Perimenopause Unmasked with Bria Gadd, the Period Whisperer and host Dr. Ben Weitz.
[If you enjoy this podcast, please give us a rating and review on Apple Podcasts, so more people will find The Rational Wellness Podcast. Also check out the video version on my WeitzChiro YouTube page.]
Perimenopause as a Neuroendocrine Transition: Foundations, Testing, and Targeted Therapies with Bria Gadd
Dr. Ben Weitz introduces the Rational Wellness Podcast and interviews Bria Gadd about perimenopause, framing it as a “reverse puberty” marked by dropping progesterone, fluctuating/declining estrogen, and broader metabolic vulnerability often missed when labs appear normal. They discuss common and overlooked symptoms (anxiety, insomnia, heavy cycles, weight gain, brain fog, urinary issues), distinctions from menopause, and contributors like adrenal depletion, gut dysfunction, liver congestion, and thyroid conversion problems. Gadd emphasizes testing (including DUTCH for cortisol patterns), foundational lifestyle routines, blood sugar regulation, hydration/minerals, and daily bowel movements to reduce “health debt.” They cover supplements (magnesium glycinate, minerals, licorice, adaptogens, DHEA, Vitex, calcium d-glucarate, resveratrol), seed cycling, vagal tone strategies, and selective hormone therapy. The conversation also addresses peptide and GLP-1 microdosing approaches, with focus on muscle preservation and cycling use.
Bria Gadd is the Period Whisperer, who is a Functional Diagnostic Nutrition practitioner, holistic health coach, and certified personal trainer, who specializes in female hormones, helping women with weight release and energy gain in pre and post menopause. Bria is the host of The Period Whisperer Podcast, a top 1% global wellness show and her website is BriathePeriodWhisperer.com.
Dr. Ben Weitz is available for Functional Nutrition consultations specializing in Functional Gastrointestinal Disorders like IBS/SIBO and Reflux and also Cardiometabolic Risk Factors like elevated lipids, high blood sugar, and high blood pressure. Dr. Weitz has also successfully helped many patients with managing their weight and improving their athletic performance, as well as sports chiropractic work by calling his Santa Monica office 310-395-3111.
Dr. Weitz: If you’re looking for clinically useful insights, not wellness hype, then this is the place for you. Welcome to the Rational Wellness Podcast, the podcast for functional and integrated practitioners who wanna practice with greater clarity and precision. I’m Dr. Ben Weitz, and each week I sit down with the leading clinicians, researchers, and lab innovators to explore the science lab testing and clinical reasoning behind modern root cause medicine.
This is a show focused on practical, evidence informed insights that you can actually use in patient care. Please subscribe to the Rational Wellness Podcast on Apple, Spotify, or YouTube. Please tell your friends and colleagues and if you could give us a ratings and review on Apple or Spotify. We would certainly appreciate it.
Finally, to access the show notes and the full transcript, please go to my website, drweitz.com. Today we’ll be diving deep into a phase of life that’s profoundly misunderstood in both conventional and integrative medicine, which is perimenopause. Many women in their late thirties and forties are told that their labs are normal.
But they’re experiencing a lot of symptoms like anxiety, insomnia, heavy cycles, weight gain, brain fog, mood problems. Too often they’re prescribed antidepressants or told it’s stress. But what if perimenopause is fundamentally. A neuroendocrine transition driven by fluctuating estrogen and progesterone levels, altered cortisol patterns and metabolic vulnerability.
To unpack this, I’m joined by Bria Gadd, the Period Whisperer, who is a functional diagnostic nutrition practitioner. Holistic health coach, certified trainer who specializes in female hormones, helping women with weight release and energy gain in pre and post menopause. Bria is the host of the Period Whisper Podcast, a top 1% global wellness show.
Bria, thanks for joining us.
Bria: Thank you, Dr. Ben. I’m super grateful to be here.
Dr. Weitz: That’s great. And by the way I wanted to mention when answering questions, feel free to bring up cases of people you are working with. ’cause that’s always helpful.
Bria: Yeah, I love that. I think it’s, it makes it more real, doesn’t it?
Dr. Weitz: Absolutely. So what defines perimenopause?
Bria: Yeah. So I think, you know, it’s a funny thing, perimenopause because it is not really a diagnosable condition necessarily. You know, we have puberty that we start to recognize. We have, you know, the actual achievement of menopause when we’re no longer cycling after a year.
But for me, I really like to think of perimenopause as our reverse puberty and
Dr. Weitz: reverse puberty,
Bria: our reverse [00:03:00] puberty, and ultimately the journey of our ovaries. Beginning to retire from their very important job.
Dr. Weitz: Okay.
Bria: Head into the next phase of their life. So that’s more of the philosophical side of it, I think, you know.
What we see in perimenopause hormonally when we’re really looking at those kind of key sex hormones, is progesterone beginning to drop. We of course see, you know, estrogen fluctuate, and then also begin to drop as we lose kind of the final final of our eggs and kind of reach that banality into our next chapter of post menopause.
Dr. Weitz: What are some of the signs of menopause that are often missed?
Bria: Huh. Well, you know, it’s funny because what I have learned in my in my practice and in my own journey as a woman in perimenopause is sex hormones get blamed for a lot of things. But as you know, and you know, you talked about metabolic vulnerability, and I just loved that term when you said that in the intro, because I really think so much [00:04:00] of t
he discomfort and symptoms that we are seeing women have more and more in this hormonally shifting time of perimenopause has a lot more to do with what I call health debt, but really just so many other functional issues in the body or so many other maybe metabolic weaknesses in the body. So, you know, I think, but to answer that question that are some uncommon symptoms, you know, I, you mentioned anxiety.
I think it, you know, incontinence or more frequent urination, you know, certainly we already know sleepness, but like, I think even restless restlessness in the body or you know, I remember for me, I was having this kind of endless twitch in my eye. For some of my clients, they start to notice. Obviously libido shifts, you know, lubrication shifts in the body.
