HRT: The Real Tea

Judy Smart has truly been life-changing for both of us. In this episode, we sit down with the HRT nurse who guided us through our hormone journeys, and we finally dig into the real medical side of HRT. No guessing, no Google spirals, just honest, expert insight from someone we trust. Plus, there are a ton of laughs! Make sure to check back next week for our second conversation with Judy.

Transcript

SPEAKER_04 0:04

Hot Flash and Sassy, a podcast with hot takes, hotter flashes, and a whole lot of sass.

SPEAKER_02 0:17

Welcome back to Hot Flash and Sassy, the podcast where we talk honestly about all the things perimenopause and menopause. I'm Holly.

SPEAKER_03 0:24

And I'm Renee. Today is the day, the day we've been waiting for. Today we're talking with a person that changed our lives forever. Judy. This name should sound familiar to most of you out there because we've peppered them through episodes about how we're gonna ask you questions, Judy. So this has long been coming. So we're here to get Judy to share her story with us and to help us answer some of our questions that we've been asking along the way.

SPEAKER_02 0:53

So if you've ever wondered whether hormone therapy might be an option for you or you're just curious about what the experience can be like, this conversation is for you. So welcome to the show, Judy!

SPEAKER_03 1:03

Thank you! Figured out the sound effects of the episode. We have to do our own sound effects because we don't know how to do the technical version. We were gonna record this. We were having guesters before this.

SPEAKER_04 1:18

Oh my gosh, that's awesome.

SPEAKER_03 1:20

We are so happy to have you and so excited. In case you couldn't tell, we were a little bit geeked out about the venue on the show. Thank you guys for being.

SPEAKER_04 1:28

Yeah, my pleasure. My pleasure.

SPEAKER_03 1:30

So we would love for you to start us off with telling us a little bit about you, who you are, where you came from, and how you got into the pellet world. I know it's not the whole pellet world. It's our pellet world.

SPEAKER_04 1:44

So um I've started working with George Allering almost 40 years ago. George and I were became very good friends, work partners, and I did a lot of infertility work with him. And as I grew older and my patients grew older, the needs were different, right? Um, the needs of okay, I've had a baby and now I don't feel well, but I'm not menopausal yet. How do I attack that? So um, and then it happened to me. I hit menopause at 48, young, and I became a person I didn't even like. I literally would say things and I'd walk away going, who said that? What what came out of my mouth? And then then I'd feel bad, you know? And so I like I have to describe this to George and tell him, I don't feel good, what can I do? And then we both went together and we started, we learned on how to do pellets, and that's how it started. And it was really hard for me in the beginning because I did infertility, re-occurrent miscarriage, which is such a rewarding thing. Um, and I never thought I'd be rewarded as much with hormone replacement, and I am as much or more to take somebody and change their lives, have them come in and they're in a big black hole, they can't get out of it, and then all of a sudden they start having a life again. I always say that if I go to a party, I can tell who has hormones because they're that'd be a fun game to play. It's like a fun little party trip. Who has hormones? Well, they dress younger, their attitudes younger, they're not complaining as much because they feel good, they're they're usually romantically involved. Um, so they seek other enjoyments besides staying at home. So when that finally happened, I decided to do it full time. And thank goodness, because I am very rewarded by helping people, and it's just not just doing it, it's like I love to feel how people feel when they walk in the door and they say, Judy, thank you so much. Yeah, it makes me feel good.

SPEAKER_03 3:50

I bet it does.

SPEAKER_04 3:51

Yeah, yeah.

SPEAKER_03 3:52

Because you literally know you you do pellets yourself, yeah.

SPEAKER_04 3:56

Yes, I've been doing them for 20 years.

SPEAKER_03 3:57

Right. So you know where they were before the the pellets happened, and now where they are after their experience in pellet.

SPEAKER_02 4:05

In fact, you started like inserting pellets, like helping others with pellets at the same time that you were doing it. Yeah, you started.

SPEAKER_04 4:12

Well, I started before. The funny thing is the first time I did a pellet, um, George was out of town and I hadn't done one yet, but I had learned. And I knew this patient because she's an infertility patient, and I said, you know what, I'll just do them. She and she goes, Judy, that was great. When was the first when did you do of your first palette? And I go, Oh, you were my first pellet.

