Hormonal Health with Dr. Devaki Lindsey Berkson: Rational Wellness Podcast 72
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Dr. Devaki Lindsey Berkson talks about the benefits and issues with using bioidentical hormones with Dr. Ben Weitz.
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Podcast Highlights
2:23 Dr. Berkson first got interested in natural medicine from hearing a lecture by Scott Nearing, who was the father of the back-to-the-land movement, which is what organic gardening was originally called. Unlike many stories of people who were eating the standard American diet and got sick and found natural medicine, Dr. Berkson was eating healthy and teaching yoga and she still got multiple forms of cancer and had 7 organs removed. The key for her to regain her health was taking bioidentical hormones, which allowed her to combat hormone altering chemicals that damage your tumor receptor genes.
9:10 Since the 2002 Women’s Health Initiative, many doctors stopped prescribing hormone replacement therapy after menopause. Dr. Berkson disagrees with this position. Also, the North American Menopause Society now is saying that hormones are ok if used for only five years after the onset of menopause. The re-analysis of the Women’s Health Initiative found that the estrogen only arm of the trial found that women on estrogen only had 33% lower risk of breast cancer and heart disease, even with this horse metabolite of urine. It is only when they added this synthetic progestin that breast cancer rates and heart disease increased. And this is for women who were past menopause for at least ten years before starting them. Doctors in Europe did not stop giving hormones like we did here because they mostly give estriol and more natural hormones most of the time. It’s important to initiate hormones as close to the beginning of menopause as possible and hormone replacement is as close as we have to the Holy Grail of slowing down aging.
15:31 Dr. Berkson said that every hormone you take should be tested and tracked. A woman shouldn’t have heart disease if she initiates bioidentical hormones. You should have a fast CT scan of your coronary artery. You should have an ultrasound of your carotid artery. You should have a vaginal ultrasound of your endometrial stripes, the thickness of your endometrium, so after you’re on hormones for 6 mths to a year you can monitor it and make sure it’s not growing out of control. Some hormone specialists say that you should not take progesterone if you don’t have a uterus, but there are other reasons to take progesterone since there are also progesterone receptors in the brain, the gut, and the vagus nerve. There are some forward thinking neurologists today using progesterone to tamp down inflammation in the nervous system. It’s very hard to find practitioners who know what the heck they are doing with hormones. Our hormones are all under attack from endocrine disrupting substances in the environment.
18:57 In January 2017 there was a public forum put on by Harvard in the Huffington Post and these scientists agreed that the three major threats to humanity were: 1) nuclear war, 2) global warming, and 3) hormone altering chemicals.
20:28 There is definite scientific, reproducible studies showing that young men in their 20s now often have the testosterone levels that men had in their 60s. There are androgen disrupters just as much as estrogen disrupting substances. It’s a big deal because hormones are not just for sexuality. Hormones run our brain, run our central nervous system, and they run our gut. We have receptors for estrogen, progesterone, DHEA, estriol, cortisol, all throughout the gut, let alone thyroid and hunger hormones and satiety hormones.
23:15 I asked Dr. Berkson in her own hormone therapy, what percentage of estriol versus estradial does she use? She said it depends upon the person. Estriol signals mostly the Estrogen receptor beta, which controls growth, while Estrogen receptor alpha stimulated growth. One of the new theories about cancer is that if estrogen receptor beta signals are shut off, that cell is more prone to cancer. Because women have less ER beta receptors in their lungs than men do, they are more at risk of lung cancer from second hand smoke. This is why soy is not such a bad food, because soy is the only food that turns the estrogen receptor beta on. We also have the rhubarb product from Metagenics that stimulates the Estrogen receptor beta known as Estrovera.
25:58 Dr. Berkson said that she learned about hormone testing from Dr. Jonathan Wright, one of the fathers of Functional Medicine, and she used the 24 hour urine test for hormones for four decades. But she has worked with good Functional Medicine doctors who successfully use serum testing, like Dr. Block in Tulsa and David Brownstein, and with Dr. Jack Monaco in Nashville, who uses saliva. You have to listen to the patient more than the laboratory results. When we measure serum or urine we measure hormones produced endocrinologically by our glands, but it doesn’t measure whether they are utilized by the receptors. It also only measures hormones produced endocrinologically. But a lot of hormones are produced intracrinologically, in the periphery, which are produced by post-menopausal women. We have no test to measure these hormones produced in the periphery.
31:30 There’s not only the importance of the level of the hormones but also the issue of receptor functionality, which can be affected by chemicals and also by nutrient status. If you don’t have optimal levels of zinc or magnesium or B vitamins, your hormone receptors cannot function properly and those hormones will not have the desired effect no matter what the serum levels are.
35:07 It is important that women have a healthy gut and that they are pooping daily and ideally twice per day, so they excrete their excess estrogen, so that it does not accumulate. If you are constipated, then estrogen will be reabsorbed instead being pushed out of the body. You want to have this healthy flow of estrogen and then you want to get rid of it.
49:45 The final metabolite, 2-methoxyestradiol, nobody knows about that, but it’s what saved Dr. Berkson from more cancers. She takes that as a biodentical hormone. It has many applications, including for cancer patients.
Dr. Devaki Lindsey Berkson is a Doctor of Chiropractic, Certified Nutritionist and Functional Medicine practitioner. She has specialized in gut disorders and hormones and she has authored over 25 books, including Healthy Digestion the Natural Way, Hormone Deception, Safe Hormones Smart Women, and her newest book, Sexy Brain. Dr. Berkson has taught hormones to doctors for A4M and she is a formulator and inventor of nutraceuticals and pharmaceuticals. She consults with both patients and providers and she can be reached at her website at https://drlindseyberkson.com/ She also offers a series of online courses that are available on her website, including her new Sexy Brain: Redefining Hormones course.
