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People who are having sexual dysfunction, specifically orgasmic dysfunction, that is a signal for heart disease. It's the same thing with women, again. That's just not talked about. Because people don't talk about sex. If you're having hot flashes and night sweats, that's coming from the brain, actually. And it is, by the way, a big red flag for cardiovascular disease and dementia. What woman isn't in a little bit of sympathetic overdrive? Right. What are some of the things that she could look at here?
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Ashwagandha is amazing. It is the king of all medicines. It gives you the strength of a thousand horses, right? Because it does increase testosterone, but it increases testosterone in women as well. Really? And testosterone is important in women and men. We have more testosterone when we're young than estrogen. Here's the deal. We use all sorts of medication off-label. I prescribe and use testosterone off-label as well. The FDA is not your mom.
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Even when you're doing all the right things, your strength training, staying active, prioritizing protein, keeping the muscle you built over a lifetime gets harder with age.
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So if staying strong is part of your longevity strategy, and I sure hope it is, visit timeline.com forward slash JJ Virgin and get 20% off your order. Hey, it's JJ. And I want to challenge something you probably think you've already nailed. And that's vitamin C. Because if you're like a lot of women I work with, you're reading labels, you're choosing good brands, and you're assuming your vitamin C is actually delivering. But vitamin C supplements in general have a problem.
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And it's not the dose, it's the delivery. With most forms of vitamin C, like basic ascorbic acid, your body actually has a limited capacity for how much it can absorb at one time. Now, unlike most vitamin C supplements in nature, vitamin C is never isolated. It's paired with bioflavonides and plant compounds that help your body absorb it, retain it,
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and use it effectively. So when that context is missing, so are a lot of the benefits. And that is why I love a new formula called Qualia Vitamin C Plus. It uses seven distinct sources of vitamin C.
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Hey, I'm JJ Virgin, PhD dropout, sorry mom, turned four-time New York Times bestselling author. As a certified nutrition specialist, fitness hall of famer, and globally recognized leader in health, I'm driven to keep asking the tough questions and use my podcast to simplify the science of health into actionable strategies that help you thrive.
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I'd also love to hear your thoughts on the show. And here's the fun part. When you send me your review, I'll reply to you using my on-demand virtual me. That's right. My team and I created a virtual JJ packed with my books, speeches, and wisdom so I can personally connect with you. Here's how you do it. Subscribe and leave an honest review of the podcast. Take a screenshot of your review.
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Text it to 813-565-2627. That's 813-565-2627. My virtual JJ will reply directly. And trust me, this will make your day. So subscribe now at subscribe2jj.com and text me your review. Let's keep thriving together.
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A couple of years ago, I had the honor of interviewing Dr. Suzanne Gilbert-Lenz when she came out with her Hormone Boot Camp book. And I was super excited to run into her at A4M's Spring Longevity Fest and find out that she's got a new book in the works. And she's going to give us a sneak peek on that book, which is all about herbal medicine. We're going to be digging into a
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which different types of herbal supplements you should be using, could be using, or should stay away from. What can be super helpful, what to look for, it's all here coming up next. So stay with me. JJ here, and I'm here with Dr. Suzanne Gilbert-Lenz. Hello. Super excited to have you here in person. So happy to be here.
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And this is a great conversation we're going to have because we haven't talked at all about botanicals and their use. I mean, at all, but especially in their use in perimenopause and menopause. So that's where I'd love to dig in. And first of all, just like your overall, like, what the heck are botanicals and why should we be paying attention to them?
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Great question. Botanicals are technically anything that is grown a plant. I include things like mushrooms in there because they're not a plant technically, but they are grown. So anything that's coming from the natural environment that has grown on its own. And the thing about botanical medicine is that, you know, like 30% of pharmaceuticals or more come from the botanical world. They come from traditional medicine. It's just often not acknowledged.
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What we're doing in conventional pharma is we're pulling out one component. We know the mechanism of action, and we're amplifying that greatly. With the plant itself, there's a synergistic experience, right? So it's multiple different chemicals that are working together, and they have multiple effects often. Many of those effects will work together toward the same goal. And what's interesting to me is if you look really deeply at botanical medicine like I have, inflammation is one of the biggest factors.
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actors, right? Which now we understand in modern medicine, inflammation is the foundation for so many of our chronic and acute diseases. But it's like the plan already knew that, right? So there's an anti-inflammatory effect, and then there's a layered, you know, there's antimicrobial or whatever it is, it's acting on the wrinkle. I mean, you know, whether it's working on bone, or it's working on AMPK, or whatever, it's so it's crazy, actually, that now we can identify all these minutiae
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But the plant itself has a larger, almost like a larger perspective on us because we grew up together on the planet. You know, for whatever it's worth. That's the way I look at it. Well, I was telling you earlier, since I went to the Amazon over New Year's and saw their perspective, I was in the sacred headwaters of the Amazon.
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Biodiverse place on the planet and their whole premise is plants and humans are equal. Yes. You know, and animals, we're all equal. So it's a very different take on things. Your background, though, is also Ayurvedic. Yes. So talk about how you've got this conventional OBGYN training plus that. What happened? Basically, I came out of my conventional training, you know, very excited and really honored to have had that experience.
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But I think it was dual. Something was a little bit missing. I've always been a really curious person, a very spiritual person. And I was doing meditation and yoga for my own benefit, right? I was a young mom with a new practice, and you can imagine how stressed I was. Just like PTSD from residency. And I thought, you know, how can I take care of myself? I started doing these things, and I really fell into learning about Ayurveda.
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Yoga and meditation are branches of Ayurveda, which is the ancient medical system of India, the subcontinent of India. And I started just out of my own curiosity. It wasn't like I was like, oh, well, now let me go put up my Ayurvedic shingle. But I just, I ended up doing like a whole, you know, accredited program. Two and a half years, study, making my own herbs, working with patients. Yeah.
