A Deep Dive on Women’s Hormones Oxytocin, Insulin, Cortisol and more with Dr. Anna Cabeca

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Content By: Ari Whitten & Dr. Anna Cabeca

In this episode, I am speaking with Dr. Anna Cabeca about helping women balance their hormones and thrive through menopause, including some unique products she has developed herself to optimize this journey.

Dr. Anna is generously offering a 15% discount on the Keto-Green Shake and the Mighty Maca when you use this special link: https://dranna.com/ari

Table of Contents

In this podcast, Dr. Cabeca and I discuss:

  • Anna’s own story of reversing menopause and giving birth aged 41 (and how that kickstarted her expertise in this area)
  • How that led her to empower women to fix their own problems without surgical or pharmaceutical intervention
  • The three main hormones to focus on (they aren’t the ones you’re expecting!)
  • Why you’ll want to pepper your whole day with love, bond, and connection, gratitude, joy, peace and love, (Oh, and maybe granola!)
  • The unrecognised effect of stress on all of your hormones and your fertility.
  • The advantages of the ketogenic diet – and how the right supplements can keep it a green, alkalising Keto diet. (Essential!)
  • Why snacking is the enemy and intermittent fasting is the cure.
  • Which hormone markers you absolutely must know (and what they mean)

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Transcript

Ari Whitten: Hey there, this is Ari. Welcome back The Energy Blueprint Podcast with me now is Dr. Anna Cabeca, who is the doctor of [inaudible 00:00:16], she’s the bestselling author of The Hormone Fix and Keto-Green 16. Dr. Anna is triple-board certified fellow of Gynecology and Obstetrics, Integrated Medicine, and Anti-Aging and Regenerative Medicine.

If the first two weren’t impressive enough, she holds special certifications in functional medicine, sexual health, and bio-identical hormone replacement therapy. She lectures frequently on these topics throughout the world to large audiences and is known nationally as The Girlfriend Doctor and is host of The Girlfriend Doctor Show. She has personally developed natural products to help women balance hormones and thrive through menopause, including the highly acclaimed Julva cream for the vulva and Mighty Maca. We’re going to talk about both of those plus a superfood blend.

She now lives in Dallas with her daughters, horses, and dogs. Welcome to the show. This has been a long time in the making. I think we’ve been chasing after each other for a long time, and I think I’m probably mostly responsible for that.

Dr. Anna Cabeca: No, it’s great to be here with you. I’ve been looking forward to it.

Ari: Yes, me too. I’ve had quite a few hormone experts on the show. In fact, just a few weeks ago, I had Dr. Shawn Tassone for the second time, I believe, on the show. I’ve had Dr. Christiane Northrup. I’ve had Dr. Mache Seibel, and I’ve had a few other female hormone experts. I think probably all of these people you at least know of, if not, you’re heard of it.

Dr. Cabeca: Absolutely. Highly admire.

Ari: Mariza Snyder and Stephanie Estima. We’ve talked a lot about women’s hormones. I’m curious, on a big picture level, what is your take on female hormones, and what do you feel sets you apart? Or where do you feel that your views on things differ or where’s your unique specialty?

Dr. Cabeca: That’s a great question. I think I also think about after hearing these amazing speakers and I know a lot of their platforms is what other questions come up. That’s what I was thinking of while you were saying how can I best serve your audience.

Something that really struck out to me is the patients who’ve had hysterectomy, women who have had hysterectomies, for instance, and women in the perimenopause. “I’m menopausal, I’m I not menopausal? Doctor says I’m too young yet I’m having all these symptoms. I feel like I’m going crazy. What’s going on today?” I know, that was me. Anyway, these are really big issues. I think what makes my approach unique is probably my journey, is being diagnosed with early menopause at age 39, and early menopause, irreversible infertility.

I failed the highest doses of injectable fertility meds. I was told the only way I was going to have another baby would be egg donation. That wasn’t an option for me at the time. I was devastated upon devastation. Anyone who’s gone through infertility knows that you’re devastated each time that period comes or the negative pregnancy test comes up, and there’s so much that goes into this. There’s so much that goes into this. The fact that I struggled with obesity, I’ve diabetes on both sides of my family. I struggled with these issues since I was a kid.

The infertility, the early menopause, and then being a surgeon, being trained at one of the best institutions in the world at Emory University, working at Grady Hospital in Atlanta and, of course, the ivory tower, Emory University Hospitals, and having my doctor bag be empty and as a result of what I learned through my own mass, my own trauma, but I wish no other physician this journey to learn what I’ve learned.

I went from treating patients surgically as I well know how, two to three surgeries per week, to empowering women over the own body to heal their bodies and doing only two to three surgeries or needing to do only two to three major surgeries per year. I reversed my– I say, with the hand of God, with the help of God, with his good grace, I reversed the early menopause and naturally conceived and delivered a baby girl at 41 years old.

There’s hope. There’s hope there’s, empowerment, there’s natural ways that we can combat the misinformation and the reliance on pharma and surgery as the first line. I think that’s where I really have dug in to understand the underlying conditions and through my own journey, help other women or keep them from suffering like I did, for sure.

The most common hormone imbalances

Ari: Excellent. In terms of hormones, from talking to a wide variety of different speakers and studying the subject myself for many, many years, I’ve seen that certain experts have different takes on what hormonal imbalances, deficiencies, or excesses women are actually suffering from. I’ve seen a number of experts really heavily focused on estrogen dominance, deficiencies in progesterone, and some, like Dr. Tassone, focused on– not that he neglects the other stuff, but testosterone deficiency, he mentions very commonly, whereas a lot of experts almost never talk about that.

