WEBVTT 1 00:00:11.759 --> 00:00:12.199 Hello. 2 00:00:12.480 --> 00:00:15.640 This is the Itchy and Bitchy Podcast because being itchy 3 00:00:15.960 --> 00:00:20.519 is bitchy and our medical system sucks. I'm doctor Keith Nolica, 4 00:00:20.559 --> 00:00:23.280 a vetnary, allergist and dermatologist. 5 00:00:22.719 --> 00:00:25.600 And I'm Stephen Miller, a doctor of nursing practice and 6 00:00:25.640 --> 00:00:27.239 a Q Care nurse practitioner. 7 00:00:27.600 --> 00:00:31.679 Send us your questions at ask at itch not dot com. 8 00:00:32.399 --> 00:00:34.840 We love you, but we're not your doctors. The information 9 00:00:34.960 --> 00:00:38.679 we discuss is not direct medical advice. Please talk to 10 00:00:38.719 --> 00:00:42.719 your provider who is the expert on your care. The 11 00:00:42.759 --> 00:00:46.439 Itchy and Bitchi podcast is sponsored by doc Itchy Medical 12 00:00:46.479 --> 00:00:50.000 Pets supplements designed to optimize your pet's health with the 13 00:00:50.079 --> 00:00:55.079 latest veterinary medical research. Visit docichi dot com or find 14 00:00:55.159 --> 00:00:58.799 us on Amazon and please click that follow button and 15 00:00:58.880 --> 00:01:02.479 send us a question at it ask at itchn dot com. 16 00:01:02.560 --> 00:01:08.120 Thanks hello, and welcome back to Itchy and Bitchy podcast. 17 00:01:08.159 --> 00:01:09.200 How are you, doctor Miller? 18 00:01:09.280 --> 00:01:10.239 We are so good? 19 00:01:10.599 --> 00:01:14.640 Okay, So this is our first first episode of questions 20 00:01:14.640 --> 00:01:18.000 that we got from our listeners, and we actually probably 21 00:01:18.120 --> 00:01:21.480 Karen has listeners from all over the world actually, so 22 00:01:21.840 --> 00:01:24.079 we definitely have some from the United States, but we 23 00:01:24.120 --> 00:01:30.000 also have dozens of listeners in Australia about Canada, Europe, Alaska. 24 00:01:30.040 --> 00:01:31.400 Hello out there. 25 00:01:31.599 --> 00:01:34.560 Yeah, big wide world. So hello to everyone, and thank 26 00:01:34.599 --> 00:01:35.879 you guys for listening to us. 27 00:01:35.879 --> 00:01:37.519 Thank you, yeah, thanks for listening. 28 00:01:37.640 --> 00:01:40.319 So we got some questions from our listeners and we're 29 00:01:40.359 --> 00:01:42.920 gonna ask us many our answer as many as we 30 00:01:42.959 --> 00:01:44.799 can as we go along. We don't want to make 31 00:01:44.840 --> 00:01:47.200 this too tedious, but we picked out some of the 32 00:01:47.239 --> 00:01:52.359 most interesting and useful to answer. Doctor Miller also got 33 00:01:52.439 --> 00:01:58.159 a screenshot of us recording and we're wearing our Puerto 34 00:01:58.280 --> 00:02:02.439 Rican San Jose bling. We have a studio set up 35 00:02:02.480 --> 00:02:04.920 in Puerto Rico that we visit sometimes, so that's why 36 00:02:04.920 --> 00:02:08.240 we're all decked out in our Puerto Rican attire. 37 00:02:08.400 --> 00:02:10.680 So we are we support the island. 38 00:02:10.800 --> 00:02:12.599 If you're interested in that, you can check out our 39 00:02:12.639 --> 00:02:15.439 website at where would the website be Itchy and Bitchy. 40 00:02:15.199 --> 00:02:18.479 Dot combitchi dot com or please go on and like 41 00:02:19.520 --> 00:02:22.000 I and b Podcast on Facebook. 42 00:02:22.120 --> 00:02:24.759 Yep, okay, so ready, So we're gonna divide this up 43 00:02:24.800 --> 00:02:27.039 and we're gonna have a few breaks. We're going to 44 00:02:27.080 --> 00:02:28.759 try to get to as many questions as we can. 45 00:02:29.199 --> 00:02:32.319 Are you ready care, captain, We're ready to roll. Okay, 46 00:02:32.360 --> 00:02:34.840 So the first question is from Tiffany from Atlanta. She's 47 00:02:34.879 --> 00:02:39.120 fifty six years old female, and she asked us that 48 00:02:39.719 --> 00:02:42.639 her doctor. She said, my doctor started me on GLP 49 00:02:42.759 --> 00:02:47.439 one and HRT simultaneously, so at the same time. And 50 00:02:47.479 --> 00:02:50.520 then she says Reddit went crazy and she wants to 51 00:02:50.560 --> 00:02:54.680 know am I over medicating? And so my opinion is, doctor, 52 00:02:54.759 --> 00:02:58.319 Reddit is not a thing, So check with your provider. 