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And I was like, you know, seeing patients on the side, a lot of my conventional patients were like, I'll be your IRED patient. You know, I'm seeing them in my like back house. I really respected and appreciated the more integrated, holistic approach to human health, right? So that the body exists in and of itself in a very integrated, coherent way. We don't always understand it. And I think in Western medicine, we're understanding it much more deeply now when I think about 25 years later.
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But for instance, all this interest in the gut microbiome now, which is like totally standard fear. Thank God, right? It's so important. But in Ayurveda, whatever the issue the person came to you with, you always created an herbal formula for their gut. Because the understanding was the gut was the seed of all your health. Right.
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I mean, I could go on and on. So it was very resonant. I was learning about this system from thousands of years, and I said to myself, this is crazy. Like, they understood a lot about, for instance, neurovascular anatomy. We didn't know about until thousands of years later. So I early in my career realized, OK, there's something way bigger going on here. Humans have always attempted to...
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be healthy and whole and to assist each other on that journey. And this is not new. Like, we don't own it here in conventional medicine. We've done amazing things and miracles, but we are just another iteration of something that had been going on for all of human existence. So that's what initially got me interested and excited. And, you know, that was my first love. So working with plants and writing about plants and teaching about how plants work is,
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deeply satisfying and gratifying to me because this is really like the book I wanted to write, you know, before I was ready to write a book. And now we're going to be waiting a year for this book. Yes, it's okay. You'll be okay. So we'll have you back again. So someone listening to this who's like, all right, this is interesting. Or someone coming to you as a patient, how do you integrate in the plant piece of this, the herbal medicine into what they're doing?
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It's listening to the patient. I think because I have this reputation in my community for being open-minded and for doing these kinds of things while still practicing in a totally conventional manner and using, you know, hormone replacement therapy, which I may hear. I take hormones, okay? Me too. I love them. Thank God. You have to pry them from me. Right? Exactly.
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So it depends on the person, and I think that's really what the therapeutic alliance is, right? Where are they? A lot of my patients, and especially now where people are much more educated and learning about perimenopause and how this all starts, a lot of them are curious and they want to prevent chronic disease, which I'm so excited about. What an opportunity to work with somebody at 37 who's thinking about this rather than 57 when they're in it. When you're unfrying the egg. Right. Exactly. Exactly. You can't what you cannot do.
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So sometimes we start with herbal and botanicals first because they're not quite ready or they're curious or they have a symptom that is actually maybe going to respond better to the herb. A lot of our nervous system issues, you know, respond really, really well to things like ashwagandha or rhodiola, adaptogens.
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They're really powerful. The sleep issues that people are starting to have, sometimes the botanicals are a more gentle entrance point for them. And the thing is that a lot of these, most of these, are actually very amenable to work with the hormones. So there's lots of plant estrogen-like molecules out there. They can work very well for certain things like hot flashes or vasomotor symptoms. One of my favorites is a very specific form of Siberian rhubarb.
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And we know that it acts like a selective estrogen receptor modulator. So it's activating in places that you want, brain and bone, and not activating proliferation in places like the uterus or the breast. We don't have the best data in the world, but we have some data. So super, super interesting. And I can fine-tune based on what's going on with her. And then if we're layering in hormones, we are. And look, I'm a breast cancer survivor. Some of my patients are in treatment. They cannot be using hormones at that time or at that time.
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She's not to usually. I mean, they can do whatever they want, actually. That's what shared decision-making is. Or maybe they have another reason why they can't. Maybe they've had a stroke or a blood clot. So maybe they can't use hormones. And these can be really, really, really helpful for modulating not only symptoms, but potentially for impacting long-term health issues like insulin resistance or bone health or brain health or gut health or cardiometabolic profiles.
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Again, they're not, we don't have the same level of data as we do for a lot of our pharma stuff, but we have a lot.
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A lot of data to support their use and their safety. Yeah, and I think that's the most important. There's safety data. We need your book, clearly, because I see this seems very, very relevant for a woman ending perimenopause, menopause. Like, there's so many things they can do.
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But for someone, let's go back over to nervous system. And I'd like to dig a little deeper into ashwagandha and muleola. So for someone, because, I mean, what woman isn't in a little bit of sympathetic overdrive? I mean, who's, so what are some of the things that she could look at here?
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Well, I mean, first of all, if some of it is timing and where you take it in the day, ashwagandha can be a little more sedating. And again, remembering that it can take some time for these things to get into your system and work. So ashwagandha, I would say, for most people, I would start with trying to take it at night. And it really can help with sleep as well because it can kind of downregulate the nervous system and it can interact with GABA receptors and help relax, right?
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Rhodiola is a little more activating and it can be a little more beneficial like maybe earlier in the day. You know, these are broad brush strokes we're painting in. So those are two things I would just think about. But adaptogens are really interesting because their goal is to get you back to homeostasis, which sounds really weird in Western medicine. It's like, well, how could it do both? But it does because, as I mentioned with plants, there's synergy.
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And they're activating more than one pathway at the same time. So those are two that are actually really well tolerated and very effective. I think understanding like the dosage and you're getting the right extract and that it's a certified product, things like that is very, very helpful.
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I see a lot of anxiety in perimenopause, a big uptick. And we also know anybody who's had any kind of hormone-mediated mood disorder, so maybe around puberty for sure if they've had pregnancy-related anxiety or depression, they're almost certainly going to have an uptick in those symptoms again in perimenopause. And we see like up to 40% of women have some kind of mood symptom. So really targeting that nervous system regulation is so important. I mean...
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game-changing. And sleep, regulating sleep. If you don't sleep, I could dip you in all the hormones and you're just, you're not going to get better. Well, it's a massive problem, let's be honest, during perimenopause. So beyond the ashwagandha, are there other things that you like for sleep?
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It depends on what you're trying to do. I mean, valerian is really powerful. I would be careful with it because it can make you very groggy in the morning, but it is really good at inducing sleep. Saffron and passionflower also have some efficacy. I think it depends on what the issue, right? Is it falling asleep? Is it staying asleep? Honestly, most of my patients, it's staying asleep. Yeah.