What is your take on what a lot of middle-aged or older women, or even younger women, whoever you want to answer this question, what are the specific types of hormonal imbalances that you’re finding women are suffering from?

Dr. Cabeca: The truth is if we really want to get down to a hormonal imbalance, we’re going to address and I always say, I studied in the best institution. I’m triple boarded, and I really studied hormones. I can tell you hormonal pathways, mechanisms of action, all that stuff, especially when it comes to the reproductive hormones, estrogen, progesterone, testosterone, DHEA, man, I love them all, Ari, I’m telling you. I just love them. The truth is the major hormones are insulin, cortisol, and the most powerful hormone in our body is oxytocin.

When it comes to balancing our hormones, I focus on those three now because as I get to the underlying, underlying issues, as I kept digging, as it kept patching hormone, supplementing with hormones– and I’m a big believer in bio-identical hormones. As I kept supplementing and looking, and I went through my own journey until I got insulin and cortisol under control and empowered oxytocin.

I start my day off with oxytocin-increasing practices. I want to end my night with oxytocin-increasing practices. I want to pepper my whole day with improving oxytocin, the hormone of love, bond, and connection, gratitude, joy, peace, love, and granola. You know how it is. Oxytocin that’s very powerful.

Ari: That’s my weakness, by the way, you mentioned it right there, which is granola. Yes, I am a granola [unintelligible 00:08:16] [crosstalk].

Dr. Cabeca: Oh my gosh. You’ve got some keto granola recipe?

Ari: No, I don’t, but my wife makes some healthy ingredient homemade granola, it’s quite difficult for me to control myself. I have great willpower with everything except granola.

Dr. Cabeca: That sounds good.

The role of Oxytocin in female hormones

Ari: You mentioned the oxytocin, that is a very uncommon thing for people to talk about. Let’s talk about, first of all on a mechanism level, how is oxytocin tying in with some of those other female hormones? Then from there, I’d like to go into some of the practical strategies, which you were alluding to there.

Dr. Cabeca: Oxytocin ties in one of the most powerful ways. I like to give this analogy, Ari, one of the things is if we look at all our hormones in our body, my first book is the hormone fix. I say it takes more than hormones to fix our hormones. It’s just like diets don’t work because it’s not just about what we eat. It’s when we eat, who we’re eating with. All of these pieces of the puzzle. I’ll get to that.

I like to look at hormones like a university setting or a school setting. Look at our hormones, all of them, estrogen and progesterone, we have over a hundred different types of estrogens, or close to. If we look at that and we think all our hormones are like the student body, we would consider the professors to be insulin and cortisol. You’ve had good professors and they keep law order. You’re going to show up to class, with good professors, you show up, you do your best, you interact, you participate, all of that good stuff, there’s interaction.

Then the dean of the university or the school, principal of the school would be oxytocin. That’s when we look at it. Each of us, each student, each hormone, has its own talents, its own gifting, its own roles and responsibilities. There’s direction that needs to take place, and then overarching, benevolent, good leadership that’s kind and fair. That’s oxytocin. When we look at that kind of interaction, that’s the best way I’ve found to illustrate it.

Ari: I want to talk about insulin, and we can talk about cortisol as well, but as far as oxytocin, how is it interacting specifically with, let’s say, estrogen, or progesterone, or testosterone? What’s the link there?

Dr. Cabeca: Majority of that comes through the interaction with cortisol and progesterone as the mother hormone. We look at a couple of areas here. We look at our hormonal cascade, and progesterone being the mother hormone, derived from cholesterol. We’ve got progesterone and pregnenolone up top. Then downstream, when we’re stressed, we’re making cortisol. We’re leading into– We’re pushing cortisol, and otherwise, we’re supporting DHEA, a key adrenal hormone, made by adrenal glands in men and women. The ovaries and women and testes in men, DHEA. Then downstream from there, we have estrogen and testosterone.

When we’re stressed, the last thing our body is diverting to are our reproductive hormones. For women, our periods are irregular, we have less sex drive and less receptivity too, so it’s less estrogen, testosterone, and DHEA. When cortisol goes up, that stress hormone, oxytocin goes down. When cortisol is up for a longer time period, the paraventricular nucleus in the brain is suppressed. It then says, “Okay, cortisol, you are frying us out. You’re the life-saving hormone but you’ve been too much for too long and now you’re frying out my nervous system, depleting all of our other hormones, and so I’m shutting you down”.

When cortisol is shut down, oxytocin is shut down at the same time because of the paraventricular nucleus of the brain, so you get this very intricate state of low cortisol and low oxytocin. That, I always say, is the physiology of burnout. It’s the physiology of divorce. It’s the physiology of isolation, depression. That physiology is from there, and for oxytocin to function well–

Again, oxytocin, if you also look at it this way, cortisol, an acidifying hormone, will rob Peter to pay Paul, so to speak. It’s a catabolic hormone. It breaks us down and oxytocin builds us up. It’s a more alkalinizing hormone too. Our hormones, especially progesterone, in the function of oxytocin are also vitamin D dependent for the receptor site, so having healthy vitamin D on board is another key interlinkage, so to speak, between oxytocin and our other hormones. That is the cascade of cortisol, is to keep that in balance and to keep our body in that more of a, I could say, optimistic state, the positive state.

