How To Optimize Your Health and Hormones, and Stay "Hard To Kill" with Dr Jaime Seeman, OB/GYN

welcome to the plant free MD podcast with Dr Anthony Chaffey where we discuss diet and nutrition and how this affects health and chronic disease and show you how you can use this to optimize your health and happiness both mentally and physically hey guys just want to take a second to thank our sponsor at carnivore bar I don't promote many products because honestly all you need to be healthy is to just eat meat for those times that you're out hiking road tripping or stuck at work and you want nutritious snack that is just meat fat and salt if you want it the carnivore bar is a great option so I like this product not because it's just pure meat but also because I want the carnivore Market to thrive as well and the more we support meat only products the more meat only products that will be available in the mainstream so if this sounds like something you'd like to get behind check it out using my discount code Anthony to get 10 off which also applies to subscriptions giving you 25 all right hello everyone it's uh Dr Chaffee I'm here again with another episode of the plant free MD and here with another plant free MD Dr Jamie Seaman thank you so much uh Dr Seaman it's so wonderful to be here thank you yeah you're very welcome well it's great to see you again um I was on your podcast some months ago and I'm glad to have the opportunity to to have you on mine so thank you very much the same the same yeah so um for people who haven't come across you can you just give us a brief uh introduction of yourself and what you do yeah so I work in my everyday life as an OB GYN so I deliver babies I do Gynecology surgery which is like hysterectomies pelvic floor incontinence um surgeries and I really take care of women across their whole lifespan so you know I see everything from teenage girls to um very post-menopausal women but a little bit about my story is I grew up in the middle of the United States so in Nebraska like in the the cornfields of the middle of the United States and I was an athlete and I played college softball for the University of Nebraska and I pursued a degree in nutrition and exercise science while I was there and um you know so I don't want to say I was like forced to work out and uh you know but but I was and after medical school or after college I went to medical school I met my husband got married went to medical school and this was this first kind of time in my life where all of a sudden I was going from being very Physically Active to being very sedentary I'm sitting in the classroom for long periods of time I'm sitting in the library for long periods of time and it was kind of the first time in my life where if I wanted to work out like I had to figure out what to do on my own so I went through actually a little stint with like P90X but um this was the first time that I started to struggle with my weight and I had this degree in nutrition and all I knew was to count calories and eat low fat so in medical school I was literally sitting in the library like counting pretzels counting Goldfish crackers and just trying to stay on this calorie restricted diet and I mean it worked it I mean it works to a degree if you you know restrict it and then we decided to start a family so I got pregnant in medical school with my oldest daughter and failed my glucose testing had like a eight pound two ounce baby my first pregnancy and then right after she was born I felt horrible and I was diagnosed with postpartum hypothyroidism and um during that pregnancy I did exercise but I mean I will fully admit like my diet was uh I mean not that great and then I had two more pregnancies during residency and once again failed my glucose testing uh my other girls were eight fifteen and eight pounds 13 ounces so good sized babies and uh after my third daughter was born I had a real bad tragedy happen in my life I lost one of my best friends in the middle of her pregnancy and um was diagnosed with pre-diabetes around that time and it was just this very pivotal moment in my life where I decided that I had to live my life very differently you know I feel like his positions we really need to be like the billboard of what health looks like and so many doctors are not that and for me that just didn't sit Well with My Soul so in 2015 I set out on trying to fix my nutrition I had this nutrition degree in a medical degree like you would think I knew exactly what I was supposed to eat but I didn't and I started with kind of a Whole 30 diet to write Whole Foods that sounds like a no-brainer and then I went to paleo and then I kind of settled on the ketogenic diet and then there was evolutions of my diet in 2018 I really started to eat more carnivore and um my own health Journey my pre-diabetes is long gone I'm not on thyroid medication I started lifting weights again in 2018 I mean my health is the best it's ever been in my adult life but what started is really changing my nutrition really changed every aspect of my life it changed the way I parent it changed me as a wife it changed the way I practiced medicine I went back to fellowship uh you know and and did additional training and integrative medicine and made became one of the first board-certified ketogenic nutrition specialist in the U.S and you know I'm really on a on a path now to change the way that we practice medicine to help more people well that's awesome I mean that's a fantastic background I'm very sorry to hear about your friend um and that's absolutely tragic especially during a pregnancy so I'm very sorry to hear that um but it's you know amazing that you're you're like you say like one of the first you know uh sort of ketogenic um you know physicians in in the U.S I think that's great that that's even an option for people to uh you know to study more and to and further the practice that way so hopefully that'll become a bigger thing um and you do you incorporate this into your your practice as well as an OB or is it is there like a side practice that that comes up in yeah no I I only have one Medical Practice I don't do telemedicine so it's just my face-to-face patience but I do practice differently than you know most OB gyns I every single you know new patient that comes in we talk about their diet what have you eaten in the last 24 hours we talk about if they're exercising we talk about how they're sleeping because all of these things are going to give me little tips and kind of ideas about what might be going on right they're having cycle dysregulation or they're missing their periods or you know whatever it is I try to connect those things back to you know how they're living and and I think those things have such a more profound impact on outcomes than you know traditional medicines and things like that I practice Western medicine I write prescriptions okay I write prescriptions for birth control pills these things have a time and a place but I think for the vast majority of people if you haven't optimized what I consider to be like the Five Pillars that I wrote about my book if you haven't optimized those things you're just I mean and you're you're trying to throw a Band-Aid on a situation and it may help you short-term it's not going to help you long term okay so what are those five pillars that you discuss in your book yeah so I I wrote a book this last year that came out called hard to kill and you know the title of the book I feel like is very self-explanatory but um when I talked about the the passing of my friend you know she died at age 29 she was she was very healthy she was a mom of two she died of a disseminated fungal infection called coccidiomycosis and you know the doctors actually kind of missed the diagnosis and it was too late and for me it was this kind of Reckoning with my own mortality that we really don't know how long we have you know on this earth now statistically speaking most people listening to this podcast are going to live into their seventh or eighth decade of life and then something will kill them and the things that are most likely to kill them are cardiovascular disease cancer or some sort of neurologic disease and so you know for me this kind of hard to kill idea