Welcome back to the Inspired
Living with Autoimmunity podcast.
I'm your host, Julie Michaelson,
and today I'm joined by Dr.
Felice Gersh double board certified
in ob gyn and integrative medicine
bestselling author and women's
health expert, and we're talking
about the hormone immune connect.
If you've ever wondered why auto
immunity affects so many more women
than men, then this episode is for you.
Join us as we discuss the synchronicity
that is our hormone system, and in
particular our sex hormones, or as Dr.
Gersh calls them, our life hormones.
Dr.
Gersh, welcome to the podcast.
Oh, I'm so happy to join you here,
This is such an important conversation
and I'm excited to share with listeners
to bring your expertise to them today.
So I'm, I'm really excited to dig
into this important conversation.
and that is for sure.
It is so important and I'm so
happy that you're emphasizing it.
Well, I always start with story.
I'm always so curious about, you know,
how did you get to be doing what you did?
And, and I think that that's
a great way for listeners to
get to know you a little bit.
So, so how did you become
this amazing expert?
Well, I always, I, I think
it was sort of intuitive.
I always knew that there was more to
helping women to optimize their health
than, than what could be offered through.
Pharmaceuticals and surgeries, and so
very early on I started my own practice.
I was one of those female
entrepreneurs and mainly that
was sort of almost by accident.
I kept trying to find someone
to join me in private practice
back in the day when I.
Went into practice and when I came out
of residency, private practice was the
thing that's really what people did.
Now, of course, most doctors are
employed by big entities, but
that was not the case back then.
And so I tried to join other
practices, but they were
predominantly or completely male.
They were sort of had a different kind
of a focus and I really wanted to.
Sort of be able to be flexible with
my schedule, to have a family to kind
of create my own dynamic of how I
would work, and I couldn't do that.
I discovered when I was looking
at other practices, so I actually
said, you know, I'm, I think.
If they could do it, I could do it.
I'm gonna start my own practice.
So I took a two day course sponsored
by the California Medical Association
called Establishing a Medical Practice.
That was, my MBA is a two day course
and I actually started my own practice
from scratch and I, I knew very early
on that I needed to add more services.
I call them my ancillaries.
So very quickly in my practice, I add.
A Chinese medicine practitioner,
a nutritionist, a psychologist,
a massage therapist.
So I, I, but I personally never
had additional training in anything
beyond conventional medicine.
But then after 25 years of delivering
thousands of babies, doing a lot of
high risk obstetrics, it was just my.
To give it up and actually get some sleep.
, my circadian rhythm was so messed
up from all those night phone
calls and deliveries and such.
And maybe because I had more time,
more rest, I actually started demanding
that all the pharmaceutical reps
that came pering through my office
regularly to actually show me the
studies that they were involved with.
You know, their companies, their,
their drugs that got them FDA approved.
And I was shocked when
I actually looked at.
Original studies.
How little they differed from
placebo and, and the array of side
effects that came out that became
apparent during the original studies.
And it's like, wait a minute.
I remember one drug that I looked
at for treatment of overactive
bladder that was, you know, big
thing for women, overactive bladder.
And the drug had such a wide array of
side effects, you know, constipation
and cognitive effects ever negative.
All of this for one less trip
to the bathroom in 24 hours.
It's like all of that for that benefit.
And then it's like, wait a
minute, I'm not doing obstetric.
What am I accomplishing?
You know, like if is my goal in life.
I could do tons of surgeries.
I was very good.
I taught surgery at USC School of Medicine
for many years and, but I said, I don't
wanna do endstage disease all the time.
I don't wanna just do surgery.
It's important.
And I didn't wanna give it
up, but I didn't want that
to be basically all I did.
I gave it a lot of thought and I
went on my own personal journey and I
ended up taking all kinds of courses.
I kept, you know, searching
for ways to expand what I call
my, my therapeutic toolbox.
Hang on one second.
I have to plug in my computer.
Sorry.
I know you can edit.
I didn't realize that I hadn't done it.
Now I'm good.
Good use.
Okay, so after.
Taking many courses
traveling around the country.
I ended up in Portland.
I was in a course with a bunch
of naturopaths and there was one
other MD there who was actually
giving a lecture, and I went up to
her during a break and I said, Dr.
Low Dog.
You and I are the only MDs in this room.
I feel so lost.
I'm really trying to expand how I can
help my patients, and I'm just sort
of randomly taking different courses.
She said, You know, after having
talked to you, I know you're qualified.
Why don't you apply to the Fellowship and
Integrative medicine at the University
of Arizona School of Medicine where.
And like the director.
And so I went home that Sunday night
after the course, I filled out the
application and two weeks later I
was in Tucson and I did the two year
fellowship in integrative medicine.
I became one of the first board certified
OB GYNs in integrative medicine along
with my board certification in ob gyn.
And I never looked back and that.