Ari: I’m reeling with questions here. I might take this in a bit of a digression, if we can geek out here for a moment. First, can I ask a simple question? Is oxytocin possible to test for it? Does anybody run a test for that?

Dr. Cabeca: Yes, there are fresh, frozen plasma. That’s one way to test for it. It’s hard to test it. I’ve been working with oxytocin since– gosh, going on 20 years now, and I think we have still have yet to be able to test.

This is what I say with all hormones, while we can test them, they are energetic molecules, and until we can test them energetically, we’re really just getting an idea. It’s good to look at saliva, blood, urine, all different ways. With oxytocin, we look at rapid testing. The other way that I’ve done it, I’ve tested for oxytocin through a questionnaire, my oxytocin quiz, and I’ve injected 10 units of oxytocin. Mix it with lidocaine because you’re—

Okay, so for our audience, oxytocin, this hormone of love, bonding connection, also may have interacted with it as a drug as Pitocin. In labor, we’re given Pitocin. That is oxytocin. Oxytocin is designed to be in abundance at the time we deliver this baby, so it’s naturally imprinting hormone, so we get this little cute, maybe ugly-looking, wrinkled, beautiful baby in our hands. We’re like, “Oh, my God. This is the most beautiful thing I’ve ever seen in the entire world”, and you just went through, maybe, like me, three days of labor and you’re like, “I can’t wait to do this again.” What are you thinking?

That is the power of oxytocin. It has that amnestic effect. It has the analgesic effect, so pain-relieving effect and it certainly is that imprinting effect and that bonding effect. That’s why that natural childbirth and breastfeeding really helps bonding and helps babies grow up to have good healthy attachment styles too. We know when that’s absent, that there’s an issue. Also, too much oxytocin or artificial Pitocin, injected oxytocin in labor can have consequences too. This Pitocin I would inject 10 units intramuscularly and look for [inaudible 00:16:29]. I’ll give you a couple of examples.

One is, I use oxytocin in my patients and in my medical practice, which I’ve since retired, but to use for PTSD, which I used it for myself in that and studied all the science behind it. I also used it for sexual function, to help with orgasm and receptivity at the time of intercourse for women, as well as men, but predominantly women. Then using it in my patients with burnout, and so I was treating one patient undergoing very difficult challenges, struggling with depression and certainly some added in sexual function complaints. I was treating her with oxytocin, and we’d had these conversations about it and all my research behind it and so she came in, scheduled an appointment for her 22-year-old son.

I’m like, “Okay.” I will say it takes a strong man to come to a gynecologist. This 22-year-old came in and slightly– She said, “He was a football player. He’d had multiple traumatic brain injuries and just is not himself. Has no motivation, no ambition.” She goes, “I slipped him an oxytocin, one of my oxytocins.” Okay, don’t do this, you all. Don’t share meds. She goes, “It just affected him and I wanted to see if you could help him.” I injected him and he would not look at me. Almost Asperger’s. Not autistic, but almost Asperger’s, and did not look at me in my eyes. Very pale skin, cold, clammy handshake.

Those are some signs of oxytocin insufficiency. Preferring isolation, not socially interactive at all. I injected him with oxytocin and I looked for the signs, and all of a sudden, he’s looking at my eyes. He’s smiling, his ears pink up around his ears. Pink up, little flush on his chest. I’m like, “Okay, he’s responsive to oxytocin, so he has definitely oxytocin insufficiency, and it was really interesting.” With everything else that we want to do to increase oxytocin and manage cortisol, and especially with traumatic brain injury, oxytocin is a piece of that puzzle. That was really beautiful to see how that shifted him.

Then he went out and got a job, went out and got a girlfriend. His life changed as a result of this. Another patient that I worked with, a 52-year-old ER physician. You can imagine the stress that she’s been under, and certainly, she had a very low score on the oxytocin quiz, so signaling oxytocin insufficiency. Also injected– because the blood test are– It’s hard to do those blood tests. Maybe easier now, but certainly when I was in practice it was a little difficult, so injected 10 IUs of oxytocin intramuscularly. some

Again, I used lidocaine, because that burns, so we don’t want to just do that by itself. Immediately, smile, sits back, relax, feels good. I’m like, “Okay, then I can prescribe her and we can use a prescription. Oxytocin, again, as a bridge while you’re working on stress management, all these oxytocin building activities.” Those are ways to supplement with oxytocin and diagnose a deficiency. If they hadn’t responded like that, oxytocin supplementation wouldn’t be my first line of therapy.

Ari: Very, very interesting stuff and I have to say, in all my years of reading books, and interviewing people, and studying health, I’ve actually never heard someone talk about diagnosing and treating oxytocin deficiency in that way. Very, very novel, good stuff.

Dr. Cabeca: It is except I will say one more thing, because this is such a powerful area and another client that I had the privilege of working with was a family and they had a 11-year-old daughter who was on spectrum. Again, with all of this, I use what’s our first way to treat or address I will say treat the gut microbiome. Treat the gut microbiome, enhance mitochondrial function, treat the gut microbiome, and you’re going to improve everything. Hormonally, and that’s a big piece of it.

