During our pre-teen years, women are taught about menstruation, pregnancy, and their bodies, but what about life after having children? Many are in the dark when it comes to the changes they will experience during perimenopause and menopause, making it harder to address their symptoms and advocate for themselves.

With all the knowledge out there today, even doctors aren't receiving enough education on the topics of menopause and the hormone imbalances that follow. Today's guest on the Checkable Health podcast is hormone specialist and integrative OB/GYN Dr. Tara Scott. "As a traditionally trained OB/GYN, I can tell you we are given zero education on managing hormone issues," says Dr. Tara.

Known as the Hormone Guru, Dr. Tara Scott helps women of all ages work through pre- and post-menopause issues. From weight gain, acne, and irregular periods, to mood swings and symptoms from conditions like endometriosis, Dr. Tara offers her expertise on battling them all. She also uses social media to expand her outreach and execute her life's mission to help women understand their bodies, hormones, and how stress and other lifestyle factors affect overall health.

If you're questioning whether you need hormone therapy or if herbal supplements are enough to relieve your symptoms, tune in to start your women's health education!

Topics discussed in this episode:

• Dr. Tara Scott’s social media presence
• Her medical background and interest in women’s health
• Conventional medicine vs. functional medicine
• Effects of hormonal imbalances before/after menopause
• Steps to take when you’re having these symptoms
• Issues Dr. Tara treats with her patients
• Addressing weight gain and inability to lose weight
• Eating well and how to pick a diet
• What being pre-diabetic taught Dr. Tara about her diet
• Using a fee-for-service payment model
• Dr. Tara’s mission to help patients become their own advocate

Get in touch with Dr. Tara Scott on her website: https://drtarascott.com/

Follow Dr. Tara Scott:

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About Checkable

Checkable is revolutionizing healthcare with fast and accurate at-home test kits, telehealth services, and a line of wellness supplements designed to keep you feeling your best while saving valuable time and money. At the forefront of home healthcare, Checkable is developing the first FDA-approved at-home strep test. Paired with a proprietary digital telemedicine platform to instantly connect consumers with healthcare professionals, you can skip the doctor's office and start treatment fast, right from the comforts of your home. http://www.testforstrep.com

This episode was produced by Podcast Boutique www.podcastboutique.com

Transcript: 

0:00:04.5 S1: Welcome to the Checkable health podcast where we're helping everyday moms like you, rethink how your healthcare begins at home. This podcast is for moms of school-aged children, who were born in the 1900s, and would buy an at-home strep test to check their child’s sore-throat symptoms from home. Hi, I'm your host, Patty Post. I'm founder and CEO of Checkable Health. I'm a mom of two teenage sons, and a daughter who's a tween. I've been married to my husband Andy for 20 years, and I believe that we really should be empowered to make all healthcare decisions from home. This podcast was created to help equip you to make better health decisions for yourself and your family. Dr. Tara Scott, thank you so much for joining me on the Checkable Health Podcast is so nice to see you. No, thanks for having me. You're quite the celebrity on social media, have to say, I'm very impressed with you being a physician as well as like you're an all-star marketer and a business owner.

0:01:11.6 S2: I have a daughter who's a business major, and so she convinced me to get on TikTok and now she's become my social media manager, and she’s helping me manage stuff. So I had to look to the kids to help me manage certain…hey, can you help me do this trend? How do we do it? So it's the kids helping me.

0:01:28.3 S1: And are you seeing that your lives are doing really well on TikTok? Yeah, and they're so variable, like this time of year, it's a holiday season, so I'll have some lives that I’ll have hundreds of people on and thousands of people watch, and then I'll have some lives that it’s not very many, you know, less than 100. But in general, most of the time, there's people who appreciate the information. I just kinda turn on the camera and just answer whatever questions come in as many as I can, and usually till my phone battery dies. It's not really super structured, but it seems like it helps people, and that's kind of my goal, is to maybe help people who can't find a provider to work with, or have any kind of question that I can help them with. Obviously because of my license, I can't give medical advice, but if there's anything, any way I can help people, that's kind of my purpose for being on there.

0:02:21.4 S2: You get so many questions too, you'll sit there and scroll through and you see these questions come in and like, how does she even choose them?  People are really in need of what you have, Dr. Scott.

0:02:35.2 S1: Tryto answer all of them, but what ends up happening is if there's a question that comes in and it takes me two minutes to answer it, then there's more that are gonna come in and people keep repeating their question over and over 'cause there's a delay, and so it clogs up the feed, and then I end up trying to scroll through, “ok I answered, this, answered this.” 

0:02:54.5 S2: Actually, I'm surprised that how many people aren't getting the information they need, so that's why... Thank you for doing these kinds of podcasts, I know it takes a lot of time and effort to do this, it's your time. And that's what I think now that people are getting the information through social media, podcast, where when I started this type of medicine 20 years ago, you couldn't get this kind of information.