Over a decade ago that I finished that
fellowship and it's just been onward
and upward and learning and teaching.
I'd always been involved in teaching
and now I continue that journey.
In terms of giving.
Lectures across the world that
got a little interrupted by Covid.
I ended up doing everything virtually,
but it's through the magic of the
computer, I was able to communicate
with people everywhere and it's been
amazing the benefits that you can
help create for women patients by.
Expanding into natural medicine, holistic
and lifestyle, the all the lifestyle
medicine tools to really expand well
beyond pharmaceuticals and surgery to help
every woman and I, and along the journey,
I really learned and did a deep dive.
Into the hormones of the ovaries,
and I know we're gonna talk about
that because that became sort of
one of the foundational things that
I teach, is what do the ovaries
do in terms of these hormones?
What are their functions in the body?
And what happens when this universal,
inevitable, unavoidable process that
every woman faces called menopause?
What happens when women go through that?
And also what happens in younger
years, during the reproductive
years when things get messed up?
Because we know infertility is
skyrocketing, menstrual problems
of every kind, whether it's cramp.
Irregular cycles, heavy bleeding.
The development of, you know,
endometriosis, uterine fibroids, PMs,
all of these, what you might call totally
unique to women's health problems.
They are so neglected.
Everything that's uniquely
female is sadly very overlooked.
It wasn't until 2015.
That's not that, that's not
exactly ancient history.
That the FDA required that women at
least be included in studies . So,
you know, so it's so it's one of my
missions is to teach and learn about
these unique issues that face just
women that are so life changing when
things are not working properly.
And so that's been my journey and
I'm just, I didn't, never gonna look
back except to learn from the past.
Cuz I'm just really forward focus.
So amazing and incredible, and
I would say you may not have had
the board certification, but you
started, like, as you had said, you
pretty much started integrative.
It just wasn't all you, but
you knew enough to realize
that we are whole humans.
So many amazing things.
I also wanna just, I know, tip my hat to
you as far as being an early entrepreneur,
you know, just because you didn't find.
The scenario you were looking for.
So you created it.
And that is entrepreneurship.
That's what it's all about.
So what a huge, huge need.
You're, you're filling.
I was complaining as such a
passion point of mine as a woman
and a mother of a young lady.
And we'll get into why I
work with mostly women.
Not all women, but mostly women.
The, what you just said about,
you know, us having these
unique issues, unique to women.
It, I know, at least for me, and I
see it even with younger, younger
ladies these days, you know,
we norm, we tend to normalize.
And that's because.
We were told for years, Well, yeah,
you're a, oh, you have cramps.
You know, Well, yeah,
you're a woman, It's okay.
You have irregular periods, you
have, you know, X, y, z fill it in.
And it's the same with menopause.
You know, people think,
Oh, menopause is terrible.
It doesn't need to be terrible.
It's not supposed to be terrible.
And, and so I love bringing attention.
To all of the things.
If we had five hours, I, I have this big
list of questions I could ask you, but
we are here today to kind of tie, you
know, hormones and autoimmunity and I
just kind of tipped a little bit with the,
you know, why, why do so many more women
than men get diagnosed with autoimmunity?
One would imagine it has, Be related,
at least in part to hormones.
So let's talk about hormone
health and immune health.
Oh, it is so intricately related and it.
There's something that everyone
needs to acknowledge whether or not
they want to have children or not.
We need to acknowledge that
the female body evolved for
optimal reproductive success.
I mean, cuz Nature's Prime directive is.
To create new life.
It's just what it is.
So to create new life, you need
as a female to have quite a
different immune system than a male.
And so women are very different in
the way their immune systems work.
It, it's a necessity in order to have.
Survival and fertility that's successful.
So if we go back to the very beginning
of life, you know when you're an
embryo, you're just conceived as a
female, you have two x chromosome.
Now a male has an X in that little Y,
but it's very cute, but a little y.
Now it turns out that the vast array of
genes that control immune function are
almost exclusively on the X chromosome.
Now we have two now, theoretically.
One of those X chromosomes
becomes deactivated in every cell.
So you end up with just one that's
functioning, but that's not actually
quite what happens in reality.
Well, it turns out that for several
weeks during the embryo logical
stage of life, when you're just, you
know, developing, Two X chromosomes.
Both of them stay functional for several
weeks, and what they're doing is they're
programming gene function that create
what we call epigenetic expression, how
the genes actually express themselves.
So they're actually programmed during
these embryo first weeks and having
two X chromosomes with all of those
active genes involving immune function.
Help to program the immune system
of females to be more robust, like,
more like proactive, more vigorous.
Then one of the X chromosomes
does get turned off in every
cell, but not completely.
About 15% of the genes on the so-called
deactivated X chromosome actually stay.
Not amazing and almost, and almost
all of those still active genes are
involved in immune function now.
It turns out that that's not all
that makes women different from
men with their immune function.
Of course.
