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  • Kris: So hi everybody, it's Kris from KrisCarr.com and I have a very special guest today - my

  • new friend, Dr Sara Gottfried. Welcome, Sara! Sara: Hey Kris! Hi everybody!

  • Kris: It is so great to have you here. And I'm such a big fan of yours. I have to say

  • that your book, The Hormone Cure, has become ... there it is! Your book! And there's a

  • paperback now - I still have the hardcover. It has become one of my new recommendations

  • and bibles and I have brought it into my Functional Medicine practitioners. And I will say that

  • I busted one of my own myths, thanks to you. I thought that I was high in cortisol but

  • it turns out I'm low in cortisol. So thank you for that, Dr Sara!

  • Sara: You know, I'm always happy to be of service. So thank you for that, Kris. I'm

  • a huge fan, let me just get that out of the way. I've been a huge fan for years.

  • Kris: Mwah, mwah! So for you guys out there who might not know about Dr Sara, I think

  • that's probably hard at this point because you're such a superstar, but sometimes I'm

  • certainly last to the party. Let me just tell y'all a little bit about her before we dive

  • into this interview. She is a Harvard-educated physician, a board-certified gynaecologist,

  • a speaker, a yoga teacher ... isn't that nice when it all comes together? I say those really

  • big educational words and then I say she's a yoga teacher! What? She's a mom of two daughters

  • and the author of this unbelievable book, The Hormone Cure, as I said. So, Sara, I want

  • to talk about something that I know is going on for a lot of women in my life right now.

  • That is an increased amount of stress. Sara: Mmm.

  • Kris: I know you are just the master at solving these problems for folks. So tell me what

  • you mean by 'runaway stress' and what happens to our bodies when we have runaway stress.

  • Sara: This is such a great question. I think that most of us don't realize that we have

  • runaway stress. You know, there's sort of tricky ways that it shows up. One way is that

  • you just feel ungrounded, or you feel anxious, or depressed - 50% of people who have depression

  • actually have high cortisol. It's a suicide marker.

  • Kris: Wow. Sara: Cortisol is the main stress hormone

  • and the problem with runaway stress is that it changes the entire hormonal makeup of your

  • body. So this is really important. It can age you prematurely ... why don't we get the vain

  • things out of the way first, Kris, does that sound good?

  • Kris: That sounds awesome! Sara: And then we can talk about the inner

  • ecosystem. So, you know, on the surface I really think that your skin is a mirror of

  • your life and if you have runaway stress, if you have bad stress and cortisol is either

  • too high or too low or, you know, maybe both within the same day, it causes you to wrinkle

  • prematurely, it shrinks - on the inside - it shrinks your telemeters, those are the cute

  • little caps on your chromosomes that are a marker of your biological, as opposed to your

  • chronological, age. And it robs you of the mood and metabolism that you most deserve.

  • So, if you don't want to be fat and cranky, you've got to make sure that you don't have

  • runaway stress! Kris: [Laughs] I like that. Nobody wants to

  • be fat and cranky. But, you know, we just don't, but I think that it's great in theory

  • but how do we in our daily lives really practise that? Because, when we get that email, when

  • we feel up against the ropes with a deadline, or when something's going on with our kids,

  • you know, from your perspective, how do we walk out of that stress cyclone?

  • Sara: Yeah, the stress cyclone! You know, the key thing with the cyclone ... actually I

  • don't know cyclones very well but I know hurricanes!

  • Kris: Hurricanes, OK! Sara: The stress hurricane, you want to find

  • the eye. Like, we all have the stress hurricane happening all the time and it's not the amount

  • of stress that you have, it's actually your reaction to it. It's your perception of the

  • stress, especially if you think it's harmful for you. So I think the key part, when you're

  • up against the wall and you have stress coming from multiple different places, is to really

  • understand your response to it. And there's a lot of ways to do that but I think it really

  • starts with measuring - and you can measure it with questionnaires, you can look at symptoms,

  • blood tests, you can measure those cute little telemeters, it's not expensive to do that.