was what are the basic foundational things that I think everybody should you know be doing to be hard to kill knowing that at any moment when I get off this podcast something could take me out and that sounds very like Grim you know to somebody listening right now but that's just the reality you know you just you just literally don't know I don't know there's maybe somebody that knows but it's not me um so the Five Pillars uh of hard to kill the first one is nutrition what we eat this is something we do every single day usually multiple times per day and when you want to make changes in your life this is actually something where you can see changes rather quickly I mean we see shifts in glucose levels insulin levels within you know a couple days of initiating a new diet we see microbiome changes within a week so this is something that can really impact your health and when it comes to nutrition and we can we can come back to this pillar and dive into it and talk more um you know we really need to prioritize protein in the diet for women because they're under eating that we need to prioritize high quality fats and we have to be really cautious about carbohydrate consumption because it's the one macronutrient that that there is an upper threshold that's that's probably dangerous for most people um the second pillar is exerciser movement our bodies were designed to do physically hard things and we live in a day and age where we drive cars and we have elevators instead of stairs we can literally ubereats food like from our phone straight to our front door like we don't have to work hard to do really anything these days and our bodies were designed to do hard things because it enrichs our you know muscular system our our bone system it helps our brain work better and you know back in the day people had to physically hunt for their food we don't have to do that so now we have like things called gyms which is just like you know crazy but um but in this pillar we really talk about you know movement that is going to be the most time effective you know I'm a busy mom and professional I don't have like four hours a day so you know the most bang for your buck is doing resistance training and doing true like high intensity interval work or Sprint work and women really need to get away from the long bouts of cardio and running and ellipticals because it's really not helping your body composition it's not making you harder to kill um the third pillar is sleep and you know we think it's just this passive thing like we lay down close our eyes but sleep really plays an important aspect in our health our hormonal Health our circadian rhythm is so important um and so uh that is its own pillar the fourth pillar is stress and stress resilience so understanding how to train is one thing understanding how to recover from our lives is even more important so creating resiliency not only physically but mentally and spiritually as well you know this this chapter and pillar kind of talks a lot about mindset which I think is kind of the magic sauce you know most patients can come into my clinic and tell me oh yeah I'm supposed to you know eat this way and move this way but who are the people that are successful and I think it really comes down to their internal uh language and the language that comes into our brain comes out in action in our life and so it's it's really uh a very pivotal thing that you have to get and you have to understand to make these changes in your life and then the fifth pillar is I call it environment but I really describe it as like people places and things so the people you hang out with um the people closest to you have an impact on your health um the places you live like our air quality water quality you know Australia versus Nebraska very you know could be very different and then the things are you know Plastics and you know phthalates and endocrine disruptors and for women like I read some study on average we use 30 different chemicals on our body every day um and these are you know might seem like little minute things but if you're really trying to optimize your health and you're really trying to be hard to kill um we have to take a survey of you know the products that we're using and you know if they may be contributing or harming our health yeah absolutely um that's something that um I've sort of heard more and more about people are going towards you know unscented soaps and and not using all the perfume and sense and and scented uh lotions and things like that what are some of those that that would um mess with your endocrine system yeah well you know the one that everybody's heard of is like BPA or bisphenol a but the truth is is that a lot of you know anything that um and it's not just Plastics people think of like plastic food storage containers but it's crazy now manufacturers are using Plastics in our clothing um thermal receipt paper is really high in BPA um and these things are easily absorbed through our skin and with the receipt paper a really interesting fact is that if you put hand sanitizer on your hands before you touch the thermal receipt paper or after it increases the absorption of the BPA tenfold and so you know then manufacturers pull BPA out of products but they're just using you know a different BPA they're you know they're still using these chemicals and um I had um uh somebody on the podcast that uh that that talked about we had spent an entire podcast talking about this I wrote a book called estrogenation and it's crazy when you look at for instance um in rats there's a specific chemical that if you infuse into these rats 100 of them get endometriosis so it might seem just like this you know kind of one-off thing but these chemicals really can have a profound they can create profound problems inside of our bodies these aren't you know these are modern day technology that we've created and in the book I kind of touch on this too that you know technology is amazing the fact that you and I are sitting on this computer right now halfway across the world talking to each other like this is awesome but it all everything comes with a trade-off right everything comes with a trade-off cars are awesome but they you know emit exhaust um your water bottle is great because you're going to stay hydrated but it's maybe leaching chemicals into your water there's a trade-off for absolutely everything it's like when I sit down and discuss risks and benefits of people you know we have to weigh both sides and um so for women in particular like the Cosmetic industry is so unregulated when it comes to what they can put in these products so you know it's uh and some these days with social media everything's coming from China and it's even less regulated but but you're like your hair products your cosmetic products that you're putting directly on your skin like those those are really things you have to pay attention to your laundry detergent you know that you're washing your clothes in and then the biggest one for me is like food storage so really converting everything to like glass or stainless steel um looking at your cookware because these are things you use really often um that really could be doing a lot of damage to your body yeah yeah and I think that's something that that completely gets overlooked who don't think about that sort of stuff there's you know some of the maybe with the Plastics you know maybe not not heating things in plastic containers or using plastic water bottles and things like that but other than I think that's where it stops for most people if they even go that far so definitely yeah you need to think well when it comes to when it comes to clothes I shared a study recently on men if you put enough polyester near the testicles of men you can render them infertile because it doesn't allow the this it doesn't allow the scrotum to to cool down like the reason that the testicles are away from the body is because they have to cool down uh to uh create spermatogenesis and so I shared this study that they basically took this polyester sling and put it around the scrotum and it made 100 of these men infertile within a couple months now it was completely reversible they were actually studying it as a male contraception