speaker 1: Well, that is excellent to know. Thank you, doctor Pointer.