Lifestyle Steps to Heal Your Menopausal Brain – with Dr. