Hysterectomy Recovery Secrets


Dr. Joel Rosen: Kerri. So great too Great to see you. Again, I’m excited to go over your results, I know we have a Dutch test to go over your lab work. And of course, we’ve already done the genetic test. But what’s really good about that is we can make changes to what has happened between the last time we talked and what we where we are now, and then relook at the genetics and see what other aspects of your biochemistry that we haven’t Incorporated. And now create a new chart, give you new marching orders so that we can, you know, continue the progress of getting you feeling better. So let’s do this. I always, you know, how we always like to start is just with an update. So we haven’t really talked for a while looks like the last time we talked was in, almost February, so much has gone on. So why don’t you just give me a little update, Kerri, in terms of what you’ve been through what you’ve done, obviously, you know, in terms of how you’re feeling, let’s go through that.




Kerri: Well, everything was going pretty well. I did have a full hysterectomy in June. And ever since then, that I’ve been starting to get those hot flashes, and I’m not sleeping well. And things are starting to slide backward now. So I want to I did the Dutch and I peeked at my results. And I could see my cortisol was high. And so I want to try to get these hormones balanced now that they’re all out of whack from the surgery.



Dr. Joel Rosen: So sure, yeah. And then again, remind me what the reasoning for why they wanted to do the hysterectomy.



Kerri:  Well, I was close to menopause anyway, and I was having abnormal periods where I was, I was constantly having my period, and I was starting to get a knee back. And then I’ve also got the brace one genes. So and my mother died of ovarian cancer, so I’ve got some of those risk factors. So we decided it was probably in my best interest to go ahead and just take it out, you know, right, on, you know, my iron again, you know, getting that back in order and, you know,



Dr. Joel Rosen: Sure just to be safe than sorry, as well as the genetic components, as well. But you mentioned though you everything was going pretty well. So




Kerri:  yeah, other than that party, you know, all the other issues, you know, that I’ve been having, like with histamines, and rashes and gut problems, all of that seemed to be you know, clearing up and, you know, I was doing well, as far as you know, those items go,



Dr. Joel Rosen: Right, and then and then the full hysterectomy in June. And then as far as the hot flashes, when did they start again.



Kerri:  They probably started about a month afterwards. So I thought I was going to be in the clear and not have any issues. But about a month later, I started getting those hot flashes. And they’re mostly at night, but they do happen during the day. But they definitely interrupt my sleep. And so, you know, my sleep had been so great before. Like I finally got my sleep nailed where I was sleeping so well. And my aura ring would tell me, you know, you’re doing so great. And then now it’s like, I’m waking up every couple hours and it’s not good.



Dr. Joel Rosen: No, absolutely not. Okay. And then you also included bloodwork for our review today as well. So what we’ll be doing is we’ll go over the Dutch test first, and then incorporate the bloodwork to get some other pieces of the puzzle information about connecting the dots. And then of course open up the genetics as well. So anything else to add? I mean, obviously, things are going well had been going well. When have you been back to the doctor that did the surgery and Is that who ordered the blood tests and they’re wanting to continue to keep the finger on the pulse for you in that area?



Kerri:  Actually, well I went back to the doctor that did the surgery for the follow-up and got the all-clear. I had a different doctor actually ordered the bloodwork she’s monitoring my thyroid and hormones. So she basically did thyroid and hormone workup. But my thyroid the numbers are a little off too. So we need to check that one out.



Dr. Joel Rosen:  For sure. And a lot of you know it’s interesting because a lot of people that I work with they come to me first with Hey, my thyroid is not working well you know, I’m taking medication where we’re changing the dose. were changing the actual brand I know a lot of people got upset when they change the tip to the actual brand of the specific thyroid and they felt worse once they did that. So But I explained to them that this is the effect not so much the cause.

In a lot of cases, it could be the cause, you know, Hashimoto’s, you have an autoimmune reactivity against the thyroid, but again, that’s really kind of if the effect of the immune system being overwhelmed and then it will create an immune reaction against the thyroid in a protective like mechanism to slow down metabolism preserve nutrients, reduce oxidative stress, it’s a proper response for an improper environmental thing that’s going on in the body. So we will bring that into consideration for sure. Any other pressing comments, questions, concerns that you want to make sure we address before we go get into all of this,


Kerri:  I guess blood sugar because I was doing keto. And then about it’s eight weeks ago, I started going back to eating carbs. And so I wanted you to look at my insulin and a one C and see what you thought about that.



Dr. Joel Rosen:  Yeah, we talked about that. And I know that you became really metabolically flexible. Yeah, we’re getting really great ketone levels. And I think that really propelled you into feeling better. And then we did talk about you going back into cycling your carbs back in there wanting to build a little bit of muscle. And you’ve done that too. Right. Tell me a little bit about that.