  • So there's lots of different ways to measure it, but I think that's where it first starts.

  • And, once you have that measurement, and you have the awareness, then you can step into

  • the grace of developing your solutions - the solutions that are really tailor-made for

  • you, because not everybody ... Kris, sometimes I have folks come to me in my practise and

  • they'll say "Dr Sara, I know you're a yoga teacher and I just want to tell you right

  • now I'm not going to yoga." Kris: [Laughs]

  • Sara: "So can we talk about something else? Because that's not going to work for me and

  • I'm not going to sit on a cushion and meditate either." So we've got to come up with the

  • solutions that really work for folks. Kris: Yeah, I love that. And I think that,

  • once we find those solutions, we actually have to practise them, because sometimes it's

  • very easy to stay stuck in our habits - including the habits that support stress - when we know

  • right around the corner there's something better waiting for us. I know, for me, dancing,

  • hiking in the woods, really unstructured time and really awesome, fun movies are my go-to

  • stress reducers. And, if I'm choosing not to do them, or I'm saying that I'm not making

  • time to do those, then I'm actually choosing more stress in my life than more joy. And

  • it's taken me a long time to actually own up to that!

  • Sara: Yeah, that's such a good point and I think, once you have your a la carte menu - I like

  • your menu, you've got the dancing, the hiking ... what was the third thing?

  • Kris: I love movies and I love unstructured time.

  • Sara: Yeah! Kris: Yeah.

  • Sara: Unstructured time and movies! So, you know, all of those, I think, suspend time

  • Kris: Mmm. Sara: And I think, for all of us, we need to get out of that hamster wheel of time. You know,

  • running from one task to the next and the To Do list that is at the front of our consciousness

  • instead of the mission that we want to rock while we're here. When you are able to hit

  • the pause button it really makes such a difference in your physiology. And it's ... you know,

  • I want to make sure that people understand that ... I'm not saying what I was told when

  • I was in my mid-30s, when I was crazy stresspants and I went to my doctor and I was, like, "Waaaaah!

  • I'm a working mother and I can't do this and I'm fat and I'm cranky and irritable and I

  • don't want to have sex with my husband." And my doctor was like, "OK, you need to reduce

  • stress." Kris: Right.

  • Sara: That's not my message at all. My message is let's hike with it a bit differently, let's

  • dance with it differently, let's take it out for a walk in nature. Because stress hates

  • going for a walk in nature. That just doesn't work at all. So we've gotta find these ways

  • to have a different relationship with stress. Kris: I love that you say that because none of us ...

  • I mean, very few of us live in the luxurious life where we can protect ourselves 100% and

  • live in a bubble from stress. I think it's very easy to kind of paint this either/or

  • reality and then the vast majority of folks out there, especially the vast majority are

  • women, feel like their problem isn't really being solved and they're still left scratching

  • their head. So, for you personally, how do you, as you say, dance with stress, meet stress

  • half-way? Sara: Yeah, oh this is such a good one. I'm

  • a yoga teacher so, you know, I had to become a yoga teacher because Iwas so stress-crazed

  • in my 30s. So I like to disrupt it with yoga. And sometimes it's as simple as sacral release.

  • You know, like one yoga pose that I'll do in the morning and the days where I could

  • go to those lovely 90-minute classes, like those days are pretty much over! So I don't do that anymore.

  • I also use my iPhone, I'll be at the grocery store and I'll pop on Inner Balance by Heart Math and

  • I'll do some coherance training, where you take the sympathetic nervous system, that half

  • of your nervous system that's in charge of fight or flight, and I'll get it into sync

  • with my parasympathetic nervous system, that half of your nervous system that does rest

  • and digest. When you connect the two ... ah, it's like biological yumminess. It's so good

  • for you. Orgasm does it too! So those are, you know, some of the things that work really

  • well for me. Kris: Let's go to my favorite subject: the

  • link between cortisol and all the bad crap that could go on in your life!

  • Sara: [Laughs] Oh yes! Well, this list is long. I'll give you a few headlines and you

  • can tell me where you want to dive deeper. Kris: You got it.

