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Rethinking heart health, one question at a time.
I’m Dr. Sanjay Bhojraj—interventional cardiologist, functional medicine expert, and lifelong student of what really keeps us well. In this podcast, we go beyond prescriptions and procedures to explore the deeper drivers of health, disease, and healing.
From inflammation to intuition, cholesterol to consciousness, I sit down with doctors, researchers, and changemakers who are reshaping how we think about the heart—and the whole human behind it.
Whether you're a fellow clinician, a health seeker, or someone navigating your own transformation, this show will challenge what you thought you knew—and invite you to stay curious.
Dr. Jen (00:00.91)
you
Sanjay Bhojraj MD (00:01.978)
Hey everybody and welcome to this episode of the Curious Cardiologist podcast. I am Dr. Sanjay Bodraj here talking today with Dr. Jennifer Pflegharr Did I get that right? like it's so difficult for me to have someone whose last name is more difficult than mine to pronounce. Dr. Jen is a wonderfully cool person, emergency medicine doc by training, and now focuses on
Dr. Jen (00:12.564)
It's pretty good. It's pretty close.
Dr. Jen (00:20.087)
Right.
Sanjay Bhojraj MD (00:28.846)
lifestyle and perimenopause and all sorts of different things. So Jen, Dr. Jen, thank you so much for being here as part of the podcast today.
Dr. Jen (00:35.704)
Thank you. Thank you for having me.
Sanjay Bhojraj MD (00:37.882)
Well, let's just jump in. it's almost invariably a question that happens on every podcast when we get started. But how did you make that transition or what was it that you decided became important enough? Let me start that again. How did you make that transition into integrative medicine? How did you decide, you know what, I'm gonna leave the emergency department and serve patients, serve people in a new way as a healer. What was that story for you?
Dr. Jen (01:04.974)
Yeah, a few different things happened at once. So first I was working full time in the emergency room and I kept seeing the same patients getting over and over again, getting the same symptoms, the same sickness, like my belly hurts, you know, had 10 cat scans, you know, at age 25 and, and stuff like that. So I saw how it didn't really work. Conventional medicine was just a lot of chronic disease, especially in the ER. And I thought when I was in the ER, I'd just be treating emergencies.
But even some of the emergencies like heart, heart attacks and heart disease are chronic illnesses and the result of chronic illnesses. So I felt very conflicted and I started doing like nutrition plans with people in the ER, like talking about them with what they ate and stuff. And I'm like, maybe it's connected. Yeah. I would have like this one patient. I'm like, can you keep a food journal? Because I think it's related to what you're eating and yeah, it was crazy. And then at the same time I had my first son and
Sanjay Bhojraj MD (01:48.006)
Are you serious? Well.
Dr. Jen (02:03.976)
You know, I was I was breastfeeding and I was like, my goodness, like when you're pregnant and breastfeeding, you're like, OK, it's not just about my health. I can't like drink in residency. I was the worst. Like I drank tons of diet Pepsi, espresso to stay awake. Like it is just survive my poor adrenal glands. Like if I knew what I know now back then.
Sanjay Bhojraj MD (02:22.884)
medical education is not healthy for the young doctors. That's a whole other thing that we can talk about. yeah, so you just get through. So caffeine and espresso and yeah.
Dr. Jen (02:25.662)
It... no. No. Ugh. It's terrible.
Yeah, and diet Pepsi. terrible. So, so you're just getting through, but then you're like, I'm pregnant. Like things, you know, it's not just about me. It's about my, my son and then breastfeeding. Like it was a whole next level, like being healthy. And then I start cloth diapering and then he had really bad reflux. So I looked into taking out gluten and dairy. It was just like, I transitioned to this like more holistic, crunchy person and was questioning so many things in my medical education.
So I look at my husband and I'm like, hey, like, you know, I'm just reading all this stuff on my own for fun, like chronic Lyme, you know, like all this stuff. And I'm like, I have to go back and do a fellowship in integrative medicine. And I'm like, it's going to cost money and time, which time is money. And, and by that time I had had my second son and my husband's like, yes, like he's so supportive. And then I'm like, and I'm going to cut down my shifts in the ER and open up an integrative medicine practice. So I did all of that and I graduated and.
from my fellowship, Andrew Wiles Fellowship Program. And yeah, and I wanted something that I could get board certified in, because it sets you apart. And the integrative medicine board certification is legit. So it is great. When people want to work with someone like me, I refer them to people with that degree a lot of the times to make sure they have a good education. So I went back and did that and.
Sanjay Bhojraj MD (03:34.478)
That's great fellowship program.
Dr. Jen (03:56.526)
Made the transition. I'm still working in the ER occasionally. We moved to Tennessee recently, so I still need to pick up, get credentialed at a hospital down here. But it was interesting, a little sidebar. I had a friend that last night, I was up till 2 a.m. because I got a text at 11 saying that her blood pressure was high and her husband was out of town. And I'm like, well, we can call the squad or I can just take you. And she knew I had to get up early and I have four kids and...
And I'm like, I'm not leaving you at the mercy of conventional medicine like right now. And I went in and they did a great job and stuff with her, but I'm very protective as I'm sure you are when people go into the hospital, because sometimes it can be kind of sketchy. And everyone's just trying to do their best job. So it was interesting because I was talking to the doctor. I'm like, I'm an ER doc. I'm like, I think the...
the real reason why this happened. Her blood pressure was elevated because of this and this. And he's just like looking at me like, okay, we're just going to get it. Yeah, we're just going to get a CTA and like, and I'm like, but don't you care? Like, and this is the problem. Like conventional medicine is, is cookie cutter protocol based. It's not personalized. It doesn't, and it doesn't work well. Like America like sucks at healthcare. Like
Sanjay Bhojraj MD (04:55.77)
Like who cares? All we care about is them. Yeah.
Sanjay Bhojraj MD (05:14.074)
Well, I think we were both in kindred subspecialties. was an interventional cardiologist, so was the heart attack doctor. And, you know, we are really the end user of a completely broken system. I've said that so many times on the podcast. And so for me, fortunately, my end user status was only in the cardiac realm, but for you, was everything. Excuse me. And I think how interesting that you got that insight in the emergency department. And I think it's a very common theme amongst a lot of us in this
kind of more functional, integrative space, lifestyle medicine, whatever you want to call it, is that we just have this realization that what we thought medicine is, is not actually what it turns out to be, right? And so I think of no better place than the emergency department to have that conversation. I mean, I think that's so intriguing that you would have food plans in the emergency department because generally it's just treat and street, right? That's what I remember from my days in the ER, how many
minutes per patient, can you get them in and out? And it just, yeah, and
Dr. Jen (06:14.876)
RVUs. Yeah, I will not work for a system. I've had some like, Henna Hunters, Locums people reach out to me because now they know I'm in Tennessee. I'm sure you've had that happen to you. So for those listening, it's like, if there's opening in hospitals, they try to get people to staff them.
Sanjay Bhojraj MD (06:32.046)
It's like a, you're like a day laborer, like basically, right? Yeah.
