Speaking of Women's Health
The Speaking of Women's Health Podcast is excited to bring you credible women's health information from host and Executive Director, Dr. Holly L. Thacker. Dr. Thacker will interview guest clinicians discussing relevant women's health topics and the latest news and tips.
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Speaking of Women's Health
How Hormonal Health Significantly Impacts A Women’s Well-Being
Dr. Holly Thacker dives deep into the world of endocrinology and anti-aging with guest Dr. Elena Christofides. Dr. Christofides highlights how hormonal health significantly impacts women’s well-being as they age.
The discussion covers common health challenges women face, potential treatments, and the importance of personalized assessments to optimize health through lifestyle and pharmacological means.
• Explanation of endocrinology and its roles in overall health
• Common health concerns for midlife women
• Importance of understanding aging vs. hormonal imbalance
• Overview of Metformin and emerging treatments like rapamycin
• The significance of mitochondrial health
• Connection between environmental factors and health optimization
• Empowerment through health advocacy and informed choices
For more information on Dr. Elena Christofides, visit endocrinology-associates.com. You can listen to Dr. Christofides podcast on medcentral.com.
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Welcome to the Speaking of Women's Health podcast.
Speaker 1:I'm your host, dr Holly Thacker, and I'm back in the Sunflower House and I am so excited to be on a new podcast episode with endocrinologist and anti-aging specialist, dr Elena Christofides.
Speaker 1:She is the founder of Endocrinology Associates in Columbus, ohio, and she is a leading medical researcher on metabolism, diabetes and related medical processes. She earned her undergraduate and her medical degrees at the Ohio State University and she then went on to complete an internal medicine residency at Mount Carmel Medical Center and then she finished a fellowship in endocrinology, diabetes and metabolism at Louisiana State University Medical Center. And she is a physician with a rare distinction of holding two active board certifications, both in endocrinology and also in internal medicine. She actively teaches and lectures and she helps train new physicians and clinicians and technicians regularly in research and she's a guest speaker for many conferences and symposias and she has a podcast. She also provides, importantly, her patients with expert care on a wide range of endocrinology issues plaguing common concerns, including obesity, metabolism, fatigue, hormone irregularities, pituitary and also adrenal disorders. Welcome, dr Christofides, we're so excited to have you as a guest on the Speaking of Women's Health podcast.
Speaker 2:Thank you. Thank you so much, Dr Thacker. It is such an honor to get to speak to your listeners and your subscribers. I know that you have a huge following and a loyal following and after you and I had a chance to connect and talk offline, I can understand why and I can appreciate very much the expertise that you provide your patients and your listeners. So I'm super excited to be here to hopefully add a little more flavor to what your interest and what your listeners' interests are.
Speaker 1:Well, this whole field of anti-aging and hormones and graceful aging, and separating out what's really correct and true versus what's a lot of hype, all these you know hacks, and we've been teasing this podcast for such a long time. We're so happy to have you here. Do you want to first just tell us a little bit about endocrinology?
Speaker 2:Sure, yeah, I love talking about endocrinology. I'm sure you figured that out when we met in person. You know I describe endocrinology as the spider web of your body's functions, because you can't really tweak one part of the spider web without feeling it across the entire spider web. So it's that integrated, it's that closely tied in all the different bodily functions and systems. All of your bodily systems are connected that way.
Speaker 2:So your hormones are the chemical messengers that regulate all your bodily functions, such as metabolism, growth, development, mood, reproduction, even immune system function, and endocrinologists monitor these to understand what's happening with your individual physiology, your things that are going wrong, monitoring the glands involved in endocrinology, making sure they're doing what they're supposed to be doing, things like your thyroid, your pancreas, your adrenal, your pituitary and, of course, your reproductive glands, like your ovaries or your testicles. So endocrinologists specialize in diagnosing and treating hormone imbalances and disorders, and some of these disorders are common knowledge. A lot of people understand what these are, like diabetes and thyroid. A lot of people, though, are less familiar with some of the other things that we do, like infertility and weight management, blood pressure, cholesterol, nutritional issues like vitamins, and are you getting enough vitamins and are you able to metabolize the vitamins that you're taking. Those are the things that we do in endocrinology, wow that's pretty expansive.