method but I mean this is like this is real world stuff for me you know being an up attrition like when a couple can't get pregnant it's like okay what kind of underwear is he wearing like I mean it really could be making a difference yeah it was a bunch of sailors are going to go out and get like polyester underwear now you know there's um some of my dad was telling me there was like there was an area of like these like um you know nuclear um you know battleships and and carriers and things like that and they had these nuclear reactors and and apparently you could go to like a certain area and or maybe like radio show anyway something admitted like you know some low enough frequency sort of radiation and all these guys whether it worked or not they apparently did this they just walked up there and just stood there for like a minute just a radiated their all their sperm and everything like that then went on Shore leave and like they use that as like temporary birth control or control that's that's going to catch up to you that's that's gonna have some long-term effects I'm sure but yeah um so speaking about um the other pillar on you on nutrition um so are you counseling your your patients what do you normally counsel them is it is it only for like a keto thing or or what do you what do you suggest for your patients uh we do some baseline lab work and we just say okay you know where is your metabolic Health at so we look at their fasting glucose and insulin levels we look at their fasted lipid panel um specifically looking like at their triglycerides and triglyceride to HDL ratio not necessarily the LDL as much if there's any you know uh abnormalities then we may get an advanced lipid panel for like an advanced cardiac panel looking at some of their other you know markers particle sizes lipids a lot of that is for my patients that come to me that are keto carnivore and that have some sort of question from you know an outside provider about what's going on um and then you know we may look at some you know vitamin nutrient things that it really just depends kind of what their initial complaint is or what you know their their goals are um we never want to order like tons of lab testing that we're not going to use but I think in a basic sense you know we look at what's their blood pressure you know what's their what's their weight or body composition what are these fasted Labs look like and then we kind of decide you know what their goals are and what might be optimal for them um I don't think that everybody needs to be in ketosis I think that there are people that can eat a low-carb diet and do really well um you could even argue on the flip side of that that there's some people that could probably eat high carb low-fat diets and Thrive I think that number is probably very small but um but we basically you know figure out where they are and you know where do we go from here um when we transition people to lower carb diets um it's most helpful to titrate the carbs down slowly um because if you go from eating 300 carbs a day to eating 30 carbs per day um with the quick reduction in insulin they can get a lot of electrolyte problems in the first week or two that makes it less likely that they stick with it um so you know we kind of go go slow we add electrolytes we work on hydration and these other types of things but I would say for the vast majority of patients I do recommend what would be by today's standards considered low carb you know even some of my CrossFit athletes you know were doing you know maybe 100 or 150 or something for performance but for for most people it's it's pretty low carb and um I have carnivore patients as well um you know that don't eat any plants or carbs and uh we we check their labs and we look at their biomarkers and if they feel good and they're functioning good and the labs look good then you know we continue with the plan and if it's not then we then we change something oh great and um is that so and that's how you approach all these and most of these would be pregnant women so um this is something that that comes up a lot you know is this is even keto safe for um pregnancy is carnivore safe for pregnancy what are your thoughts on that yeah I mean the real answer is we don't know because you know we're not going to be able to do a randomized control trial in pregnancy you know telling these women to eat a carnivore diet and these women to eat a ketogenic diet and these people to eat a you know vegan diet or whatever it is and so a lot of the data that we have is very observational now when we look at the recommendations for pregnancy the lower threshold recommendation for carbohydrate consumption in pregnancy is 175 grams um which is probably lower than than some people are eating but the number uh isn't really based in science it is it's somewhat arbitrary in the sense that they've calculated what the kind of like obligatory use of glucose is uh by the fetus and by the mom and the fact that the mom's body is growing and then they kind of look at two standard deviations and that's how they came up with 175. I think that our goal in pregnancy is not only normal glycemia but normal insulin levels and let me kind of break this down a little bit we know from data in the HAPO trials this was the hyper glycemia adverse outcome trials in pregnancy that glucose and outcomes like NICU admission large babies risk of C-section risk to your baby long term like your baby developing type 2 diabetes in their lifetime is a linear relationship it's a linear relationship higher the glucose levels the higher the insulin levels the more risk there is now obviously as a doctor I have to pick a cut off when we're diagnosing something like gestational diabetes to say like okay here's the line you people have a problem you people don't but because it's a spectrum because it's this linear relationship there's people that get missed right they can still still have problems and so when it comes to carbohydrate consumption it's not just normal glucose levels we want if a woman comes to me and I have her test her blood sugars and she's eating a you know High carbohydrate diet and her numbers look normal the question I'm always asking myself is at the cost of what amount of insulin because the pancreas puts out about 30 percent more insulin in the first trimester of pregnancy and it develops physiologic insulin resistance from these subtle hormones in the third trimester and the reason that this is a physiology process is because the body is wanting to make sure that there is a continuous supply of both glucose and fatty acids that are shuttled across the placenta for the baby and so you know really the the placenta is what I call like team fetus it's not you know if there's adverse problems for the mom too bad we want to make sure this baby survives and so um and so what can happen is that you know your body will just put out more and more and more and more and more insulin just like it does outside of pregnancy um to to keep the the glucose levels you know within range but hyperinsulinemia so even if your blood sugars look normal hyperinsulinema increases the risk of preeclampsia which is you know a very uh dangerous disorder for pregnant women to get and we're get we're seeing it on the rise gestational hypertension of pregnancy um it still increases the risk for large babies risk of shoulders so C-sections and and a lot of risks for your baby long term because hyperglycemia and hyperinsulinemia create epigenetic modifications meaning they actually alter your baby's DNA turning this you know certain genes off and on and these are inheritable conditions so basically you're altering your uh your family for for decades and centuries to come you're altering the DNA um so diet and pregnancy is very important you know to say that 175 and no less than that is the recommendation could be causing harm and in medicine right we say Do no harm I think there are patients you know I've had gestational diabetic patients that certainly have to eat way less than that to control their blood sugars and I have patients that come into pregnancies have been you know very healthy doing well on low carb diets you know prior to pregnancy and they ask can I