Dr. Jen (06:33.93)
I know. Yeah. Well, and, that's the thing. I'm, I'm just like, that's, that's fine. Like I'm not like super burnout. And when I work at ERs, like I will take time with patients. I'm not going to get paid on my RVUs. I'm going to get paid on how well the patient's treated. You know, I'm just going to get hourly. Right. And it's been really fun though, since being in integrative medicine and working in the ER, I will give a little side integrative medicine consult and be like, yeah. And be like,
well, like, when did your mother go through menopause and oh, she had a hysterectomy. Okay, then that means that's probably why you're having heavy periods and ovarian cysts because you're not good at metabolizing estrogen. And let's talk about your diet and how you know, and they're just like, oh, every once in a while, like, I have a book I co authored, eat, sleep, move, breathe, and I'll bring it with me to the ER. And if they're really engaged, and I know they want to change, and they just haven't had the opportunity or they can't afford to see
you know, a cash-based integrative functional doctor, then I'll give them my book at least to help them. Because I think a lot of people, go to the doctor and they're just, I don't know, they just do what they say if it's like a pill, right? Because it takes longer to sit down and go through lifestyle changes, habit changes, finding root cause environment, all of that. And it's frustrating. And honestly, so I didn't talk about this.
with me, I was diagnosed with Hashimoto's thyroiditis in medical school and I was told there was nothing I could do. And I look back at pictures, my 17 year old daughter like looks with me and she's like, you are so inflamed. And I'm like, I know during residency, I was so fluffy and inflamed and just like, like my adrenals were stressed. I had an autoimmune disease. Oh yeah.
Sanjay Bhojraj MD (08:17.552)
The stress, the diet probably, yeah. And the stress certainly contributed to the autoimmunity probably, I would guess 100%. I mean, so getting, I just wanna jump back into that ER kind of discussion though before we move on. when patients come to physicians, I think they've been gaslit over the years to think that a pill is the only way to solve things, right? And a lot of the...
Dr. Jen (08:24.507)
yeah. It's wild.
Sanjay Bhojraj MD (08:46.87)
I mean, I guess from an ER perspective, what percentage would you say of the quote unquote acute visits that you saw were really chronic things that really should have been addressed with lifestyle. But in our conventional MDDO training, we're just never taught that. When I think of, famously we all say we got like 15 seconds of nutrition education in our medical career and that's probably a 14 second overestimate of how much I got.
But when you think about something as simple as diabetes or cancer, I don't, and of course I went to med school now what, 20, 30 years ago I guess, but longer ago than I like to remember. But is it an issue of we didn't know at the time about these chronic things that present acutely or they just didn't care and we're just so happy that we're dealing with the acute issue that nobody's really caring about what the root cause is. don't worry about the blood pressure, just drop some Clonidine in there and we'll be okay.
Dr. Jen (09:43.604)
Yeah, I think it's complicated and I don't think we can always blame doctors. We were kind of groomed in medical school to match disease with a drug and a pharmaceutical, but don't use brand names, you know, because we can't use brand names. I mean, it's kind of silly, but in the ER, I would say 90%.
90 % of the people that I would see was a result of chronic disease. And we could even talk about, or things that could be prevented, the kid coming in with an ear infection. So I'm a DO, so I learned osteopathic techniques also. So in the ER, I would show the kid or the mother how to do auricular drainage and to rub the ear to open up the ear.
So many times, so I worked night shift mainly when I was raising my little kids and it would be, you know, that two, three AM they'd come in with that earache and they'd already been doing Tylenol or Motrin and I'll do that osteopathic drainage technique and show the mother how to do that. And their ear pain would be gone, you know, so this is prevention. And then also I talked to them about maybe getting adjustments, maybe massaging the neck because if the muscle's tight, the lymphatics can't move. Maybe talking about their diet.
and how they can prevent your infection. I mean, we're just talking about a systemic lack of prevention, but if we have no one in the ER and no one in the hospitals, the insurance companies aren't gonna make money, the drug companies aren't gonna make money. So there's such a lack of prevention and the prevention that we have going on is more like screening, like mammograms and pap ser, that's screening.
Sanjay Bhojraj MD (11:12.88)
Yeah, or aggressive pharmacotherapy. Like when we talk about cardiology, they want the whole world to be on statins. And as an interventional cardiologist by training, I'm not saying statins aren't for everybody, or aren't for nobody, but they're definitely not for everybody, right? And so we have to pick and choose, but this idea of prevention, like drugs as prevention, I think I just take such issue with.
Dr. Jen (11:18.028)
gosh.
Yes.
Dr. Jen (11:37.804)
Yeah, and even look at autoimmune diseases, which represent a lot of, you know, the flares and stuff, a lot of visits to the ER. Like doctors have looked at me and said, or argued with me on social media that Hashimoto's can't be reversed. And I'm like, hi, like my antibodies are zero. And they were in like the 500s and Crohn's disease I've seen reversed, you know, RA, systemic lupus. have a patient that her rheumatologist is like,
Sanjay Bhojraj MD (11:53.403)
Yeah.
Dr. Jen (12:04.684)
You're doing so good. Like what's going on? But does he pick up the phone and call me? Like what the heck are you doing? Like how is she better? Why aren't I giving her more drugs? Why are her kidney? Why is her kidney function reversed? Like, you know, my phone, I give them my cell phone, these doctors. It's just, it's quiet. They don't call me. Yeah.
Sanjay Bhojraj MD (12:25.07)
It's crickets. I mean, I have the same thing. I just had a client in my metabolic program who suffered from chronic migraines for years. he just emailed me this morning saying he went to his neurologist and said, yeah, I haven't had a migraine for about four weeks. And so she asked him, the physician asked my patient, well, what'd you do? He told her about this metabolic lifestyle program. And she goes, that's amazing. Keep doing it. And that's it. There's no like.
what's his name? Like, and I even said, you know, if she wants, I can give myself or tell me who it is. I'll call. And there's just this weird disconnect. I feel like there's, I call it kind of this weird arrogance in medicine to think that in our conventional training, only we can be right. Even in the face of all this other success that happens through other channels. mean, like I wish I'd known about that auricular drainage for my daughters. have triplets.
listeners of the podcast know now they're in high school, but man, that would have been awesome because we had to have surgical tubes put in their ears and maybe that didn't need to happen, right? Like, and I remember like I'm a proceduralist by training, right? So we had dropped, you know, like anesthesia, sedation, all that stuff. And I had these little, little kids. were what, like maybe a year old at the time getting, you know, and we have triplets. So was just one ear infection became three and it was just a, you know, we were just underwater. And I'm like, wow, how amazing that.
You know, so a technique probably my grandmother used in India. Like if that had made its way down to me, we would have been able to avoid a surgical intervention on my kids, right? Like, like why don't we have more of that?
Dr. Jen (13:52.642)
Right.
Dr. Jen (13:57.132)
Yeah. Yeah, I think we just, it's just priming and what we see and we, know, this fantasy that a drug that something easy that we can just take will, will fix everything, but it doesn't, it doesn't. And what's disgusting is the United States is one of two countries that can advertise pharmaceuticals. Do you know, do you know what the other country is?
Sanjay Bhojraj MD (14:22.662)
Uhhh... I don't.
Dr. Jen (14:24.578)
Well, guess what? I mean, it's kind of a random one, but.
Sanjay Bhojraj MD (14:27.462)
I would say let's go India. I don't know.
Dr. Jen (14:30.85)
Okay, no, it's New Zealand is the only other one. Yeah, isn't that kind of random? But yeah, I mean, illegal, illegal for drug companies to advertise. you know, like I not like I use GLP ones appropriately in my practice I have for the last five years before the Kardashians started using them. But I mean, when you turn on the TV and they show all these people dancing and happy and I lost weight and they're, you know, they're bright colors and they're like waving around like
ribbons and you know that's what your body is like I'm gonna ask for a drug and a drug will make this easy and you know and it's ridiculous and then the side effects you know those and the like rheumatoid arthritis or the Crohn's ones make me so mad I'm just like mmm yes
Sanjay Bhojraj MD (15:17.648)
Well, because so much of it is lifestyle and particularly GLPs, mean, great medicine, there are people who need them, but it's turned into the easy button. And what people don't realize, mean, we all, at least in our space know about weight loss is a significant portion of that is muscle and bone, right? And so not healthy, but how long are you gonna be on these medications? If you're on them for life, maybe that's one thing, but when you stop, you rebound.