Speaker 1:What are some of the more common reasons that women come in to see you, especially midlife women?
Speaker 2:Yeah, this, honestly, is some of my favorite groups of people to help, because I feel like I wish we really did get a manual for our bodies when we go into puberty, because once we hit puberty, sort of all bets are off and obviously as we age things happen and are breaking down and are falling apart in ways that we don't really always understand. So the most common reason that women actually of all ages come to see me are the ones that I think probably plague all of us at some point in time in our lives Basically feeling more tired than we should or feeling like we're more tired despite getting good rest. Of course we have weight gain, weight gain without really doing anything or even though we're going to the gym or eating healthy. Most of the time I get a pretty common complaint of people just feel off, not themselves.
Speaker 2:Women just will describe for me that they're developing sexual dysfunction. They feel like their nutrition is off, their sleep balance is off and that just leads them to this sort of state of feeling like they're stuck and they don't really know how to move forward, because they sort of figured out how to handle their bodies, their physiology, when they were young and more vital, but now we hit our 40s and our 50s and then even older. You know we don't understand what's happening. We don't seem to understand what's happening, and the things that we used to do to control our physiology, control our weight, control our sleep, control our sexual function don't work anymore. Control our weight, control our sleep, control our sexual function don't work anymore, and so the normal habits that we have stop working, and that's usually when people come to see me is the things they know to do are no longer working and they need new guidance.
Speaker 1:Well, I have to endorse. I hear all of those things and sometimes I wonder how realistic people are. I mean, I see women in their 50s and I think that they're expecting and I know I do the same thing myself that you're expecting to just have that same energy. I used to be able to work and then come home and spend all this time with my kids and then put them to bed and then burn the midnight oil and crank out work and manuscripts and all sorts of things, and now there's no way I can crank out anything after like 9 pm at night.
Speaker 2:Yeah, no, I feel you. I see that too. I feel that personally as a woman in her early 50s, and I see that as well in all of my patients. You know, men and women alike. I think you know, in all of our minds we are stuck at a certain age, and certainly for me I'm stuck at like 28 to 32 in my mind.
Speaker 1:Yeah, I'm 29. I'm 29.
Speaker 2:Yeah, forever 29. Right, Like I agree, Like I look at that person I was and I think how did I do that? You know, how on earth did I do that? How on earth did I accomplish all the things I accomplished, you know, when my family was young? But I hear you, I don't think it's unrealistic, though, that people feel that they should still be able to do the things that they want to do within reason.
Speaker 2:I never really feel like I encounter somebody who is not being reasonable Within reason. I never really feel like I encounter somebody who is not being reasonable about their desire to have more energy or flexibility or more stamina. I don't think people are unreasonable to want to be able to do things when they come home from work in the evening and not feel like they have to collapse and they don't have any energy for themselves after a work day. So I hear you, I agree that I do sometimes wonder, and you know what's funny is I feel like my 70 year olds are actually the ones that are more unrealistic than my 50 year olds. I think they definitely come in with this desire to be like they were when they were 50. And I do find myself chuckling a little bit more about my 75 year olds and the amount of energy that they think that they should have.
Speaker 1:So how do you tease out like how much of it's lifestyle versus natural aging, versus hormones, versus nutrition? I mean sometimes, by the time I see people, they have problems in every single area and a lot of them, unfortunately, are not getting regular primary care, gynecologic care, hormonal assessments, let alone anything nutritional or lifestyle, and it's like a lot to just deal with all at once.
