I am thrilled to connect with Dr. Tyna Moore today. She is a naturopathic physician and chiropractor, host of the Dr. Tyna podcast, a best-selling author, and an international speaker who offers a unique perspective for those seeking a stronger foundation for their health and well-being.
Recent statistics indicate that approximately 13% of Americans have used GLP-1 agonists, a class of drugs primarily prescribed for weight loss or metabolic health issues. According to a KFF health tracking poll, over 15 million people were prescribed GLP-1 drugs as of May 2024, and a Truvada report revealed that more than a million patients used those medications between January 2018 and September 2023.
Dr. Tyna thinks outside of the traditional media narrative regarding GLP-1 drugs and has been very successful in using them with her patients. In our discussion today, we explore the underlying reasons for the metabolic health crisis in our country, looking at sarcopenic obesity, why we are malnourished yet over-fed, and the impact of a sedentary lifestyle. We also dive into GLP-1 drugs, discussing their origin and their neurologic benefits, debunking the myths surrounding them, and examining their use during perimenopause and menopause.
Stay tuned for today’s enlightening discussion with Dr. Tyna Moore on these incredible new weight-loss drugs and their application.
IN THIS EPISODE YOU WILL LEARN:
Why are we so sick as a country?
The limitations of traditional allopathic medicine regarding lifestyle-related diseases
Why weightlifting is essential for optimal health
The benefits of peptides for cognition, pain reduction, and preventing brain fog
The advantages of using GLP-1 agonists for treating depression and metabolic dysfunction
The potential risks of using GLP-1 drugs
Debunking the myths surrounding the use of GLP-1 drugs
Why women in perimenopause and menopause face unique challenges with metabolic health
Why middle-aged women are the most stressed group of people, and how stress can exacerbate insulin resistance
The merits of using GLP-1 peptides for treating middle-aged women with metabolic issues
Why proactive lifestyle changes are essential for the neurocognitive health of menopausal women
Bio:
With nearly thirty years immersed in the medical field, Dr. Tyna Moore is an expert in holistic regenerative medicine and resilient metabolic health. She is licensed as a Naturopathic Physician and a Chiropractor, drawing on knowledge from both traditional and alternative fields of science and medicine to provide a comprehensive perspective to individuals striving to enhance their health and well-being. Dr. Tyna holds degrees from the National College of Natural Medicine, an esteemed naturopathic medical school, and the University of Western States Chiropractic College. Her work is not just about treating symptoms- it’s about understanding and healing root causes to build a robust foundation for long-term well-being. She is well-known for her fierce and open-minded exploration of the peptides Semaglutide/Ozempic as longevity tools for healing. Dr. Tyna champions medical autonomy and individual accountability, and she is on a mission to help as many people as possible experience the freedom and joy that health brings.
As the host of The Dr. Tyna Show Podcast, a top-ranking podcast in the health and wellness space, and an international speaker, she is dedicated to empowering others to take control of their well-being, heal their metabolic health, and build strength and resilience. Her cornerstone recommendations for every patient and listener are weight lifting and sunshine. Additionally, she extends her expertise to support fellow doctors in cultivating their online practices, helping them transition away from the insurance-centric model to reclaim time, financial stability, and freedom.
Dr. Tyna lives in Oregon with her husband and daughter and is a proud dog mama. He is also passionate about public speaking, coffee, wine, reading, stand-up paddle surfing, and resistance training.
“Women can still turn the ship around and build muscle, even in their 60s, 70s, and beyond.”
-Dr. Tyna Moore
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Transcript:
Cynthia Thurlow: [00:00:02] Welcome to Everyday Wellness podcast. I'm your host, nurse practitioner Cynthia Thurlow. This podcast is designed to educate, empower and inspire you to achieve your health and wellness goals. My goal and intent is to provide you with the best content and conversations from leaders in the health and wellness industry each week and impact over a million lives.
[00:00:30] Today, I had the honor of connecting with friend and colleague Dr. Tyna Moore. She is both a licensed naturopathic physician and chiropractor, and she brings a unique perspective to those wishing to build a more robust foundation in their health and wellbeing. She's also the host of the Dr. Tyna podcast, a bestselling author and international speaker.
[00:00:51] According to a May 2024 KFF Health Tracking Poll, 6% of US adults or more than 15 million people, were currently taking a prescription for a GLP-1 drug as of May of 2024. These are drugs like Ozempic, Wegovy, Mounjaro. A Truveta report found that between January 2018 and September of 2023, over a million patients were prescribed a GLP-1 medication and lastly, one in eight or about 13% of American adults, have used a GLP-1 agonist, a class of drugs prescribed predominantly for weight loss to treat metabolic health issues.
[00:01:30] Today, I spoke at great length with Dr. Tyna about why we are so sick as a country and as she refers to it, "A busted metabolism," the role of sarcopenic obesity, being malnourished, overfed and under muscled, the impact of being sedentary. Key information about where GLP-1s drive from. Key benefits including neurologic benefits, neuroplasticity, as well as a reduction in neuroinflammation, myth busting and false narratives specific to the use of these drugs, including concerns over dosing relevant to gastroparesis, too fast to titration, monotherapy, lack of strength training, gallbladder issues and so much more. How to use these drugs in perimenopause and menopause? And as Dr. Tyna says, we want to train for menopause and whether or not she feels that these are lifelong drugs or drugs that need to be tapered.
[00:02:27] This is a very interesting, informative, and proactive discussion about the utilization of these drugs in micro dosing and how Dr. Tyna has had incredible success with her patients and is thinking outside the kind of traditional media narrative specific to these weight loss drugs. I know you will enjoy this conversation as much as I did recording it. Well, Dr. Tyna, I've been so looking forward to this conversation. Welcome to the podcast.
Dr. Tyna Moore: [00:02:57] Thank you. Thank you so much for having me. I'm excited to be here.
Cynthia Thurlow: [00:03:01] Yeah. Let's talk a little bit about why we are so sick as a country. I think that you and I have probably both been in clinical practice for roughly the same amount of time. And I jokingly say I feel like in many ways, we're heading in the wrong direction. And then I do see points of brightness and clarity that remind me that there are individuals that are working hard to change the trajectory of this metabolic health crisis, but what do you perceive to be the main reasons why we are so metabolically unhealthy?
Dr. Tyna Moore: [00:03:33] Oh, it's so interesting. I'm guessing we're close to the same age. I won't guess your age, but I'm guessing we're of the same Generation X, and we probably watched this happen and unfold during our lifetimes. And back when I was a kid-- I did grow up in southern California, which was a very active, outdoor lifestyle kind of place, but there were maybe a couple kids in our school who had struggles with obesity, and their parents would generally as well, and so there was something familial going on there, but what it has turned into and where we're at now, I think is absolutely a crisis. I am not as hopeful as you. I honestly feel like we are headed towards extinction as a species to be totally honest with you, and there are my reasons for saying that, not to start the whole thing off on a glum note, but I have watched this progress over my clinical practice for decades.
[00:04:21] My mentor, I became his receptionist when I had graduated from undergrad. Prior to that, I was working in an Alzheimer's and dementia clinic in a big teaching hospital in Portland, Oregon. So, I've always been in medicine. And then before that, I was a patient. But I saw the changes in these Alzheimer's patients, which we know a few years later after that, they were coming out saying this was diabetes type 3, and we've known that for like 20 years. It's just now catching on on social media that these changes in the brain and this dementia is driven by blood sugar dysregulation.