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But also looking at things like blood sugar and activity level, right? If you're super, super active later in the day, you're going to have your cortisol is going to be up. You're going to have a harder time going to sleep. If you're drinking alcohol, I feel like I shouldn't have to say this, but I have to say it. Like, sure, it's going to make you fall asleep. You are not going to have a good sleep for a million reasons. It's not good for your brain, and it's definitely not good for your blood sugar. So understanding insulin resistance is also climbing at this time of life. And insulin resistance and glucose metabolism actually play a big role in our sleep.
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So it's kind of hard to nail it all on just like one. But I think passionflower and saffron are ones that people don't think about. And they're great. And saffron also can be used for mood disorder. Yes, for sure. A lot of the things, anything that works on the HPA axis or the HP ovarian axis in this case, is going to help with mood and with sleep. So you see a lot of crossover here. And you can layer these as well.
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Now, of course, the other big issue, and you mentioned it, is all of the, we're starting to get more insulin resistant. So we've got blood sugar issues. Are there some things you like to use for that? Yeah. I mean, these herbs are not as great, but I like them. I mean, it depends on how big your issue is. Berberine actually has plenty of data to support its use. I think that we're seeing some newer ones coming online. And some of the older ones, like, look, there was a...
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Kyolic acid, which is aged garlic and it's a very specific thing, was having its moment for a while there. I cannot take that step. Yeah, I don't think it works that well. There's some really interesting work with a very specific hops that really is acting like a GLP-1. I mean, it's not in the same long-acting way. Oh, is that the calicurb?
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Yes. And honestly, the data is really fascinating. It's very interesting. So those are some of the ones I know I'm leaving something out. I can see my slide and I'm just like blanking on what that was. But these are some that I reach for. There's a plant sterols, which is going to be more for your cholesterol and fiber. I mean, really, like you don't have to get fancy. Like people need people don't get enough fiber.
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It could be as basic as that. Well, when you look at fiber, because there's different types of fiber, how do you recommend doing this for your patients? It's such a basic that the reality is the majority of people are getting a third of what they need. Oh, yeah. First of all, people have to track what they're doing, right? Because I'm going to tell you something. When I talk about fiber just generically, I mean, are you talking about soluble fiber? Are you talking about insoluble fiber? And they all say to me, especially my – I have a very –
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a very educated demographic and very health-focused demographic, right? And they are all telling me about vegetables, which are amazing. Absolutely, you need to eat vegetables. You're not getting nearly as much fiber in your fruits and vegetables as you think you are. That Arugula just did not crank up your fiber intake. No, it really didn't. So the first thing I do is have them kind of look at what they're doing. I actually have a cheat sheet, JJ, that I send them because some people like lentils and some people, you know, like chia pudding. I don't know. Maybe we can include the cheat sheets.
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Oh, my God. Absolutely. I'm voluntolding that. Yeah, yeah. We'll gift the cheat sheet to the audience. Yeah, absolutely. Cool. Yeah. So there's – and some of my patients are vegan and some are – you know, whatever. So I think helping them make selections and understanding like 25 to 30 grams if you can do it. But I have a hard time with it. It's like a freaking full-time job.
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I know. I track it every day, too. I'm like, I'm a big tracker, but I love it. It's so important. Look at me with my two devices. You know, like stack everything. Yeah. But fiber especially, that is like that 10 grams per meal. Yep. Yep. Exactly. Divide it up. Divide it up. Although I will brag about it. I've already gotten 20 grams. Of course you have. Just so you know, it's like a new one, you guys.
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I haven't had lunch yet, though. And a lot of this is actually the perimenopause and menopause stuff that I talk about botanically is a lot of it is actually in my book, Menopause Boot Camp. Because I focused a lot on stuff that people just were not talking about yet. And people still are not talking about this enough. So we're going to keep bringing it to the.
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And what we're going to do is we're going to put that in the show notes. Amazing. Because we did your interview on that. That was a while ago. Yes. Yes. So we did that interview. It was four years ago. Four years ago. Yes. Wow. Yeah. All right. Crazy times. So other things for people that they can use here. We talked about things for mood. Yeah. We talked about things for sleep and blood sugar. But what about just, you know, hormonal symptoms? Yeah.
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Yeah. I mean, so again, some of these phytoestrogens and some of these CIRMs are actually really interesting. What's a CIRM? So CIRM is a Selective Estrogen Receptor Modulator. So it is selectively turning on or off estrogen receptors in different areas because estrogen acts all over the body, right? It is not just...
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You know, in your uterus or your ovary, it's in your bones, it's in your brain, it's in your heart, it's in your liver, it's in your muscles, it's everywhere. So we want to be careful that we are targeting the areas that are causing us a problem. So if you're having hot flashes and night sweats, that's coming from the brain, actually. And as, by the way, a big red flag for cardiovascular disease and dementia. What? Yeah. Yeah.
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Yeah, that is a signal. I have never heard this. Yes, severe hot flashes are a signal. Okay, so if you have severe hot flashes, but then you control them. It's probably having a positive impact. Okay, so it's like, it's not just that. They're not benign. They're not just a joke. Wow, that is so funny. Why is that a big risk factor?
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Because part of what's happening is it's originating in the thermoregulatory center in your brain. But it's having an impact actually on the vascular system as well, which is where the hafash is kind of being acted out. So we know that it's related to reactivity and then more issues. Like you're losing nitrous oxide, which helps to relax the blood vessels. And you're also having an impact on the endothelial lining, which is a very important thing.
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the lining of the vascular tree of all those vessels, which of course is going to, you have more inflammation. So, okay, and then the inflammation is, yeah. And you know, I'll tell you something. So should you have some beetroot or what should you do? Well, I mean, you should, here's the thing, you should not grin and bear it. You should treat your hall flashes. So whether you're using-
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Yeah, suffering is like not only is it like unnecessary, you're not getting a gold star for it, and it's harming you. So I really want people to know, yeah, a hot flash is not just a funny joke and like, oh, get a fan. I mean, get a fan if you need it. But like take care of that. And if your clinician does not understand that this is a signal for your longevity, we got to find you another doctor, okay? We just really do.
