There are a lot of women out there who don't
quite feel right. They've had the test done.
The tests all look normal. Women are under -researched
anyway. We've stopped listening to the patient
in front of us. Six minutes is enough time to
say hello, write a script, say goodbye. There's
also an element of women being told their pain
is not real. I almost missed that too. I said,
you know, I believe you. So many of us don't
know who we are anymore playing roles that's
why when it comes to perimenopause and your hormones
say you know what fuck this shit when we fall
off The wagon in perimenopause, we fall off spectacularly.
It is not acceptable to not have that conversation.
The only person we have to really live with for
life is us, women in their 40s particularly.
They really need to start loving themselves as
much as they've loved everybody else. The 40s
Formula. The 40s Formula. The 40s Formula. Hosted
by Jasmine Dillon. Integrated health strategist
specializing in gut health, hormones and midlife
well -being. And Amanda Lim, director of Lift
Clinic and a leading expert in female strength
and metabolism. Named one of CNA's top podcasts
and winner of the 2025 Asia Podcast Awards in
the Best Health and Wellness Podcast category.
The 40s Formula is your no fluff, science meets
real life guide to thriving in your 40s. Have
you ever noticed that your body reacts differently
in your 40s? Your sleep feels lighter, anxiety
feels louder, and energy is less predictable.
And even though you're not doing less, things
suddenly feel harder to manage. A lot of women
experience this and struggle to explain why,
because the symptoms just don't sit in one place.
Our guest today is Dr. Olivia Lee -Lesler, an
Australian medical doctor and an expert in psychoneuroimmunology
and longevity medicine, known for her ability
to connect the dots across complex, multi -system
conditions that don't fit neatly into conventional
frameworks. Before we get going today, we need
your help. Subscribing is what allows us to bring
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So if this show helps you feel seen, understood,
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us. Hi, Olivia. Thank you for joining us today.
Hi, thank you so much. You know, it is my first
podcast this year. Oh, thank you for kicking
off the year with us. We're really honored to
have you. Thank you. Oh, we are really excited
for this conversation because there are a lot
of women out there who don't quite feel right,
but don't know what's going on. They've had this
out there. In here as well. Yeah, I mean, I think
you're 100 % right there. But, you know, they've
had the test done. They know something's not
the way it should be. The tests all look normal.
What is going on with these women? Well, first
of all, we all know that women are under -researched
anyway. So we don't fit very neatly into all
the algorithms that doctors have because a lot
of those algorithms are actually built off men.
And actually, specifically, white American men.
There's no doubt that there are plenty of people
and women who fall out of those algorithms. And
so it's a little bit harder to pick up. I mean,
what's the statistic? It's something like six,
seven, eight years to get diagnosed with endometriosis.
Yes. Right. And it's not the only thing that
gets missed. So the reason why a lot of people,
they don't feel quite right, but nobody can sort
of tell them what's wrong is because too many
doctors, not everyone, But too many practitioners
are going off those algorithms. We've stopped
listening to the patient in front of us, treating
them as a whole person, listening to their story.
It's the system that we're in. We don't have
time to listen to our patients. Six minutes is
enough time to say hello, write a script, say
goodbye. So in part, it's the system. In part,
it's the algorithm. And in part, I think. we've
actually also lost interoceptive capacity. Interoception
is that ability to know what's what in your body.
How many of us women have very good intuition
and it gets beaten out of us in our lifetime,
right? We're meant to be the nice girls. We're
meant to accommodate other people. We're meant
to be the people to regulate others. We're meant
to serve. Whatever the role is that we have assigned
ourselves or being assigned by society. It tramples
on our interoceptive capacity. So many of us
don't know who we are anymore because we are
playing roles. That's why when it comes to perimenopause
and your hormones say, you know what? Fuck this
shit. Oh yeah. Right? And your kids are now off
to school. You know, you have to discover who
you are again. And all of a sudden you're like,
wow, this, I don't, I don't know. And this is
the thing, you know, you just said that women
are not, listening to their body or they can't
hear their body and if they can't hear their
body how are they meant to articulate it to somebody
else who might be able to help them that's exactly
it and i think there's also an element of women
being told their pain is not real and that drives
me back to your endometriosis yeah situation
we just recently had a guest on the show talking
about her own delayed diagnosis of endometriosis
Because she was already a chronic pain sufferer.
So a lot of doctors, they hear chronic pain,
they immediately turn off because they're like,
oh, woman's talking about pain. It's undiagnosable,
you know, sporadically symptomatic, whatever
it might be. She has stage four invasive endometriosis,
but she didn't have the words for that specific
kind of pain. And so it was dismissed. Yeah.