There’s really kind of no end to the number of symptoms that can be tied to this time.
Dr. Weitz: You mentioned incontinence. It’s interesting I don’t go to drugstore too often, but I had to pick up a prescription for my [00:05:00] son and I noticed there’s an entire aisle for Depends and the like and realize there must be a lot of people with issues like incontinence.
Bria: Yeah, and I think we could do a whole, you know, podcast episode about that. And more and more I recognize that my clients more pelvic floor issues that just were never addressed and you know, we’ve seen a significant uptick in things like hysterectomies in women because of issues going on in the period, maybe not addressing t
he underlying issue. And so we, this is the path we choose and that also really impacts the a weak pelvic floor.
Dr. Weitz: Oh, it’s amazing the problems that women have where everything drops and they have to get these elaborate surgeries where they try to hold things up with netting and all kinds of stuff.
And it’s really all because you we’re getting weaker and you don’t have the core muscles, the hold thing’s in place.
Bria: Yeah and I think just even to remove a big organ, which might [00:06:00] need to happen sometimes there really needs to be proper rehab and physiotherapy around that. So add to that this estrogen, you know, declining in this phase and we start to have more issues with incontinence in that area.
Dr. Weitz: So how is perimenopause hormonally different from menopause?
Bria: In menopause we actually see the official retirement of your ovaries. So we now know you’re not getting ovarian production of your sex hormones, your estrogen, your progesterone, your testosterone. In perimenopause, we still have eggs. We often are still cycling, maybe if it’s a regular or not.
So we still have ovarian production of these hormones happening. It hasn’t fully passed. The torch to the adrenals is where I like to look at it.
Dr. Weitz: What about when you have early early loss of estrogen, y
ou know, when you have premature ovarian failure?
Bria: I think, you know, as you know, everyone is so different, [00:07:00] but what I see certainly in my clients, I have, you know, to give more examples, I have a lot of women that I work with that are very high achieving, high driven.
They’ve had, you know, big demands on themselves physically in terms of their physical health for years. Likely raising a family. They’ve had children. They’re also, you know, have big careers on their own and. What I often see is a significant depletion of adrenal hormone as well as maybe congestion in the liver.
And this combination, you know, maybe adding in some thyroid challenges really can be a big part of what is draining. The ovarian production, like sometimes we we just don’t have the ingredients in the body to make the hormones so the ovaries are completely capable. But, you know, another example I have is a client who was having a lot of digestive issues and and.
So her estrogen and her progesterone were all, and her testosterone were all really quite low. But when we went into her [00:08:00] gut and really saw how depleted her gut was, almost like a dried desert trying to grow something. If we’re not absorbing the nutrients we’re taking in, then we don’t even have the, those rudimentary bare bones ingredients for the body to make the hormones in the first place.
Dr. Weitz: Yeah. Interesting. Do you think that some women in perimenopause should be on hormones, or is that something that should wait till menopause?
Bria: No, I definitely think there are certain situations where women will benefit from hormone replacement therapy. Sometimes, you know, I’m a big believer in testing and not guessing.
I think that it’s. Important first and foremost to understand the detoxification pathways in a body. Like how is the liver detoxing the hormones, how is the gut methylating and getting those hormones out before we start adding more fuel to the fire. But if all pathways are clear and hormones are low, then absolutely I think we can benefit from from some [00:09:00] hormone replacement therapy.
It’s just going to depend on what that person needs. Sometimes it’s. You know, DHEA that we can benefit from. Sometimes it’s an adrenal hormone fatigue that we need just to boost hormone replacement, but sometimes we need that progesterone, we need that estrogen. We need that testosterone because maybe we’re not producing it, or maybe sometimes we only need it for a little while to build up our reserves.
And that’s where it becomes more of an art, I think, than just a science or prescription sometimes.
Dr. Weitz: Yeah. And sometimes getting the right testing. And when it comes to hormones, there’s a lot of controversy. You just mentioned adrenals. I think adrenal issues are way underdiagnosed, and that’s partially because of the way we test adrenals.
We, if you just do a serum cortisol test you rarely see anything and I think you really need to. Look at that cortisol multiple times during the day through urine or through saliva.
Bria: I agree. I agree. I’m a huge fan of the dried [00:10:00] urine test for comprehensive hormones, the Dutch, because we get those, that pattern of the free cortisol.
We get the free cortisol, and we also get the metabolized cortisol, so we get to understand. Where the functional issue might be. Sometimes we don’t have a production issue. We simply have like a clearance issue or a function issue down deeper. And so the answer to coming back to that is gonna be different.
Dr. Weitz: Have you helped women who were in perimenopause. Get their hormones balanced without taking hormones?
Bria: Absolutely. I would say 75% of my clients, I primarily work with women. 40 to 50 I would say. I do have some, you know, 50 to 60 and occasionally I have some 35 to 40. But I would say if we’re looking at the, like the mean average of who I work with, 75% of the time we’re not, we don’t even need hormone replacement therapy.
It’s other functional issues to bring the body back into. You know, metabolic balance and then that hormone production often comes back on its own, I think. [00:11:00] So
Dr. Weitz: what are some of those issues? You mentioned gut health.
Bria: Yeah, definitely. The gut’s a huge one. I mean, as most of us know, we talk about it, but when it comes to our hormones, it’s a kind of a double player.
Because again, we have this ability or this need for our gut to break down and absorb the nutrients. Most women I work with eat very well. They eat a lot of wonderful food. They eat healthy and whole foods and clean foods. Maybe not enough sometimes, and that kind of comes into play. But if the gut.
For whatever reason, and there are many, it is not breaking down and absorbing things properly. Then one, as I mentioned, we don’t have the ingredients to make. Any of our hormones, thyroid hormone, you know, sex hormone hunger hormone, satiation hormone, adrenal hormone, all of those things. But also it’s so important, the gut for, again, methylating and getting these hormones and other toxins out of our body.