SPEAKER_02 4:32

Surprise, surprise.

SPEAKER_04 4:34

So from that point on, and that was about 30 years ago.

unknown 4:36

Okay.

SPEAKER_04 4:37

Yeah. I started doing men about 20 years ago. So yeah, and the first male I had was a dear friend of mine, and he had horrible Alzheimer's in his family. Horrible. Mother, grandparents, and he was 54, and I said, You have to start replacing your testosterone. The correlation and the research about dementia and Alzheimer's with the low hormones is huge. And um, he wouldn't do it, he wouldn't do it. About a year later, he said, Okay, I give. And now he's 73, and he's doing great.

SPEAKER_03 5:10

Yeah.

SPEAKER_04 5:10

So that was my very first male patient, and that was so 50. Yeah, so he's about 20 years ago.

SPEAKER_03 5:16

What?

SPEAKER_02 5:16

I know 20 years. Holly. I just feel like it wasn't talked about, really.

SPEAKER_04 5:22

It wasn't. Pellets have been around for at least 50, probably, but nobody did them. Nobody did them.

SPEAKER_03 5:29

The synthetic ones for 50 or the good ones.

SPEAKER_04 5:32

Bioidintical. Okay. But nobody did them. I mean, nobody did them.

SPEAKER_03 5:35

Are there synthetic pellets?

SPEAKER_04 5:37

No, they're not.

SPEAKER_03 5:38

No, gotcha.

SPEAKER_04 5:40

They're they're compounded, they're biodentical.

SPEAKER_03 5:42

Gotcha.

SPEAKER_04 5:43

And the difference, I don't know if people understand what the difference is.

SPEAKER_03 5:46

I'm not gonna say, let's go down that little hole.

SPEAKER_04 5:48

Synthetic is they're both man-made, right? Um the biodential are plant-based, but the biggest thing is going down the pathway, how they metabolize. So the synthetic goes down to a different pathway, and when you look at it, your estrone level, the bad estrogen, you know that it's we need it in our system, but it's actually can cause belly fat, which we all complain about, breast tenderness, and breast cancer down the road. So, but it's the estrone, it's not the good estrogen that does that. So in the synthetic, you see that there's estrones are higher. Biodenical, they go down like your own metabolism of your own hormones. So they're identical. So biodentical. So again, synthetic might get rid of hot flashes, but the biodenical does it in a healthier way.

unknown 6:37

Okay.

SPEAKER_02 6:38

That's great. That's a great explanation. It is a really good explanation. So confused. I know.

SPEAKER_03 6:44

I know. All I tell people is I don't know, but I get the good stuff. I get the good stuff. There's bad and there's good. Make sure you get the good. I mean, it's important.

SPEAKER_04 6:58

It is very important to get the good stuff.

SPEAKER_03 7:00

We this is the reason that we reference you in so many of our episodes, because we have no idea what we're doing here.

SPEAKER_02 7:06

No.

SPEAKER_03 7:06

And we found that a lot of our listeners really don't know how to navigate this stage of life because sometimes you don't even know that a symptom is related to your hormones.

SPEAKER_04 7:16

Just the example is your joints hurt. Yes. People like my knees hurt. Well, they go in and they think they have arthritis, and that and actually then you give them hormones and they're like, oh my gosh, my knee pain went away.

SPEAKER_01 7:29

Yeah.

SPEAKER_04 7:29

And then you that's because those joints need fluid, and as we lose our hormones, things dry. Vagina's dry, you know, our eyes dry, our mouth, everything. And so when we have low hormones, then we start having joint pain.

SPEAKER_02 7:44

You know what's so interesting about that is that right before the winter before my hysterectomy, I started having all these issues with my eyes, and I kept thinking I was getting pink eye, and I had drops at home before my kids, and I was like, you but like nothing was going away. And then I went to the doctor and they were like, You have like these chronic dry eyes, and I was like, I've never had I've had dry eyes, but never like so, it was so bad. And it's interesting because that was before I had my hysterectomy got, and I never even thought about it.