You know how many stories there are like that
out there? And thank God for social media, which
I mean, you know, for all its flaws. it is at
least bringing these sorts of issues to light.
You know, stories of women's pain being dismissed
because there is still in the older generations,
you know, the idea that women can be hysterical.
The one thing that I have come to understand
in my practice, and it was a journey to get to
where I am, you know, and I'm still on this very,
very long journey, I'm sure, is that you really
have to hear the patient. I almost made, this
mistake not too long ago, where I had a 41 -year
-old male, and he'd been with me for a couple
of months or so. He knew something wasn't quite
right. Seven years, all his tests were normal,
right? And when I'm talking to him and listening
to him, to be honest with you, he kind of came
across as a little bit health anxious, okay?
And I was... Just about to label him as such
in my head and then sort of try to do the reassurance
thing rather than the be curious thing. Big mistake
for a doctor. I said, you know, I believe you.
If you say something is wrong, I believe you.
And that changed my frame of mind so that I started
to look at things a little bit differently and
started to investigate things a little bit differently.
Early onset neurodegeneration. Wow. At 41. Wow.
I almost missed it as well. Wow. So he'd seen,
I think, two or three previous doctors. No one
had picked it up. He's 41. He's a high -functioning
C -sweeter, you know. And I was brought in just
as kind of like a consultant, second opinion.
Yeah. And I almost missed that too. Wow. How
did you pick it up? It was from observation.
One of the subtle things that I noticed with
him is that about 6 to 10, 12 hours after a heavy
gym session, his sense of humor would change
very subtly. And his ability to multitask changed
very subtly. So subtle, you couldn't pick it
up. All the psychometric testing that we did,
you know, you didn't pick it up, right? Word
recall, fine. He's a C -suite executive. And
because it's so early. You know, he was still
compensating really well until he didn't. And
then he was able to compensate until he didn't.
And you just had to pick it. So it was looking
for those very, very subtle signs. I wound up
doing a neuroquant test. So a neuroquant test
is a scan of the brain, which shows you all the
different volumes of different parts of the brain
matched against age match controls, basically.
How big that part of the brain is compared to
other people your age. and global atrophy to
the brain. A friend of mine happens to be the
chief scientific officer for Alzheimer's Research
Australia. So I was able to get a test, which
is actually available in the US. It's a blood
test, 97 % sensitivity for Alzheimer's, or rather
a amyloid process in the brain that has started.
And his was high. Does the high intensity gym
session relate to... Your muscles are the organ
of fight flight. So it is going to prioritize
the remodeling. It's going to prioritize the
maintenance of expanded tissue mass. And when
it's prioritizing that, something has to give.
And so at that point in time, when the energetic
demands are the most during remodeling and maintenance,
there is a window of neurocognitive vulnerability.
Does that actually mean that A equals B? No,
there's a lot more things in between, but that's
basically what happened. But that was the signal
that you were able to pick up on. Yeah. How interesting.
What about women? I'll tell the story again.
Make it a woman. Oh, actually. Oh, yeah. As I
saw this pattern, I started to ask more questions,
not just of him, but people that I was seeing
outside. who were gym goers. And I happened to
meet a female bodybuilder in Bali. And so I kind
of said to her, you know, when you guys are bulking
up and preparing for competition, do you get
brain fog or neurocognitive issues? And she goes,
oh yeah, that's common. Anybody who's shredding
gets brain fog. I was going to say, I feel like
it would be the shredding situation rather than
the bulking situation. I feel like the bulking
is probably when you feel kind of your best.
Exactly. And the literature does show that. So
it's not a whilst you're bulking or whilst you're
resistance training or anything like that, that
you get this neurocognitive fatigue. It's a delayed
window. Right. So it's a few hours later. That
my hypothesis is on. And it's only for in context
of people who have constrained bioenergetics
and susceptible individuals. It's not universal.
And this female bodybuilder was telling me that,
you know, cognitive fatigue or brain fog is actually
very common. It's almost universal when you're
shredding. Now, of course, in bodybuilders, it's
all confounded by the fact that many of them
are using... steroids and stuff like that. So
too difficult to sort of sift through to try
and find a signal. But her experiences really
helped sort of move me along in this path. And
I've been working on this problem for about six
months and I just finished the paper to then
send to potential co -authors to then have that,
to then send it in for peer review. So I'm very
far away from publishing. That's so exciting.
We have a little behind the scenes of what's
upcoming. Obviously, people come to you when
they need answers because the first pause of
call hasn't given them the answers, the justification
compared to what's actually going on and how
they're feeling. Is there a common theme that
you're seeing, especially women in their 40s?