And how many patients I've had over the years that have had like gastric bypass or whatever it is. And there's always some side effect lurking behind. And I think we just have to be so cautious. kind of feel that the, I mean, again, I don't want to put my foil hat and stuff on, but like over the years, we've taken agency away from patients, away from people such that they don't feel that they're in control of their health anymore.
because we don't talk about lifestyle. don't talk about, in fact, I remember for a time I had a patient get really mad at me and wrote a really unfavorable Google review because I took the time to say, you know, I think as a cardiologist, I think you need to lose weight. We need to do it a healthy way. You know, let me get you with a dietician or whatever. And you know, in cardiovascular disease, I think it's pretty apparent that, you know, that lifestyle drives cardiovascular disease. It just ripped me apart on Google. And this was like,
I was six months into practice, so I was bright-eyed, bushy-tailed, and it just really stung and made me very reluctant to talk about diet and lifestyle changes because people just don't want to hear it. They want to live the life that they want to live, and they figure a doctor will just fix me, right? That's what we've got people thinking. There's a drug for that.
Dr. Jen (16:45.08)
Yeah.
Dr. Jen (16:58.104)
Mm-hmm.
Dr. Jen (17:02.082)
Yeah, I had a similar situation when I was newer resident also, and I was in the urgent care section. I'll never forget this patient, right? They were in a wheelchair. They had like all this knee pain and I just, I did all the things for them. And then like, I maybe talked for like a minute about, you know, weight loss would really help take some of the pressure.
off of your knees. And this was before integrative medicine. This was before, um, and they wrote a horrible press Ganey on me. And I was like, Oh my goodness. Like I generally like was just caring for them. And, and that kind of stung me. But then when I did my fellowship in integrative medicine, we had way too much time, but for a reason on motivational interviewing. And if I would have said to that patient, instead of like, Hey, you know, lose some weight, less pressure. I would have been like, do you want to like stand up and
Sanjay Bhojraj MD (17:44.07)
Mm.
Dr. Jen (17:52.406)
follow, you know, run after your grandchildren. Like, is that something that like, what do you want to do in 10 years? Where do you see? Yes. Yes. And, and that that would have taken more time. And, and it's a skill. It's a skill we do not learn in medical school, because if we were, if we were doing motivational interviewing and talking to patients about their lifestyle, goodness, give supplements, you know, like
Sanjay Bhojraj MD (17:58.192)
What do you value? Like reverse engineer their health based on their goals. Yeah.
Dr. Jen (18:18.446)
Allopathic medicine acts like supplements are like snake oil and that's not true either. And if we would take that time to do that, well, what would happen? They would need less hospitalization, less surgeries, less medication. So this is why like you and me, we have to break out and be the black sheep for a while to, know, and, you know, I'm sure you've have colleagues, friends that kind of, you know, have given you the snub, right? Or like been like,
Sanjay Bhojraj MD (18:46.854)
I I feel like it's turning into my therapy session, but my old hospital, my old institution. know, interventional cardiologist doing these heart valves and all these advanced procedures that normally would be an open surgery. was going through the leg and the wrist doing all these things. And when I decided that, you know, my career, the destination of my career or the path of my career was changing. And to your point, kind of, said, you know, I need to do this integrative functional kind of lifestyle stuff more.
Dr. Jen (18:47.584)
Yeah, because in we just have to keep going. Yeah.
Sanjay Bhojraj MD (19:15.942)
And so I asked them if I could do a webinar for the metabolic program I run. And their policy was anybody who's on staff at the hospital can promote themselves or whatever they want to talk about. And so I was doing a webinar a month basically for all these advanced cardiac procedures. But when I left, I said, you know, I'd love to do a podcast, a webinar on my diet lifestyle program. You know, it took them about six or eight weeks and they came back and said, you know what? I think we feel that this would be a conflict of interest.
Dr. Jen (19:27.104)
Nice.
Sanjay Bhojraj MD (19:45.776)
for us. And never more. I mean, I could have chosen to be very hurt in that moment, but I just kind of dug in my heels and it cemented exactly what I was upset about in the conventional system was in a sense. And again, I don't want to be, you know, conspiracy theory guy or whatever, but the goal of conventional medicine is to keep you just healthy enough not to feel sick, but just sick enough to never feel healthy. Right. If that makes sense. Right. So that there's always a need. And I was just like, wow.
Dr. Jen (19:46.7)
Hmm.
Dr. Jen (19:55.96)
your decision.
Dr. Jen (20:10.85)
Mm-hmm.
Sanjay Bhojraj MD (20:15.46)
Why? Why do people have to have heart attacks? Why do people have to have high blood pressure? Why do people have to become insulin resistant? And we have such lame things to tell them. This happened to my father-in-law when he went to see his doc. My father-in-law, frankly diabetic, though he will not admit it, is hemoglobin A1c is well in range. And I'm the one kind of managing his metabolic issues because the doctors, he's a little bit older and they say, you know what, no big deal. But their lifestyle recommendation was eat less, exercise more.
Dr. Jen (20:43.928)
my goodness. Are we in like the eighties, the 1980s? Like we've, we've right. We've, we've evolved. We've evolved like medicine. my goodness. So yeah, I agree with you. I think, I think it's really hard. It's funny. My husband, when I started my practice, I'm like, my goal is to help people so they don't need me anymore. And he's like, that's a horrible business strategy. And I'm like, you're right, but I don't care. But like I've, I've been blessed so much. Right. And with hormones, like
Sanjay Bhojraj MD (20:45.872)
Like, that's like the 1880s. Like, what is that? Where does that come from?
Dr. Jen (21:13.006)
patients that they feel back in homeostasis and they're doing really well and thriving, I still have to see them for hormones and hormone checks, perimenopause and menopause. So I'm not really losing them. I'm gaining happier, healthy clients or patients. But I mean, yes, it's a bad business strategy to fix the problem completely, like you were saying, and that's why it never is.
it, and it's, it's frustrating, but yeah, I mean, I, especially during the pandemic, I was just basically the black sheep and I just, I'm kind of proud of it now. Like I'm like, okay, I like to be different. And I teach my children. like, we are different. We eat different, you know, we do things differently. They're homeschooled now. Like we have a mini farm, like we're different and it's okay to not be like the normal in America right now.
Sanjay Bhojraj MD (22:02.918)
Well, I especially think that when you're forward thinking, you always feel that you're off, right? Like, you know, you're kind of ahead of the game. And I think of it like when I visited high school after having been in college, right? Like there, you you go back and you're like in it, it kind of feels familiar, but you kind of have a different perspective on things. And it just seems smaller, invariably, no matter what, you know, things seem smaller. And that's how look at conventional medicine. And that's why I think it's important, getting back to something you had said before about board certification.
and having the right practitioner do this because there's a cardiologist who I didn't realize that you had moved, sorry, so who was in Ohio. has a big social media following and he just did this post about functional medicine and how it's garbage and you can go to a weekend course and call yourself a functional medicine doc. And then I trained through Institute of Functional Medicine, which is
And there's an exam at the end of that. You did a fellowship, which is, would arguably say even more intense than what I went through. But I mean, these are not easy exams to get through. But I also think that it becomes so much more important for people like you and I that are conventionally medically trained to be in this space because we have, we're like a Swiss army knife. We have both sets of tools, the conventional one, need them and the integrative functional stuff.
Dr. Jen (23:03.18)
Yeah.