continue and when we look at the Institute of medicine recommendations they admit in The Institute you know of medicine recommendations that if you are eating adequate dietary fat and protein carbohydrates are non-essential really for life and for pregnancy now does that mean that women should be zero carb I don't know that that's the answer um you know I think that we have to be careful about you know metabolic stress and physiologic stress and the pregnancy um but I think that there are people that do really well in pregnancy on low carb diets and um you know I wish we could see more of this published data but it's really observational at this point I mean that's just the the real answer yeah well I mean it's at least interesting at least they're saying that you know that um you know that you don't necessarily need it and that's um you know it's kind of it's uh yeah interesting they said that you know it's it was also um I found it interesting you're talking about the epigenetics and how this can have Downstream effects and be inheritable I I'm just randomly recently saw a video on some uh research done I think it's like in the 20s and 30s it was called pottinger's cats and this guy was doing research on cats and like actually like exploring TB and he wanted to like take out their adrenals they thought there was you know people that had like adrenal issues were more susceptible to tuberculosis so he's doing this in cats and he found that the cats that they were feeding like cooked meat to just me weren't really surviving these surgeries these adrenalectomies and but the ones that were having just raw meat were doing fine and they were doing very well and they were healthier in other metrics so we actually switched course of his entire research and just started studying um the the effect of these nutrition on these cats and just had cats just eating cooked meat and just eating raw meat and they found that the ones you can cook meat were not healthier for a lot of different reasons but then the next Generation they were physically structurally different they were generally smaller stature their brains and their psychomatic Arch weren't completely formed and and the bone mineral density or bone mineral percentage was actually much lower is like half of what it would normally see and then in the third generation it was even worse and I think they had only had like three percent uh bone mineralization in the third generation of the just cooked meat it's still meat it's just cooked meat and um and then the bones were like almost spongy like on foam rumber rubber and they had all these fractures and breaks and and that after that point they were sterile um and they they couldn't uh they either couldn't procreate or they had stillbirth and um they said that they could reverse that by putting them back onto uh a raw meat diet but they finally took four generations to to get them back to where just the the Raw food um cats were you know at the beginning so I thought that was very very interesting and it just sort of demonstrates the effects of of these knock-on effects that you were describing yeah I think it's fascinating I mean I think our bodies are uh they're a brilliant species they're always trying to adapt you know to our environment and our stressors and things like that but um there there's real world ramifications of these things for for generations to come I mean it's not just like oh Grandma had diabetes and you know that was her story it's I mean your your DNA is but that but the other caveat with that that I want to say is that um we are finding that epigenetic modifications probably matter more than your your DNA written code so the good news is that you you have a lot of power you know the person listening right now like just because your mom smoked and drank and ate Cheetos her whole pregnancy like doesn't mean you're doomed um you yourself have you know the power to turn these switches off and on and um and and that will matter for your for your children so you're not just doomed but they do you have a profound impact on on your health yeah absolutely um and so have you have you noticed that these dietary changes can affect female hormones and fertility as well well infertility is a growing problem um in the in the country and really across the world um you know sperm is getting worse than men women are having a lot more ovulatory dysfunction another reason for infertility is um the ovaries in women basically determine the rate at which we age and so if we do things in our life you know like develop insulin resistance or smoke or whatever it is we can accelerate the Aging of the ovary and so we get poor egg quality poor egg quantity and a lot of hormonal problems you know that can occur and so um infertility is is a tough one because it's sometimes it's male based and sometimes it's female based but I think that nutrition does have a profound impact on on fertility and the ability to reproduce because we have these nutrient sensing Pathways in our body that are they're a requisite for life right so as women as a reproductive species our body every single month when we go through our menstrual cycle is saying is this a good time to reproduce and if it senses in any way that there is some sort of perceived stress now it doesn't know if your boss yelled at you or if you're not eating enough B12 right the cell just says I'm stressed and then it will you know send these signals that you maybe won't ovulate it won't create the endometrial lining how it's supposed to there will be problems that won't allow you to get pregnant and so that's why you know we say like the menstrual the menstrual cycle is like a Vital sign right um and so nutrition is important when we think about what nutrients are required to get pregnant and to grow another human you know we kind of touched on this idea that carbohydrates are probably you know non-essential we can make enough carbohydrates from protein and fat substrates now I also said you know is zero the answer I don't know probably not but um when it comes to protein um the minimum threshold for a pregnancy by The Institute of medicine is like uh you know 80 90 grams which is incredibly low when you think about the protein requirements required in pregnancy and so if you come into pregnancy not eating a lot of meat and protein and then suddenly having to increase the first trimester is brutal so you know I find that most women even my carnivore patients in the first trimester it is like they're like oh my gosh like I'm choking down you know this meat um and then fat and it's the type of fat we're eating we need you know really high quality fats we need things like eggs you can even eat organ Meats like small amounts of over but you know we need butter we need Seafood we need these these foods contain uh the right nutrients for a healthy pregnancy and when you tell a woman to eat 175 grams of carbohydrates it becomes mathematically and statistically impossible to get the amount of vitamin D and choline and iron and these other very very very essential things in pregnancy um and so you know that's where people who are wanting to get pregnant have to be you know really cautious when you're eating something like a lot of Wheat and Grains you know they they don't contain all the right nutrients you need and they come at the cost of a lot of calories and so that's why I'm kind of saying it becomes mathematically statistically impossible because you're going to have to eat a lot of calories to get that amount of nutrients and it can come with with um side effects Yeah well yeah and that and that makes perfect sense I mean if you're if you're trying to meet certain certain thresholds with your your protein and fat and you're trying to pack in 175 grams of carbs I think yeah you know somebody's got to give um and it could be your waistline you know and so yeah um yeah that's a problem yeah I mean even if you're just eating you know let's say you're eating fruits vegetables and you know a little bit of quinoa or something like that like that's it you would still like without eating processed carbohydrates like you're probably not going to hit 175 you know just eating blueberries and you know things like that so