Kim Vopni (00:01.379)
Thank you so much for joining us, Dr. Betty Murray. I am excited to have a conversation with you. I joined you recently on your podcast. I've known for a long time that I wanted to have you on mine, so I'm glad we got to flip it over and have you here. I love your work. I'm a huge fan of anything, anybody, anything talking about hormones and optimizing women's health and the reframe that you have that menopause is not this.
decline or aging is not something that we should just think is going to suck and it's eventually just, you know, eating us away. We have to look at us as your term of a power surge, which I love. So before we dive into that, I would love for you to introduce yourself. Tell us a little bit more about who you are. What got you into this world of women's health and gut and hormone and all the things we're going to talk about today.
Dr. Betty Murray (00:51.32)
Sure, sure. So, you know, think first and foremost, I think like most people that end up in the integrative and functional world, I didn't start here. I actually was in, I was in tech, so as we talk about kind of what I'm up to today, this will all make sense. But I was diagnosed with colitis and this was in my 30s and I asked the doctor what I thought was a really legitimate question. Could I change my diet and change the trajectory of this autoimmune digestive disorder? And he barked at this laugh in my face. I mean, it was like,
And he goes, it has nothing to do with what you eat, and very, very condescending. And I was like, that's interesting, because you know what? If I don't eat, oddly enough, my gut stuff starts to get better, but I can't starve myself. And so I had already been doing yoga and trying to work on my stress. I was in IT working 100 hours a week as the first woman hired into the company that I worked for in that department. So it was difficult. And when I went back and I kind of got deeper into, particularly organic chemistry, I was like,
oh my God, this is where I need to be, which I know sounds weird to most people, but you know, it's just like, oh, this is what really happens at a cellular level. And so I was able to get my digestive stuff underway, but right behind that, in my late 30s, my hair started falling out, I started getting acne on my chin, I had been on birth control for forever, I had my tubes tied because I didn't wanna be on birth control, but I didn't wanna have children at that point.
Kim Vopni (01:53.529)
You
Dr. Betty Murray (02:19.574)
And at the time they're like, it's your adrenals, your thyroid, your this, your that. Well, that started this basically decade long journey of a really horrific perimenopausal experience. And Kim, this is despite having access to the most luminary New York Times bestselling authors of functional medicine. I'm an OG. I was going to IFM events when there was like, you know, a thousand people at most.
And everybody I worked with, everybody I talked to, it was something different. No, it can't be this. No, it can't be that. And a lot of what I tried didn't really work. And that's what prompted me to go back to get a PhD. And I ended up getting a subsequent master's and PhD really looking at how we metabolize hormones. So not just how we make them and what we do with them, but how do we package them for the trash. And for me, that helped illuminate a lot of what I experienced. Because I experienced weight gain overnight after my tubal. I'm talking.
like 30 pounds in a matter of six months. And I used to body build, right? So it's not like I don't know how to manipulate my body. And you know, so I understand when women are like, the wheels came off the bus. And so I've had a clinic for 20 years and so we've been working on this framework for forever. And so once I've really got even further down that road and research, we've really kind of changed how we treat, because we've been doing hormone replacement the entire time. And I was able to now, I'm 55, I'll be 56 next month.
I feel better than I did at 40. I am at the same body composition I was without having to be like, no carb passes these lips, because I'm also not willing to do that in this particular life that I'm in, in this time period. And I feel better than I did. And there's just so much misinformation and also lack of information for women. And it's quite frankly pissing me off.
Kim Vopni (04:08.823)
Yeah, yeah. All right. Well, let's let's use that fuel for those that aren't familiar with. Well, I think I think it started to become a bit more talked about, but there still are some people who aren't familiar with the terms functional or integrative medicine. Can you elaborate a little bit on what they are and are they two distinct tracks? What's the difference?
Dr. Betty Murray (04:27.853)
Yeah, there's actually, I'll give you three kind of definitions to sort of clear it up. We have what we would call conventional Western medicine. Conventional Western medicine was born out of warfare and infection, right? You identify a pathogen or a symptom, we find a way to cover that up or make it go away. Cut it, burn it, pill it, right? And that's conventional medicine. And so the vast majority of the Westernized medicine that we use in the United States, Canada, and Europe,
is westernized and it works great for acute. Like I want western medicine if I wreck my car. However, it's not very good at chronic illness and that's why particularly in the United States we have the worst outcomes in all westernized worlds for all chronic disease. And so it really fails because when we look at health, health is more of a combination of other things. So integrative medicine is really integrating more conventional standards along with
complementary things, and complementary things can be nutrition, mind-body techniques and other things, supplementation, plant medicine, even like counseling. So integration means integrating different methodologies and different, maybe even specialties together. Functional medicine is looking at your body and the breadth of biology within a systems approach.
So westernized medicine was great at going, okay, you've got a digestive tract, you've got a heart and vascular system, you've got a brain and nervous system, and they kind of separate it, like our specialty separated, but those things have shared mechanisms, right? An inflammatory response in one area is gonna be inflammatory everywhere, right, in different degrees. And so what functional medicine came in and said was, hey, we're using the same understanding of science, except we're starting to look at it at a systems approach.
and go, what's the shared mechanism between IBS, hormones, and let's say, neurological disorders or dementia? Very clear indications actually. And so we look at it that way, and so we bring those pieces together, and functional medicine also often gives an integrative approach, which might be diet, lifestyle, exercise, all of those things, plus nutrition, plus supplementation, plus medication when necessary.