Kerri:  Yeah, so it has been eight weeks of adding the carbs in and over the eight weeks. Because I’ve been doing it strategically not just like eating ice cream and whatever, you know, I’ve gained 3.6 pounds of muscle, I think it was in 1.4 of fat. So it is going more I mean, I know the fat is going to come with you know, you can’t just selectively gain only muscle, but I’m really happy with you to know, the muscle part because that’s because



Dr. Joel Rosen:  You felt like you were underweight or you just were weakened, you didn’t have the lean weight that you wanted you to feel your muscles were deteriorating like your goal. You know, yeah,



Kerri:  A lot of it is a little bit of it was from fasting and things, because I may have overdone it on that side, you know, and I, my starting weight was like 95 pounds. And at one point when I was doing a lot of the fasting, I went down to 89 pounds once and that’s just like those so I think I got a little overzealous with my fasting and eating one meal a day. And so I was losing a lot of muscle and, and, you know, I wanted to get bone strength and everything. So I need to I need some more muscle as I was looking for what are you weighing now carry? Today I weighed 10102102 points set one or two?



Dr. Joel Rosen:  And the ultimate where you’d want to be I mean, you know,



Kerri:  um, well, I mean, probably maybe more like 110. Okay, more muscle not you know, it’s kind of hard to say what the actual weight would be because I want it to be muscle instead of fat. Yeah, really read a baby.



Dr. Joel Rosen:  It’s so funny. So you know, some, some women have the problem, of losing weight, right. And then other women have the problem of gaining weight. And I’ve, you’ve heard me say this before, where adaptogenic li like an adaptogenic herb means if you have too much cortisol, you take an adaptogenic herb, it lowers the cortisol, it’s adaptogenic. Or you have too little cortisol, the adaptogenic herbs, same herbs will raise the cortisol so it’s used in terms of whatever your body needs, the adaptogenic herbs will help that physiological effect. And I believe the same thing happens with a weight where if we have biochemistry issues, histamine issues, mast cell issues, inflammation issues, blood sugar issues, immune challenges, then your body might be locked up in more of an A Toff.

Genic break down difficult to build up versus someone else might be more into a mtorr building. Difficult to break to release. So you know, I always tell people like Be careful what you wish for her number one, and then number two, it comes down to both sides of the equation is getting to the root cause of the problem. And then adaptogenic Lee helping your body do what it needs to do. And you understand that for sure.



Kerri: What was interesting is because before I started doing the keto to do all the inflammation, I was you know, overweight I mean not tremendously, but I was my body fat was like 30% you know, I weighed like 126 to one 30 somewhere around there. And it wasn’t very muscley



Dr. Joel Rosen:  he was more fluffy, right?



Kerri:  And when you put me on the keto diet I didn’t even know keto was for weight loss, you know, I just happened to start losing weight. And I’m like, what, what is going on? And so I almost got addicted to keto, you know, because I just loved it how you know, you could start to see your muscles, and then you would lose that weight. But then I think I took it a little too far. And so now I’m adding the carbs back in. But what was really cool is, I’ve been testing my ketones each week by adding in the extra carbs. Last week was the first week that I fell below point five, that I was actually out of ketosis with eating and eating like 270 carbs a day now. Wow, yeah, I was eating like 240 when I tested them, and I would be like at point six with ketones.

They say, you know, point five and above is in ketosis. So and, and at first, my blood sugar was high. When I started the carbs, it would be like in the 90s. But then it dropped into the 80s. And then the other week, it was down to 77. Again, like that kind of like keto so I yeah, the body’s finally starting to adapt carbs again. Yeah, I haven’t touched her ketones yet. I have just been doing it once a week.