Yeah. So a lot of it would be symptoms that are
not proportionate to what's happening in their
life. So kind of like a PMS thing. or PMDD, so
a premenstrual dysphoric disorder, perimenopause,
you know, and all these things are frightening
because it's not how you would normally react
to X, Y, Z. So that's one of the first things.
Neurocognitive strain, fatigue, brain fog, that's
another thing for sure. But a lot of it in the
40s is usually sort of dismissed as perimenopause,
which to be fair. A lot of it is, but that's
a very complex condition to be in. And the psychoneuroimmune
endocrine system interactions are huge. It's
not just a label you stick on someone and you
get them out the door with a little bit of estrogen.
We're talking a proper life transition, a beautiful
concert. of all the different pathways interacting
with each other and a whole person in front of
you that's about to walk into the next phase.
And so to dismiss them out of hand for bits and,
oh, it's just anxiety. I'll just get some, get
more sleep, whatever. It's very damaging. You
know, for women, especially who many of us haven't
been taken as seriously as we should have been
when we were growing up, when we were at university,
when we were in male dominant. dominated industries
and this is yet another opportunity for the medical
fraternity for health practitioners to step up
and to validate someone's experience i think
that's the thing a lot of women just don't have
the capacity whether it's the physiological capacity
or the psychological capacity everything just
feels so much more limited in what they can do
I've heard you speak about communication, like
your body is trying to tell you something. Can
you go into that for us? I truly believe that
generally speaking, your body is trying to protect
you. It's literally survival, right? It is going
to implement physiological and behavioral patterns,
which are going to hopefully help you survive
in whatever environment you find yourself in.
So when we see people with an itch we know from
an evolutionary perspective that that itch is
actually meant to help you scratch off a pathogen
or something trying to get in asthma with the
constriction of the bronchioles is to prevent
a possible issue going deeper into the lungs
which is a lot harder to get rid of so i see
symptoms as your body trying to protect you in
some way, shape or form. And it's responding
to a threat, which does not have to be overt
or objective for that matter, which is why one
person's threat is another person's eh. And so
a lot of it is about perception, not necessarily
prefrontal cortex perception. You know, it can
sometimes be a subconscious perception. Some
of these things are running, these scripts are
running in the background that we have no idea
about. Then you can sort of go into the epigenetic
stuff, intergenerational, transgenerational traumas.
I mean, there is a lot of research and evidence
for stuff like that. Actually, I was talking
about the cherry blossom mouse study to someone
recently. And basically what they did was they
had a generation of mice and they exposed them
to the smell of cherry blossoms and then they
electrified the floor, causing them pain. Wow.
So then, of course. They associate the smell
of cherry blossom with pain. So when the smell
comes down, they're then hiding. They had pups
who were also afraid of the smell of cherry blossom.
But had never been electrified. But had never
been electrified. And had not had any contact
with the parents. Wow. So it wasn't like... So
they were just separated from birth. Right. And
so did the grand pups. Wow. That is incredible.
And then... So meaning they tracked it for two
generations. Right. Well, and then the third,
the great grandpups were fine. So, you know,
there is something to be said about intergenerational
and transgenerational issues, trauma. And that's
just a smell, girl. Imagine some of the things
that your patients and folks that we see as well
are telling us. And this is encoded because it's
going to help you with survival. Exactly what
we were saying about some of these symptoms that
women are experiencing. It's their body trying
to make sense of this world that we find ourselves
in, where we have ancient genes and an ancient
brain trying to survive in a modern world. And
a lot of our responses were. adaptive at some
point but are now maladaptive and then we pathologize
them instead of going let's be curious what's
happening here how do we calm your system how
do we let your body your heart your mind know
that you are indeed safe how do we develop coping
mechanisms how do we increase resilience how
do we increase bandwidth like these are the questions
that we should be doing asking instead of pathologizing
everything and then the quick fix is a drug to
numb there you go because that's not treating
the actual issue no and it can increase bandwidth
which is very important for some of us right
yeah a an anxiolytic you know something to help
with anxiety something to help with sleep can
really help just put you in a position where
you can begin the work of building your resilience.
And sometimes that's a week and sometimes that's
a year and sometimes that's forever. There's
no shame with that. But when we doctors are in
a position of authority where we tell someone
that they're broken and that their only salvation
is in this script, that's what I have issue with.
And I think that is where the medical profession
has unfortunately evolved to to quite some degree.
And I think I see that even more here in Singapore.