Dr. Ben Weitz is available for nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also specializing in Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure and also weight loss, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.
Podcast Transcripts
Dr. Weitz: This is Dr. Ben Weitz with the Rational Wellness podcast bringing you the cutting edge information on health and nutrition from the latest scientific research and by interviewing the top experts in the field. Please subscribe to the Rational Wellness podcast on iTunes and YouTube and sign up for my free ebook on my website by going to drweitz.com. Let’s get started on your road to better health. Hey, Rational Wellness podcasters, thank you so much for joining me again today. For those of you who enjoy Rational Wellness podcast, please go to iTunes and give us a ratings and review so more people can find out about the Rational Wellness podcast.
Today we have an interview with Dr. Devaki Lindsey Berkson. She’s been in practice in functional medicine with an emphasis-
Dr. Berkson: For a long time. Longer than most of you have been alive.
Dr. Weitz: Not me. I’m old, too.
Dr. Berkson: How old are you?
Dr. Weitz: I’m 60. I just turned 60. I just turned 60.
Dr. Berkson: No, it’s not longer than that. You look good, real good.
Dr. Weitz: Thank you. Her practice is focused on nutrition, hormones, digestion. She’s one of the thought leaders in natural medicine. She’s trained many doctors in the science behind natural medicine. She’s published original research. She’s taught for functional medicine programs. She’s a best-selling author. She enjoys a beer when she gets home from work. She’s written a number of books including How Beer Creates … no, Healthy Digestion the Natural Way, Hormone Deception, Safe Hormones, Smart Women, and her newest book, Sexy Brain. Dr. Berkson thank you so much for joining me today.
Dr. Berkson: Oh, it’s really great to be here. I think your audience is about ready to be blasted with molecules from every portal of existence.
Dr. Weitz: Okay. Can you tell us your personal story? How did you become so interested in natural, Functional Medicine?
Dr. Berkson: Natural, Functional Medicine just made sense to me. I heard when I was 17 or 16 1/2 years old a lecture by Scott Nearing, which many people will not remember Scott Nearing. He was the father of the back-to-the-land movement. That’s what organic gardening was originally called was back-to-the-land movement. He had been a professor of economics at Penn State. He saw that children were being abused in the workplace. He fought for child labor laws. He became blackballed to teach. He had to figure out what the hell to do if he couldn’t teach. He had a PhD. Went through all that trouble and now, because he fought for the rights of children, he couldn’t teach. So he went to, first, Vermont. He started a maple syrup business. He started gardening without chemicals. He was the first guy.
And then he gave some land to Eliot Coleman. The two of them are really credited with the whole organic gardening movement. I heard a lecture by Scott, who was very famous. He wrote 55 books. His very famous book was called Living the Good Life. And then when he was 100 years old, he always said when he was no longer a contributing member to society, he would fast himself to death, so at 100 years he fasted himself to death. His wife wrote a book called Loving and Leaving the Good Life. They became best friends to me.
I heard a lecture at the Theosophy Society when I was 16 1/2 or 17 by him. He wrote the foreword of my very first book, and we have all kinds of things that happened between our lives together. They said you are what you eat. This was in the early 1970s. He said you are what you eat. What you eat is going to create your future. Well, that made a lot of sense to me, so I started eating organically. My mother was a major athlete. She was one of the very first women in the United States to be a state champion and athlete and also a dancer. I was exposed to that when I was very young. So I did all those things. I’m the totally different story than you hear.
You hear stories that people were living the standard American diet, get ill, get terribly ill, see the light, do everything better, and get well. That was not my story. My story was I heard Scott, so I ate organically. My mother was an athlete. I became a yoga teacher. The Beatles came back from India from following the Maharishi. I said, whoa me. I’m going to go to India. I went to India, and I learned Ayurvedic medicine. I was a yoga teacher for many years. I kept getting cancer after cancer.
Dr. Weitz: Wow.
Dr. Berkson: And illness after illness doing everything right. Food isn’t the whole answer for everything. That is not the answer for everything. It’s certainly what drives our microbiome and a lot of our consequences, but it’s not the only thing that’s involved in wellness. My path, my karma was that I was doing the things that people are getting the memo on now: food and nutrients and meditation and forgiveness and detox. I was doing all that. I was getting cancer after cancer and tumor after tumor after tumor.
Dr. Weitz: How many forms of cancer did you have?
Dr. Berkson: I had breast cancer, then was diagnosed with kidney cancer. I lost seven and a half organs before I figured out what the heck was going on. I had to hack my own health out of the mountainside. Now in my older age … Can people see us? Am I on video as well as-
Dr. Weitz: Yeah, there’s going to be a YouTube video version as well as the iTunes version.
Dr. Berkson: I’ve been in practice for 47 years.
Dr. Weitz: You look great.
Dr. Berkson: So I’m not a spring chicken. In my older age I now can enjoy the youth that I never was able to enjoy in my younger age and the looks and the vitality and the energy, because I figured out what to do. It’s not just food. I got so enticed by Scott Nearing, by Bernard Jensen, by Paavo Airola, the early speakers, Jeff Bland. I was just enthralled with natural medicine, but it wasn’t because I was ill because I was already doing all the things that natural medicine said to do. Thus, my path took me on hormones, because hormones were my answer and how to combat hormone altering chemicals that damage your tumor suppressor genes and reboot them. I couldn’t go to any Functional Medicine internist or any chiropractor or any nutritionist. There was nobody who could give me that information. All that was offered to me was that you have a very complex case. You keep having cancers. Let’s whip out those organs.