SPEAKER_04 8:12

Oh yeah, because um, when I need my pellets, because I'm the last person to get pellets, because you know, at the end of the day, I'm like, I don't want to do my pellets, I'll just go home. And I make it when my eyes get dry. I'll be working and I'm like, oh, I need to do my pellets because my eyes are so dry and they burn and stress. Yeah.

SPEAKER_02 8:28

Wow.

SPEAKER_03 8:30

Well, I could get a little bitchy too, but that sounds so much nicer than what happens to me. Mine is climbing up the stairs. I definitely have the knee situation because the way I described it to Holly before I came to you was it it took two hands to pull me up my flight of stairs at home. It was so hard. I was out of breath at the top of it. My knees hurt, everything hurt. Just going one flight of stairs. And I, you know, I did. I was that person. I'm like, well, I'm getting older. Right. I guess this is what happens.

SPEAKER_04 9:04

And how many people just think that? I'm getting older.

SPEAKER_02 9:07

Yeah. Check that off.

SPEAKER_03 9:08

So many people.

SPEAKER_02 9:09

Right. They're like, it's just what you deal with. You're getting older. Right.

SPEAKER_03 9:11

Yeah. But no, it how could I have had arthritis from head to toe at the young age of 29, which our listeners know me as 29 years old. She is, I promise. She's one of my youngest. Um, so yeah, that was my big telltale when I after I had the pellets, I ran up the stairs with the dogs. And I'm like, what just happened?

SPEAKER_04 9:38

That's incredible.

SPEAKER_03 9:39

Clicked in my body that all of a sudden I can do stairs without issues.

SPEAKER_04 9:43

That's incredible.

SPEAKER_03 9:44

It's all because of the pellets.

SPEAKER_04 9:45

Yeah, yeah, for sure.

SPEAKER_02 9:47

For sure. So with getting our pellets, you're big on blood work. We do blood work.

SPEAKER_04 9:52

Correct.

SPEAKER_02 9:53

But a lot of this stuff comes back. It's hard to read, obviously, the blood work. And you see all these ranges. Some of them it looks like you're in it, but maybe you're not. Like, what does that mean that it's not, and not everyone's cut the same, right?

SPEAKER_04 10:06

So correct. So I always say that you know, we've been taught in medicine to look at the right side of the lab, right? Which is all the norms, right? It's normal between here and here. A man's testosterone is normal between 250 and 1200. That's a huge range. So if you you know, you look at just the norms, like, well, you're 300, you're great. You know, well, you feel horrible, you're not great. So I look, number one, I treat men under 500, so I'm not gonna treat them when they're still real high, but you have to also listen to their symptoms. So I always say with my patients, I'm not looking for the norms, I'm looking for optimal to make you feel good. And the biggest thing that I always I'm not big on overdosing, the least amount of hormone to give you to make you feel better is the right dose, right? So if you feel great at 100 milligrams of testosterone, why should I give you 150, right? So that's how we go about it. You gotta listen to the patient. You also have to look at the labs. Now you gotta be careful because if I give you too much, you can get a high hemoglobin hematocrit, which thickens your blood, and that's why they kind of got a bad rap because people weren't checking that, you know, and so that's where the blood clotting and all that comes in. It doesn't, if you keep your hemoglobin and hematocrit low, you will not have that issue.

SPEAKER_03 11:27

Okay. Which is why it's so important that you get blood work.

SPEAKER_04 11:31

The blood work regularly.

SPEAKER_03 11:32

Correct. Because then you can adapt the hormones for that.

SPEAKER_04 11:37

Right, and that's the only when people have a complaint on that they don't feel great. They're only way I can I can listen to them, but I gotta have both combinations. I have to have the blood work and listen to them and figure out the combination that's gonna fix them.