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So, look, black cohosh, which is much maligned and does not act as an estrogen, works pretty well. Very specifically, rummy famine. The Germans are always on it. They're really good with plants. But 50% reduction in hot flashes. Wow. Yeah. Genistein digs in, which you can find in, like, soy products and stuff people should not be afraid of.
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The right kind of soy, soy can be very powerful for these things. And Siberian rhubarb is one that acts like a selective estrogen receptor modulator, works very well for hot flashes as well. I think as long as we're on the signal for health issues, people who are having sexual dysfunction, specifically orgasmic dysfunction, the penis is the analog to the clitoris, okay? The clitoris is the original. We're the default, XX.
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We are. This is just biology, folks. So everybody knows, or they should know, that erectile dysfunction is a signal also for heart disease. Same thing, those small vessels are not working, right? They're closed down, they're not opening, nitrous oxide isn't getting in there, they're not getting expansion, they have inflammation.
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Men should know if they don't know that that is a signal for heart disease. It's the same thing with women. Again, that's just not talked about. Because people don't talk about their clitoris and people don't talk about sex. And it's not just that pleasure is a birthright, but it's part of our health. It's a part of our body. So we can culturally detach from it, but your body knows better.
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So sexual health is health health. So there are things that you can work on with that. I don't know that there's a plant medicine that's perfect for that. But I mean, kind of leading from this into sexual health, I mean, there are things that we can do that actually, ashwagandha in Indian medicine and Ayurveda, it is the king of all medicines.
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and it gives you the strength of a thousand horses, right? Supposedly that's because it smells like horse urine. But it's also, the allegory there is, or the poetry there is that it is very important for men because it does increase testosterone, but it increases testosterone in women as well. Really? So why wouldn't we all be taking this? Well, I mean, I think again, because I don't believe that everybody should do everything, but I think in consultation with someone who knows about it, ashwagandha is amazing.
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It is. It's great for a lot of things. Again, adaptogenic, it's doing a lot of different things. And this is one you take in the evening. Yeah, you're probably better off doing that. There's tons of them. Tribulose is another one that can increase testosterone. So, and testosterone is important in women and men. We have a lot of testosterone. We have more testosterone when we're young than estrogen. Yes, more testosterone than estrogen. So when we lose it and it doesn't fall off a cliff like estrogen, it kind of declines slowly, we're losing a lot of benefit.
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I mean, this could be a 10-hour podcast. And it would seem then that you could use some of these things, like ashwagandha and tribulus, and then see how much you might need to supplement with testosterone. Exactly. Since it's so darn hard. Like, when are they going to get over this thing with women and testosterone? It's going to happen, but I don't know when.
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I mean, here's the deal. We use all sorts of medication off-label. I prescribe and use testosterone off-label as well. The FDA is not your mom, okay, and it is not the police. Like, we got to use our brains and use the available evidence. So people who are scared about using testosterone in women, you should take pause and make sure you understand what you're doing.
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But that's not a thing. Are we, like, trying to block 25-year-olds' testosterone? Women? I hope not. I mean, we kind of are with birth control. But, you know, like, no one's doing that. So let's, like, take a deep breath and, like, think and learn. So testosterone doesn't do the fall off a cliff. It's just a slow decline. Yeah. And is that one that starts slowly declining? Yeah. In your 30s probably, yeah.
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I had a very smart doctor. I went on it in my early 40s. Yeah, amazing. He gave me that before anything else that actually helped pull my estrogen up a little. Testosterone can help with sleep. I mean, look, the data, the preponderance of the data is in sexual health, and it is very, very helpful for a lot of people for libido, for interest. But the reality is that we have testosterone receptors everywhere too, so it's very important for a sense of well-being, for calm. It helps people sleep.
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We actually, okay, now I'm going to really get in the weeds and, you know, I don't want to get myself or anybody into trouble. But there are some data showing that it may be beneficial in breast cancer, like may decrease the risk of breast cancer. So I'm not saying everybody go out there and, like, but people need to be more thoughtful and not so, like, binary and black and white.
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All right. We will make sure we link to Hormone Boot Camp. Yes. And to this cheat sheet you're going to use, please. Yes. I'm going to send it to you. And we are waiting, waiting, waiting for the next book. I definitely want to have you back and we will do a deep dive on that book. Do we know a date for this book? It's going to be probably spring 27. Okay. Spring 27. We can't wait. Thank you so much for stopping by. Thanks for having me. Fantastic.
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For someone who's, we're going to link all this in the show notes, and we'll put this all at, I'm going to put it at jjvirgin.com forward slash Ask Dr. Suzanne. Perfect. I know that's what your IG handle is. For someone who wants to learn more, just give us all that information, and we'll put it in the show notes too. Yeah. Where do they find you? If you go to my website, which is the Dr. Suzanne, T-H-E-D-R-S-U-Z-A-N-N-E, all my socials are there. Okay. And so find me where you like me. Perfect. Yeah. All right. Thank you so much.
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Be sure to join me next time for more tools, tips, and techniques you can use to look and feel your best and be built to last. Also, I'd love to connect with you and hear your thoughts on the podcast. Here's how. First, subscribe to the podcast and leave an honest review. Second, take a screenshot of your review.
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And third, text it to 813-565-2627. That's 813-565-2627. When you do, I'll reply using my brand new Virtual JJ app.
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It's my on-demand virtual self built from my books, talks, and years of experience so I can interact with you directly. You'll make my day, and I can't wait to hear from you. Thanks for tuning in, and I'll catch you on the next episode.
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Hey, JJ here, and just a reminder that the Well Beyond 40 podcast offers health, wellness, fitness, and nutritional information that's designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional and ask you to do it.
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make sure that you do not disregard, avoid, or delay obtaining medical or health-related advice from your healthcare professional because of something you may have heard on the show or read in our... Best thing that's ever happened to you financially. Go. Easy. Sold by car on Carvana. Amazing offer. Really?