I have such an interesting tale because I now am I professor for A4M and PCCA, which are the … If an MD or a nurse practitioner wants to go further after allopathic medicine, they can take these further higher board certification courses, which are usually about four years long and cost about 50 to 60 grand. Now I’ve become a professor on those. Usually when the number of the professors … I’m on the gut module and on the hormone module and environmental medicine module. A lot of the docs talk about being a straight doc until they get ill, and then they have to clean up their diet, clean up their food, and they get better, but that wasn’t my story. My story is the story of hormones. So my book Sexy Brain and a lot of my books are the story of hormones. Based on one of my very first books on the environment, Hormone Deception, which came out about 24 years ago, which was one of the very first books on how things in our environment are futzing with our hormones. That came out a long time ago. I was invited based on that book, which took me six years to write because nobody knew about that stuff back then. I was invited to be a scholar at an estrogen think tank at Tulane Med School. I got to work with the number one scientist in the world, Elwood Jensen, who discovered how hormones even work and Jan-Ake Gustafsson, who was the second scientist who discovered how the second estrogen receptor, ER beta, works. So it’s unusual to learn hormones from your own health story and then learn hormones from the guys who are making the field and then be in practice to have the honor with which to navigate that and explore that with patients.
Dr. Weitz: Now, since the Women’s Health Initiative, most doctors are telling their patients not to take estrogen replacement and hormone replacement therapy, but you have a different opinion about that, right?
Dr. Berkson: Well, I don’t think that’s really true anymore. The North American Menopause Society, NAMS, which is the most well distinguished society and sends all the data downstream to the gynecologists and endocrinologists, they’ve been coming out and saying, well … In their last several consensus statements they’ve come out and said hormones are okay if used for a period of five years for symptoms. They’re okay in breast cancer and high risk women if they’re given vaginally. They’re fudging the lines a little bit. But honestly, it’s stupid. Stupid. I just can’t take it anymore. If you read my book, Safe Hormones, Smart Women, which I actually have a book that I already updated but unfortunately the first molecule I discuss in the new updated book, the FDA is having an issue with, so I didn’t publish that book yet. The Women’s Health Initiative came out with bad news in the beginning of July 2002 saying that hormones really didn’t do anything that we thought they did and you should, doctors and women, throw them out the window because they’re going to cause breast cancer. At the re-analysis that began fervently because it was the number one selling med over proton pump inhibitors and antidepressant meds at that time, so there was lots of re-analysis by very prestigious statisticians at Yale and all over the world.
They saw very quickly that the women who were used within those trials, the estrogen only trial and the estrogen and progestin, synthetic progestin, the Prempro trial, were older women who had been out of menopause for over 10 years. Most of them were obese. They used a synthetic hormone. After you looked at all the data, all the data, and even the guy that wrote the fertility gynecology book that all the gynecologists say. I’m trying to think of his name. Leon. I can’t think of his name right now. He’s a professor at the University of Oregon. He said you can’t throw the baby out with the bath water. The clinical experience and hormones makes such a difference based on this trial. The reanalysis of this trial ultimately said that the estrogen only arm when re-analyzed showed that women on estrogen only had a 33% less increase of breast cancer and ultimately the arm, that means the group of women, that had estrogen and progesterone, it was the synthetic progestin that actually, if a woman had a preexisting cancer, really ratched that up or gave her a higher increase of stroke. So, first of all, doctors in Europe did not stop giving hormones like we did here, because they mostly give estriol and more natural hormones most of the time. Not all of the time.
Doctors who read the data and listen to the data or read my books or listen to my podcast gave up what the Women’s Health Initiative was saying or didn’t even listen to it. So there was a group of doctors who said that’s based on synthetic hormones. That’s based on women who were off hormones for at least 10 years. Because there’s a window of the best time to initiate hormones. The younger the woman, the healthier the woman, the less or zero the heart disease, the better the outcome of taking hormone replacement. But hormone replacement is as close that we have to the Holy Grail of slowing down aging of anything. Anything, anything, anything, anything.
When I used to work at the family practice clinic here at Wiseman Family Practice, Dr. Wiseman, who started the practice … I love to work with doctors who have been in practice 50, 60 years before they retire, because they’ve been around for so long, they’ve seen so much. They’re such rich resources. At the water fountain he and I would have these great conversations. He would say, “You know, Lindsey, if you have 100 people in a room and they all got the memo to do exercise, to eat right, but half of them are on hormone replacement or doing some intervention to balance their hormones, which there’s a debate about those interventions and the delivery modes and which way you take your hormones and how you assess your hormones, you could cherry pick them out.” Out of the 100 people where everyone’s doing, “everything right”, the people on hormones would have shinier hair, have bigger posture, be talking faster. If you have a lot of women sitting right here on your radio show about my age, they will not be speaking the way that I’m speaking right now. They won’t be. They won’t be as upwardly lilting as I am. They won’t look as I am. I want them to be this. I don’t want to be the only one on the block being like this, but hormones make a difference.
I had breast cancer 24 years ago. A lot of doctors will never give a woman hormone replacement if she’s had breast cancer. I’ve come to realize that that’s not true. It’s hormones out of balance that put your genes at fear of disregulating to put you more at risk of your tumor suppressor genes not working. You have to have somebody who knows all this, which aren’t a lot of people. In fact, I just created an online course last year called Redefining Hormones in Today’s Toxic World. It’s a 30-hour plus hormone course on what is really going on with hormones in light of hormone altering chemicals and all the new stuff we know, because doctors aren’t given this. Whether you’re a naturopath or whether you’re an MD, you’re not trained in this in school. I thought mostly smart patients were going to take my course. I had gynecologists, family practice docs, and internists, and everybody was saying to me why don’t we learn this in med school? This information just has not yet entered the academic curriculum of docs. It hasn’t trickled down yet into the clinical arena.
Dr. Weitz: Now, do you personally take natural progesterone along with the estrogen?