Dr. Joel Rosen:  It’s interesting as a great conversation because it just really points to bio-individuality. You know, you can’t just read a book and say, Okay, you got to be 20 grams or less, you know, that everyone’s different number one. Number two, it really speaks to your metabolic flexibility. I would I think that yes, there’s a major hysterectomy is major surgery. And there are some genetic components that we have some major challenges with. But with that being said, Kerri, I think that we’re gonna, and I like to cycle into and out of that’s a really advanced strategy, not for the average person to do. But you and I’ve been working together for quite some time. And that’s why it’s so important for us to check in because now we’re recalibrating, I call it like a bonsai tree, we need to trim around the hedges. But it’s kind of like, you know, setting coordinations and then and then not really checking into, are we moving forward? Are we moving sideways? Are we moving backwards? And what I would say is, is that the ketones and metabolic flexibility and bio-individuality are going to be is key for everyone we work with, but specifically to you, I think that cycling, like figuring out like, What’s your ideal glucose ketone index. So meaning like, when you look at your glucose, and you say, Okay, I’m seeing it’s getting into the 70s, again, or I’m measuring my ketones, and it fell below point five. Okay, but what does that mean in relationship to glucose ketone index, meaning when you look at your glucose, you divide it by 18 because that will convert it into millimoles. And then you divide that by your ketones, and you’ll see how your glucose ketone index, and two numbers I want you to be aware of, okay, where do I feel best with my glucose ketone index? You know, it is if I’m not below five, that could be where we need to get you below five? Or if I’m, if I’m below five, I don’t feel so great. So that’s going to be key number one. And then the other number would be, we know where do you feel best with your actual ketones? You know, maybe like dipping below point five isn’t good. And you are stretching the limits of your metabolic flexibility. So it may want you to be Hey, Kerri, I want you to get those ketones into a point eight to 1.2 range. And that means you got to drop your carbs to two from 270 to 220. Now, I think it’s important to, like people listening to this, if they were to listen to this would think, Oh my gosh, I couldn’t have 220 I mean, I’m not that’s gonna blow me out of ketosis. I’m not going to produce any ketones, my glucose levels are going to be high. We’ve worked really hard to get you to where you are. But I think the bottom line is being aware for your own self of Okay, glucose ketone index number is more what I need to start to focus in on and really understand where do I feel best? Is it is if it’s below the point, not if it’s because really, you want it below 9.5? So if you look at your glue, and you are way below that, but you may want to be below six, or you may want to be below five, or just looking at the ketone number. You may want to be above 8.8 or you may want to be above one. So that’s where I want you to start to build Have that yourself, like start to make inferences between? How do I feel with that glucose ketone index as the number as a quotient? Or how do I feel like the actual ketone level itself? So that would be something we would definitely look into. So all right, those are all any other things you want to add? Or let I mean, we got to get into.



Kerri:  Yeah, I think those are the things right now.



Dr. Joel Rosen:  Yeah, cuz I got someone at 10. And we meet for an hour. And I want to make sure we get through all this. All right, so let’s look at your Dutch test. And as we’re waiting for it to populate you did you said you got it first. And this was the Gutsche plus, which means it looks at your, at your cortisol awakening response, which basically means when we first get up in the morning, you have a, a should have a doubling of your cortisol. And that’s why they call it the cortisol awakening response. So you can see in the purple in the blue lines, actually, let me put this as a continuous scroll. You can see here, I didn’t change


one second.


Alright, so you can see here, and in these, this line here, this is your, this is your line. And then this is our ideal line. So you can see and this is your free fraction, meaning the part that’s not bound to a protein. That’s why they do the saliva. That’s what’s so cool about this test is they do both urine and saliva. And so, right here is what we look at. So this is typically what we’ll look at the first thing we’ll look at this section, and we’re saying, Okay, this is your cortisol awakening response, we should see it rise in the morning, which it is, and then throughout within the first half-hour, and then after an hour, it’s on its way down, and slowly descends throughout the whole day. And, and you could see that for yourself. But obviously, you can also see that your levels are elevated, which you mentioned. So your free fraction is high, which can input with, which can imply a lot of things. I mean, it can imply that Sorry, I’m trying to erase all these numbers, these signs here, it can apply a lot of things, it can imply that we’re under stress, you know that we’re ramped up, our HPA axis is over is being stimulated. It can also imply that where we have a free fraction that’s not being utilized, right, in terms of, if you look at your metabolize this, I always like to look at this for clients is let’s look at the relationship between the metabolized, which is how much did you produce for that given time period. So when you do a urine sample, you’re measuring the output of cortisol for the entire time period that you’re doing it. So if you do it, when you first wake up, and then you do it, you know, your last reading is is before bed, then that is the time period that you’re measuring your cortisol levels. That’s called metabolize cortisol, how much did you produce for the whole day, whereas saliva only represents 1% 3% 5% of your total cortisol production.

So that’s why I tell people to be careful when you look at the saliva samples. Because you’re not measuring your total output, you’re measuring your free fraction that’s available for use. And there’s a lot of factors that will impact what’s available. inflammation, thyroid issues, abdominal obesity, stress, genetics, there’s a lot of things that will impact that, but what we like to do is we’d like to look at this a ratio of Okay, you’re really high in how much you’re producing, you’re too high, but you’re metabolized is not as high. So there’s a ratio challenge there. And there are things that you think about, you can think about over activity or under activity of the thyroid, that’s one of the things that you think of with that. So one of the things I’ll do carry is I’ll go right to this page over here and look at your whereas it will look at your,



