MD and Chef Team - The Show!

Dr. Lara Briden - Natural Birth Control, Perimenopause & Menopause

May 03, 2021 Dr. Isabel MD & Culinary Nutrition Expert Chef Michael Season 2 Episode 12
MD and Chef Team - The Show!
Dr. Lara Briden - Natural Birth Control, Perimenopause & Menopause
Show Notes Transcript

๐ŸŽ™ In this Episode of the MD and Chef Team, Dr. Isabel interview Dr. Lara Briden, and they discuss Natural Birth Control, Perimenopause and Menopause.

๐Ÿ’– ๐˜“๐˜ข๐˜ณ๐˜ข ๐˜‰๐˜ณ๐˜ช๐˜ฅ๐˜ฆ๐˜ฏ ๐˜ช๐˜ด ๐˜ข ๐˜ฏ๐˜ข๐˜ต๐˜ถ๐˜ณ๐˜ฐ๐˜ฑ๐˜ข๐˜ต๐˜ฉ๐˜ช๐˜ค ๐˜ฅ๐˜ฐ๐˜ค๐˜ต๐˜ฐ๐˜ณ ๐˜ข๐˜ฏ๐˜ฅ ๐˜ฃ๐˜ฆ๐˜ด๐˜ต๐˜ด๐˜ฆ๐˜ญ๐˜ญ๐˜ช๐˜ฏ๐˜จ ๐˜ข๐˜ถ๐˜ต๐˜ฉ๐˜ฐ๐˜ณ ๐˜ฐ๐˜ง ๐˜ต๐˜ฉ๐˜ฆ ๐˜ฃ๐˜ฐ๐˜ฐ๐˜ฌ๐˜ด ๐˜—๐˜ฆ๐˜ณ๐˜ช๐˜ฐ๐˜ฅ ๐˜™๐˜ฆ๐˜ฑ๐˜ข๐˜ช๐˜ณ ๐˜”๐˜ข๐˜ฏ๐˜ถ๐˜ข๐˜ญ ๐˜ข๐˜ฏ๐˜ฅ ๐˜๐˜ฐ๐˜ณ๐˜ฎ๐˜ฐ๐˜ฏ๐˜ฆ ๐˜™๐˜ฆ๐˜ฑ๐˜ข๐˜ช๐˜ณ ๐˜”๐˜ข๐˜ฏ๐˜ถ๐˜ข๐˜ญ โ€” ๐˜ฑ๐˜ณ๐˜ข๐˜ค๐˜ต๐˜ช๐˜ค๐˜ข๐˜ญ ๐˜จ๐˜ถ๐˜ช๐˜ฅ๐˜ฆ๐˜ด ๐˜ต๐˜ฐ ๐˜ต๐˜ณ๐˜ฆ๐˜ข๐˜ต๐˜ช๐˜ฏ๐˜จ ๐˜ฑ๐˜ฆ๐˜ณ๐˜ช๐˜ฐ๐˜ฅ ๐˜ฑ๐˜ณ๐˜ฐ๐˜ฃ๐˜ญ๐˜ฆ๐˜ฎ๐˜ด ๐˜ธ๐˜ช๐˜ต๐˜ฉ ๐˜ฏ๐˜ถ๐˜ต๐˜ณ๐˜ช๐˜ต๐˜ช๐˜ฐ๐˜ฏ, ๐˜ด๐˜ถ๐˜ฑ๐˜ฑ๐˜ญ๐˜ฆ๐˜ฎ๐˜ฆ๐˜ฏ๐˜ต๐˜ด, ๐˜ข๐˜ฏ๐˜ฅ ๐˜ฃ๐˜ช๐˜ฐ๐˜ช๐˜ฅ๐˜ฆ๐˜ฏ๐˜ต๐˜ช๐˜ค๐˜ข๐˜ญ ๐˜ฉ๐˜ฐ๐˜ณ๐˜ฎ๐˜ฐ๐˜ฏ๐˜ฆ๐˜ด.

๐Ÿ”ฌ ๐™’๐™ž๐™ฉ๐™ ๐™– ๐™จ๐™ฉ๐™ง๐™ค๐™ฃ๐™œ ๐™จ๐™˜๐™ž๐™š๐™ฃ๐™˜๐™š ๐™—๐™–๐™˜๐™ ๐™œ๐™ง๐™ค๐™ช๐™ฃ๐™™, ๐™‡๐™–๐™ง๐™– ๐™จ๐™ž๐™ฉ๐™จ ๐™ค๐™ฃ ๐™จ๐™š๐™ซ๐™š๐™ง๐™–๐™ก ๐™–๐™™๐™ซ๐™ž๐™จ๐™ค๐™ง๐™ฎ ๐™—๐™ค๐™–๐™ง๐™™๐™จ ๐™–๐™ฃ๐™™ ๐™ž๐™จ ๐™ฉ๐™๐™š ๐™ก๐™š๐™–๐™™ ๐™–๐™ช๐™ฉ๐™๐™ค๐™ง ๐™ค๐™› ๐™– ๐Ÿ๐ŸŽ๐Ÿ๐ŸŽ ๐™ฅ๐™–๐™ฅ๐™š๐™ง ๐™ฅ๐™ช๐™—๐™ก๐™ž๐™จ๐™๐™š๐™™ ๐™ž๐™ฃ ๐™– ๐™ฅ๐™š๐™š๐™ง-๐™ง๐™š๐™ซ๐™ž๐™š๐™ฌ๐™š๐™™ ๐™ข๐™š๐™™๐™ž๐™˜๐™–๐™ก ๐™Ÿ๐™ค๐™ช๐™ง๐™ฃ๐™–๐™ก.