So it can be problematic on. Sides. If the gut’s not doing that very well, then you [00:12:00] know, that’s very stressful on the adrenals. So now we can move into seeing why adrenals might be very taxed long term. We can also see if the gut’s not getting things out. We can also see where a liver might get more and more congested.
And then we can start to see when the liver comes in play, we see very easily where thyroid conversion, you know, gets thrown off as well. So it’s. It’s all, as you know, all of our systems, our hormones, our immune, our digestion, our detox, our energy production, our nervous system, they’re all connected like an orchestra.
And so when one goes off, one instrument goes off very quickly. That orchestra is playing an entirely different tune. And it’s often not as simple of a fix of just fixing and tuning that one. Instrument, bringing it back into,
Dr. Weitz: so what are some of your keys to restoring gut health? I know you like to run a GI map.
Do you use some variation of the four R or five R program that a lot of functional medicine practitioners use?
Bria: Yeah, I do love the four R five R. But I always find when I start working with a client, I’m always, I’m really thinking of the body and this transition. In perimenopause as where is the energy supply and demand?
If we understand that the retiring of our ovaries, the transition through perimenopause into menopause, like all transitions is a big energy demand, then we can start to see where all of a sudden if we have women going through life already juggling all the balls or losing some function in different areas, barely keeping things together, this.
Added ball that gets thrown in. This added energy demand starts to create an energy supply and demand deficit. And that deficit I like to call health debt. And I think before we can even begin to start, you know. Looking at labs, we need to first look at our lifestyle, our foundational pieces, to make sure that we have a solid ground where [00:14:00] we’re not wasting unnecessary energy and where the energy coming into our body is as great as it can be.
So sorry, I don’t wanna interrupt you there.
Dr. Weitz: No, that’s okay.
Bria: Yeah. So some of the simple things that I like to do first that I think people can do on their own, even just listening to this podcast is having a really good gut check on their basic foundations of their health. We so quickly wanna try really fancy diets, really fancy workouts, really all these fancy things.
Dr. Weitz: Well, how did they know what the best diet is for them? There’s so much information out there. They should be fasting. They should be eating vegan, they should be eating carnivore. They should be eating Mediterranean.
Bria: So my answer to that is really only, you know, but you have to try and pay attention and,
Dr. Weitz: but most people don’t know.
Bria: They don’t know. And I think it’s because, and I was one of those people, I was I came from the fitness world and I was like, nailed my fitness no matter what, but my nutrition was, eh, [00:15:00] iffy. And you really just, you know, can’t the demand of fitness like that on most people without having really quality athletic nutrition.
Is always going to cost you something more than it’s providing. So I think one of the very first things I always wanna say is like, have a really good gut check with yourself at your kind of four key health pillars where your energy supply and demand come from in foundational health. So nutritionally, that’s obviously one of our biggest energy suppliers into the body.
We wanna make sure we’re not consuming things that we know cost the body more energy than they provide. So very simply, those are gonna be your inflammatory foods, processed foods, things that I think most people do understand pretty quickly. But
Dr. Weitz: I’m not sure we really know what anti-inflammatory foods are.
One person says it’s eating vegetables. One person says it’s eating meat.
Bria: Well, I’d say infl. No. There’s known inflammatory foods. We know that alcohol is inflammatory. Inflammatory. We know [00:16:00] that processed sugar is inflammatory. We do know that gluten is inflammatory. A lot of,
Dr. Weitz: there’s arguments about that, but yeah,
Bria: there we know that it’s,
Dr. Weitz: I agree with you.
Bria: Yeah. Cost. So there’s some key players, but I would say like caffeine, sugar, alcohol. Okay. We already kind of know we can, I think we can all agree on those ones. So we wanna make sure we’re limiting those kinds of things ’cause they’re just costing our body more energy than they’re providing. And I think that can be a really empowering way to look at nutrition.
Is what I’m about to eat, going to provide my body energy, or is it going to take more energy away because we need to have more energy to handle this transition and more energy to heal and age well? I.
Dr. Weitz: But we have doctors out there telling people if they eat certain kinds of vegetables or legumes, that they have lectins and fights and all these things that are inflammatory.
So I guess I can’t eat vegetables, but then if I eat meat, then I’m gonna have saturated fats and those are inflammatory. [00:17:00] So I guess all I can do is drink water.
Bria: Yeah, I agree. I do. And so I really like to encourage my clients to, you know, let’s do a little, couple week to a month, you know, experiment on ourselves, starting with the foods that we are commonly eating.
And I find food tracking really frustrating and exhausting. But I think if we can track our nutrition, not what necessarily what we’re eating and how many macros it consume, can, you know, has and how many calories, but how does that meal make you feel? One to two hours after you eat it, you know? Do you have consistent energy?
Do you feel full and satisfied? I believe very strongly that in regulated blood sugar, which I think is kind of our. Fundamental kindergarten basics of nutrition is how do we regulate our blood sugar, which is typically three meals a day, maybe a snack. So each of those meals should keep us full and satisfied and have consistent energy for about four to five hours.
So if you just take a few days, a [00:18:00] week, two weeks in women, it would be ideal to do a month because our cycle changes things a little bit with blood sugar. That if you could just like put your, the rubber to the road for, you know, one month and track how your food makes you feel, it becomes very eye-opening.
What works for us and what doesn’t on a very individual level.
Dr. Weitz: Yeah, I think blood sugar is super important and now we have continuous glucose monitors that we can utilize, which are very cool tools.
Bria: Very cool tools for sure. I’m also a big believer when it comes to foundational health. You know, even though I come from a fitness background, and I really believe that putting on lean muscle is like a, the gold standard for aging well, and wrapping your body in armor.
I do think that when we don’t have enough energy supply to meet the energy demand of our body athletic fitness, it can often be doing us a disservice until we have those funds again, those energetic funds again. So I really like to talk to clients first and foremost. Again, like [00:19:00] during this. Two weeks to a month when you’re food tracking, instead of working out, let’s just functionally move that body.
