If you are considering BHRT, this is for you. Even if you’re currently on BHRT, you’ll learn or confirm something here.

If you’ve got daughters or DIL, in my case, there’s something here for you on that front too. If you’ve wondered why does cholesterol go up for so many women or why do autoimmune numbers increase in midlife? There’s a reason to be considering BHRT, and our guest explains why.

My Guest:

Dr. Shilpa Sayana, MD is a Triple Board Certified in Internal, Obesity Medicine and Functional Medicine. She is recognized by her peers by receiving the “Most Humanistic Intern and Resident” award in all three years of her Internal Medicine Residency and celebrated by her patients by being presented the Best Doctors Women’s Choice Award.

She treats women in perimenopause and menopause, optimising their hormones, energy and weight, especially if they have been previously told that their labs are normal.

Questions We Answer in This Episode:

[00:07:54] What are natural ways to improve your hormones above 45?
[00:14:27] What tests do you recommend to a woman considering hormones?
[00:22:30] Do you have a unique opinion on starting both progesterone and estrogen at the same time or layer in one?
[00:26:06] Do you advocate for women taking testosterone and what are the benefits and side effects of using TRT?
[00:30:21] Why do autoimmune markers increase in perimenopause and menopause? and what to do about it?
[00:32:04] What can help cholesterol and blood sugar levels?

#1 Longevity Hormone Panel

Purpose: To get a baseline of all key hormone levels

Includes:

Morning cortisol (before 10am)
DHEAS (hormone that makes cortisol)
TSH (thyroid)
Free T4
Autoimmune Reverse
T4 (Hashimoto’s)
Reverse T3
Estrogen, Progesteron, Testosterone
Total Testosterone
Free Testosterone
Sex Binding Hormone Globulin
ANA (antinuclear antibody or autoimmune antibody)
ESR (erythrocyte sedimentation rate to check inflammation rate for autoimmune)
CRP (C-reactive protein)
Ferritin
Genetics
Vitamin B12
Vitamin D

More Tests to Truly Know If You’re Ready Before Considering BHRT

#2 Gut Test

Purpose: To assess inflammation, microbiome health, and how well your body can process and eliminate hormones

#3 Toxin/Environmental Load Testing

Purpose: To detect environmental toxins that may be disrupting hormone production or metabolism

Track Your Hormones

Functional vs. Conventional medicine’s approach to lab results:

Functional Medicine
- Focuses on what’s optimal, not just normal.
- Listens to the whole person (hormone networks), not just the labs.
Conventional Medicine
- Labs are often labeled "normal" if they fall within the wide reference range.
- No action is taken unless results are severely out of range.

Connect with Shilpa:

Website - Sayana Medical
Instagram - @sayanamedical
YouTube - @SayanaMedical

Other Episodes You Might Like:

Previous Episode - Smart Movement for Aging Better with Lara Heimann
Next Episode - Can We Just Stop the Self Sabotage to Feel Your Best Ever
More Like This - Restore Hormones to Factory Settings? More Science for bHRT
More Like This - How to Have and Still Thrive with Autoimmunity in Menopause

Resources:

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