Dr. Berkson: Well, every hormone that you take should be tested and tracked. A woman shouldn’t have heart disease if she initiates bioidentical hormones, because in some women, and those are the women that it could be dangerous. I never see any patients whose doctors have done this. You should have a fast CT scan of your coronary artery. You should have an ultrasound of your carotid arteries. You should have a vaginal ultrasound of your endometrial stripes, the thickness of your endometrium, so after you’re on hormone replacement, after six months and a year, you can monitor it and make sure it’s not growing out of control. You got the right mix.
Dr. Weitz: And that’s the benefit of having a progesterone to keep the endometrium from over growing, right?
Dr. Berkson: Right, exactly, but a lot of doctors still feel if you don’t have a uterus you shouldn’t use progesterone. Tori Hudson, who leads the female health department at National Naturopathic College, where I went when I was going to chiropractic school in Portland, she teaches at her conferences, if you don’t have a uterus, you don’t need progesterone. Progesterone doesn’t just have receptors in the lining of the uterus. It’s got receptors in the brain. It’s got receptors in the gut. It’s got receptors in the vagus nerve. Forward thinking neurologists are using progesterone to tamp down inflammation in the nervous system. It has a lot to do with the health of the nervous system. So it’s very hard to find practitioners these days that know what the heck they’re doing with hormones. And then that leaves the woman or the man, because there’s manopause was well as menopause. We’re all, all of our hormones are under attack, younger and younger. Harvard just came out with a study. The pediatricians at Harvard just did this shocking study. It was in February of this year. They looked at girls who had problems with body image, anxiety, over exercising. We’re such an obsessive society about beauty and thinness and all that stuff. They measured their estrogen levels. They found many of the to be deficient. They slapped an estrogen patch on girls from 14 years old to 20 years old. I’m kidding you not. Fourteen years old to 20 years old because these women were insufficient in estrogen. The majority of those people felt totally better, lost their body dysphoria, did a lot better in school, and functioned better. These pediatricians in Harvard diagnosed hypoestrogenism in young girls. Why in the heck would that be?
Dr. Weitz: Because of the toxic estrogens in the environment that are glomming onto the estrogen receptor sites and preventing their natural estrogen from working.
Dr. Berkson: That is definitely one of the reasons. And too much stress, cortisol, can promiscuously block estrogen receptors or if people have bulimia and eating disorders and eat too little. Fat makes estrogen, so if you get too thin you stop making estrogen because you have less fat cells and you conserve your energy. There’s multifactorial reasons today between stress and the demands on a young girl. So many young girls hate their body and hate themselves.
Dr. Weitz: Anorexia, bulimia.
Dr. Berkson: Right. In January 31st of 2017 there was a collaborative public forum put on by Harvard in the Huffington Post. A lot of the guys that I worked with at Tulane were on that forum. They said that there are three major threats to humanity. The first one is nuclear war. Everybody agrees to a nuclear war. The second one is global warming. Most of the scientists agree with global warming. Trump’s base doesn’t agree with global warming. We won’t go there. The third one they said, which is really huge, because it’s making issues with pregnancy, issues with milestones of reproduction. When a young girl goes into menarche, she starts menstruating. When a woman goes into menopause, it’s changing the pattern, the template of the human race, are hormone altering chemicals. That’s what I wrote Sexy Brain about was hormone altering chemicals and its effect on intimacy in the brain. They actually said this was the third threat to humanity.
Dr. Weitz: Wow. Yeah, endocrine disrupting substances, which include BPA in the plastics and mercury, which is spewed into the air by coal-fired power plants, and pesticides and chemicals in personal care products and phthalates. There’s so many endocrine disrupting substances, it’s amazing that anybody’s hormones are even halfway normal.
Dr. Berkson: Well, there is definite scientific, reproducible studies showing that young men in their 20s now often have the testosterone levels that men had in their 60s.
Dr. Weitz: Yeah, I just called one of the labs that we use. We’ve been using Spectracell. It’s 75% of the men of all ages have low free testosterone. I said is your lab wrong. They said no, we double checked them.
Dr. Berkson: There’s androgen disrupters just as much as estrogen. When I first was going to write Hormone Deception, which stands as well today if you want to understand endocrine disruption. You go to Amazon. You get Hormone Deception. You will learn everything about what we’re talking about. When I first tried to sell it, even with an agent, people said, “What the hell is this?” Nobody had heard of endocrine disruption. They said this is only worth a little teeny magazine article. This is not worth a book. Until McGraw-Hill believed in me. Judith McArthur, my agent at McGraw-Hill believed in me. Now it’s on everybody’s lips. Is it in lipstick? Is it in makeup? Is it in personal care products? Is it in the air? It’s a real deal because hormones aren’t just about sexy and reproductive things. Hormones run our brain. They run our central nervous system. They run our gut. We have receptors for estrogen, progesterone, DHEA, estriol, cortisol, all throughout the gut, let alone thyroid and hunger hormones and satiety hormones.
I have a new textbook coming out that I haven’t finished yet, about an 800 page monster. I put huge amounts of the unappreciated role of hormones in the gut. Hormones are like our physiologic internet system that send emails to little satellite dishes called receptors that run a lot of who we are. Being that our environment is rife with hormone altering chemicals, especially in the womb and in this egg and the sperm, that’s being attributed to the increasing rapidly incidents of diverse diseases in kids, behavioral issues, autism, cancers, et cetera. That’s a lot about what I discuss in the class is trying to put that together. How often when you go to see a doctor if you have an issue with your hormones, they say go see the gynecologist. Go see the endocrinologist. They’re not trained in any of this. Who does the patient go to if that’s influencing their health or they want to really caretake their hormones? That’s become my mission. In my own experience I had to do that for myself to get well. And my passion.
Dr. Weitz: Interesting. As far as your own hormone therapy, what is the percentage of estriol versus estradiol in what you use? Do you use a formulation that has a higher percentage of estriol?