[00:04:53] And my mentor really instilled in me the value of keeping your waist circumference in check and managing serum insulin levels, blood sugar. When I met him, was about the time that they had dubbed metabolic syndrome as syndrome X. It was kind of this vague term. And from there, it's only really collectively gotten worse. And I would screen all of my patients from day one of practice. Well, even when I was a student, I was screening everybody for metabolic dysfunction. I took a lot of heat from my colleagues, which I thought was interesting because we're naturopathic doctors and chiropractors, I'm both and you would think that both of those groups would be particularly interested in metabolic dysfunction, but they sure weren't. And I remember catching some flak from some colleagues saying, "Tyna thinks everybody has metabolic dysfunction." And this was in like 2008, and here we are.
[00:05:42] The vast majority of US adults has some version of metabolic dysfunction. So, it's really a problem, and it goes way beyond aesthetics, it goes way beyond just, "Oh, no, somebody's going to walk into type 2 diabetes, and we've normalized that, we've normalized fatty liver, we've normalized all of this because it's so prevalent. The doctors diagnosing it have it, and we're really at a place where I think if we don't turn the ship hard, we're going to be in big trouble.
Cynthia Thurlow: [00:06:09] Yeah. It's so interesting for me because my clinical background as a nurse practitioner was in Cardiology. And I distinctly remember in about 2010, when I was coming out of the haze of having two kids under the age of 5, that I distinctly remember having these conversations with my colleagues and saying, "I think we need to spend more time talking about lifestyle." And they thought that was funny. In traditional allopathic medicine, there's not enough time to spend a good amount of effort discussing sleep and stress and nutrition and yet those are the things that are the biggest needle movers. You know exercise and-
[00:06:46] -I kind of was brought up in the timeline of exercise more, eat less. And not that I was ever in a position where I shamed my patients, but that kind of prevailing philosophy of, like, "Oh, the lifestyle piece isn't really-- Just exercise more and you burn more calories that way," like simplifying things down to calories in, calories out. And I know a lot of the bro science guys across social media will talk about why-- It's just about caloric restriction, and that's how you lose weight, and that's why it's so effective. And so, I feel in a lot of ways, we've moved the needle forward in discussions, but we haven't done enough in terms of patient education and prevention. And certainly, allopathic medicine, there are people that are doing exactly what we're talking about, but more often than not, they're over hairy, they have not enough time with their patients.
[00:07:37] We've conditioned our patients to take a pill for lifestyle-related diseases and we haven't empowered them enough. I know that you talk a lot about sovereignty and patient accountability and why that's so important. And so, when we're talking about, as you refer to, "busted metabolisms," that's kind of the start of this kind of nuanced conversation, I also think about the role of sarcopenic obesity and how so many people are incredibly malnourished.
[00:08:03] I know our mutual friend Gabrielle Lyon talks about being under muscled and overfed. And so, in a lot of different ways, helping people look at this crisis a little bit differently. I know that, especially on social media, I see you lifting weights and talking about the importance of muscle. And so, let's shift the conversation and talk a little bit about some of the other things that are contributing to this crisis, not just the ultra-processed foods, but this lack of muscle development and how sarcopenic obesity really will magnify things, especially as women are navigating perimenopause and menopause.
Dr. Tyna Moore: [00:08:36] That is a great conversation because that's really what I came out online with over a decade ago. That was my platform, was lift weights and eat meat, and lift more weights and eat meat. And nobody wanted to hear it. And in fact, my colleagues didn't want to hear it. And I would go around lecturing at medical conferences and they would heckle me and they didn't want to hear it. And I really couldn't get people to understand how critical it was to take care of that organ system that is your muscle, your skeletal muscle. And I'm so happy to see it actually catching some mainstream attention. And definitely kudos to Dr. Lyon and everybody else. It was popular online for health influencers to tell people to go vegan and do yoga, I was like, just deadlift and eat steak.
[laughter]
[00:09:20] Get some sun while you're at it, do it outside. And it was really just kind of this meathead way of looking at it, that's how I got treated, I was like, "Oh, Tyna's just a meathead." But I have since watched those critics age over the past 10 years or so, and they're not looking so good. So, I think I maybe found the secret. The fountain of youth here is truly on the barbell and in those kettlebells.
[00:09:40] We are looking at everything from this really mechanistic, simplistic standpoint. Like you said, the calories in, calories out is really hard for people to let go of because it was drilled into us. Our generation was like the cardio bunnies. Like, do cardio, cardio, cardio. We had the gyms with the little pink rooms. Did you ever have those?
Cynthia Thurlow: [00:09:57] Yes.
Dr. Tyna Moore: [00:09:58] The room was pink. It was for the girls, the women. It had little pink dumbbells in there, and that's just how we’re raised up. And I am just kind of a punk rock girl who likes to listen to heavy metal and has tattoos, and I like throwing weights around. So, I found my tribe of people, and I'm happier with that crew, so I took to it. But I know that's an intimidating visual for people, and a lot of women are like, "I don't want to get bulky, and I don't know where to start, and I don't feel like I have the skill." And it really is a skill set, so I know there's a barrier to entry, but all that said, when I was in practice, my practice was predominantly regenerative medicine. I still see some patients, but my big clinical practice was regenerative medicine, physical medicine, all day long.
[00:10:38] This is where I figured it out. My mentor drilled it into me. He drilled it into me in the 1990s, stopped doing cardio, start lifting weights, but I did not listen. And then I am years later in clinical practice, and I'm noticing a theme between my patients who healed and my patients who didn't. So, I was inducing healing by injecting natural substances, oftentimes their own cells, PRP, platelet rich plasma stem cells, dextrose solutions, different solutions that were natural derivatives to induce joint regeneration. And the one defining factor that I could put my finger on and say, this person's going to heal really well, and do well with this was whether they had good muscle mass. Their diet could have been in shambles. A lot of these guys were sucking down Mountain Dew and eating kind of garbage food, but they had great muscle mass because they were in the gym regularly, and they always healed well. They always responded well. They always did beautifully.
[00:11:31] And my patients, who just got nowhere, had very low muscle mass. They were usually very thin women who were like, "I can still fit in my jeans from high school." I'm like, "Well, good job, honey, but you're just literally all fat and bone now, you have no muscle, and that's not going to serve you well going forward as you age, it's certainly not helping your hormones or your bones or your longevity." And those ladies did not do well because their joints were literally hanging off of their body and by ligaments that were stretched out. So, I became keenly aware that muscle was the dividing line on who was going to heal and thrive and who was not.
[00:12:08] And so, I was walking into menopause early years, I was seeing it on the horizon. I was around 40 years old and I'm 50 now, and I remember thinking about my mom and her horrific menopause, and then at the time, I was hearing about my sister's transition, and I was watching all these women in my practice go through it, and I was like, "This sounds miserable. I'm going to train for this. I'm going to literally train for this." That was it, it opened up a whole new world to me of understanding, and I'm a research nerd, so, of course, I was researching the benefits of muscle way back then and really finding out all this information.
[00:12:44] My paths crossed with Dr. Lyon years ago, so it's been really fun, kind of learning from her along the way as well. And it's not just about the food we're eating either. People want to make it that simplistic. My profession really carries that torch. Oh, it's about the food, it's about the supplements, but their train wrecks of metabolic health themselves for the most part, it's about more than that.