Speaker 2:Oh for sure. I mean, that's exactly why people come to us, right? They come to us to help them sort out what's real, what's imagined, what's fixable, what isn't fixable. You know, realistically, patients come in wanting to make sure, number one, that there isn't something terrible that they're missing. You know, is there some terrible illness or disease that this fatigue is a sign of or a concern of? But in general, you're right, people want to know, like, what is real and what can I expect? And is this rational and what can I do to improve my situation? And how I tease that out is basically a comprehensive panel of hormonal studies, vitamin studies, with a complete nutritional review of what they're eating, when they're eating, what they're drinking, when they're drinking, what time they go to bed, what time do they work out. I mean, this isn't something that can be done in five minutes, right? This requires a comprehensive understanding of, you know, from sunup till sundown and everything in between.
Speaker 2:And that is the point of this expertise in endocrinology is to be able to tease out the complaints that somebody has and then tie it to either a lifestyle thing that they may be doing and or nutritional and or hormonal dysfunctions, and then to act on those things that we see and recommend changes and then see what happens, and some things might be just a few days that they might impact. Like you might make a I don't know a simple change with, like, say, a lifestyle issue and then we'll be able to see an impact within a few days, maybe a few days that they might impact. Like you know, we might make a I don't know a simple change with, say, a lifestyle issue and then we'll be able to see an impact within a few days, maybe a few weeks. Some things take longer. Some hormonal problems are kind of insidious and they're sort of underlying and they've been there for a while. It may take us longer to tease those out and fix them. It may take months for that to sort out.
Speaker 2:But at the end of the day, how we tease that out is I have to do an assessment, right. I have to sort of understand where you are right now hormonally and nutritionally and then I can understand what we have as reasonable options to do, to recommend, and then we can guess okay, this is a reasonable option for you and this is how long I think it might take. And then we reconvene, right, we reconvene and discuss. Okay, this is a reasonable option for you and this is how long I think it might take. And then we then we reconvene, right, we reconvene and discuss okay, what happened, what happened, that was good, what happened that was bad, what happened that was that didn't happen, did anything not happen that you expected to happen? And then we can reevaluate.
Speaker 1:Now for women who say they've optimized their health conditions, their lifestyle. You know they're. You know eating whole foods, healthy diet, have taken out, you know the seed oils and the inflammatory substances. They've optimized the important vitamins so many women are low in vitamin D and magnesium. They've addressed their sleep, maybe had a sleep study. Their hormones have been assessed and if they're in menopause, you know, and low in estrogen and other selected hormones which many women are, that's addressed. Let's say, all of that's optimized and they're just looking for optimal health.
Speaker 1:Do you promote or recommend, like the anti-aging treatments of glucophage metformin? I know in the lab it appears to be anti-aging. Do you recommend an otherwise healthy person take it? I remember my PhD in molecular medicine, son Stetson Thacker, who's been on this podcast when he was reading about it years ago. He's like mom, I think I need to go on metformin. I'm like what you know, you're an athlete, you're ripped, you have no glucose intolerance. Like this is a medicine that can affect your stomach and your liver and your kidneys. Like no, it's a prescription medicine. So what do you say to patients?
Speaker 2:Yeah, though that's a great question. I get that question quite regularly, of course, because that's the hot topic in aging and healthy aging. So I first want to just remind everyone who's listening just because you think you've optimized your health and nutrition and vitamins doesn't mean you actually have, because everybody's different. Right, I get that all the time. It's almost a very defensive mechanism, right? People come in and they say but I've done all the things I'm supposed to do and you know, like you said, you've eliminated the seed oils, you've eliminated the processed sugars, you're sleeping appropriately. That isn't always true in terms of what's actually happening. So I just want to just make that point before we start getting into obviously more exotic things like anti-aging medications. So let's talk about metformin, because obviously metformin is kind of a staple in endocrinology.