Dr. Betty Murray (06:50.093)
And so like my clinic, my clinic is both functional, integrative, and also diagnostic. So we have a little bit of everything, and even my telemedicine company has what we can deliver virtually like that.
Kim Vopni (07:01.411)
Yeah, yeah, I've always my view as I kind of, you know, grew up and was able to be more aware and think of things on my own away from my parents growing up, we just you went to your doctor once a year and you had your checkup and that's kind of how things weren't. When I was, know, in my kind of like my mid to late 30s, when I started having children and after that it was I first learned about naturopaths and didn't know about functional integrative at that point, but it became this
it became very apparent to me that it wasn't, it shouldn't just rely on one doctor. It should be really a teams based approach. And that's what I really love about it. Even the description you just had is, is there's, we can all work together. We can all play in the sandbox together. We all have different areas of expertise that can complement. Maybe we need an emphasis on one side, but I just think that's the way forward for health is the work that you're doing and what other people in the functional space are.
Dr. Betty Murray (07:58.798)
Yeah, mean, it's like, think about it. If you had something wrong with your house, like let's say you had some very basic kind of things you needed to fix. You might hire a handyman that knows how to do a little electricity, a little bit of this, a little bit of that. But if you need to rewire your electricity, you hire an electrician. And so a lot of times a really good functional practitioner can kind of be your handyman quarterback, right? They help integrate all those pieces, particularly helping explain
and sort of bring all the pieces together because your internal medicine is supposed to do that, but they don't. They just prescribe you to go to somebody else. And then as a patient, you come back and you're like, okay, my gastroenterology told me to do this. My cardiologist told me to do this. None of them looked at what the other one did and whether there was contraindications. And then what happens as a patient is we go home and we go, well, I like what he said and I like what they said. I don't like all of it. So I kind of make my own and I'm the only one that didn't go to med school.
Kim Vopni (08:56.121)
Yeah.
Dr. Betty Murray (08:56.213)
or nutrition or whatever. so our team, the team of people that work with us at Living Well and also at Minerva, we take on a lot of that, like, OK, let me help you understand what those labs mean and how to pull that together so you know what to do. even as somebody that's a professional in this world, like caring for my mom, man, I don't care how much you know. You don't know enough. And it's not fair to put people in that place. And Western medicine really does it, particularly in the US.
Kim Vopni (09:25.847)
Yeah, yeah. So one of the areas, well, I guess I want to start first with you had said, you know, aging and menopause doesn't have to be a decline. You frame it as a power surge. So tell me a little bit about what you mean by a power surge.
Dr. Betty Murray (09:44.142)
Yeah, so I think there's a couple of things. We have, particularly in our very ageist, youth-focused sort of media and community, right, particularly in the US, like I remember somebody saying that Scarlett Johansson was aging out at like 35, and I was like, who do I punch? What are you talking about? But we have a very youth-focused.
environment. So a lot of women will get into our middle ages, right? And I don't even like that word like like midlife, a little more seasoned, which is like what I would have say. And we feel very invisible, right? And our body's changing and all these other things because there are a few truisms. You don't get a pass on menopause. You may be less symptomatic than someone else, but no one no one misses that, right? It's a hundred percent gonna happen. And so we do lose those hormones, estrogen, progesterone, and testosterone. However,
A decline in mental function, a decline in physicality, muscle mass, bone, all those things are optional. And we get told, you know, it's just this inevitable roll downhill. And the reality is, is we have all these other things that happen as a woman that may not be directly physical, but are very, very clear. Like a lot of women come into this time period, it's the first time that we don't have to like, many cases our kids are grown or almost grown.
They're at empty nesting. We are at a place in our career where we might be looking at it and going, what am I getting out of this? And is this where I want to put my stake in the ground? And for the women that embrace that and say, this is my next season, then it's a supercharge, right? Because the reality is, is if you look at the women that have left their mark, Maya Angelou, Mary Clea, all your researchers or whatever, the vast majority of them did that after 50.
Kim Vopni (11:32.003)
Mm-hmm. Mm-hmm.
Dr. Betty Murray (11:32.366)
Right? So if we look at the world that way and start treating our body as if it can maintain and sustain with effort, right? You can't just sit on the couch with effort. Aging is pretty much optional when it comes to the degradation of aging. You know? And then if you do things like all the things that you teach people to do with their physical body and dial in your sleep and your diet, add hormones if they're right for you, you can really, really live this second 30, 35 years of your life.
Kim Vopni (11:47.223)
Yeah.
Dr. Betty Murray (12:02.355)
in, I guess, technically almost third, but that you could really have an amazing, amazing last season.
Kim Vopni (12:09.645)
Yeah, yeah. When you think about the people that come to your clinic, I guess I want to kind of... You made one point there that I want to highlight where some people may go through this transition with no symptoms at all and other people can have every symptom under the sun and I would fall more so in that category.
What do you see as the difference? Why do some experience more severe symptoms than the other? And I've heard some people say, and I kind of agree, the people that don't have symptoms, I think in some ways it's not necessarily positive because that might mean they don't necessarily look into hormone therapy or do any dietary changes or all the things that may support a better transition. You can argue both sides of that, I guess, but what do you see?
that in terms of the people that are more symptomatic during that time, what are some of the commonalities that you might see?