So are the hormones quite different?
Estrogen has receptors on
every immune cell of the body.
So if we look at the immune system as sort
of like an overview, there's like the,
what we call the innate immune system.
That's the part of the immune
system that activates when there's a
pathogen, like a bacteria, a virus.
Parasite or fungus trying.
Take hold in your body and the
innate immune system has what I
call the first line of attack.
So you have these cells that are
programmed just to go after whatever.
I mean, they have receptors that pick
up all the different kinds of pathogens,
like the mass cells, like the, they line
all the interfaces between the outside.
And your inner body so that it
acts as like the sensory guards to
check over and take care of things.
And when something gets in,
it's like they become activated.
They bind with their little things
called toll-like receptors to the
pathogen, and then they explode.
They call it like de granulation.
They like explode and
release inflammatory product.
SIGNALING agents to bring in the troops
and they create this inflammatory
response, which is lifesaving.
They also are activated in response
to damage tissue, like injured
tissue, so that you can repair
dam, get rid of the old damaged
tissue, and then create repair.
So you gobble up like pathogens.
You gobble up old dead cells,
damage cells, and this is all
part of the innate immune system.
Every one of those cells, mass.
Neutrophils, Macrophages, monocytes,
they all have receptors for estrogen.
So it estrogen is an immune modulator.
It regulates the immune system
from top to bottom, so it's
on all of the immune cells.
So that's the innate immune cells.
And then the adaptive immune cells are
the cells, the type of lymphocytes called
B lymphocytes that make antibodies.
Now those also.
Estrogen receptors on
them and different types.
There's the alpha receptors are
predominant on the innate immune
cells and the beta receptors on the
other types of immune cells that
make antibodies the be lymphocytes.
So everything is modulated in
this sort of interaction to
enable success for reproduction.
Now what is that?
What is that talking about?
Well, it turns out that when you are
pregnant, You make a special type of
estrogen, little estriol, which binds
predominantly to the beta receptor.
That's on the, the cells of the
immune system that make antibodies.
And it turns out when
you have high levels of.
Activation of the beta receptor, it
down regulates the alpha receptor.
So those innate immune cells, like the
attack cells of the body are actually
quieted down so that they become actually
less effective so that you don't do what,
you don't attack and kill your fetus.
So the immune system is totally modulate.
During the menstrual cycle, there's
changes with the hormone changes
and levels, and progesterone also
has a big role, which I'll explain.
And so what is all so critical
is that you don't kill the sperm.
You don't kill the fetus by your immune
system thinking it's a foreign invader.
This is totally unique to females.
Males don't have to do this, so it's
just an amazing type of a situation.
That's why many women who have autoimmune
diseases like multiple sclerosis,
actually go into like a remission during
pregnancy because the attack part of the
immune system that makes these things.
Inflammatory cytokines like
tumor necrosis factor alpha, the
interferons, the interleukins that
are actually pro-inflammatory are
all down regulated during pregnancy.
So it's like what you might call
an immune modulator, like the
pharmaceuticals that are given that
downregulate, the innate immune.
Production of these cytokines is that
create the inflammatory response.
So that's why they give warnings on those
kinds of drugs, like Humira and Remicade.
Like be aware that if you get
an infection you could die.
You know, it doesn't, but that's why
women who are pregnant, If they get an
infection, like they get chickenpox,
they get the flu, they get covid, they
are more apt to have a more serious
outcome because there it's a compromise.
Everything in the body is a compromise,
so the body down regulates its immune
response, which would be also against
pathogens, but also it down regulates
it so it doesn't kill the fetus.
Now it's really important when women
aren't pregnant that they survive.
Pandemics epidemics because they
have to be able to nurse their
babies and raise these children to
sexual maturity so that they can
do it all over again and reproduce.
So when women aren't pregnant,
their immune systems are
more, I mentioned, robust.
They have women have, because
of their programming, right?
In embryonic stages, they
have more white blood cells.
They have more cells that make antibodies.
They have more immune cells, so
they are more likely to have a
more robust inflammatory response.
Now, when you get an infection,
That's what saves you.
That's why you want a very initial,
robust inflammatory response to attack
and wipe out that pathogen and also to
deal with trauma so that like for example,
women who are premenopausal, if they
have traumatic brain injuries, they do
much better than postmenopausal women,
and they do better than men, women.
The pandemic's better
women die less from hiv.
They die less.
They can bleed.
They, they do can die from anything,
but they have a better survival
rate from on the flu because the
estrogen and progesterone is also very
anti-inflammatory because you don't want.
Inflammatory response
when you're pregnant.
So progesterone is
antiinflammatory, but an estradiol.
The estrogen made by the ovaries.
That's very important because remember
I said estriol during pregnancy has a
different binding capacity than estradiol.
So that's why we don't wanna give estriol
when you're not pregnant, you know?
Cuz that's not what the
body is like interested in.