Let’s get your seven to 10,000 steps in each day. Let’s, you know, do some really good mobility and stability work, or yoga or whatever you wanna call it. Stretch your body a few times a week just to see where the body is at on a base level of energy without you putting a bigger demand on it. And I find that really helpful for people to start to really hear the messages from their own body again.
Dr. Weitz: Should women in perimenopause eat low carbs? Should they fast? Should they do intermittent fasting?
Bria: I, a quick answer I’ll say to try to drag this out, I would say no, I don’t think we should, would, should do long fasts. I believe really strongly in eating within two hours of waking, eating four to five hours later.
Eating four to five hours later. And if life happens and you have to go longer than that, you have a snack. I think in the in-between we get little fasting times for the body to rest and digest. And get back into [00:20:00] healing. But that regulates that blood sugar. And if you eat like that, you know, let’s say you, you eat at 8:00 AM you know, for breakfast, you eat lunch at 12 to one, you eat dinner at five to six.
I mean, there’s a 14 hour fast in there at night. But everyone, of course, our starting point is so different, and I think this is where this can be so confusing for women with which, what do I follow is it’s not necessarily considering where we are. Starting at a woman who has such dysregulated blood sugar that she’s not sleeping through the night’s, waking up multiple times or waking up in a sweat, might often need a bedtime snack.
Might often need a in the middle of the night snack just to get us sleeping. Because it’s very hard to, you know, lose weight, to feel optimized, to put on lean muscle, to feel our best and regulate those hormones if we’re not sleeping.
Dr. Weitz: Sleep is a real problem, especially for going through perimenopause and menopause.
I’ve, I have a lot of female [00:21:00] patients who are really struggling with sleep and when they get on hormones, progesterone can be a real game saver. Right.
Bria: It can be a real game saver, especially if really the fundamental thing we’re seeing is that their progesterone is low. It can make such a difference for women.
So, I’m a big fan.
_____________________________________________________________________________________________________________________________________
Dr. Weitz: I’ve really been enjoying this discussion, but I just want to take a few minutes to tell you about a product that I’m very excited about. Imagine a device that can help you manage stress, improve your sleep, and boost your focus. All without any effort on your part. The Apollo wearable is designed to just to do just that, created by neuroscientists and physicians.
This innovative device uses gentle vibrations to activate your parasympathetic nervous system, helping you feel calmer, more focused, and better rested. Among the compelling reasons to use the Apollo wearable are that users experience a 40% reduction in stress and anxiety. Patients feel that they can sleep.
Their sleep improves up to additional 30 minutes of sleep per night. It helps you to boost your focus and concentration and it’s scientifically backed. And the best part is you can get all these benefits with a special $40 discount by using the promo code Weitz. W-E-I-T-Z, my name at checkout to enjoy these savings.
So go to Apollo Neuro and use the promo code Weitz today. And now back to our discussion.
_____________________________________________________________________________________________________________________________________
What are some of the other things we can do to simulate sleep?
Bria: I think we all wanna deny it because it’s, feels maybe less tangible, but deep nervous system regulation [00:23:00] is so important. The, I think when our body is in this health debt, when the energy supply is not meeting the demand, or when we’re in this hormonal chaos, that’s very stressful for our body.
And if you almost look at it as if. You’re, you’ve been thrown on a deserted island or you’re in survivor. You know, if we’re stressed and somewhere we’re not familiar with and that nervous system is riled up, we’re not gonna sleep well. Like that is a survival mechanism. So I think first it’s really beautiful to understand, well, your body’s actually trying to survive right now, so let’s under, let’s try to bring it into a place of calm.
So I think. Treating our bodies the way we treat our babies and even our animals, I think is so valuable. We make sure our animals eat on a routine, walk on a routine nap, on a routine, get love on a routine. Same with our children. We’re very adamant about making sure they have these wonderful breakfast and these wonderful lunches, and that they have playtime and that they have a proper bedtime.
But we don’t do that for [00:24:00] ourselves. And I think when our nervous system is dysregulated. One of the most powerful things we can do to regulate it and bring calm to it is routine. So when we eat, when we sleep, what we do in that time before bed.
Dr. Weitz: So have a consistent schedule to help regulate the circadian rhythm.
Bria: Absolutely. And also I think help the body feel. Like it knows what’s coming. Like I think there’s a very science aspect of it, but the philosophical side makes a lot of sense. It’s building trust between you and your body. Again, especially if maybe you’ve been very hard on your body as a lot of women have been for decades.
So I think that is a really important piece. I definitely think. Consistency in that bedtime routine is so important and this becomes challenging, but I can even see on Dutch tests when we’re looking at that cortisol pattern, I can see a great pattern. And then this light spike of cortisol at bedtime, which is a huge part of [00:25:00] what’s gonna keep our melatonin from coming up.
It’s gonna keep us not getting the integrity of the sleep that we need. And so when we dig into what’s going on at night, you know, we get things like, you know, while I was checking my work emails or for many of us in perimenopause, I have a teenage daughter and the only time she wants to talk to me is at, you know, nine 30 at night when I wanna be going to bed.
But, so we need to recognize where some of these things are and. One of my clients was just like avidly watching the news late at night, and that jacks up that nervous system. And it’s these things that we get in the habit of doing that, that seem benign, that actually really mess with our ability to calm down and then feel at peace when we rest.
Feel safe.
Dr. Weitz: What are some of your favorite supplements that you like to use to help regulate adrenals and hormones in perimenopause?
Bria: Yeah, these are great questions. And again, I’m always like, oh, it just [00:26:00] depends so much on what the problem is. So when it comes to our sex hormones, I think if,
Dr. Weitz: let’s say somebody has really low adrenal function, you know.
Bria: Really low adrenal function in general. So, and we know it’s just from maybe life, like maybe just from overwork. ’cause often if it’s from the gut, we have to correct that gut first. But let’s say just overall, you know, if they have low cortisol overall I do like a little licorice root. I think that can be really helpful to extend that half-life of cortisol.