SPEAKER_03 11:50

Yeah. You know, the first time she read my blood work, I was blown away. I brought my mom with me because I'm a little baby and I because other people I brought my mom with me too. You both have but it blew me away how you went through each one and you're like, well, this one causes this, and this one causes this, and here this one's for belly fat. And I'm like, what? I'm like, we have an excuse for my fat belly. Let's get on that one first. But it really was fascinating to know well, A, I've never had a doctor go through even my CBC at that level of detail with me. You know, they just say, Well, you're normal, moving on with life, or this one's a little bit low, we'll have to watch it in six months. But also to know what those that blood work was telling you was fascinating for me because the way you were interpreting it was completely different than the way I've ever experienced a medical provider interpret it, but then to even say how it physically affected me. You know, it was that aha moment where I'm like, oh, okay, now we're looking at them. And I'm I'm thinking, I can't take notes fast enough. Right. I should have recorded the conversation because it was like, oh my god. That was the inspiration. We should have had her read my blood, my first round of blood work. As that's just that could have just been an episode.

SPEAKER_01 13:24

That could be a whole Renee's blood work.

SPEAKER_02 13:28

Well later she's gonna give Renee a booster.

SPEAKER_03 13:34

If only we had video for this episode. All right, where do you want to go next?

SPEAKER_02 13:42

Well, I do want to ask a little bit more about blood work really quick. Um of the questions we had on here, I think, is important because some of the stuff that you test for is also I've never been tested for before, and I think it's really important.

SPEAKER_04 13:54

Okay.

SPEAKER_02 13:55

So, like D. All these things.

SPEAKER_04 13:58

Vitamin D number one is so important for our immune system. Now we remember that we can only get from the metabolism from the sun, right? We gotta have sun. We live in Missouri, we wear sunscreen, you know. Even people that live in Florida have low vitamin D. All the new studies say your vitamin D should be between 50 and 70. Another example, the range, the norm range is 30 to 100. But um, you'd have to live next to the equator to get enough sun, you know, that's close because the sun's close to us. But the biggest thing is vitamin D helps metabolize testosterone, too.

SPEAKER_01 14:34

Okay.

SPEAKER_04 14:35

Study study about weight is that they did a group of study with on a group of people that had taken vitamin D 5000 units, and one didn't, and in a year, this one had lost, they were both dieting. This one had lost 12 pounds more on vitamin D. Wow.

unknown 14:51

Wow.

SPEAKER_04 14:51

Yeah. It's not like vitamin D is gonna like shed, it's not a GLP one, but it's definitely going to help stimulate your metabolism.

SPEAKER_03 15:00

Well, and one word that you said earlier was the optimal. You want to get people to their optimal level. So it sounds to me like that helps them get there. Right.

SPEAKER_04 15:09

And if somebody comes in and they're in their 30s or even low 40s, I put them on vitamin D. Yeah, because you just have to just think of our bones as we age, you know? So, and vitamin D with K2 in it is just as important as calcium.

SPEAKER_02 15:24

Does yours have K2 in it? I don't know that mine does. I better take mine. Yeah. Well, so I went down a lower dose than the one I originally was on that you guys. The 5000 was too much because my D came back high on some of my blood work. But now I just use whatever Jake gets from Costco. Yeah.

SPEAKER_04 15:40

Which is fine. The K2 just helps, as I explain it, it helps push it into the cells or push it into the bones to help a little bit more. Okay.

SPEAKER_03 15:50

That's scene.

SPEAKER_04 15:51

You metabolize it better.

SPEAKER_03 15:53

Listen to this. We're already learning something. I mean, first 10 minutes of the deal, what?

SPEAKER_02 16:00

That's crazy.

SPEAKER_03 16:01

Yeah.

SPEAKER_02 16:02

Crazy. Okay. The next thing, we we already talked, you already touched on the difference between synthetic and biodental. But what is the difference between all the options out there? Like, there's pellets, there's creams, like one, what are the options for what is the difference?

SPEAKER_04 16:17

So the um the options would be pellets, creams, sublingual tablets that you put under your tongue every day, or trochies, they're the same kind of thing, they're just made a little different. Um, injections. I usually don't use injections on women on a regular basis. I'll give boosters, but on a regular basis, I see that their estrone levels go up too high. Now the injections are plant-based, they are plant-based, but I see that estrone's going up higher when I do just straight injections. So I usually don't do them. But you can do creams, you can do pills.

SPEAKER_02 16:52

Is that for both, like estrogen and testosterone? Correct. Okay.

SPEAKER_04 16:55

Correct.

SPEAKER_02 16:56

There's a testosterone cream.