Sanjay Bhojraj MD (23:23.396)
when you can bring those in and it just brings a completely different perspective in to the patient care.
Dr. Jen (23:27.98)
Yeah, we're dangerous. We're dangerous. so, okay. I kind of want to know who that is. Number one, I think I have an idea, but we won't say the name. my goodness. Okay. How about this? I know who it is because he was in the hospitals that I worked at. Number one. And number two, how about you release the name to your listeners if they, if you get five reviews before the next or something. Yes, let's do that. No. Okay. Okay. Okay. We won't, we won't.
Sanjay Bhojraj MD (23:34.586)
He's got spiky hair. Have you seen spiky hair?
Sanjay Bhojraj MD (23:40.515)
Okay.
okay.
Sanjay Bhojraj MD (23:51.896)
like to put, I don't like to put bad juju just that people find them. But, but the point, but my point being, but my point, yeah, he's let, let, let's just say he shares a name with a very fancy yoga brand. How do we say it? Yep.
Dr. Jen (23:57.282)
People will find him. Well, can I tell you this though? It's so funny.
Dr. Jen (24:04.49)
yeah. Okay. So he almost had a heart attack. So I was speaking at a conference. We were both speaking at a local conference in Northwest Ohio. Well, everyone knows him from there. So now they'll really be able to find him. But, I was just like eating, a keto brick, you know, I was breastfeeding still, could eat tons of calories. You know, I was, working on metabolic flexibility and doing more keto and I was just eating this keto brick and he was like losing his mind and his like,
calories are calories and and I'm like no he's like people can lose weight if they just eat less and I'm like what I've worked with hundreds and hundreds of women like and men and that and I'm just like mmm This is so good So I like taunt him now and we have like a good relationship because I like to tease people and he likes to like You know like I don't know I think it's funny because like I'm just working on like actual like clinical patient data, but anyway, so
Sanjay Bhojraj MD (24:35.831)
Ugh.
Sanjay Bhojraj MD (25:01.36)
Yeah, I mean, I think that...
Dr. Jen (25:02.476)
So you got thrown under the bus with him?
Sanjay Bhojraj MD (25:05.574)
Yeah, I mean, he kind of came after and all this stuff and I'm, you know, on my social media presence, I don't bring badness anywhere and I turn into being brown to the forest. And I'm like, I'm like a dad of triplets, right? So everybody has to be equal and I have to have wisdom and things, but you know, he just goes, goes into tirades about, you know, like why supplements are useless and all that stuff. And what I don't love is when people become arrogant about stuff like that, like they, they negate that all of medical
history, like any innovation in medicine, started out as a what the heck kind of like, like, like stents, like cardiac stents, you know, as a cardiologist, there were fistfights at cardiology meetings between surgeons and cardiologists about, about the outcomes and all this stuff. And now we take it to be like, no, everybody, you know, a stent is, the most straightforward thing on earth. I mean, in recent times I used to do transcatheter aortic valve replacement, which is where rather than opening the surgical chest, I go in through the leg and deploy a surgical valve.
Patients are walking the next day and all these things. And the first time that I had heard about it about eight or nine years ago, my mind thought, wow, what an amazing thing. And this was like a debate between cardiologists and surgeons, cardiologists from Mars and surgeons from Venus, of what are those situations? And the surgeons were visibly upset and they're like, this is gonna fail, you're gonna kill patients. And now it's become standard of care. So part of the reason why I call this a career.
Dr. Jen (26:06.382)
Crazy.
Dr. Jen (26:28.13)
Mm-hmm.
Sanjay Bhojraj MD (26:30.758)
The Curious Cardiology podcast is because I think it's so important to be curious and maybe there is a better way, right? But when you become so arrogant in what you do that you just talk down and you're condescending to any other point of view, I think that you've really just demonstrated yourself as someone who cares more about themselves and cares about the patient, right? Like you're a parent, I'm a parent too. remember thinking before I had kids, my gosh, my...
Dr. Jen (26:35.448)
Mm-hmm.
Sanjay Bhojraj MD (26:57.99)
you know, when you're at Target or the grocery store and some kid has a tantrum about not getting, you know, whatever candy they want, you're like, oh my gosh, I would never have my child be that way, you know, blah, blah, blah. And then you have a kid and then you get that hubris of, all right, God, thank you. You're, you're, know, instant, not so instant karma, but karma is back and my kid's having a tantrum. And, know, and you see the, the progression of parents that are looking at you saying, I get it. You're not doing anything wrong. You see the,
Dr. Jen (27:22.967)
All
Sanjay Bhojraj MD (27:24.25)
the people who don't have kids yet and they're like, my God, I would never let that happen. Like you experience it instantly, right? And so I don't think that, yeah, I mean, I don't think we should be doing crazy wackadoodle things. Like if somebody says that the best way to manage heart disease is jumping off a bridge, I'm not saying we do that, right? But anything with a reason, yeah, let's keep a curious mind. Let's keep an open mind because if you have a closed mind, then it's a problem. in terms of, and I don't know, you probably get a lot of this in the hormone world too is,
Everybody in the conventional world talks about evidence-based and randomized control trials and this, that, and the other, and cardiology is full of that. But I can point to so many studies that were done that were designed not to fail. Number one, number two, repeat analysis, and we can even talk about Women's Health Initiative maybe, but like a repeat analysis or looking actually backwards shows that the conclusions they drew were absolutely wrong. They were just trying to advance a certain narrative that they had, or as was the case in a recent thing that came out about a medication in the cardiology
cardiology world called ticagrelor, there was actually data that was censored or whatever that they didn't use that showed that the drug didn't have the effect that it had, but they just kind of swept it under the rug to get their big push, right? So why don't we just jump into hormones? Because it's fascinating. And I know that that's kind of where a lot of your time is spent nowadays. And why is there such a resistance to bioidentical hormones? We are still...
dealing with the repercussions of women's health initiative. And for me, I feel that honestly, hormone replacement is just as important to cardiovascular protection as cholesterol therapy or cardiometabolics, right? Like, and that's my own little weird cardiology world, but let's just kind of launch into kind of that part of your practice now.
Dr. Jen (29:09.774)
Yeah. And the reason, gosh, why I wrote the book, the pair of menopause reset is I, those were my patients that were coming to me. They were gaslit at their doctors. They were in perimenopause, which could be age 35 to 55, where you have declining progesterone, pretty erratic estradiol levels. And they're given, what are they given? An antidepressant and birth control. And here's the thing. Okay.
Sanjay Bhojraj MD (29:25.179)
Yeah.
Sanjay Bhojraj MD (29:36.806)
I mean SSRI for hormone imbalance like
Dr. Jen (29:40.738)
But they, so will they come, so perimenopause, the symptoms that you can have can be anxiety, depression, worsening cycles, shortening cycles, heavier cycles, weight gain, brain fog, hair falling out, like all these different erratic symptoms, but a lot of women, they just, they feel off. They are forgetful. They're more low mood. They're anxious. Anxiety is big. They're not sleeping well. So the doctor has,
no answers or they don't have a big toolbox, right? Their toolbox is medications. So that's what they give them and they gaslight them or they say so many times to mothers, you're tired just because you're a mother. No, you're tired because your hormones are jacked up, your thyroid's low, your insulin resistant. That's why you're tired. anyway, so perimenopause, what I've noticed is that these women, they are just not getting any attention because
Sanjay Bhojraj MD (30:22.534)
Mm-hmm.