  • Sara: I mentioned, you know, that, when cortisol's like a runaway train, you can get fat and

  • cranky. So why don't we start first with fat? Kris: [Laughs]

  • Sara: So, when you're stressed out, and I get ... I used to get stressed out over the

  • most minor things. But, what I found when I was in that place of being thin-skinned

  • and highly sensitive, was that I would get fat so easily. I would go into survival mode

  • and, when you're in survival mode and cortisol is either really high or you're at more the

  • burnout phase, where it's low, then what happens is you're storing fat. So your body is kind

  • of like, if you imagine an Irish potato farmer who has a famine upon them, they don't know

  • where their next meal is going to come from. So you store fat like crazy and especially

  • where you can pick it up fast - which is right here at your belly. And that's not such a good thing. It's fat that is not just at

  • your waistline, it's also around your liver and in your liver. It's around your organs

  • and it's a special kind of bad fat that is metabolically active and working against you.

  • Kris: Right. Sara: Including shrinking the telemeters.

  • Kris: That's not good. Sara: None of us want to be fat. We want to

  • be lean. In fact, we know that longevity, Imentioned that telemeters can track your

  • longevity, when it comes to longevity you want to be either maintaining your lean body

  • mass or making it better as you get older. That happens to be one of my goals. I want

  • to look totally hot when I'm in my late 90s! What do you think Kris?

  • Kris: I think that's a good idea. I like that plan.

  • Sara: Yeah, green juice, keep the cortisol in check.

  • Kris: Exactly. Sara: Right? So, yeah, what else. #1 you're

  • going to get fat. #2 it robs you of those happy brain chemicals. I was making the joke

  • about dopamine, which is responsible for pleasure and satisfaction, and addict brains tend to

  • be really focused on dopamine and I happen to be one of those addict brains. If something

  • is worth doing it's worth overdoing! And also serotonin. So serotonin is ... I like to call

  • it Dr Serotonin, that's what my assistant calls it.

  • Kris: [Laughs] Sara: Serotonin's in charge of your mood and

  • your sleep and your appetite and it's not like all these brain chemicals are created

  • equal. Like serotonin is the gatekeeper. You really want to love up your serotonin, it's

  • very important when you have runaway stress, when you have high cortisol or low cortisol,

  • it effects the levels of these happy brain chemicals. So that affects your mood, anxiety,

  • depression, ADD, memory issues, those are some of the things that happen. In fact, we

  • know, for people who have high cortisol, it can shrink your hippocampus.

  • Kris: Oh. Sara: I just wanted to say hippocampus for

  • you, Kris. Kris: It's a sexy word, hippocampus! It's

  • such a sexy word. It's really for after-hours but, since you went there, here we are!

  • Sara: [Laughs] It's cocktail hour somewhere, I thought I could bring in hippocampus! So

  • your hippocampus is in charge of your emotional regulation and memory consolidation and, if

  • you are shrinking that puppy in your brain with high cortisol, you are going to walk

  • into a room and just be like, why did I come in here again? I can't remember. And you're

  • not going to be able to emotionally regulate. And, oh my gosh, aren't relationships the

  • most important thing on the planet? Kris: Yeah.

  • Sara: We need our hippocampus to have strong, supportive relationships. So those are a few

  • of the things. I could go on and on about what happens with the ...

  • Kris: Cortisol, yes. Sara: When cortisol goes bad.

  • Kris: So let me ask you a question, because I bet a lot of people out there listening

  • to this will probably wonder how do I know if mine is high or low or where I stand? What

  • would you suggest? Sara: Well, I ... I want to give a range of

  • options here, ranging from absolutely free to ...

  • Kris: Very expensive! Sara: Very expensive! Some of the tests that you can

  • do ... free would be that you do a symptom questionnaire. And I have a free one on my

  • website. I'm happy to give the URL for that. You can also, if you get my book, on page

  • 24 through 31 you can take my questionnaire that I've been using in my practice for 20

  • years to identify problems with high cortisol, low cortisol, and anything in between. So

  • those are some of the suggestions in terms of measuring. You can also do a blood test.