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People who are having sexual dysfunction, specifically orgasmic dysfunction, that is a signal for heart disease. It's the same thing with women, again. That's just not talked about. Because people don't talk about sex. If you're having hot flashes and night sweats, that's coming from the brain, actually. And it is, by the way, a big red flag for cardiovascular disease and dementia. What woman isn't in a little bit of sympathetic overdrive? Right. What are some of the things that she could look at here?
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Ashwagandha is amazing. It is the king of all medicines. It gives you the strength of a thousand horses, right? Because it does increase testosterone, but it increases testosterone in women as well. Really? And testosterone is important in women and men. We have more testosterone when we're young than estrogen. Here's the deal. We use all sorts of medication off-label. I prescribe and use testosterone off-label as well. The FDA is not your mom.
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Even when you're doing all the right things, your strength training, staying active, prioritizing protein, keeping the muscle you built over a lifetime gets harder with age.
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So if staying strong is part of your longevity strategy, and I sure hope it is, visit timeline.com forward slash JJ Virgin and get 20% off your order. Hey, it's JJ. And I want to challenge something you probably think you've already nailed. And that's vitamin C. Because if you're like a lot of women I work with, you're reading labels, you're choosing good brands, and you're assuming your vitamin C is actually delivering. But vitamin C supplements in general have a problem.
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And it's not the dose, it's the delivery. With most forms of vitamin C, like basic ascorbic acid, your body actually has a limited capacity for how much it can absorb at one time. Now, unlike most vitamin C supplements in nature, vitamin C is never isolated. It's paired with bioflavonides and plant compounds that help your body absorb it, retain it,
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and use it effectively. So when that context is missing, so are a lot of the benefits. And that is why I love a new formula called Qualia Vitamin C Plus. It uses seven distinct sources of vitamin C.
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Hey, I'm JJ Virgin, PhD dropout, sorry mom, turned four-time New York Times bestselling author. As a certified nutrition specialist, fitness hall of famer, and globally recognized leader in health, I'm driven to keep asking the tough questions and use my podcast to simplify the science of health into actionable strategies that help you thrive.
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I'd also love to hear your thoughts on the show. And here's the fun part. When you send me your review, I'll reply to you using my on-demand virtual me. That's right. My team and I created a virtual JJ packed with my books, speeches, and wisdom so I can personally connect with you. Here's how you do it. Subscribe and leave an honest review of the podcast. Take a screenshot of your review.
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Text it to 813-565-2627. That's 813-565-2627. My virtual JJ will reply directly. And trust me, this will make your day. So subscribe now at subscribe2jj.com and text me your review. Let's keep thriving together.
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A couple of years ago, I had the honor of interviewing Dr. Suzanne Gilbert-Lenz when she came out with her Hormone Boot Camp book. And I was super excited to run into her at A4M's Spring Longevity Fest and find out that she's got a new book in the works. And she's going to give us a sneak peek on that book, which is all about herbal medicine. We're going to be digging into a
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which different types of herbal supplements you should be using, could be using, or should stay away from. What can be super helpful, what to look for, it's all here coming up next. So stay with me. JJ here, and I'm here with Dr. Suzanne Gilbert-Lenz. Hello. Super excited to have you here in person. So happy to be here.
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And this is a great conversation we're going to have because we haven't talked at all about botanicals and their use. I mean, at all, but especially in their use in perimenopause and menopause. So that's where I'd love to dig in. And first of all, just like your overall, like, what the heck are botanicals and why should we be paying attention to them?
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Great question. Botanicals are technically anything that is grown a plant. I include things like mushrooms in there because they're not a plant technically, but they are grown. So anything that's coming from the natural environment that has grown on its own. And the thing about botanical medicine is that, you know, like 30% of pharmaceuticals or more come from the botanical world. They come from traditional medicine. It's just often not acknowledged.
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What we're doing in conventional pharma is we're pulling out one component. We know the mechanism of action, and we're amplifying that greatly. With the plant itself, there's a synergistic experience, right? So it's multiple different chemicals that are working together, and they have multiple effects often. Many of those effects will work together toward the same goal. And what's interesting to me is if you look really deeply at botanical medicine like I have, inflammation is one of the biggest factors.
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actors, right? Which now we understand in modern medicine, inflammation is the foundation for so many of our chronic and acute diseases. But it's like the plan already knew that, right? So there's an anti-inflammatory effect, and then there's a layered, you know, there's antimicrobial or whatever it is, it's acting on the wrinkle. I mean, you know, whether it's working on bone, or it's working on AMPK, or whatever, it's so it's crazy, actually, that now we can identify all these minutiae
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But the plant itself has a larger, almost like a larger perspective on us because we grew up together on the planet. You know, for whatever it's worth. That's the way I look at it. Well, I was telling you earlier, since I went to the Amazon over New Year's and saw their perspective, I was in the sacred headwaters of the Amazon.
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Biodiverse place on the planet and their whole premise is plants and humans are equal. Yes. You know, and animals, we're all equal. So it's a very different take on things. Your background, though, is also Ayurvedic. Yes. So talk about how you've got this conventional OBGYN training plus that. What happened? Basically, I came out of my conventional training, you know, very excited and really honored to have had that experience.
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But I think it was dual. Something was a little bit missing. I've always been a really curious person, a very spiritual person. And I was doing meditation and yoga for my own benefit, right? I was a young mom with a new practice, and you can imagine how stressed I was. Just like PTSD from residency. And I thought, you know, how can I take care of myself? I started doing these things, and I really fell into learning about Ayurveda.
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Yoga and meditation are branches of Ayurveda, which is the ancient medical system of India, the subcontinent of India. And I started just out of my own curiosity. It wasn't like I was like, oh, well, now let me go put up my Ayurvedic shingle. But I just, I ended up doing like a whole, you know, accredited program. Two and a half years, study, making my own herbs, working with patients. Yeah.