I don't say blind trust, but that's what comes
to mind of physicians and medications. I do feel
like there's less of a critical eye on anything
the physician says here and any drug that's prescribed.
Anytime you go to the doctors here, you know,
you'll come back with a bag full of medicines.
It's like, OK, which one do I really need? Exactly.
So I suppose, I guess it's cultural in Asia maybe.
But you know, in Australia, the TGA, which is
like the equivalent of the FDA, they are funded
by industry at the highest percentage in the
entire world. 96, 94 % of the TGA is funded by
industry. I'm not saying that that in and of
itself is bad, but you can understand why our
algorithms are very heavily skewed towards pharmaceuticals.
Are pharmaceuticals inherently bad? No, of course
not. This is a very nuanced topic, but I think
that it's important for us to know who the players
are, to know how much influence those players
have, so that we can make informed decisions
about how we practice the art of medicine. Because
medicine does require us to interact with a person
and all their fabulous genetic, social, psychological,
emotional components too. And sometimes patients
don't want to be numbed. Sometimes patients don't
want a quick fix. A lot of people I feel now,
more and more, They are willing to do the hard
work. And we have more tools for people to do
the hard work, right? And I think that the medical
fraternity has to catch up a little bit. Can
we talk about how no one prepares you for how
your skin changes in your 40s? Honestly, one
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So don't forget to support the show by using
code TFF. You mentioned modern life seems to
be at the sort of crux of a lot, a lot of people's
problems, you know, like food. the processed
food, the lack of movement, the ingestion of
risky substances, maybe not being able to manage
their stress properly, that lifestyle is something
that can actually help in a way that maybe medicine
can not deal with, but medicine can assist with.
But there needs to be other changes involved
as well? Yeah, absolutely. I mean, lifestyle
medicine has exploded. So central because a pill
is something that you do in a split second, which
obviously has some effects physiologically over
a longer term. But lifestyle is intrinsic and
it's something you do every day for the rest
of your life. And the best part about lifestyle
is that it's your choice. We're bringing agency
back into the room. The other thing about lifestyle
as well is that because there are so many lifestyle
factors, tools to choose from, you pick your
own adventure. You're able to experiment and
see what works for you. Whereas when we do a
drug or a supplement for that matter, it's got
a very defined scope and it's kind of a one -size
-fits -all situation. But lifestyle is just,
there's just something a little bit more fluid
about it. And there are so many lifestyle pieces
to choose from. And you get to decide how you
want to layer those behaviors when you introduce
them, when you pull back on them. The best part
about lifestyle factors is that most of them
are free. Lifestyle is a huge, huge part of health.
No question about it. If we boil down the top
five causes of death and the relationship of
lifestyle to that, I mean, it's clear, right?
However, talk to me about your perspective on
the role of lifestyle and the role of a specific
drug. So GLP -1 receptor agonist in that group.
You mentioned how sometimes the use of drugs
is a tool. So we're prescribing clinic for these
types of drugs, which is why I'm asking this
question, right? It's interesting because patients
come in, half of them are like, I want to get
on this drug. I want to get on it quick so I
can lose weight quick. Then on the flip side
of that, we have patients presenting with obesity
and diabetes that don't want to get on the drug
because they want to do it. the right way, the
lifestyle way without the assistance of pharmaceuticals.
Because it's cheating. Because it's cheating.
And because I should be able to do it myself.
Can you talk about how you would have a conversation
with that patient? Well, first of all, anything
where you constrain a person morally, right?
Because they put a moral judgment on the GLP
-1s, right or wrong. And anytime you have moral
constraints, philosophical constraints like that,
that's stress on your system, right? That's where
judgment comes into play. Then you've got guilt,
then you've got regret, and you've got all these
other low vibration emotions that will follow
constraints like that. So the first thing I need
to do, talk to the patient, is actually talk
about why they have these philosophies around
the right or wrong of whatever it may be. doing
it the right way, that's already scary. But if
they want to do the work, that's different from
thinking that that is the right way. I think
that patients who kind of, you know, no, doc,
I don't know. I'm kind of happy to sort of lose
weight slowly and go to the gym. And, you know,
I don't want to take that. That's very different
from, no, no, no, no, no. That's bad. This is
good. I personally think that GLP -1s are like...
every other drug and supplement where used for
the right patient at the right dose the right
frequency at the right time can be very appropriate
the problem when you have such a effective let's
just say tool is that there is infinite scope
for overshooting absolutely And we do patients
no services when we assist their wanting to not
do the work. Weight is not just metabolic. It's
psychological. It's emotional. Absolutely. We
have only so much time before we become old.
And this is another thing that we have to address.