Okay?
That's not natural.
So that estradiol is an immune modulator.
By that I mean you can say regulator.
It's part of initiating the inflammatory
response when it's appropriate, like
to trauma damage tissue and infectious
agents trying to get into your body.
So it initiates that initial.
Powerful immune response to
wipe out that infection, to
help with injuries and so on.
And then when it's appropriate at
the right time, it down regulates
the immune system to promote
anti-inflammation and resolution of
inflammation and the healing process.
And in fact, back in the 1990s before
that, idiotic, sorry, it is idiot.
Women's Health Initiative.
The Women's
From 20 years ago came out,
there were so many studies.
I researched this on
PubMed, my favorite site.
Oh, okay.
So I researched, and back in the
1990s, there were so much research
going on, looking at putting
topical estradiol on the skin.
And what they found was
concerning wrinkles.
Within two weeks, they could
see reduction of wrinkles.
It improves everything about the skin,
the ceramides, the, the hyaluronic acid,
the collagen production, everything.
It changes the, the microbiome of the
skin, everything, the sebum, you know,
types and the fatty acids coming out.
And it also was found to be very
amazing for healing wounds because
at part of the inflammation, Is the
resolution which involves healing.
That's part of platelets.
You know, platelets cause blood
clotting, which is part of
the pro-inflammatory response.
And then it actually helps with growth
factors, which is part of the healing,
part of the inflammatory response.
And all of that is under the
auspices, the umbrella of estradiol.
So estrogen is amazing.
Now what happens is many women, All kinds
of problems going on with their circadian
rhythm and their nutrient status.
I do lectures on.
Issues involving micronutrients.
If you have even one deficiency, it has
ramifications throughout every cell in
the body because these micronutrients
are essential for running the co enzymes,
the cofactors nuclear like dna, rna.
Stabilization, I mean,
so many different things.
So, so many people have nutritional
deficiencies and all of these things
impact so many different issues.
And when you have, and it can lead to
dysfunction of the ovaries and then the
ovaries don't produce hormones and the
proper sequence and so on, and that has.
Further downstream ramification.
So you get this horrible cycle of
gut, this function, brain dysfunction,
circadian rhythm, hormonal imbalances,
and that's where it's complex.
People want a simple solution.
There is no simple solution.
And the solution is not to cover it
up, like I call it, smoke and mirrors
by giving birth control pills to
the young reproductive women because
the menstrual cycle is a vital.
Sign of female health, a vital sign
is like, what's your temperature?
What's your pulse?
What's your blood pressure?
Right?
So if your menstrual cycle is
messed up, guess what, ladies?
You are messed up and the solution
isn't to just cover it up.
It's to fix it, and you'll
never fix it if you just put
people on birth control pills.
And that's the go to now.
I mean, it's just so sad because
these women often have nutrient
deficiencies because of diet.
They often have just, you know,
circadian rhythm problems, dysbiotic, gut
microbiomes, like they have, you know,
they have wrong microbes in their gut.
They have what we call impaired
gut barrier or leaky gut.
I mean, there's so many different
manifestations and that leads.
Problems with the brain,
the gut and the brain.
They communicate and oh my
goodness, there's, it gets complex.
But the solution isn't to like, if you
have mold in your wall, the solution
isn't to put on pretty wallpaper
that isn't going to fix the problem.
And then in menopause, the reality
is that you don't have hormones
that are coming outta your ovaries.
That's gonna have
ramifications everywhere.
Because remember, every system in the.
Has estrogen receptors.
I mentioned the immune cells
have estrogen receptors.
They also have progesterone receptors.
So too, every system, the cardiovascular
system, you know, the heart, the
blood vessels, the musculoskeletal
system, the ligaments, the tendons,
the bones, the Neurological system.
The enteric, the gut nervous system,
the brain, the central nervous system.
If you look at the skin I
already mentioned, like the skin,
Oh, you name
every organ, right?
You can go like every organ, the,
you know, the GI, Tracted, every
part of the GI tract, they all have.
Hormone receptors.
So it's one body, and it works in
synchrony, in a beautiful synchrony
to support reproductive success
and survival so that you can have
multiple episodes of reproduction
and create multiple babies and then
be alive so that you can raise them.
So it's all about survival so that
you can raise the kids survival and
health so that you can have the kids.
And then all of that kind of comes to.
An end of sorts when you hit menopause.
So nature doesn't make us
die when we hit menopause.
By the way, most organisms,
most creatures on planet earth
die when reproduction ends.
Only a few animal types where one of them.
Actually has life after reproduction ends.
But it's kind of like a fend for yourself
situation here, . And so we need to
actually access every therapeutic tool
in the book to have healthy longevity.
But if we understand that these
hormones, estrogen in the form
of estrodiol and progesterone and
testosterone, which doesn't drop
at menopause, it's really, it's.
Related to menopause.