As I was working with her, this 11-year-old got microbiome. We also work with oxytocin increasing behaviors, cutting out all exogenous hormones, like from dairy and really cleaning up her diet, gluten-free addressing the gut microbiome, adding in very short term, five days a week for school oxytocin, and only for three months and as that gave her just that leg up for healing. She graduated at the top of her class, she’s now in college. It’s really beautiful to see that shift, but also that social interaction, social behavior, social connection that, again, it’s not never a pill or potion a product, it’s always a combination effect. I think that there’s a lot of need for that got that cleaned up and naturally empowering oxytocin through lifestyle.

How cortisol affects hormones

Ari: I want to get more into practical strategies in a minute, but maybe we’ll dive into mechanisms a bit more. You mentioned cortisol, you mentioned the paraventricular nucleus. I want to bring in another little angle here, which is I spent about a year of my life digging into the literature, specifically on different fatigue syndromes and burnout and stress-related exhaustion disorder. Basically stress-related fatigue and chronic fatigue syndrome, in relationship to cortisol and HPA Axis function. What’s interesting and surprising and counterintuitive about the vast majority of that research is it actually doesn’t link low cortisol levels to those conditions.

There’s a small amount of the studies and minority that links slightly lower levels and other minority that links slightly higher levels of cortisol, but the vast majority of the studies show actually no difference in cortisol levels, between people with those syndromes and normal healthy people. Have you found, I would say overall, the overall body of evidence and different kinds of stressors, whether we’re talking about psychological stressors, relationship, financial stressors, career job stress, or even physical overtraining syndromes from doing too much exercise, the vast majority of that literature actually links higher levels of cortisol with, for example, overtraining syndrome, where people suffering the consequences of severe stress states.

On average, of course, this is generalizing and there’s a subset of people that do have lower than normal cortisol, but deep, do you think there’s also a mechanism for high levels of cortisol to interfere with hormone functionality? Whether we’re talking about female hormones, or oxytocin, or anything else?

Dr. Cabeca: Absolutely. I think that’s that chronic spikes, that chronic push, it’s like putting your foot on the gas and the brake at the same time. That’s what they see in those states. It’s almost like the gas and the brake at the same time. How does that look and how does it affect our circadian cycle? When is that cortisol bend again, coming right back up at 3:00, 4:00 AM in the morning, when our body’s been rested enough, and then we get those spikes in cortisol?

Depending, it’s interesting to hear that and to see that and considering what’s normal, what’s optimal, and when are those averages being taken 24-hour urinary cortisol versus what’s the pulse at all throughout the day, and I’m interested in that as well. When cortisol goes up, you’re going to get that suppression of oxytocin when cortisol goes up. Estrogen and testosterone DHEA are going to be depleted and testosterone aren’t being anabolic, DHEA being a prohormone and the precursor upstream from testosterone and estrogen.

I think especially in the male versus female physiology, men have 10 times as much testosterone as women. These chronic stress conditions, these are going to affect women, women are more vulnerable to than men. In fact, especially as we get into this hormonal shift between age 35 and 55, we enter this period of neuroendocrine vulnerability. We have the irregular cycles, the irregular bleeding, often consider that an interruption of the function of progesterone. Its first time it’s estrogen dominance, for others progesterone insufficiency. I think it’s chicken or the egg.

You’re getting into this state. What happens is, when you’re depleting, when you have a lot of cortisol, you’re in this state of neuroendocrine vulnerability, you add all the downstream consequences of either chronically elevated cortisol, or that combination of foot on the gas pedal, foot on the brake, so the paraventricular nucleus shutting down, trying to shut down that production of cortisol. Fry out your nervous system, that cortisol is the key, like I spoke with Dr. Fasano. I love this analogy. It’s like the key that unlocks the gate to those membranes.

You get the leaky membrane, whether it’s leaky gut, leaky heart causing atherosclerosis leaky nervous system, our brain to be causing Alzheimer’s and dementia, that’s cortisol, that’s that acidic catabolic function of that.

When we look at that with women 35 to 55, we have those changes, and our progesterone, this mother hormone to cortisol, to estrogen and testosterone is declining rapidly. Beyond the GYN symptoms, the other symptoms that are bringing our patients in to see us is the anxiety, the PMS, the irritability, the mood swings, the loss of sex drive, the difficulty sleeping, the crashing fatigue, the waking, all of those as a function of this and neuroendocrine vulnerability. It can start early with our menstrual cycles and, again, a mood change. Not just hormonal, but the nervous system. These are neurologic symptoms, and that’s what really fascinated me and my research, and in solving, getting to the underlying reasons why this is happening.

During this time period, 35 to 55, especially with this change in hormones, and again, men don’t have that rapid transition, but women do. Dietarily, nutritionally, lifestyle, we have to approach it in a different way. Now I forgot what question you would ask me to begin with, I went on a tangent.

The most common issues with insulin

Ari: No, that was excellent. I was asking you about the relationship of cortisol to oxytocin. Let’s jump to insulin now because I know that’s a big one. That’s a big part of what you do. I love the analogy that you gave, kind of looking at some of these hormonal players, as the professors of the student body to help listeners differentiate between– just understand that not all of these years dozens of different hormones are equal players in the results you get, but some are kind of bossing around the others. From your perspective, what is insulin doing in relationship to a lot of these different female hormones. What problems do most people have with insulin?

Dr. Cabeca: Yes, I think one of the things is that as we age, our reproductive hormones naturally decline, and it’s important to dial those in and support them as naturally as possible. Insulin, however, increases as we age and as we become more insulin resistant as we ate. Insulin and progesterone have also this love-hate relationship. I’m not exactly sure how that works, but definitely as we start getting declining levels of progesterone and estrogen, we do also become more insulin resistant.