Speaker 2:A lot of people listening may or may not know that this drug was definitely a breakthrough when it was discovered and used, starting back really in the mid-1900s, mid-1950s or so, for diabetes patients, and so it's not a new drug by any means. In fact, we used it for decades and didn't even have any idea how it worked. Even it really wasn't until the early 2000s, mid-2000s that we figured out actually how the drug worked and you're absolutely right. In the lab there is a lot of support that metformin is anti-aging because it inhibits the mTOR pathway of cell signaling. Mtor is basically a shorthand term for the cell signaling that communicates the longevity of the cell, or how long a cell should live, and it's kind of global, it's not just a particular part of the body, and so as a result, metformin garnered a lot of attention for that in the early 2000s and there was plenty of work done on that in the animal models to show some potential benefit. And it is interesting because in the diabetes literature there is some really interesting data that supports and suggests that metformin decreases the risk of cancer development in diabetes patients Because we know that diabetes patients have decreases the risk of cancer development in diabetes patients because we know that diabetes patients have an increased risk of cancer due to the excess sugar in their blood.
Speaker 2:And there is data that goes way back decades that suggests that being on metformin somehow stabilizes that risk or reduces that risk as compared to diabetics not on metformin.
Speaker 2:But the reality is it's hard to tease out what is good glucose control from the medication itself doing that benefit.
Speaker 2:So the conversation around metformin is a little more complicated by the fact that it does have a negative side effect component that I'm not happy about, and that it does cause B12 vitamin deficiency and can block B12 vitamin absorption, even if you're taking supplementation. I think that is something that cannot be ignored. I think it is an important consideration and one that actually for a lot of my diabetics who are more advanced with their disease, I tend to take them off of metformin because I'm worried about the development of neuropathy, which is a diabetic complication associated with B vitamin deficiency, and so it is a complicated conversation. I definitely think there are better options than metformin, which I'm sure you will ask me about, but if the conversation with a patient is about mTOR and about longevity and about the desire to, you know, decrease their cellular aging in a healthy and a safe way, I actually think there are better options to that than metformin for that purpose, now that we know how metformin works.
Speaker 1:Very interesting that form and works Very interesting. You have been listening to the Speaking of Women's Health podcast and I'm your host. Dr Holly Thacker, the Executive Director of Speaking of Women's Health and in the Sunflower House, is guest endocrinologist and anti-aging expert, dr Alina Christofides from Columbus, ohio, where she has a very interesting and unique practice. And we're in talking about anti-aging and we just went through glucofage and metformin and I would definitely echo your thoughts about checking B12, which I check in pretty much everybody over age 60 or anyone on glucofage, metformin or also PPIs, because you don't want to treat one thing and then make something else worse and also the interesting information that you talked about cancer and sugar.
Speaker 1:Certainly a lot of cancer patients will go on like a high protein or keto type diet and take out all sugar because sugar can feed cancer cells and I guess teasing out how much is metformin versus just changing your diet, which all of us adults can, you know, pretty much take sugar. I always say there's no essential carbohydrate, there's essential fats, ditto yeah, and essential proteins. And I'm like the older I get, I've just like lost my sweet tooth. So I don't know if that's somehow protective it's not totally gone, but like it's. You know it's definitely muted. It's not like I enjoy it as much. So, talking about that whole mTOR pathway and cellular aging, what about rapamycin? Tell us about this prescription medication, the risk and benefits. Are you using it? Are people coming to you to ask for it?
Speaker 2:I'm so glad you asked about it because I think this is probably the hottest topic in health span conversations that's happening right now, because it's such an interesting drug. So the short answer is yes, I use it, I do like it. Patients do come to me asking for it, and it's such an interesting medication. Number one, not the least, of which is the fact that it was named for the islands of Rapa Nui, because that's where it was discovered, and a lot of people know this island by its more European name of Easter Island, which is where the Moa statues are famously shown on the island. And it is the original drug that we were using to suppress the immune system in patients receiving transplants. You know from the beginning days when it was first discovered in our mid-1900s, 1970s, I think. It's technically when it was first discovered in our mid-1900s, 1970s, I think is technically when it was discovered.