๐Ÿ’– ๐™Ž๐™๐™š ๐™๐™–๐™จ ๐™ข๐™ค๐™ง๐™š ๐™ฉ๐™๐™–๐™ฃ ๐Ÿ๐ŸŽ ๐™ฎ๐™š๐™–๐™ง๐™จโ€™ ๐™š๐™ญ๐™ฅ๐™š๐™ง๐™ž๐™š๐™ฃ๐™˜๐™š ๐™ž๐™ฃ ๐™ฌ๐™ค๐™ข๐™š๐™ฃโ€™๐™จ ๐™๐™š๐™–๐™ก๐™ฉ๐™ ๐™–๐™ฃ๐™™ ๐™˜๐™ช๐™ง๐™ง๐™š๐™ฃ๐™ฉ๐™ก๐™ฎ ๐™๐™–๐™จ ๐™˜๐™ค๐™ฃ๐™จ๐™ช๐™ก๐™ฉ๐™ž๐™ฃ๐™œ ๐™ง๐™ค๐™ค๐™ข๐™จ ๐™ž๐™ฃ ๐˜พ๐™๐™ง๐™ž๐™จ๐™ฉ๐™˜๐™๐™ช๐™ง๐™˜๐™, ๐™‰๐™š๐™ฌ ๐™•๐™š๐™–๐™ก๐™–๐™ฃ๐™™, ๐™ฌ๐™๐™š๐™ง๐™š ๐™จ๐™๐™š ๐™ฉ๐™ง๐™š๐™–๐™ฉ๐™จ ๐™ฌ๐™ค๐™ข๐™š๐™ฃ ๐™ฌ๐™ž๐™ฉ๐™ ๐™‹๐˜พ๐™Š๐™Ž, ๐™‹๐™ˆ๐™Ž, ๐™š๐™ฃ๐™™๐™ค๐™ข๐™š๐™ฉ๐™ง๐™ž๐™ค๐™จ๐™ž๐™จ, ๐™ฅ๐™š๐™ง๐™ž๐™ข๐™š๐™ฃ๐™ค๐™ฅ๐™–๐™ช๐™จ๐™š, ๐™–๐™ฃ๐™™ ๐™ข๐™–๐™ฃ๐™ฎ ๐™ค๐™ฉ๐™๐™š๐™ง ๐™๐™ค๐™ง๐™ข๐™ค๐™ฃ๐™š- ๐™–๐™ฃ๐™™ ๐™ฅ๐™š๐™ง๐™ž๐™ค๐™™-๐™ง๐™š๐™ก๐™–๐™ฉ๐™š๐™™ ๐™๐™š๐™–๐™ก๐™ฉ๐™ ๐™ฅ๐™ง๐™ค๐™—๐™ก๐™š๐™ข๐™จ.

๐Ÿ”ท Dr. Lara's Mission is to help women achieve healthy natural menstrual cycles without the use of hormonal birth control.

โžฅ Download & Listen for the Rest of the Story!

๐Ÿ‘‰ย  ย 
For those of you who want to continue following Dr. Lara, you can find her at โ€”
this is her handle in Instagram, itโ€™s
larabriden ๐Ÿ‘ˆ
and then her website is ๐Ÿ‘ˆ

To know more and order Dr. Lara's Books -
Period Repair Manual and Hormone Repair Manualย  ๐Ÿ‘‰

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Speaker 0 (0s): Coming up on this episode of the MD and chef team show. I wanted to ask you, what are you, what are your thoughts about the copper IUD? Yeah. I have a blog post called the pros and cons of the copper IUD. I talk about it in some detail in peer to peer Daniel, its main advantage is that it allows natural menstrual cycles. So that's a big plus. Considering most of my work is around the value of regular ovulation, the value of natural menstrual cycles and making our own hormones and the copper IUD permits that it has some downsides. 

Welcome to the show from DMDs chef team. I'm Dr. Isabel medical doctor here at the MD and chef team. And who are you? I'm chef Michael Coleman nutrition expert. I'm the chef part of the team. And what are we going to talk about bad. Now I can see that cause he's my husband. Well then we'll be talking about marriage relationships, parenting intimacy. Talk about mindsets that success overcoming depression, anxiety, I'll be getting into functional nutrition, recipes and tips from the kitchen. 

And we're going to both get into how to live a long, healthy, vibrant life. Yes, I love it. Our mission is to help you prevent and reverse the disease and give you both in the process. Oh yeah, we might have to have the show. Hello everyone. I am doctor Isabel and welcome to the MD and chef team podcast. And I get to interview Dr. 

Laura by all the way here, where I'm living in New Zealand and Christ direct welcome Laura. Thanks for having me, Isabella. I'm excited to talk to you. Yes. And for it to talk to the audience really excited. I'm going to go ahead and just talk a little bit about you. If you don't mind. Of course, Laura Biden is a nature path doctor and best-selling author of the books, period, man period, repair manual, and also hormone repair manual, healthy hormones, greater than 40 years of age. 

This is a practical guy for treating period problems with nutrition, supplements and bio identical hormones. And I love the way you explained bio identical hormones as body identical hormones with a strong science background. Laura sits on several advisory boards and is the lead author of a 2020 paper published in a peer review peer review medical journal. She has more than 20 years experience in women's health. 

And currently has consulting rooms in Christchurch, New Zealand, where she treats women with PCRs, PMs, endometriosis, perimenopause, and many other hormone and period related health problems. Her view is the body is a logical responsive system that knows what to do when given the right support with nutrition and natural treatments. And her mission is to help women achieve healthy, natural menstrual cycles with the use of hormone with without, without the use. 

Sorry about that. Without the use of hormonal birth control pills, I cannot wait until I start asking you all these questions. So tell me, how did women have natural periods without birth control? 

Speaker 1 (3m 50s): Our body wants to have natural periods, as you know, that's the natural States of the female physiology is to obviate regularly to have symptomless periods. And my experience has taught me that for most women that's possible usually by identifying, correcting any underlying health issues that could be affecting periods, right? So our menstrual cycle is an expression of our general health. It's not a separate category, which is, I think one of my key messages is to bring the menstrual cycle back into, into general health because when we do that, then it combats the narrative that Oh period problems are all just too complicated. 

You just have to take the pill and you know, that's a separate thing. They're not separate from our health. 

Speaker 0 (4m 40s): No, they're not how we procreate. 

Speaker 1 (4m 44s): And they're very important. 

Speaker 0 (4m 46s): Now I wanted to ask you, how would a woman have natural menstrual cycles without getting pregnant? Do you talk about that? 

Speaker 1 (4m 56s): Yeah. So my first book peer to peer manual goes into more detail about all strategies for avoiding pregnancy. I talk about it. I do talk about it in the second book as well. Here's the short version. I mean, there are some methods of avoiding pregnancy that do not involve contraceptive drugs, but there are not as many as there should be because research has really been dragging its feet on this. I mean, it, shouldn't not be that complicated to avoid pregnancy. Let me give you an example like this. 

There is a bit of research that has not been brought to market, but a medication potentially that men could take that interferes with sperm motility, but doesn't shut down their entire hormonal system, the way the pill does for women. For example, like the way we, the medications that are used for women to avoid pregnancy, it's just massive overkill. It's like let's induce chemical menopause, temporary chemical menopause just to avoid pregnancy. So obviously we need big picture. We need a lot more research. 