Dr. Betty Murray (13:06.881)
Yeah, I mean, we have some very good research that show different ethnic backgrounds. So women of East Asian descent experience more metabolic distress, right? So higher risk for diabetes, weight gain. People African descent almost always have more heart palpitations, hot flashes, night sweats, the more pronounced, worse. Hypertension changes, lipid changes. And then there's everybody in between.
So the stats are, the average, so the average woman will spend at least eight years symptomatic in that perimenopause-menopause transition, and 87 % of women have verifiable, consistent symptoms. So that means there's outliers like the 16-year, and then the person that's kinda like a sorta breeze through it. But the ultimate impact of that is those hormones really, really regulate lots of things in the body. They help the metabolism and the loss of those hormones even without symptoms.
accelerate the aging process, particularly in the bones, the cardiovascular system, and the brain. And so, you know, it helps when somebody's highly symptomatic. Number one, it usually prompts them to go do something about it, right? Because it's so profoundly affecting their world. know, Mayo Clinic did a study and they looked at the impact to the GDP, gross domestic product in the United States and business as a whole, both through additional medical costs.
and lost either lost wages to presenteeism or absenteeism or women leaving the marketplace during this time period because it's a radical shift. Women will go, OK, I can't handle this anymore. It's $26.8 billion in the US alone. It's what it costs our economy. And it's at a time, particularly when women are often contributing the most, and this is when they have the best opportunity to really make a change in where they're working and all those other things. And so.
Kim Vopni (14:44.281)
crazy.
Dr. Betty Murray (14:57.389)
You know, I look at it and I'm almost happy when someone's like, yeah, this is almost untenable. Right? I'm like, cool. Because A, number one, we're promoting, you know, mentally in our own minds, we're promoting our own willingness to probably go that extra mile. Because we can't do what we did when we were 25. We can't eat the same way. We can't exercise sleep. All that stuff is sort of changing. We don't have the freedom we did before. But it also helps because we can see the profound difference pretty quickly. Right?
And we also have in medicine, they like to call it compliance. don't like that word because it sounds like you're being told what to do and forced into it. But you're much more likely to continue doing something when you see the side benefits of it. Like I can tell you, I used to be able to sleep for only five, six hours a day and then I'd be fine. I could go out on the weekends. I'm like, oh no, mama's in her pajamas by nine. It is an extraordinary thing for me to be out by 10. I just can't. I don't feel good. I don't like it.
Kim Vopni (15:33.625)
you
Dr. Betty Murray (15:54.7)
You know, and so that feedback is helpful for me to stay in my healthy lanes, right?
Kim Vopni (16:00.132)
Yeah, yeah, yeah, for sure. So one of the things that shifts, and I hear a lot of people talk about is triglycerides, like cholesterol will start to go up in this perimenopause transition. And then of course we know the allopathic response to that. What is the functional or integrated view of why are triglycerides, like why are cholesterol, all that sort of stuff starts to shift at that phase of life?
Dr. Betty Murray (16:29.525)
Yeah, you know, if you look at the research, we expect about a 15 to 20 percent increase on average for cholesterol levels in women as they go through menopause. Now there's multiple reasons. know, first is LDL cholesterol is the raw material the body uses to produce actual hormones, right? So think of that as kind of the eggs and the making and the bread making mix. However, some of it is the impact of the loss of estrogen on liver function because it's not the cholesterol generally that you eat. It's the cholesterol your liver is making.
And it's well known, right? It's well known, so we see this sort of steady march. Now the triglycerides and blood sugar connection, because even though we look at triglycerides as part of the lipid cholesterol profile, they're actually more tied to insulin sensitivity and blood sugar. It's how your body stores sugar and fats together. We have such a big impact of losing estrogen. mean, estrogen affects insulin sensitivity at the cell.
It affects, think of it as the sort of taxi cab that picks up blood sugar at the cell wall and says I'm gonna take it to the powerhouse to burn. That is estrogen receptor sensitive, so if we don't have estrogen, it kind of slows down, so it sort of piles up outside. And it affects just the absolute function of mitochondria. Most of that research, which is your powerhouse, most of that research was looking at the brain, but we have mitochondria everywhere.
And so we see this side effect that we start to see in labs that are conventionally used for pathology. Because anytime you see high triglycerides, high cholesterol, even for the cholesterol naysayers, those are all indicators that we're going to have more inflammatory response and more cardiovascular risk over time. And like diabetes risk too.
Kim Vopni (18:10.307)
Yeah, so it's like as our hormones are starting to decline, the body is trying to basically produce more cholesterol because that's how we, that's a big part of making our hormones.
Dr. Betty Murray (18:21.717)
Yeah, well and the other side of it too is estrogen. every, so when we lose estrogen, that is a full body effect. There are two cells out of the trillions of cells in your body. We have two cells that don't have estrogen receptors, red blood cells and one cell in the brain. So when you lose that, every single body structure is changing and estrogen acts as an anti-inflammatory, particularly on the vascular system. So if I have estrogen, it helps the body rebuild this little hair-like structure in the arteries called the glycocalyx.