What’s happening during this time period, is what patients come in and explain and have symptoms of memory loss, brain fog, more mood swings. That waking without doing anything different. That was my story when I turned 48, I had reversed early menopause and then 48 was spiraling down with brain fog, memory loss, and I had a really amazing memory to make it through [inaudible 00:30:10] and work and do all those things at the same time and to have brain fog was really disturbing and as well as I would say, as a single mom raising kids, my ex-husband had had a traumatic brain injury.

You can’t afford to have a brain fog and memory lapses when you have got teenage girls at home, they will take advantage of you. [laughter]

That is one thing. Worse than that was that waking without doing anything different and at one point in my life I was well over 240 pounds and lost that weight and was able to keep it off for over a decade but that time shifted and it really was when my patients would come in and tell me that. They would say, “Dr. Ann, I’m gaining 5, 10, 20 pounds without doing anything different.” I was like, “Really?” You’re not in my head. I would never say that in person. I was like, “Really, you’re not?” I would do all the thyroid workup, dial in the hormones, lo and behold and when that happened to me, I was like, “Well, like seriously not doing anything different.”

Well, here I was becoming more and more insulin-resistant and what happens as we hit this period of neuro-endocrine vulnerability, our brain requires estrogen at some point most likely progesterone as the precursor but we know that gluconeogenesis in the brain. Our brain is going to preferentially use glucose for fuel in abundance. We’re going to use glucose for fuel quick and easy and when that’s not available, we’re going to go into using our ketone bodies. The use of ketone bodies is not hormone-dependent. As I predominantly wanted to fight that weight gain without doing anything different, anyone knows who’s lost a significant amount of weight you start gaining it back without doing anything different you’re like, “Oh my God, I’ll be 300 pounds before this stops.” That’s when I really started a ketogenic diet.

My oldest child had seizures, I was very familiar with it. I used it in my neurologic patients and modified forms of it in my Candida patients. I just went straight keto but I felt crazy. I felt cranky, I felt irritable, and I needed to understand why but as I shifted to go into ketosis and then understand that with women, especially in the perimenopause/menopause, we don’t have a lot of [inaudible 00:32:30] steroids on board like men. We don’t have a lot of testosterone and because our progesterone and add in a good healthy dose of stress or post-traumatic stress and your body’s diverting spare resources to make life-saving cortisol, you’re going to deplete those hormones even more so that brain fire and memory loss is really a big issue. Now you’re really in an acidic state.

We’ll talk about blood pH. I want to get into that. Urine pH changes and cortisol increases hydrogen ions secretion across the renal tubules so we’ll see an acidic urinary pH. You can have the best diet and be under so much stress that your urine pH is still acidic. That’s a biomark, that’s a vital sign that we should biohack a lot more aggressively. As I got into the state of then realizing I was so acidic, as acidic as urine pH paper strips red, just the bottom line acidic, that was an aha moment to me to add in the alkalinizing to the ketogenic, to the intermittent fasting, to the higher fat. Really cutting out aggressively all carbohydrates. Adding in those key alkalinizers, getting that combination of alkalinity and ketosis.

It was like the lightbulbs turned on. It was like being in a chapel and angels singing. I call it energize enlightenment, to get into ketosis with an alkaline urine pH at the same time. I’m talking about this because that brain fog lifted and it is that sense of that brain fog lifted yet I’m at peace in my body versus, okay, I’m using [inaudible 00:34:10] this when I’m feeling cranky and irritable and on edge and why should it be different for women and that’s where I went researching and trying to dig in and understand more about it. There’s so much that needs to be done especially in the perimenopausal women.

That’s why there are many different clinical opinions, but that combination, it’s really empowering so that regaining that insulin sensitivity through cutting out carbs, intermittent fasting, stopping snacking, which women over 40 do not need to be doing with rare, rare, rarest exceptions, it’s a powerful biohack. It’s a powerful change to become more insulin-sensitive and to modulate cortisol through monitoring your lifestyle practices as well as adding in those good gut foods for the gut microbes [inaudible 00:35:10] those good alkalinizers and fiber to help feed that important bridge for hormone metabolism and that’s the gut bacteria. That combination becoming insulin-sensitive and really empowering oxytocin over cortisol is beautiful.

Ari: Very nice. As far as insulin sensitivity is concerned, the main driver, as you know, of insulin resistance is actually excess body fat. Do you feel that that particular dietary approach that you’re talking about is effective as a result of primarily that it’s driving weight loss, or that it has unique additional mechanisms on its own accord, regardless of whether a woman loses excess body fat or not?

Dr. Cabeca: I think it’s in addition to that. In addition to that overpowering because doing my first book, The hormone fix, I went on to write Keto‑Green 16. I actually have it on now, my continuous glucose monitor, a CGM, because I was checking, I have another book coming out so I’m checking all my menu plans again but for Keto‑Green 16 I want to make sure that I kept the blood sugar in a really stable way and what I learned from this, Ari was that when we are, especially in this neuro-endocrine vulnerable time period, or metabolically conservative are in survival mode, however, we want to look at our body, Amazonian survival, I could live in the Sahara for six months and still do really well.