SPEAKER_04 16:58

You well, they compound it. The pharmacy, like the tablets, um, and for men, that's they use testosterone cream. They use a scrotum cream actually, that they absorb it. Look at all the stuff you're learning.

SPEAKER_03 17:13

Oh, I'm learning stones. Yeah, bringing home about night. Could you even imagine it? Uh he's like, oh, Jimmy, okay.

SPEAKER_02 17:24

I I've tried, it doesn't work. Is it not working? No. Okay, all right. Or would you think, like, what is the main difference? Is there really no difference just in how much you have to apply it?

SPEAKER_04 17:39

Apply um the bioavailability for pellets is going to be the best. You know, shots you go up and then you gotta do it every, you know, sometimes you do it twice a week, depending on your level. Sometimes you do it once a week. Um, it's how that's absorbed. You know, if you're putting it in underneath how the pellets work is, you know, you make a small incision and you put the pellets in, they look like little tic-tacks, and they stick to the fat cells, right? And fat cells have a lot of vascularity. And so then once they stick, that's where they get the vascularity and get um absorbed systemically.

unknown 18:14

Okay.

SPEAKER_04 18:14

So the bioavailability, that's why when people look at somebody on pellets, like, oh my god, the levels are so high, and they're not for somebody on pellets, right? You know, you always have to remember a menopausal woman, if I got her testosterone up to 45, she wouldn't she'd think she wasted her money and it's not helping. You need to have uh for a woman, I get them up to about 150, with I like a free around 10.

SPEAKER_00 18:40

Okay.

SPEAKER_04 18:41

So when you're looking at tablets, you don't it's hard to get them up there. Now you can use them vaginally, but you know, people don't like putting things in their vagina.

SPEAKER_03 18:50

Hold on.

unknown 18:51

Gosh.

SPEAKER_03 18:52

She just made me drop my mouth.

SPEAKER_04 18:55

You can put, yeah, tablets and the same, you would use them orally or put them in your vagina. The mucosa is how, because it's under your tongue, how they absorb. You know, and so the biggest thing is it doesn't go through the liver, right? It just goes through the mucosa, which goes in the bloodstream. So you're wanting to protect the liver. You know, the liver's our filtration, but it also you don't want to overload it with things, medicines and stuff. So it doesn't go through the liver.

SPEAKER_03 19:19

Wow. You're gonna try that?

unknown 19:22

No.

SPEAKER_04 19:23

I mean, somebody I have patients that like them. I just I wouldn't be compliant. Yeah, I just know myself. I'd be in bed and I'm like, oh, I forgot to put my pill on my vagina and I would not get up.

SPEAKER_02 19:34

I'm not getting up to do that. That's my biggest thing, is with that's one of the benefits of the pellets. I know is that I don't have to remember to do something.

SPEAKER_04 19:42

I know, because I am such an in a non-compliant patient. And I try not to be, I mean, I try to be, but I'm not.

SPEAKER_03 19:50

No, I'm 100% not. I mean, I could barely take the birth control pill regularly. And that was preventing me from having a child. Like, what do you think I'm gonna be regular with this?

SPEAKER_02 20:00

And that seems easier to take than put something in your vagina. You think if you were in bed already all cozy and like, I gotta give up. I gotta put it up.

SPEAKER_01 20:09

Put something in my vagina. No. Yeah.

SPEAKER_04 20:14

I was just gonna say that to something. I was just saying you just described something.

SPEAKER_03 20:26

You won't get up to put something in your vagina every day. It's not that. Just not that. Next to the bedside, too. So I don't really have to get out of bed to use.

SPEAKER_02 20:36

Okay, I'm gonna learn too much about Renee today. Okay. I want to talk about progesterone. Why are some women prescribed progesterone and others are not?