um you know these people are eating processed carbs and Wheat Thins and Goldfish crackers and bread and pasta and you know all of these things and in in pregnancy you know it's kind of a myth that you need uh to eat for two the caloric increase in pregnancy is maybe 100 calories in the first trimester 200 in the second and 300 and the third I mean that is a snack that is not you know and then in lactation breastfeeding maybe about 500 calories um and so it's really not that much more calories per se and so you know we don't want to encourage women we'll just eat more eat more eat more uh because that increases her risk for a lot of things like gestational diabetes and high blood pressure so you want to be eating Nutri done foods and when we say what are the most nutrient dense foods they are animal foods and they are the most bioavailable form you know that's easily absorbed and easily utilized in the body yeah absolutely my mom just think about when you're talking about you know birth birth weights and things like that remember just all my siblings there's five of us we were all like nine pounds eight ounces my brother was 10 pounds even uh my mom's five two she's this tiny little thing oh my god there was no way that was happening so like we're all C-sections all five of us were cesarean and so um yeah and we just yeah and I'm not saying I mean I'm maybe genetically I mean I'm not a small person I'm you know like five nine my husband's six two I mean maybe genetically I was supposed to make an eight pound fifteen ounce baby my suspicion though is that my one hour glucose test was over 200 and that baby came out uh I mean she was like a bowling ball uh so you know I mean that's the thing is you know when we talk about um excessive fetal growth or growth restriction even you know the the real question is looking at this baby is this baby meeting its growth potential is this baby the size it's supposed to be you genetically or is this due to an insufficiency of nutrients or blood flow to the placenta or over overfed with nutrients uh you know from the from the placenta yeah that makes sense um and then do you see have you I don't know if you check hormones and things like that I presumably do in um at least in fertility uh side of things what have you noticed um when people go change their diet dramatically maybe go keto maybe go carnivore are you seeing dramatic changes in or any changes in their hormonal health yeah so checking hormones is hard because every day of the month the hormone levels are going to be different from month to month they're going to be different from hour to hour they're going to be different so tracking you know hormones by by blood work is a little bit nuanced there right we have to interpret it where you're at the menstrual cycle from a fertility perspective there's a few points in the menstrual cycle that we'd like to check we typically check them around cycle day three so around cycle day three we're looking at FSH and LH um because if the FSH is real high it could indicate maybe some ovarian insufficiency or premature menopause if the LH to FSH ratio is abnormal it could indicate something like PCOS and then we're looking at estradiol production so you know is the estrogen really low I've seen that on people eating really low-fat diets or eating vegan or vegetarian diets that are really high in plant-based fiber material there are actually studies on this that you can eat enough fiber to create infertility because you drive your estrogens solo um but fiber is so vital it's just this vital nutrient that's just so important yeah hey like I said there's a trade-off for everything so um uh and so yeah so we look at estrogen um I I like to look at thyroid uh especially for somebody who's wanting to get pregnant it's that's not a recommendation by governing societies to check that but I think it's important um and then uh you can't look at progesterone until you get into luteal phase so the other time of the cycle I like to look at um hormonal production is luteal phase which is after ovulation usually around cycle day 21 to see if corpus luteum is producing enough progesterone to support a pregnancy now all these sex hormones estrogen progesterone testosterone are all made from something called pregnant alone which comes from cholesterol so all of our sex hormones are made from cholesterol so you want you know healthy amounts of of cholesterol in the system and um we can eat that when our liver can also make that um but I would say when we when we see dietary changes it kind of depends you know where they were starting from you know a patient with PCOS that I place on a ketogenic diet we see amazing improvements in their LH to FSH ratio normalization of estrogen levels normalization of testosterone levels um their glucose comes down their insulin comes down their lipid panel their blood pressure all things improve in those types of patients um in patients with like unexplained infertility those are a lot harder you know um and I think there's probably things we don't know about the microbiome and things like that that I think could be at play I did a whole podcast with a dentist talking about the oral microbiome and its association with pregnancy loss and things like that um which once again is involved with diet there's four bacteria in your mouth that can cause really bad pregnancy adverse outcomes and they're all fed by carbohydrates um there's one that's not there's one that's not um and so you know I think that your hormones can be affected by your diet now every woman comes into my office and they're like I want to balance my hormones I like it's like it's like nails on a chalkboard for me because if you through these nutrient sensing Pathways if you sleep well and eat well and don't over exercise and know how to understand and deal with stress you know take care of your autonomic nervous system your body will naturally balance your hormones it will do that and it will tell you that because you're going to have a normal menstrual cycle you're not going to have it in fertility like that is a sign that you're doing something right and so there's no way to magically manipulate these hormones there's there's too many inputs happening you know into it but I do think that diet you know has an effect that um you know it can change your it can change your hormone levels and and you should know that by by tracking your cycle yeah yeah great um and you know just talking about the oral biome and you mentioned microbiome as well um do you know much about that and and how that affects and keto and carnivore and things like that something that people ask quite a lot actually about the microbiome yeah yeah I don't I don't I think we're still finding out a lot um you know the uh the bacteria that I was talking about in particular so there uh there is a panel you can wear I don't do a lot of microbiome testing it's not a usual part of my practice I'll do some GI mapping and things like that but I just think there's so much we don't know yet that clinically I don't know you know how relevant it is but we do know that with dietary changes there is a shift in the microbiome in like less than seven days so it's actually very quick that this happens and um you know what is the most ideal you know bacteria to have I don't I think that's different for all of us um it's kind of like I said these epigenetic modifications your bacteria are are constantly trying to to shift and adapt based on what you're doing and most people are are pouring a lot of things down the hatch that are destroying good gut bacteria they're letting the bad bacteria flourish and it's causing you know a lot of problems where are actually more bacteria than we are human if you really want to be honest and when it comes to fertility like I said there are particular bacteria that can live basically you know everyone talks about the gut but everything that's down in the gut started in the mouth so um you know if you have poor done it's and it's one thing I look at when I'm talking to a patient you know as they're talking I'm looking at their teeth and their gums if they don't have a healthy looking mouth I can already tell you they've got gut problems they've got