Think of that as like, I'm gonna use a brand name just because people my age will remember it, Teflon, right? Not safe for you, but Teflon protects the artery lining so nothing can get through it. Well, it starts to break down when we lose estrogen and we get arterial placking from cholesterol and we, so it's, a lot of it is that increased in inflammatory response, increase in insulin resistance, increase in inflammatory cytokines, which are the little messengers from cell to cells, particularly from abdominal fat underneath the muscle.
All those things are all part of the sort of the mix of metabolic changes that happen during menopause that if we don't put estrogen in place, we have a little more challenge. And the other thing I would say about that is some people experience like more abdominal weight gain than others. There's genetic variability and epigenetic variability. There's all these reasons why that may be true. And the big part is we haven't looked at this in over 20 years. We just blew off women's health completely.
Kim Vopni (19:46.49)
Yeah. So when you see in your, in your clinic, people who are, maybe have been struggling, maybe they have high levels of cholesterol on the, on a lab reading, when they start hormone therapy, do you notice a shift in that? Does that start to change?
Dr. Betty Murray (20:00.769)
Yeah, it does start to come down. And then you can do dietary things like increase fiber, food quality. Some people are hyper absorbers of saturated fat. So if they're doing a lot of coconut and palm and fatty meats and things like that, for those individuals, just shifting their fat content to an olive oil avocado often helps. So there's ways to do it. But definitely getting the hormones dialed in often will reduce it. What's interesting is we don't necessarily always see it go back to, let's say, your
45 or 40 year old baseline, but we do see it come down
Kim Vopni (20:33.945)
Yeah, yeah. And a big part of all of this is going to be the gut. And I know that's another area of passion of yours. in terms of like, what are the reasons why gut health is talked about so much and it, you know, seemed like a trend for a while, but it's staying because it is such an issue for so many people. So what is it that is, first of all, interfering, like what's creating the gut health epidemic and where do you start with somebody in terms of improving gut health?
Dr. Betty Murray (21:02.549)
Yeah, so I think if we look at it as the first thing, your body can only make and do with what you're able to ingest by eating, what you're able to break down and digest by your own digestive function. And then what the microbes do with it, so our microbes take fiber and they ferment it, they take the polyphenols and the ingredients in fruit and that's their food source, and then they produce things.
in order for your body to make a protein or an enzyme or anything, it has to get nutrients from you. So the gut is ground zero for that, right? And we do know that if a baby is born and vaginally delivered and breastfed, they are significantly healthier than their C-section, know, non-breastfed counterparts. And part of that is when we, when an infant goes through
the birth canal, we actually get our first pass of the microbiome. So we inherit the microbiome from the vaginal canal. And that, because at that point, until that moment, we don't have any bacteria in our gut. And then we get it from the tissue on mom, and we get immunoglobulins, which are basically some more immune support from mom, from mother's milk. You can't get that from infamil and soy, you know, stuff. And so,
And so that is a big thing, you know, because I grew up in a time and you grew up in a time where a lot of mothers were told, hey, better living by science. You don't have to do that. Why would you breastfeed? Or even later in the, you know, early 80s and 90s, it was like, well, why would you have a normal birth? We want to schedule that and make it easy on you, right? You know, and like, yeah, that's great for scheduling, not great for your baby.
Also, our foods are devoid of nutrients and our microbiome diversity in our soil is radically different. So when you compare United States, Canada and like Europe to let's say Burkina Faso, Burkina Faso will have over 400 species. So think of your gut as like a jungle and how many animals do I have in it? Average American at 140 if we're lucky. Right, so somebody has carpet bombed your Amazon, right? There's nothing left in there.
Dr. Betty Murray (23:18.761)
And what that does is that modulates your immune system. So your gut bugs and the gut lining and all of that tell your immune system what's self and what's not, right? And it's monitoring things in the gut. then your ability to actually keep things, if you think of your gut, your entire digestive tract is a tube within your body that keeps everything inside the tube out of your body. So it's somewhat outside the body and inside the body at the same time.
Right? And the only things that should get out of that gut wall is once it's completely digested, everything's cleaned up. But if that is like a soaker hose and stuff is oozing into your rest of your body garden, bad, bad, bad stuff, right? And then that stimulates your immune system. And so if there's inflammation, leaky gut, bad microbiome, know, infections, all those things, it's gonna have a full body effect. Right? And then...
The gut also has its own what we call enteric nervous system. So it has its own brain. And that brain is more active and more attached to the rest of the body than the brain we think about. And it produces all of our neurotransmitters. So like serotonin, everybody thinks of as the happy neurotransmitter. We make 95 % of that in the gut, right? Our microbes impact that.
And so if we don't have a healthy gut, we will also see neurological side effects. We have good research showing Alzheimer outcome changes and Parkinson's changes by just looking at what's going on in the gut. So you can't really, in our world, in a functional world, you can't really be healthy with a super jacked up gut, right? You just can't.
Kim Vopni (24:58.509)
Yeah. So where do you do, like, do you start somebody with testing or are you just basing it on symptoms? And what would be the first step in terms of healing or repairing gut health?
Dr. Betty Murray (25:12.225)
Yeah, mean, you know, so especially in our clinic, we very much, and even in telemedicine when we're working with women's hormones, we believe in a test, don't guess, right? Because what that does is a couple things. I'll give you an analogy. Let's say you're going to go to the spa, right? And you haven't been to the spa before, right? You can get there much faster with a lot less stress and pain if somebody gives you the map, right? What left or right do I need to take at what street? Testing is that left or right.