0:03:19.0 S1: I remember when I went to medical school, there was no internet. Isn't that crazy? So in medical school, you went to medical school and then you are an OB-GYN, so you had a residency and a fellowship as an OB-GYN. Yeah, so I did general medicine year, and then I did four years of OB-GYN, and then I practiced pretty much normal OB-GYN for 17 years, delivering babies, and then overlapped, after the first seven years or so, I really saw a need for someone to learn more about menopause, and even just hormone imbalance. A lot of it was spurred on by my own infertility. I had endometriosis, I had irregular periods, and then when I tried to get pregnant, I couldn't get pregnant without drugs, and then once you get pregnant, there's like nothing for you right? Like, ok, you’re not trying to get pregnant. So I was like 33 at the time, way too young to be menopausal and then there’s nothing for me, except for birth control pills. Which obviously I didn't need birth control pills because I'd never conceived, and I didn't really love the way I felt on them. That really led me to start really studying about it, and then trying to find an alternative option for that kind of thing. And so when you were talking about that kind of thing of being conventional medicine versus practicing functional medicine.

0:04:37.8 S1: So at first, I don't even know that it was called functional medicine, honestly, 'cause like I said, I’m dating myself, this was like circa 2003, functional medicine may have been functional medicine on the coasts, but in Midwest, it wasn't even called Integrated Medicine back then. So it just became a hormone specialty, and then in 2006, I became a certified menopause practitioner. So the North American Menopause Society is not integrative or functional, but they are kind of like the experts on menopause. So it really gave me kind of a foundation to know, Here's what traditionally is doing and the research, and I'm still an accredited member today and certified, I keep my certification up even though it's not really the approach that I do, but I wanna have access to the research to make sure what I'm doing is evidence based. You have camps out there, people who maybe dabble a little go to a weekend course on hormones, and then they might be prescribing high doses or not in monitoring them correctly. And I've always been the type of person that had to know everything and be the expert.

0:05:49.0 S1: So that's why I try to make sure that there is science and evidence behind what I do. Which your patients appreciate, because there are... So I think that's the hard part of social media and having access to all of this information is…

0:06:03.0 S2: Who can we trust because anyone can hang up their profile and say, I'm an expert at this, but I really, at Checkable, we really believe in those researchers and the physicians and the clinicians that live and breathe this, and research it, and I think... I really appreciate that you're not just doing group think. What you're doing is you're looking at your patients, and then through your research, you practice. You have your own practice now, so tell us about what is this practice and how do you use... How do you specialize? Today, I specifically, selfishly, I wanted to talk about hormones, and I love what we have here, why diets fail, because those two things, and as a woman, you talked about…

0:07:00.1 S1: Okay, you have your babies and then you're just kind of coasting like, Okay, well, what's the rest of my life and then, oh, suddenly you're in menopause.

0:07:07.8 S2: But we have this whole season of life that we're experiencing symptoms, and you get blood work done and you're kind of like, Well, what do I do with this blood work? What's going on with me? I know I experience symptoms, but why?  That's what I want to chat with you about. I feel like that's actually the age that I have a heart for, because menopause is a year without a period, and then you're in menopause. And there's a fair amount of research and no one's gonna tell you you're not in menopause, you either are or you aren’t. It's a clinical diagnosis. You might have a provider not well-versed on hormone therapy and women are still being told not to take hormone therapy, which the North American Menopause Society says that between the ages of 50 and 60, there's more benefits for you to take hormone therapy than risk. Putting that aside, it's those people that were like me, 33 to 54, that had a hormone issue that were told there's nothing wrong with them, it's normal as you age, just normal to put on weight, it's normal to have X, Y, Z symptom. Even just yesterday, I had a patient come in

0:08:12.6 S1: Who, she's not even 40 yet, and she had already had an endometrial ablation for a procedure for her heavy periods, but she's having such painful cycles that she literally has to hold on to the counter. I’m like that is not normal. 

0:08:28.5 S2: Who is telling people it’s normal to not leave your house because you're bleeding so heavy? Or to continue the weight thing, it makes... I'm so sensitive about it because I come from a family who is overweight and my genetics are such that I was pre-diabetic, and I know that those... I know that people try, and if you're not hormonally balanced, no amount of caloric restriction and increased exercise is going to work, and these women are told like, just lose weight, even people with PCOS, just lose weight and you'll be fine. And it bothers me, and as a traditionally trained OB GYN I can tell you we are given zero education on how to manage hormone issues. We are taught we can cut out a baby in an emergency section in a minute. I mean, I don't know if I still could. But imagine that.

0:09:23.4 S1: Very little menopause training. I actually do the lectures for the local residency on menopause, but we're talking about three or four a year, so that's not even enough. So as a traditionally trained OBGYN, you're taught how to get someone pregnant, how to prevent someone from being pregnant, how to manage a pregnancy, how to cut out a uterus, that's it. And so these are the go-tos that women are going to like, what happens? My periods are X, Y, Z? If it's a period issue, then maybe you'll get some attention, but even what about these people who can't sleep or all of a sudden are depressed or have anxiety and what are they given? An antidepressant. When they're really deficient in progesterone. Or they have another hormonal issue, then they gain weight because they're put on an SSRI, and that's one of the side effects, and their libido is low because those are the side effects, and they're not really deficient in serotonin per se, they’re deficient in a hormone. So glad that now we have social media. I mean, it's a double-edged sword. I get some shade from some of the traditional, there's a few traditional OB GYNS on social media who really like, criticize what I say. We gotta get thick skins, but to reach the people, I'm like, Okay, just keep going.