other chronic problems um it's a really easy thing to assess and you know Dentistry is a modern profession um people back in the day I mean everybody knows you know Western price and the work that he did like these people didn't have teeth problems and these days right we're going every six months get our teeth cleaned kids are having cavities or having to pull teeth and do all this crazy stuff but when it comes to fertility um there's a handful of bacteria that we know if we do saliva testing and you have them in your mouth they increase your risk for stillbirth first trimester pregnancy loss preeclampsia um all these adverse pregnancy outcomes which right it's like okay how can this bacteria in your mouth cause those problems down in your uterus well it's because everything starts in your mouth and babies are born through the vagina which is right next to your rectum and urethra and it's by purpose It Is by purpose that your baby comes out of the vagina because the skin bacteria the bacteria gets in its mouth from breastfeeding and from being born through the birth canal um is important for our health so it's crazy to think that and some people might be like ooh you know that's gross or whatever but like that's where we were all born you know one way or another and we know that the difference between a vaginal birth and a C-section birth these babies have very different bacteria on their skin and in their guts and so um you know it the bacteria is is a big deal and we're going to find out so much in the next you know 5 10 15 20 years about about the microbiome and the testing is getting better and better and better um I it's it's fascinating I actually have a bacteria in my mouth that some carnivore people can have called fusobacterium nucleatum it's not fed by carbohydrates and so I'm now I'm on a personal mission to figure out how to get this out of my mouth but um yeah we're not we're not perfect I'm human over here so yeah yeah it's mouthwash with Everclear or something like that just scorched the Earth and start over No I gave up alcohol October 1st so funny I'm switching spit you know okay yeah now I'm actually using um uh Xylitol so Xylitol actually um there's some I can't I won't be able to spout off all the research on Xylitol but there was a study that came out that if women choose Xylitol gum it decreased their risk of preterm birth so I started digging into this research and it's because the bacteria in the mouth will that like carbohydrates will eat the Xylitol but then it kills them so xylitol is amazing for the oral microbiome and you can get Xylitol lozenges you can get gums they make Xylitol toothpaste they make Xylitol mouthwashes which are way safer than traditional mouthwashes with alcohol that kill the good bacteria so I'm using a combination of Xylitol and then some other good bacteria like lactobacillus rooteri and it can crowd out that bad bacteria within 30 to 60 days is what the dentists are telling me so very cool yeah yeah like a you know just about the you know the oral biome going into the mic you know getting into the intestines and things like that and then being seeded from your mother and birth uh just just reminded me of um not not very appealing but like koalas and and gorillas like when they can't really digest this plant material very well and especially the the baby koalas and their guts aren't developed properly it might be hard to do with the microbiome as well so they they eat um you know pre-digested uh plant material AKA feces they call it fecal Pap and so they're actually eating this stuff and that that's something that the babies can actually absorb this partially digested eucalyptus pulp and um probably you know getting all the the bacteria well they will be getting all the bacteria as well so yeah that's it's funny to think about yeah what's crazy too is that when you think about you know so the baby's born right and it's inoculated with with all of this bacteria on their skin um the baby's stomach the pH of the stomach does not become really acidic until a couple days after birth so when the mom is making this low volume colostrum and breastfeeding that allows this bacteria to get past what would normally be a really acidic stomach and to populate the small intestine and large intestine and then after a couple days the acidity starts to rise her milk starts to come in um but but the the breast milk is actually putting a lot of immunoglobulins and things down there that help establish a normal healthy microbiome and I I get it that it you know fed babies are best but breast milk is the most optimal thing you know from a health perspective for your baby so everything we can do to even donor milk and things like that I think are amazing we're seeing more milk banks in our communities but that's one thing you can do to establish your baby's microbiome from the get-go yeah definitely yeah that's very interesting and yeah and like you say Obviously you know babies just need to eat and eating something is better than nothing um what are your thoughts on formula though I I I think that um well I've seen some studies that would suggest that actually there's there's a higher prevalence even in like things like autism and babies that are that are bottle fed and formula fed as opposed to breastfed as well what are your thoughts on that yeah I mean our formulas in the US are are not great uh when you look at the ingredients I mean corn syrup solids and things like that I mean it's no no different than some of the processed foods that we're eating and then we wonder you know why formula fed babies have higher rates of of these problems and so um when I had my girls I um had some trouble with Supply I mean I only had four weeks of maternity leave so you know I was pumping in bathroom stalls and I had low Supply after about like nine to ten months and so I had to start supplementing and so I started looking you know at like oh what can I supplement with and I ended up getting some products from Europe because I felt like they were more Superior to then you know what I could find here in the us and people send me DMS all the time asking for recommendations and I'm not a pediatrician and it's been a long time since I had to feed my babies but um I do think that you know there there's no replacement for breast milk like I said these donor Banks uh where you can I mean there's women that are like hyper lactating that you know like a milk cow I mean they they donate to these NICU babies and things like that which I think is so important you know when you think about a baby that ends up in the natal Intensive Care Unit I'm a critically ill baby you know that's even more important right their nutrition their microbiome and those types of things and so um whatever we can do to support those people um you know I know during the formula crunch of of during the pandemic you know people were like trying to make their own formulas I'm sure there's a way I'm just not a pediatric nutritionist by any means but um you know certainly what's good for us is good for our babies too yeah you would you would imagine right yeah yeah okay great um and then you've just recently finished a fitness competition as well which uh I saw just through your Instagram stories went very well can you uh tell us about that I uh I've taken care of people that have competed in the bodybuilding world I've always had a very negative viewed it through a very negative lens because you know we look at these people on social media and we think that that's what healthy looks like and the unfortunate part is that that level of body fat is probably not healthy especially for women so I've always viewed it through a very negative lens I just want to grow out there my husband wanted to compete for the first time in 2020 and prepped for a competition the pandemic hit he couldn't compete but it was amazing watching him do this it was like it seemed really easy to him and he said that he actually enjoyed the fact that he didn't have to make decisions every day like it was like he was like I'm gonna eat this I'm gonna train this way and it took less stress off of him I'm like okay that's kind of interesting and he was being coached by Robert Sykes at the