Dr. Berkson: It depends completely on the person. Estriol signals mostly estrogen receptor beta. When women think of the bad estrogen dominance, they think of growth out of control, gaining weight, feeling bad in your premenstruum, all the negative things. Everyone has heard about the bad estrogen dominance. But estriol signals the good estrogen dominance. It signals estrogen receptor beta, which controls growth. In fact, the new theory of cancer is that you have estrogen receptor beta signals that are being signaled that protect a cell from turning into a cancerous cell. If the estrogen receptor beta signals are shut off, that cell is more prone to cancer. A hormone delivers a signal to a set of proteins in the shape of satellite dish called a receptor. Hormones signals into a receptor, simplistically. Estriol signals to the estrogen beta signal and that controls cancer. So women have a lot less ER beta receptors in their lungs, which is why they are much more at risk of lung cancer from second hand smoke or primary smoke than a guy is. Because we don’t have those protective receptors in our lungs like guys do. That’s why soy is not a bad food, because soy is the only food that turns the estrogen receptor beta on. In fact, the guy that discovered the estrogen receptor beta, who I worked with at Tulane, Jan-Ake Gustafsson, he’s been wooed over to a pharmaceutical company in Houston. So now he’s a big, tall Swedish guy with a cowboy hat on trying to make an analog patentable drug that acts like the estrogen receptor beta, but he keeps finding herbs and nutrients that do that, like milk thistle and flax seeds and things that naturopaths and chiropractors have been talking about for a long time.
Dr. Weitz: Rhubarb extract, right?
Dr. Berkson: Rhubarb extract. Exactly. That’s what Metagenics came out with their-
Dr. Weitz: Estrovera, yeah.
Dr. Berkson: … Estrovera product. There’s a lot of ways to do it. I don’t believe that there’s only one formula for estriol to estradiol. In the olden days people gave all three. It was called tri-es. Estrone, estriol, estradiol. Most people do not give estrone because that can have pro carcinogenic actions. I think you have to look at somebody’s blood work or urine or 24-hour urine or saliva, whichever way.
Dr. Weitz: What do you prefer for testing for hormones?
Dr. Berkson: Well, Jonathan Wright, who’s the father of bioidentical hormones was my mentor. Alan Gaby, when he was a student … Alan Gaby is considered the father of nutritional medicine, so to speak, along with Jeff Bland. Alan Gaby was a student. Both of us took our first rotation in integrated medicine with Jonathan in 1977. Jonathan fixed Alan and I up on a date, which is a whole other story. Alan and I have become lifelong friends. All of us that have started functional medicine have been really close from early on. Jonathan taught me to run 24-hour urine tests. That’s what I used for decades. So I’ve been running for four decades 24-hour urine tests, but I’ve worked now at many clinics studying under other very smart docs. I love to learn older smart docs that have been around for a long time. I worked with Dr. Block in Tulsa who taught at two different med schools and was triple board certified. He only used blood. David Brownstein, who’s a really good friend of mine in Michigan, he only uses blood. At the family practice here they only use blood, even though they do pellet insertion.
Dr. Berkson: I lecture a lot with Jack Monaco, who’s a OBGYN who’s now gone rogue and is a gynecologist and one of the smartest, nicest guys I know in Nashville. He wants me to move to Nashville, but I don’t want to move to Nashville because I love living here. But I love Jack. Jack only uses saliva. You can use anything to monitor hormones. I’ve come to learn that there is no one best way. It’s the way that you feel works. Because hormones aren’t just what’s in the blood that you can pick up, it’s not just a test. It’s also the patient. The real true doctor-
Dr. Weitz: In how the patient feels, you mean, right?
Dr. Berkson: Exactly. You listen to the patient more than the laboratory. The reason is is the study of hormones in the blood stream that we pick up on saliva or blood or urine is called endocrinology because the prostate or the ovaries make a hormone and it travels throughout the body. Everybody knows that’s endocrinology. But a lot of hormones are produced intracrinologically. Men mainly produce their hormones intracrinologically. A women, when she’s becoming peri and post menopausal mainly produces her hormones that way, which means they’re produced in the periphery. They’re produced in the periphery, and we have no test at this moment to pick that up. We have a whole contributing system of our hormones which we now know is true intracrinologic endocrinology, but we don’t have an assay, a test, yet for that, so a really smart dude of a doc or a lady will listen to what the patient is saying in how they feel along with whatever assay or testing method that they decide and their comfy with using. It’s unfortunate that today in training it’s mostly by algorithm because the insurance companies are what run everything. They want a doc to only run these tests and only do these meds. You become a smart person. You learn how to take all those tests, and you go into practice and you stop thinking. And you stop listening to the patient.
Dr. Berkson: Most doctors are burned out because they know that this is true. They’re unhappy along with the patient. That’s why there has to be a revolution where people have the time to think, the luxury to think, and they don’t have to have a high volume practice with all these rules. We’re being regulated to death. Everybody’s being regulated to death. Our hormones are being regulated to death, and the patients are being regulated to death, the doctors … It has to get to where people are enjoying their life, because otherwise your hormones stay ill no matter what you do for them.
Dr. Weitz: Right. Essentially what you’re saying is is that the hormones that get measured in the blood or the urine are not necessarily indicative of how much of the hormones actually get to the tissues and the organs where they’re really needed. How much is being absorbed and utilized, we don’t know that. We’re just looking at this measurement of what’s in the blood, and that’s not really representative of what’s really being utilized.
Dr. Berkson: You said that really well. That is really true. Once you really grok that, Vulcan mind-meld that, it’s shocking. The other reason that’s true is you could, let’s say, have a perfect level. You go. You’re a guy, and your wife has badgered you to go get your hormones tested because she heard a podcast somewhere that testosterone will suppress the expression of the ApoE4 gene. Your family has had dementia. She doesn’t want you to get dementia. She happens to really love you, and she wants you to go see your doc. Your doc looks at your level of hormones and he goes, “You’re fine. It’s within normal limits.” But that doesn’t mean anything because some men might operate better at high normal than other men. So there’s that issue. Then there’s the issue where it isn’t really representative of the intracrinological or local production. But there’s another issue, Ben, and this is the issue that’s not taught anywhere. That’s that the level in your blood or whatever way you assay it isn’t telling you if that could really deliver its signal to the receptor, the proteins in the shape of a satellite dish. That’s where hormones, where the rubber meets the road, is receptor functionality.