0:10:38.9 S1: This person is happy that you told them this information or whatever, just do it for them. So there's more...

0:10:44.9 S2: You have it more accessible to you now than you did when I was. It's so mentally draining too, Dr. Scott, as a female going through all of this because of the images that we see out there in the media of just, you know, as a woman, you compare yourself to others, and even our peers, and we're all unique beings and just because something works for one person doesn't necessarily mean it works for you. And then we start shaming ourselves on why can’t it... I'm dieting, I'm doing everything that I can, and then people kinda look at you skeptically like, Oh sure, she binge eats, or whatever it is, and it's mentally so draining. And then to go in, I literally created Checkable because I hated going to the doctor for my kids when they had strep throat, and so we're bringing an over-the-counter strep test through the FDA process of a clinical trial so you can buy it at the pharmacy. I think it's the same thing when you go into your provider and you say, I'm experiencing these symptoms and I just need help, like what's going on? And then when you're sort of dismissed or you don't have any long-term plan, it's like, well that is...

0:12:03.6 S2: This is how I'm gonna live the rest of my life? Like hair falling out, for example. And that’s a huge one, too. For someone listening that hasn't, one, they should, they will follow you now after this because we'll put all those links up.

0:12:19.0 S1: But let's say you're experiencing these types of symptoms and I live in West Fargo now, what type of physician do I, is it first, listen to your webinar to educate myself? Like, how do you go through this process? What's the first step? Yeah, I do try to put a lot of free information out there, either with the YouTube channel, Tara Scott MD, and any of my social media sites for the webinar, but basically, I usually recommend for people to ask their provider whether it's your OB-GYN, what experience do you have about hormones, do you comfortable checking hormones? Because patients wanna know, what should I tell my doctor? And even if you go in to the next doctor and they say sure, I'll order that, they don't know how to interpret it. Right. And if you would look at estradiol, for example, at any time in your cycle, if you don't know when to put it in the normal range, it's gonna be normal, it's always gonna come back normal. So people are told labs are normal because they don't know what range, when to draw the labs, when to do it. So I think people get frustrated with me 'cause I'm like, Well, what can I tell my doctor? I'm like, Oh, the thing is, is like, if you came to me and said, Can you please speak to me in Greek? I would love to, I love languages, but I don't know Greek, I mean I know Spanish...

0:13:35.4 S1: Or Spanglish, whatever you wanna call it if you spoke Spanish, but I don't know Greek. And so even if I'm super nice and I wanna communicate with you, I just don’t know Greek. So I'm not gonna... Even if you said, what are these Greek letters? And helped me... 

0:13:52.5 S2: I think because now there's so much that people can do on their own, they still wanna navigate themselves, and so it’s hard because I'm restricted to a medical license, I can't give medical advice to somebody that’s not a patient, then somebody that’s not in the state, and that kind of thing. So I try to put enough out there, for example, foods and lifestyle, and stress management that you can do that can change your hormones; supplements, although those are usually an individual recommendation too.

0:14:24.3 S1: There's not one for everyone, but I'd try to put some of that out there, so that there are some options.

0:14:31.2 S1: We do have the online course Hormone Guru and documentation, and there's like this, these are the different types of testing and this is what each one shows. So it's hard. I try to also put out information on how and where to find a hormone doctor, so you could go to ifm.org, that's the Institute of Functional Medicine, that's generally functional medicine, that's more based on family medicine, autoimmune, generally not hormone specialists.

0:15:02.3 S2: a4m.com, that’s Anti-Aging, regenerative functional medicine, that's where I did my fellowship, and I'm on senior faculty there, so I train, speak to doctors and train them, they have a provider directory, but again, anyone can join and pay a membership fee. You have to look for member fellowship board certification, there’s a little icon. All three. You can put in your zip code under the directory, and then say, I wanna look for someone in hormones and then look, there's little icons by their name in the directory, so that's a place. You can actually go to testing sites themselves, dutchtest.com and ZRT Labs is the saliva test that I use the most, they have a provider directory, so there’s providers that use the test, and you could put in your zip code and location and look there. Obviously if someone's ordering a Dutch test, they know they generally know how to interpret it, but... So many hurdles. Interesting. Some are such a specialized thing, even within the functional medicine world, not every functional person does hormones or understands hormones. If you asked me about Lyme disease, I'm not your person..

0:16:14.6 S1: I know a little bit, I know a little bit about it, and I know what it does to your cortisol, I'm not your person to treat it just because I’m functional. I mean even like mold, I kinda dabble in that. My patient has it, I’m not the mold expert, I’m the hormone expert. So even within integrated and functional medicine you gotta look for somebody and one of my colleagues was asking me, how many integrative GYNs do you think are in this country, and I start to think, and I'm like, I could think of maybe five. Wow.

0:16:42.8 S2: Really. The ones that are teaching, the ones that have a profile, not... I'm sure there's more than that, they just aren’t on the radar. I’m just trying to think of who's on social media, who has a product, who has a whatever, who teaches with me, who's actually an OBGYN and has done similar training, so it's a super niche... I didn't realize that. So that is also another hurdle for patients getting the care they need. Right, it's hard to find some, because when you do look at a website of a functional medicine physician or practice, they list everything and you're like, wow, are you?