Speaker 2:So rapamycin is actually very specifically an mTOR pathway inhibitor that does not appear to have any downstream negative events or consequences like metformin does. It does play a very central role in regulating cell growth and metabolism as it relates in response to nutrients and growth factors and stress. But what's really interesting about rapamycin and why it has so risen to the forefront of the conversation about health span and healthy living is that in the early days when we used rapamycin, we used very, very high doses for transplant patients, very, very high doses for transplant patients. But in the work of David Sabatini back in the early 2000s there was a lot of identification and understanding that at lower doses, very, very low doses a fraction of the doses that we were using for the transplant patients you could actually inhibit the mTOR pathway and extend the life of a cell healthily under normal circumstances without the immune suppression.
Speaker 2:And interestingly, I believe if it's not already happened, it's about to happen that rapamycin is going to get approved to extend the life of dogs because the studies have been done for life extension for our canine companions and, like I said, minuscule doses so let's talk about transplant doses are in the tens and hundreds of milligrams daily, whereas when you're doing it for life extension you're talking four or five, maybe 10 milligrams once a week. So a radical difference in the dosing between the two opportunities. And I do find it super encouraging that we already have data and support for getting this FDA approved for life extension for our pets, certainly at least in dogs. So that's where we're trying to steer the conversation for people in regards to the use of mTOR inhibitors, because it appears that you can get the benefits with rapamycin without the negatives of metformin.
Speaker 1:And so is this something you just offer to anybody over 50 or anyone who's interested, or people who are still fatigued or feel like you know their body systems are just too sluggish.
Speaker 2:Yeah, absolutely. There's obviously a conversation that has to happen because this is what we consider off-label usage right. So the use of rapamycin in this setting would be not for an approved indicated usage according to the FDA. So that requires a separate conversation, as you well know, and I don't routinely recommend it, but I do bring it up in the following circumstances Patients who have persistent fatigue or evidence of inflammation, despite doing everything that we know to do within the realm of traditional medicine and lifestyle changes.
Speaker 2:I do routinely bring it up with people who have come to me with the request or understanding or desire to improve their health span. Obviously they're already motivated and thinking about that, and I am also recommending it to people who have ongoing autoimmune disease. I have found a pretty, pretty strong correlation with individuals who have ongoing autoimmune disease and persistent autoimmune disease and where they keep getting additional problems and additional concerns. That's something that I offer. So what that looks like for a patient is let's say, you have Hashimoto's hypothyroidism, which is a pretty common autoimmune disease. About one in seven women suffer from it. I myself suffer from it. Many, many, many, many of my staff and patients suffer from it. It's a really common disorder. Many, many, many of my staff and patients suffer from it. It's a really common disorder and that by itself may not be a problem. You may be able to treat it and do well with it. But let's say you start acquiring other autoimmune issues, which is not uncommon. You know, you have one autoimmune problem, you start acquiring other autoimmune problems and in those circumstances, if a person is really suffering from those autoimmune diseases kind of persistently and they keep getting more and more, I might suggest something like rapamycin to modulate the immune system. It's not about suppressing it. I'm not interested in suppressing it. I'm not trying to do transplant levels of suppression by any means. But we do know that at these low doses of rapamycin once a week, we can see a calming down of the immune system, and so I will suggest it to those individuals and I see a lot of rheumatologic disease individuals that also have endocrine problems, like, let's say, you have Hashimoto's, hypothyroidism and lupus, or rheumatoid arthritis or psoriasis. These overlapping conditions are frequently where this drug has its star moment Because, as you rightly pointed out, a lot of these individuals have persistent fatigue.
Speaker 2:So if you have persistent autoimmune disease or you have persistent underlying inflammation of whatever origin and you've already done the dietary changes, you've already done your lifestyle changes, you've already identified what hormonal changes need to happen and you're still persisting in this daytime fatigue, sleepiness, lack of mental focus, lack of acuity, and you feel like you've just lost like 100 points of your IQ. That's how patients feel and how they describe it. Rapamycin may certainly play a role in what we recommend moving forward, and we'll do a trial of, say, 12 weeks of therapy and see if a person feels better. This is by no means you know the be-all and end-all. It may work and it may not work. But we certainly do like to do a trial of 12 weeks to see how somebody is feeling on it, and the response is kind of black and white, it seems. Either you do really really well on it or you don't feel anything from it whatsoever, and that's fine.
