Tracking Your Body’s Data to Improve Health Outcomes with Dr. Sara Gottfried
Nov 15, 2023
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Dr. Sara Gottfried, MD from Harvard Medical School and completed residency at UCSF, talks about tracking data for precision medicine, impacts of birth control pills on women's health, erectile dysfunction as a warning sign, hormone replacement therapy for women, tracking cortisol levels, consequences of early menopause, sleep tracking with wearables, challenges of ketogenic diet, significance of testing for improved health outcomes, and the balance of weightlifting and cardio.
Hormone balance is crucial for menopausal women to maintain their overall health and well-being.
Hormonal birth control, such as the pill, can have significant effects on hormone balance in women.
Sleep is a critical factor for maintaining overall health and hormone balance.
Deep dives
Importance of Hormone Balance for Menopausal Women
Hormone balance is crucial for menopausal women to maintain their overall health and well-being. Testosterone, the most abundant hormone in women, plays a significant role in vitality, bone strength, muscle mass, and libido. In cases where levels are low, symptoms such as low sex drive, hair loss, and reduced confidence may arise. It is important for women to track their hormone levels, especially during perimenopause and menopause, to ensure that they are relatively symptom-free and to identify any imbalances. Hormonal changes in menopause can also impact cardiovascular health, with women experiencing different symptoms and risks compared to men. Understanding these differences, such as the increased risk of cardiovascular disease in women during perimenopause and menopause, is crucial in providing adequate care and prevention strategies.
The Impact of Hormonal Birth Control on Hormone Balance
Hormonal birth control, such as the pill, can have significant effects on hormone balance in women. While it is commonly believed that birth control pills can help balance hormones, they actually override natural hormone rhythms in the body. Women taking birth control pills may experience low testosterone levels, which can lead to symptoms like decreased sex drive, hair loss, and reduced confidence. Additionally, hormonal contraception may result in micronutrient deficiencies and increased inflammatory tone in the body. Women considering birth control should weigh the risks and benefits and be aware of potential long-term effects on hormonal balance. For women, it is important to track and monitor their hormone levels, especially if they have previously used hormonal birth control, to address any imbalances and ensure overall health.
The Importance of Sleep for Overall Health and Hormone Balance
Sleep is a critical factor for maintaining overall health and hormone balance. It plays a key role in recovery, restorative processes, regulation of blood sugar, immune function, and hormone production. Sleep deprivation can disrupt hormone levels, leading to imbalances in cortisol, growth hormone, and insulin. Lack of quality sleep can also contribute to increased cravings for carbohydrates and poor decision-making. Monitoring sleep patterns and ensuring sufficient sleep duration and quality is crucial for optimizing hormone balance and overall well-being. Incorporating good sleep hygiene practices, such as maintaining a consistent sleep schedule, reducing exposure to electronic devices before bed, and creating a conducive sleep environment, can support healthy sleep patterns and hormone balance.
The importance of addressing trauma and stress in maintaining hormonal balance
Trauma and toxic stress can dysregulate the hypothalamic pituitary adrenal thyroid gonadal gut axis, leading to cortisol imbalance. Somatic-based trauma-informed therapies and psychedelic-assisted therapy are recommended for trauma resolution. Addressing the root cause, such as finding ways to reduce stress, can be more effective than relying solely on supplements to manage the effects of cortisol imbalance.
Insulin as an early indicator of pre-diabetes and the importance of continuous monitoring
Insulin levels, especially post-prandial insulin, can be an early indicator of shifting from a healthy metabolic state to pre-diabetes. Continuous glucose monitoring and regular insulin assessments are recommended to identify changes in insulin levels, even if fasting glucose and A1C appear normal. Conventional medicine's focus on treating disease often overlooks early signs such as insulin changes, underemphasizing prevention and proactive interventions to maintain metabolic health.
In this episode of Longevity By Design, Dr. Gil Blander and Ashley Reaver interview Dr. Sara Gottfried. Dr. Gottfried received her MD from Harvard Medical School and completed residency at UCSF, however she is more likely to prescribe a continuous glucose monitor and personalized nutrition plan to her patients than the latest pharmaceutical.
This episode is a must listen for anyone trying to optimize their wellness plan. Dr. Gottfried discusses all the data she tracks and how that helps her practice precision medicine. This conversation also sheds light on how birth control pills impact women's health, how erectile dysfunction is an early warning sign for atherosclerosis, and gives advice for women seeking hormone replacement therapy.
Episode timestamps:
Introduction: (0:00–1:00)
Dr. Gottfried’s motivation for becoming a physician: (1:00–4:30)
Dr. Gottfried’s fascination with performance and healthspan: (4:30–5:30)
How do we define “hormone balance”: (5:30–7:10)
Is hormone balance more common in men or women? (7:10–9:30)
Understanding heart disease trends in women: (9:30–12:07
Why women should track their body composition over time: (12:07–16:23)
Testosterone is the most abundant hormone in the female body: (16:23–19:19)
Chronic stress can accelerate testosterone decline in women (19:19–20:20)
How the birth control pill impacts women: (20:20–26:58)
Cortisol is one of the most important hormones in the body: (26:58–32:50)
Dr. Gottfried’s recommendation for lowering cortisol?: (32:50–37:30)
Insulin and avoiding diabetes: (37:30–38:45)
Tracking your metrics over time (time-series): (38:45–40:30)
DEXA scans and tracking body composition: (40:30–42:30)
Cortisol in professional athletes: (42:30–45:43)
The female athlete triad: (45:43–49:45)
Understanding your health goals: (49:45–51:50)
The importance of sleep: (51:50–59:11)
Behavioral science: (59:11–1:03:10)
Keto diets and the mediterranean diet: (1:03:10–1:07:30)
Hormone replacement therapy: (1:07:30–1:15:35)
Erectile dysfunction: (1:15:35–1:19:00)
Dr. Gottfried’s top tip for healthspan: (1:19:00–1:21:33)