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And I was like, you know, seeing patients on the side, a lot of my conventional patients were like, I'll be your IRED patient. You know, I'm seeing them in my like back house. I really respected and appreciated the more integrated, holistic approach to human health, right? So that the body exists in and of itself in a very integrated, coherent way. We don't always understand it. And I think in Western medicine, we're understanding it much more deeply now when I think about 25 years later.
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But for instance, all this interest in the gut microbiome now, which is like totally standard fear. Thank God, right? It's so important. But in Ayurveda, whatever the issue the person came to you with, you always created an herbal formula for their gut. Because the understanding was the gut was the seed of all your health. Right.
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I mean, I could go on and on. So it was very resonant. I was learning about this system from thousands of years, and I said to myself, this is crazy. Like, they understood a lot about, for instance, neurovascular anatomy. We didn't know about until thousands of years later. So I early in my career realized, OK, there's something way bigger going on here. Humans have always attempted to...
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be healthy and whole and to assist each other on that journey. And this is not new. Like, we don't own it here in conventional medicine. We've done amazing things and miracles, but we are just another iteration of something that had been going on for all of human existence. So that's what initially got me interested and excited. And, you know, that was my first love. So working with plants and writing about plants and teaching about how plants work is,
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deeply satisfying and gratifying to me because this is really like the book I wanted to write, you know, before I was ready to write a book. And now we're going to be waiting a year for this book. Yes, it's okay. You'll be okay. So we'll have you back again. So someone listening to this who's like, all right, this is interesting. Or someone coming to you as a patient, how do you integrate in the plant piece of this, the herbal medicine into what they're doing?
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It's listening to the patient. I think because I have this reputation in my community for being open-minded and for doing these kinds of things while still practicing in a totally conventional manner and using, you know, hormone replacement therapy, which I may hear. I take hormones, okay? Me too. I love them. Thank God. You have to pry them from me. Right? Exactly.
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So it depends on the person, and I think that's really what the therapeutic alliance is, right? Where are they? A lot of my patients, and especially now where people are much more educated and learning about perimenopause and how this all starts, a lot of them are curious and they want to prevent chronic disease, which I'm so excited about. What an opportunity to work with somebody at 37 who's thinking about this rather than 57 when they're in it. When you're unfrying the egg. Right. Exactly. Exactly. You can't what you cannot do.
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So sometimes we start with herbal and botanicals first because they're not quite ready or they're curious or they have a symptom that is actually maybe going to respond better to the herb. A lot of our nervous system issues, you know, respond really, really well to things like ashwagandha or rhodiola, adaptogens.
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They're really powerful. The sleep issues that people are starting to have, sometimes the botanicals are a more gentle entrance point for them. And the thing is that a lot of these, most of these, are actually very amenable to work with the hormones. So there's lots of plant estrogen-like molecules out there. They can work very well for certain things like hot flashes or vasomotor symptoms. One of my favorites is a very specific form of Siberian rhubarb.
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And we know that it acts like a selective estrogen receptor modulator. So it's activating in places that you want, brain and bone, and not activating proliferation in places like the uterus or the breast. We don't have the best data in the world, but we have some data. So super, super interesting. And I can fine-tune based on what's going on with her. And then if we're layering in hormones, we are. And look, I'm a breast cancer survivor. Some of my patients are in treatment. They cannot be using hormones at that time or at that time.
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She's not to usually. I mean, they can do whatever they want, actually. That's what shared decision-making is. Or maybe they have another reason why they can't. Maybe they've had a stroke or a blood clot. So maybe they can't use hormones. And these can be really, really, really helpful for modulating not only symptoms, but potentially for impacting long-term health issues like insulin resistance or bone health or brain health or gut health or cardiometabolic profiles.
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Again, they're not, we don't have the same level of data as we do for a lot of our pharma stuff, but we have a lot.
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A lot of data to support their use and their safety. Yeah, and I think that's the most important. There's safety data. We need your book, clearly, because I see this seems very, very relevant for a woman ending perimenopause, menopause. Like, there's so many things they can do.
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But for someone, let's go back over to nervous system. And I'd like to dig a little deeper into ashwagandha and muleola. So for someone, because, I mean, what woman isn't in a little bit of sympathetic overdrive? I mean, who's, so what are some of the things that she could look at here?
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Well, I mean, first of all, if some of it is timing and where you take it in the day, ashwagandha can be a little more sedating. And again, remembering that it can take some time for these things to get into your system and work. So ashwagandha, I would say, for most people, I would start with trying to take it at night. And it really can help with sleep as well because it can kind of downregulate the nervous system and it can interact with GABA receptors and help relax, right?
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Rhodiola is a little more activating and it can be a little more beneficial like maybe earlier in the day. You know, these are broad brush strokes we're painting in. So those are two things I would just think about. But adaptogens are really interesting because their goal is to get you back to homeostasis, which sounds really weird in Western medicine. It's like, well, how could it do both? But it does because, as I mentioned with plants, there's synergy.
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And they're activating more than one pathway at the same time. So those are two that are actually really well tolerated and very effective. I think understanding like the dosage and you're getting the right extract and that it's a certified product, things like that is very, very helpful.
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I see a lot of anxiety in perimenopause, a big uptick. And we also know anybody who's had any kind of hormone-mediated mood disorder, so maybe around puberty for sure if they've had pregnancy-related anxiety or depression, they're almost certainly going to have an uptick in those symptoms again in perimenopause. And we see like up to 40% of women have some kind of mood symptom. So really targeting that nervous system regulation is so important. I mean...
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game-changing. And sleep, regulating sleep. If you don't sleep, I could dip you in all the hormones and you're just, you're not going to get better. Well, it's a massive problem, let's be honest, during perimenopause. So beyond the ashwagandha, are there other things that you like for sleep?
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It depends on what you're trying to do. I mean, valerian is really powerful. I would be careful with it because it can make you very groggy in the morning, but it is really good at inducing sleep. Saffron and passionflower also have some efficacy. I think it depends on what the issue, right? Is it falling asleep? Is it staying asleep? Honestly, most of my patients, it's staying asleep. Yeah.