[00:13:04] And it's not just about the muscle, but I will say, of all the factors, muscle will carry you the furthest. I think that is a bigger needle mover than a lot of these others. I'm not saying eat crappy food, but all things considered, if I were to have to pick only one, going into older age, I would pick a slab of well-trained skeletal muscle above making sure that we need to keep that muscle and therefore we need good adequate protein. But this conversation and tribalism around what to eat and what supplements to take and all of this, "I'm like, just make sure you lift some weights along the way. That's really going to be the critical factor as you move forward and not breaking a hip." I don't know, what do you think about that?
Cynthia Thurlow: [00:13:45] No, no, I think you're bringing up such a good point, because on this podcast, I have the opportunity to talk to physicians and researchers, and more often than not, when we're not recording, they'll tell me, "I eat really well, I prioritize my sleep, I prefer doing yoga, I don't like lifting weights." And for me, the very first time I met Gabrielle, honest to God, it would probably within five minutes, she said, "I don't think you're eating enough protein." And it was the first time like, it was four years ago, this light bulb went off in my brain. And when we had this conversation, I said, "I cannot think of another physician that has had such a large impact on my thought process," because it changed everything for me.
[00:14:24] And it made me think back to the 50-year-old patients that couldn't get off a bedside commode in the hospital. It made me think about the degree of frailty, and really, when we're talking about muscle mass, we're talking about insulin sensitivity, this very metabolically active organ, but we're also talking about this risk for falls. I just personally went through this with my father, and he fell, and he was very frail and hit his head and got a head bleed and that was the end.
Dr. Tyna Moore: [00:14:49] Aww.
Cynthia Thurlow: [00:14:50] And so, for me, it's such a personal story about understanding, not just for myself, but making sure listeners take it seriously. And I just interviewed Dr. Vonda Wright, and she was talking about, you need to lift heavy enough that you are lifting four to six reps, and it's too heavy to lift more. Like helping people understand like that is what you are working towards. It is not lifting the same weight 25 times, like that can be for endurance. But I think to your point about talking about the pink gyms and the girl’s gyms and all those things women have been conditioned to believe that we want to prioritize cardiovascular exercise at the expense of maintaining muscle, and I think that can be incredibly detrimental over time.
[00:15:33] Now, one of the things that I really value about your work is you've been very outspoken about talking about the use of this drug class, these GLP-1s. And so, let's talk about how they work mechanistically and then some of the false narratives that come along with these GLP-1s, because, admittedly at the very beginning, when these drugs were becoming more popular, I had some guests on and it was more focused on, these are the concerns about why you don't want to take them, and now there's a lot of nuance and certainly the microdosing. I know that we'll get into talking about a lot of the neurological benefits of being on these drugs, but let's talk about how they work, how they came about, and then for you may be giving us some of your least favorite false narratives that are surrounding these right now.
Dr. Tyna Moore: [00:16:20] Sure. First, I have to tell you a funny story, though, about lifting weights. The other day my husband was standing there, and I said, "Babe, you're getting a little thick in the midsection." And he said, well, you know, he teased me. He's like, "Why you got to tell me that?" And I said, "Because I need you at a certain weight so I can deadlift you to safety if anything happens." I train to make sure I can deadlift his weight. Like, I literally train to make sure I can deadlift his weight. And I give myself about a 10-pound leeway because I know if there's a lot of adrenaline, I'll get there. But I was like, "I need you to stay under this amount so that I can--"
[laughter]
Cynthia Thurlow: [00:16:54] For safety reasons.
Dr. Tyna Moore: [00:16:56] Lifting weights is a real. This is like a real issue of just being a helpful human in the world, maybe saving your own ass or saving somebody’s you love. So that's how I look at lifting weights when people say, "Oh, a little dumbbell’s okay?" I'm like, "I don't know, can you deadlift your husband?" [laughs] That's what we're going for.
Cynthia Thurlow: [00:17:12] That's a very practical approach, but one that is very important.
Dr. Tyna Moore: [00:17:16] Oh, man. And I fell down one time. I tripped and I went straight for a curb, like teeth first. It was end of a concert, it was dark out, and I caught myself and I pushed myself out of it. And I remember clearly thinking, because the concert was like a band that was age appropriate for me, so everybody there was my age. And I remember thinking that just about any other female that walked out of that venue would have just smashed her face open and been in the hospital. It was a bad fall. And I caught myself right at the curb and pushed out. And I was like, "Thank God for bench press." These are practical applications.
[00:17:48] Okay, GLP-1. So, I like you was hearing all of the information coming out about a year ago last summer, and I just thought-- It was last spring. And I was like, "This is really sounding propagandized," because everybody was singing the same tune. And I was like, "Let me look into this." And so, I started looking into it, and the first thing I do is look up mechanism of action. And I'm like, "Oh, these are peptides. These are not drugs. These are peptides. They just are being dispensed by the pharmaceutical industry."
[00:18:14] And so, I immediately went over to, like-- I'm friends with a lot of the bro science guys, and I start going down that pathway, and I'm in the regenerative medicine community, so I have friends in that world that use peptides. And I start asking everybody, and they're like, "Yeah, this is a peptide, we've been using it." Really, actually for your listeners in the intermittent fasting community, big tool. It's just a really wonderful tool to help with getting people going on that intermittent fasting journey. And they're using it a bit as an appetite suppressant, they might be using it to cut some weight off, but these are all very fit people already. They're not necessarily using it on in that biohacking community, it's more of a longevity. It's more of a fine-tuning type of peptide, and I was like, "Sweet, sign me up. That is what I was looking for at the time."
[00:18:58] I was having a lot of brain fog. I am 50 years old. I'm in that perimenopause period. Post COVID, I had some brain fog, as many people did, very common. I was under a tremendous amount of stress, more than I had ever endured, and it had been longstanding. And I just was feeling like my circuits were not firing on all levels up in my brain. And I have some pretty unfun autoimmune conditions, and one of them drives a lot of chronic pain for me, which I well understand is a central origin. I very much understand how the brain works. I have a particular interest in neurophysiology and pain. And so, I thought, "Well, I wonder how they work up there?" And that was the first thing I looked up and found wonderful literature supporting neurocognitive benefits, anti-inflammatory benefits on the brain, neuro-regeneration. I was like, "What? This is crazy. We don't really have anything that works like this." And then I thought, this is not what we're hearing. This is not what we're hearing in the media.
[00:19:56] Looking into it further, obviously, this is a naturally-produced peptide in our bodies. It's produced by the L cells in our gut. It's produced in our brain as well. It's got to have more impact on our brain than just appetite suppression if it's produced up there, and there's receptors all over the brain for it in different parts of the brain. But what was interesting, you understand, because you're a functional medicine doctor. I thought, well, everybody has gut issues. Like, I can't remember testing a patient who didn't have gut issues, and they've got leaky gut, maybe they have IBS, maybe they have something as extreme as inflammatory bowel disease. And I thought, well, a lot of people's L cells in their guts are probably shot to hell. So, I wonder if folks are having some kind of functional deficiency. And in my world, I treat functional deficiencies with the peptide or the hormone that's needed. If somebody's lifestyle their way into hypothyroidism, I'm still going to give them thyroid hormone, I'm going to dial in their lifestyle, I'm going to dial in their health markers, but that doesn't mean I'm going to keep them from having the hormone that they need to feel better, that's just how I treat.