The fact that we feel that unless we are slim
and young and beautiful, especially women, then
we think that we are of no value. And this is
a message that gets repeated at all levels, overt,
subconscious, and weight is intricately linked
to that message. So Peter Diamandis is in town
at the moment. He's the co -founder of the X
Prize. He was talking about three things that
would be, you know, oh, you want to be young
and bright and thin. I hate that word thin. Yeah.
I also hate thin. Well, and skinny. Yeah. I hate
the most that one. But thin is like what my mom
would say. And no offense, mom, but meaning like
neither of those terms are favorable to me. It's
kind of like how we discuss men sometimes when
we talk about height. When we say, oh, blah,
blah, blah, and he was tall and he was this,
implying that short is not attractive. There
you go. Now, of course, weight is an important
topic. Of course, it's about metabolism. It's
about mobility. It's about strength. It's about
a lot of things. But the discussion around weight,
I think. has to be nuanced. We can't be talking
about thin being an end goal. That's how we get
eating disorders. Yes. And you know, when you
say weight, what I always talk about with my
clients is this idea of lightness. It's like,
it's not about how light. You are on the scale.
We can do that with osteoporosis. Sure. You want
me to take something from you? I'll take your
bones. But if you need something heavy, I'll
take your bones out. But we always say we want
you, for our patients at Live Clinic, we want
you to be the heaviest version of a healthy weight.
So the heaviest possible. healthy weight person
you can be that's actually what we want from
you because then you know that speaks to your
most dense bones your most dense muscles you
know and again healthy weight is a huge range
right it's a huge range so it's not it's not
pinpointing you to you know ideal weight which
again is another term I actually hate ideal weight
goal weight can't stand it yeah you know but
if there's a range of weights at which your cycle
is regular you're able to do the athletic activities
you want move without pain that that weight within
that range And then the heaviest version of that
range, that's actually where you're thriving.
You know, that's interception as well, right?
Because people looking at a scale to tell them
where they should be, that's a problem. You know
when you're bloated and your hormones are playing
up a little bit lethargic and whatever. Those
are the signs that you know when something doesn't
sit quite right. But looking at an external thing
to tell you how you should feel. Slippery slope.
That brings me to wearables. So what's your opinion
then on wearables? Like people looking at their...
We won't be offended. I'm doing it. So my resting
heart rate right now for the last seven, eight
months, I feel like it's been off. It's been
months. It is high and I'm like freaking out.
But the other day my battery died. It wouldn't
charge. And I was like, you know what? I'm just
going to ignore it. And I went to sleep and I
woke up and I was like, I feel good. I don't
know what my resting heart rate was like, but
today it's still high. But what's your opinion
on that? People looking at a wearable to decide
how they feel. Okay. Again, goes back to interoception.
And in part, I totally get the test don't guess.
Yeah. And you can't change what you can't measure.
Those are absolutes. And it's a bad idea to deal
solely in absolutes. That was an absolute. Never
do that ever. But there is obviously some logic
and some wisdom to those tropes. But when a patient
sacrifices their mental well -being to the scales,
to their wearables, that's when that's a problem.
When we completely ignore. how someone feels
in deference to, but your tests are normal. That's
the other side of the coin. I don't have a problem
with wearables when they're used appropriately
at the right time for the right patient, at the
right dose, at the right frequency. But I would
never tell my patient what to do for themselves.
But I don't wear wearables. I did an Oura ring
for a few months. And it's a really interesting
concept where they're taking data to be able
to tell you where your valence and intensity
is with regards to arousal. In other words, it's,
are you in a highly aroused state whereby it's
probably going to be a speed hump to making good
decisions? Therefore, if you were the president
of the United States and you were hovering your
hand over the rip, big red button to start nuclear
war why don't you wait till your valence and
arousal is a little bit lower it might open up
some bandwidth to make better choices and what
what um metrics is that running for how is it
so it's it's hrv and yeah the algorithm has been
sorted out by neuroscientists neurophysiologists
i'm not privy to that The company is called InTruth
Technologies and they've just launched actually.
I'm really excited. And it's through Garmin?
You can use, right now we're using Garmin, but
I think you're going to be able to use a number
of wearables. So InTruth is the technology? Yes.
And the algorithm. You know, things like that
where it doesn't tell you. Good, bad, yes, no.
It just gives you information with which you
can make decisions and you can experiment. Okay,
when I'm in a highly aroused state like this,
I actually feel clearer. It is helping me strategize.
Okay, that's you. That's great. That's my husband.
That's an emergency medicine doctor right there.