SPEAKER_04 20:49

So the perimenopausal woman, um, the definition of menopause is no period for a year. And um, FSH, follicle stimulating hormone, over 25. So I'm very pretty picky about not putting people on estrogen until that year is there. If they're close, maybe if they're having Willie symptoms and their lab show it. But my in my experience, those people bleed. You know, the it they end up bleeding. So um, if you remember, the when you're trying to have a baby or your you the your estrogen goes up and it forms a follicle around three to four hundred, it ruptures, you ovulate, and your progesterone goes up. Your progesterone stays up. If it drops, you'll have a period. If it stays up, you're pregnant. So the women that need progesterone are the people that aren't making it themselves, right? The menopausal women with a uterus. So women that have had hysterectomies do not need it physically because, as I said, that lining. Builds for implantation. So your brain does is trying to figure out oh she's making all this estrogen, so the lining builds and it's ready for implantation, but you never get progesterone because you're not making any progesterone. So if you take it, it keeps that lining thin just because then your the estrogen won't affect it as much.

SPEAKER_02 22:21

Okay.

SPEAKER_04 22:22

Estrogen and progesterone have to equal.

SPEAKER_02 22:24

We talk about a lot of stuff that progesterone is like the calming hormone, but I've also seen a bunch where like it can actually impact your mood negatively.

SPEAKER_04 22:34

Yes. And so this is what in my practice what I do. If somebody comes in with a hysterectomy and they don't need it physically, I um say, let's get your hormones going and let's get it started. And if you still can't sleep and you still have anxiety, then we can add progesterone. There is two, you know, every two different philosophies. Everybody is like, oh, you need it no matter if you have a uterus or not, and then there's a side that says it's one more pill or one more hormone that you don't need. So there's two, so I I will use it on patients with hysterectomies. Um, but I start without. If you see the signs that they could, if their life could improve, because if it's improved, but I usually let the pellet kick in and see how they feel. Is it helping their sleep? Is their anxiety? Because 90% of the time that will help based on that.

SPEAKER_00 23:28

Yeah. Right.

SPEAKER_04 23:29

Um, I used to use it all the time with people that were just on testosterone, but were still ovulating, still having periods, and I just found they didn't need it, you know, unless they still have anxiety and still have progesterone, you know. Now remember that progesterone is in a birth control pill. So if I'm giving progesterone every day, you know, a lot of times that can mess up your period. But if they need it, then you we we use it.

SPEAKER_03 23:54

Okay. Huh. Does that answer your question? It does. It does. You are not getting progesterone, just so you know. I'm not getting progesterone.

SPEAKER_02 24:02

I did know that. But I it's always called the calming hormone when we talk. It's like, well, maybe you need some calm.

SPEAKER_04 24:09

It is. I mean, you could always try it. The great thing about I love patients that have had hysterectomies, you know, because I don't have to worry about them bleeding. That's like, you know, because you're always worried about bleeding, even though it's not a severe side effect, right? You can usually up their progesterone and it stops. But you don't, you know, you always have that concern when somebody's had a hysterectomy, you don't have that concern anymore.

SPEAKER_02 24:31

I was gonna ask you to try it, but I so I don't but I'm not having anxiety and I'm sleeping fine. But then I heard a couple stories from people that were taking it and it it impacted their mood poorly. Like they got depressed when they started.

SPEAKER_04 24:45

Yeah, I've had a couple of patients.

SPEAKER_02 24:47

So then I was like, I don't really want to roll the dice. I because I'm not testing seeming. Well, I am, I mean, my sleep is great. So I've done everything.

SPEAKER_04 24:56

I wouldn't know, you know, you can always try it. It's not so somebody that has a uterus, if I give them progesterone takeaway, give them progesterone takeaway, they'll bleed, you know, because their brain's thinking they need to start a period because their progesterone dropped, right? Yeah, and so they'll start bleeding.

SPEAKER_03 25:11

Okay, okay, that's interesting.

unknown 25:14

Okay.

SPEAKER_03 25:14

I don't want to try it now. You do know I don't okay. Well, that's enough of an explanation for me. I'm good.

unknown 25:21

Okay.

SPEAKER_02 25:22

Do you want to ask her about thyroids?

SPEAKER_03 25:26

Well, funny enough, Judy knows about my thyroid situation because she is similar to me. Aren't you? Yes. We're both Hashimoto's Hashimoto's. And you actually helped me because I had some of the irregular symptoms, and you told me about my antibodies acting up. Can you explain that a little bit more?