0:17:21.2 S1: Is that you?

0:17:22.4 S2: So can you tell us, I'd love to hear some of your stories of the women that you've helped, what comes to mind of someone when they first came to you and then after working with you, what they experienced? Well, certainly women who have issues with their periods, painful periods, there's one subset that I love to help, and this is like teens with acne that have been to five dermatologists, or menstrual issues because it’s generally an issue with estrogen detoxification. So if we run the dried urine test, we can find out and we can actually help them and prevent possibly... I can't prove it, but prevent endometriosis, fibroids. That was how I dealt with my own endometriosis, is that approach. And I don't suffer with symptoms of that, and I haven't known for at least 10 years because I was able to balance my hormones. That’s not everyone’s, maybe, results, so I love seeing the patients, I really love seeing people in their 40s, because I think about, that's when the weight starts packing on, that's when you stop sleeping, that's when you have brain fog. And women are busy and working, and they’re parenting to their parents, taking care of their kids, trying to be business owners, whatever, wives and husbands, and whatever it is. If you tend to put on about three pounds a year over 40, if you think about that then, by the time you're menopausal, that's 30 pounds, and if you keep going and people keep telling you, Oh, guess what, exercise more, eat less, and you're restricting your calories, you're not getting results, so at some point they say forget it.

0:19:03.3 S2: So a lot of these women either make too much estrogen or don't have enough progesterone or don’t clear estrogen with their detoxification pathways, so that's super rewarding to be able to do. A lot of women in perimenopause, some of them, it's just a matter of overhauling their diet and lifestyle. And believe it or not, I ate crap when I was in my thirties. I had pre-diabetes, was eating convenience foods, processed foods. I always liked to exercise, but I really wasn't healthy, I didn't sleep a lot. And so I had to kind of overhaul my diet and prioritize sleep and stress management and everything, so those things people can do, if you guide them on how to do that, but some people need to take progesterone and that’s a prescription and it needs to be monitored and dosed appropriately to be able to help. And then once you get through menopause, some women need estrogen. Some don't, but some do.

0:20:01.3 S1: The dosage matters.

0:20:03.0 S2: The way you monitor it matters, it's not like everybody should have a crazy-high dose. I just was in Miami teaching a course last weekend with doctors, and the pharmacist’s like this doctor is giving everyone the same dose, X dose. And just like eek, that’s a high dose. He’s like, everybody’s getting that dose. But at least he's listening and he's trying to use bioidentical hormones, but he's not doing it the right way.

0:20:26.2 S1: Right, so it's hard.

0:20:28.2 S2: But I think... I love even seeing even people in their 30s, getting them on the right path, and to learn about how their body processes hormones, how important stress is, making sure their guts are okay, and then I think they navigate the change. I even look at even my friends or people I went through med school with, and for the most part, everyone's pretty healthy, I'm really the one who's really dug deep. I had the worst hormones and things I did probably less than in medical school. I still think, Okay, hey, I look younger than I am, but coasting, it's working on myself anyway, and the patient... but sometimes the innovations that we do are not that drastic. The problem is we can't control what the tests cost. Dutch test just increased the price of their tests, we can't control everyone. A lot of times, we just use traditionally blood work that people can run through their insurance, but you have to know what to order, when to order, how to interpret it... And so a lot of the hormones I use for menopause are FDA-approved bioidentical hormones that come in generic. I pay zero. I'm paying no copay for my estrogen patch, I do take a compound of progesterone that's about 30 or 40...

0:21:47.3 S2: Probably $40 a month.

0:21:48.9 S1: But it's not supposed to be crazy expensive bar. You mentioned three things that if your body isn't producing enough progesterone, if your body can't process it, three things that you said.

0:22:03.1 S2: So what is it once you're diagnosed, then it’s the treatment plan, and that's why it's very important to see someone that knows what they're doing.

0:22:15.8 S1: How can we ensure that that is... Right, right. Let's take the teen with acne.

0:22:20.4 S2: Or the teen with bad periods, for example. I'm rarely giving them a prescription, they usually don't need a prescription. It’s usually that they're not clearing estrogen, through their estrogen detoxification. And then with the acne, a lot of times it can be estrogen dominance or it can be gut bacteria, so they might need a prescription for that, antibiotic with some kind of herbal microbiotic. Like I said, teens that have gone to five dermatologists and they haven't been able to clear it until we've done some of the things, stool testing and the hormone testing.

0:22:54.0 S1: That's so sad. As a teenager to have acne, is there anything worse like...

0:23:01.9 S2: Yeah, diet,'cause the teens what they eat, it's not very good. So for those patients, I'm usually not prescribing anything, and certainly people in their 20s, once you get over 40, some, a lot of women, you just don't make as much progesterone because your eggs are aging, so it's more... you need a prescription then. Not everybody does, sometimes people respond to herbal supplements or there's even something called seed cycling, which is a food pattern of how to help regulate your cycle. So as I get older, I probably prescribe less. That's evolving more... That we're working more with the body instead of trying to give someone something, but there are times when you do need to have a prescription, and that's even like some people might need something like metformin, sometimes people... We've been doing a lot of the semaglutide, which is for weight loss, and that is a prescription, but there's these poor people who have worked so hard and are starving themselves and exercising and nothing's... Hormones have put on the weight, but fixing hormones doesn’t necessarily take it all off. 