Right, so if I identify with symptoms, so we look at symptoms, but lack of symptom doesn't always mean there's not something going on. But symptoms are a really good sign, and a good practitioner's always kind of going, okay, this sounds like, because they're trying to figure out what would be great to test, what isn't really necessary, because there's a lot of cool tests out there, but some of them are not helpful for everybody, right? So we do believe in testing, and we're going to start with gut testing first. In the clinic, we do stool testing, we do it a lot.
Because the question is, can you digest your food? That's a different question than, is it a microbiome problem? Is it bad guys? Like, do I have a bunch of cockroaches that have overgrown and snakes? Or is it the microbes that I have that are normally really good, like, let's say, gophers, and they've overgrown and they're tearing stuff up? Those are different questions. And you're guessing if you don't know that. Or is it immune stimulation or something else? The stool testing available today, it's not
Yes, your microbes will change over time and other things, but it can give you a pretty clear snapshot of how to get in there and start looking at that and get more targeted so you can get to the spa faster. know, early on, because you know, my clinic, we've been doing this for 20 years. Early on, food sensitivity testing was a little better than stool testing way back in the day before DNA was available. And food sensitivity was very in vogue.
Right, so I did a lot of that. So for me, gluten and eggs were a big part of my digestive symptoms, particularly early on. But what I have found, and especially after all of my research, particularly with my PhD, my current stance is, and I would say the research sort of alludes to this, is that a lot of food sensitivities people have, where they are now reacting to foods they used to be able to handle,
Dr. Betty Murray (27:29.865)
is probably because the digestive function and the microbiome and the gut is not healthy. And then if you correct for that, then you may have a few outliers there, but it's not, because people routinely get a food sensitivity back with like 80 out of 97 foods are reactive. like if they had a lot of stuff going on and we worked with a lot of autoimmune, I'm like, okay, you can't possibly remove those foods and also not academically helpful. So,
Instead, we work a lot on the gut, get that fixed up, and then look for what's left over. And even if we have women, and on the telemedicine, we are primarily focused on hormones. So we're not running every test under the sun, because we can't help hundreds of women. But we do make sure somebody has a clean and really healthy for the microbiome diet. Because that is just going to make your hormones work better.
Kim Vopni (28:19.674)
What does that look like?
Dr. Betty Murray (28:21.485)
You know, if we take some very basic things that we know are very, very helpful for the microbiome and helpful for estrogen. No one likes to hear this, but it's fiber, right? One of the most powerful ingredients in the world is fiber. Fiber binds to cholesterol in your gut and makes sure you can't absorb it. I can lower your fasting cholesterol by getting you enough fiber alone, right? It also binds to all the other junk in there too, because the liver is sort of your cesspool and that's where we got to things out.
So it can it can also lower estrogen because it binds to estrogen getting slated for detoxification and excretion Fiber helps feed your microbiome. I can change your microbiome composition by giving appropriate fiber And then the combinations of fibers can even preferentially help grow different ones That includes things like fermented foods fiber rich foods fruits and vegetables nuts and seeds legumes What's interesting is the research shows that?
dietary fiber from the food, right? So actually eating the vegetables is better than supplementing with the exact same gram count from supplements. We use supplements to support it, but it doesn't mean, because I've had people go, can't I just take 35 grams of fiber and just skip the vegetables? I'm like, no, just no, no. Because there's also ingredients, know, vitamins, minerals, compounds, polyphenols, all these things in there that are important for your body and your health.
Kim Vopni (29:37.72)
Nope.
Dr. Betty Murray (29:48.174)
So that's a no-go. And we have some women that we have to slowly work up, but our goal is to eventually get to 30, 35 grams. Protein is an absolute, I know everybody's like sick of hearing about the protein goal, but you know, and there are days that I make it and there are days that I don't. Like I try really hard, but I'm just like everybody else, but we don't make muscle as well, right? And you can't detoxify the liver without protein. So anybody that's ever done a juice cleanse, I'm gonna go ahead and get on this rant.
I'm going to do a juice cleanse with fruits and vegetables for a week. You detoxed nothing. Amino acids are required for that pathway and they come from proteins. Now, fruits and vegetables have some, but they have very, very little. so amino acids from that help your body detoxify and help you build muscle. Super important. Hydration, because the solution to dilution, or pollution is dilution, right? You've got to get enough hydration and move things out. Those are baseline for everybody.
The food combinations and other things depend on the person, but that's like a baseline everybody should be shooting for.
Kim Vopni (30:50.618)
Yeah, and for everybody who's listening and if you've been here for a while, you know how much I talk about constipation. You know that constipation and hydration, those are the first two things that we have to address with anybody because the other side effect in terms of my community is constipation is a major contributor to urinary urgency, frequency, prolapse, all the things, and dehydration, same thing, right? So we have to get all of that in check and so many people are checking.
fiber supplement, fiber supplement. They're not drinking enough water and they're also, their diet is devoid of so much and that's, yeah. So a supplement is supposed to literally be the supplement. It's not supposed to be the thing, the fiber or whatever it is. So I love that you cover that. I think that's so important. And...
Dr. Betty Murray (31:30.572)
the thing.
Yeah.
Yeah.
Kim Vopni (31:38.426)
Hormone wise, you've alluded a little bit, we can, without the fiber, that's an important part about how we're actually detoxing. But how does the hormonal system, how do our hormones support, like the reverse now, how does it support optimal gut health?