It's like the most insane of situations. He is
crystal clear. And then it's like your day -to
-day stress. Took the kids to school yesterday,
forgot one of my son's socks. I was like, bro,
socks. There's an S at the end for a reason.
Yeah. Interesting. But yeah, so it's like, you
know, I think there are people that operate at
that highest level in that highest state, but
potentially that would never be everyone. Yeah.
That's why we're not all emergency medicine doctors.
And now you have this information which you can
learn what that means for you. whereas I feel
a lot of wearables where they have these reference
ranges you know oh your heart rate variability
is too high it can be very stressful for some
patients not everybody some people are like eh
and other patients I have this story actually
a concierge patient this is a few years ago he
woke up and he had to go film he was making a
movie he woke up and his my readiness score is
really low. Oh dear. And I'm thinking, oh my
God, okay. And we spent like 45 minutes, an hour
discussing what did you do differently today
than yesterday? How was your sleep? What did
you eat for dinner? How did that affect you?
Blah, blah, blah, blah, blah. It was an aura
ring. And then eventually, because we basically
came up with nothing, I said, hey, hey, hey,
how do you feel? I feel fine. Well, then go hit
it. Go film that movie. I think they're all tools
and tools are only as good as, you know, first
of all, how you use it. But secondly, if they
stay servants to you being the master, the minute
it starts to run your life, that's a problem.
And I think now's the perfect time to bring in
our sponsored segment, which is Fuel Your 40s.
And it's sponsored by The Meat Club, where they
bring you sustainably sourced. produce and protein
from Australia and New Zealand. And they have
a question for you, Olivia, and that is from
your perspective, what do you see when women
are under fueling, especially when it comes to
protein? How does that affect women? I think
it can be said across the board that most people
are not taking in enough protein, full stop,
end of story. When it comes to women, we tend
to not only be the people running the households,
we also have important jobs where we're needed
there. And we also tend to have the majority
of the emotional and housekeeping labor. So before
when I was talking about that finite substrate
pool, that finite pool of resources that the
mitochondria need, that includes protein. When
we don't consume enough protein, we put ourselves
at risk. For our mitochondria not being able
to produce enough energy for us to meet all the
demands that are placed on us, specifically as
women in this day and age, quite a few more demands
on us that are unseen, not taken into account.
And so when you put yourself on the back foot
like that with not enough protein, not enough
substrates to feed your mitochondria, you actually
do open up these windows of vulnerability. It
doesn't have to be neurocognitive, doesn't have
to be your muscle remodeling or maintenance.
It can be emotional. It can be psychological.
And because we're the ones sort of regulating
the household sometimes, who's regulating us.
That's so true. So many of you have got amazing
partners and you're very lucky because there
are many women who don't. Anyway, I'm glad that
you guys, Talking about meat. This is a foundational
sponsorship for us because we really believe
in animal -based and quality proteins. And obviously
sustainable sourcing is huge. Yeah, absolutely.
For us, it's a non -negotiable. I believe in
energetics. And so I do believe that if an animal
is not kept in a well state before it's brought
to the table to fuel our bodies. that we carry
some of that energy forward, which is why when
I do eat meat, it really, is this grass fed,
grass finished? You know, is it pasture raised?
Does it have a name? Do you have a photo? Did
it smell cherry blossom at any point in its life?
But you've hit the nail on the head. It's quality
protein. Now, can some... Can women fuel themselves
with plant protein? Of course they can. For example,
I know my genetics. I have a BCMO1 SNP, which
means that I do not convert beta carotene. So
it's the pre -vitamin A in plants. I don't convert
that well at all to a usable vitamin A that a
human can use. That's so interesting. Does that
mean that you have poor eyesight? It means that
I have to be very conscious of where I get my
vitamin A from. Or yes, my eyesight is left vulnerable
and then can lead to poor eyesight. Maybe that's
what I have. Why am I so blind, Dr. Olivia? That
wasn't part of your circle. I mean, they don't
give you the snips, do they? No, they don't.
But does it say on there? I can't remember if
it tells you what your eyesight is like epigenetically.
We've both done circle DNA, which is kind of
like Singapore's 23andMe. One of the things I
did was I took my circle DNA. And I put it into
chat GPT and I was like, tell me, you know, like.
The real deal. Yeah, like evolutionarily. Who
am I? Who am I? You know, like what role would
I have had? What role would I have had if I was,
you know, living in a tribe? Just because I 100
% agree with you that, you know, as humans, our
genetics haven't changed. But our world has,
and there is this massive mismatch between, you
know, who we're meant to be and who we are today.