0:24:14.2 S1: Right. 

0:24:16.1 S2: We are using some of that for our patients, and because it is working metabolically, it's getting their insulin down, it's getting their sugar down, and so that's why I normally wouldn't do a weight loss drug, but this is a little bit different with your metabolism. So it really depends on the patient. A lot of it is... A lot of it’s, we have a health coach in the office, a lot of it could be just education, partnering with peers, nagging maybe you shouldn't eat this. Food sensitivity is another cause of unexplained weight gain, also derail your hormones as well. When you gain more weight, your fat produces more estrogen, so it's just a cycle. There's a lot of things and in our environment, all the endocrine disruptors and all the toxins are messing with our hormones as well. So a lot of it could just be identifying the problem, working with a plan on how to combat it, it's not always a prescription, but often it could be. It reminds me of a woman that was constantly working with a personal trainer and paying an immense amount of money to see the best of the best, and had food delivery programs and she was following it, and she would get to her trainer and just not see the fat decrease. She was looking at her muscle mass and she wasn’t losing weight, and she just was like, I'm gonna get skinny when I guess I'm an old grandma at 90.

0:25:49.4 S2: Like my mom got skinny.

0:25:51.5 S1: And we don't have to do that. Tell me about your practice in North Dakota.

0:25:59.3 S2: Do you have a practice where we can work with you remotely or are you only practicing in Ohio? Well, I do have a medical license in Florida and Montana, but we are restricted to whatever state we’re licensed in, and the medical [board] defines where you practice medicine as where the patient is. I know there are some people that get around it and work remotely with patients because they're coaching, so there might be... There might be a different licensure for coaching, but as a medical doctor, I have to abide by that. So now what happens is patients actually come in to Ohio for the first visit, and then you do the run remotely, so I've had patients come from New Jersey, California, Las Vegas, Texas, whatever, and they're just like, Oh, once a year, if I have to just come in and have the appointment. So that could work for some people. I have a network, I did sell my practice last year to Forum Health, and we do have a network with, we have 28 sites, so there might be another provider at one of the Forum Health sites that they could work with, or I might have some colleagues. I don't have colleagues in every state. One of my colleagues created like a hormones club. She's tried to get someone in every state, so it depends.

0:27:20.3 S2: I know people reach out to me all the time about it, and if I can help them, I do, if I don't know anyone near them, I... I don't know, but I don't wanna randomly recommend someone I don't know just from a directory. I kind of... Sometimes I'll look at the directory and said, Well, this person has actually done the fellowship and got the board certification, so you could try this person, but I don't know them. That's what I do, so work remotely. That's why I try to provide just free content on the website, on the YouTube channel, we do have that online course, and we just recently have been partnering with a lab company, a lab distribution company, to try to even get the lab to be included in the course. Which is also a lot. That’s great. People can’t get the Dutch test, can't get the whatever. So do that, but then the problem is then interpreting it

0:28:11.8 S1: Or... And then because everything is so personalized, they might say, Oh, you know, I did the Dutch test, but they do it the wrong time, or maybe they didn’t do the right test fee, maybe they did saliva, maybe you just need to... It's hard because unless you take a detailed history, you don't know what type of test they need.

0:28:33.3 S2: So we do have, like I said, the online course, and we're working with the capacity to be able to add the test on, so for people to have, and then you’re a few steps closer to finding someone, you've already done the testing, so it just depends. I wish there was a way to help everyone. Yeah, well, of course you do, you have a heart for it. Obviously, you have dedicated your life to this. In watching your webinar, I really thought it was... Really spoke to me when you showed the picture of when you got married, and then you had a picture of you and your husband now, and I thought it was so cute because you said, he said that this is okay.

0:29:16.6 S1: But you really haven’t aged since you've been married and he is an emergency physician and doesn't take as good of care, my husband doesn't either, so he didn't say that I could say that, but I will say it, doesn't take as good of care of himself as I do.

0:29:36.4 S2: You think that's directly related to everything that you've done as the investment in your own body? I think... I guess... And I don't know if you... I don't remember what the latest version of the webinar was, but my brother passed away at 38, suddenly of a heart attack, and that happened, he had every risk factor, he was a diabetic, he had very high cholesterol, so I was so affected by that because I felt that was completely preventable, and so that was the turning point for me. And coincidentally, I was already starting to manage hormones, but I wasn't really functional medicine yet and into prevention, but knowing that his death was completely preventable, and he was 38 years old and literally just had a heart attack and died, just really affected me. And so it affected my family too, obviously, such that my dad's kind of super healthy, he’s 83 and he's obsessed about his blood sugar too, same thing, so that's kind of what made me do the shift. And so it was a challenge, growing up with two of the kids kind of subscribe to my point of view, one of them to his point of view, and could they fix it and be fine.