53 00:02:58.400 --> 00:03:01.360 Your provider is the expert on you, and that would 54 00:03:01.360 --> 00:03:04.479 be my first response to that. Probably there's some medical 55 00:03:05.199 --> 00:03:07.400 data as far as GLP ones and HRT. 56 00:03:08.039 --> 00:03:12.240 Yeah, so it's worrisome, but you know, when you and 57 00:03:12.360 --> 00:03:17.479 your particular situation have a therapy change and you put 58 00:03:17.520 --> 00:03:20.560 that out there in the world, and so then all 59 00:03:20.680 --> 00:03:24.400 kinds of people with varying opinions weigh in, and so 60 00:03:24.479 --> 00:03:28.599 I think it's important to definitely trust your provider and 61 00:03:29.599 --> 00:03:33.639 at least balance ideas and questions off your provider. Now, 62 00:03:34.000 --> 00:03:37.560 on the hormone side, it is the interesting More and 63 00:03:37.599 --> 00:03:41.800 more information is coming out on the GLP one ras 64 00:03:42.400 --> 00:03:47.639 and in women with PCOS, which is polycystic ovarian syndrome 65 00:03:48.319 --> 00:03:52.360 which can be tied to obesity and hyperinsulinism. In this 66 00:03:52.400 --> 00:03:57.080 and that there is an issue related to testosterone levels 67 00:03:57.240 --> 00:04:02.159 rising as part of PCOS and so lyriglue tide is 68 00:04:02.240 --> 00:04:05.759 found to reduce serum testosterone levels over about a three 69 00:04:05.840 --> 00:04:12.319 month period, which then it leads to improved androgen profiles. 70 00:04:12.759 --> 00:04:16.000 And so it's important to remember too with weight loss 71 00:04:17.000 --> 00:04:20.920 that all the six hortomones are fat soluble hormones, so 72 00:04:20.920 --> 00:04:25.160 there's this shift that happens. This particular study came from 73 00:04:25.199 --> 00:04:29.199 a systematic review of glp ones in patients that had 74 00:04:29.240 --> 00:04:30.160 metabolic syndrome. 75 00:04:30.399 --> 00:04:33.120 Okay, so that was a lot of information. So what 76 00:04:33.160 --> 00:04:35.959 I got from that is that the hormones and the 77 00:04:36.000 --> 00:04:39.720 glp ones are definitely interacting. When you start losing weight, 78 00:04:40.120 --> 00:04:42.600 some of the hormones that have been deposited in the 79 00:04:42.639 --> 00:04:44.800 fat are going to be released. You're going to have 80 00:04:44.839 --> 00:04:47.720 fluctuations there. It sounded to me like you need to 81 00:04:47.759 --> 00:04:51.240 have an expert that would be your provider monitoring hormone 82 00:04:51.319 --> 00:04:55.639 levels and checking and really doing a frequent revisit monitoring 83 00:04:55.759 --> 00:04:58.040 rather than in every six months kind of situation. 84 00:04:58.199 --> 00:04:58.639 Yeah. 85 00:04:58.720 --> 00:05:03.079 It also you mentioned and polycystic ovary disease. How common 86 00:05:03.160 --> 00:05:03.399 is that? 87 00:05:03.439 --> 00:05:12.240 It's extremely common, certainly as BMI goes up, people start 88 00:05:12.279 --> 00:05:18.800 to develop pcos and then there's also some reproductive repercussions 89 00:05:18.839 --> 00:05:21.040 that come from that. And so the GLP one a 90 00:05:21.160 --> 00:05:26.759 is also are thought to impact estrogen mediated pathways and 91 00:05:26.839 --> 00:05:31.920 reduce viseral fat, which then can potentially have impact on 92 00:05:32.319 --> 00:05:37.319 gonatal effects and weight loss mediated effects for reproduction. 93 00:05:37.800 --> 00:05:40.800 Yeah, so previously we did an episode and I compared 94 00:05:40.839 --> 00:05:45.160 this whole hormone pituitary cascade, like having fifteen toilets interlinked, 95 00:05:45.160 --> 00:05:47.199 and you have all of these water flows and crazy 96 00:05:47.639 --> 00:05:50.879 ups and downs and feedback loops and everything, and it 97 00:05:50.920 --> 00:05:53.639 really is a very very complicated system just with the 98 00:05:53.800 --> 00:05:56.839 HRT and the hormone issue, but then you add on 99 00:05:56.920 --> 00:05:59.920 to that the GLP one which can have some dreg 100 00:06:00.199 --> 00:06:04.519 influence on hormones, but also as you start degrading the 101 00:06:04.560 --> 00:06:07.519 fat and losing the weight, then that also changes the 102 00:06:07.560 --> 00:06:10.199 water level and the tanks and the hormone levels. So 103 00:06:10.240 --> 00:06:12.240 it gets really really complex. So would you would have 