We new methods at the moment, what we have as you know, is condoms, which I am a fan of fertility awareness method, fertility awareness based methods, which are making a comeback. So that's tracking your cycle with temperatures either with or without a approved algorithm to help you to do that. Because as women, we're only fertile six days per cycle, we're actually only fertile one day per cycle and then sperm survives five days. 

So that's six days and the rest of the cycle, we cannot become pregnant. So this is the idea of 

Speaker 0 (6m 39s): It was during that time, 

Speaker 1 (6m 41s): It's becoming more and more popular. Other just quickly other methods of the copper IUD, which has pros and cons obviously, but does not shut down hormones the way hormonal birth control does. And there was a couple of other outlying things as the diaphragm has made a bit of a comeback and those withdrawal, which I always mentioned, I know it gets kind of poo-pooed but honestly the research for withdrawal is if it's done properly and responsibly, it's actually as effective as some of the barrier methods. So just to give a lay of the land there, you know, there are other options for avoiding pregnancy, certainly which one do you like the most fertility awareness based methods. 

Speaker 0 (7m 20s): So just affording during that six day period, 

Speaker 1 (7m 23s): You need you just as a, a comment. You can't just guesstimate that, right? Yeah, 

Speaker 0 (7m 28s): No, you cannot. 

Speaker 1 (7m 31s): So that's where the tools come in or the training, understanding your cycle. Usually it's checking temperatures through the month. Or as I mentioned, there's a few approved algorithms for there. Most of them are temperature based has a product called Daisy, just a little computer that gives you a, a green, yellow, or red lights on the device. If you're agreeing as you're good to go, you can't become pregnant. Yellow is all. I'm not sure you should take precautions. And red is, there's a flashing. Red is like you are, today is the day I, to my patients, maybe on the flashing red day, don't even risk a Gundam or, you know, that's the day to avoid intercourse 

Speaker 0 (8m 12s): Yet. 

Speaker 1 (8m 15s): It's a device computer thermometer and there's some future apps every year. It seems like there's another app being approved. There's a couple of FDA approved ones for avoiding pregnancy that are fertility awareness based methods. So that's the future. Fem tech is stepping up where perhaps the pharmaceutical companies have let us down in terms of methods of avoiding pregnancy. Yes. 

Speaker 0 (8m 43s): And the reason I'm asking all this is because my, my daughters are 24, 26 and they'd like to kind of live their life first, which I'm all for now, let ask you, cause there'll be what listening and watching this button and getting your book. I know I'll be promoting that book. The first book, that period repair manual I wanted to ask you, what are you, what are your thoughts about the copper IUD? 

Speaker 1 (9m 11s): Yeah. I have a blog post called the pros and cons of the copper IUD. I talk about it in some detail in peer to peer manual. Its main advantage is that it allows natural menstrual cycles. So that's a big plus. Considering most of my work is around the value of regular ovulation, the value of natural menstrual cycles and making our own hormones and the copper IUD permits that it has some downsides. It can be painful going in. It can increase menstrual flow by about 30%, between 30 to 50% ongoing. 

It potentially alter the microbiome of a theater in the vagina. So, you know, there's some, I'm just pointing those out, not to scare women away from it. Cause I still think it's possibly the right choice for certainly for some women and just sharing, you know, some of my naturopathic doctor colleagues choose the copper IUD as their methods. So that tells you something. Yeah. I don't know. It's it's, it's one of the methods we have right now. I think it's far from perfect is that this is another example of, I think we could do better. I think science could come up with something better than a technology that's been around for 60 years or something like that. 


Speaker 0 (10m 21s): Yes. Good point. Very, very good point. Before we move into the, the wiser woman I'd like to talk to you about acne, what, what are your, do you have any natural ideas for helping women, you know, in the twenties and thirties with acne? Absolutely. Yay. Let's hear it. 

Speaker 1 (10m 42s): Well, a couple of things to say about that. I mean first is to figure out if you have PCOS or not, as, you know, polycystic ovary syndrome, a hormonal condition can cause acne. So I feel it's quite important to get an accurate diagnosis around that. And then if that's partly what's going on, then implement the treatment strategies I provided in the book for PCs, the natural treatment strategies, the other situation for acne, and this gets its own special mention. I have a blog post about this called how to treat and prevent post pill acne. 

So this is if you've been on a pill like Yasmine or down here, we have Brenda or Diane. So these are pills that have the progestin, a drug called other Jasper known or sipped her own. These are drugs that progestins, that have a strong anti-androgen effect. So they have an anti-acne effect and often girls are prescribed them when they're quite young and after years on those drugs and then trying to stop them, there is a withdrawal syndrome from those drugs where you stop the drug, the androgens temporarily flare up and can actually buy androgens. 

I mean, male hormones and can actually get sort of a temporary picture or certainly a quite a severe acne picture. These again, these are women who may be trying to stop one of those pills in their early thirties say, and they, the active starts about three to six months off. The pill is a little honeymoon period where it's fine. And then the skin comes on and I've seen and heard reports of skin that is unbelievably bad during that process. You know, it's like worse acne than you ever had before as a teenager that you could have imagined was possible. 

And it's part of the drug withdrawal process. And I just say that because of course, as women, we always blame ourselves like, Oh, I must be broken. This must be, something's really wrong with me that my skin would do this 

Speaker 0 (12m 34s): Or I'm eating the wrong food, eaten that. 

Speaker 1 (12m 38s): And so one of my messages around post pill acne is it's not you it's the drug you were given and trying to withdraw from it, withdrawal from it and then putting in place some supportive measures during that time, knowing that they won't be forever. It's usually takes about a year to kind of get through that withdrawal time. I'm happy to just list, you know, cookbook lists like some of the top things for controlling acne. Yes. Diet plays a role. So I will say during that time, potentially dairy-free and reducing sugar quite dramatically. 

And again, not to say that that'll always have to be the case, but during that time, that could be a strategic thing to do normal cows dairy, avoiding that. And then, and it's some research around that that I talk about in the book. And then my top supplements are zinc, which you have to kind of take at least 30 or 40 milligrams per day, or it's not even going to touch it. And do you like giving it at nighttime? I usually just think that with the biggest meal to avoid that zinc nausea that some people can experience, although arguably at night, this, you know, the stomach acids or this more stomach HCL, and it's easier to absorb minerals potentially with the evening meal 

Speaker 0 (13m 52s): And then go to bed. So you're not going to know if you're nauseous anyway. 