You know, I do love some adaptogens for people. So really low cortisol, you know, we could look at some Rhodiola in the morning. I really love adrenal cocktails and electrolytes. I think those can be really simple, easy ways and absorbable ways for us to support our adrenals. Starting at the beginning of the day,
Dr. Weitz: is there a particular supplement combo that you like to use for lower adrenal?
That you find really helpful?
Bria: Yeah, it’s I, again, I will always start with kind of basics [00:27:00] before I get into the supplements, but where I, as I mentioned, I love an adrenal cocktail in the morning, so, and or some electrolytes along with minerals. So we’ll do a good trace minerals in the morning. I think that’s very helpful for people because I find the adaptogens, you know, I also, I like ashwagandha.
But I find that can be very tricky for people at night. You know, sometimes some people don’t do well with ashwagandha if we’re trying to bring that cortisol down. But I guess if you’re asking for just overall low cortisol, yeah. I wanna rep, I wanna support the minerals in the body because I think they’re kind of a foundational piece.
So trace minerals, lots of magnesium and an adrenal cocktail in the morning.
Dr. Weitz: What kind of magnesium do you like?
Bria: I love magnesium glycinate or bisg glycinate for sure, as a nice absorbable amount. And I think that women can take a lot more than we think. I think we can take about five times our body weight in magnesium.
You know, and you bump up against that bowel barrier. So I think that’s the nice thing about magnesium. You know, you’ll take. You’re taking too much if you Oh
Dr. Weitz: yeah. No, it’s [00:28:00] amazing how many women I talked to who said, oh yeah, I’m taking magnesium. How much are you taking? Oh, just one capsule. Yeah.
Bria: Right.
Whereas if you know, you know, for easy math, if you’re a hundred pounds, you could be taking 500 micrograms of magnesium. So it really starts to show us
Dr. Weitz: 500 milligrams.
Bria: Sorry, milligrams of magnesium, we be taking quite a bit. And sometimes we need that much just to restore what’s lost and bring calm to the body.
So have
Dr. Weitz: you used glandular adrenals?
Bria: I have used glandular adrenal. So if the metabolized cortisol and the free cortisol are low, like if we’re just in that exhaustive state, yes, I will absolutely use those. And then DHEA for sure, I love to use for women. If we see that DHEA is low as well,
Dr. Weitz: what kind of dosage do you like for DHEA?
Bria: I always wanna start slow. We’ll start with five, which
Dr. Weitz: is what? Five?
Bria: Five? Yeah. Really slow. Five milligrams five times a week. And then build up
Dr. Weitz: five once a day. Okay.
Bria: Five once a day. Sometimes [00:29:00] we’ll move to twice a day, but I like a liposomal, so it’s got liquid liposomal okay. Over pills. And then we could move up to you know, slowly move up to 20.
Should
Dr. Weitz: wait. Is there a particular product you like to use?
Bria: I like Quicksilver Scientific. They’ve got a nice liposomal, DHE,
Dr. Weitz: you know, their DHEA is really high dosage though.
Bria: Yeah. That’s why I think in the liposomal we just use the five milligrams of the liposomal. So maybe that’s what we’re talking about is
Dr. Weitz: Oh, okay.
Bria: So I’m using a liposomal that is yeah, probably quite potent. And it goes in the mouth, not, it’s not a rub on or
Dr. Weitz: yeah,
Bria: not a skin one. Yeah. But I find, I always, with my clients, I prefer to use a liquid where possible because of how often I see the gut struggling to absorb.
Dr. Weitz: Give us some a couple of clinical pearls about how you help clients improve their gut health.
Things that not everybody thinks about in the functional medicine world.
Bria: Yeah, it’s a great one. So I think [00:30:00] priority one with gut is pooping every day. So, you know, I think we always wanna look of course to, to nutrition, but if we, let’s say we are eating, you know, lots of cruciferous vegetable getting in that fiber and we’re still not pooping every day.
That is where I love to use magnesium to get us into a daily habit.
Dr. Weitz: Let’s say magnesium’s not working, what’s your next?
Bria: Yeah. Okay. So after that then I am a big fan, especially if there’s bloating of working with some digestive enzymes. Absolutely some dead digestive enzymes to get it, but
Dr. Weitz: they’re only pooping once every four days.
Bria: They’re only, yeah. So, okay. This is interesting.
Dr. Weitz: Gimme the big guns.
Bria: Okay. I do think we need some vagal nerve tone stimulation in conscience. Okay. A lot of times we have issues. With that vagos nerve tone, that big note nerve that goes from our gut to our brain. So if you’re, especially for people who have had long-term constipation, so some, obviously we’ve heard of humming and gargling, but gagging is actually a really fascinating and [00:31:00] potent way to work on the tone of your
Dr. Weitz: Yeah I’ve heard that for years from Datis Ian, but yeah.
I’ve never found those techniques to really help all that much. You find that the gargling and gagging helps.
Bria: They have, they know the, here’s the trouble I find Dr. Ben is that they have to be done consistently and repeatedly. So you gotta be like for three weeks, two to three times a day. And I think that’s where compliance comes in a little bit.
So it really depends on, how much people are struggling that way? I think if someone is really not pooping, we can look at things like coffee enemas to be very helpful as well.
Dr. Weitz: Have you used any of the vagal nerve stimulators?
Bria: No, not personally. No. I’ve used Have you?
Dr. Weitz: Yeah. Yeah. There’s a lot of products on the market.
Bria: Mm-hmm. What’s your favorite?
Dr. Weitz: There’s one called what is it called? Called it’s called, I forget the name of it. Ceto.
Bria: Ceto, okay.
Dr. Weitz: It’s a thing [00:32:00] that goes right here, wraps around your neck. And it uses electrical current, but there’s ones with light and, you know, we’ve used infrared light and there’s a number of different products to try to stimulate the vagal nerve, which goes right along the carotid.
Yeah.
Bria: Do you find ’em helpful?
Dr. Weitz: I find it’s helpful,
Bria: yeah.