104 00:06:12.480 --> 00:06:15.120 if this were your patient, and we're not your we're 105 00:06:15.160 --> 00:06:17.759 not your doctors, but it would have been better to 106 00:06:17.839 --> 00:06:20.720 do one for six months and then do the other, 107 00:06:21.079 --> 00:06:23.199 or is it bad to do both at the same time? 108 00:06:23.279 --> 00:06:25.360 If they're not, you know, and this depends on. 109 00:06:25.319 --> 00:06:27.439 How I think it met it possible to make that 110 00:06:27.560 --> 00:06:30.319 call because we just don't have enough information on this 111 00:06:30.399 --> 00:06:33.480 particular evaluate the patient, and so I think a full 112 00:06:33.639 --> 00:06:37.040 evaluation with full hormone levels. I do think that we 113 00:06:37.639 --> 00:06:43.040 underestimate the impact of weight gain, and certainly even among men, 114 00:06:44.040 --> 00:06:48.160 there's been some association with gp one ras and increases 115 00:06:48.199 --> 00:06:52.720 in testosterone levels as people lose weight as well. 116 00:06:52.759 --> 00:06:57.160 So definitely contact your your doctor. Taught asked these questions 117 00:06:57.240 --> 00:07:00.639 to them. But Reddit is not really a great source. 118 00:07:01.480 --> 00:07:04.360 You know, I've been involved in Reddit and various marketing 119 00:07:04.399 --> 00:07:06.399 and science and data and you know, I have a 120 00:07:06.439 --> 00:07:11.000 textbook that I've written, and Reddit is public source and 121 00:07:11.079 --> 00:07:13.879 there's some usefulness in that. But these are not people 122 00:07:13.879 --> 00:07:16.639 that know your situation. They can say, you know, space 123 00:07:16.680 --> 00:07:20.800 aliens came down and stole your ovary and there's just 124 00:07:20.879 --> 00:07:23.199 no you know, rhyme or reason to some of the 125 00:07:23.199 --> 00:07:27.000 stuff on Reddit. So talk to your provider. Definitely, there 126 00:07:27.000 --> 00:07:30.800 can be some interactions. If you're definitely having any symptoms 127 00:07:30.800 --> 00:07:36.160 that seem a typical, absolutely get evaluated again. Okay, any 128 00:07:36.240 --> 00:07:37.279 last thoughts on on. 129 00:07:37.360 --> 00:07:43.319 Tiffany Tiffany Yeah, thank you so much for engaging with us. 130 00:07:43.480 --> 00:07:49.319 And I think you are certainly inquisitive and would like 131 00:07:49.360 --> 00:07:51.879 more information, so make sure that you follow up with 132 00:07:51.920 --> 00:07:56.120 your hormonal expert that you're seeing perfect. 133 00:07:56.240 --> 00:07:58.839 Yes, So Reddit's not a doctor and we're not your 134 00:07:58.920 --> 00:08:03.680 experts on you your provider, so seek more information. Okay, we're 135 00:08:03.680 --> 00:08:05.199 going to do one more question, then we're going to 136 00:08:05.199 --> 00:08:08.199 take a break. So this is from Luke, who's fifty 137 00:08:08.240 --> 00:08:10.680 nine years old from New York and this is actually 138 00:08:11.160 --> 00:08:14.680 a guy, so that's good. So mainly we have women 139 00:08:14.720 --> 00:08:17.519 listening to the podcast because of all the work Karen's done. 140 00:08:17.879 --> 00:08:22.319 So Luke wants to know do I have brain fog 141 00:08:22.600 --> 00:08:27.000 or Alzheimer's And he doesn't really give much more detail 142 00:08:27.079 --> 00:08:30.240 than that. So definitely, we're not your provider. We're not 143 00:08:30.279 --> 00:08:33.679 your doctor, so seek medical assistance. But I think this 144 00:08:33.759 --> 00:08:37.279 is a really common question. I'm fifty eight. I think 145 00:08:37.360 --> 00:08:39.639 maybe fifty nine. I'd have to calculate. I'm not so 146 00:08:39.679 --> 00:08:42.600 great at math. But I actually ask this to my 147 00:08:43.519 --> 00:08:45.879 groc I have a Tesla so it comes with free 148 00:08:45.919 --> 00:08:48.679 groc Ai and I couldn't remember what day of the 149 00:08:48.720 --> 00:08:51.440 week it was, like, I really had trouble remembering if 150 00:08:51.440 --> 00:08:54.799 it was Thursday or Friday. I have a housekeeper that 151 00:08:54.799 --> 00:08:56.679 comes on Friday, so that's important if I have to 152 00:08:56.720 --> 00:08:59.080 get the house set up. I really couldn't remember, so 153 00:08:59.120 --> 00:09:02.919 on the way to work, I actually used the AI 154 00:09:03.240 --> 00:09:05.799 in the car and asked, do I have early on 155 00:09:05.879 --> 00:09:08.720 set dementia or Alzheimer's if I can't remember what day 156 00:09:08.759 --> 00:09:11.320 of the week it was? And it said, what do 157 00:09:11.360 --> 00:09:11.559 you think? 