Speaker 1 (13m 55s): So my patients, I don't want anyone having nausea from zinc. So it's usually if I take it within a food or split the dose or something, it should be fine. Then in the book I talk about herbal phytonutrient called berberine, which I'm sure you're familiar. It has lots of properties, lots of benefits it's has an anti-microbial effect. That's quite good for skin it delves down insulin or improves insulin sensitivity. So it can be quite good for the skin. Then there's a couple other ones. The nutrient dim, which is often used for estrogen clearance actually has a, seems to have quite a strong anti-androgen effect for, especially for skin. 

So din is one of the ones that people seem to get the best results with. And again, it wouldn't be forever. It's just during that time when your androgens are flaring because you've come off Yasmin or Dianne or one of those pills. Yep. What about vitamin? Yeah. Then D anything vitamin a, I mean, I guess skin is a, a reflection of our overall health. So certainly being fully nourished in all sorts of ways is going to be important for skin. Yes. 

Speaker 0 (15m 5s): Thank you. And any, any ideas like how would somebody know whether they've got PCO? 

Speaker 1 (15m 13s): Yeah, so that's a whole interview and it's on its own, but I'm happy to touch on it. Okay. 

Speaker 0 (15m 20s): Okay. Talking about it. We can have another interview. 

Speaker 1 (15m 26s): We could do a deep dive on PCs. Cause I know a lot about this condition. I've been, I wrote a paper on it. I'm thinking about it for a long, long time. I've treated patients with it. Okay. Here's the, in a simplest term, what PCs is? It is the situation of high androgens or male hormones in a woman. When all other causes of that have been ruled out, basically it's a catchall kind of umbrella diagnosis. So if you, if you are showing signs of androgens, whether that's strong jawline, acne, or hirsutism, you know, body, hair, facial hair, and it's those, that's not from other conditions such as something called adrenal hyperplasia or you know, high prolactin or other things can cause that if it's none of those other things, then you're left with this. 

It's it's otherwise unexplained high engines. And so in that sense, one of the things about the diagnosis is it's quite it's heterogeneous, right? Like you can have lots of different women qualify for a PCs diagnosis, but they've actually got lots of different things going on with them. In some cases it's very much tied to insulin resistance, but not always. And a lot of cases, there's also a strong problem with not ovulating regularly, but not always. You see what I mean? So it's, it's a diverse set of physiological pathways to get to that diagnosis, which is why in my work I talk, I've broken it into functional types as sort of the insulin resistant type or the post pill type of PCs or the inflammatory type. 

And I just get a lot better clinical results. If I look at it through that lens. And the other thing I want to say about PCs, I have to get this in here. PCs cannot be diagnosed or ruled out by a pelvic ultrasound. That is a takeaway. I want to say that again, PCRs can not be diagnosed by ultrasound, not to say that a pelvic ultrasound is not a helpful diagnostic technique. It is for lots of things, but for this particular condition, the appearance, the so-called polycystic appearance of ovaries on ultrasound means almost nothing because lots of women have polycystic, which just means they have lots of follicles that month. 

And didn't, I'll be late that month. Didn't make a dominant follicle that month. For whatever reason, lots of women can have that one month and then it's normal the next month. And lots of them have it and don't have the hormonal condition piece through us. Conversely, you can have someone, especially an older woman let's say in her thirties or forties have PCLs essentially have high androgens state have normal looking ovaries on an ultrasound because she's 40 and has fewer follicles, right? Ovarian follicles. Do you know what I can say? 

Like this is the, there's so much confusion around the polycystic ovary finding. That's why people are calling for a name change for the condition. Cause having polycystic in the name is quite problematic because it's actually nothing to do. 

Speaker 0 (18m 25s): Cause it's almost an Oxy Nora oxymoron, you know, just because you've got some cysts on your ovaries doesn't mean you've got pieces of that. 

Speaker 1 (18m 34s): Yeah. So as you know, I mean women can have an abnormally large ovarian cyst of all different types. Like it's, you know, it's just means a fluid filled structure on the ovary, which could be from all different reasons. That's an entirely different thing from just the highest number of eggs or follicles, which is what the polycystic ovary description is describing. I mean, eggs are cysts. So I mean, by definition, the ovary has fluid filled structures. So the name is really a problem. 

And just one final thing I want to say about it because something I see a lot and suspicious, especially in the age group of women under 30, they might be in the situation of having lost their period to undereating or come off the pill and they'll cut their period because they're under eating where quite a common scenario becoming more common undergo investigations, polycystic ovaries are seen on ultrasound. And so mistakenly told they have PCs then read online or get the advice to, Oh, your PCs. Therefore you should go low carb. 

And then so eating less and in their situation, they're now going in 180 degrees, the wrong direction from ever getting a period back. That's an example of where the policy is to go over a diagnosis really failed. In fact, there was a brand new, it has been two British medical journal articles about this problem of overdiagnosis of PCs with ultrasound. So we can put those in the show notes. If you wanted some time for a change, 

Speaker 0 (20m 5s): It is time for a change. I will underline that you can not diagnose PCLs with an ultrasound. And what I wanted to talk to you about a little bit. I know I can see your passion in women's health. Why are you so passionate about women's health? What happened to you? What is your story? 

Speaker 1 (20m 28s): The question in all honesty, my periods have been pretty normal and uneventful, so I didn't come at it through a personal story. I think I can genuinely say it's from 20 years, 25 years actually now patients. And I think my, my emotional reaction to just all the crazy stories I heard, like all the things women have been told, mistakenly told essentially, you know, by the doctors put on the pill for things that were, I'm just sitting there going, this is crazy. 

Like, you know, your body doesn't need any of that. Your body knows what to do. So it's just been a campaign to help women reclaim their own hormones, their own physiology. Like I just feel quite strongly that I predict that in 50 years, maybe less future generations of women and doctors will look back at this era epoch of contraceptive drugs that will have gone on for 70 or 80 years and not quite be able to believe that that's what we did that we've just had routinely gave out drugs that shut down the hormonal system of young women, young women routinely putting on women and took chemical a temporary chemical menopause and expecting that to be okay. 

It's, you know, it's just, emperor's new clothes situation. When you really start looking at it and seeing the research that that's growing, that women benefit from our own hormones, that oblation is the only way to make those hormones like tea, to have this idea that we can routinely switch off female physiology with drugs. We'll be like saying to men, look, you don't need your testosterone until you're ready to make a baby. So we're just going to shut it down with this drug and give you back. It's just, you know, a hormone that's kind of like testosterone, but not really. 