Dr. Joel Rosen:  Your body’s I call this the general of the body. So whereas we look at the HPA axis is the metabolize cortisol. So the brain tells the adrenals to produce that’s we call that central command, the brain telling the adrenal so they metabolize is more of a, of a marker of the glandular, then the brain’s signaling to the gland to produce whereas the 11 beta HS D, which is basically, at the cellular level at the tissue level, once the cortisol has been produced, is it telling the cortisol to be active? Or is it telling the cortisol to be inactive? So sometimes the brain signals are different than the cellular signals the brain, the pituitary, and the hypothalamus wants that adrenal hormone around to function because its brain is the priority. So it will say, hey, adrenals, make more. So that’s where your metabolize cortisol will be high. Whereas at the cellular level, this is a marker at the cellular level staying the brains producing too much. And so when it comes into our cell, we tell that cortisol to be deactivated, or the brain is not making enough. And we tell that cortisol to be more active. And so the 11 beta HSD, I tell them, it’s, it’s the Army Sergeant that tells the troops, hey, we need more troops on the battlefield, or we need fewer troops on the battlefield. And you can see in your case, you’re telling your body to make more troops. Right? So it’s, it’s in the favor of cortisol. So that’s why you will see that free cortisol be higher. Right, because you’re at the cellular level, you’re telling the adrenal, you’re telling the cortisol to be more active, so convert more into the active hormone. And that happens in the kidneys, it happens in the liver, mostly the kidneys, where it’s saying, hey, you need to activate your surplus or your, your, your amounts of stored cortisol zone into cortisol because we need more troops at the level. And, and that’s catabolic. And it’s, it’s also stimulating, right? Because cortisol, will produce energy will dump glucose into the bloodstream will help balance your minerals. So what it’s telling me is at the cellular level, your body’s wanting more cortisol, it’s there’s more stress at the cellular level, there’s more inflammation.

So a couple of things we could do carry in that instance if you feel like okay, I’m not sleeping very well. We can attempt to get more cortisol converted into cortisone. I mean, at the end of the day, we want to get to the root cause of the problem, find out where the inflammation is coming from, see if we can address immune health, gut health detoxification issues, you know, is their mold, whatever. But you know, to give you some state, we want to convert that into the inactive hormone, because your free fraction is high in cortisol, and your body is favoring cortisol production, even though even your cortisone production is high too. But we want to kind of convert that into this here. So one of the great products we’ve talked about the company we like so much is premier research labs, tranquil Hall is a really great product you can take you to know, a couple of capsules before bed, and what that does is it’s got this fish roots go-to layer. And those are really great nutrients that will help to lower that cortisol into cortisone, you know, so that we have that amount being deactivated, it’s helpful. I’ve had people work really well. On the flip side, sometimes I’ll have people favoring too much cortisone, and their and their half-life of cortisol doesn’t stay around very long. So what we’ll do is we will recommend licorice root so I would not recommend licorice root for you here because you already have a lot of quarters free cortisol and your body’s already you know, squeezing the sponge and getting as much juice out of it as it possibly can. which suggests what’s going on at the cellular level what’s going on inflammatory wise, why why is your body wanting to squeeze the sponge out and get as much juice of cortisol as it possibly can. So cup so required let’s look at the bloodwork. So that’s really a good time to Hey, let’s put this down here. Let’s minimize this. And let’s jump into your blood work here. So



Kerri:  And you mentioned that cortisol, you know, going to the kidneys because on my bloodwork like my been creatine and creatine a level was kind of high like the lip some of the liver and kidney things were high that has never been high before. And I don’t know if it’s because of the high protein, you know, the more protein right now. All right, all right. Cortisol now that you mentioned that,



Dr. Joel Rosen:  yeah, I mean, listen, um, so it can’t draw on here. But if I could, so when you look at the Bun, you know, I don’t look okay. So whenever we look with clients, I’ll look through your lab results first, right. So I will Okay, your bu and creatinine ratio is high. Right? So But if the BU n is in the lab range, and the Korean is in the lab range, but if one’s a little bit slower than the other one, the question is going to be higher low outside of their own. So I don’t look at that range carry if both of these are in the ranges. Meaning if you’re a big uns in the range, your craton is in the range, then if the quotient is out of the range, Hmm, maybe you’re creating is a little low. And that comes down to methylation issues. And we can support that with creatine because it’s an end product of methylation.

That’s where I would look at your genetics. And then we’ll say, Okay, do you have a ga mt snip? Let’s take a look. I don’t remember you don’t. Right. So GMT is what helps to produce creatine. So sometimes I’ll make Hey, let’s get you on creatine you’re cratons low or your B un ratio is high because you’re creating an is low kind of thing. Or you may have other methylation issues you do like FET to is one that helps to absorb b 12. Helps to give you proper Flora helps to make stomach secretions, stomach acids. So we’ll also want to look at your bloodwork are their markers of protein absorption issues, because protein is necessary for cellular processes repairing. And if we’re having problems putting weight on, then the weak link in the chain breaks where your GI issues are not allowing you to absorb proteins and or your immune systems upregulated requiring protein. So you have a supply and demand problem to the right plus you have a genetic component of not making that microbiome healthy with your FET to and not absorbing your B 12. So we would say hey, you have some b 12-factor concerns, you want to look at your bloodwork for that there are some empty, you know, your homozygous for MTHFR.