  • And I'm a big fan. I practise functional medicine, as you know Kris, and I like to do blood work

  • first, because it's the universal language of mainstream medicine. Now, that's a separate

  • conversation, how I want to completely change mainstream medicine and bring them our way!

  • But I like to start with blood tests, because most mainstream doctors don't really buy the

  • whole cortisol issue and adrenal disregulation, even though there's thousands and thousands

  • of studies showing that there's a link to cancer and to diabetes and metabolic syndrome

  • and all these other issues. Kris: Now what about saliva or urine or anything

  • like that? Sara: Yeah, so I say by any means necessary.

  • I like to start with the blood test, because I think it's a good screening test and it's

  • got this universality with other doctors that I like and then, if you haven't detected a

  • problem or if you want to go further, I'm a big fan of saliva testing. And the most

  • common is to do what's called a four-point test. The fancy word is 'diurnal'.

  • Kris: Yes, yes. Sara: Diurnal. And that's where you check, when you

  • first get up in the morning, your saliva for cortisol, before lunch, before dinner, and

  • before you go to bed. You know, what happens with cortisol is you want to be high in the

  • morning, not too high, not too low, you want to be at a certain level and you have this

  • lovely downhill ski-slope that you run over the course of the day. And, if you don't have

  • that slope, if you're flat, for instance, which is one of the things we see in folks

  • who suffer with cancer. If you don't have that slope, it can be worse than smoking for

  • your health. Kris: Wow.

  • Sara: So you really want to pay attention to this. Another thing you can do is you can

  • measure cortisol in your hair. How about that? Kris: Hmm.

  • Sara: It's a bit of an average, so it's harder to kind of see the slope.

  • Kris: Yes. Sara: And then you can also measure it in

  • your urine. Kris: The reason why I brought that up is

  • because I think that the ... I was calling them quizzes but I think that the forms in

  • your book that you can go through to really figure out what's going on with you as so,

  • so useful. And I've been a [laughs] a patient in functional medicine for a long time. And

  • sometimes I feel like I know as much as some of the doctors that I've worked with - just

  • because, when you're up against the ropes, you tend to get very passionate and learn

  • everything you want to know or need to know about your particular situation. It wasn't

  • until I took one of your ... I filled out one of your questionnaires that I was like,

  • wait a minute, this is all off, because my blood test - and I share this with everybody

  • because I think it might be common and Sara will tell us in a moment - my blood test was

  • fine. So then I did the four-point test and that's when I learned that my cortisol was

  • way too low in the morning. And, just taking some licorice first thing in the morning,

  • with a really large glass of water before I go on to my warm water with lemon, I could

  • see such a difference in my overall day. And it was that simple.

  • Sara: Yeah. Kris: And, until then, I had licorice but

  • I was taking other things and I thought this probably isn't the most important thing on

  • my list. Sara: [Laughs]

  • Kris: And I just relegated it off to the side because sometimes I take a lot of different

  • supplements. Well it turned out to be the difference between being exhausted throughout

  • the day or being like a regular human. So that's why I brought up the saliva test. And

  • my question is, with, for example with the blood test, is it common that sometimes it

  • can come back and everything looks fine but it really isn't still?

  • Sara: Absolutely. There's so much, there are so many nuggets in what you just described

  • and I want to unravel a couple of them. I'm going to come back to thsi point about the

  • blood test and how it's not the best screening test, especially if you really think that

  • there's an issue. So I wanted to say first that I totally believe that you are your best

  • doctor. Kris: Mmm.

  • Sara: You know, especially when you've had a wakeup call, as you have had, Kris. I think

  • it just allows you to step into that place of kind of divine investigation that is very

  • hard to find in a clinician. And if you find it, oh my gosh, hang on to that person!

  • Kris: Exactly! Sara: You want to create a partnership, I

  • think that is so crucial. #2 I want to say that the blood test, you know, even though

  • it's part of this universal language that mainstream medicine speaks, it's a snapshot

  • of the 10 seconds that a needle is in your vein, right?