It's kind of more like estrogen and that's going to be fine for you. And yes, it will cause depression and weight gain, but 

Speaker 0 (22m 27s): Exactly caused you to have depression and waking like black woman needs to have weight gain and depression. It's already hard enough with the hormone up and down, you know, and all round and around. So I know, I know. I agree with you. 

Speaker 1 (22m 49s): Okay. 

Speaker 0 (22m 50s): Let's talk about perimenopause. Can you, can you explain what perimenopause is? 

Speaker 1 (22m 57s): Yeah. And this is my new passion. So for 20 years I've been very passionate about menstrual cycles. Now I'm very passionate about the end of menstrual cycles. 

Speaker 0 (23m 5s): So why is that 

Speaker 1 (23m 8s): Misunderstood again, it's seen as a shameful thing. I think women are going to internalize this idea that maybe I've done something wrong by getting older. Like it's just this whole crazy narrative. And this idea that menopause is an accident of living too long, which is not the case. And my book might be book, hormone, repair manual. I go into how actually there's evidence that menopause evolved that, you know, as humans, even going back hundreds of thousands of years, that during our evolution, you know, our lifespan has for a long time, been 70 years old, you know? 

So for a long time, women have spent 30 years in poster productive and potentially that's quite beneficial. Like I went to that in the book. So what is perimenopause menopause 

Speaker 0 (23m 57s): Is perimenopause 

Speaker 1 (23m 59s): Pause. I'll start with that. And I use the definition of my colleague reproductive endocrinologist. Jerilynn Pryor who, if you don't know her work, you should have a look. I quote her extensively in the book she uses the definition. Menopause is the life phase that begins one year after our final period at menopause itself. As I explained in the book should be quite a cruisy easy time. I mean, there could be a few things that could be vaginal dryness, which I talk about in the book. But usually by that one to two years after the final period, it's easy town. 

Like, you know, you're, you're in the sort of the new, newly calibrated hormonal system. There can be some women can have problems, but the, for most women, if they're going to be symptoms it's before that it's during perimenopause, which is the two to 12 years before that, including the, you know, waiting to see if that's your last period, that final year. And usually more. And that I, in the book, I call second puberty that is, can be a ton of symptoms for completely understandable reasons. 

It's a time of massive recalibration of every system, including the immune system and including the brain. 

Speaker 0 (25m 14s): So you're causing second puberty is really perimenopause. Perimenopause is second. And that can be up to 10 years, right? Yes. Yay. 

Speaker 1 (25m 27s): Yeah. Well, but it can be, as obviously I talked about in the book, you know, it can be associated with symptoms, but those symptoms can be addressed. So my goalposts would be that most women can transition that relatively easily, keeping in mind that because it's a time of recalibration. It's also what I call in the book, a critical window of health. So it's, if there was ever a time in our adult lives, you know, to look after health it's it's, then maybe the postpartum would be the other example, but just put this perimenopause because the physiology is in such a dynamic changing state. 

What the research shows is, if you experience an insult to your health during that time, let's say like a major, stressful time or strong insulin resistance developing, or, you know, something kind of is not going well during that time that can potentially amplify into longer term problems. The way it wouldn't amplify, if the same insult happened during your more stable reproductive years. If 

Speaker 0 (26m 41s): That means that it's because of this 

Speaker 1 (26m 44s): Concept, it's like a tipping point or a pivot point in health because everything 

Speaker 0 (26m 48s): Is it, the load, is it that concept the load you've reached your over flowing your load is reached the level, the type, 

Speaker 1 (26m 56s): Maybe the analogy I give because it's a recalibration. The analogy in the book, one of the analogies I give is it's like when your computer software is updating and you know how, when it's updating, it's like, do not unplug it. Do not press, do not touch basically the computer while it's undergoing it's because it needs to do all these changes. And then you come out the other side, you've got newly installed software and you're good to go. Whereas if you switch off your computer unexpectedly, you know what, it's not recalibrating, it's fine. 

It just, you know, shut down and turn on again. So this is sort of an analogy I think, and obviously it's not always within our control. There's going to be stress. It's going to be things that happen during that time. But I make the case that if you can, during second puberty, it look, take extra steps to look after yourself, to move your body, to look after your gut microbiome, to eat well, to quit alcohol, I would put that in there or drastically reduce it. That's the time to do it because the dividends will pay off. 

Right? Like if you can look after yourself in your forties, then by the time you get to your sixties, you're good. Right? Like you're, you're quite stable and can go back to some of your busy ways and maybe, you know, reintroduce some wine and things like that. Yeah. 

Speaker 0 (28m 16s): Alcohol is so detrimental to women, 

Speaker 1 (28m 21s): Especially during prime metaphors, but in general, yes. 

Speaker 0 (28m 24s): Unbelievable. How, but you know, we, you and I live in New Zealand, the culture is it's wine. O'clock, it's normal to be drinking two bottles of wine a week. When I ask women how many glasses are in a bottle of wine? They'll say three. I'm like, but I, Hey, I've lived here for 20 years. I know the culture I got caught up in the culture. Alcohol messes up my sleep and I love to sleep. 

So I have been like off to the side as much as possible. Yeah. 

Speaker 1 (29m 1s): And it's one of those things where I would just offer to anyone listening. If they are struggling during perimenopause, with sleep problems or night sweats or hot flushes in combination with same easy Evans. And we have supplements, I provide and eating well and moving, moving your body, just like drastically cutting alcohol, maybe getting rid of it for awhile might be all you need to do. Like I've had patients who were like, wow, Oh my nice sweats are gone. I'm like, I'm fine now. And all they had to do. And it's not just the night sweats you might have the night after you drank. 

Like, that's one thing, but it's cumulative. So just generally getting it out of your life, it means that you'll be building up a better quality and a more drink alcohol at all. Well, this is, yeah. I'm happy to share this. So I always loved having, you know, three or four beers in the week. Beer is my, my drink of choice. And so when I was in the thickest part of perimenopause, like a couple of years ago, cause I'm almost through it now I would go through, this is my, I like, I would love to have a beer with dinner, kind of thinking about it, but you know, I could do that and then wake up all sweaty at three in the morning or I could not have that beer and I could sleep through the night. 