What I noticed is that through going to a meal plan which is maybe two meals a day or maybe two meals and a smoothie or three meals a day, but stopping snacking, increasing intermittent fasting, you move your hemoglobin A1C marker, your continuous blood sugar marker and monitor how well we’re maintaining our glucose or glucose levels long term, we see a really big shift in that. It becomes this really big driver for increasing insulin sensitivity and lowering your hemoglobin A1C versus when we’re snacking, I can’t move the needle in my patients. They can lose weight but I’m not going to move the needle like I can with intermittent fasting and stopping snacking and as I saw with my own, continuous glucose monitor. Even when you’re eating healthy so-called snacks, you’re still driving up your baseline glucose but you can be fasting and be thinking stressful thoughts and your blood glucose is going to go up. I remember speaking on stage fasting for a conference. I was fasting and it was 10 AM and my blood glucose was up to 150. It’s baseline’s at 80s. It was up to 150 for 30 minutes, because I get terrified to speak. Anyway. That was fascinating to me. I learned that just the power of our thoughts, of our body and that’s where beyond what we eat comes into play with balancing our hormones and increasing insulin sensitivity.

The most common causes of hormone imbalances.

Ari: Very, very interesting. Well, this, I think is a wonderful deep dive and map of how these different hormones relate to one another. I love how you emphasize that hormones are not just hormonal abnormalities that occur for random reasons. There’s a lot of people who are under the misconception that, “Oh, I have hormone abnormalities and the hormone abnormalities are the cause of my problems,” and who need to understand the link between, “Okay, well, what’s causing those hormone abnormalities?

How do we track that back to your nutrition and lifestyle and environmental habits, environmental exposures?” I love the way you created that map that emphasize the role of insulin and cortisol and oxytocin in affecting that. What do you think, and you’ve mentioned a few of these already, but what do you think on a practical level what’s the blueprint of the most effective habits and routines for someone to optimize their insulin, their cortisol, and their oxytocin?

Dr. Cabeca: Thank you and I like that you put in here blueprint because you are the blueprint king. [chuckles] Let’s say for a blueprint for me, it’s really creating the easy habits that work best for you, that make you smile, that bring you joy, that give you satisfaction for the long run, not just for the moment. That’s where I dug in. I say number one is [unintelligible 00:40:26] gas, know your baseline markers. There are four key hormone markers, and very quickly vitamin D 25-hydroxy, hemoglobin A1c, hsCRP, and DHEAS.

I think if we know nothing else, and had money to only get the four key markers, I look at those because it gives me pieces of each of those pictures from adrenal to cortisol to insulin, and I like to see that, and inflammation. Look at that, and then check your pH and ketones because more effects are on your pH. It’s a biomarker, it’s a vital sign. We can be vegan, eating greens all day and be in a stressful marriage, be in a stressful job, watching the morning and evening nighttime news, and you’re going to be acidic.

It doesn’t matter how much you’re eating if your thoughts are based on fear, and that’s a dial. Are my actions based on fear, or based on love? I look at that as a dial. If what I’m doing, how I’m thinking, is it fear-based thinking or love-based thinking? How am I honoring myself and others in this process? That perspective shifts your physiology in such a dynamic way that you do manage cortisol and empower oxytocin when you do that.

Starting the day, and for me, a day in my life looks like this and my clients online and my girlfriend, Dr. Club community and have done my magic menopause program, I read my books know like this is our process. Before I even open my eyes in the morning, I’m thinking what am I grateful for? Where did I see love yesterday? Where was I loving? Where did I laugh? Where could I have laughed at myself more? Just like, how can I laugh at that now, because laughter is incredibly good for oxytocin. Gratitude banks love where you see love is increasing oxytocin.

Starting off your day with that as a first step, for me having traumatic PTSD and severe burnout and all of those things, that’s been life-saving, rewires my brain, rewires my physiology from a negative downward spiral to a positive upward lift. That’s a critical practice that’s as important as what I eat the Keto-Green diet plan and lifestyle plan that I follow that first we want to shift our behaviors, we have to shift our morning. That shift in the morning is probably the most powerful thing I and my clients do.

Ari: I want to interrupt you for one second, and please bookmark your thoughts so you don’t lose track of where you’re heading. I just read a fascinating study just a few hours ago in women who were lactating or breastfeeding their children. They measured the effects of laughter on melatonin production, which is obviously another hormone, another important hormone in sleep and brain health and mitochondrial health, and many other things. They showed that compared to, I think they used a serious movie versus a comedy that invoke laughter and they found that laughter doubled melatonin production before bed and doubled the measurable melatonin levels in the breast milk that was being fed to the babies.

Dr. Cabeca: That’s fascinating.

Ari: Yes, absolutely, how much that laughter component that most people wouldn’t necessarily think is having a direct impact on hormones is now affecting melatonin and oxytocin, which is affecting sleep quality and so many other aspects of your physiology. Anyway, just connected the dots between something that happened earlier today and what we’re talking about.

Dr. Cabeca: Oh my goodness, that makes me think so I just started with my daughter watching the series, of watching an episode in the evening. We have no TV, but we started this at Netflix. It’s old one. It’s Gilmore Girls. Anyway, just cracks me up being a single mom, and totally relating, me just cracks me up every night. I’ve been sleeping better now than ever according to my bio strap, which I’m not wearing right now but I’ve been sleeping with. Laughter increasingly melatonin, I hadn’t made that connection. I love it. I think that’s awesome, and decreasing cortisol for sure.

Ari: Yes. Cool. Do you want to pick up where you left off, or I’m happy to jump in with the question? I just want to make sure I’m not interrupting your flow.