Dr. Betty Murray (31:46.125)
Mm-hmm.
Dr. Betty Murray (31:56.408)
Yeah, so my research was looking at how we metabolize hormones, so how we take them after we're done with them and kind of package them to get rid of them at the liver and then excrete them. And it's interaction with the microbiome, because the microbes can either liberate stuff ready to go to the trash and put it back into the bloodstream or not. And what I found really interesting is, I'll give it IBS for an example, because it was in women with IBS.
Which is again, three quarters of women will be diagnosed with IBS at least once in their life. Because that's a blanket statement. Three quarters. Three quarters of women will have some diagnosis of irritable bowel or at least describe irritable bowel. Because irritable bowel is a junk diagnosis. No shit. Pardon me. Can I swear? No shit I have irritable bowel. Like I don't need to go to a gastroenterologist to tell him that. Like I got it. I know it is, right? And so it's a junk diagnosis because we don't.
Kim Vopni (32:26.692)
How much? What?
Kim Vopni (32:36.588)
Yeah, yeah, yeah. Wow. Yes, please.
Kim Vopni (32:45.508)
Yes.
Dr. Betty Murray (32:50.195)
actually just just by labeling it doesn't give you any direction of what to do with it, right? It doesn't give you any causal effect and Mike my curious thing was it's more female seems to be more second half of your cycle Definitely worse when we get into that perimenopausal phase But in women in their 60s and 70s, it seems to be less so and I thought that was kind of interesting So the first thing is is our wall of our intestines. We have musculature and nerves that you stimulate it to move
We also have receptors. So those are key holes for neurotransmitters like serotonin and dopamine and norepinephrine and epinephrine. So all the stuff you think of as brain chemistry. We also have estrogen receptors, testosterone receptors, progesterone receptors. And those are also potentially influenced. And the same pathways that we use to kind of wrap up and prepare like estrogen to be excreted also excrete adrenaline.
you know, your dopamine, your serotonin. And so when we have genetics that might make those pathways not work as well, or we have microbiome that may be interfering with those neurotransmitters and other things, and hormone changes that are radical, there's likely a lot of impact on that. There's not a ton of research. Like I was very surprised when I, you know, went out to look at my research, because when you're in a PhD program, you have to find something no one else has looked at. Not easy.
And of course, I'm a nerd, so I'm like, all these things. And it was like, wait, I got to get really focused on this tiny thing, or I'll never finish. And I was really surprised that no one had examined whether bacterial produce an enzyme called beta-glucuronidase that basically recirculates estrogen that you had ready for the dumpster. No one had ever looked at it in IBS in women. And I was like, OK. And we did find that women with that have constipation-dominant IBS.
have an increased activity of this particular enzyme from the microbiome, right? Now, it would be great to do 100 other studies and someday we'll get that funding, not from the US anytime soon. That's a whole other story. But there's a lot of interaction there and there's probably even more so. We just don't know, right? We just don't really know.
Kim Vopni (34:54.266)
You
Kim Vopni (35:00.804)
Yeah, yeah. Something interesting you said that I want to move sort of away from the gut but still kind of intertwined there. You said estrogen receptors in all but two cells, blood and one cell in the brain, one type of cell in the brain. Why is it then that brain fog is such a common, like if there's just one type of brain cell, you would think that, it wouldn't have such an effect.
Dr. Betty Murray (35:25.485)
We have lots of brain cells, but there's only one that doesn't have a receptor for estrogen. Almost all of the brain has receptors for estrogen, particularly the cannabinoid system. So the cannabinoids are what the medicinal side of CBD, CBG, and all those things work on. That's also estrogen receptor positive. So it's an analgesic, reduces pain, improves mood.
Kim Vopni (35:32.325)
sorry, okay. Okay.
Kim Vopni (35:43.918)
Mm-hmm. Mm-hmm.
Dr. Betty Murray (35:51.702)
I think the most important thing is this was research done out of Dr. Mosconi's group at the Weill Center in Cornell. She's no longer with them, but she did this for years. They did imaging of the same woman from, let's say, 40 all the way through menopause. So for the first time, we captured women, and we saw the transition. So the first thing that her team noted and saw repeatedly over and over again, and now it's known to be true, is the brain goes through a massive remodeling process as we go through perimenopause and menopause.
Kim Vopni (36:09.626)
Hmm.
Dr. Betty Murray (36:20.277)
And within about a decade, it's kind of done. Well, what happens? The brain shrinks. We lose white matter, which is where we store memory. The prefrontal cortex, which is the part that we get executive function here, it starts to take the neural pathways. So think of those as super highways to all your decision making. And it pops those highways loose and start remapping them back to the creative centers. And then we lose the cannabinoid system, so we feel more pain and other stuff.
And all of those things result in the likely symptoms of brain fog, know, anxiety, depression, know, agitation. You know, I don't take my hormones. I'm going to rip somebody's head off. And I was, I'm like, I am not, that is not who I am. But man, if I don't have hormones on board, I am ready to fight with somebody. And it's funny because it's just never been my personality, but it is now. And so the brain goes through these remapping. And so when you keep estrogen in there, so they had women that they treated, that stuff doesn't occur.
Kim Vopni (36:58.49)
Mm-hmm.
Kim Vopni (37:07.662)
Yeah.