That comes with the mental load. That comes with,
you know, everything that's going on. And like
you mentioned earlier, that social media seems
to be the forefront of what's happening in our
lives today. You know, everyone jumps on and
like sees what's going on on social media. And
it is affecting us. in a big, big way. It's that
unseen stress that we're not really taking on
board. I had a client the other day and she was
lamenting her Russian genes. So there's two types
of Russian women. There's right off the catwalk,
born skinny, gorgeous, tall, just outrageous.
And if you've been to Russia, you will see these
women lining the streets, no joke. And she said,
then there's me. And my aunties and my grandma,
grandma, and we're the working class. And, you
know, and we just, you know, we're short, we're
stocky. We're, we're, you know, we make it to
105 years old. You know, the little Russian grandma
that you imagine in your, in your caricature.
And she's like, I just wish I was the other one.
And I was like, I'm going to, I'm going to counterpoint
that and say, if we view these through a lens
of metabolic health, she's. muscle dense. And
this is something you just kind of tangentially
referred to about having too high in HRV. When
she went through my InBody, all of her muscularity
was over. The category that InBody gives you
is over, right? And she was like, see, see. And
I was like, no, over -muscled doesn't really
exist. Optimally muscled is what I always say.
If you want to see an O word on the page, it's
optimal. Like you want to be over -muscled. The
point being, social media and cultural conditioning
are obviously why she sees her own body type
as less than or as less desirable, right? Because
right now, it's less congruent with what she's
seeing on social media is the idea. Do you see
that in patients even our age? Definitely for
women our age, for sure. I think that the younger
generation coming through seem to be less married
to... archetypes. Partly, I think it's because
they're rejecting what we're trying to shove
down their throats. But then again, I don't see
pediatric patients and I don't have kids. So
this is what my corner of the Instagram is telling
me. I just can speak about women in our 40s.
Part of our burden is that we are at that, unfortunately,
coming out of the block. where the Women's Health
Initiative really trampled on doctors prescribing
hormones for fear of cancer. And I tell this
to all my female patients with whom I'm speaking
about hormone replacement therapy. My mother
had a full hysterectomy with a miscarriage after
me. So she was quite, I think she was in her
early 30s. And so from her early thirties, she
was put on HRT. And she was that rare person
who did get a breast cancer more than likely
from the HRT. And I still recommend HRT. HRT
now is not the HRT then. We understand far more
about... more biologically identical hormones.
This is not from pregnant mares anymore. We are
talking about not just estrogen, but also progesterone
and a touch of testosterone. We are monitoring
our women far closer. We're also talking to them
about their psycho -emotional, psychosocial health,
stress reduction, stress resilience. HRT today
is not the HRT of 20, 30 years ago. So any woman
who is entering or in past perimenopause and
they are not on HRT they need to have a very
good clear discussion with a doctor who is not
just empathetic and sympathetic but someone who
is truly informed it is not acceptable to not
have that conversation and that's what we're
trying to determine here making sure that people
understand that all we're saying is that it is
appropriate very appropriate to have the conversation
because estrogen is neuroprotective. Estrogen
is actually also a mast cell stabilizer. When
you don't have estrogen, for those people who
have a propensity for your mast cells to degranulate
so that you have these allergy -like symptoms,
the hay fevers and the hives and the gut issues,
that could be because of that loss of estrogen
and your mast cells are a little bit more twitchy.
Yes. We see that all the time in clinic, by the
way. The unexplained hives and rashes. Okay.
I used to have that. And so literally the patient
will be sitting in front of us and she'll be
in for, let's say, hot flashes or whatever, whatever.
And at the very end of the conversation, she
goes, oh, and do you have anything for like high,
like thinking this, we've ended the conversation
about hormones. Let me talk about skin. And it
was like the same conversation. We're already
in it. Same conversation. Let's continue this
conversation. Tell us more. Or they'll bring
up the frozen shoulder. Yes. They're like, okay,
so yeah, so I need, you know, my sleep needs
to improve, blah, blah. Oh yeah, doc, because
my husband's also a sports med, right? So they're
like, oh doc, you know, do you know about anything
about this weird shoulder thing? Also hormones.
Also hormones. And I think your point about the
lack of knowledge around women's health in terms
of what's public, why is it that the Women's
Health Initiative study, it just won't die. I
mean, the ramifications of, you know, or the
mantra, you know, HRT causes breast cancer, right?
That's in everyone's, somehow in everyone's mind.
And yet the knowledge of these 70 plus documented
symptoms of perimenopause that would warrant
a conversation about menopause hormone therapy.