0:30:58.0 S1: Oh really? But

0:31:00.3 S2: Yeah, it's definitely been a challenge, and I've just kind of decided I do what I do for me. And yes, yeah, you can make fun of me for taking these supplements or going to bed on time and not drinking a lot of alcohol, that's what works for me. And how you feel great and then you look great to prove it, then that it’s working for you. 

0:31:22.5 S1: Yeah.

0:31:23.9 S2: I think obviously, it's not so much about the vanity of looking good, although it’s like, oh, you know, these wrinkles…

0:31:38.2 S1: I feel like this is my ministry and my mission, and I wanna be around patients and help patients, and so I have to be healthy. And even since the webinar we've had like a family was in an accident and had to kind of change things, and so there's lots of things…You never really know what, you're never guaranteed health. No.

0:31:58.7 S2: And being a mother, I think that you're the example for... I have a daughter too, and just, you’re an example to her of what is that body image, how are you taking care of your body? And they see that, and like you said, either they're gonna adopt one style or another, or choose their own path, but hopefully they adopt the healthier one. Yeah, yeah, yeah, for sure.

0:32:27.0 S1: The last thing I wanted to ask you about was... And this in regards to the dieting.

0:32:33.2 S2: That's this time of year, as moving into the new year, we're gonna hear so many different... Pushed all of these different diets like, well, if it's keto or if it's whatever, carnivore diet, and instead of being on this hamster wheel that we're on, what advice would you have for a woman that knows that she wants to make a change in her health, and what's a good first step there? So pertaining to women in perimenopause and menopause, and that's really 40 up, even 35, everybody will respond differently to a diet and that we're finding a lot about, that's your genetics of how you process fat, how you process sugar. Most women who are either estrogen dominant or in menopause are carb-sensitive and low-carb diets like a modified Paleo, even keto is a good place to start if you love to eat meat, or if you like that type of cuisine.  They actually did a study based on...keto wasn't involved, and was like Weight Watchers, Atkins and paleo, and the one that people were most successful on was the one that most likely mimicked their palate. Right, so if they... I don't love meat, I eat it.

0:33:55.2 S2: I don’t love it, I don’t have any political reason not to, but if someone told me you never can eat meat again, I don't think I would have a problem. So in general, there's a lot of hormones in meat, if you think about chicken breast, how much bigger they are today than they were. Be careful about the quality of your meats and whether there are hormones in it. I think a lot of people eat too many carbs and not enough protein.

0:34:17.9 S1: And I think the standard American doesn't eat enough plants.

0:34:21.8 S2: Yeah, no, I generally make sure I have... Even today for lunch, I was kind of pressed for time and I went to a local market to get my daughter's creamer since she's coming home from college, and I got a piece of salmon, but I didn't just eat the salmon, I put it on lettuce. And I have my radish that I have every day, and my Brussels sprouts, shredded Brussels sprouts, raw, and put that on the bed of it, everything like a... Let's put anything on a bed of lettuce rather than just having a sandwich, and a protein on a salad every day for lunch, so whatever a protein. Me, I generally... I can't eat dairy, I Hashimoto's Thyroiditis, so I don't eat that. I try to do grain free, but there's a lot of allergens, a lot of inflammatory things in gluten and dairy. Now, I'm not sugar free. I have a sweet tooth. I don't drink alcohol, maybe a couple drinks a month, maybe three, maybe four at most if it's the holiday season. I think just decreasing sugar, decreasing alcohol, eating more plants, being conscious of your carbs and your protein, all those are things that generally work for my patients, then we sit down and we figure out like, Wow, this person wants to do keto. 

0:35:38.5 S1: Okay, well, here's how you do keto, don't make it all about bacon. Or this person, they’re vegan and then all they’re eating is the fake meat, which is all, it's all carbs and they’re eating vegan but they're not eating very many vegetables, you know. That doesn't work, 'cause then you have so much carbs, so you gotta be careful. But most women, if you are really mindful about alcohol, sugar, really inflammatory foods, now it's not like eating three meals and just, now it's really going down to two meals. That’s really, if I post what I eat, some people are like, you don't eat any breakfast? I do eat, drink something if I'm gonna run.

0:36:17.1 S2: I know I ran six miles this morning, of course, I drank like a sports drink, I'm not gonna run on an empty stomach, but I don’t eat, 'cause all breakfast is gluten and dairy, so I don't tend to eat breakfast, sometimes I will, but I usually just eat lunch and then I eat an early dinner and then that's much pretty much it. I mean, it’s really just figuring out what works for you and being consistent and preparing.

0:36:42.9 S1: That's the other thing is I prepare everything.

0:36:46.2 S2: I mean, on Sunday, I'm like, Okay, what, do I have enough of this? I like this local lettuce, do I have enough of my radishes, my Brussels sprouts, my avocado, and what protein am I putting in myself? And then I actually do a meal service, Sun Basket just for two meals a week, so it delivers, so that I cook it. So for me, it takes out the shopping and meal planning for these two meals, the rest I'm gonna have to cook, you know, my kids are coming home this week, I’m gonna cook something Sunday night for them. And so I try... Planning is really the thing. And even when I go out of town, I was out of town this last weekend.