So for me it was like, yeah, it's actually just not worth it. And also likewise, you know, just avoiding it generally meant my sleep solidified. So that's been my personal experience, but that's also been my experience with a lot of patients say the same thing. 

Speaker 0 (30m 26s): So when you go out to Drake, when you go out to have a meal with your family, what do you order? Just so everybody knows. 

Speaker 1 (30m 34s): Well, I'm a big sparkling water. Yeah, I do. Yeah. My husband bought me a soda stream a few years ago cause I was just going through so much sparkling water. So that's 

Speaker 0 (30m 44s): I love sparkling water. I love it. Yeah. Yeah. I hear you loud and clear. Was there anything else about perimenopause and menopause that you wanted to touch base on? 

Speaker 1 (30m 57s): Oh no. I think Chloe just kind of scratched the surface, but just that it being the recalibration and the symptoms being temporary and it being this critical window for health, I think a lot of that is quite important and also being normal, not being nothing to feel ashamed about. I have nothing to be afraid of. I did an informal survey on my social media accounts where I asked women how they feel about the prospect. I shouldn't laugh, but like how they feel about the prospect of perimenopause and menopause. And most of them are like afraid, you know, just, which is no surprise given how it's portrayed and it doesn't have to be like that. 

Speaker 0 (31m 37s): Yeah. And on a personal experience, I just kind of want to share a little bit about, I can understand why women are afraid of perimenopause and menopause. I, you know, when I started doctor on a mission, I gave a private practice about eight years ago and started doctor on a mission and I was going through perimenopause, but I thought it was sweet. As you know, as they say, I'm sleeping, I got this all under control. And then a year into building doctor on a mission. I just felt the weight of the world on me. 

I wasn't sleeping. I went to an event where I only slept for 17 days. I only slept two hours every day and I was getting more and more anxious and concerned. And you know, cause I still had to function as a doctor and as a wife, as a mother and I, I tried to take my life twice in three days and now that I'm way on the other side and I've realized the 10 pillars that needed to get healed with my anxiety, my depression, I realized that hormones really plays a big role. 

And I want women to know that depression is not normal for perimenopause and menopause and, and you can get help. And there's just a big, there's a lot to be done. It's not just, you know, my, my, I was, I was shuttled off to a psychiatrist, kept me alive. You know, I was grateful for that place on an antidepressant and I'll never forget him saying to me, Isabelle, just stay on this for the rest of your life cause you need it. And I was like, I just knew in the pit of my stomach that is wrong, wrong, wrong. 

And now that mess has become my message to help women overcome anxiety and depression. And bio-identical hormones played a huge role. I mean I want bio identical hormones. I plan to live to be 120 years healthy and strong and helping people, you know, and bio-identical hormones really are very, very important. So I guess my message to your, your team and to my team is you can get help. 

There's good help out there. You don't have to be on an antidepressant. You are not deficient in an antidepressant. You're deficient in a big, there's a lot of pillars that need to be repaired. 

Speaker 1 (34m 11s): Well, I couldn't agree more. And thank you for sharing your story. Yeah. It's the research does back that up that it's a window of time when the risk for anxiety and depression increases. I think it triples for women. I know 

Speaker 0 (34m 25s): That I had no idea about that. 

Speaker 1 (34m 27s): And then the risk actually goes then after, you know, with menopause and into women's 60, late fifties and sixties, the risk actually goes right back down to normal and possibly even better than normal for that individual real. And you're so right about this mistaken message that, Oh, okay, now you need to send a depressant and Oh, that's how you're always going to be. You're always going to need this. So that's one of my messages. It's a, you know, it's a transition time. Be very careful to not be given a label, other depression or fibromyalgia or some of the other diagnoses that can be given during that time to not take that on as a permanent thing, but rather potentially a manifestation of this recalibration process and also to speak to yes, the bio-identical hormones. 

Why don't we talk about that now? I mean, they can, that's both estradiol and progesterone. We can talk about this. They can be very helpful and there's actually research to suggest and certainly clinical experience that there are far better option than an antidepressant. I mean, they're there, they're helping the, supporting the brain in a way that it actually needs. Should we define kind of what bioidentical body it is and just direct women how to get that because yeah, because I want to start by differentiating what we're talking about right now, estrogen and progesterone from the contraceptive drugs in the pill, just to circle back to that because, 

Speaker 0 (35m 54s): Because there's a lot of confusion in the medical community, conventional doctors had no clue, not until I was trained in bio-identical hormones that did I realize, Oh my gosh, they're different. Why do we get taught in medical school? 

Speaker 1 (36m 11s): Dogs in the pill are referred to as estrogen and progesterone, but then, well, they're not in this. Okay. So estrogen is a generic term that can refer to it as to dial is our main estrogen, or it can refer to ethanol estradiol. That's the drug and the pill, or it can refer to different things. Progesterone is not a generic term. Progesterone is only describes the progesterone in our own body or that you can take in the form of a gesture that's been manufactured, but it's identical to the pedestrian in our own body. Like the same molecule as a, and just, this is a really important point. 

The progestin in the pill, which would be circling back. I was talking about dress pronoun or sifter. And these are a few of the progestin drugs that get used and are called progesterone. But they're not, those have strikingly different effects in the body. And particularly in the brain like strikingly different effects. I can't emphasize that. 

Speaker 0 (37m 5s): And this also includes my dropsy progesterone, Provera, pedestrian either, but we say it as doctors, Oh, we're going to put you on some progesterone. It's not progesterone. It's chemical progesterone 

Speaker 1 (37m 22s): That really illustrate the difference for progesterone versus progestin. One is that most progestins progestin some more than others, but most of them carry a small breast cancer risk, like an increased risk of breast cancer due to that drug. That's true for most. Progestins, that's what the research is showing now, including medroxyprogesterone progesterone from the research we have so far true. Progesterone does not seem to have that risk. And in fact, professor Pryor, who helped me with this book, I referred to her earlier Jerilynn Pryor. 

She has keeps presenting several lines of evidence that progesterone may actually reduce the risk of breast cancer. So that's, Justin's increased the risk, but just to run, reduces the risk. So that's one example of how entirely different they are. And that's actually one of the reasons why progesterone real body identical bioidentical, progesterone is now the preferred gold-standard treatment for menopause even conventionally that's happened the last six or seven years, which is, 

Speaker 0 (38m 26s): Oh yeah, I take progesterone at nighttime. It's wonderful. And we've got to let everybody know that progesterone is what your body makes when you're, you know, so it's that loving, calming. And I don't have to have children. 