Receptor functionality is based on a tapestry of things. Are those receptors clogged with chemicals from the environment or from other hormones, like a stress hormone? Those DNA binding sites have to be flush with nutrients. That’s where your diet makes a difference is in the binding capability, like a parking lot, for your hormone car to pull into the parking lot of your hormone receptor and be able to do a great job of parking and deliver its signal to the gene. You have to have magnesium and zinc and B vitamins. That all affects how long the signal is delivered, how effectively the signal is delivered to the gene. That’s where your eating choices make a difference is where hormones can or not deliver their signal. And then that depends on digestion because if you’re eating great choices but you’re not digesting, you still won’t get the nutrients there. So hormones tend to be this bigger tapestry that somehow for some reason is not taught there. But when I was at Tulane we put on 33 years. I was only there for about 12 years of the 33 years of estrogens in the environment.
The last six or seven years of symposia were called e.Hormones. The last two or three sounded like naturopathic conventions, because they were, well, B6 has a lot to do with how long estrogen gives its signal and the zinc fingers need to pull the whatever. It sounded like you were at the nutritional symposium because nutrition and hormones are absolutely intimately intermingled. But nobody seems to know about this. It’s in the textbooks. But the patient misses out. The doc says your hormones look great. I can’t give you to them. Or you’re on hormones and I don’t know why you’re not feeling better. It’s because there’s all these nuances. You have to check this and check this. There’s the bullet list to check to see if your hormones are working well or not. And then there’s the peripheral production of hormones that we don’t have a way yet of testing other than your symptoms.
Then just one other thing and I’ll shut up. When I wrote Sexy Brain I had a consultant. He has written all the estrogen books for the medical books. His name is Michael E. Baker and he’s the scientist from UC Davis. We had an interplay of 50 to 60 emails of writing my book, Sexy Brain, which is all about how estrogen came on the planet and what testosterone did and how you interpret that up into the bedroom and what does that have to do with your brain. Nature design didn’t enlist you to protect our brains. But with hormone altering chemicals that wonderful design of nature is being attacked. He’s discovered in some new papers a few years ago that a healthy microbiome actually produces hormones, too. So your microbiome, which of course is this explosion of research and flurry about it, is intimately related to your hormone health. But if you go to your gynecologist and say, “Should I take hormones,” you’re 98% of the time going to get a wrong answer. The answer isn’t going to include checking off all of these different nuances of what might be glitching your own hormones. That’s my passion is to try and pass that forward.
Dr. Weitz: Sure. You mentioned the importance of the gut and the health of the gastrointestinal tract. You look at the percentage of people who are constipated. If you’re constipated, you’re not excreting your estrogen. It’s getting recirculated. Having a healthy gut is so crucial to having healthy hormone balance.
Dr. Berkson: That is so right. When I wrote Healthy Digestion, the Natural Way, it was published by Wiley and one of their best selling books. It came out about 25 years ago. I talked about the studies. I’m trying to remember the name of the authors on the study. I can’t remember it right now. It came out in about the ’50s where they took women that had normal breasts but they aspirated their nipples. They forced liquid out of their nipples so they got some cells, some liquid and some cells. And then they looked at the women’s bowel habits. It was such a great study. It was done on several thousand women. And then they replicated the study, which of course is the hallmark of science. I don’t remember if it was replicated by an independent laboratory, which is more the hallmark of science. They found that if women went to the bathroom twice a day, had a bowel movement twice a day, they never had any abnormal cells that were able to be aspirated out of their nipples.
Dr. Weitz: Fascinating.
Dr. Berkson: If they went to the bathroom once a day, they had five percent abnormal cells. If they went to the bathroom every other day or had constipation, they could go anywhere up toward 30 to 40% of abnormal cells. Exactly for the thing you just said, estrogen accumulates. When you poop twice a day, it tends to rinse out of your body. You make estrogen. You get rid of it. You make it. You get rid of it. You want to have this nice flow, this tai chi flow of estrogen throughout your body and out of you. Part of the way you do that is through two bowel movements. I tell all my patients our goal is two poops a day. The larger the poop, the smaller the hospital.
Dr. Weitz: And how many women have one bowel movement every two or three days and consider that normal? They don’t even think that’s a problem. It’s very common.
Dr. Berkson: I’ve noticed this that in a lot of my patients, more and more today people are eating well, exercising and even being on hormones and they’re still very ill. They’re doing everything right, and they’re not getting well. When you go in, my intake is several hours long. When I go in their intake, often they will say my gut’s always been my problem or I was constipated for 20 years until I learned about magnesium and chia seeds and so forth. But they have a history of many years of things not being wiped out of them. Do you see that in your patients?
Dr. Weitz: Very common, yes. There’s probably I think 75% of the people out there have some problem with their gut. You really have to probe them because you ask them how’s your gut. Oh, it’s fine. You ever get gas and bloating? Yeah. How about constipation? Well … You get reflux? Well, sometimes, but I’m fine. Really?
Dr. Berkson: But gastroenterologists don’t believe that food has much to do for the gut other than fiber and probiotics. They really don’t. They’re nice guys. It’s not like they’re jerks.
Dr. Weitz: I know. it’s unbelievable.
Dr. Berkson: They’re making their money in those colonoscopy banks. It’s extraordinary.