Dr. Weitz: Sometimes we use mo pro motility products, like, yeah. Like ginger and you know, Motil pro and motility activator and some of those products
Bria: Yeah. To help things go along. Yeah. So I think that can be a big one. But most commonly, I think when we address nutrition, when we address hydration, which is a big thing that I see in my clients that are just not hydrated enough and we rest.
Yeah.
Dr. Weitz: A lot of people are not drinking enough water For sure.
Bria: As well as the trace minerals. I mean, we’re just so under mineralized I think these days. So when we address the minerals and we address hydration when we, you know, really bump up that [00:33:00] magnesium I really haven’t had too many problems having people be stuck.
Dr. Weitz: Any other supplements for hormones? Do you have used Vitex help with progesterone? Have you used pregnenolone?
Bria: Yeah, I don’t use pregnenolone as often. I love Vitex. I think for Chase tree Berry we also call it for for if progesterone is a little low if periods have felt kind of wonky. I’m a big lover of resveratrol and calcium derate for helping to, you know, really detox that estrogen.
So if part of the reason, you know, we’re feeling the way we are is our estrogen is way off, I like to do that ’cause it doesn’t lower our estrogens. It just helps to make sure those are getting out of the body. I love seed cycling. It’s again, you know, again, a really powerful way for us just through food to help regulate our cycle or help support the detoxing of our hormones and the production of our hormones in a way that they need.
I’m not sure if you guys have talked about that on here before, seed cycling, but it’s a nice,
Dr. Weitz: I, you know, it’s come up a few times. [00:34:00] Maybe you could explain what seed cycling is.
Bria: Yeah, absolutely. So it’s a methodology where you use four different seeds. We use pumpkin seeds and flax seeds, and then sesame seeds and sunflower seeds at different times of a cycle.
So even in an irregularly cycling woman, we can kind of, you know, pick a date guess and go from there because the seeds are all full of a lot of great minerals and nutrients that either help to detoxify your estrogen. Or really promote your testosterone, promote your progesterone, you know, in the second half of the cycle.
So the idea is from days one to 14 ish of your cycle, if you have a regular cycle, you’re consuming a tablespoon each of pumpkin and flax seeds, we want them ground up, we want them fresh. You know, you can put them in
Dr. Weitz: your, and what are each of those seeds? Do.
Bria: Yeah, so those in particular contain like great things like omegas and and things that are gonna really help benefit the detoxification of your estrogen.
So it helps move your estrogen through [00:35:00] your body and support your body in its detoxification, because more often than not, if there’s a problem or a hormone imbalance. It is not always, but it is commonly pour from poor estrogen detoxification. The other two seeds that you switch over to taking each day in from days 15 on are gonna be your sesame and your sunflower.
And those ones have a lot of great magnesium. They’ve got a lot of great zinc. They have things in there that help really support that progesterone production. So in essence, we’re just trying to bring balance through food in a dense way in into those hormones Again, for you.
Dr. Weitz: I know you’re a fan of peptides.
Bria: I am. Yes.
Dr. Weitz: And I’ve read some of your stuff and you sometimes talk about peptides as a group, but most people think of them either as weight loss, drugs, like Ozempic.
Bria: Mm-hmm.
Dr. Weitz: Or the other peptides, like BPC 1 57 and Lin. [00:36:00] And these are typically prescribed by longevity physicians?
Bria: Yeah.
Dr. Weitz: And usually made by compounding pharmacies, or they’re recommended by trainers or biohackers who buy ’em online from quote unquote research labs.
Bria: Yeah. Yeah.
Dr. Weitz: Let’s start with the drug of the year, the GLP one. Agonist like ozempic. Yeah. And these drugs are very controversial in my opinion. I think that they can be life changing. On the other hand, they are, I think, very problematic because people lose muscle, and I’ve seen quite a number of people lose a bunch of weight, 40, 50 pounds, and they just gain it all back with less muscle when they stop.
Bria: Yeah, I agree. So you, we wanna start with the semaglutide and the
Dr. Weitz: Yeah.
Bria: So as a non prescribing practitioner,
Dr. Weitz: so how do you work that, do you have an MD that you work with? Regularly?
Bria: I have, [00:37:00] no, I have a telehealth company that that works with a certified compounding pharmacy.
It’s a 5 0 3 a pharmacy, 5 0 3 B pharmacy. So it is the integrity is there, the certifications are there. I always. Test things on myself first before I’d ever.
Dr. Weitz: Now, are compounding pharmacies allowed to use GLP ones now? ’cause they were, and then they weren’t allowed. And
Bria: they are right now. Yes.
Dr. Weitz: Okay.
Bria: Now,
Dr. Weitz: And I know the companies that make the GLP ones don’t want you getting ’em from compounding pharmacies.
And so I think they had it blocked. Right. Be how is it that they’re allowed to be made right now? Do you know how that works?
Bria: Well, I think with compounding pharmacies, the idea is that they have. You know, certified tested ingredients, and they are and that, and they do have to uphold to certain regulations.
Even if a compounded product isn’t technically FDA approved, the individual components of that product have to be certified and allowed. So I think what [00:38:00] is being allowed right now is. That is marketed under a different name. So we’re not going out with this big brand name of Ozempic, there’s the life brand of, or Kirkland brand of, or, you know, Tylenol or any of these other things I think
Dr. Weitz: around,
Bria: That way.
Dr. Weitz: Okay, so you get these compounded GLP one agonists.
Bria: Yes. So, the way I work in my practice is I would not. Let just anybody, I would not refer anyone to use, just anyone to use these things. I do personally feel for the most part that a full dose of a GLP one and my preference is tirzepatide. I find it’s much more muscle preserving.
And I’m a big believer in more of a micro dose. But when we see the need for it, so I think what is missed often in the. Pharmaceutical land of just writing prescriptions for people. Is the f again, this coming back to these foundational markers for people. Like, are you putting in the work to sleep properly, to eat consistently, to move your body, to manage [00:39:00] your stress?