0:37:25.0 S1: The first thing I did when I landed Friday, Google Whole Foods. Oh, I can walk to Whole Foods. It’ll be a walk to Whole Foods…

0:37:30.2 S2: I’m gonna get my staples, my snacks, my stuff that I know that I can eat. I'm always prepared with something to eat because I can't do the gluten and dairy, and I can't usually eat on the run, so for airports, I have to usually pack a lunch when I can. Coming home, I can't pack something, so I kind of scope things out and make sure I have something. But planning and once you do it, it's really not that difficult, it just can be at first. Yeah.

0:38:00.5 S1: Yeah.

0:38:00.8 S2: And it's time management and it's not always being rushed to get to the next thing, it's being thoughtful about it, intentional. The alcohol piece, I gave up alcohol over a year ago, and I can't believe how that dramatically changed my life, and just my overall way of thinking. Very helpful for me. Yeah, I think for women your age, my age, whatever, is when they're not feeling well, they start to drink a little alcohol to calm themselves down, and then it turns into a drink every night while I'm cooking dinner or whatever, and it does help initially, but then it disrupts your sugar. And I don't think people are drinking like they're getting addicted, I just think there's a hormonal imbalance, and it’s calming you down and it's making you feel somewhat better, so that's why people do that. Yes, yeah, it's funny. It was exactly... And I sort of followed my mom's pattern because when she would cook, and we like to cook, so I'd get home from work and I would cook and that's my love language for my family, but then I would have a glass of wine. It would be probably more than a glass, but then I would get a headache at...

0:39:14.2 S2: I don't even know why I was doing, I'm like, Why am I even? This is dumb. It just makes me not sleep and feel even worse, and then you end up eating things that you don't want to be eating too, throws your inhibitions out a little bit. Even a glass of wine. Yeah, the sleep is why I did find a wine called Bev, Drink Bev, where it's a California company made by women, I love to support women businesses, it has zero added sugar. The sugar is a lot of what disrupts your sleep and everything.

0:39:46.6 S1: And it has, like a little can...

0:39:48.1 S2: So you don't have to open a whole bottle, one, four cans is actually more than a bottle, it's like a bottle and a third, but you could just open a can... Of course, I have that in my fridge and it's been untouched all these months, but if I wanted to have some, that's probably what I would drink. I’ve worn a continuous glucose monitor and it doesn't spike my blood sugar and I can sleep at night, as opposed to if I have regular wine. I mean, it doesn't taste as great as wine, but sometimes I try to present those kinds of options to people who it’s a social thing for them, and they don't wanna give it up. Then we try to work around that issue.

0:40:24.4 S1: That's interesting that you were...

0:40:26.2 S2: Are you diabetic that you wear a glucose monitor? No, I was pre-diabetic and my brother was a diabetic, and that's why he passed away so young, so I have worn it intermittently. I haven't done it in a while. Just because it teaches you a lot about what certain foods do to you. So I thought I was eating healthy doing those Daily Harvest vegetable bowls, so all vegetables, but they were spiking my blood sugar. It was too many carbs for me. Some of them were good carbs, so we're talking about Brussesl sprouts, chickpeas, and beans, and it's all... I don't know if it was vegan, it probably was probably vegan 'cause I don't do dairy, but it was convenient for me just to take to work. Well, then it was totally spiking my blood sugar, so I'm like, okay, I gotta go back to having protein on my salad, so that's why I switched to the... Usually I do chicken salad on greens or whatever, and for example, sweet potatoes spike my blood sugar, but if I ate salmon with it, and less sweet potato fries, then it didn't spike my blood sugar. It really taught me about what was going on in my body and it wasn't until I tried a little bit of intermittent fasting that I got my A1C and my blood sugar down.

0:41:39.1 S2: That's so interesting. I've been wondering about just testing my own insulin because I've been finding...

0:41:47.6 S1: And do you have, to do a continuous, is that by prescription?

0:41:51.9 S2: To use a glucose monitor is. You don't have to be a diabetic for some insurances, mine covered it, just as impaired glucose tolerance or pre-diabetes. We prescribe it for our patients a lot. For a lot of patients, we're checking metabolic labs, which is a full thyroid panel and insulin, glucose and A1C. We’re checking metabolic hormones like leptin and nectin, which are inflammatory hormones; leptin resistance makes you gain weight because you don't feel full, you feel hungry and all of your hormones affect your hunger, your metabolism, your glucose metabolism, so generally, we're doing a pretty thorough evaluation of patients that are coming in with, if they had the unexplained weight gain complaint. One thing with your practice and with others, if patients are sensitive to a cash, a fee-for service model versus insurance.

0:42:49.0 S1: How do you recommend...