Dr. Jen (30:38.55)
Menopause, like some doctors will know to just at least put them on an estradiol patch, right? But perimenopause, like doctors don't know what to do with these women. And I've noticed that women in general, they're just more vulnerable, right? They're vulnerable, more vulnerable to stress. There's a lot of divorces. There's a lot of women that are just seeking things like outside of themselves to like get peace and they're spiritually attacked. And it's just this really just...
precious time in our lives where we could make it really wonderful or it can be really, really hard. And there's a lot of transitions to like parents are getting older, kids are getting older, you know, and there's just a lot on your plate. So when we look at bioidentical hormones, that's what they are, they're bioidentical hormones. So estradiol is made in a lab to be estradiol, okay? And progesterone is progesterone.
Sanjay Bhojraj MD (31:15.611)
Mm-hmm.
Sanjay Bhojraj MD (31:34.918)
So, before we go, let's talk about women's health, for instance, because they did not use bioidentical hormones, right? That was part of the problem. were using, sorry, what did say? But yeah, so what did they use and why did they use? Like progestins and all these other things.
Dr. Jen (31:35.02)
What? Yeah.
Dr. Jen (31:41.58)
Right, and the Women's Health Initiative. Yes. Yeah.
Dr. Jen (31:50.572)
Yeah. Yeah. So they use progestins and they used conjugated equine estrogen, CEEs, which equine, yes, horse urine. Yes. Like that's awesome. And I thought, you know, during COVID, you know, we're not supposed to take medications that horses take. So, but whatever. I mean, the FDA does what they want when it's, when they make money. So anyway, so those women's health initiative used synthetic hormones. So
Sanjay Bhojraj MD (31:59.728)
horses.
Sanjay Bhojraj MD (32:10.15)
Yeah.
Dr. Jen (32:19.522)
They don't act like real hormones. would be like, you know, when you're like, you're trying to open a door with a key, but, it fits in the lock, but it doesn't actually like turn the lock. Yeah, the key's in there and you're like, but it won't unlock it. won't turn it. So that's like synthetic hormones.
Sanjay Bhojraj MD (32:30.222)
The key, yeah, yeah.
Sanjay Bhojraj MD (32:37.282)
Or for me, it's like coffee, right? Like there's sleep and then coffee would be like synthetic sleep, right? A lot of people call it a wake juice or whatever it may be, but it's not the same. You don't get the same restorative powers, actual sleep from two cups of coffee, right? So, yeah.
Dr. Jen (32:46.083)
Mm-hmm.
Dr. Jen (32:51.296)
Yeah. Well, and like the scary thing is especially like, so progesterone balances estradiol. Like estradiol is, is great. It's cardio protective. It's brain great for brain health. It's bone protective, helps with saggy skin, all the things, right? We need our estradiol, but synthetic estrogens, they clog up your liver and they were given oral synthetic estrogens, which
that has to break down through the liver and you get toxic metabolites if you're taking oral estrogen. So lots of issues with that. And then like look at progesterone. So progesterone, which our body makes during the luteal phase, the second half of our cycle, that is going to increase nitric oxide and dilate the blood vessels and good for endothelial health. Progestins, which are synthetic, like shut it down. And some can have androgen like effects, which are going to increase blood pressure. So I mean,
like for you as a cardiologist, like having someone on synthetic hormones is like a nightmare, right? mean, they're increased risk for a lot of vascular problems.
Sanjay Bhojraj MD (33:53.094)
Well, mean, increased risk for everything. And honestly, I mean, in the conventional world, we never even thought about this, right? And I kind of now feel, you're a victim of your learning, right? And so I can't go back in time, but I often think of how many women in their 30s, we'd see that LDL bump, you know what I'm talking about, where it goes from really, really good to not quite so good, but it's still below threshold for treatment. That's really, to me, an indicator of, hey, you know what, perimenopause is knocking at the door.
Let me, even if I like now I'm a little bit more conversant with it. I'm not to say I'm a hormone expert, but at least I know now, but that's the time I think to really start having the hormone replacement conversation, not necessarily about improving symptoms, but to your point of what you said, bone health, cardiovascular health, mood, all these things are affected. And we have a very natural thing on our annual labs that is like the check engine light to me for hormone replacement.
Dr. Jen (34:51.116)
Yeah. And that's the crazy thing is so many women will go to their doctors and ask for even demand hormone testing and they just won't do it. They say it doesn't matter. It fluctuates too much. So, so we, I, I check women's hormones if they're still cycling on day 19 to 21 of their cycle. If we're just looking for generalized hormone health, like where's their progesterone act is usually that's the problem. Usually progesterone is tanked and estradiol is elevated or we're not detoxifying estrogen. Well, we're like estrogen dominant. Yeah. And the balance is off and we're
Sanjay Bhojraj MD (35:17.99)
So that balance is off.
Dr. Jen (35:21.08)
feeling it more that luteal phase. during perimenopause, a little bit of luteal phase progesterone, bioidentical progesterone is lovely. And most of the time in perimenopause, we'll give it oral. And because of how it breaks down, it gives like better sleep, activates the GABA receptors, it's fabulous. So that second half that luteal phase now, estradiol, because of what it does during perimenopause, it
it will sometimes like go really high, like super therapeutic levels because the body is like, did, well, it's because like the follicles aren't as high quality. So it's like, did you give one or not? So then we'll get a second surge of FSH follicle stimulating hormone and more estradiol. So that is kind of up and down roller coaster. So I am very cautious. My mentor, Dr. Pam Smith, like the goat of hormone therapy.
Sanjay Bhojraj MD (35:55.462)
It's resistant.
Sanjay Bhojraj MD (36:14.16)
think I've got some of her books here somewhere. Yeah.
Dr. Jen (36:16.142)
yes. Yeah. She's like the she wrote the forward in my my new book. So she's she's fabulous. So she like I I've learned from her. And I just I'm very cautious. So I don't do estradiol during perimenopause. We wait until menopause to replace estradiol unless it's a really specific situation. But what can happen to women during that perimenopause is their face skin starts to get saggy, they
Sanjay Bhojraj MD (36:20.047)
cool.
Dr. Jen (36:43.65)
their vaginal health is not as good, right? So we can do a topical esteril, that is an option. But I will say, yes, yeah.
Sanjay Bhojraj MD (36:52.646)
for like frequent urinary infections and painful sexual intercourse and things like that, yeah.
Dr. Jen (36:57.646)
Yeah, but I will say a lot of people don't know this even, a nurse practitioner in the urgent care one time didn't know that if you gave a diabetic steroids, steroid cream for a rash that it would affect their blood glucose. And I'm like, yeah, that was a good learning, you know, at the patient's expense. But so you have to be careful. So when you put stuff on topically, it is absorbed. So you still want to check levels there. This is
Sanjay Bhojraj MD (37:08.614)
shoot up there. Yeah.
Dr. Jen (37:23.242)
Another reason why you need to look at credentials of who is giving medical advice or any information you're getting on the internet. I say, if you can't see their credentials in three seconds of visiting their website, their YouTube, their Instagram, their TikTok, then they're probably not who they say they are. And that's when we're using doctor and giving medical information during that. And it's not medical advice, but it's medical information. So there's that. Yeah.
Sanjay Bhojraj MD (37:48.07)
which people take as advice though, right? mean, I think it's a stupidly artificial line, right? To say, your cholesterol is 120, I'm just giving you information, do XYZ, and then someone's cholesterol is 120 and they do it, like it's advice.
Dr. Jen (37:51.948)
That's a problem too.
Dr. Jen (38:03.03)
Yeah. Well, so then it was interesting. So I had a patient and we were checking her saliva hormones and I had her on some testosterone and progesterone, you know, low and slow, not super therapeutic. Pellets are really dangerous too. Not a fan of pellets. So, so she listened to a podcast and this health coach just was like, yeah, put estradiol and Estriol all over your body for saggy skin.