[00:20:54] And so I thought, I wonder if I utilized physiologic dosing and that would be different for everyone, but I'm suspecting it would be significantly lower doses than most people are taking for weight loss and diabetes if I wouldn't see some profound impacts on different organ systems of the body that I was finding literature on the heart, the kidneys, the pancreas, the muscles, the bones, the joints, that's my wheelhouse is, the regenerative medicine space. And I was finding really, really compelling literature on not just human studies, but mice and rats showing regenerative, anti-inflammatory, and healing impacts on all these different organ systems.
[00:21:35] It was very exciting because at that time, a lot of data was coming out, good data on big trials for finalizing like the select trial that finished up at the end of 2023, all about cardiovascular benefits. And so, I don't know, I've just been kind of riding this wave, and I have been knee deep in the literature, and this is all I've been paying attention to for the past year, is what are GLP-1s doing in the body? And it's fascinating to me. And so that's where I became interested. I started speaking about it on my podcast, and then I have a decent-sized audience like you do and I was getting a ton of feedback from my followers who were reporting, "I went on it for this reason," usually some kind of metabolic dysfunction, weight loss, or type 2 diabetes, frank type 2 diabetes, but they were having all of these other impacts. They were able to come off their antidepressants. They were coming off of their autoimmune drugs. They were coming off of even sometimes being able to lower their thyroid dose. They were having their thyroid antibodies normalized. So, I'm getting feedback from hundreds of people from all over the world in real time telling me these incredible benefits. And so, I feel like I'm in a unique position for having stood up and said something, because now I'm getting all this feedback talking to doctors, etc. And it's really exciting and it's not everything the media is telling us.
Cynthia Thurlow: [00:22:50] Well, and that's why I was so interested in having you on the podcast, because I'm a nerd and I love to learn. And I went down a rabbit hole. And then for me, I thought to myself, "Okay, we're thinking too myopically about these drugs. We need to think broad and we need to educate ourselves that in appropriate dosing, whether it's micro dosing and/or compounded dosing, that it's so much more than just weight loss." I think that's been the media's focus. And then, contrary to that also the media's focus is on weight loss. And then, "Oh, you're going to end up being nauseous, you're going to vomit, you're going to have bowel issues, you're going to be on these drugs forever," and I think what it really comes down to is that there's a huge role of bio individuality. We really have to understand that they are applicable for more than just solely weight loss.
[00:23:37] And for me, I found it really interesting how they're working mechanistically, that they're helping with insulin sensitivity, they're helping with a reduction in appetite, they're helping with neuroinflammation, as you mentioned. And how many people are dealing with neuroinflammation to some degree or another? Especially women in perimenopause and menopause who are already struggling with that loss of insulin sensitivity, they're becoming sarcopenic if they're not actively working against it. They're working against their hormones. For so many of us, that you have less circulating estrogen, you have less circulating progesterone, most of us have less circulating testosterone. Our thyroid may need to be on life support. And I love that you're speaking to these things, because for a lot of people, it is beyond just the weight loss aspects, and that's why I think this conversation is so vital and needed.
Dr. Tyna Moore: [00:24:27] Thank you. Yeah, well, you know, the way I've been treating in my clinical practice for the past several decades is really no different than what I'm trying to share out right now. I just plugged GLP-1s into the equation. They're just a tool amongst many others. Probably like yourself, I have been giving out the bioidentical hormones all of these decades. I was not scared off by the Women's Health Initiative, two decades ago when they were like, "Estrogen will kill you." I knew that study was flawed. I knew they were using progestins and not progesterone. I knew better. I had great mentors. I've been in this world a long time. And so, for me it was like, "Oh, this is just this wonderful tool that's such a needle mover."
[00:25:05] And I firmly believe and I'm getting confirmation from other clinicians on this as well, and this is pretty well known in the space of longevity medicine and doctors who are using this peptide for some time is that the dose really makes the poison. So, when you overdose someone on a-- It's a signaling peptide hormone, first of all, that is also what insulin is. Insulin is a signaling peptide hormone. If we overdose someone on insulin, they'll die. These are not innocuous. And so, when we look at the standard dosing, they're starting out too high I think in many people. So, people are getting slammed with the dose and they're so sick they can't get past that first hurdle. And then they are bumped up relatively quickly and steeply over about 16 weeks. And that's what the studies looked at. So that's how doctors have been prescribing them.
[00:25:51] But I actually think the whole community at large, not just our sect of the woods, but I think that even in the allopathic community, I'm seeing folks come out at different congresses and sharing what they're doing in their clinics and doctors are realizing this is an individualized approach. We don't have to go up to super high doses. We can stay at lower doses depending on the individual and depending on their response. And obviously, we need to implement other lifestyle factors. And so, there's even data coming out showing that those who are exercising during their use of GLP-1s are indeed able to come off and maintain that weight loss to a significant degree. They're showing that if you titrate them down slowly, people are able to come off and have success with continued weight loss.
[00:26:35] And so, I think it's just common sense will eventually kick in here, but the dose is too high in most cases. And I think a lot of what we're seeing and what we're hearing about this clickbait propagandized mainstream media story is cases of overdose. They're just being overdosed on GLP-1s and it's making them horrifically ill, and so, they're getting terrible nausea or they're getting terrible gastrointestinal symptoms. Although the data, even at super high doses, does not equate to what the media is telling us. We're hearing in the media, and we're hearing from some folks online, different influencers, saying, "Oh, 80% of people are having extreme nausea," that's bullshit. The data shows more around 20% to 25%.
[00:27:18] The muscle loss story, I'm so tired of that one. I'm about at the end of my rope on that one because I'm hearing, actually, intelligent people perpetuate that myth, and it's getting tiresome. The muscle loss situation is that anytime you put somebody on a calorically restricted diet that's intensely calorically restricted, they're going to drop to 25 to 35, somewhere in there, percentage of lean mass loss that's on par with bariatric surgery, that's on par with very low-calorie diet. We don't need to dose people into complete loss of appetite. We don't need to dose people into crushing their appetite to the point where they don't want to eat.
[00:27:54] So, that's not the way you do it, that ain't it, right? We want about one pound of body weight loss a week, not 20 pounds in a month. And the traditional standard way of doing things is just too aggressive. And so, you're taking somebody who doesn't know how to eat well. They don't have the lifestyle pieces in place. They probably wouldn't have gotten into this mess in the first place if they did. And so, they are sort of flying blind. Their doctors don't know what they're doing. You know, most doctors don't have a clue how to deal with metabolic health. I mean no disrespect, but that community, even our own community, so many people in our own community are still like pumping supplements.
[00:28:28] I was thinking about this morning. It's like, "Here's your supplements, and here's all this fancy shit and all your fancy tests." And I'm like, "Dude, are you having them lift weights and go in the sauna and walk?" They still don't get it. So that's where we're at. And I feel for the patients, but these patients are flying blind. They're losing weight, it's exciting. Losing weight is exciting. They're feeling better because of all of these impacts on the body that are independent of the weight loss. They're having these profound impacts on their brain. There might be having antidepressant effect. They're feeling good and they start losing weight crazy fast. And it blows out their muscle mass because it's too fast. And they might not be prioritizing good quality, nutrient dense foods and their proteins, instead they're just choosing to eat less of the same garbage food they've already been eating for years with the habitually eating. So, they're not being taught new habits. And they're certainly not strength training and prioritizing muscle. We've already covered why that's a daunting task for people. And so, everyone's blaming the peptide and I'm over here like, "Well let's talk about the management and the dosing. And let's also discuss the compliance on the patient's end," because there are a lot of good doctors trying to do good work, and you know as well as I do that getting patients to lift weights and eat protein is like pulling teeth. So, there's a lot of things here that are nuanced and variable in the equation that have nothing to do with the peptide.