The skillset of the ovary
to make testosterone is
unrelated to the skillset to.
Estrogen, estradiol and progesterone
because you need to have a supply of
eggs to make estrogen and progesterone.
You don't need that to make testosterone.
So it's separate.
It's, it's a very vital hormone.
It's much smaller in women in terms
of production amount, but it's
often overlooked
Totally overlooked.
Totally overlooked.
And I do talks about, you know,
testosterone, ma, everything matters, but
you can put it in hierarchy, you know,
so I put, you know, estradiol at the top,
but all these other matter, I mean, you
know, thyroid, I mean, that's a big deal.
Of course, you know, but, and
actually they all interact.
So, like, for example, when you have
high levels of estradiol, It actually
upregulates the progesterone receptor
so that progesterone works better when
you have high levels of progesterone.
It actually down regulates
the receptors for estradiol.
When you have high levels of estradiol,
it up regulates the receptors for
thyroid hormone, so it works better
testosterone, so it works better.
And it's also that women have a good
sex drive , by the way that the, you
we'll keep reproducing
Exactly, and that's why all women
after menopause have symptoms
that fit with low thyroid.
Even though you measure their thyroid
hormone, it may be normal in the
reference range and it looks fine.
And the doctor says you don't have thyroid
problems, you probably need Prozac.
That's not it.
They, because without adequate
estrogen, estradial, The thyroid
receptors are not gonna work well.
It's like if you have a baby and
you want to feed your baby mash.
So you buy all this mashed
peas, or you make it yourself.
So you have this big supply and it turns
out that the baby gets one sniff of it
with the spoon, and it's like, I hate
peas, but you know, I'll take like mashed
peaches, but I do not like mashed peas.
So it shuts the baby's mouth.
The baby will shut.
You know, babies have very.
Very particular taste, right?
They like they, and when they don't
want something, you know what they do?
They shut their mouth and then if you
try to shove it in, they use their
little tongue, blah, blah, blah, and
they push it right back out, right?
Like they'll just push it right out.
So it doesn't matter how much you
have, if the receptor, the mouth
doesn't wanna receive it, right?
So it doesn't matter how much thyroid
hormone you have, if you can't get it into
a functional receptor, that's what happens
when you have insulin resistance, right?
You have all that insulin.
all time favorite visual of a
Okay,
I will, I will never not.
any conversation regarding hormones
and receptors be, I will always
see the baby and and the time.
It's so true, though
I once tried to give my youngest daughter.
Eggplant . And I'll tell you
did not go well.
did not go well.
So that picture never left me
when she like tried the eggplant,
like, no way, Nohow never gonna
open my mouth again for that.
Now she actually likes, but that was.
When she was a baby.
And so it's like, it doesn't matter
what you want to go into that receptor
when the receptor says No way.
And that's what happens
with, like I said, insulin.
When you have insulin resistance, that
means the receptor isn't working well and
you body, your body makes all this extra
insulin but isn't like working well, you
know, so your blood sugar keeps rising.
So, you know, at least after a while, you
know the insulin isn't gonna compensate.
And you know, like, it's like,
it's like you get a big team and
you keep like shoving on the door.
Eventually it opens, but eventually
that door gets totally stuck and you
put all the insulin in the world and
it's just not gonna really open well.
So that's what happens when you,
you know, with these other hormones.
So everything is so interactive.
So I always say this.
If you for some reason had like a big
gor, you know that's your thyroid,
a big swollen thyroid, but it wasn't
cancer or anything, but it was so big.
This, by the way, can happen.
It was so big that it was pushing on
your trachea so you couldn't breathe
well or you know, swallow well.
Cuz it's like this giant
thyroid right here.
So what do they do?
They sometimes might take it out.
This doesn't happen very
often, but they take it out.
Now, if somebody removes someone's
thyroid gland, they would never.
Well, it's okay.
Why don't you me?
You don't need it.
Why don't you meditate or eat more
vegetables or take a walk or something?
No, they would say you
have to have thyroid.
So I say the same thing when
you lose your ovarian function.
I know it's natural.
I don't care because earthquakes,
which we're having a hurricane now,
coming to Florida, that's natural.
Some people, it won't go
into climate change here, but
it's still a natural event.
Maybe promoted by climate change.
But in any case You know, it
doesn't mean it's good for anyone
living in Florida, I can tell you.
So natural doesn't mean good.
Okay?
Remember, death is natural.
And so is arsenic
Exactly.
You know, poison toad stools.
So just cuz it's natural doesn't mean
you know, if you want it natural,
then don't come and see me cuz then
you don't want any, I like intervene,
but I try to intervene in a way
that's, Adapted to the human body.
That's physiologic that I try to
use like natural medicine before.
I use pharmaceutical medicine when
I can, If somebody comes in with
incredibly high blood pressure, I'm not
going to just say, eat more vegetables,
go on the dash diet or something.