Dr. Betty Murray (37:17.101)
And that's why if you look at some of the particularly retrospective data, women that had been on hormones and stayed on hormones didn't have a reduced risk for dementia and Alzheimer's compared to women who have not had hormones. And three out of four Alzheimer's patients are female. It's not male. Nursing homes and assisted living are full of women.
Kim Vopni (37:35.908)
Mm-hmm. Mm-hmm.
Yep, yep, same. Okay, so I had flipped that, but yes, as you're saying, there's a predominance of cells requiring estrogen. Okay, now back to the gut. The gut is now also responsible for what's happening in the brain. So you've touched on a few things, but just kind of hitting home the importance of why we need our gut health in check for our brain.
Dr. Betty Murray (37:41.259)
My mom included.
Dr. Betty Murray (37:50.081)
Mm-hmm. Yeah.
Dr. Betty Murray (37:58.734)
Yeah.
Dr. Betty Murray (38:08.045)
Yeah, so here's the way to think about it. You know, so the other thing I want to point this out to you, because this was new about a year ago. We have always said in the medical community, we had nothing to prove this at all. So a lot of times these things get said and then people parrot it and we have no proof. So the dogma was that when a woman went through menopause, the receptors for estrogen dried up and went away. And we've been saying that. I've even said it for decades. Did we have any science that could prove any of that? No, not a single bit.
We don't know how to, we don't have good ways to see what the receptors are doing. Well, Moscone's group created a tracer, kind of like what we use for like breast biopsies, using it in animal studies. And what they found was as an animal goes through menopause, the number of receptors in the brain increases, not decreases, right? So, what do we know about biology? Things don't operate in a vacuum. It is likely that any estrogen-sensitive
Kim Vopni (38:52.366)
Wow, so it's looking for, like it's creating and yeah, makes sense.
Dr. Betty Murray (39:02.753)
you know, tissue probably does similar things or the vast majority of them do. We don't know that, but I'm like, okay, deduction, my dear Watson, hmm, you know, like, let's see, right? So we have a bunch of that action. So there's probably receptor changes in the gut and everywhere else. So we have a super highway, the vagus nerve that goes from the brain down into the gut for every message that goes from your brain to talk to the gut, whether it's rest and digest or do this, do that, there are nine going back.
Kim Vopni (39:10.51)
Mm-hmm.
Dr. Betty Murray (39:32.14)
And the nine going back, mostly are coming from the microbiome. So there's a bunch of crosstalk between the brain and the gut. And so, you know, if your gut's messed up, this is going to be more messed up. And then you add hormones, you know, fluctuations to it. We're probably going to have a lot wilder ride, which has always been my kind of my scientific stance. I was like, why do I have an autoimmune condition and my husband doesn't, you know, why do I have all these symptoms? And when I really started looking at it, I was like every really chronic debilitating disease.
is female-centered, right? Autoimmunity, 50 million people are assumed to have autoimmune conditions in the United States, and most of them have more than one, except it's nine, basically nine out of every 10 is women. And I'm like, okay, so that is a women's disease. It is hormone-driven, full stop. You can't say, well, we don't know. Oh, really? Really, statistically, that kind of odd cannot happen if it wasn't driven by hormonal changes.
Kim Vopni (40:17.07)
Mm-hmm. Mm-hmm.
Kim Vopni (40:27.161)
Yeah.
Dr. Betty Murray (40:27.423)
And so, you know, and so that's what really has driven me in this arena. Cause I was like, we just, yeah, we're, we have a huge road to hoe here. We got to get further ahead.
Kim Vopni (40:37.146)
To tie that part up with a bow, and I know we're getting towards the end of our time, we've talked about diversity, so fiber, eating lots of fiber. What are, say, two or three other things people can do to support their gut health so that all of these other things that we've been talking about are also going to be more optimized?
Dr. Betty Murray (40:58.753)
Yeah, you know, so even selections of foods, right? So there are some foods that are advantageous to help get rid of estrogen. So the other thing to know is it's not just about the hormones we make or take. We also have an extraordinary amount of environmental chemicals and food chemicals and things that we come in contact with that look like estrogen to our body. So plasticizer, herbicides, pesticides, BPC, any plastic stuff.
You know fragrances, parabens, phthalates, those are endocrine disrupting estrogenic like compounds. so, you know, fiber binds to some of those things, but the pathways, so think of these as sort of the, I'm getting the stuff out of my garage and I'm gonna wrap it in tissues to get it to the dumpster, are driven by a lot of our most healthy foods that people generally don't like, right? So your brassica family, broccoli, Brussels sprouts, kale, cauliflower. Now, if you've got like,
A lot of gut problems, those are foods that are probably not friendly to you, right? But those foods have compounds like indole-3-carbinol and sephoraphane that actually drive those detox pathways. Citrus bioflavonoids, you we have a lot of people out there right now talking about, fruit causes high blood sugar and you can't have fruit. Okay, every human clinical trial that has ever been done that looked at fruit intake, fruit intake at an appropriate amount, not just fruit, right? At an appropriate amount.
reduces body fat content, right? We're talking about whole fruit, not juices. Citrus bioflavonoids in particular, so these are ingredients kind of in the citrus, actually help the detox pathways. know, things like rosemary and some of your other ingredients that we use in cooking. So when we look at foods, you want to think of your food as much medicinal as it is food. Another family that doesn't get a lot of like,
Props are some of your sulfur rich foods like your alum family like onions and garlic now again If you are this is a sign if you can't eat those foods your guts a problem Those are all foods your microbiome likes and if you've got the wrong guys in there, they're gonna have a party But those foods literally help you detox literally
Kim Vopni (43:02.874)
Mm-hmm.