[00:29:48] The peptide itself is actually regenerative to muscle. It might even have a anabolic impact in a way, because it hyper perfuses the muscle with new blood supply which brings in essential amino acids, which induces muscle protein synthesis. It is anti-inflammatory on the muscle and the joints and the ligaments and the whole structure of everything. So, it's anti-inflammatory on the synovium of the joint. It's really, really cool what it does to the musculoskeletal system. And yet we're still hearing these seemingly intelligent folks saying, "Oh, it's the muscle mass I'm really worried about. It's really profound." It's like, "Okay, well you can keep believing that, but that's not what the data is showing."
Cynthia Thurlow: [00:30:28] Well, and it's so interesting because when I heard you speaking to this specifically, I thought to myself, you're absolutely right, that in many instances the things that we and I say we as collectively as a community are expressing concerns about are probably completely unrelated to the drug, unless it's a dosing issue, thinking about too fast titration because that's what they did in the studies. If you're not talking about macros with your patients’ protein, fat, and carbohydrates. If you're not advising your patients to reduce or eliminate ultra-processed foods, which we know are not going to be metabolically satisfactory, thinking about just using GLP-1s, this is what I oftentimes see, women will share on social media or their share privately with our team, and they'll talk about what they're doing. And I'm like, "Well, if we're not talking about prioritizing sleep and movement just at a basic level, and we're not talking about macros, and you get put on a GLP-1, and you're still eating ultra-processed foods and you're sedentary, not managing your stress, of course, you're not going to see what you're looking to achieve."
[00:31:36] And I love that you brought up the one to two pounds per week maximum of weight loss, because that is what is sustainable. [crosstalk] losing five or ten pounds a week, that is not sustainable weight loss. And I remind patients all the time, you know I used to say, slow and steady wins. And so, I would say if you lose four to six pounds a month, that is much better than this sudden, drastic weight loss, because that will then create this kind of yo-yo dieting, which we know already we're in a toxic diet culture to begin with, but that is what feeds into that yo-yo dieting mechanism where we know more often than not patients will gain back even more weight than they lost initially.
Dr. Tyna Moore: [00:32:15] Yeah. Especially if we crush their appetites to the point where they do lose this extreme amount of muscle mass, they're going to be sitting on the tail end of this really metabolically devastated. So, we take somebody who's potentially overweight and type 2 diabetic. Type 2 diabetes, by the way, which I know your audience knows this, but for anyone listening who doesn't, that is a very extreme form of metabolic dysfunction. We have normalized it to the point where everybody thinks it's, "Oh, it's not a big deal, it's just a number on a lab, and now you have it." No, you've been having severe metabolic, dysfunctional and mitochondrial changes for decades leading up to that diagnosis, and a lot of damage has been done in the body.
[00:32:52] And insulin resistance is no joke. I got, how many people do you think?-- I can't even remember seeing somebody's labs not have insulin resistance to some degree. This is decades ago when I started practice. So, it's a real mess, and these folks on the tail end of this Ozempic journey, if it's not done right, are going to be really, really in a pickle and probably some bone loss in there as well. So that's a real mess that's happening.
[00:33:18] And I totally understand why people are up in arms about this. And a lot of people have gotten mad at me, and I take a lot of heat for it because they're seeing their coworkers or family members just literally waste away in front of them, and that's not good. This is not what we're talking about.
[00:33:33] I actually had somebody the other day asked me, "From last summer till now, I'm 20 pounds lighter. And it's because I've been taking tiny doses of GLP-1s for various reasons unrelated to weight loss, but the weight loss was a nice side effect." And she said, "Well, you don't have Ozempic face. How did you do that?" I'm like, "Because the peptide doesn't cause Ozempic face." These are not causal, these issues. The Ozempic face is because of drastic weight loss and lack of muscle mass, but I lift weight and I eat my protein and I move my face.
[00:34:06] I think a lot of the, maybe the celebrities were saying, those folks have had decades of Botox and significant atrophy. I'm not saying Botox is bad. I'll raise my hand and be the first to say I've had my fair share, but they have had significant atrophy to their facial muscles and now they just lost all their fat very drastically. And then the media puts filters on it to make them look even more sickly. And they're like, "Look what happened to so and so, you're all going to die." It's just bonkers. And to go back to your question about some of the myths, can I hit a few real quick?
Cynthia Thurlow: [00:34:37] Absolutely.
Dr. Tyna Moore: [00:34:38] So, the gastroparesis, that's not permanent. That is a phenomenon where things get slowed down. Although I just saw a study yesterday, they looked at. This is interesting. I do not have the details exactly in my head, but I saw it, and I was like, bingo. They actually realized-- Oh, they were looking at giving or pulling the GLP-1s prior to surgery because it can slow down gastric motility, and they don't want patients to be aspirating food that's been sitting in their gut for a long time when they're under general anesthesia. And what they found was that it really didn't slow gastric motility that much compared to those who were not on GLP-1.
[00:35:13] So anyway, it can cause some cramping and terrible feelings in the stomach. I have given myself a little bit too much, and it does happen. That is transient and it goes away as the peptide leaves your system. The thing that no one's talking about is that the group taking these the most, the folks who are in that type 2 diabetes category, and the folks who are obese, but mostly the ones who've had extreme blood sugars for a long period time, they have hyper sugared up their vagus nerve. And type 2 diabetes drives you into gastroparesis, it's the main cause of gastroparesis. So, these folks are very often sitting on the edge of a compromised system and a compromised vagus nerve that's leading to their gut, that's impacting their gut motility, and then they get cranked up on this high dose and it throws them over the edge. It's like how COVID really sort of brought out whatever somebody was sitting on the edge of. Like a lot of women got thrust into menopause, a lot of people dropped into thyroid issues. You compromise a system and you're going to go over the edge.
[00:36:10] The other thing that is very common in those who are obese and dealing with type 2 diabetes is gallbladder issues. And there is a real risk with the gallbladder issues. It's actually not as pronounced as people might think it is, and the way the media has told us it is, but there is risk. And so, if you've got a sludgy, slow gallbladder, which is very prominent in folks who are dealing with blood sugar dysregulation and/or obesity and hormonal disruption, and women who are in that middle-aged category, then you could potentially throw a stone into your pancreas, and that will cause pancreatitis, and that is an emergency, and that's terrible. So, there's a risk there, so obviously proceed with caution and work with somebody who knows what they're doing so that and don't keep crushing Chick-Fil-A thinking that you can just eat less of it'll be okay. Eat the good healthy food, avoid the crappy fats.
[00:37:02] What are some other ones? The thyroid cancer one. They've really just come around recently and said, we're just not finding causation at all. We've looked at long-term studies that SELECT trial, that was years of data. Like people say, "Oh, these have been around only a little while." No, we have years of data going back on these. And even prior to semaglutide and tirzepatide, which are the newer ones. Semaglutide for the audience is the Ozempic, Wegovy. Mounjaro is tirzepatide, but we have other versions of this peptide, other generations of it, going back 20 years with great safety data. It wasn't until this weight loss conversation came about that everybody started losing their minds and having very strong opinions and division.
[00:37:41] But the thyroid cancer black box warning is real. It's on these peptides. It's on rats, it's not on humans. It's on rats who have a type of cancer called medullary thyroid cancer, which is a very rare type of thyroid cancer in humans. It's very common in rats and it will spontaneously show up in rats. So, I've had many pet rats myself, this was interesting to me because I grew up with rats as pets and they would all develop cancer in their throats. So, I was like "Oh yeah, I've seen this."