Speaker 1 (38m 42s): No, I didn't have biological. No, I don't have tissues them 

Speaker 0 (38m 45s): When you breastfeed a child, you know, it's just that progesterones coming out and the oxytocin and then you as the mother and the baby just want to fall asleep. And it's, that's what the progesterone does. Is it just calms you down. Even my male patients use a little bit of progesterone, 

Speaker 1 (39m 3s): The brain, the brain loves progesterone. You're right. So part just around converts to a metabolizes naturally to a neurosteroid called allopregnanolone, which interacts with the GABAA receptors. So it's like the whole model Valium. That's what it's usually called. Whereas no progestin, no progestin, whether it's drospirenone a, Juxtapid just start a none of those convert to allopregnanolone. So that's another big difference. The first differences in the breasts, how progestin versus progesterone behave and the second is in the brain. 

And so yeah, progesterone, most women love it. If you take it at bedtime, I take it as well for sleep. So in New Zealand, well it's two ways you can get it. So you get it compounded. We can talk about that. But the main products in New Zealand is called U2. Justin that's in the UK, it's the same. I don't know where your listeners are from and in the U S and Australia and Canada, it would be Prometrium is the brand. Those are all body identical, progesterone. I E AKA bio-identical down here in Australia, New Zealand, the preferred term seems to be body identical. 

I think it's, 

Speaker 0 (40m 7s): I liked that body identical. That's really good. Where do, where do they get the nutritious? 

Speaker 1 (40m 15s): So it's a prescription item here. So it's specialist authority. No, I don't think no. I think any, any doctor can prescribe. So actually at the moment, the standard hormone therapy prescription that's given in Australia and New Zealand, it's the same in the U S and Canada. And the UK is an, a body identical estradiol patch usury, or the estrogen is given to the skin. It's combined with a body identical progesterone capsule also referred to as oral micronized progesterone, brand name, U2, Dustin, or Prometrium that's the standard. 

Now I was, I remember the first time like that eight or nine years ago when I just think of the date in Australia, when I was practicing in Sydney, Australia, that became the standard in around 2016, the end of 2016. And I remember the first time a patient came in and showed me what she'd been prescribed. And I almost cried. I'm like finally, after literally decades of like natural practitioners saying it would be so much better. If you give real hormones, you know, body, identical hormones, body image for pedestrian, that would be so much safer. That'd be so much safer that was knocked. Like literally for decades that was knocked back as pseudoscience. 

And then finally in the late 20 teens, it just quietly became mainstream. And it's, that's been a big step forward for women just to point out, not to say that that's the conventional prescription now is body identical, but women need to actually check what they're taking because they might've been given something else. 

Speaker 0 (41m 47s): It's not, it's not, it's not normal in New Zealand for a GP to give new Justin, 

Speaker 1 (41m 53s): You too, Justin. Actually, I feel one of my patients, that's what they're being offered anyway or something 

Speaker 0 (41m 58s): Because they're with you because they're with you and you've taught them, which is what we're doing now is teaching. 

Speaker 1 (42m 4s): So what you do is you say, Oh wait with, you know, I'd like to try some hormone therapy and then they write the prescriptions. Oh, is that just taking? But is that a patch plus you true Justin? Because I've heard that's better. 

Speaker 0 (42m 15s): Good. That's really important is teach your patient to be the CEO of their health so that they can teach the doctor. Cause our patients do teach us. 

Speaker 1 (42m 24s): Yeah. And just a tip when you're talking, if you're talking to a doctor about this, this seems small, but I recommend to not use the word natural. When you're talking about these hormones, they are natural hormones technically, but I find that most doctors that's adds confusion to the conversation. You don't have to bring that into it. You could just say, I want that particular brand name because it's safer than a progestin. 

Speaker 0 (42m 49s): Very good. Beautiful point. Let me see. I give you a hundred percent on our, let me see. I'll give you a big heart on that one. 

Speaker 1 (43m 2s): Oh, funny. Oh, I love your drops and yeah. 

Speaker 0 (43m 5s): Thank you. Yeah. And just so everybody knows, this is just a piece of material back here. It's not, it's not a backdrop. I just saw the material at the store the other day. And I was like, I love it. Okay. So let me see, where were we? Well, we've been all over the place. 

Speaker 1 (43m 28s): You're talking about the mood risk, the real mood risks with perimenopause. We're talking about how certainly hormone therapy, body, identical hormone therapy can be helpful for that in the book, in my book, I talk about these two kind of pathways for that. You can go the progesterone, progesterone only route, which is a little bit unconventional, or you can do it for just around plus an estrogen patch, which sounds like maybe that's what you're doing. Certainly a patch can be adding the estrogen can be quite a mood lifter and quick. 

Yeah. And it can also be good for as, you know, helping bone density, maintaining healthy bones, 

Speaker 0 (44m 5s): Thinking, thinking and all my gosh. So have you ever heard of Dr. Dale Bredesen? He wrote this book called the end of Alzheimer's. Yes. Yes. Okay. Well, he's trained a bunch of doctors around the world and I'm one of them and my husband's one of the nutritional chefs. And so what we found is there's like there are six ways that people can get Alzheimer's you like if you think of your head as the house, the roof, and if there's, if there's holes in the roof and it rains, then you're going to get flooded out. 

Well, your brain is the same way. If you've got deficiencies or deficiencies, then you're going to go ahead and be at higher risk for Alzheimer's and cognitive decline. And the first one is inflammation. The second is prediabetes. And second, the third is hormones. And how, how important estrogen is for women for their cognition. It's amazing. 

Speaker 1 (45m 7s): Let's talk about that. Cause I, I got, I go into that in quite a bit detail in the book. So the estrogen actually, it's funny, you mentioned the side by side, you mentioned pre-diabetes or insulin resistance and then estrogen next, just now they're related. Right? So the way they're related and the way this all relates to dementia risk is that with the drop in estrogen, we, all of us get a shift too, that pushes us to insulin resistance to some degree because estrodiol our main estrogen normally has quite a strong insulin sensitizing effect through throughout the whole body and including in the brain. 