Sanjay Bhojraj MD (38:18.349)
Mm, I agree.
Dr. Jen (38:32.85)
And she was using like, cause they said use as much as you want. And I have patients do like a pea size amount of Estrel. Like, so I get back her lab results and I'm like, what, what is going on? I'm like, even if you have like an estradiol spike, like it would not be this high. And then she admitted she was using this cream all over your body and her estradiol was so high and her progesterone was normal, right? But it's like not covering. I'm like,
I can't guarantee that you didn't create like cancer cells somewhere in your body, you know, from like, from estrogen breaking down, like not fast enough, not well enough from, you know, breast cells replicating because we didn't have the checks and balance that's put in place that we're all given, you know, that progesterone. And it was, it was very like humbling and scary because, you know, everyone is just looking for medical advice wherever they can get it because they go to their conventional doctors.
and they get gas lit. but that is like this, I mean, this cream, it had like one milligram of estradiol per pump. And that's like, yes, I don't even have most postmenopausal like women on this. And literally still that podcast is still out there. Like people are doing this. So you really have to be careful.
Sanjay Bhojraj MD (39:40.241)
so much
Sanjay Bhojraj MD (39:54.682)
And we think of it too because on the detox side, if that person has detox snips, it is not detoxifying the estrogen correctly or they're stuck in phase one and not getting into phase two. Toxic, I mean, this is the blessing and the curse of being a physician as you know too much. And so when I hear a milligram per pump, is that what you said?
Dr. Jen (40:04.174)
Yeah.
Dr. Jen (40:14.88)
Yeah, one milligram of estradiol per pump and I think like more some Estrel too. No, it's sold over the counter on online. I'll send you the link. if I can find it. It's like, it's crazy. But you know what, like,
Sanjay Bhojraj MD (40:18.106)
I mean, I'm surprised there's even a compounding pharmacy that would make it in that like.
How is that an over-the-counter supplement? Are like... no.
Dr. Jen (40:33.524)
I, we, we fixed it. she's doing great. I actually use the slides, like when I lecture as like a teaching point, like you've got to, like, we have to educate, we have to educate, right. because, you know, it's, it's, it's a dangerous thing. You know, hormones can be done improperly and you know, you, when I mentioned pellets, you were like, yeah, no. So this is another big thing is, med spas, you know, ran by.
Sanjay Bhojraj MD (40:56.196)
Yeah, I.
Sanjay Bhojraj MD (41:00.164)
Yeah.
Dr. Jen (41:01.728)
I don't know, like a lot of them are just ran by nurses and they are just like putting pellets in everyone. And I will tell you, testosterone is a controlled drug. Testosterone will make you feel really good for a couple months. And then you develop tolerance and you crash because it's super therapeutic and women are not supposed to have high, high testosterone without estradiol being a good level because it can harden our arteries. Right. I mean,
Sanjay Bhojraj MD (41:04.666)
Yeah.
Sanjay Bhojraj MD (41:25.444)
I mean, I, yeah. well, mean, completely too much. mean, so I think that becomes important about your practitioner and where you're getting these things done, because really an important part of this is checking levels afterwards. Like I, like here in Orange County, there is a clinic and the reason I made the sour face about pellets is I always think of this older woman. She must've been in her late seventies, early eighties, went to this place, had all the complaints, you know, this, that, and the other. And it was like a pellet factory, not like unbeknownst to her. So they just.
Dr. Jen (41:38.893)
Mm-hmm.
Sanjay Bhojraj MD (41:55.276)
shot her with all these pellets and she came to me and she's like, I'm jittery. can't sleep. my gosh. I can't do all these things. And, and I'm like, well, what's changed since your last visit? And she told me about this and they weren't going to check levels on her for another like six months. And yeah. And, and, know, in these pellets, you can't take them out once they're in, like if you're on a stay, I guess the use case would be if you're in a stable dose and we know the absorption.
Dr. Jen (42:09.801)
What?
Sanjay Bhojraj MD (42:21.542)
you know, I could see maybe why there would be a use case for a pellet in that situation. But as upfront therapy, I mean, I've had so many Orange County, like, you know, men's clinics, they're like, Oh, come on, we'll shoot you up full of pellets. And, you know, your muscle mass would be great. You won't be chubby anymore. And all these things. And I'm like, yeah, no, because it does. It can like when you're shooting overshooting, you can do so many bad things. Like, like I had a guy who came to me his hemoglobin, which is a measure of your red blood cells, right? Was like 28. And I was like, dude, like
That's double normal. And here I'm thinking he may have like a blood cancer or P vera or something like that. And I'm like, and then he finally kind of told me, no, I've been, there's a guy at my gym that I've been shooting, you know, whatever, some sort of testosterone analog from. And I was like, dude, number one, a guy in the gym, like, come on, let's be serious. Right. But number two, like there are serious health consequences for people from doing this the wrong way. And you know, as, as MDs and DOS, we are
regulated so closely, but a lot of these med spas, they don't have somebody in house or they don't even care about doing the follow-up testing because all they want to do is get the pellet in you and charge you for that. It's such an industry. We just need more common sense, I think, in this world.
Dr. Jen (43:28.322)
Yeah.
Dr. Jen (43:32.65)
Yeah, and it's really hard and it gives the people that are doing it the right way a bad name. And this is why, you know, spiky hair guy is trash talking it because there are people doing it wrong. And yeah, and I think it goes back to like your name, the curious cardiologist, like I'm curious to like, I will jump on just like whatever learning pops up, you know, in my emails, because I'm like, I can always learn more. Yes, I'm an expert, but experts
Sanjay Bhojraj MD (43:44.326)
100%.
Dr. Jen (43:59.296)
always need to learn more. I will never know everything. Only God knows everything. And some of these people, think they do, they think they took a weekend course in hormone pellets and hormones, and they're an expert. And here I am, you know, over a decade later, being an integrative medicine, still doing continual learning, still learning. It was scary though, I just popped on like one of these webinars, and they had like a med spa person with a really big social media following leading
the course and she, but she has no training, you know, outside just normal nurse practitioner school or no, she's a PA outside a normal PA school. And she literally was saying to only like, you don't have to test hormones. You just have to go on symptoms. And I was like, I like wrote the company and I'm like, this is not who you should be having teaching like your course. Like this is dangerous. If someone heard that and applied that to practice, that would be very, very dangerous. And they would have
very bad outcomes. so it's, you know, while functional and integrative medicine is good, it's, it's the same as if you go pick a surgeon, you know, to do an operation or something, you, you have to do your due diligence, check them out, make sure they're legit, make sure it's just not a sales pitch, you know, make sure they're actually still learning, make sure they have some credibility to their name.
Sanjay Bhojraj MD (45:22.246)
I mean, I almost wonder, like, if you could ask, you know, your surgeon, how do you sleep the night before you do surgery on me, right? Like, my patients would always ask, did you get a good night of sleep last night, doc? And I would say no, because I was worried about all the things that could go wrong today, right? And that's like, and then, you know, yeah, I told them myself, but I have tortured sleep, but I'd be like, you know, I just, always want to make sure that I run through all the scenarios in my brain before it happens.
Dr. Jen (45:30.659)
Right.
Dr. Jen (45:34.35)
Aww.
Dr. Jen (45:41.506)
Did you say that to them?