158 00:09:11.559 --> 00:09:15.120 It said doctor Miller, Well, I mean dementia among our 159 00:09:15.159 --> 00:09:18.559 age group, early dementia is very rare, very rare. 160 00:09:18.559 --> 00:09:22.360 Correct, so statistically probably not. And then it also said 161 00:09:22.399 --> 00:09:25.480 that really most likely not, that you're probably stressed, fatigued, 162 00:09:26.279 --> 00:09:32.120 overwhelmed with other issues. That true, Alzheimer's is not necessarily 163 00:09:32.759 --> 00:09:35.440 dementia is not really forgetting where you park the car, 164 00:09:35.519 --> 00:09:38.840 but it's totally forgetting that you have a car and 165 00:09:38.879 --> 00:09:41.559 that you can drive, like way more serious. 166 00:09:41.279 --> 00:09:43.519 And the issue really comes down to figuring out what 167 00:09:43.559 --> 00:09:46.799 the root cause is. Right, So root cause of that 168 00:09:47.200 --> 00:09:50.480 scenario in a fifty year old man would be something 169 00:09:50.559 --> 00:09:56.919 like anxiety and depression and chronic stress or sleep disorder. Medication, polypharmacy, 170 00:09:57.519 --> 00:10:03.759 metabolic and indricin causes chronic alcohol substance use and then 171 00:10:04.200 --> 00:10:08.480 is subjective cognitive declimb. But again the point being that 172 00:10:08.559 --> 00:10:11.200 it's important to do a root cause and make sure 173 00:10:11.240 --> 00:10:14.879 that you're following up with someone to if it becomes 174 00:10:14.919 --> 00:10:16.639 a persistent problem. 175 00:10:16.879 --> 00:10:20.039 Yes, so I actually for two weeks about horribly uncontrolled 176 00:10:20.080 --> 00:10:23.600 migraine headaches because my insurance company wouldn't cover my Ajovi, 177 00:10:24.240 --> 00:10:27.039 which was working great for a year. That's a whole 178 00:10:27.039 --> 00:10:29.759 another episode of why this system sucks. But so my 179 00:10:30.440 --> 00:10:32.679 not being able to remember what day of the week 180 00:10:32.720 --> 00:10:36.440 it was is probably related to stress activities and work, 181 00:10:36.519 --> 00:10:40.480 but also my severe migraines for two weeks. Yeah. 182 00:10:40.559 --> 00:10:44.960 Yeah, so certainly we've got to get that evaluated and 183 00:10:45.039 --> 00:10:45.559 checked out. 184 00:10:45.919 --> 00:10:48.039 Yeah, Okay, we're going to take a break and then 185 00:10:48.080 --> 00:10:51.279 we'll come back and we'll answer a couple more questions. Anything, 186 00:10:51.440 --> 00:10:55.440 last comments before we take a break. No, great question, perfect, Yes, 187 00:10:55.480 --> 00:11:10.080 And just those questions, Luke and Tiffany, we really appreciate them. Okay, 188 00:11:10.200 --> 00:11:13.159 we're back. I hope you hung with us after the break, 189 00:11:13.639 --> 00:11:18.039 And so we have a couple more questions from our listeners. Again, 190 00:11:18.080 --> 00:11:20.919 these are probably actually Karen's listeners, but thank you very much. 191 00:11:20.960 --> 00:11:23.960 I hope you hang with the podcast as we transition 192 00:11:24.360 --> 00:11:27.159 and make the transition. And so I mentioned that we 193 00:11:27.279 --> 00:11:30.600 have people all over the world listening to us, mainly 194 00:11:30.639 --> 00:11:33.440 from the United States. So this next question is from 195 00:11:33.679 --> 00:11:37.159 Violet from Dallas, and Violet didn't say how old she 196 00:11:37.279 --> 00:11:39.360 is or what the exact situation she is, but she 197 00:11:39.399 --> 00:11:44.200 said my dog is fat, that she have menopause, And 198 00:11:45.000 --> 00:11:48.919 we tend to answerpomorphize that means we put human characteristics 199 00:11:48.960 --> 00:11:52.279 on dogs. And so this is kind of thinking, Okay, well, 200 00:11:52.279 --> 00:11:55.519 I'm getting older and maybe having some menopause symptoms. Probably 201 00:11:55.559 --> 00:11:58.120 I don't know how old Violet is or her situation. 