SPEAKER_04 25:48

So Hashimoto's is a condition where your body builds up antibodies against your thyroid. Um, why? People don't really know. I mean, sometimes pregnancy, when we were doing infertility, it was like what came first, the chicken or the egg? Does she have thyroid antibodies because and she miscarried? Or did she miscarry because she has thyroid antibodies, or did thyroid antibodies cause the miscarriage?

SPEAKER_01 26:14

Miscarriage. Yeah.

SPEAKER_04 26:14

Yeah, you know, you I don't think we know. You know, we don't know. So when you have an autoimmune, that's what Hashimoto's is, an autoimmune that your body is fighting it off. So your body is constantly against your thyroid. Yep. What can help that? No gluten, you know, inflammation causing things, um, things foreign. And you know, um, the pellets don't patients with Hashimoto's don't have a reaction to the pellets. Some people do with breast implants, you know, because they're foreign to the body, and so that has caused it. So, and they have also there's some research that shows that for miscarriage that placental cells can attach to your thyroid. I read this a long, long time ago, and I've had a miscarriage, and all I thought is, oh my god, I'm gonna have my ex-husband with me the rest of my life.

SPEAKER_03 27:10

I don't believe this is true. Denied, denied.

SPEAKER_04 27:17

So, um, but Hashimoto's even when say your TSH, your T3, and everything's normal, at some point, if you keep fighting your thyroid, you are going to have hypothyroidism. You will have it. Um, thyroids are interesting, it's another one of those which way do we go? You know, the optimal. New research says they like T3s, three. They used to, and I think they still do, a lot of people just check TSH, thyroid stimulating hormone, and they'll reflex it to a free T4 if it's abnormal.

SPEAKER_00 27:52

Yep.

SPEAKER_04 27:52

If it's not abnormal, they don't test anything. They never test a T3, a free T3, or they never test a reverse T3.

SPEAKER_00 28:00

Yep.

SPEAKER_04 28:00

And um, and then you know, then the antibodies, that's just part of it. I went to, I kind of had a weird thing happen. I'd been on thyroid medicine for a long time and I flipped and kind of went into Graves disease, which is hyper. My pulse got it really high. I didn't lose that much weight, unfortunately. I was gonna say, I didn't want it. And I went to this endocrinologist because George looked at me and he goes, Well, I guess you're gonna have to go to a doctor now, aren't you? And I'm like, Yeah, I guess so. And he's like, Why did you run all this stuff? It doesn't mean anything. And I didn't want to argue, I just needed some medicine, you know. Here's what I need you to put me up. Exactly. So, um, but it definitely, if you don't look at the whole thyroid, you're missing out that subclinical hypothyroid person that feels miserable and you can't get them to feel good with your their pellets. There's something else going on. Thyroid's the furnace. Remember, it controls a lot of other hormones. So if your thyroid's not in check, the other hormones won't feel as good. Right. You won't get the benefits from them.

SPEAKER_03 29:06

Right, definitely. And that was one thing I was excited about when I saw my first round of blood work because she did check the full panel of for the thyroid, and I'm like, oh, okay.

SPEAKER_02 29:17

She checks everything. That's the most blood work I can get back.

SPEAKER_04 29:20

You get so much back on there, and everything's important, and you know it, you know, like your B D is important, your B12, you know, people need methylized B12. Um, so there's a little everything in there is important, it's just not random stuff.

SPEAKER_03 29:34

Yeah, right, exactly. It all means something, it all means something. Yeah, yeah. Yeah, so I was excited to know that at least I was in well, I was in good company, not that anybody wants to be in Hashimoto company, but at least she knew what I was going through and she could help monitor that while I was going through the pellets as well.

SPEAKER_04 29:54

When I first got diagnosed, um I checked my thyroid antibodies are supposed to be under 30 and mine were 4,000. And George is like, oh my gosh, this is too high, Judy. He had never seen them that high. And we'd test people all the time because we did re-occurrent miscarriage. That was one of our things. And so he called Escorn, who is a great endocrinologist. I don't think he practices anymore. But back then he said, Well, if her TSH is fine, don't treat her. And I looked at George and I'm like, I'm treating myself. Right. Because I feel like I feel terrible. I was the person that got up at five o'clock in the morning, went to the gym, I stayed up till 11, I had tons of energy, and then all of a sudden I was falling asleep on the sofa at 7, gained 10 pounds, you know, it was something was wrong. Right. And with my thyroid antibodies. It was my thyroid antibodies. So we started thyroid medicine then, and I was like game changer.