You know, are we re mineralized? Are hormones and gut optimized because, you know, a GLP one or a semaglutide, you know. We know it slows the gastric emptying. So when you have a gut that is not functioning very well and then you add even a microdose, let alone, yeah, a
Dr. Weitz: big problem is lack of motility.
It’s a major cause of SIBO and other gut problems, constipation, et cetera.
Bria: Yeah, I think it is. Irresponsible. And I think so when we, for me with my clients, that’s why we’re always gonna, we’re always gonna nail foundations first. We’re always gonna optimize the hormones. Second, by looking at those pathways, making sure they’re doing all of these other things.
If we are doing all of the things over four to six months and we just have this sticking point of, you know, maybe hemoglobin A1C is elevated. You know, we have some inflammation that just can’t seem to go away. The hormones have restored quite nicely, but we just are [00:40:00] not having the metabolic system that we need.
That’s where I think a microdose of Tirzepatide microdose can be very effective. And even with my clients, I often encourage them, there’s a, they’re through their prescription. ’cause again, I’m a non prescribing practitioner. They get kind of a standard microdose and I really encourage people to use.
Even half of that to start, because for some people, that’s all we need to restore that messaging. And then when the insulin sensitivity has been restored, when the inflammation has come down, then the body can do a lot of this on its own because it’s supported in the background by all of these great habits.
Dr. Weitz: And do you think the real benefit is from just making them not hungry? Is it from the insulin sensitivity? Is it from some other signaling?
Bria: I in my clients. So again, I’m, I work with a very niche, you know, group of women that are usually the women come to me. They are actively working out, they’re actively eating well.
They do probably [00:41:00] way more than they should in a day. So we would always have to work on some of those things. But I find, the biggest impact is on the insulin sensitivity. So we see that A1C come down, and also the inflammation. Inflammation that’s just stuck. So even when we’ve optimized hormones, if we have someone with, you know, just high, you know, estriol or high, you know, 16 oh H pathway, estrogen, that’s been stuck in there, I have seen it be quite effective in finally bringing that inflammation out of the body.
Which again really impacts a lot of things. We know inflammation is the beginning of most problems for people. Yeah.
Dr. Weitz: And by using these GLP one agonist drugs in this way, by using a lower dosage, yeah. By making sure they’re eating enough protein, that they’re doing weight training, that they have all these foundational things, do you find they’re able to sustain the weight loss once they stopped taking them?
Bria: A hundred percent. I [00:42:00] find, you know, and I’m a big in my practice, I’m a big believer of cycling. Like I just don’t think we should be doing a, aside from bioidentical hormone replacement, once those ovaries have shut down and we just don’t have that production. I’m a big believer of with peptides of, yeah, just using it for its key purpose, which is to restore a communication in the body that’s likely been broken down due to some form of chronic stress or inflammation.
So if we restore that messaging and the body’s. Doing and we’re doing the things to support the body, that messaging should be there. It’s like healing a line of broken telephone, then it should be able to do that all on its own. The one caveat I might say is we live in a very chronically stressed world.
I always say like, if I could scoop my clients up outta this world, take them to Costa Rica for six months, it would be shocking how much we could transform in that period of time. Oh. All that to say that we wanna cycle off if you cycle off and things go really well, but in another year you’re just finding some inflammation [00:43:00] happening.
Based on the nature of where we live and the culture that we live in, maybe you do another three months of a round of a microdose. But I really fundamentally believe in what I’ve seen in my practice that we shouldn’t need much more than that.
Dr. Weitz: Interesting. So what about the other peptides?
Bria: Yeah. Yeah. The other peptides are my favorites, although I’m happy for people to be able to get.
The benefits of things, of their hard work, you know, in a bioidentical way. So, some of my favorite peptides I’m a big lover of, well, it’s not technically a peptide, it’s a co-enzyme, but NAD plus which is what
Dr. Weitz: you mean, NMR and NR or NAD injectable,
Bria: NAD injectable. I do like NMR and NMN and T-M-G-T-M-G.
I really love the, anything that kind of helps with methylation, anything that helps with like firing up that mitochondria and a TP production in the body. For a lot of my clients who. Again, have almost like a very depleted body. You know, I think there’s very inflamed [00:44:00] bodies and then there’s often very depleted bodies where we see just not a lot going on.
And so that energy is really tanked. We often see more of a sluggish thyroid conversion. We see more congested livers, more oxidative stress, I find an injectable, NAD. Plus can be so powerful for a couple of months just to restore mental clarity, just to restore, again, mitochondrial function in the body.
And I think they call it a vitality peptide. ’cause I think it, it, I really find that it does that for me and my clients is that you just feel more youthful, more alive.
Dr. Weitz: Oh, what about so many other peptides?
Bria: Yeah. So in my practice we’ll also use some of the growth hormone releasing peptides like Ella Imar and Tess.
I find that these can be, again, in midlife really helpful.
Dr. Weitz: Which one of those is most effective?
Bria: You know, it’s interesting that you say that there’s a lot of different research because ipi specifically targets the targets our growth hormone release in a different way than [00:45:00] re and intestine.
And Tessa, I would say are a little bit, and particularly Tessa often comes across as a little bit stronger. So sometimes we’ll see. See these bundled together like an ipa, Tessa IPA together, or sometimes we’ll see them on their own. So it’s, what I find with most of these things is like everything, we have to try them to know if they’re going to work for us.
So if your lab work, you know, is healthy and we know we don’t have any issues with growth hormone in our body then I
Dr. Weitz: How do you determine if there’s growth hormone issues in their body?
Bria: In blood work, I like to look at IgG levels. To know, you know, are there, is there anything, there are some concerns with the growth hormone, leasing peptides that they encourage.
Growth. So if we have anything in the body where there’s a tumor, for example, or any indications of a tumor, it’s realistic to think that encouraging growth is going to encourage growth in all of the body.
Dr. Weitz: Do you look at IGF one levels? Yes.