202 00:11:58.200 --> 00:12:01.720 I'm not her provider, and you know, kind of transposing 203 00:12:01.720 --> 00:12:04.360 this onto the dog who's also gaining weight. And it 204 00:12:04.399 --> 00:12:06.840 turns out dogs don't have menopause. So the way they 205 00:12:06.879 --> 00:12:10.639 go through cycles and the way they're ovaries and uterus 206 00:12:10.639 --> 00:12:13.799 work is that they never really extinguish all of the 207 00:12:13.840 --> 00:12:19.600 population of eggs and hormones and have the depletion of 208 00:12:19.639 --> 00:12:23.200 the ovaries and hormones, which then caused the feedback loops 209 00:12:23.200 --> 00:12:27.759 of the pituitary to go crazy. So the weight gain 210 00:12:27.879 --> 00:12:31.120 in dogs. Unfortunately in America, we tend to have really 211 00:12:31.159 --> 00:12:35.639 heavy dogs, and that is also reflected in the human population. 212 00:12:35.879 --> 00:12:38.840 But so I'm curious like that, how do we know 213 00:12:38.919 --> 00:12:44.840 if a dog has Yeah, so menopause, So we're not 214 00:12:45.120 --> 00:12:45.840 so menopause. 215 00:12:45.840 --> 00:12:47.080 I thought you were going to ask me if they're 216 00:12:47.120 --> 00:12:51.399 overweight or not. So if they're overweight dogs, you should 217 00:12:51.440 --> 00:12:53.919 be able to feel their ribs, but not see their 218 00:12:54.000 --> 00:12:56.080 ribs as kind of a good standard, they shall also 219 00:12:56.240 --> 00:12:58.879 have a little bit of a waste, but for menopause. 220 00:12:58.879 --> 00:13:02.720 So we actually and dogs can do really things that 221 00:13:02.759 --> 00:13:05.200 you can't do in people. So a lot of studies. 222 00:13:05.200 --> 00:13:07.759 We can actually put them in a kennel and for 223 00:13:07.879 --> 00:13:11.360 twenty four hours, seventy two hours, seven days. We can 224 00:13:11.720 --> 00:13:14.120 know exactly how many calories we're giving them. We can 225 00:13:14.120 --> 00:13:16.679 collect their p and poop so we know exactly what's 226 00:13:16.679 --> 00:13:20.320 coming out of them. We can do culture's DNA analysis 227 00:13:20.320 --> 00:13:24.360 on the feces. We can do like crazy things analysis. 228 00:13:24.399 --> 00:13:27.440 So we can also do hormone levels and actually do 229 00:13:27.639 --> 00:13:31.120 monitoring of hormone levels every hour for seventy two hours 230 00:13:31.639 --> 00:13:35.360 and every week for five years in a research setting, 231 00:13:35.399 --> 00:13:37.720 which would be really really difficult to do in humans. 232 00:13:37.759 --> 00:13:43.080 So we actually have much much more fine granular data 233 00:13:43.200 --> 00:13:46.039 in a lot of our animal species because we can 234 00:13:46.080 --> 00:13:49.919 do better, more detailed research that you really could never do. 235 00:13:49.840 --> 00:13:50.799 In a huge female. 236 00:13:50.879 --> 00:13:53.600 Dogs have estrogen, yes, so they do cycle and they 237 00:13:53.600 --> 00:13:56.519 have eggs. But the whole menopause system is that the 238 00:13:56.519 --> 00:14:00.639 ovaries get depleted and then they stop producing the hormones, 239 00:14:00.639 --> 00:14:04.000 which then the pituitary gland goes crazy and tries to 240 00:14:04.039 --> 00:14:06.679 get the body to produce more and more sex hormones 241 00:14:06.759 --> 00:14:10.279 because the ovaries have kind of burned out, and dogs 242 00:14:10.320 --> 00:14:13.039 never get to that burned out station. There are situations, 243 00:14:13.039 --> 00:14:15.720 so you can actually have a very old dog that's 244 00:14:15.759 --> 00:14:19.200 still going through heat cycles metabolically. They may not be 245 00:14:19.200 --> 00:14:22.720 able to get pregnant because of the nutrition and variety 246 00:14:22.720 --> 00:14:25.399 of other reasons, but they can still cycle, so they 247 00:14:25.440 --> 00:14:28.720 still have the hormones at the appropriate levels. And so 248 00:14:28.840 --> 00:14:33.120 menopause is not really the lack of reproduction. It's the 249 00:14:33.200 --> 00:14:36.399 lack of sex hormones and the balance in the body. 250 00:14:36.120 --> 00:14:38.759 And those sex hormones among older dogs start to drop 251 00:14:38.799 --> 00:14:41.120 off just the same way as with they do. 252 00:14:41.240 --> 00:14:44.159 But yeah, so in humans, as we age, our hormones 253 00:14:44.159 --> 00:14:47.559 and males and females drop and pretty much all the 254 00:14:47.600 --> 00:14:51.240 hormones drop, so melatonin and thyroid and everything, and that 255 00:14:51.320 --> 00:14:54.519 absolutely does happen in dogs. Dogs only live nowadays about 256 00:14:54.559 --> 00:14:59.360 fifteen years, but absolutely there's an age related decline, and 257 00:14:59.440 --> 00:15:01.320 some of that we don't even understand. So now we 258 00:15:01.399 --> 00:15:05.879 have a geriatric hormone imbalance that seems to respond to melatonin. 