I'm gonna say, I need to put you on a
blood pressure drug now, and we're also
then
Right.
We're also going to do,
Right, right, right.
If someone has a giant ovarian
tumor, I can't just give.
Cucu in, I mean, like, I know.
Okay.
You know, there are limitations
to, That's why I, I have a not,
I'm not alternative medicine.
Integrative.
integrative.
I Exactly,
But you're getting at that root cause.
It's not
Always.
Not
I, I will always treat symptoms, but
I will never only treat symptoms.
You got it.
You
Yes.
I love it.
I've,
problems.
Yeah.
You got it.
I've heard you say which I loved,
I hope I'm gonna quote it correctly
cause it didn't write it down when
I heard it, but I was like, Ooh.
We were just talking about estrogen
and estradiol, progesterone,
all the, all the sex hormones.
And I heard you refer to them.
You're, you're changing the name I hear.
Oh yes.
I don't wanna call them sex hormones.
I wanna call them life hormones
And this is directly what you were
saying about, you know, we don't
hopefully die when we're done with our
reproductive years and if we want to
live young and vi, and that's why topical
estrogen makes your skin look beautiful,
because that's why we get wrinkly and
trivially when we lose our hormones.
You know, like I have, I work with a
compounding pharmacy who makes a product
that has estrogen and progesterone
in it, and my patients love it.
I always, I, I mean
secret, but not so secret.
I use it.
Okay.
You know what, it's natural.
I, I would rather do that.
I'm, like I've said, I, I, I once had
a bad concussion from falling off a
bicycle when I was mountain biking.
Back in like 2002.
Okay.
And so I will not put my brain under,
you know, voluntarily under anesthesia.
Anesthesia doesn't get, its due
in terms of its harm to the brain.
It's like getting a little brain trauma.
So especially the older, you
Or big, depending
Yeah, the, it's not good for the brain to
be put under anesthesia, let's you know.
That's why they try to avoid it for little
bitty children and old people, especially
cuz their brains don't do as well.
Of course, if you're on estrogen, it will
do better with estrogen, it really will.
And I know estrogen at progesterone
is very neuroprotective, absolute.
And the brain makes estrogen and
the brain makes progesterone.
It's just that after menopause,
the the, it's even with making it,
it doesn't make enough because the
precursor to estradiol is testosterone.
So men, when they have good
testosterone levels, make plenty
of estradiol in their brain, but
no matter what, women will never.
Testosterone levels that are high
enough and their brains are not even
designed to be making a ton of estradiol
because it's not how we're programmed.
So we need that.
But it's very, they're
both all neuroprotected.
That's why they're often called neuro
steroids because they're actually
very involved in neurological
health and, and function and so on.
But the bottom line is that I would
much rather put hormones on my.
I'm not going under anesthesia.
I'm not gonna have a facelift.
It's just not gonna happen because
I might value my brain function
more than I care about wrinkles.
But
Well, and you don't even have
any, or you know, or you have
you know.
Well
in the
now I never bet.
I just truth, I never use
filters on any pictures.
Like I am who I am.
I never want someone to meet
me in person and say, Why?
Do you use like a 20 year
old photo or something?
No,
Right.
Well, and I, I joke, I'm 53.
I didn't think I was gonna live to see 50.
So like, I wear 53, like a badge,
Like I'm thrilled to be 53 and I've
earned, you know, we, we just, But
the thing is that as we're talking
about, there are things we can do
absolutely, and
for listeners who are thinking like,
Wow, well I have auto immunity.
No one's ever asked me about hormones.
You know, maybe they're still,
you know, fully cycling.
Maybe they didn't have fertility
trouble we, that we could do in a
whole nother episode as to why people
oh, you know what?
You know, I wanna touch on that.
Thank goodness it's so
easy to get sidetracked.
But the reason that women make up 80%
of all people who have autoimmunity
is because they have so many more
cells that can make antibodies,
and they have so much of a more.
Outsized oversized immune response.
So if you have a chronic infection,
now a chronic infection can be like
a herpes infection because there are
many herpes, there are many viruses.
And by the way, You know, Covid is now
recognized as one of them that can promote
and cause long term chronic infections.
Now, if you have a leaky gut, then
bacteria and viruses in your gut will
be continually leaking into your body.
That's like a chronic infection.
They even now, like Dr.
Shaunfeld from Israel, who's a
famous immunologist, says, and I
had some conversations with him.
I said, There's no question.
From what our conversation that
the vagina can cause leaky vagina.
Okay.
And then bacteria in the vagina
can leak into the body proper
and create this essentially like
a chronic state of infection.
And so the body in, in exchange
for trying to survive, you know,
that's what it's trying to do.
It creates antibodies.
Against the infectious agent.
Women make more antibodies and
they have a more aggressive
response to infections than do men.
So if now every time you have
an infection, a hundred percent,
you will make antibodies
against that infectious agent.