[laughter]
[00:38:12] And what they did in these studies is they gave them crazy high doses and some developed medullary thyroid cancer and so did some of the control group, but they don't tell you that part. So, boom, black box warning slapped on it. And this is a rare type of thyroid cancer in humans because we don't have the same receptors on our thyroid that rats do. And so yes, if you have a history of medullary thyroid cancer, any thyroid cancer or family history, proceed with caution, of course, but we don't have any causation. We have correlative studies at best looking at big data banks of chart notes of patients charts and saying, "Well this group has a propensity." But guess what group has the most propensity for thyroid cancer? Those who are obese and diabetic. They have a significantly high risk for thyroid cancer. Obese folks, actually the most, more than type 2 diabetics. So again, potentially, people sitting on the edge of something and getting thrown over the edge.
[00:39:05] The latest one is this eye stroke. You probably heard about it. This has been all the rage this week. I just did a podcast on it that's coming out. And I sat down with my friend who is a naturopathic cardiologist and I was like, "Can I talk to you about this? Because I understand physiology. I want to run my physiology understanding by your understanding and let's see what we can do." And basically, what we concluded, this isn't new by the way. We have data showing a worsening of diabetic retinopathy with GLP-1s. They didn't know what was causing it, but when you think about it, when you have a nerve and vascular system that is used to really high levels of blood sugar from prolonged hyperglycemia, from prolonged being in that diabetic state, and then you pull that sugar away, you drop them into a normal glycemic or hypoglycemic state quickly with the use of these peptides, those tissues freak out and the vasculature, quite literally spasms. We know this, this is a known issue. And so, I think that's what's happening. I think that they're taking a--
[00:40:09] The study failed to tell us. Again, this study was not correlative. They even said it, this is an association, they were looking at chart notes on a big database of chart notes of patients, and they didn't tell us if these patients had type 2 diabetes. They didn't tell us how severe it was. They didn't tell us the dose of the GLP-1, really how long they'd been on it. They did say that this was occurring more frequently with the onset of the early period of use of the GLP-1, so the patients had been on it for a short period of time, so what dose were they on? We don't know. We don't know any of their back history, really.
[00:40:45] But that would make sense with my hypothesis here, that it's a blood sugar issue leading to potentially vasospasm, and who knows what's happening to a nerve that's used to being hyper nourished and then we pull back all that excess glucose. I don't know, this is my best guess. But it's really rare, and the media has ran with it like crazy the past couple of weeks. So, there's a lot of these things. I think those are the big ones. But if you understand physiology and you understand what groups are most at risk for these conditions, you realize the group probably taking these the most are the ones who are most at risk already. And then potentially a high dose of a GLP-1 might just shove them over the edge, that's my theory.
Cynthia Thurlow: [00:41:28] No. And it's so interesting because I think there's so much clickbait nonsense in the media. They'll take, one sentence from a study or they'll extrapolate information. And I think most people probably don't know how to properly interpret research, that's problem number one.
Dr. Tyna Moore: [00:41:45] Right
Cynthia Thurlow: [00:41:46] Number two, the media loves to run with clickbait. And I can tell you from prescribing antihypertensives to blood pressure medication, certainly lots of diabetes medication over the years. When patients have a high blood pressure for a long period of time or even high blood sugar, when you get them back into a normalized range, they sometimes don't feel good. I would have patients that would tell me when I got their blood pressure between 120/80 and they had been running high for a while, they would tell me, "I don't feel good. I feel nauseous." You get their blood sugar within range, I would say under 100 mg/dL, which is still too high as far as I'm concerned, and they would tell me, "I sweat, I don't feel good. I'm nauseous." And it's because their level of homeostasis was so abnormal for so long that when you start to bring them back down, they really feel poorly. And if we look at the statistics, 92% to 93% of Americans are not metabolically healthy. Is it any wonder that we're seeing a lot of reported side effects?
[00:42:45] And I love, as it pertains to gastroparesis that you were talking about, it was one of the worst side effects of diabetes that we saw. We would see a lot of cardiology patients that would just tell me they were miserable, they were bloated, they felt like they were chronically constipated. And it was because they had longstanding diabetes, that vagus nerve, so bi-directional relationship between the enteric brain and our regular brain, they were chronically feeling really, really poorly, yet another reason why we don't want to get to a point where we're developing diabetes.
[00:43:14] And what's interesting, which is going to date me quite a bit, when I finished my nurse practitioner program a long time ago, the concern about diabetes was at 140 mg/dL. And my listeners know that even Robert Lustig talks about, "If you're fasting blood sugar is between 90 and 99, that is not benign, you are still at 30% greater risk of developing diabetes." And so, we can really talk about how, in some ways medicine's moving in the right direction, and then we're taking 20 steps back. Now, my listeners, for the most part are women in perimenopause and menopause, which I would imagine many from your community are as well.
Dr. Tyna Moore: [00:43:55] Yes.
Cynthia Thurlow: [00:43:56] What for you are some of the high-level reasons why women are dealing with unique challenges at this stage of life in terms of why do they suddenly become weight loss resistant, why do they start-- If they maybe weren't struggling in their 20s and 30s, they start to struggle quite a bit with this metabolic health issue.
Dr. Tyna Moore: [00:44:17] Well, let me preface this with saying that my practice, it was never insurance based, it was always application only for the most part. And I took care of hot, fit women and I took care of active people who wanted to stay active. And so, I was doing a lot of bioidentical hormone replacement along with the regenerative medicine, because they go together, you can't do one without the other. You really can't do one well without-- If they're not in a good, healthy hormonal state, they're not going to heal, so what's the point of trying to extract their hot mess of stem cells and put it back into their body? You're not going to get anything but more inflammation out of that.
[00:44:54] So, I would have a lot of women just like you and I, who would walk into my clinic, and I'm in my 30s, so I'm like pretty thin and lean, and like not worrying about anything, everything's pretty easy at that point. And they would walk in and they would say-- I hadn't maybe seen them for a year, come in for their yearly visit, wherever we reevaluate their hormones, reevaluate the prescriptions, rerun labs everything. And they would say, "I gained 15, 20 pounds out of nowhere. And I don't know what's happening. I haven't changed anything." These are not women who are not accustomed to tracking things and keeping really tight reins on their health, on their diet, on their stress, on their alcohol. I wasn't teaching these people from zero, these people were well versed in-- They were teaching me a few things of how to be a really fit, healthy, vital, optimized, middle-aged person. And they would say, "I don't know what's going on." And with it most often would come some pain or some joint complaints. Some joint was starting to go on them, and they needed me to fix up the shoulder or the hip or the knee.
[00:45:55] And I always thought, "Damn, that sucks for them, this sucks." And try as I might, I could not get some of these people back. And it just would progress so quickly. It just would happen like that. And they'd go and next thing I know they're starting to look aged in their face. And it was really like night and day in some cases. And that was the glimmers of insulin resistance starting. It didn't show up for about a year on labs. So, I knew what was happening from a physiologic standpoint. And of course, were trying to rein everything in, but the unfortunate part is this age group of women, I really think it comes down to stress.