Goes by the wayside. Including our eyesight,
by the way. Yeah. And hearing. Whatever do you
mean? I could never be in perimenopause at my
age. Well, we heard it from a doctor as well.
You're hearing. I was like, what the hell? A
revelation. Now when my kids are talking to me,
I'm like, I can't hear you. You need to look
at me. You need to say it clearly. Articulate.
Yes. I was actually 36. I had newborn twins and
I started getting hot flushes. If it wasn't for
the hot flashes, I wouldn't have connected that
my anxiety, my wrist pain, which I thought it
was because I was holding two bottles. There
was a lot of stuff going on that I just thought,
oh, this is happening because of the babies,
my sleep. Obviously that was the babies, but
it was also the perimenopause. Oh, you started
perimenopause? Yeah, straight after the twins
were born. I was 36 years old and... You know,
I was sitting there, I was watching TV and I
had a hot flush and I jokingly said to my husband,
I think I'm in menopause. Because at the time,
perimenopause wasn't a term that people used.
So I booked a doctor's appointment. I went in
to see them. They did some blood work and they
basically told me I had premature ovarian failure.
I remember crying, having this big conversation
with the doctor and being like, you know, will
I get cancer? She sat me down and we spoke about
the bioidentical and I made that decision. I
said, OK, let's do it. And I'm so glad I did.
And then I've got friends now who, you know,
are mid 40s and they're like, oh, I feel like
this. Have you been to the doctors? Have you
spoken about HRT? And they're like, no, I will.
I will. And I'm like, why are you putting it
off? I have this conversation. A lot of patients
don't realize that there is a window within which
you need to start the HRT or it doesn't confer
as much benefit as it could if you wait too long.
Especially for any woman out there who has got
2E. which means ADHD, autism, OCD, giftedness,
something. So it's two of these exceptional diagnoses.
So especially twice exceptional women, women
in particular. So when we have giftedness and
ADHD, when we fall off the wagon in perimenopause
because we lose the neuroprotectiveness. the
neuroprotection of estrogen, we fall off spectacularly.
Wow. And our mortality rate compared to non -2E
counterparts is 15 years if we do not get on
top of the hormone and then the subsequent neuroimmune
dysregulation. So is that when women... go through
burnout is that part of what's going on there
yeah because you hear that a lot you hear that
you know you know women are like is it adhd is
it burnout but actually it could be because of
the adhd the lack of estrogen is leading to this
because adhd along with lots of other things
right that the stress at work and balance you
know balancing a family with twins and Three
boys I've got, by the way. So it's just my household
is nuts. But all these are drawing from a reserve
and that reserve is finite. And of course we
replenish, but if we don't get enough protein,
if we don't get out in the sun enough, if we
don't ground, if we don't have any of these practices
that are going to feed us and not, I don't mean
just calories here, right? Then your... pushing
through your resources quicker than the next
person. And that's why for us, where we go into
perimenopause, we start to see symptoms that
can be a lot more drastic than some of our counterparts.
Wow. Olivia, this has just been an incredibly
insightful conversation. I wish we could continue
for another hour because it's just been so amazing
being able to speak to you and hearing your insights.
But we do have to finish up today. But before
we do, we have one last question we'd like to
ask you. And that is, what's your 40s formula?
What can women do in their 40s to really help
them thrive in this decade? So I recently, despite
my profession and my age, but I recently discovered
resistance training and, you know, really get,
yes, really getting into it. And I'm loving it.
And I still, that's still not my answer, even
though that's so important. My answer, and it's
driven by my own personal experiences. It's self
-compassion. Because we've had to hold so much
and some of us haven't had anyone hold us. And
the self -compassion bit is about providing that
space for ourselves to just be. And whatever
you come as is okay. Doesn't matter if you're
fat or thin or... you know, divorced or any of
these other labels that get slapped on you, which
tells you that you're not enough. The only person
we have to really live with a whole life is us.
And the self -compassion piece is really important.
If we could campaign for a seventh pillar of
lifestyle medicine. And I'm serious. I'm like
actually serious. I think it would be self -compassion.
Because, you know, when you give so much of yourself,
which women do, you give so much of yourself
your entire life. At some point, you hope that
your neuroimmune system doesn't learn to not
look within. The autoimmunities, possibly some
cancers. Anyway, self -compassion. I'd love to
say that that was the formula for the 40s. It's
the formula for everyone at all ages. But yeah,
I think women in their 40s particularly, they
really need to start loving themselves as much
as they've loved everybody else. That's right.
And I love that. Yeah. Sooner the better, right?
Yeah. Thank you so much. It's been amazing. Thank
you. Thank you.