So what the research has found, and I quote a couple of researchers, including my own menopausal brain, the woman who wrote a book called XX, Oh, Lisa Mosconi there. I remembered it. She's a researcher. She wrote a book called XX brain. She, 

Speaker 0 (46m 6s): Oh yes. I've seen that 

Speaker 1 (46m 9s): Roberta Brinton. These are the two neuroscientists. I talk like quote in the book. So what they've observed is with menopause when estradiol drops not to zero, but drops substantially it that QED correlator result in an up to 25% reduction in brain activity or brain energy, they can see that on the scans that they use. So what's happening is with the drop-in estrodiol the brain cells, the mitochondria to be precise, loose in part, lose their ability to turn glucose into energy and they have to switch to turning ketones into energy. 

So there has to be this degree of metabolic flexibility that has to happen as we transitioned to this low estrogen state. Now I, in my book, I touch on a whole evolutionary mismatch aspect of that. I, you know, evolution or menopause has been a lot around for as long as we've been human. I think in previous food environments, you know, sort of more in the pre-industrial age time that shift to reduce insulin sensitivity in the brain wouldn't have been as problematic because our food environment was such that we work in a big prone to insulin resistance anyway, but when you have this, this change compounded with our food environment, compounded with the problems with the gut microbiome and all the environmental toxins that are impairing metabolic flexibility, then the brain doesn't make that critical shift to burning work more ketones, if that makes sense. 

And that's where an estrogen supplement can come in, as the dial can support that system. Other ways to also not either either instead of, or in addition to, to support that system is to not have insulin resistance, right? Like to do everything you need to do to have good insulin sensitivity through the perimenopause transition and onwards into the coming decades. And that can all help to reduce the risk of dementia. Yes, absolutely. 

Lisa Mosconi the researcher I just quoted, she actually says quote in the book, dementia begins in menopause, not in every woman, right? And not only cause other well like susceptibility to it, but she's like the change is the energetic crisis in the brain that can lead eventually to menopause actually starts in our late forties and then takes 15 years to get to 20 years to fully manifest a fully developed. So this goes back to what I was talking about perimenopause and that early couple of years after the final period, being a critical window for health, right? 

This is an example of that. Your brain is recalibrating. It needs to switch to being able to burn ketones more efficiently to not get dementia, basically like, 

Speaker 0 (49m 3s): Amen. I agree. I agree on our website on under the tab of ending Alzheimer's we've got an ending Alzheimer's masterclass, it's a five-part series just because we want people to start this in their forties to start taking good care of so that they don't get Alzheimer's. Cause you don't have to have Alzheimer's you don't have to have dementia it's even if you've got the DNA, even if you've got the APOE E four, four gene, you don't have to have it. 

Dr. Bredesen has taught us how to prevent that from being expressed. So I love that you're talking about taking good care of yourself in a forties because it, it really will be advantageous to so many people, for sure. But you know, in our forties, we're all kind of like just getting started with the family and our profession and it's a busy time. It's such a busy time. It's incredible. It's true. So I'm glad you bring awareness to that. 

Were you going to say someone else 

Speaker 1 (50m 7s): Is going to just touch back on alcohol again? I was just going to 

Speaker 0 (50m 10s): Totally God for culture 

Speaker 1 (50m 15s): Narrative, right. That during this busy time, you know, wine is the answer and I, and it's, it's just so harmful to women. It's such a stereotype of, yeah, it's just, it's just doing a lot of harm and I just, I just really want to put the message out there again. And I have a big section about alcohol in the book and talk about when it's time to debunk this idea that, you know, alcohol is good for you in some way. It's not, it's not good for you. I mean, like, I guess I would acknowledge that in the, you know, certain situations would be not that bad to have a couple of drinks in a week or something like that, but big picture during this critical window it's yeah. 

It's not. 

Speaker 0 (50m 53s): Yeah. And we know that it increases your risk of anxiety and depression anyway. So bright red breast cancer. Yes. 

Speaker 1 (51m 1s): Here's a step for you if I can get this. Right. Like, so of course we've been talking about hormone therapy, body menopausal hormone therapy, which we both think can be quite helpful, although not to say every woman needs it, but if they want to, and you know that it's safe for them, they could try it. Of course has been a fear around. Okay. Does that increase the risk of breast cancer? Well, the short answer is probably not. If you use it with real progesterone, Richard, Justin, that we've been talking about it from atrium, but even then the estrogen component of it has a slight, slight, potentially breast cancer risk associated with it. 

But not as much as alcohol. Right? So moderate drinking, even like four or five drinks in a week increases the risk of breast cancer more than estrogen therapy does. Right. So it's just this to kind of put it in perspective that 

Speaker 0 (51m 58s): I don't think that message is out, especially in New Zealand. I don't know about Australia. Cause I don't live there, but definitely not in New Zealand. 

Speaker 1 (52m 5s): Yeah. Yeah. The, the risk between alcohol and breast cancer is not tentative, right? Like it's a known risk. The research is really solid and it's a linear risk, which means there's always a risk, but it goes up the more you drink, the more the risk goes up obviously, but even a few drinks in a week carries a risk. Yeah. So yeah. We're not going to be a popular podcast. We're we're we're the bearer of bad news. 


Speaker 0 (52m 37s): Yeah. But Hey, don't we want to live life without disease. I do. How about you? Yeah, definitely. I've taken care of too many people that have got chronic disease and are sick and it's an ugly life and it's all it's most of it is preventable for sure. Thank you, Laura. You've been wonderful. Now I wanted to do a call out for your two books. You have another book in the making. 

Speaker 1 (53m 3s): Oh, not yet. Now 

Speaker 0 (53m 6s): I've written one book. I know how painful that was, but I'm sure it wasn't painful for you. 

Speaker 1 (53m 10s): Oh, it's a lot of work. I always say to people, imagine how much work you think it's going to be and multiply that by 10 

Speaker 0 (53m 17s): Having homework every single day for months after months after months. Yeah. Okay. So the first book is period manual. And the second book is hormone repair manual healthy four months after 40. Thank you so much. And your website is Laura by Bryden. That's L a R a B R I D E And we'll be having links and contacts and everything on all of this. Okay. 

Speaker 1 (53m 46s): So nice to meet you. Maybe I'll meet you in person. Like we were saying, we're in the same country. We 

Speaker 0 (53m 51s): I'd love to. I'd love to go out and have a meal with you on some soda. Water. 

Speaker 1 (53m 55s): Yeah. Posts too. Yeah. 

Speaker 0 (53m 59s): And we'll do a picture and put it on social media. All right. Thank you so much. 

Speaker 1 (54m 6s): Thanks for having me. 

Speaker 2 (54m 11s): Hello, chef Michael here. If you enjoyed today's episode, we would love it. If you subscribed to the podcast and left us a review.