So we will want to make sure we got enough, full eight in there as well. And even folinic acid, because dhfr helps to make folinic acid as well. So we may want to, you know, look at adding some substrates of folinic, full A B 12 gi support to make sure we’re getting our proteins to make sure that our you know our immune systems functioning fully. And that could be one of the reasons again, why your cellular level is squeezing the sponge so much to bring more cortisol to the tissues. Does that make sense?



Kerri:  Yeah.

And really put back together with the cortisone,



Dr. Joel Rosen:  Right, but then you know, okay, so we look at the liver enzymes and say, okay, liver, liver enzymes are high from a lab range, you know, this one’s gonna be high from a functional range. Because when we look at it from the functional range, which is more than that, what we consider the healthy ranges, you can see how this level is actually high, we can actually draw on here, this level is these two levels are high, you know, but when we look at it from the lab range, where we oversteer when we look at it from the lab range that only one of them is high. Right, so, so again, liver methylation is a big energy producer for the liver for the kidneys, B vitamins support, is there toxic chemicals, or pathogens or things that the body’s having a process that’s not keeping up and I say liver enzymes being high like, okay, that would make sense that your free cortisol would be high to like, the body’s under stress. cholesterol, I mean, in fact, that’s actually lower than usual, right? I mean, yeah.



380 the last time,


Dr. Joel Rosen:  right, right. And that’s where you and I had a lot of talks about, hey, like, maybe like keto, from the genetic standpoint, should be controlled. And I think that’s where dialing in again, to the glucose ketone index, finding that happy medium of, Okay, I can’t be at 270 carbs and really continue to test my metabolic flexibility to a point where it starts to produce fewer ketones, but I can drop my carbs significantly without having to raise my protein, my fats. So I don’t bump up my cholesterol at the end of the day like I am concerned when I have someone who has higher cholesterol, but I’m more concerned if there’s inflammation associated with that. Right, because then that oxidizes and creates more cardiovascular issues. But I that’s I’m sure you’re happy to see that be lower right? Yeah,




Kerri:  There. Yeah. For me, that’s, that’s lower.



Dr. Joel Rosen:  Yeah. And so again, it’s going to come down to playing around with your metabolic flexibility. Your glucose ketone index, your total ketones, and also just understanding like, hey, it’s been eight weeks now that I’ve added those carbs in. Let me go back into maybe eight weeks of cycling back into lower carbs. And see if I if my night sweats because that’s really the barometer is okay I always want to keep my finger on the pulse of my objective labs. But also sometimes my objective labs aren’t changing as fast as my symptoms are favorably or unfavorably, and I’m feeling better. I’m not having the night sweats. I’m sleeping through the night, I’m still maintaining my muscle mass, my cholesterol levels are still staying in the ranges. So that would be more of the take home. And again, this is sophisticated talk right like this is we won’t start this way with someone I worked with right from the very beginning. But I like you and I have been working together for quite some time. This is a sophisticated talk. Right? And you get Okay, this makes sense. I need to take that I need to understand that. A one c 5.4. I mean, do you remember? I mean, we can look through some of your old labs have they were lower in the past? Correct.


Kerri:  Even down to like four something 4.5 when I hire before I started keto like it was 5.7 or something, you know before I started working with you and everything.


Dr. Joel Rosen:  Yeah, I mean, some doctors like to see that 4.8 you know, five-point I like to see it in the lower fives. Did they do that fasting insulin on here? Yeah. So again, I probably want that a little lower to, you know, some doctors want to see that less than three. And so you know what, what spikes insulin 270 carbs is a lot in my mind, you know, like, but


Kerri:  then it was on 230. But that was when I was still kind of like my blood sugar was still a little high. Like it was 98 that day that I went there, my fasting glucose, right? But like now it’s been dropping lower in the morning. So I don’t know. Because can insulin change that quickly? Like if I have high blood sugar that morning? Like a higher normal reading? Because like I had bad sleep that night before? I think it’ll go up.


Dr. Joel Rosen:  But it can be volatile based on what you’re eating based on if you’re experiencing an inflammatory trigger, you know, stressors. But in general, it you have to keep it in context hasn’t been higher hasn’t been lower. Yeah. What was it in the past? I’d still say absolutely. Like, it’s going to be more of the effect of changes more than Hey, let’s just take something to lower insulin kind of thing. Um, when I remind me again, Kerri, when you had the hysterectomy, what was the strategy in terms of estrogen replacement? And hormone support? Is she



Kerri:  Well, that’s when she wanted to have me test you know, wait a little bit after the hysterectomy and then test to see where we’re at. Right now I have topical estriol just because that’s more of the protective like, but I know that’s not the type of estrogen that needs to get replaced. So I’m taking progesterone, the micronized and compounded, compounded progress grown by I’ve been taking that before the hysterectomy as well. So that’s the only thing that I’m that I was taking as far as hormone replacement, but I’m going to be meeting with her next week. And then I don’t know what she’s gonna recommend as far as estrogen and that’s what I kind of wanted to talk to you about.