0:42:50.5 S2: Because you wanna seek the care, I always think, don't let dollar sign just impede you from living your best life. How do you work with that with your patients? That's been really difficult, and that is one of the things that I don't like about this industry, 'cause when I opened my practice, we were on insurance. Using that model, we had to spend less and less and less time with each patient. There were times where I couldn’t pay my rent, I couldn’t pay myself because they just don't reimburse you. We’re spending an hour with patients, they will not reimburse you for that much time. The model was based on you spending 10 or 15 minutes with a patient, and seeing 30, 40 patients a day. I'm now seeing seven or eight patients a day, you can do the math and you can see that you're not gonna make it, you're not gonna make ends meet. So I slowly had to go off of insurance and find other creative ways, because I wouldn't compromise that kind of care we were giving. So we have things like we found... We've negotiated lower lab fees for patients, 'cause I know for me, I have a high deductible, so if I get my thyroid drawn, it's gonna be like $1,400, and the insurance won’t pay for it because I have to meet my deductible. So I negotiated like $150 so I just pay for my own lab. I’ll never meet my deductible, unless we have a catastrophic thing, so we do have some of the things ready, but it is a problem, and so that's why I try to do social media.

0:44:20.8 S2: I do things like online bootcamp challenges, and honestly, we used to do more, but it's a lot of work in the evenings, you know? It's just the knee that's kind of been resistant to meet. I have a partner who’s a health coach. She’s kind of the one who does my courses with me, and now we just did a thyroid one, which we included the thyroid labs, so obviously we have to pay the lab for the thyroid labs so it does cost something. I think we only had five or six people sign up, and so it... It's still our time creating it, doing it, facilitating it. I'm like, I'm happy to do it, but if people don't wanna come or do it…so that's how I'm trying to figure out how can I help other people, like... Should I try to go back, and we've done boot camps before that, we've had 200 people in 14 states and six countries.

0:45:16.7 S1: We haven't done that for a while. Cool. It's a five-day in a row that we go through hormone stuff and how to balance it, and we talk about detox, and we talk about food, we talk about a lot of stuff, fasting, but it's just a lot of work. It is a time in my life right now where I have that issue, so I'm still trying to figure out how in doing things like this, if I can help someone just by listening. See something on YouTube or something, I'll just keep trying to figure... But it is a major deterrent for a lot of people, and I never really wanted to have an elitist practice. There's a reason why we have obviously malpractice insurance and rent, and all this stuff, and it’s in this field 'cause it's lucrative, right? I would have stayed in OBGYN if money was the thing I was in for, so this is not the field to get into if you wanna make money.

0:46:16.8 S2: But you're helping lots of people.

0:46:19.5 S1: Yeah, and that's my goal.

0:46:21.4 S2: It's not fortune, I'm blessed that I can do what I want for a job, and so now that is my goal, it’s not about the bottom dollar. But there are some people that have to pay off loans and they have whatever. We have two kids in college, one graduated, so we've got, obviously, expenses as well. What you are putting out on social and the webinars that you are putting out there, I am very grateful, and I know that even the women that work at Checkable are big fans of yours, so thank you so much for gracing us with just all of your knowledge and just being present and digging into this because we need it in the world, and let's hope 10 years from now, this is all normalized and it won’t be so hard to find. So what you're doing and what people are doing are moving the needle, it's not coming from the doctors, it’s coming from patients, and so they're pushing for it, and so it is so much more wildly available than it was even 10 years ago. Amazing, good, good. So that's progress.

0:47:33.1 S1: We will share everything, all the ways to get a hold of you, and your URLs, and if there's anything that you would like to leave the audience with, it's all up to you there. I really just...

0:47:48.0 S2: One of the main reasons I tell everybody, there's three reasons I basically got on TikTok, one is to educate people. Two, is to advocate. I wish it wasn't that you had to push, push, push for your own care and seek out what you need, advocate, whether it was to get the right testing or to get the right prescription, or even to get the right dietary or whatever, you just have to be your own patient advocate. And the third reason is to embarrass my kids, which I don't know if I'm doing that or... So literally like laughter is good medicine, so I laugh, but there's some really funny creators on there, a lot of content. That’s hilarious. The biggest thing is like if you think something’s wrong, something might be wrong, you don't let people tell you there's nothing wrong, it's normal.

0:48:35.7 S1: And that's the message is that, seek it out. We're blessed that we have the internet now, we have social media, do your research. Don't put up with symptoms, find someone that knows when you're right, you have to have that attitude that you wanna have prevention and you wanna invest in yourself, and not everybody has the means, or not everybody wants to. Yeah, right, as long as there's the opportunity there. Thank you for providing it to us. Dr. Tara Scott, thank you so much for joining us. It was an absolute pleasure, and we will be checking back in with you and promoting anything that you come out with in the future.

0:49:13.8 S2: All the best in 2023. And thanks for all you do and all the hard work that goes into... I know it's hard, so I appreciate your time. You bet.

0:49:22.9 S1: Do you wanna be a part of a group with other moms of school-aged kids that would buy an at-home strip test? Search no more, join the Hero Moms Facebook group today, and be a part of a group that is non-judgmental and a little light, we actually have quite a bit of fun with entertainment and laughing about the things that we go through every day as moms, but there's also advice and recipes, and it's just a great community sponsored by Checkable Health. So find it today at Hero Moms on Facebook. If you liked this episode, I encourage you, please give us five stars, that helps us keep going, subscribe, and thank you to the wonderful Checkable Health Podcast team and Grow the Show who helped us edit this. Now, would that keep empowering yourself to make those clinical evidence-based healthcare decisions from home, thrive and enjoy your best, healthy life for yourself and for your family. I'm Patty Post signing off. Until next time.