SPEAKER_02 30:51

Wow.

SPEAKER_04 30:52

And I did stuff like no gluten and try to watch, you know, be more natural eating vegetables, and it helps. It really does help.

SPEAKER_03 31:01

That was my endocrinologist was only doing the TSH. Uh-huh. And then uh my functional doctor, she recommended that I make sure that I'm getting all of them checked. And reluctantly, the endocrinologist ran it because she's like, Oh, well, you can look at it, but it's not gonna tell you anything. And I'm like, Okay, but it'll tell somebody something, and that's right. Right, right. If you don't want to look at it, that's fine. I just need the numbers so we could treat it functionally.

SPEAKER_04 31:29

It's just like when you look at a TSH and say it's normal. Then you look at the free T4 and it's normal, but you look at the free T3 and it's low. So it's all gone to reverse T3. So the it converts and it goes to reverse, and reverse I always describe to patients as just kind of sitting there, it doesn't really do anything. The free is what goes to our organs and works, makes our body work better. Right. So if you're looking at just at TSHs, you're gonna miss a lot. So those people are a good example of people that should be just on T3 because they are converting wrong. So I took I had one patient, it took me forever to get her doctor to put her on some T3 because she was on synthroid, the standard of care.

SPEAKER_00 32:12

Yep.

SPEAKER_04 32:12

And um her T3 was actually lab abnormal, it was 1.7, and I like them at three. And um, he finally did put her on some cytomal some T3, but it took a while.

SPEAKER_03 32:23

How did she feel then?

SPEAKER_04 32:24

Much better.

SPEAKER_03 32:25

Yeah, I had to ask for it. They I begged, I've changed endocrinologists several times because the first two just would not even play with it. They wanted me to be on this synthroid, and that was it, and I'm like, it's not working, there's something wrong with it. And then, of course, they're like, Well, wait another three months, we'll check your numbers again in three months. And I'm like, I have to live in that three months time, you know, like it was not an option just to check it again in three months for me. So I found somebody that will help me with it, and so now I'm on one that works better. But it was probably two and a half years before I found the person that would help play with it and make find what worked for me. That's great, yeah. But I think that's a message to our listeners because it's about getting the full blood workup, but then also advocating for yourself as well. I'm sorry to say you have to be at all that you need checked because they might do some things like your your vitamin D levels or something along those lines, and you're like, oh, no other doctors ever checked this, but there are some things you might be missing that you don't know to check, like the reverse teeth. Yeah. Correct.

SPEAKER_02 33:37

Yeah. Well, okay, so we have to end this episode. We do. So we can do the next one.

SPEAKER_03 33:43

Yeah, this is a B continue. Okay. Perfect. B continue, which is very exciting. Right. We told you guys we were gonna have a lot to talk about on this episode. Yes, yes, yes, yes, yes. Okay, what an incredible conversation. A huge thank you to Judy for joining us and sharing her expertise as a nurse specializing in hormone replacement therapy. We are so grateful for her knowledge, compassion, and reassurance she brought to this conversation.

SPEAKER_02 34:10

One of the biggest challenges women face during perimenopause and menopause is trying to figure out what's happening to their bodies while also feeling dismissed, confused, and overwhelmed. Conversations like this help empower women with information, options, and the reminder that they do not have to suffer in silence.

SPEAKER_03 34:28

So, so true. Whether today's episode helped answer questions about hormones, gave you a better understanding of HRT, or simply helped you feel seen and validated, we hope you walk away knowing there is support available and that your symptoms deserve to be taken seriously.

SPEAKER_02 34:45

And as always, remember, you are not crazy, you are not alone, and you deserve to feel like yourself again. If today's episode resonated with you, please share it with another woman who may need to hear it. And don't forget to follow Hot Flash and Sassy on Facebook, Instagram, and TikTok.

SPEAKER_03 35:01

Until next time, stay fabulous, stay fierce, and of course, stay sassy.