Speaker 2:But I'm very much happy to have a conversation about residual inflammation and how that may be modulated by this drug, and fatigue may be the only symptom of residual inflammation that somebody has, and you're absolutely right to pick up on that because realistically you should be able to accomplish the tasks you set about for yourself in the day. I mean assuming they're not, like on laundry list a mile long, you know, but reasonable things, like you know. Go to work and cook food for yourself or your family. Um, maybe do some exercise, maybe do a hobby, you know, maybe watch some tv at night. Like you should be able to do these things in a day without feeling like you have to nap or that you have to save up your energy for the next day and the next day. So absolutely worth a conversation.
Speaker 1:And so I know that my functional medicine colleagues and I have information on our speakingofwomenshealthcom site. Medicine colleagues and I have information on our speaking of women's healthcom site about low dose naltrexone to kind of like recharge that opiate system for pain, and I see that used in people with chronic pain and um autoimmune conditions. So how do you differentiate between when you're going to use low-dose naltrexone versus a weekly dose of rapamycin?
Speaker 2:Oh, that's a great, great question because I love low-dose naltrexone for all the reasons that you mentioned. So typically what I will do is, if there is a fair pain component involved in someone's presentation or they have a lot of rheumatologic issues, we might start with low-dose naltrexone because it's well I mean, the data on that is well established and typically easier to find low-dose naltrexone or typically easier to get low-dose naltrexone. But yeah, if there's a large pain component or a history of opioid resolution like if somebody has taken opioids in the past or they've taken anti-inflammatories of that pathway in the past and had success then I'm much more likely to recommend low-dose naltrexone first. Interestingly, there's a lot of people don't appreciate that one of our anti-obesity medications actually has low-dose naltrexone in it.
Speaker 1:Contrave.
Speaker 2:Right Contrave, which is one of my favorite medications for obesity, and the oral side, not the injectable side. So low-dose naltrexone factors very prominently in the Contrave's benefits and, as a result, if there is obesity as well, in the conversation that we are having with somebody around their desire to have mTOR inhibition or fatigue or inflammation treatment, I might recommend low-dose naltrexone first in that realm. So if there's a presence of overweight or obesity, chronic pain in conjunction with their inflammation, we'll start with LDN. I don't always add rapamycin to it.
Speaker 2:I will sometimes switch to rapamycin if they are not responding to low-dose naltrexone, because I want to be able to differentiate between the two drugs and what they're doing for somebody. So we might start with one, go to the other and then we might combine. And I do have people who are on both because they're doing different things and I need my patients to help me understand what the drug is doing for them very specifically so we know how to monitor the two. So yes, I will pick lodelsnaltrexone in those circumstances, maybe switch to rapamycin if need be and then tag team it if we have to later, if it looks like they're doing two different things for people.
Speaker 1:And what are your thoughts about like trying to energize the mitochondria, the little powerhouses inside the cell? You know we all inherit, I guess, all of our mitochondria from our mothers. In fact, my son said oh yes, every person has more genetic material from their mother than their father. You know, you would think it would be 50-50, but obviously you know it's not. And you know I have patients asking me about CoQ10, which I will recommend to anyone who's on a statin, even though I don't think that's typical American cardiology practice.
Speaker 1:And I really generally discourage statins in women who don't have any vascular disease because of the increased risk of diabetes, and I don't always see people differentiate that gender difference but are using NADH. I did a podcast and we've got some information on our website on red light therapy. I know that's like all the rage and I just wondered if there's obviously a healthy diet. But you know, certain antioxidants are kind of promoted as such.
Speaker 2:I wonder how you approach that. No, it's absolutely true. I mean, mitochondrial function is absolutely the hot name in moving forward with health span right and healthy aging. And you are 100% correct. Right, we get all of our mitochondria from our mothers, because it only exists in the egg and the ovum. The sperm that fertilize the egg don't have any mitochondria. They fall off. It's actually they are located on the tail of the sperm, but they fall off once the sperm ovulates the egg and fertilizes the egg I should say not ovulates, fertilizes the egg. And so that's why we have more DNA from our mothers than we have from our fathers because of the mitochondrial contribution. So some of us are born, or some of us inherit really great mitochondria and some of us inherit not so great mitochondria as the case might be.