Dr. Joel Rosen:  Yeah, I mean, you could see here, you know, without er t replacement, you’re in the range, right. So, now I don’t have a functional range for estrogen. But that’s where we can now oscillate to back to the Dutch test. And take a look and see. Yeah, it is definitely low. But your liver is is is sluggish right now. Right. So



Kerri: I had been kind of lax with my milk thistle and sulforaphane. So I started back up on those again, because,


Dr. Joel Rosen:  yeah, I mean,


Kerri:  not as good.


Dr. Joel Rosen:  Yeah, well, exactly. So, you know, we have phase one and phase two, right?  Here’s the estrogen e one, e two, e three. And we really want it to go down this protective pathway. It’s only coming down there 48%. Now I’ve seen a lot of women go wrong, where they’ll take dim, right? And they’ll take a lot of dem and i don’t and what happens is like they’ll come they’ll switch this ratio to be 100%. But dem will also lower your starting points. So we’ve been don’t want that. Although one of the products that I really do like is the the estroflavone. And I believe it’s made by premier research labs, I’m just opening it up right now to take a look and see what it looks like. Because you do want to push it down that protective pathway. But that’s where I would say like the sulforaphane if you stopped it, you need to get back on it. Um, but let’s take a look at the sto flavone just so that I can see. Premier research, labs, Astro. Okay. So, I believe, and it’s inexpensive, it’s 20 $21, right. So it’s always a good price. And then you’re getting 103 13 milligrams, it could be something you do like once every three days, right? You know, just to get some extra support, where you’re not really gonna lower it too much. Because 113 divided by three, you’d be getting like 40 milligrams per, you know, per day averaged out, right? So it’s, it’s a little or you can do it once every five days, something where you’re just supporting that, but, you know, going back to your genetics now, that’s where we look at some of your challenges like nerf two, you mentioned the blockage gene, which is supportive for signaling your, your antioxidants, and supporting tumor suppression and so forth. But yeah, I mean, you have challenges there. So sulforaphane is key for you. You know, so we see that in a lot of the the the blockage. Family of, of, of foods, right? So broccoli sprouts, Brussels sprouts, stuff that are gonna have high sulfur-based nutrients in there. But this whole row is antioxidants. And so if we look at, we need that antioxidant support, because it’s playing out in terms of your phase one needs support, look at how good your phase two is. Phase two is really working hard. It’s actually clearing out more than coming into it. Right? That’s because it’s working to clear out some of these other metabolites that are going down these alternative pathways, but at the same time, it’s scraping the bottom of the barrel, meaning there’s not a lot there to have to clear out. Right? So that’s where you, you can see that your E three is okay, it’s higher, I would want to work on liver phase one, phase two, phase three before you would add in the extra estrogen so that you’re making sure you’re metabolizing this properly so that when you do add it in phase, phase one is supported. Phase Two is supported.



Dr. Joel Rosen:  so to speak. Does that make sense?



Kerri:  Yeah.

Right, because we need more estrogen when I can’t clear it out.



Dr. Joel Rosen:  Well, you can clear it out. But you’re you are going down. I mean, you’re going down this unhealthy pathway 41% of the time, you don’t want that. And if you’re getting way more estrogen, that would not be good. That’s what creates those breast cancer concerns.


Kerri:  Okay,



Dr. Joel Rosen:  sorry, estrogen-like concerns because it oxidizes creates DNA damage, and depletes your gluten ion, right? So sulforaphane, maybe a little bit of that Astra flavone every, you know, it also has other nutrients. And then looking at your genetics, which is new for us is really seeing like sulphation needs support glucuronidation needs support, those are all phase two metabolites that are phase two processes, wear it on the surface level, you look like you’re doing fine with your phase two. But you know, you could have challenges with your phase two.

If you start to push things down more that pathway. Now, it’s never gonna be super high, again, like you’re not gonna take but I do work with a lot of women that take way too much estrogen. And if they have a slow phase to a phase, if they have a slow phase one, that’s going to be problematic, because it’s going to be creating all these extra metabolites that may be going down the unhealthy pathway. Right. So, again, I’m not prescribing estrogen. The hot flashes may get better by getting some estrogen support, but making sure that your phase your liver enzymes are high on your bloodwork making sure that you’re supporting the liver, it’s not just taking milk fissile, but it’s looking at your phase one, phase two, phase three, and saying, okay, like, how could I support all of these things and work your way backward. So phase three is binding, making sure you’re eliminating your bowel movements or working well, you’re getting toxins out of the body. So you know, that’s, that’s key. So binders are always key to and then looking at phase two stuff. methylation. You know, we talked about B 12, and methylfolate. A and your GI support, maybe creating to give you that end product. And again, I don’t want you on 1001 supplements, but we’re just talking out loud. And then looking at calcium digluconate could be a really good nutrient for you for helping that estrogen metabolism. So that’s probably what I would layer in right away, is that calcium digluconate or glucuronidation support like a glucuronidation assist.