Dr. Cabeca: No, that was basically the start of my day and then keeping an intermittent fasting practice of 13 to 16 hours on a regular basis, sometimes longer sometimes not, is a key aspect and then breaking fast in a Keto-Green way, that’s a healthy ketogenic choices, healthy fats, high quality grass-fed, free-range protein, and lots of those good green alkalinizers.

Ari: I wanted to come back to the urinary pH thing because it’s somewhat controversial topic, in the sense that there’s one group of people, and there’s certain books that have been popularized, I think, maybe from the 90s or early 2000s around the idea that we can alkalize our bodies and out change our body’s pH in really profound ways. There’s a lot of people operating under that premise belief system, and then there’s a whole bunch of “evidence-based community” who cuckoos all that and says, “That’s all a bunch of nonsense, our body maintains this precise range of pH regardless of what you do, and you can’t affect that no matter how much you try, and alkalizing your body is a bunch of nonsense,” but what’s interesting, and usually unknown to most of those evidence-based trolls as I would refer to those–

Dr. Cabeca: That text right?

Ari: Yes. Is that, there actually is a body of literature around something called potential renal acid load; PRAL. It does show that, for example, eating more alkalinizing foods, more greens, more fruits, and vegetables, actually does change urinary pH. Even though the body’s maintaining this precise pH range and blood and some of the other tissues, depending on what you eat, you’re straining those pH buffering systems to some degree.

There is a body of literature showing higher potential renal acid load is linked with much greater rates of diabetes and other health conditions. There is this link, it’s kind of this weird hidden link that’s there because blood pH isn’t changing that much, but there still is something to the pH story.

Dr. Cabeca: Right. There absolutely is. I found this interesting, but again, a little on my background is that before I went to med school, I was a bench scientist, so to speak, researcher with a diving medicine department of the US Navy, working with navy divers, deep-sea divers, dive tables, and very stressful conditions. I was exercise and respiratory physiology, so I lived in that pH balance. We monitored that pH balance, we’re looking at blood gases at 310 atmospheres.

Where can we push the body, and how do we recover the body? I ran mass spectrometry already. That’s a long time ago, we’re going on 30 years now plus. When was that? 1988? [chuckles] Okay, a long time ago.

Ari: CO2 plays a huge role in blood pH.

Dr. Cabeca: We had CO2 scrubbers. We looked at that work, and actually published on that in Amsterdam for the Royal Navy way back when I was 22 years old. I love this stuff. I would hear that and I’m like, “What do you mean it doesn’t?” We’re going to rob Peter to pay Paul. What’s the urine pH said, it’s not just about how we’re nourishing our body, but it’s the stresses. It’s the CO2 burden. What’s interesting because I had been under this investigation since I started talking about it in 2014, 2015 about the importance of urinary pH.

The reality is, I went to the research, when we even talk about ketogenic diets, we look at the Inuit tribes in Alaska and many people have said, “Well, they’re high-fat diets, and they don’t have high heart disease or cancer or this stuff,” but what they’re doing. So I was like, where are they getting their alkalize, their minerals to combat the acid load of a ketogenic diet? Well, they’re eating bone broth. That’s a staple, a daily fish bone broth, that’s your minerals. Now, what is the ketogenic diet community saying, they’re saying, “Oh, take mineral salts, your tri salts, your mineral salts.” I’m like, those are your alkalinizers. Those are your buffers. Those are your pH balancers to again, to keep from being catabolic and why it took so long, because more women had to come on board because again, men have protective testosterone, 10 times as much testosterone, and more circulating estrogen in the brain than a menopausal woman by the way.

Because we’re relying on our ovaries, that’s why we have to. I don’t think it’s just a good idea to be in an Intermittent Fasting Lifestyle, a healthy Keto-Green type lifestyle. In perimenopause and beyond, it’s mandatory. It’s mandatory for brain health. It’s mandatory for mitochondrial health, cellular health. I know you know more about the mitochondria than I ever will. I’m looking forward to interview you on my show so you can enlighten me further with your brilliance. I’m looking forward to it. That’s so powerful. Right? We need to shift. Men and women are different.

Understanding those differences, understanding the importance of alkalinizing, that’s why when I started using, and I encourage clients, just check your Urine pH, get an alkaline urine pH. It can take a long time. Get an Alkaline Urine pH along with ketones. Urine ketones, blood ketones, however, you’re measuring ketones, but I measure Urine pH and Ketones together. When you get that combination, It feels so, so, so good.

That’s when I encourage how do you feel? What’s your end of one showing you? Right? The best science I have to support it is, it’s going to make a whole lot of difference. It certainly shows you when you’re on track and when you’re off track and client after client who do shift to prioritizing that Alkaline Urine pH and, getting into ketosis at the same time, periodically at least.

They tell you they are raving fans. For me too gave me that clarity and that peace that in the Bible, it says the peace despite all understanding. Right? That being the eye of the storm or the ocean, not the waves. That physiologic balance that’s very grounding that can help. I always tell clients if you’re having trouble three days of camping in nature, that’s a quick way to an Alkaline Urine pH. So go figure it.

Ari: Very, very cool. Dr. Cabeca, I’ve really, really enjoyed this. This has been a lot of fun to speak out with you on all these hormonal pathways and what affects, what really novels and interesting stuff. Thank you for that. I know you have a few interesting products. I was joking with you before this, that I’d love to give you a testimonial for your Julva Cream, but unfortunately, I don’t have a vagina to try it on. Tell us about your Julva Cream and also the Maca product and you have one more product, the Keto Green–[crosstalk]

Dr. Cabeca: Keto-Green Protein Shake.