[00:46:32] Middle-aged women are the most stressed group of people on the planet. And no disrespect to stressed-out middle-aged men, but man being a woman of middle age is something else. There's a lot going on there. Your hormones are shifting. They're shifting in such a way that you become a bit testosterone dominant, even if you're low testosterone, but there's more of an assertiveness that comes out, and women can either take that by the reins and use it as a power, or sometimes the hormones are so out of whack and the metabolism is so out of whack that they just feel crazy and bitchy and completely out of line. Their children are often leaving and moving out. We thrive on purpose as humans. A lot of purpose for women is derived from the rearing of our children. So, our children are leaving, our relationship with our husband might be changing our partner, because those children are gone suddenly, we have to really look at our partner and be like, "Oh, we're married still."
Cynthia Thurlow: [laughs]
[00:47:27] Like, a lot of relationships were existing because the children were still in the house, so a lot is going on for the middle-aged woman. And very often, sadly, these women are walking in under proteined, undernourished period. Hormones are just plummeting out and it's just the perfect storm. And I remember having this elderly doctor tell me once in the regenerative community, he said-- I don't even know if he's still alive. He was such a brilliant man. He said, "All of your female patients are undereating protein and that's why they hurt. So, we need to be ramping that up." But here's the thing, I read a statistic somewhere the other day stating that close to 70% of women aged 45 to 60 were overweight or obese. And we know they're under muscled. We know they're walking into--
[00:48:15] I mean, this is a very difficult time period to get through for some of us. I can knock on wood, I can say for the most part, my transition into menopause as it's coming has been much easier than many of my friends because I trained for it and I prepared for it. And I've been doing the hormones. The hormones never bottomed out on me. I just have sort of stayed the course. But this is a train wreck for so many women. And like you said, when the estrogen plummets out, we become more insulin insensitive, and they're already insulin insensitive, and the testosterone plummets out, and so that sarcopenic obesity really takes hold and it's just a disaster for so many women, and that is devastating, and it is something that not everybody can even pull out of even with the best care.
[00:48:58] Even if you and I showed up as a team and said we're going to get to work on this woman with our knowledge base, which would be a dream, I think, for any woman in the middle age, we still couldn't pull them out sufficiently. These GLP-1s are pulling people out of a tailspin. And that glimmer of insulin resistance, that first 15, 20 pounds that everybody thinks is innocuous, that everyone's like, "Oh, that's just vanity, you're just being vain." No, that is a storm coming and she'll gain another 15 or 20 pounds and she'll end up on blood pressure meds and on statins and on Metformin and potentially have a heart attack or stroke.
[00:49:32] Not to mention the chronic pain and joint degeneration that's going to be occurring that nobody has an appreciation for except those of us who treated it every single day. And that pain perpetuates the lack of movement, so everything slows down. Quality of life goes in the shitter. Vaginal tissue atrophy, so they're not having great sex anymore. I mean, it's a disaster. It's like a total dumpster fire. And insulin's over here throwing lighter fluid on the fire going, "Ha-ha." And you're doing everything you can you hear it from your followers, "I'm doing everything right." I'm like, "Honey, you need hormones. Take the hormones, please. And consider the GLP-1s," because I think hormones combined with GLP-1s are like the middle-aged woman's BFF. It just has to be done right. It has to be done responsibly.
[00:50:17] I'm not looking for six pack abs. I still have a little pooch of a belly. I'm just built that way. If I want to go push it into no belly fat land, I'm going to plummet out all the hormones I do have still left in my body, so I understand that. I just want to be strong. I want to have a vagina that lubricates well. So that I can have great sex with my husband. I want a libido. I want my sleep to be intact. That's a disaster that perpetuates the whole mess that starts going. I want to have a good appetite, but I don't want to overeat and feel ravenous because my blood sugar is all over the place. I want to hold on to that muscle that I'm working so hard to build. And there's a way to do this, but we are discounting it by being divided on this and saying, "Oh, that's just for lazy people. They just need to eat less and work out more. And, oh, I'm doing it without hormones and hormones are poison." I'm like, "You clearly don't know how hormones work because you might as well have one foot in the grave in my opinion if you're going to try to go through middle age without hormones, you're looking at diabetes just knocking on your door at whatever and cardiovascular disease." So that's just my strong opinion.
[00:51:20] I think that most women over 40 could probably benefit from some thyroid replacement. I think that these are things that I have seen change thousands of patients lives, and my mentor before me taught me how to do this the right way. So, GLP-1s are just this awesome tool that really to me the way I was explaining it to my husband as I was researching it before I started on it, he's an electrician. And I said, "I feel like a circuit in my brain, like the panel in your basement, it blew. Like, something blew and things were not working right." And no matter what I did, I couldn't fix it. If I worked harder, it got worse. There's this sweet spot when you're middle aged where if you over exercise, you get fatter. If you under exercise, you atrophy. There's like that middle ground you got to figure it out. I was having the damnedest time, and I said, "I feel like someone just needs to go down to the basement and reset the breaker in my brain. And I think GLP-1s will work this way." And lo and behold, that's exactly how it feels. It feels like somebody just reset the breaker. The fluff came off, some of that immunologic puff, a lot of women are walking around with this sort of low-grade immunologic-- Even if they're not diagnosed autoimmune, they've got this puffy edema. It causes pain it makes you feel bad, it makes you look bad. You think you're fat, you're not, you're just swollen. Part of that's insulin, part of that's hormones, part of it's your immune system.
[00:52:42] Your immune system actually shifts from an M1 to an M2 macrophage. So, you literally go into this proinflammatory mode as you get older, it's called inflammaging, you know this, but just for the listeners, GLP-1s address all of that so beautifully. And I think they're really a nice first line therapy because we don't want to put estrogen in a body like that. That tends to go down the wrong pathways. They might need it, but throwing estrogen at a metabolically busted woman with excess adiposity on her body, who's inflamed to the hilt, is not a great idea, in my opinion. We need a lot of work to do, but this speeds up the timeline of that work, and so it opens this window of opportunity.
[00:53:21] And the other thing is that it actually induces neuroregeneration, which would theoretically induce neuroplasticity. And neuroplasticity is the ability of the brain to rewire. So, if we have a patient on these and we're dosing her nice and low and we've got her in that sweet spot, it's this wonderful opportunity for them to embrace these new lifestyle habits and really hardwire them in. So, we're literally rewiring the brain. It heals the metabolism. It doesn't just mask it or band-aid it. It quite literally heals the metabolism, it heals the tissue. So, I think longevity on them matters. Some people may want to stay on them forever. I do. I would like to be on these forever. I'm going to cycle them, I'm going to rotate them, and I'm going to try to keep the dose as low as possible so that I can just-- I don't want symptoms. And none of my patients are having any side effects, but we're all enjoying the benefit that we're going for. And others are going to want to do a cycle of them and come off just like they might cycle a round of testosterone, right?
[00:54:21] So, doctors who know how to do hormones, this is a really easy addition, and it's really elegant and it's really simple, and it's so incredibly helpful as a needle mover. And then other people might really have severe obesity and need to be on higher doses, and they might need to be on it for life, but we have to look at the risk to reward ratio here. And the risks of living in a diabetic and obese body are plentiful. So, at the end of that is retinal damage, blindness, kidney damage, a life of dialysis, and if you get through that cardiovascular disease hasn't taken you out yet, you will end up with dementia. And that's where our entire country is headed. And the entire world, we've outsourced our diabetes to the entire world. So, in my head I'm thinking like, what a wonderful miraculous peptide we have just figured out how to use, let's use it. And not even to mention the infertility rates and what metabolic dysfunction is doing to that, that's a whole other conversation that I'm not the expert on, but man, I've read the data and it's devastating. So, I'm trying to save humans. At the end of the day, I'm just trying to save humans.