Dr. Weitz: No, it’s really amazing. Just shocking, that the tube that the food goes through, food has nothing to do with it. Well, I think it’s changing a little bit. I know some of the local GI docs are actually buying machines to do their own SIBO breath testing. Maybe LA is a little different because Dr. Pimentel is here.
Dr. Berkson: I think LA is a little bit ahead of the times. When I lectured in Chicago at A4M and the Gut Module, there was a fabulous gastroenterologist from LA who I’ve fallen in love with. If he wasn’t married, I’d be-
Dr. Weitz: What’s his name?
Dr. Berkson: I’d be on it. I’d be in LA. I’d be on it. He was so marvelous. He was so great. His name is Dr. Sam Farshad. He runs the Los Angeles Gastroenterologist-
Dr. Weitz: Yeah, he’s a friend of mine. I had him on the podcast a month ago.
Dr. Berkson: He’s fantastic.
Dr. Weitz: He’s great.
Dr. Berkson: I use his breath test. We talk all the time now. He wants me to come down to LA and talk to about 500 gastroenterologists, but they didn’t want to pay me anything. I was, wait a second. These guys are making $30,000 a day in their colonoscopy banks. They want to make me come down. Just something stinks in Denmark. I don’t know. But I love him. He’s such a great guy.
Dr. Weitz: Sam is great, yep.
Dr. Berkson: My two specialties, I do see a lot of complex patients. That what I love to see are people that have been everywhere, seen everybody, and no one can help because I love to see if I can put a fresh set of eyes on it and help them as I’ve done with myself and many patients. I tend to see more of breast cancer patients probably because I’ve been there and inflammatory bowel disease patients. I’ve had quite a number of patients that either were told they had to stat get a colectomy and get their colon removed or they’ve had their colon removed and they’re still not doing well. Now after working with me for three to six months, it’s usually very fast. This isn’t a two to three year program. I add hormones to the mix. I add estriol to the mix. I add totally different things. I have pre and post colonoscopies of people who have saved themselves from getting rid of their colon. Usually they’re women in their early 20s or they’re somebody who had a colectomy 15, 20 years ago and they’re still ill. And then we now finally get a normal scoping.
I’ve gone and had a visit with the guys at Austin Regional Gastroenterology and I showed them four cases of pre and post colonoscopies. Gave them the lay of the land of what I was doing. They laughed at me. They said there was no way we would ever do any of this. Hormones belong to the endocrinologist. They don’t belong to the gut, even though there’s gut receptors for hormones in the gut. If we were going to do nutrition, we would hire a dietician and they don’t know anything about this. I said, but look it. You wanted this woman’s colon out stat, and now there’s no evidence of disease. No, we honestly don’t think that food has anything to do with the gut.
Dr. Weitz: You know who’s a great gastroenterologist in Texas is-
Dr. Berkson: Brown.
Dr. Weitz: … Ken Brown. Exactly, yep.
Dr. Berkson: I had him on my show. He’s a really great guy. He designed Atrantil.
Dr. Weitz: Exactly.
Dr. Berkson: I don’t know if he’s really a functional doc though in the same sense where he-
Dr. Weitz: No, not as much as Dr. Rahbar. No.
Dr. Berkson: He doesn’t approach it like Dr. Sam Fahid who is a true … In fact, when Dr. Brown heard that I was going to be lecturing with Dr. Fahid, he got all in a tizzy. He said can you please connect us. He’s my hero. He’s really doing functional gastroenterology like nobody in the world is. You’ve got him right there. You lucky ducky you. If anybody has any kind of gut issue, you’ve got the best doctor right in the world right there. And he’s your good friend?
Dr. Weitz: Oh, yeah, he’s great. He was on the podcast. We talked about IBD. I organize a monthly meeting of Functional Medicine docs, and he came and spoke. We got to chat. It’s great. Yeah, he’s a great resource.
Dr. Berkson: One of the things I appreciate about him, which I feel in you, too, which is so nice, is he’s very centered. In today’s world where everyone’s so spinning out of control, it’s so exhausting. You just speak with him for a few minutes and you start having both sides of your brain resonate at the same speed and your chakras, if you believe in them, are lining up. I tend with my closest friends to try and seek out people who feel grounded. When I talk to patients and they’re trying to get well and they’ve seen 15 doctors and they’re spinning all over, I go, “You know, you’re not occupying yourself. We have to talk about how you can not abandon yourself and maybe become more solid and in sync with your own self. That’s part of your healing, because our society pulled you away. How can we pull you back? Because if you’re not occupying your own body, then how can any intervention you pay any amount of money for with any doc you use heal you?” He just resonates that centeredness, which is why I found him such a delicious person on so many levels. The real deal.
Dr. Weitz: Cool. Well, I think this has been a great podcast. We haven’t got to talk about your book.
Dr. Berkson: You got to go buy my book. You’re crazy if you don’t.
Dr. Weitz: I have your book. I bought your book. I have a digital copy of it. Everybody should buy her book, Sexy Brain. It’s a great read.
Dr. Berkson: It really is. Although, every single scientist and mentor, doctor I’ve sent it to, the first thing they go is go to the sex chapters. Look, I have to be honest with you. I just went to the orgasm chapter first. We have all this crazy science and translating estrogen and testosterone. No, I went right to the A spot, the B spot, the C spot. Okay, you’re a guy. You’re a guy. It’s okay. I’m not a woman who doesn’t like guys. I think the American male is in such an interesting position today, because there’s the Me Too Movement and women have been reading books and taking exercise classes and becoming bigger, stronger, better. Wow. Guys, we need to have some iconic figures with guys to help them feel more comfy inside themselves. The definition of the male today is somewhat confusing as it’s been with women, so we forged our living out loud to embrace it. This is great that you’re having a show like this. Maybe you can be an iconic figure for some guys.