Ari: Yes, tell us all about it.

Dr. Cabeca: Yes. I created products to help me on my journey as I travel. I’ve had my own struggles, and there was nothing I could write on a prescription pad essentially or do with a surgical knife that was going to give me the results that I needed or wanted for my patients. You mentioned Julva, that led me to create my over-the-counter vulva Cream Julva, Just like vulva with a J and use that has a combination of ingredients that we benefit from as we get older. It includes plant stem cells from the Alpine Rose, which is this rose that blossoms in the Swiss Alps amongst the harsh conditions of rocky terrain and icy inhospitable weather. I’m like, “Okay, if that doesn’t exemplify femininity, I don’t know what else does especially as we age.” The stem cells have great science behind them, including antiviral properties, certainly the anti-wrinkle collagen-building properties. That’s the Alpine Rose Stem Cells.

Ari: I always wondered about that, because I have been seeing in the last year or two about these different plant stem cells that are being put in some of these anti-aging creams and things like that. Honestly, I’ve never looked into it and never seen a study on it because I’ve never taken the time to delve into it but I was wondering, is there any science on that stem cell stuff?

Dr. Cabeca: Yes, there’s really beauty on the Alpine Rose Plant stuff. I studied many different plants before I decided on the Alpine Rose plant stem cells, but because of the antiviral in the collagen-building and these beautiful and just the essence of it. It’s a really beautiful stem cell. There are a lot of really good science behind it and in basic science. Then I added in DHA, which I used in my patients, prescribed for my patients, compounded for my patients, and then added DHA. That’s just one of our adrenal pro-hormones and it’s over the counter in the US. In Canada, it has to be powered by prescription, but I added that in as well as coconut oil, shea butter, and just really a blended trade secret proprietary blending formulation that really works to drive deep into the tissue.

You can use it externally. Does not have to go in to the vagina to be absorbed really well and work. You can use it as a lubricant during intercourse. You can massage it in. I will tell clients a pee size amount massage it in daily or wipe with it, clitoris to anus, keep all that tissue really healthy. Game-changing results. You can read thousands and thousands of testimonials on my website about Julva.

For helpful about accidental bladder leaks, and I’ve had my athletes, Olympic athletes even just really big, big, big fans and relying on Julva as a natural option for them. It’s really beautiful. Then my breast cancer patients too, being able to give them something that turns back some of the changes that chemotherapy and radiation therapy cause in a very natural and healthy again. A lot of good science on my website at dranna.com to help with that.

My first formulation was my Mighty Maca greens product, my Mighty Maca superfood blend. As a result of my own healing journey that I took for a year around the world. In that there’s that my Buddha saying, “Everywhere you go, there you are.” I would say I went around the world to figure that out. [laughs] That’s where I experienced Maca, the superfood healing power of Maca and that a root that grows in the Andes in Peru.

It’s native there. My Maca is from Peru. I’ve been using the same sustainable source for over a decade, almost close to 15 years now. The science behind Maca is beautiful to help with men with erectile function, stamina, and energy. Women with hot flashes, sexual function. Helps improve all areas of sexual function.

I combined it with other superfoods that I experienced around the world, including resveratrol, turmeric, quercetin, cat’s claw, and this formula has been around getting close to 15 years. I have people on it for 15 years now. We have helps with fertility. I mean, it’s pretty amazing formula and all my products are 100% money-back guarantee. If you don’t like it, don’t worry, we’ve got you covered and we have a great customer service. I’m here to help. Then my Keto-Green, after I wrote the hormone fix and created my Keto-Green plan, everyone wanted a chocolate-flavored Keto-Green shake, so I formulated that with some hormone balancing that’s in seed blends and of course all our bioavailable I’ll be in micronutrients and key related minerals to make it a real meal replacement with zero grams of sugar. That’s really important in our shakes especially again in menopause and beyond. We become real sensitive to any sugar so really eliminating that so that we have stable blood sugars, meaning strong willpower. Then that Keto Green Shake is there. We’ve got a great offer for your audience. We put a package together of Mighty Maca and Keto-Green shake at a huge discount for your audience.

Ari: Oh, awesome.

Dr. Cabeca: Yes. That’s at dranna.com/ari.

Ari: Beautiful. Thank you for doing that. I didn’t even ask you to do that. Thank you. I’m glad you did. [laughs]

Dr. Cabeca: You are very welcome.

Ari: Wonderful, and they get a discount. What did you say the details on that were?

Dr. Cabeca: Yes. You can say 15%. Over $25 on the Keto-Green Shake and the Mighty Maca.

Ari: Okay, and the website is dranna.com/ari

Dr. Cabeca: dranna.com/ari. Yes, ari.com

Ari: Awesome. Thank you so much, Dr. Anna. This was a lot of fun. I really enjoyed connecting with you. It was worth the wait and I look forward to more conversations in the near future.

Dr. Cabeca: Me too. Thanks for having me, Ari. Thanks

Show Notes

The most common hormone imbalances (05:48)
The role of Oxytocin in female hormones (08:36)
How cortisol affects hormones (22:05)
The most common issues with insulin (28:31)
The most common causes of hormone imbalances. (38:48)

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