Now, we all life forms, every life
form has the same building blocks
the nucleotides we don't have.
5 trillion different nucleotides, like
every, the building blocks are the same.
They're just somewhat rearranged.
It turns out that we humans have
protein structures and amino acids
and nucleotide sequences that are
similar to the pathogen, so you might
quote, They call it molecular mimicry.
It's like mistaken identity.
So the antibodies will just say
against strep because people
know that strep is associated.
When they used to not treat it with
antibiotics, it could cause rheumatic
heart disease, which is where the
antibodies attack the heart valves.
Okay.
So we can have human structures.
It could be in the joints.
It could be on the nerves, it could be the
sheath that covers nerves like with ms.
So, It could be thyroid,
which is the most common.
Okay.
Could be anything.
The gut lining cells, you know, so
any cell in the body could have a
similar structure to the invading
pathogen, and they've actually
had some linkages between them.
Okay.
Especially with rheumatoid arthritis.
So if you make an antibody against
a pathogen and that infection is
long term, then that antibody is
gonna be continually produced if
you have a short term infection.
During that short term infection, you
will make antibodies against yourself.
So, but it's short lived and
when the infection is over, the
antibody production is ro way
down, so it's not gonna cause harm.
But if it's an ongoing infection and
you keep making antibodies over and over
and over, you're going to end up making
antibodies against your own tissue.
Some kind of tissue is
gonna be similar and.
The initiation of autoimmune disease,
it starts from a chronic infection.
And we have so many different
chronic infections that now, you
know, because people's guts are so
leaky and other things are leaky.
And we have, you know, environmental
poisons that interfere with our own
hormonal systems that we call these
ubiquitous endocrine disruptors
and so on, that interfere with the
normal function of our immune system.
So I.
Attacking the invader
and then eradicating it.
It allows the chronic infections
that that sort of sets the stage
for these autoimmune conditions.
And we know that a lot of autoimmune
conditions are now linked to
nutrient deficiencies like vitamin
D, and so it's all like every,
all the systems are interlink.
another hormone, by the
Right.
It's like a pre-one.
It's like a pre-one, right?
So the bottom line, and we're
supposed to manufacture it, but people
aren't doing a good job of that.
So the bottom line is that because
women have this unique immune
system that we have way more
production of all the immune factors.
The cytokines, the antibodies, we have
more immune cells and a more exaggerated
response because it's about survival.
But now it's sort of turned against us.
When you have an acute
infection, we survive
We rock it.
right?
We reckon.
But when it's a chronic infection,
we can end up with autoimmune
diseases, which are now epidemic.
Okay.
And I deal with them all the time.
So you gotta heal leaky gut,
you gotta calm the system down,
you gotta give immune support.
So there are like a whole sequence
of events and you've gotta look
for environmental toxicants, like
poisons and chronic infections.
And so you gotta look at all these things.
And this is like what people are doing,
like with Alzheimer's, they're looking
at all these different things because.
Because the same setup that
creates autoimmune creates
chronic neuroinflammation.
Chronic chronic inflammation,
which increases autoimmune,
which increases allergies, which
increases cardiovascular disease,
which increases cognitive problems,
Metabolic
So one, right?
So that's right.
Cardiovascular, like vascular.
So once you understand the
foundation, Suddenly you see
how everything is interlinked.
That's why it drives me crazy
when I see an article said, Oh,
we just made this great discovery.
Like women who have osteoporosis
are more likely to have dementia.
It's like osteoporosis is an
inflammatory process and it's, you
know, related to hormone deficiency
would Thank you.
I was like, Eh, we're back to hormones,
right, right, right.
Because hormones, once you understand,
Estrogen and progesterone are about
having all the organs work optimally
and in synchrony because they're also
involved in the master clock that sets the
circadian rhythm so that all the organs
work on the same time zone , you know,
and they work optimally for the purpose.
Survival and reproductive success.
Then suddenly there's no mystery how
everything is a beautiful symphony
and that the hormones are life
hormones, and they create this,
what we call metabolic homeostasis.
That, that the goal is to keep
everything kind of calm, but
ready on alert in case of trauma.
Or pathogens, but not activated
until they need to be activated.
Yes.
And that's where most listeners
are, are like, Ooh, this is , That's
how it's supposed to work.
So what, what would be, we covered a lot.
Like, Wow, I'm, I can't wait
to listen to this again.
What is one thing listeners can do today?
Just one step they can
take to start to move their
Okay.
Well, I always say, Well,
you gotta start somewhere.
The place to start is number one,
and this is just the prelude.
This isn't actually the start is to.
Define the problem and
understand the problem.
You can never solve a problem if you
haven't even defined what the problem
is, so you understand the problem.
You know, you understand the things
that you are doing in your own life
that may be not really helpful for
your health, you know, so define.
I'm going to jump in and clarify because
I can already hear like, Well, I,
you know, Oh, I know the problem, and
they're filling in their diagnosis.