I hired a guy to come build a closet in my office. My kits, my gut kits and my DNA kits, my office is overrun with kits. Turns out that he had done a book on photographs of men and their sons but with famous men, with Presidents and their sons. He was on Oprah. He was on Joan Lunden, if you remember her. He was on all these shows. I said, “You should be doing this now. Men need you now. I want to get you on my show now.” We got into this whole conversation. We have such a gender confusion and a gender exploration where a lot of young kids today, teenage kids, are saying I’m not the right gender. I want to be a different gender. That’s really trendy at the moment. I go into that quite a bit in Hormone Deception.
Sexy Brain is more for hetero couples, but I talk a lot about what might be contributing to that. It’s an interesting thing finding out who you are and how to really connect with another human being. The whoever you are, you can have the hormones that turn on your brain and allow you to be who you want to be. But if hormone altering chemicals are suppressing that and you don’t want a lot of intimacy because so many people today, young kids even, don’t care about intimacy. That’s with Sexy Brain. It takes you on an exploration that is a story that needs to be told.
Dr. Weitz: Awesome. So for our listeners who want to get a hold of you, what’s the best way for them to contact you?
Dr. Berkson: I have a website, drlindseyberkson.com. That’s D-R-L-I-N-D-S-E-Y-B-E-R-K-S-O-N. There I’ve got my radio show, Dr. Berkson Best Health. I’ve got my blog. I do all kinds of fun things in my blog. In fact, this week I’ve got a new thing coming out about the new a2 Milk. I don’t know if you know about a2 Milk. In fact, DABSE just said they were going to publish that in their journal.
Dr. Weitz: Oh, yeah. I know a little bit about that. Right.
Dr. Berkson: I talk about a lot of stuff. My last blog was on the heavy metals in prenatal vitamins and how you should know-
Dr. Weitz: I saw that article, yeah.
Dr. Berkson: And the one right before that is why do we hate older women and three ways to stop that. With all the research about the bias against … Now that we’re turning women on, we’ve left out a group of the women. We’ve left out the older women. We’ve left them in the dust. I wrote an article on that, because in that dust clumping myself. They can also, if they want to feel like they want to have a consult with me, I consult with people all over the world. I work with your own medical team. My number is 512-507-3279. My intake and the notes I write up and everything, it takes about five hours all together. It’s all personalized for you. You get my 47 years of experience and of writing 21 books and of having radio blah, blah, blah, blah. I get that focused onto you for hours to try and see if we can tease apart how to really get you well from another viewpoint. Nobody can help everybody, but I have a good track record of helping very complex cases because those are the ones I like the best because I love to think. Let’s see. Is there any other way people can get a hold-
Dr. Weitz: You have some online courses that are available as well. Right?
Dr. Berkson: Oh, thank you. I have a little growing Berkson University. I’ve got a 30-hour course called Sexy Brain, Redefining Hormones. And then I’ve got a course called the New Estrogen because nobody knows all about the new estrogen. There’s many things that estrogen does that the new academic research … Did you know that estrogen drives epigenetics? Did you know that estrogen protects mitochondria from damage? It has a lot to do with mitochondrial health.
Dr. Weitz: Interesting.
Dr. Berkson: That’s a course on that. Then the final metabolite of estrogen called 2-methoxyestradiol, nobody knows about that. That’s what saved me from more cancers. That was the molecule that I couldn’t talk about because the FDA … Anyway-
Dr. Weitz: I see. And that’s the benefit of measuring hormones with urine, because you get the estrogen metabolites, the two, four and the 16.
Dr. Berkson: Right, but we give the final metabolite, we can give that as a bioidentical hormone. It has so many applications, but it’s-
Dr. Weitz: Ah, interesting.
Dr. Berkson: … very people know about that.
Dr. Weitz: Yeah, I didn’t know about that.
Dr. Berkson: It’s very useful in cancer patients, in many cancer patients. That’s what stopped me from having cancers is 2-methoxyestradiol.
Dr. Weitz: Wow.
Dr. Berkson: That’s what stopped me. That’s one of the main hormones I take.
Dr. Weitz: And you get that formulated by a compounding pharmacy?
Dr. Berkson: There’s only one compounding pharmacy right now that sells it. It’s called Key Pharmacy, and Jonathan and I have been using it for about 15 years in hundreds and hundreds of patients. That’s the only pharmacy at the moment that sells it.
Dr. Weitz: Wow, okay.
Dr. Berkson: I called the FDA. I said, “How come more compounding pharmacies can’t sell it?” They said, “There’s not a monograph.” I said, “Can I write the monograph?” They said, “Who are you? You need to be a researcher.” The Center for Bio and Environmental Research where I worked at Tulane had closed down, so I applied to become a researcher at the Health Sciences Collegium. I became one, and I just haven’t written the monograph yet, because that all took a period of time. I’d like to make 2 MEO available for doctors to decide to prescribe and make it available. Right at the moment it’s not so available. It’s quite extraordinary.
Dr. Weitz: Interesting. Fascinating.
Dr. Berkson: I have a course on that that’s available. I have a course called Hormones, Biomes, and Breasts, Oh, My. Hormones, and Biomes, and Breasts, Oh, My. I’m going to have new courses. I have Oxytocin, the Love Hormone, and the Role in the Gut. I’m going to be publishing that soon. I’ve got a course on birth control. What is really going on with birth control? What is it doing? What should you take when you’re on it? Who shouldn’t take it? What are the options for birth control? I’ve got a course like that. I’ve got a number of courses coming out. The Unappreciated Role of Stomach Acids and the Dos and Don’ts of Stomach Acid. I’m going to be populating all these courses. If people want them, they could just take them for so much money, and then if they want to get them and download all the slides, they could pay a little bit more money and get the slides.
Dr. Weitz: Cool. Awesome. Thank you. Thank you for your contributions to Functional Medicine in the world.
Dr. Berkson: I’ll have a sip of beer to this.
Dr. Weitz: Talk to you soon.