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But also looking at things like blood sugar and activity level, right? If you're super, super active later in the day, you're going to have your cortisol is going to be up. You're going to have a harder time going to sleep. If you're drinking alcohol, I feel like I shouldn't have to say this, but I have to say it. Like, sure, it's going to make you fall asleep. You are not going to have a good sleep for a million reasons. It's not good for your brain, and it's definitely not good for your blood sugar. So understanding insulin resistance is also climbing at this time of life. And insulin resistance and glucose metabolism actually play a big role in our sleep.
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So it's kind of hard to nail it all on just like one. But I think passionflower and saffron are ones that people don't think about. And they're great. And saffron also can be used for mood disorder. Yes, for sure. A lot of the things, anything that works on the HPA axis or the HP ovarian axis in this case, is going to help with mood and with sleep. So you see a lot of crossover here. And you can layer these as well.
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Now, of course, the other big issue, and you mentioned it, is all of the, we're starting to get more insulin resistant. So we've got blood sugar issues. Are there some things you like to use for that? Yeah. I mean, these herbs are not as great, but I like them. I mean, it depends on how big your issue is. Berberine actually has plenty of data to support its use. I think that we're seeing some newer ones coming online. And some of the older ones, like, look, there was a...
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Kyolic acid, which is aged garlic and it's a very specific thing, was having its moment for a while there. I cannot take that step. Yeah, I don't think it works that well. There's some really interesting work with a very specific hops that really is acting like a GLP-1. I mean, it's not in the same long-acting way. Oh, is that the calicurb?
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Yes. And honestly, the data is really fascinating. It's very interesting. So those are some of the ones I know I'm leaving something out. I can see my slide and I'm just like blanking on what that was. But these are some that I reach for. There's a plant sterols, which is going to be more for your cholesterol and fiber. I mean, really, like you don't have to get fancy. Like people need people don't get enough fiber.
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It could be as basic as that. Well, when you look at fiber, because there's different types of fiber, how do you recommend doing this for your patients? It's such a basic that the reality is the majority of people are getting a third of what they need. Oh, yeah. First of all, people have to track what they're doing, right? Because I'm going to tell you something. When I talk about fiber just generically, I mean, are you talking about soluble fiber? Are you talking about insoluble fiber? And they all say to me, especially my – I have a very –
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a very educated demographic and very health-focused demographic, right? And they are all telling me about vegetables, which are amazing. Absolutely, you need to eat vegetables. You're not getting nearly as much fiber in your fruits and vegetables as you think you are. That Arugula just did not crank up your fiber intake. No, it really didn't. So the first thing I do is have them kind of look at what they're doing. I actually have a cheat sheet, JJ, that I send them because some people like lentils and some people, you know, like chia pudding. I don't know. Maybe we can include the cheat sheets.
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Oh, my God. Absolutely. I'm voluntolding that. Yeah, yeah. We'll gift the cheat sheet to the audience. Yeah, absolutely. Cool. Yeah. So there's – and some of my patients are vegan and some are – you know, whatever. So I think helping them make selections and understanding like 25 to 30 grams if you can do it. But I have a hard time with it. It's like a freaking full-time job.
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I know. I track it every day, too. I'm like, I'm a big tracker, but I love it. It's so important. Look at me with my two devices. You know, like stack everything. Yeah. But fiber especially, that is like that 10 grams per meal. Yep. Yep. Exactly. Divide it up. Divide it up. Although I will brag about it. I've already gotten 20 grams. Of course you have. Just so you know, it's like a new one, you guys.
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I haven't had lunch yet, though. And a lot of this is actually the perimenopause and menopause stuff that I talk about botanically is a lot of it is actually in my book, Menopause Boot Camp. Because I focused a lot on stuff that people just were not talking about yet. And people still are not talking about this enough. So we're going to keep bringing it to the.
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And what we're going to do is we're going to put that in the show notes. Amazing. Because we did your interview on that. That was a while ago. Yes. Yes. So we did that interview. It was four years ago. Four years ago. Yes. Wow. Yeah. All right. Crazy times. So other things for people that they can use here. We talked about things for mood. Yeah. We talked about things for sleep and blood sugar. But what about just, you know, hormonal symptoms? Yeah.
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Yeah. I mean, so again, some of these phytoestrogens and some of these CIRMs are actually really interesting. What's a CIRM? So CIRM is a Selective Estrogen Receptor Modulator. So it is selectively turning on or off estrogen receptors in different areas because estrogen acts all over the body, right? It is not just...
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You know, in your uterus or your ovary, it's in your bones, it's in your brain, it's in your heart, it's in your liver, it's in your muscles, it's everywhere. So we want to be careful that we are targeting the areas that are causing us a problem. So if you're having hot flashes and night sweats, that's coming from the brain, actually. And as, by the way, a big red flag for cardiovascular disease and dementia. What? Yeah. Yeah.
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Yeah, that is a signal. I have never heard this. Yes, severe hot flashes are a signal. Okay, so if you have severe hot flashes, but then you control them. It's probably having a positive impact. Okay, so it's like, it's not just that. They're not benign. They're not just a joke. Wow, that is so funny. Why is that a big risk factor?
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Because part of what's happening is it's originating in the thermoregulatory center in your brain. But it's having an impact actually on the vascular system as well, which is where the hafash is kind of being acted out. So we know that it's related to reactivity and then more issues. Like you're losing nitrous oxide, which helps to relax the blood vessels. And you're also having an impact on the endothelial lining, which is a very important thing.
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the lining of the vascular tree of all those vessels, which of course is going to, you have more inflammation. So, okay, and then the inflammation is, yeah. And you know, I'll tell you something. So should you have some beetroot or what should you do? Well, I mean, you should, here's the thing, you should not grin and bear it. You should treat your hall flashes. So whether you're using-
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Yeah, suffering is like not only is it like unnecessary, you're not getting a gold star for it, and it's harming you. So I really want people to know, yeah, a hot flash is not just a funny joke and like, oh, get a fan. I mean, get a fan if you need it. But like take care of that. And if your clinician does not understand that this is a signal for your longevity, we got to find you another doctor, okay? We just really do.