Right.
Oh, not a diagnosis.
about that.
it's not a diagnosis.
It's like like I eat a lot of processed.
Right.
I go to bed at 2:00 AM I mean, we're
talking about like choices that you can
control, not a, not a medical diagnosis.
Like you gotta define things that,
you know, like make a list of things
that you think you can do better with.
Like maybe you.
Like, like we said, you know,
you go to bed at a crazy
time that you don't have to.
Cuz I know people that
they have social jet lag.
They in, they intentionally go to
bed at crazy times or they eat meals.
Erratically, they eat late at night,
they eat a lot of processed food,
which have a lot of chemicals.
They don't eat enough
vegetables, they don't hydrate.
Right, Right.
So, you know,
we know you're right.
If, if you take a moment and get
quiet, you can find those places to up
then, so sort of like define
the, the problem in terms of
the things you can control.
You know, like, I can't say sell your
house and move to a different state.
Okay.
We're talking about realistic things that
you can control and then, you know, pick
the one that you feel you can actually do.
Starting tomorrow.
Okay.
Now if you have no idea,
then start with the gut.
Okay?
We always say start with gut.
So start by doing something simple
like saying, I am going to eat
vegetables at every meal, or I will
absolutely not buy box cereal anymore.
Drive, you know, like make a commitment.
And keep it, you know?
So, you know, I can say, I want
you to eat three cups of vegetables
with every meal, a cup of fruit,
never snack, stop eating at 6:00 PM
start where you are.
know, I mean, I ca I mean, I would love
to get everyone to do everything I want.
Okay.
But I have to be realistic.
So every week make a positive change,
you know, like, Maybe invest in a little
treadmill that you can like, slip under
the couch, who doesn't even take up space.
You can buy things like that.
Or find a buddy, you know, that
you can take a walk with or, you
know find, you know, like start
going to the local farmer's market.
And asking the vendors there, what
vegetables they are selling, what
they are if you don't like, I don't
know what heck, I was like once upon
time it's like, what heck is this?
It's cold.
Robby, what heck is cold?
Robby?
You know?
You know, like, I didn't know.
It's like, And how do you cook it?
They're always happy to tell you.
You know, they often have
sheets with recipes and of
course you can always go online.
So experiment.
Try a new vegetable every week.
You know, and leave some
bad thing out of your life.
It could be a toxic person,
, you know, so you know,
It's
So, you know, set a schedule
that's realistic and make a
positive change every week.
Make a list of things that
you know you don't like.
Need a healthcare professional,
you know, you know.
all know, we
You know, things that you're doing
that are really not ideal, right?
Like, are you like, you know, like
stop snacking, you know, say, But if
I do have to snack, I'm only gonna
snack on raw, organic nuts and maybe.
Raw, I mean not raw, cuz they
are raw, you know, like, like a
fruit that you like, like grapes,
you know, or something like that.
So, you know, so you say, Okay,
I'm gonna try not to snack anymore
because it's not really great cuz
you can't keep your insulin under
control of your snacking all day.
But at least if you eat
something, it adds nutrients.
Okay.
And not poison, you know?
So just take these steps and
you know what's gonna happen.
A year's gonna come and go and at
the end of the year, You're gonna
be one happier, healthy individual.
Amazing.
I love it.
For people that are listening on
the go and aren't gonna check out
the show notes, where is the best
place for people to find you?
Well, I'm actually, I told you
I'm in an exam room in my office.
I, I have, I'm an old fashioned doctor.
I have a brick and mortar practice.
I also can do telemedicine.
And I am in Irvine, California,
so that's Southern California.
The name of my practice is integrative.
Medical group of Irvine.
And for those not familiar, Dr.
Gersh is being modest.
She's also has this amazing presence
on Instagram and gives so much
information and I believe it's, it's Dr.
Fe Gersh on Instagram?
Correct.
so it's a, the only thing that's tricky
about it is, is a period after doctor,
So it's d d r period and then fe ksh.
And I do try most, most weeks.
Sometimes I miss, cuz I'm
like out speaking, I travel, I
still, now traveling is back.
So I'm, I'm traveling, I'm doing
lectures and I do have three books.
I'm hoping to write many more.
So I have two books on P C O S.
One is the foundation book, P C O s, sos.
The other one is for women trying
to get Pregnant and now called
P C O S SOS Fertility, Fast
Track, and One on Menopause.
That's my newest book, Less
than a Year Out, and it's called
Menopause 50 Things You Need to Know
And I love that you put the 50
50 things in there, amazing
resources for everybody.
Dr.
Gr, thank you so much
for joining us today.
Thank you for inviting me.
For everyone listening.
Remember, you can get the
transcripts and show notes by
visiting Inspired living.show.
I hope you had a great time and
enjoyed this episode as much as I did.
Listen to it twice.
I'll see you next week.