Because I believe it’s got dandelion in there as well. Yeah. Yeah. So that could be really good for you as well. So get the liver working, help it methylation wise sulforaphane Gouda ion, though, those will help glucuronidation getting good sulfurs and your foods that will help with sulfation. That’s the key for you really, you know, and then, of course, glucose ketone index, we’ve talked about some at some length here. You know, a lot of people I find when they see that their cortisol levels are this high, they’ll take fossil title serum. And I don’t know, if that may be lower the free fraction, yeah. But we’re getting more to the root of the challenge here. Like, you know, like your face, your Phase One is, is going down more of a different pathway than we’d like to see. We’re getting false readings potentially on your face, too. Because we see genetically you have a lot of challenges, but it’s looking like it’s good relative the little Isay phase one is like you having a party and bringing the garbage to the curb or the side of the house. And phase two is the garbage bin taking it away. So we’re saying, well, your garbage men are doing a good job taking it away, but you’re bringing nothing to the curb for us to even make a decision that they’re doing a good job. And I already know that you don’t have the best garbagemen sort of speak based on genetics, right? So I’m Kelsey de gluco rate. sulforaphane, those would be the things you know, even coffee enemas, castor oil packs, saunas, giving that extra support to the liver. And I find in today’s day and age with the exhausted burnt out, people that I work with, you’re never going to do a bad job. You’re never going to go wrong, per se in terms of identifying the liver as something you need to support. But you can go wrong in terms of doing things too quickly when your body’s not ready for it. Questions with that at all carry? I mean, I know we’re talking a lot we’ve said so much there. I know.



Kerri:  I was wondering if the fact that the hysterectomies, like the adrenals, are working more to try to produce the estrogen if that’s one of the reasons for the



Dr. Joel Rosen:  free cortisol, the



Kerri:  high cortisol?



Dr. Joel Rosen:  You know, it’s, it’s a good question. I think it’s more it could be, but that would be more reflective of your HP, your metabolize cortisol being higher, okay. Which would be over here this value. Okay, but, right, because that’s the central station, right? Although,



Kerri:  okay,



Dr. Joel Rosen: you’re that could be why you’re 11 beta HSD is higher, but I don’t think so. I think it’s more like, I mean, it’s a stressful thing to have a major surgery right in the body and your body’s needing to repair and regenerate and kind of learn what to do without its partners anymore kind of thing. But at the same time, your liver enzymes are high, and you’re going down alternative pathways and phase one and you have genetic susceptibilities. So really supporting liver, liver. Okay, yeah, yeah. And then looking at your, your other blood markers, some of the things we always want to look at thyroid, so, you know, 5.93 we’ve had a huge some doctors will say, oh, my goodness, that’s so high, Like what? So take me through. We got 10 minutes here. So take you through your, your thyroid strategy right now.



Kerri:  Okay, so I’m on armor. I looked at my last direct because I had been on Synthroid for a Longtime and then they kept the TSH down, but nothing was really working well. So I’ve been on armor, I think it’s been about two years, and my TSH has been lower. But my, the TSH, like a year ago was like at six. And so I don’t know why the TSH is up so high when she didn’t do a full panel on this, but she did the free, four, and three and I think they were within range. So not sure why the TSH is still signaling.



Dr. Joel Rosen:  You know, it’s, it’s, it’s an effector, we talked about that earlier where your thyroid is, is the effect of, of things going on in the body. So your brain your pituitary saying, Hey, you know, the pituitary is the jockey, the thyroid is the horse, your pituitary is saying the horse to cadence should be faster, you need to get over the hump, you need to get over that hill. So you need to speed up, put your foot on the accelerator. Unfortunately for animal lovers beat that horse faster and run faster. Right? Um, so I don’t know, again, if like, what I would say to that is is that pituitary wind up in flat secondary to stress, inflammation, liver detoxification issues, methylation issues, blood sugar changes, you know, glucose, all those types of things like we’ve given you so many tools to understand how to do that. So So in that case, I would have liked to see that reverse t three, because we like to look at that ratio, right? So maybe we can layer that in there and say, okay, what’s your total t three looks good. It’s at 3.1. We like to see between three and four. So so that looks good. So I don’t default to Oh my God, we got it, like changing your thyroid meds. My goal is always with working with clients, if possible to get to the root cause of the problem, support all those pathways, and get them off the thyroid meds. Right. But if it’s been on it for a long time, and my I’m not really licensed to get you off, I’m not really I’m not licensed to take you off. I’m licensed to support you. And I look at that as Okay, well, we see your free cortisol be high. And your pituitary is definitely working overtime. Quarter steps. Mushrooms are really well for that for pituitary support. But all the strategies we talked about with liver support, calcium d-glucarate, great sulforaphane methylation support. You know, what are the methylation supports that we like, what are you doing for B vitamins right now?