259 00:15:05.960 --> 00:15:09.240 So it's a geriatric hymns is what we've been calling it. 260 00:15:09.799 --> 00:15:12.840 But that's still not a menopause situation. So for instance, 261 00:15:12.840 --> 00:15:15.960 twenty percent of large breed dogs over thirty pounds will 262 00:15:16.000 --> 00:15:20.480 have true hypothyroidism, and up to forty fifty percent of 263 00:15:20.519 --> 00:15:23.639 small breed dogs as they get older will have cushions 264 00:15:23.720 --> 00:15:26.799 or atypical cushions, which we now cause this call this 265 00:15:26.960 --> 00:15:33.000 a geriatric hymns melotonin responsive hormone imbalance, but it's not 266 00:15:33.039 --> 00:15:33.799 true menopause. 267 00:15:33.919 --> 00:15:37.039 To me, it seems like we don't really know. No, 268 00:15:37.159 --> 00:15:41.360 I think we absolutely do. Flashes and all of those 269 00:15:41.600 --> 00:15:44.679 symptoms you can't really assess in a dog, right, I mean. 270 00:15:46.000 --> 00:15:47.799 Correct, I mean they can't tell us if they're having 271 00:15:47.799 --> 00:15:50.200 a hot flash, but they're not panting and things like that, 272 00:15:50.360 --> 00:15:54.919 except our older dog, which that's another story. But we 273 00:15:54.960 --> 00:15:57.279 actually do know for sure. So if you call menopause 274 00:15:57.360 --> 00:16:00.639 like the symptoms of menopause, they can't really tell us that. 275 00:16:00.679 --> 00:16:02.759 But if we look at the hormone levels and what's 276 00:16:02.759 --> 00:16:06.360 happening with the ovaries, the uterus, and the pituitary, we 277 00:16:06.519 --> 00:16:10.840 know that what's happening in human primates and whales is 278 00:16:10.960 --> 00:16:15.960 very very different than what's happening in dogs, cats, horses, cows, 279 00:16:16.000 --> 00:16:19.840 so very very different. So the overweight from Violet who 280 00:16:19.840 --> 00:16:22.879 asked the question, going back to the original is from 281 00:16:22.919 --> 00:16:27.799 calories in calories out, American lifestyle, not menopause. 282 00:16:27.879 --> 00:16:30.919 And so that was a violent just maybe should cut 283 00:16:30.960 --> 00:16:32.080 back on the feeding a bit. 284 00:16:32.399 --> 00:16:35.120 Yeah, calories in calories out, so you know, it would 285 00:16:35.120 --> 00:16:37.600 be good to get up and move for both Violet 286 00:16:37.679 --> 00:16:43.000 and puppy dog. That's always good. So that would be excellent. Okay, 287 00:16:43.080 --> 00:16:45.679 so you want to do one more question or take 288 00:16:45.679 --> 00:16:46.879 a quick break here and come back. 289 00:16:47.000 --> 00:16:48.120 Who can do another question? 290 00:16:48.200 --> 00:16:52.159 I take that. The next question is from Amy who 291 00:16:52.720 --> 00:16:55.159 is in Alaska. So thanks for listening to us, Amy 292 00:16:55.159 --> 00:16:58.159 and Alaska, and she's fifty nine years sorry, fifty two 293 00:16:58.240 --> 00:17:01.720 years old. And this is pretty typical maybe for the 294 00:17:01.840 --> 00:17:08.200 Canadian and Alaska listeners, but Amy's question is is drinking 295 00:17:08.319 --> 00:17:12.039 as bad as people say or is this just another 296 00:17:12.279 --> 00:17:14.960 health panic? And I think this actually goes back to 297 00:17:15.119 --> 00:17:18.960 Tiffany's question, which is interesting that Tiffany is the one 298 00:17:18.960 --> 00:17:23.160 that's on GLP one and HRT and is taking Reddit 299 00:17:23.279 --> 00:17:26.960 seriously and very worried about what Reddit says, doctor Reddit, 300 00:17:27.440 --> 00:17:32.000 and Amy is the opposite, wanting to ignore the information 301 00:17:32.079 --> 00:17:34.240 from people. We don't really know who the people is, 302 00:17:34.480 --> 00:17:37.640 but it sounds like Amy wants to keep drinking. So 303 00:17:38.200 --> 00:17:41.960 I guess the question is is alcohol how much alcohol 304 00:17:42.000 --> 00:17:45.039 is good and bad? My belief I drink. I do 305 00:17:45.240 --> 00:17:47.880 love wine oftentimes this we have a podcast. Sometimes we 306 00:17:47.920 --> 00:17:50.880 have a glass of wine. But it is a neurotoxin 307 00:17:51.000 --> 00:17:52.559 alcohol absolutely. 