Speaker 2:So, first and foremost, the number one way to improve mitochondrial health is going to be with diet and exercise. Let's make that very clear. We know that. That data is very, very clear. High-intensity interval therapy workouts are very good for improving mitochondrial function, as you've already rightly pointed out. Low-carb diets are very good for improving mitochondrial function. That goes without saying. When you talk about supplementation, we absolutely are in the realm of improving supplementation for patients who have mitochondrial dysfunction. When we do that, as you well know, NAD and NMN are not well-absorbed orally, so we do discourage oral intake of NMN or NAD because they're not well-absorbed, they're destroyed by the gut and so they're not high quality contributors to mitochondrial health. So we do do peptide infusions and peptide treatment with NAD, so I do do peptides as well for people who are in that realm. I agree with you.
Speaker 2:Coq10 and statins. We could probably have an entire podcast on statins alone and the do's and the don'ts of statin therapy. That's a whole separate conversation because, like you, I don't think statins need to be in the water. I think there are times to use it and there are times that we abuse it. I do think that we are not seeing all the other benefits yet of things like methylene, blue or red light therapy.
Speaker 2:There are a lot of other things out there that we have that we can do. I think it's a matter of mix and match. Personally, I find that cold exposure and red light therapy do more for me than some of the supplements, and I think we have to take that into consideration, that cold exposure and sauna Cold and sauna are well known to improve mitochondrial function as well, and so I think it's a matter of cost and access, Because I don't think anybody can do everything. We have to cherry pick, so I do go through that list with people. We used to have a great cryo facility in Columbus, Ohio, where I live. It was a fantastic room for doing cryotherapy, and they've since left the city and I'm not happy with what we have you know that behind, like the places that we have currently?
Speaker 1:Is that the cold plunge?
Speaker 2:Well, so this is the thing, right. So cryotherapy in a room is actually better than a cold plunge, because the majority of people who do a cold plunge do not get head cold and when you look at the data on decreasing body temperature for longevity, you have to get your hands and your head cold. So some cold plunges do not actually immerse you in enough cold water for long enough to get the benefits of the cold plunge if you look at the data and how they did it statistically. So yes, I'm referring to cold plunge, but it's actually the cold room is my preference over the cold plunge, unless you're going to dunk your head completely, which is the preference if you're going to do an actual cold plunge.
Speaker 1:Well, my very cost efficient way of cold plunges, much to my husband's dismay, is I just go outside in the winter in my sleeveless pajamas and shorts to do yard work.
Speaker 2:He's like 100%, very cost effective. I do the same. I go outside without a coat, without hats, without gloves, and I keep the. I keep the bedroom really, really cold and I will, when I can really feel like I can tolerate it, turn the shower super cold.
Speaker 1:Oh, that's hard for me Before I get out.
Speaker 2:That's really hard, but you're right, that's free. That's free and that's easy, unless you live somewhere where you don't have cold year round, and of course, in the summer that's not super easy, but yeah, so cold exposure is a really really good one as well.
Speaker 1:How much does that have to do with stimulating the brown fat, like I just noticed, with the season changes, because we of course have season changes here in Ohio that, like I, don't tolerate the cold very well at the very beginning of the season, but then the more I acclimate to it, the easier it is for me just to go outside without, you know, a coat on.
Speaker 2:Yeah, some of it is definitely brown fat adaptation, for sure. But you know, the interesting thing about that is that the body remember the endocrine system is a spider web and you can't tweak one area without affecting the other area. And, interestingly, when you are able to stimulate brown fat through, say, cold exposure, that does improve inflammation and improve mitochondrial health, because you turn on more mitochondria for heat production when you do that, and then that has the knock-on effects of improving your overall metabolic function, which, you know, the more cold plunges or the more cold exposure you do, the more sustained. That is which is why you feel subjectively like you are better tolerant of the cold at the end of the season than at the beginning of the season.