Bria: IGF one, IgG [00:46:00] levels. Yep. All of those things. And then like white blood cells and things like that.
I like to run a full blood panel for my client.
Dr. Weitz: Yeah, because it’s common now in longevity circles. There’s. Certain doctors that are out there trying to promote the idea of having lower growth hormone levels. Yeah. That is better for longevity because growth hormone might increase cancer risk.
Bria: Yeah.
Dr. Weitz: And as a result of that, they recommend eating lower protein and they point to the Ron Dwarfs in Ecuador because they don’t have any growth hormone and they have virtually no cancer.
Bria: Yeah. It’s it’s complex. Like, like you were, you, we kind of started this conversation and it’s like, I mean, there’s not, we’re not cookie cutter unfortunately, right.
Dr. Weitz: Yeah. I don’t mean to put you on the spot. I just like to bring up some of the controversial stuff, you know? No,
Bria: I didn’t felt it feel on the spot at all.
I really appreciate it because I think,
Dr. Weitz: I personally don’t agree with that perspective for the most [00:47:00] part. I mean, I realize that if you have cancer, like you’re saying that taking things that promote growth aren’t necessarily good, but as people get older, if you don’t have. Growth and regeneration. And if you’re not replacing and maintaining and increasing your muscle and your bone and your brain and everything else, then you’re gonna be in big trouble.
Bria: Yeah, that’s very true. Absolutely. So with these anyway, with these particular peptides, we see, you know, a much. Better ability to put on lean muscle to recover in my midlife women, I see much deeper, more improved sleep, which as we already talked about, is one of the biggest challenges. I even see libido kick up because it’s sort of overall, it’s a youthfulness to our body that.
You know, re stimulated. And I think the beauty of it is that it is restimulating our own body’s amount. So again, we’re not coming into these massive amounts of things into the body that it never knew or understood we’re reestablishing something that was once already [00:48:00] there.
Dr. Weitz: Some of these peptides are now available orally.
Have you used any of those?
Bria: No, I have not used many oral options. I do find that. The efficacy is best in injection. And I don’t find that the cost is that much different. So if you’re really wanting to kind of bypass that, you know, gut absorption issue that we run into and get the most bang for your buck, I find that the injectables are the most, yeah, most effective.
Dr. Weitz: On the other hand, I think when it comes to the gut. If you’re trying to
Bria: Yeah.
Dr. Weitz: Help the gut, then I think like oral BPC 1 57 is probably better than injectable.
Bria: Absolutely. If we are targeting, and I will do this with my clients. If we are targeting, you know, very specific, especially with the mucosal barrier being very weakened, it can be very powerful just as an oral option
Dr. Weitz: And now we have plant peptides.
I don’t know if you’ve seen any of those?
Bria: You say plant peptides?
Dr. Weitz: Yeah.
Bria: [00:49:00] No, which ones are you thinking?
Dr. Weitz: Yeah, there’s one called Pep Is Strong, which is for Building Muscle. I’ve been using that. Oh. And using that with some of my clients. Yeah.
Bria: Do you like it?
Dr. Weitz: Yeah, I think it’s really helpful. Yeah. It’s some of the companies are carrying it designed for health is carrying it as performance peptides.
They’re being made from a company in in Ireland called Nuritas, and they have a new sleep one and they’re gonna have a whole bunch of ’em.
Bria: Oh really? Well, I’m I’ll, I’m definitely a big fan of Designs for Health, so I’m looking forward to digging into this after this. Thank you.
Dr. Weitz: Alright, great. So, let’s let’s wrap this interview up.
What are some final thoughts that people should think about?
Bria: Yeah.
Dr. Weitz: When it comes to perimenopause.
Bria: I think what I always want women to understand is I think perimenopause is a gift and not a curse. You know, I think if we can understand that our body is going through a major transition, that all transitions require energy, and if we look for [00:50:00] ways to, to.
Bring more energy into our life and decrease the energy demand. It doesn’t feel that simple, but it can be that simple to start to reestablish foundational health, which has to be priority one. I also think that functional lab work is going to be one of the most. Direct ways for you to feel very compliant to your plan, to not feel like you’re having FOMO and looking everyone else’s things around there.
’cause you now know the data inside of your own body for optimizing that hormones. And then you have things like peptide therapy if that is something you’re interested in. But I think the gift I always think about perimenopause for women is that from puberty to perimenopause, we are. Hormonally hijacked every single month in the name of procreation, of course, but ultimately, it has us put everyone else above ourselves.
That time is changing in our favor now, and so I think use this time to listen to the [00:51:00] discomfort of your body. Take action right now because. At, well, I’m 44. I mean, as this is happening in the forties to fifties for most women, we have decades left to live without being hormonally hijacked. So I think be patient, you know, get the clarity that you need and go after it, because I think it’s the gift you didn’t ask for, but that you need.
Dr. Weitz: That’s great. So how can listeners and viewers get in touch with you and find out about your programs?
Bria: Yeah, thanks, Dr. Ben. So I also have a podcast, as you mentioned, the Period Whisper podcast. You can watch it on YouTube, you can catch it anywhere you get your pods, or come and hang out on Instagram at Bria, the
Period Whisperer.
Dr. Weitz: That’s great. Thank you so much.
Bria: Thank you so much for having me.
___________________________________________________________________________________________________________________________________
Dr. Weitz: Thank you for making it all the way through this episode of the Rational Wellness Podcast. For those of you who enjoy listening to the Rational Wellness Podcast, I would very much appreciate it if you could go to Apple Podcasts or Spotify and give us a five star ratings and review.
As you may know. I continue to accept a limited number of new patients per month for functional medicine. If you would like help overcoming a gut or other chronic health condition and want to prevent chronic problems and wanna promote longevity. Please call my Santa Monica Weitz Sports chiropractic and nutrition office at 310-395-3111 and we can set you up for a consultation for functional medicine and I will talk to everybody next week.
And get a free ebook: "How to Reduce Digestive Distress"