Sanjay Bhojraj MD (45:50.298)
And in a sense, you know, that's an OCD trait, right? But that's what I think makes you a better doctor is that you care about the, you care almost more about not screwing up than having a success, if that makes sense, right? Like, I don't want to, you first do no harm. That's prima dono, right? That's one of our fundamental things as physicians. And when you get these people that are talking about boosting sales and I, for a brief moment in time had a medical aesthetics kind of a spa that I was,
working with and I got out of that, but it was just such a different world. I remember going to one of the meetings and they were talking about how Botox and fillers are no longer making the margins that they used to. So we have to get into hormones. have to get into, that point, GLP ones were kind of new. And they're talking about all these compounding pharmacies and all these shortcuts they were taking. they're like, you can get the real stuff from the pharmacy and it's more expensive. So we just have a compound or that this, that, the other. Not that there's anything wrong with compounding pharmacies. They're good ones.
Dr. Jen (46:35.66)
Yeah, I've seen that.
Sanjay Bhojraj MD (46:48.1)
as there are bad ones, just like there's good physicians and bad physicians and good bus drivers. There's a spectrum of all of them, but just the fact that they were, to your point, like that PA, so evangelical about how they cut corners for profits, I just felt like, man, that is just not the right motivation. You really need to be caring about the patients that you're dealing with or their clients or whatever you call them and be so obsessed with them having a good job or having them have a good outcome that...
Dr. Jen (47:02.572)
Yeah.
Sanjay Bhojraj MD (47:16.56)
you know, success will just kind of flow from that, not, you know what, I need to keep the lights on, so this month I have to sell 30 more GLP-1 prescriptions than I did last month. I mean, those motivations never work out well for the business owner or for the patient, right? Like, I just...
Dr. Jen (47:30.03)
Yeah, I back in Ohio, my brick and mortar, I had natural aesthetics attached to it because I, I wanted something natural for my patients, you know, as they're aging, like micro needling and stuff like that. And we brought in like Xeomin, which is a more natural Botox, which I never used. use frownies. I don't know if you've ever heard of frownies, but you plaster these papers.
Sanjay Bhojraj MD (47:43.142)
Mm-hmm.
Sanjay Bhojraj MD (47:52.902)
My face regime regimen is soap, so I don't have anything.
Dr. Jen (47:56.75)
Yeah. Well, you're a guy, so that's a little different, but, but yeah, I mean, we would go to these aesthetic conferences and you're right. I really saw a big push towards the GLP ones, but they're not doing them correctly. And it was crazy. One of my friend's mother in Florida, she went to one of these med spas for GLP one and they told her you're going to be on this the rest of your life or you're going to gain weight. And they didn't tell her about like how to preserve muscle and stuff like
I, my patients have to go through a regimen before I even consider a GLP-1 and then they have to be on specific supplements to maintain muscle, working out, and then they're only on them for a couple of months and then we take a break and see how they do. I mean, I am very, very particular with it. And it's interesting because I know my patients can get it online from one of these, like they're probably just made in China. They're probably not a real compounding pharmacy.
Sanjay Bhojraj MD (48:45.712)
Mm-hmm.
Sanjay Bhojraj MD (48:49.134)
of these pronoun companies that are out there.
Dr. Jen (48:52.5)
Yeah, yeah, it's crazy. And I know they can do that. But I also they know that that is a shortcut. But have you seen the GLP one now they there's a company with a little elephant I think it is I don't know and and they have influencers selling their GLP ones.
Sanjay Bhojraj MD (49:11.238)
I mean, it's unsurprising. mean, I don't know. Well, to your point about advertising drugs, right? Only being many medications only here in New Zealand. I mean, I think that these mega pharmacies wield too much power and they've somehow made it okay. Kind of similar. I mean, look, I'm going to sit here and talk about the decay of society, but like online gaming. I don't know why we have to have online gaming, why that exists everywhere. Like, you know, like all these, like...
Dr. Jen (49:13.068)
Is that it? Should that even be legal? Like I just
Dr. Jen (49:19.106)
Yeah.
Dr. Jen (49:37.516)
Mmm. That's weird.
Sanjay Bhojraj MD (49:40.934)
All these things in society are kind of falling apart. But like, how did that get legal? You know, why is it legal to, like I have a friend who, you know, she got, she's a physician got, I don't know, left her practice or, or was let go from her practice because of downsizing or whatever. was a big corporate practice. And so she just needed to make ends meet. So she was prescribing for one of these online pharmacies. And she told me that their quota was 22.
prescriptions per hour. Yeah. No, per hour. So she had to look at the medical information that presented on the screen to her and based on that, had to give a thumbs up or thumbs down the prescription. That's the doctor review, the physician review for, and this is one of the big ones. And I said, well, how often did he say no? And she said, well, almost never because they didn't want you to say no.
Dr. Jen (50:11.564)
What? I thought you were going to say per day or something and I was like, what?
Dr. Jen (50:37.356)
Because, right.
Sanjay Bhojraj MD (50:39.51)
It's a just say yes. And I don't know why, how that can be legal, right? And okay, like it just, doesn't make, it never made sense to me, but.
Dr. Jen (50:49.496)
Well, I'm gonna sign up for that and get me some good drugs. They're just approving everything. Like, let's go.
Sanjay Bhojraj MD (50:52.358)
I mean, what's the point of even going to medical school anymore, right? But let's talk a little bit about your book. I see it in the background. Yeah, let's talk a bit about your book. So, the perimenopause reset. And you mentioned a couple of things because I think when most people think reset, they think of diet, right? But you mentioned spirituality and emotions and all of these things. And I think of that holistically. Like I run my program, called Well 12, and it's based on 12 pillars of wellness.
Dr. Jen (51:00.494)
Let's not talk about that yet. Yes, yes, yes.
Dr. Jen (51:15.223)
Yeah.
Sanjay Bhojraj MD (51:21.414)
Health is just one of them, but mental, emotional, spiritual connection, community, all these things become important. So as we look at the pause of menopause, the ideas that we can take some time to rethink our lives and rethink of ourselves, what are all the components involved in this reset that you talk about?
Dr. Jen (51:25.356)
Yeah.
Dr. Jen (51:38.966)
Yeah, so body, environment, and then spiritual. And we go through in each of the parts, like how to cleanse, how to cultivate, how to clean it up, like just going through everything. And it's kind of just a beginner's guide to a lot of holistic things, but things, know, everything from the pan you cook in to...
you know, if you have perfume that you wear, that can affect your hormones and that can make perimenopause symptoms worse. And we talk about estrogen detoxification and I have patient stories in there and it's really about understanding what you're going through because I think like when you go to the doctor, they just tell you to do something. And if it's something with a habit behind it, if you don't know why you're doing it, it's not going to stick.
So I go through all of that. It's a pretty long book, but it's not a terrible read. It's entertaining, I promise. And you'll really get to a decent amount of diagrams and stuff. But you'll really get to know like me. There is a 28 day devotional in there where I share a lot of stories from my life, what I've been through, what patients have been through during the perimenopause. And then there's also a download with just like a full 28 day like guide with
Sanjay Bhojraj MD (52:36.464)
A lot of pictures, a lot of pictures.
Alright.
Dr. Jen (52:58.988)
workout, meal ideas, all the things. So it's really a complete package for the perimenopausal women. And I'm just really excited about it. It's been like a labor of love and there's been a lot of just hiccups along the way to get it out. So I think it's going to help a lot of women. So my goal is to reach 500,000 women because there's 8 million women in perimenopause in the United States. So that's a lot of women that are struggling.
Sanjay Bhojraj MD (53:24.166)
Yeah. And someone else told me, but there's only like 700 menopause practitioners in the United States or something, like just an amazingly disparate number of clinicians per client. Like it's unbelievable to me.
Dr. Jen (53:40.27)
Mm-hmm.