Kerri:  I use the PRL the max. Yeah. Yeah.



Dr. Joel Rosen:  Yeah, I mean, to me, that’s my favorite thing. And that’s probably why your phase two looks so good. Even though it’s not a great indication of if you’re bringing more garbage to the curb kind of thing, how good your garbageman is doing. But it’s still a good sign of what’s going on. So I don’t know if I would change that too much. on there, there are things that are missing here, like I would have liked to see like, let’s look at your bloodwork here. And that’s the challenge like when you know we get clients that have their doctor to run bloodwork, but they are not getting all of the values that we want. And again, from the lab range, the creatinine was fine. But from the functional range, it’s slow. So again, even though you don’t have a GMT snip, maybe short term creatine will help to give you that end product of methylation. So that now you’re methyls are more available to be able to do other things. Right. So that could and I think we’ve had creatine in the past, haven’t we?



Kerri:  Yeah, I used it on and off. So I’ll just put it in the little shapes that I have my workout.



Dr. Joel Rosen:  Yeah. And then we talked a little bit about, you know, proteins, right and keeping our eye on that. So you can see chloride is low from a functional range, we call that hypochlorhydria, where you’re not, you don’t have enough chloride to support stomach acid secretions. And that is causing your total proteins to be elevated. So again, you know, helping someone with digestive secretions is key, right? And that can create, like if the liver is sluggish, and it’s not pumping everything out from phase one, phase two, phase three, and it’s backing up, then that can create some of that microbial concerns. And that can create bile in the blood and that can create decreased stomach secretions so that that’s key to keep our eye on. And then as far as white blood cells go, and red blood cells go. That would have been key to know like I would have liked to know like, Are your white blood cells low? Are they high? Are your neutrophils low or high because if you’re getting any gi disturbances, we may want to layer that into our protocol as well? So we’re missing some things there. Kerri, how are you feeling gi wise?



Kerri:  I actually feel good gi wise.


Kerri:  I get a little bloated from eating so often with the carbs, but I’m regular, right? I’m not Yeah. But I kind of backed off my HCl a little bit because I’m eating more often so I didn’t want to take too much of that like, but maybe I need to bring that back in to help



Dr. Joel Rosen:  I would layer it in Yeah, so like in closing here, you know, keeping aware of recycling, maybe re-cycling back into a little more ketone levels being elevated and you know, strategies to do that. Longer, like more time between meals and eating windows, a little more fats, but more so in your case, dropping the carbs, not so much bringing the fats up, and then focusing on liver support, focusing on sulforaphane maybe a little bit of that esto flavone we talked about the tranquil all helping with getting that free cortisol into into cortisone but all the things we’re doing will will support that controlling detox controlling the breakdown of proteins all of that will result in potentially your your your free cortisol not squeezing the sponge and getting you know as much out of it as possible and then potentially seeing that thyroid levels value drop I think that a better blood test is in order right get get some iron panels get the free get the T three the reverse t three ratio, so we can keep our finger on that pulse and then don’t do anything rash in terms of okay I got to get on my on more estrogen because I’m having the night sweats I think that your livers congested and and these strategies and that will help process estrogen a lot more favorably and and now you’re you’re not getting the night sweats and you didn’t need to go on because postmenopausal without estrogen you were in the ranges right. So



Dr. Joel Rosen:  I think you’re okay there.



Kerri:  Does that make sense? Yeah, it does actually that because I don’t want to go on estrogen if I don’t have to. So that actually makes me feel a little bit better. All right. And



Dr. Joel Rosen:  then lastly, pituitary support if you wanted to. The mushrooms the fermented mushroom blend from premier research labs, a really good product, I like that. But you know, hydrochloric acid, taking your foot off the accelerator on the sulforaphane, hydrochloric acid, adding in the calcium digluconate, or the glucuronidation support, which is another product where we can, you know, you know how to get that one, though, those would be the things so that you’re not layering in 1001 different supplements.



Kerri:  Right. Okay.



Dr. Joel Rosen:  All right. Is that helpful?



Kerri:  Yes. Very helpful. Thank you.



Dr. Joel Rosen:  All right, Kerri, we will schedule it for another time to you know, get that bloodwork, and then let’s check in on what’s going on there. So we have it in contact with some of those other values.


Kerri:  Yeah, sounds good.


Dr. Joel Rosen:  Awesome. Kerri,

I’ll talk to you later.


Kerri:  All right. Thanks. All right. Bye-bye.

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