308 00:17:52.599 --> 00:17:58.839 And the current recommendations is actually moved toward greater caution. 309 00:17:59.480 --> 00:18:04.400 And you know, the only entirely risk free behavior is 310 00:18:04.440 --> 00:18:07.839 no alcohol at all. Now, the reality of it is 311 00:18:07.880 --> 00:18:14.960 that the dietary guidelines for Americans from they did an 312 00:18:15.000 --> 00:18:18.240 evaluation from twenty twenty to twenty twenty five, and for 313 00:18:18.799 --> 00:18:21.680 men it's less than are equal to two drinks per day, 314 00:18:22.400 --> 00:18:24.759 and for women it was less than one drink per 315 00:18:24.839 --> 00:18:27.559 day and one drink equal a twelve ounce beer, five 316 00:18:27.559 --> 00:18:29.279 ounces of wine, or one and a half ounces of 317 00:18:29.279 --> 00:18:33.119 some distilled liquor. And the reason that there are differences 318 00:18:33.160 --> 00:18:37.319 among sexes is because there was a trending toward cancer 319 00:18:38.119 --> 00:18:41.880 among women who went beyond one alcoholic beverage day. So 320 00:18:42.920 --> 00:18:45.359 it's important to point out that, you know, the US 321 00:18:45.440 --> 00:18:49.960 Surgeon General Advisory says, this is a toxic substance that 322 00:18:50.000 --> 00:18:51.279 you're taking into your body. 323 00:18:52.079 --> 00:18:55.680 So two added little comments here. So one is five 324 00:18:55.720 --> 00:18:57.799 ounces of wine is not very much. When we go 325 00:18:57.839 --> 00:18:59.759 to restaurants, they all ask us if we want to 326 00:18:59.799 --> 00:19:02.480 see sounds for nine ounce poor so they don't even 327 00:19:02.519 --> 00:19:05.039 offer a five ounce por So the amount of alcohol 328 00:19:05.079 --> 00:19:09.279 that's considered safe is really small compared to what most 329 00:19:09.279 --> 00:19:12.400 of us drink. The other kind of funny thing I 330 00:19:12.440 --> 00:19:16.279 think about this, we have various acquaintances, and you know, 331 00:19:16.279 --> 00:19:18.920 if you're taking vitamin supplements or going to the METI 332 00:19:18.920 --> 00:19:22.039 spot to get IV treatments so that you can drink 333 00:19:22.079 --> 00:19:24.680 more wine and more alcohol, you know, you're kind of 334 00:19:24.680 --> 00:19:28.960 taking a toxin and then you know, over amping the 335 00:19:29.920 --> 00:19:32.359 recovery phase on the back end, and that's kind of 336 00:19:32.400 --> 00:19:35.079 an illogical process. So if you really want to be 337 00:19:35.079 --> 00:19:37.160 as healthy as possible, don't drink alcohol. 338 00:19:37.279 --> 00:19:41.519 Well, major healthcare organizations have shifted their opinions, and those 339 00:19:41.559 --> 00:19:45.240 opinions have shifted more recently. The American Heart Association basically 340 00:19:45.319 --> 00:19:49.319 says avoid alcohol entirely, and the American Cancer Society says 341 00:19:49.359 --> 00:19:53.440 it's best not to drink alcohol. The World Health Organization 342 00:19:53.559 --> 00:19:56.400 says there's no level of alcohol consumption that's safe for 343 00:19:56.480 --> 00:20:01.480 your health, and of course, the American Diabetes Associated advises 344 00:20:01.519 --> 00:20:06.319 against drinking it, the point being that it is a toxin, 345 00:20:06.599 --> 00:20:09.079 and if you are going to drink alcohol, you should 346 00:20:09.119 --> 00:20:13.519 do it in moderation and certainly take into consideration the 347 00:20:14.559 --> 00:20:19.920 current findings from our recommendations from the dietary guidelines. 