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So, look, black cohosh, which is much maligned and does not act as an estrogen, works pretty well. Very specifically, rummy famine. The Germans are always on it. They're really good with plants. But 50% reduction in hot flashes. Wow. Yeah. Genistein digs in, which you can find in, like, soy products and stuff people should not be afraid of.
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The right kind of soy, soy can be very powerful for these things. And Siberian rhubarb is one that acts like a selective estrogen receptor modulator, works very well for hot flashes as well. I think as long as we're on the signal for health issues, people who are having sexual dysfunction, specifically orgasmic dysfunction, the penis is the analog to the clitoris, okay? The clitoris is the original. We're the default, XX.
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We are. This is just biology, folks. So everybody knows, or they should know, that erectile dysfunction is a signal also for heart disease. Same thing, those small vessels are not working, right? They're closed down, they're not opening, nitrous oxide isn't getting in there, they're not getting expansion, they have inflammation.
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Men should know if they don't know that that is a signal for heart disease. It's the same thing with women. Again, that's just not talked about. Because people don't talk about their clitoris and people don't talk about sex. And it's not just that pleasure is a birthright, but it's part of our health. It's a part of our body. So we can culturally detach from it, but your body knows better.
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So sexual health is health health. So there are things that you can work on with that. I don't know that there's a plant medicine that's perfect for that. But I mean, kind of leading from this into sexual health, I mean, there are things that we can do that actually, ashwagandha in Indian medicine and Ayurveda, it is the king of all medicines.
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and it gives you the strength of a thousand horses, right? Supposedly that's because it smells like horse urine. But it's also, the allegory there is, or the poetry there is that it is very important for men because it does increase testosterone, but it increases testosterone in women as well. Really? So why wouldn't we all be taking this? Well, I mean, I think again, because I don't believe that everybody should do everything, but I think in consultation with someone who knows about it, ashwagandha is amazing.
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It is. It's great for a lot of things. Again, adaptogenic, it's doing a lot of different things. And this is one you take in the evening. Yeah, you're probably better off doing that. There's tons of them. Tribulose is another one that can increase testosterone. So, and testosterone is important in women and men. We have a lot of testosterone. We have more testosterone when we're young than estrogen. Yes, more testosterone than estrogen. So when we lose it and it doesn't fall off a cliff like estrogen, it kind of declines slowly, we're losing a lot of benefit.
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I mean, this could be a 10-hour podcast. And it would seem then that you could use some of these things, like ashwagandha and tribulus, and then see how much you might need to supplement with testosterone. Exactly. Since it's so darn hard. Like, when are they going to get over this thing with women and testosterone? It's going to happen, but I don't know when.
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I mean, here's the deal. We use all sorts of medication off-label. I prescribe and use testosterone off-label as well. The FDA is not your mom, okay, and it is not the police. Like, we got to use our brains and use the available evidence. So people who are scared about using testosterone in women, you should take pause and make sure you understand what you're doing.
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But that's not a thing. Are we, like, trying to block 25-year-olds' testosterone? Women? I hope not. I mean, we kind of are with birth control. But, you know, like, no one's doing that. So let's, like, take a deep breath and, like, think and learn. So testosterone doesn't do the fall off a cliff. It's just a slow decline. Yeah. And is that one that starts slowly declining? Yeah. In your 30s probably, yeah.
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I had a very smart doctor. I went on it in my early 40s. Yeah, amazing. He gave me that before anything else that actually helped pull my estrogen up a little. Testosterone can help with sleep. I mean, look, the data, the preponderance of the data is in sexual health, and it is very, very helpful for a lot of people for libido, for interest. But the reality is that we have testosterone receptors everywhere too, so it's very important for a sense of well-being, for calm. It helps people sleep.
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We actually, okay, now I'm going to really get in the weeds and, you know, I don't want to get myself or anybody into trouble. But there are some data showing that it may be beneficial in breast cancer, like may decrease the risk of breast cancer. So I'm not saying everybody go out there and, like, but people need to be more thoughtful and not so, like, binary and black and white.
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All right. We will make sure we link to Hormone Boot Camp. Yes. And to this cheat sheet you're going to use, please. Yes. I'm going to send it to you. And we are waiting, waiting, waiting for the next book. I definitely want to have you back and we will do a deep dive on that book. Do we know a date for this book? It's going to be probably spring 27. Okay. Spring 27. We can't wait. Thank you so much for stopping by. Thanks for having me. Fantastic.
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For someone who's, we're going to link all this in the show notes, and we'll put this all at, I'm going to put it at jjvirgin.com forward slash Ask Dr. Suzanne. Perfect. I know that's what your IG handle is. For someone who wants to learn more, just give us all that information, and we'll put it in the show notes too. Yeah. Where do they find you? If you go to my website, which is the Dr. Suzanne, T-H-E-D-R-S-U-Z-A-N-N-E, all my socials are there. Okay. And so find me where you like me. Perfect. Yeah. All right. Thank you so much.
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Be sure to join me next time for more tools, tips, and techniques you can use to look and feel your best and be built to last. Also, I'd love to connect with you and hear your thoughts on the podcast. Here's how. First, subscribe to the podcast and leave an honest review. Second, take a screenshot of your review.
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And third, text it to 813-565-2627. That's 813-565-2627. When you do, I'll reply using my brand new Virtual JJ app.
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It's my on-demand virtual self built from my books, talks, and years of experience so I can interact with you directly. You'll make my day, and I can't wait to hear from you. Thanks for tuning in, and I'll catch you on the next episode.
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Hey, JJ here, and just a reminder that the Well Beyond 40 podcast offers health, wellness, fitness, and nutritional information that's designed for educational and entertainment purposes only. You should not rely on this information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other healthcare professional and ask you to do it.
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make sure that you do not disregard, avoid, or delay obtaining medical or health-related advice from your healthcare professional because of something you may have heard on the show or read in our... Best thing that's ever happened to you financially. Go. Easy. Sold by car on Carvana. Amazing offer. Really?
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