Speaker 1:Boy, this is also fascinating. I really want to have you on again, because we haven't even talked about growth hormone or the panel of blood work that you order, or you know so many other important topics, so I hope I can book you again. Do you have any final words of advice for our listeners? And you need to tell us how people can make an appointment with you, how your practice is set up, because, of course, since you're so comprehensive and individualized, this isn't something that obviously regular, quick, five-minute appointment healthcare traditional healthcare covers.
Speaker 2:Oh for sure. Now our appointments are 30 to 60 minutes on the first go and usually 30 to 60 minutes on subsequent go arounds, and I am more than happy to come back and talk any time about hormones. I obviously love talking about them, and growth hormone is a really special and unique one, so it's an important one. But most definitely, if people want to get a hold of me or get in touch with me or make an appointment in my office, going to my website is the best way to start. That, which is wwwendocrinology-associatescom. You can also just do a search on my name, elena Christofidis. I think I'm the only one that's in Columbus, ohio. I hope so. I haven't found a doppelganger yet. So endocrinology-associatescom.
Speaker 2:And then the two things I want people to take home with them after this I want our listeners to be sure to remember.
Speaker 2:Number one is to take charge of your own health and be your own advocate, and that also requires tempering your expectations and understanding that there does need to be a health care advocate in your corner guiding this process, and that's the second part. Staying healthy involves finding a team of health care providers that are just as interested in preserving your health as they are, and believing in that process, you know, because you can get really overwhelmed with what you see online and think you have to do everything, and that's not always the case and it needs to be sort of systematic. So, you know, my advice is always just remember yes, you need to be your own advocate, but that doesn't mean that you should, you know, go rogue and do all these things on your own, without somebody to help you monitor and identify when things are going wrong or when things are going right, because so much of this is based on blood work, so much of this is based on, you know, understanding where your body systems are stabilizing.
Speaker 1:You know, in the background, Well, you certainly live our motto about being strong, being healthy and being in charge, and we will have your contact information in our show notes and our social media and tell us where people can listen to your podcast.
Speaker 2:Yes, wonderful. My podcast is called Case Breaks in Endocrinology and it's hosted on medcentralcom. I co-host it with a good friend of mine, a primary care physician, by the name of Dr Joseph Winchell, and we discuss all endocrinology different conditions as well as medications and our takes on it right Primary care versus endocrine, and that's on medcentralcom slash case breaks and endocrinology, also linked from my website.
Speaker 1:Well, we will put that also in our show notes. And is that something that primarily physicians tune into? I mean, I have so many smart listeners and smart patients who, even if they're not in healthcare, they like to listen to the podcast that I sometimes do with physicians, so I assume that the case discussions are higher level, more focused on physicians, and I should have my fellows listen you know, honestly, we don't restrict access.
Speaker 2:I agree with you that it's a little bit of a higher level conversation in some topics, but I don't think that the topics are a problem or difficult or not listenable for anybody. Really, honestly, I think you know fellow providers, your fellows, you know doctors in training, nurses in training and certainly your patients. I think they would find something that they could take from our discussions and use it for their own health advocacy. I absolutely think that we cover the topic you know pretty thoroughly, but not, you know, this is not a conversation that other people would not be able to get something out of. I absolutely would welcome them listening to it.
Speaker 1:Well, that is terrific, and thank you, Dr Alina Christofides, and thanks to our listeners for tuning in to our Speaking of Women's Health podcast. We're really grateful for your support and we hope that you'll share it with others. You can donate on speakingofwomenshealthcom and leave us a five-star rating and, to catch all the latest from us on Speaking of Women's Health, subscribe or follow on Apple Podcasts, Spotify, TuneIn or wherever you listen to podcasts. It's free to subscribe and when you subscribe, you won't miss future episodes, including when I am hopefully able to get Dr Christofides back in the sunflower house. Remember, be strong, be healthy and be in charge.