348 00:20:19.960 --> 00:20:22.839 So I used to lecture for a living traveling all 349 00:20:22.839 --> 00:20:25.559 over the country and internationally, and one of the things 350 00:20:25.599 --> 00:20:29.200 I would point out is with various medications for allergies 351 00:20:29.240 --> 00:20:31.240 and dogs have a lot of side effects. And so 352 00:20:31.279 --> 00:20:33.519 I'd ask the audience, well, you know, this is like 353 00:20:33.640 --> 00:20:37.680 asking your provider how many cigarettes is safe? So what's 354 00:20:37.680 --> 00:20:41.039 the different way? How many cigarettes is safe? Doctor Miller? Zero? Okay, 355 00:20:41.039 --> 00:20:43.400 So how many drinks are safe? 356 00:20:44.000 --> 00:20:47.039 The shift is now towards zero. Now it's interesting for our. 357 00:20:47.079 --> 00:20:49.920 So we like wine and we like to drink, is 358 00:20:49.920 --> 00:20:52.400 why we are so hesitant to give up. But the 359 00:20:52.440 --> 00:20:53.720 answer the question is zero. 360 00:20:54.160 --> 00:20:57.880 Well, it's also interesting for our Canadian listeners, which I 361 00:20:57.880 --> 00:21:01.440 think they'll find this interesting. Is at in twenty twenty three, 362 00:21:02.359 --> 00:21:06.160 Canada their guidelines went to a continuum of risk approach 363 00:21:06.720 --> 00:21:10.440 rather than a single threshold approach, so they consider the 364 00:21:10.480 --> 00:21:14.920 Canadian entities consider low risk less than two standard drinks 365 00:21:14.960 --> 00:21:18.799 per week week, moderate risk was three to six drinks 366 00:21:18.799 --> 00:21:22.000 per week, and increased high risk was greater than are 367 00:21:22.000 --> 00:21:25.720 equal to seven drinks per week. So kind of differing 368 00:21:25.759 --> 00:21:31.799 opinions around the world on this topic, but culturally. 369 00:21:31.359 --> 00:21:34.440 The ultimately how many cigarettes are saved zero? How many 370 00:21:34.559 --> 00:21:36.559 drinks of alcohol are safe? Zero? 371 00:21:36.680 --> 00:21:38.880 Alcohol is a Grade one carcinogen. 372 00:21:39.000 --> 00:21:40.480 There you go, So okay, we're going to take a 373 00:21:40.559 --> 00:21:42.359 quick break and when we come back, we're going to 374 00:21:42.400 --> 00:21:44.480 go a little bit faster and try to get as 375 00:21:44.519 --> 00:21:46.839 many questions in as we can. Thank you very much, 376 00:21:46.920 --> 00:21:51.000 Amy and Violet for sitting us questions and Alaska from Amy, 377 00:21:51.039 --> 00:21:52.720 I think that's just kind of part of Canada. So 378 00:21:52.960 --> 00:21:57.000 there you go saying okay, listen stay tuned, come back, 379 00:21:57.119 --> 00:22:11.519 and we'll be right back. All right, we're right back. 380 00:22:11.559 --> 00:22:15.240 We're going to take a few more questions and a 381 00:22:15.240 --> 00:22:16.920 couple of breaks in between, but we're going to go 382 00:22:16.920 --> 00:22:18.920 a little bit faster. So this next question is from 383 00:22:18.960 --> 00:22:23.440 Brenda from Baltimore, who's actually says she's turning sixty this week, 384 00:22:23.839 --> 00:22:30.480 so bretty birthday, Happy birthday, Brenda. So Brenda wants to 385 00:22:30.519 --> 00:22:33.400 know can I get addicted to my GLP ones? 386 00:22:34.319 --> 00:22:36.880 Yeah, there's been no evidence at this point to show 387 00:22:36.920 --> 00:22:41.119 that GLP one is having any addictive property at all. 388 00:22:41.440 --> 00:22:44.440 So that I think going taking a step back is 389 00:22:44.519 --> 00:22:48.039 what's the definition of addiction. So if you stop taking 390 00:22:48.079 --> 00:22:50.720 the GLP ones, will you have withdrawal and get sick 391 00:22:50.759 --> 00:22:54.240 like a heroin addict? No? Probably not, most likely not 392 00:22:54.319 --> 00:22:55.279 based on everything we know. 393 00:22:55.519 --> 00:22:59.119 But if you have not modified your diet your exercise regimen, 394 00:22:59.519 --> 00:23:03.160 then clearly once the GLP one A washes out, then 395 00:23:03.720 --> 00:23:09.440 certainly dositiety and diet and exercise returning to get and 396 00:23:09.480 --> 00:23:11.480 you have to continue to moderate that. 397 00:23:11.759 --> 00:23:16.559 So if you lost weight with the GLP one and 398 00:23:16.599 --> 00:23:19.359 you stop it, you will gain weight unless you've changed 399 00:23:19.440 --> 00:23:24.039 your lifestyle with exercise, food and all of those things. 400 00:23:24.079 --> 00:23:28.160 So is that addiction? You know, again, the definition of 401 00:23:28.160 --> 00:23:31.920