Kim Vopni (43:10.318)
Yeah, I was in that realm for like, as I was trying to navigate and not feeling confident working with a medical doctor, you know, reading books and going through the whole thing and figuring stuff out on my own. I did do some food sensitivity testing, I did a stool sample and I came up with this list and I took out, I was very restricted in terms of what I was eating. I guess in the moment it helps with certain symptoms, but
Really at the end of the day, I had no diversity and it was getting, you know, working on the gut health piece that now I eat basically everything now. Yeah, yeah.
Dr. Betty Murray (43:49.41)
Yeah. Yeah, you know, I think, you know, I struggle with is, and this is true because I'm a nutrition professional in biochemistry, right? We have, you know, we're always looking for the right diet. I don't know the first time I went on diet, but it was probably somewhere around the latter part of elementary school. I'm not kidding, right? We all did it. And so we're always looking for this perfect thing to do whatever it is. And there's the concept of a therapeutic diet.
Kim Vopni (44:03.609)
Yep.
Dr. Betty Murray (44:12.629)
Right, so a therapeutic diet might be a low, low carb diet to get insulin sensitivity, or it might be a FODMAP diet where we remove those most fermentable carbohydrates. That is not a maintenance diet. You do any of those things long term, you cause significant sort of malfunction in your microbiome, your metabolic function, fuel utilization. They're therapeutic, and the goal is to use them for a short period of time while you correct the underlying problem. But if you're like,
Kim Vopni (44:28.985)
Mm-hmm.
Dr. Betty Murray (44:39.649)
a FODMAP diet person and you still can't do any of those foods three years later, you shouldn't be doing it like that. There's something still wrong and we need to figure out what that is. And some people will have certain groups, I have people that have done FODMAP and they're like, I just can't handle onion and garlic. I'm like, okay, okay, maybe not those. But if there's an entire swath of foods like that, that's like half of the food supply, there's something really wrong. And the more you perpetuate it, the worse you're gonna make it.
Kim Vopni (44:57.507)
Mm-hmm.
Kim Vopni (45:03.225)
Yeah. Yeah.
Yeah. So in terms of practitioners, somebody could come and work with you. You have telehealth. Where can people find you? Or if they couldn't work with you, what type of practitioner should they be working with?
Dr. Betty Murray (45:15.853)
Yeah, so I have, so I don't take patients anymore. I've got two companies I'm running. A matter of fact, I've got a tech and technology and telemedicine company that we're bringing hopefully by the end of the year, a consumer-based, not this year, but next year, a consumer-based entire digital health intelligence platform for women that will basically transform women's health. Whole reason why I went back for a PhD.
Kim Vopni (45:36.857)
amazing.
Dr. Betty Murray (45:39.59)
So I have a telemedicine company called Minerva. These are all practitioners trained by me. They use the framework that we created at my clinic in Dallas. And we can treat women all across the United States. I know you're in Canada. Not Canada yet. Working on it. Canada's unique. A little bit unique. So hopefully sometime soon. But we treat with hormone replacement therapy for perimenopause, menopause, and postmenopause.
Kim Vopni (45:52.078)
Mm-hmm.
Kim Vopni (45:55.71)
Yes, yes.
Dr. Betty Murray (46:04.641)
We look at this deeper dive at how you detoxify them and we use organic bioidentical hormones that are prescribed. not over the counter. can't, over the counter versions are not strong enough to improve those metabolic markers. And then I have a clinic in North Texas and we take patients from Texas. And at that clinic we can do a lot more than what we can deliver online. So in Texas we do a little bit of everything but.
If somebody is like, okay, I don't know if I want to do that or maybe have gut stuff. There's a couple of organizations that I look at. The Institute for Functional Medicine at ifm.org is probably one of the best places to look. And you probably won't find a Swiss Army knife, right? Like the perfect practitioner that can do everything under the sun. And if they are really good at everything, chances are they aren't good at everything, right? Because there's too much.
But you can find somebody that can help you get there. And often it might be that you have a tribe that helps you or you work with somebody for a period of time and then sort of move on. And I think there's a lot of opportunity for people to find help that may not also be an MDDO. Nutrition professionals are amazing at helping you fix your gut. And then from my standpoint, I have my podcast, Menopause Mastery. I talk about this stuff all day long. I have wonderful people like you, Kim, on my podcast.
And then I have e-books and other things. And then I have a YouTube channel also. So there's ways to get educated and understand and then reach out when you're ready to need help. And if people want to look up our telemedicine company, it's gethormonesnow.com. Makes it really easy. Gethormonesnow.com.
Kim Vopni (47:42.606)
Awesome. That's a good one. That's awesome. I'll have all the links in the show notes below. Thank you so much for sharing your wisdom with us. yeah, and yeah, I learned a lot and super fascinated by your work and I'm really excited for what you're doing next. I think that's gonna really change the landscape for women.
Dr. Betty Murray (47:49.665)
Yeah. Thank you.
Dr. Betty Murray (48:03.469)
Yep, me too.