time which he wrote an amazing book um on on natural bodybuilding and doing it with a ketogenic approach so I my science geek brain was thinking you know maybe that maybe there is an approach that's healthy because I take care of so many women who competed and their thyroids are ruined their estrogens in the tank they just have all of these problems and I think they have a lot of disordered eating patterns and uh so I tested Labs on my husband when he recompeted again in 2021 and it was amazing he like maintained testosterone levels like everything really looked good so in uh uh or sorry and so then last year in 2021 I decided to or this year in 2022 I decided to compete and checked Labs on myself and I just wanted to experience it I wasn't doing it because I want to be a you know a professional bodybuilder but I wanted to experience it I think you can learn a lot about yourself going through something that requires an intense amount of discipline um and it was a great experience I mean I love competing I'm like you and former athlete so it's fun to compete and I don't get to do that a lot in my adult life except maybe with my kids at the a board game at the kitchen table no um so it was a great experience I competed in women's physique which is a little different than like the girls that do bikini or figure and wear high heels like I wanted to be on my feet and uh you know like do all the poses or whatever it was and I mean I was humble I had a lot to learn I was a a true novice you know is what they call it in the in the world but I did kind of resonate with what he said I loved the level of discipline with like I ate a ton of beef and eggs so I did it completely ketogenic a ton of of ground beef and eggs because that was easy for me to titrate you know the portions and things like that um and butter and then uh you know I don't know if I'll do it again I I kind of got an itch I kind of got an itch this year to maybe do it but uh Robert told me no he said you know you should take if it took you six months to train for it you should take at least three times that off which is 18 months so now I'm you know my followers know I'm in a building phase so now I'm trying to build as much muscle on my body as I can um which is you know it's always I think more enticing to like look lean and shredded but you know uh for me it's just how I function so I'm in a I'm in a building phase of trying to put some muscle on this body which means I get to eat and I like eating so he's gonna my husband's gonna compete again this year so I'll just get to watch from the sidelines yeah very cool well congratulations on that and it's a huge accomplishment those take a ton of work and uh and dedication and and you know they can be miserable like you say thankfully you didn't have any of the hormonal issues that other people can get but that just means that what you were doing uh was probably the right way to do it so it's really good well yeah I mean I think when you when you think about because I mean you're essentially titrating calories really low so if you're going to be on a really calorie restricted diet you know the the scientific question is is it more advantageous to cut fat or cut carbs right because you want to keep protein really high everybody agrees um and I think there are some advantages to keeping the fat higher and and just cutting the carbs from a hormonal preservation perspective um a brain function perspective um and I yeah I'm I'm sold I think I think Robert's done an amazing thing and wrote an amazing book So for anybody listening you don't have to be a bodybuilder you can it's great advice for just being super fit and looking super fit and functioning great so I mean it's it's in it's thorough it is a thick book so um go check that out for anybody that wants to learn more yeah definitely and for people watching I've you know I've had Robert Sykes on on the show as well and all his all that his details in his book and stuff like that are in the description there but yeah I agree it's um it's um uh I think that that Roberts you know a lot of really really good stuff and it was great talking to him as well getting his insights in that so I'm sure having him as a trainer was uh pretty awesome yeah it was and then of course now these days you know uh steroids and performance enhancing drugs are the topic of conversation and um you know Robert's completely natural and he looks amazing and um you know I competed in a federation where people could use stuff and I showed up on show day and was like oh yeah I can't compete with that yeah yeah and I only did that show because of the timing like the way it worked out but there's natural federations that do like drug testing and those types of things and um yeah people have to be cautious about that because you can you know you only have so much natural genetic potential and I think it's very enticing when people start competing to want to use these other substances to you know be able to compete yeah or you can just eat you know massive amounts of Raw Liver apparently and uh like yeah and just totally totally natural yeah oops yeah exactly I mean who who didn't know that that was that that was the case I mean that was funny you know I think someone asked me um yesterday like what do you think about the Revel Revelation with liver King and I was like well you know the Revelation to me was that people thought it was a revelation I I never thought there was anything else going on yeah I mean I think the right thing to do is to just you know admit it and I think he actually did I think I looked it is this week or yesterday or something like that and you know that's the thing is like we just have to be honest humans and uh and and we are humans you know I a lot of people think like that I have some magic sauce over here I mean I said this in my book listen just because I wear a white coat doesn't mean I know everything and I'm humble enough um you know to admit when I'm wrong and to be very open-minded about things and you know I'm I'm more interested in in what's right than about being right and I think that's kind of the key message here is that you know you see these people on social media but like we're not perfect like we don't all sleep perfect we don't I've got use a bacterium nucleatum in my mouth like you know but we're on a you know we're on a path to trying to figure that out and uh for ourselves and for other people and um you know I think he does good things I mean he has good messages for people unfortunately it got deluded you know by by the fact that he wasn't honest and and like I said hopefully he can admit it and move on and uh you know continue to help people yeah I I agree with him I have nothing against that guy I just thought it was I honestly was surprised that people were surprised you know really because I didn't care one way or the other you know he was he was doing this and he was you know loud and gregarious and and that's what he was doing and he was getting a lot of attention and it you know and that's exactly what he wanted to do which is great he did a very good job at that and uh but yeah he has I he has like done an apology and things like that and you know I think that's that is kind of the problem though because he's so adamant about no definitely not um that it does it does take away from the rest of it because people are going to sort of you know throw out everything out awesome you know some people were even saying um I saw on like a lot of different comments and things like that that um they're like well is you know carnivore you know now too is everyone just doing stuff and just not talking about it and obviously you know he wasn't carnivore but he ate a lot of meat and he you know espoused the the benefits of eating uh you know meat and things like that and so unfortunately yeah it does it does muddy the the message but hopefully that can sort of be smoothed over and people can you know keep doing what's good for them yeah yeah um speaking of which uh so what are you eating now um just in your own normal daily life so my my diet has a lot of red meat and eggs it you know through like a different variations that that's always kind of maintained we we buy a cow every