Yeah. And really it's interesting because I thought that I just wanted to kind of niche down to thyroid or something like that or something easier. And no, like the Lord was like, you're going to be pairing menopause, but, but honestly it's, it's the women that like hundreds and hundreds of women coming to my office, paying cash to see me, you know, really invested in their health that they were in that 35 to 50 age range. That is where women need help. And
This book, I feel like it could get so many women just better just by doing this. And sometimes they'll need a prescription. But I mean, we even go into detail on like how mold can affect your hormones during perimenopause. I have someone I'm working with right now and I thought she would be easy. I thought it would just be, insulin resistance. We'll just fix that and she'll be better. No, she came to me and she already was on progesterone. She was already on like some things.
And I'm like, and the reason why she's not losing weight or detoxifying well and her hormones are out of balance is because of mold exposure. So it's very interesting. And I guess if anyone's listening out there, no matter what health struggles you're going through. yeah, hello. Is anyone listening?
Sanjay Bhojraj MD (54:56.774)
Hopefully some people are listening.
Hello to all my thousands of followers who are listening.
Dr. Jen (55:03.576)
For the five of you that are listening, no, just kidding. No, if you have any health struggles, like just make sure you keep like just digging, digging, digging for that root cause. Just peel off the layers and you will get there. You will do it.
Sanjay Bhojraj MD (55:18.534)
Yeah, I think that's so important and in my experience and tell me Dr. Jen and yours, feel that 80 to 90 % of the people who present to me with XYZ complaint, whatever it may be, 80 to 90 % of them just get better with lifestyle interventions. And then it's left for me to take those remaining 10 or 20 % of people and then put my thinking hat on, do the diagnostics, whether it be mold or chronic.
you know, lime or, or, you know, whatever it may be, some sort of other exposure that they don't realize, you know, kind of that, then, then we have to put our thinking hats on, but it's amazing how much better so many people can feel with just eating the right foods. I like that you talk about detoxification. In fact, I have a lecture in my series, in, the program I run called, does this frying pan make my butt look fat? Right. Because people don't realize that these endocrine disruptors are obesogens and
Dr. Jen (56:08.982)
hilarious.
Sanjay Bhojraj MD (56:13.626)
They affect our hormones and they get taken up in adipose tissue. And so we can't detoxify them correctly and all sorts of different things. So many different environmental exposures affect us. And I just don't think that in the conventional world, we think about that. All right, well, if people want to find you, we'll put links in the show notes or certainly to the book and everything. But someone wants to work with you. You're in Tennessee now, you mentioned.
Dr. Jen (56:29.612)
Mm-mm.
Sanjay Bhojraj MD (56:41.318)
So how do they work with you? How do they reach out? Like I said, we'll put some links in there, but what's the best way for them to find you?
Dr. Jen (56:48.384)
Yeah, so you can go to Dr. Dr. book, Dr. Jen book, and that has all the information about my book and how to work with me, all those things. And then I hang out on Instagram mainly at integrative Dr. Mom. So yeah.
Sanjay Bhojraj MD (57:03.278)
All right, so we'll put all the links. So thank you so much for being here. Before you go though, I've always got three questions I ask our guests. So number one, where is your favorite place on earth? What is the, if you vacation there, you live there, just one place where if you never left, you'd be so happy for the rest of your life.
Dr. Jen (57:06.754)
Thank you.
Okay.
Dr. Jen (57:21.996)
I mean, I would honestly say at my home right now on our mini farm, just like with my kids, just like watching them be outside and at home.
Sanjay Bhojraj MD (57:31.974)
Awesome. I love it. So, Mini Farm, how mini?
Dr. Jen (57:35.7)
just under 10 acres, so we're s-
Sanjay Bhojraj MD (57:38.022)
You're talking to a Southern California guy. I've got like a postage stamp from my backyard So I love that just under 10 acres is a mini farm. What do you grow on the farm or do you have animals or?
Dr. Jen (57:42.337)
Right.
Dr. Jen (57:45.736)
so yeah, I have a black thumb. so maybe next year we'll do a garden, but we have a lot of deer. There was actually some deer walking around while we were recording, but we have some Guinea fowl, two turkeys, a bunch of hens, one rooster, which wasn't supposed to be a rooster. So I don't know what we're going to do with that situation. Cause my, my one son said, if we have a rooster and the eggs are fertilized is not eating any of them. So, but we have about like 40 chickens.
Sanjay Bhojraj MD (58:05.689)
All right.
Sanjay Bhojraj MD (58:11.6)
So does the rooster identify as a chicken? Maybe, who knows?
Dr. Jen (58:15.528)
No, because he he crow or he, you know, cockadoodle dude. And I was trying to like refuse it. I was like, I did not hear that. I did not hear that. I was so mad. Well, because you get Pulitz and Pulitz are just supposed to be girl chicks. And every once in a while, though, I mean, they'll get sex strong and he's pretty, too. He has a little poof on his head. So we'll see. That's that's some drama. So but. Yeah, yeah, that's true.
Sanjay Bhojraj MD (58:25.606)
Where did he come from? Yeah.
Sanjay Bhojraj MD (58:37.04)
Alright.
And you have a built-in alarm clock.
Dr. Jen (58:44.876)
He's so little though, who knows how loud he'll be, but yeah, it's fun.
Sanjay Bhojraj MD (58:47.94)
Well, louder than you'd like them. All right, number two is what's your favorite food? I guess maybe not chicken, but what's your favorite thing you need? Healthy or unhealthy, I'm a Chicago guy, so I go deep dish pizza all day long, but what's yours?
Dr. Jen (59:00.408)
I would say a nice ribeye with some like butter on
Sanjay Bhojraj MD (59:04.93)
It is amazing to me how many of the people I talk to just go straight to stake. Probably I'd say 80 % of my guests so far go to stake, which is awesome. It's just so good. And number three, what keeps you curious? What do you like to read about outside of medicine? What do you love? What lights your fire?
Dr. Jen (59:18.615)
Hmm.
Dr. Jen (59:22.21)
Yeah, so outside of medicine, which we both nerd out on a lot, theology. So I've gotten really interested in theology. So we moved from Northwest Ohio, went to a non-denominational church, and then we ended up at a Southern Baptist church. And I'm just really digging the theology right now. It appeals to that scientific, nerdy brain of mine. So yeah, that's what I've been doing lately.
Sanjay Bhojraj MD (59:28.249)
Okay.
Sanjay Bhojraj MD (59:47.75)
Love it. Absolutely love it. Well, Dr. Jen, thank you so much for being here. We will put the links to your book and all the wonderful work that you do. You mentioned something about a 28-day reset as well, right, or a 28-day program that you have. So...
Dr. Jen (59:51.95)
Thank you.
Dr. Jen (01:00:00.458)
Yeah, so that that is free when you buy the book so you can download that.
Sanjay Bhojraj MD (01:00:04.174)
So to my five listeners out there, hopefully, my mom is probably four of them, but download the book, get it wherever you can get it. We'll put the link there and try the reset. It is amazing how quickly you can see change with the proper diet and lifestyle intervention. So thank you so much for being here and to the listeners, the listener, maybe listeners, hopefully more than one. Thank you for being here as well on the Curious Cardiologist podcast.
Dr. Jen (01:00:11.219)
hi mom.
Dr. Jen (01:00:25.262)
Thank you.
Sanjay Bhojraj MD (01:00:32.928)
If you like what you heard today, then please like and subscribe to the podcast. If you connect with something we said or you say, Sajay, you're full of it, you don't know what you're talking about, leave a comment down below somewhere. I always, always, always get back to the comments. I love engaging and interacting with you guys. So leave a comment, let me know that at least one of the five people out there listen to the whole thing. And I will catch you next time on the Curious Cardiologist podcast. Bye everybody.
Alright, well-