Cynthia Thurlow: [00:55:29] No. And it's such an important conversation. I mean, a lot of the training for menopause, you need to trademark that, like helping people understand that there are things we can be doing to navigate perimenopause into menopause. I love that you touched on their neurological benefits of these GLP-1s. And for listeners, if they're not aware we actually have GLP-1 receptors, not just in the gastrointestinal system, but also in our brain. So, when Dr. Tyna's talking about this reduction in inflammation, but also this ability to create new synapses so that we can learn new things, apply new things that can help with reinforcement of these lifestyle shifts. And certainly, for every one of us, as we are navigating our 40s, 50s and beyond, we have to be making changes to the way we live our lives. It is a non-negotiable.
[00:56:18] I went to my 30th high school reunion a few years ago and I was struck by-- Most of my friends looked great and it was great to see them, but there were people that were partying like they were 18 years old and they looked super inflamed and they looked super miserable. And they were saying to me, "Oh, you don't understand." And I said, "If you are eating and drinking and partying like you were at 18 and you are 30 years older, you are not going to navigate your 40s, 50s and beyond well." And one thing that I want to reinforce is, Dr. Lisa Mosconi's work where she talks about our brains in our 60s, 70s and beyond are made in our 40s and 50s.
Dr. Tyna Moore: [00:56:59] Yep.
Cynthia Thurlow: [00:57:00] I have a loved one right now who's in an Alzheimer's unit with end-stage Alzheimer's. And I told the family member that was married to her a few months ago this was totally preventable. And that is the saddest thing of all, is that we are seeing a cataclysmic shift of especially women, because women are protected until they go into menopause. As we are losing estrogen sensitivity, as we are losing insulin sensitivity, as we are navigating these changes, if we are not being proactive, we will end up having neurocognitive decline, and we do not want to see our loved ones in memory care. It is such a sad thing to sit next to my loved one, and she'll say to me, "I know my brain's not working right." Like, she knows enough to know that she's not processing information in a way that she used to and it's really disappointing and upsetting, and it's devastating quite honestly, because she's a lovely person, but she's not who she was before because of this progressive neurocognitive decline.
[00:57:58] Now, I know that you mentioned that in many instances, depending on the individual, these may be a lifelong drug, these may be a drug that gets tapered on and off. For the benefit of listeners, if we're wrapping up the conversation, let's kind of end it talking about, what do you see as the next thing that's coming? So obviously, Ozempic is this kind of-- it used to be Byetta. I have a family member that used to be on Byetta, which was kind of the drug from 20 years ago that they were putting people on that were losing insulin sensitivity. There's this second generation that tirzepatide. And I think there's other drugs that are coming that probably are going to be more expensive but have even a lower side effect profile. What are your thoughts about things like practical applications that may be forthcoming?
Dr. Tyna Moore: [00:58:43] Well, there's a whole slew of GLP-1s coming down the shoot from different pharmaceutical companies. So, pill form, I really think these are going to become much more affordable in the future, and they're being studied for things like Parkinson's and Alzheimer's. The data around the cardiovascular disease benefits that came out at the end of 2023, the big argument since then has been, "Well, that was just because of the weight loss. The cardiovascular benefits were because of the weight loss." And they reevaluated that data and just presented it at the European Congress on obesity and said, "No, it was independent. Even if people didn't lose weight, they're still having these incredible cardiovascular benefits." So, I think we're going to see a lot of that happen, and hopefully more insurance coverage, maybe better pricing, maybe some of these things will go generic, who knows?
[00:59:27] As far as that goes, none of this is going to work if the lifestyle things aren't addressed that you and I always talk about. So, this is not a one or the other. This is not a take GLP-1s in isolation. Since I've been doing podcasts on this, I'm getting a lot of questions, "What's the dose, Dr. Tyna? The dose is irrelevant." It's completely irrelevant, and it's completely individualized to the person. I talk about this inside my course, but and there is some clinical reasoning to it, but that said, what's much more important to me is what are all the other lifestyle factors that are being addressed and are they being addressed? And so, these things need to be prioritized regardless of whether someone decides to take a GLP-1 or not.
[01:00:03] So, all the things you talk about, the strength training, the prioritizing sleep, the getting adequate protein, eating nutrient dense foods that are a variety of colors and bright colors, making sure we're mitigating our stress, something is just so underappreciated. Elevated cortisol for a long duration will destroy your metabolic health. Making sure we're in healthy relationships, the people we are around, their microbiome is indeed contagious. So, making good choices about the people we choose to surround ourselves with. Easier said than done, I know really having a hard look in middle age, is your career path serving you or killing you, is the job that you're working, really doing bad things to your stress levels, and if so, do you have the courage and the wherewithal to shift that so that it doesn't take you to an early grave?
[01:00:49] I mean these are make it or break it years. And I've made my own mistakes, but I know that training for menopause was the best thing I could have done, the earlier the better. And we can still turn the ship around in those later years. We can still build muscle, even women in their 60s and 70s and beyond, and men can build muscle, but you can do so much. 35 to 45, I think, is the magic window, what say you? I mean, is that seems to be that where we're like, "Yeah, we can turn this around or it might be a little harder."
Cynthia Thurlow: [01:01:20] That is the window of opportunity. And I've had other female podcast guests that have said the same thing even without being prepped they'll say, "That is the timeframe." If you are between 35 and 45, you have work to do.
Dr. Tyna Moore: [01:01:33] Yep. And that's it. And because we're training for our future self, I would be devastated to see a loved one in a state of Alzheimer's. That's the world I worked in an undergrad, but I don't want myself there. I don't want someone wiping my butt. I don't want to break a hip. I have a hot husband, I want to have fun, I want to travel, and I want to have hot sex. I just want to stay hot and happy. That's really the goal for longevity. Like, these are our golden years, and I really want to rock it out and have success with it. And so, I'm just excited that I think there's some really great innovations in medicine. And if we throw the baby out with the bath water--
[01:02:06] I understand people's hesitation with Big Pharma. I have been beating that drum for a lot longer than the past few years, and I get it when people are feeling like these things might not all be for our own benefit. But that said, there's a lot of good out there and there's a lot of great doctors. Not all doctors are evil. Not all pharma is evil. This whole purist camp versus whatever. I'm going to treat the patient in front of me, but the patient in front of me has some work to do, so I'll leave it at that.
Cynthia Thurlow: [01:02:32] Well, I've so loved this conversation today. Please let listeners know how to connect with you. Obviously, you have an amazing podcast, how to access your resources and even your new course.
Dr. Tyna Moore: [01:02:41] Thank you. Yes. So, my podcast is the Dr. Tyna Show. You can find me on Instagram @drtyna. And then I have a free four-part video training series called Ozempic Uncovered that you can find @drtyna.com/ozempicuncovered. Or you can find it on my website. And it's really informative. I deep dive into a lot of the things we talked about here, and then that will lead you into an opportunity. I have a course that's a deep dive, and it's geared towards practitioners, but it's open to the general public and it's all the things. It's how I clinically address a patient holistically from tip to toe including hormones. So, that's a great resource, I'm really proud of it, I've been and working hard on it, and I hope that it's helpful to people.
Cynthia Thurlow: [01:03:22] Well, thank you for all the work that you do and thank you for being a bright light, especially for us middle-aged women.
Dr. Tyna Moore: [01:03:28] Thank you. Thanks for having me.
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