year so you know from like feeding our family perspective it's just most cost effective we buy a cow so we we eat a lot of red meat um I don't really eat chicken or turkey or any lean meats like that but I love Seafood so we'll do you know shrimp or scallops now I'm I'm in Nebraska I'm not near the ocean but you can get some like wild caught salmon and shrimp and scallops so we we love seafood and we eat tons of eggs now I am not like 100 carnivore so you know last night at dinner I had some blackberries with my girls you know I'll have an occasional you know plant I do love Dairy you know so I'll have some cheese and um I'm dipping my toes in the water starting to like make my own yogurt um but I think my people would think my diet was very boring I you know lot of the same things every single day and honestly that's what keeps me you know most consistent and when I Stray From that ever um I feel it like I can tell that my brain doesn't function like over Thanksgiving I had you know like a few foods that I wouldn't normally have and like ah just like I can tell it just it changes the way that I function and for me like I have to be on every single day you know like I'm I'm basically on call 365 days for my job I mean I do take vacations but you know I have to be on all the time and I have a full-time medical practice and I'm a mom of three and I do all these things and people are always like oh my God how do you do it well the real answer is I don't know I just do it but I do think that because of the way that I take care of care of myself and the way that I feel myself it allows me to work at another level and um you know I think once people kind of realize that it makes sticking with this type of Lifestyle you know I don't want to say easier because you know I I used to be a pre-diabetic you guys like I ate half price sonic milkshakes and cheese sticks like through my pregnancy like um you know it's every day is like a recommitment to you know like living this life but the food is delicious I mean when you're eating with you know these healthy fats and butter and eggs and you know some bacon and lots of salt like these foods are delicious and um I've been you know living through different evolutions of this diet since 2015 and um one thing's been pretty consistent over the last couple of years and that's you know beef and eggs yeah definitely and so would your family be pretty much eating the same thing I know you your husband may be doing something different for his prep but um is he sort of doing the same thing and would your kids be eating the same way as well yeah so he's like completely ketogenic um and uh carnivore um for this to prep so um a lot of you know red meat eggs MCT oil um butter uh things like cream things like that um my kids so basically you know whatever protein we have if it's ground beef or eggs or whatever it is they have that and then they might have you know some berries or you know this morning my daughter wanted an apple you know they might eat some other you know fruits or vegetables or things like that that we might have around um but uh they're super active kids and they're in sports and you know we try to limit you know sugar and sweets and things like that but I'm also not the militant person that's like no you can't have that that's a bad thing for me with my children it's very much educational because at some point point they're going to leave my house I don't want them to be like mom never let us have this I'm going on the Taco Bell diet yeah um you know for me it's like teaching them how the food makes us feel what it does inside of our body and like let them screw up if they want to screw up but it's like you know for a while like in 2015 2016 when my husband and I first were changing our diet I didn't change there so like I was making salmon for dinner and they were eating mac and cheese and they started to notice they're like Mom why are you eating that and I'm eating this and I think as a mom and for other moms listening like at the end of the day when you come home and you're stressed and you don't know what to cook for dinner like you just want everyone to eat dinner and not complain and just like move on and I I resonate with that at the same time um you should be like the example for your children and I decided in 2018 that we were going to start to kind of change their diets let's get rid of some of these snacks and you know let's let them start participating in like the preparation of the food let's talk about like you know what the food does for us and um I've been mind blown I mean like the first time you know that I made salmon or scallops or whatever like they were eating these foods and they like these Foods my oldest daughter Brooklyn I mean she the kids above steak if you're like hey where do you want to go for your birthday she picks the most expensive Chop House in Omaha like the kid knows what like a good like a good piece of meat is and um that's been so cool because that was not me when I was a little kid I was like a carboholic so um they they love steak they love beef they love eggs all the foods that we cook and but you know they might have a few things here and here and their kids and they're gonna be fine yeah well you're right I mean it does um it does come back to bite you if you're if you're too overbearing and then they're gonna they're gonna want to to go out the other way and just educating them because you're right I mean they're you know half the time they're out of the house at school or at friends even when they're they are living at home and so as long as you've educated them and they they know what to do and the right thing to do and what they want to do and then they'll just do it on their own um it's funny you say the Taco Bell died I was definitely on the Taco Bell diet in college they had the they had it was like 59 Cent um soft tacos and and you get what was your thing was like chalupas gorditas like Crunchwrap Supreme I always I always wanted I always wanted to meet right and so like I found like the like the best meat to you know uh whatever tortilla ratio like the soft tacos and those are also the cheapest and so you could get they were 59 cents at soft taco and you could get a 10 pack for like five dollars 550 or something like that this is literally nothing and so I get 10 of these things and just like just just wolf them down and um yeah and then there was um there's a burrito place that had these big massive burritos just full of like you know chopped up steak and things like that so like I sort of just lived on that for a while but it was actually it was pretty meat heavy but yeah I've I've been on I've been to the Taco Bell diet I know that yeah yeah um not recommended long term no no God no um great well well thank you very much I really appreciate it I want to take um too much of your time but I really appreciate you taking the time to speak to me today it's been an absolute pleasure and very very uh interesting and educational I hope everyone found that as well I'm sure they did um where can people find you and find your book yeah so I have a website Dr fit and fabulous.com where you can find links to the book in my podcast and I'm very active on social media mostly on Instagram and Facebook I've got I've got Twitter and Tick Tock but I'll be real honest with you guys I don't get on there um I'm most active on Instagram so uh yeah go check out the book if you're interested and we've got an online Academy that goes with it but you know uh Dr chafee thank you for you know what you do and uh for everybody listening because you know with podcasts and things like these you know we rely on our followers and our listeners to disseminate this information and tell their friends and family so thanks everybody for you know taking the time to tune in yeah very good point and um yeah yeah thank you to everybody and and hopefully you guys found this helpful and can pass it on to someone who would also find it helpful and useful I think there's a lot of really really important information there especially for people trying to get get um pregnant and um have a successful pregnancy and a young family so thank you very much for for all of that thank you foreign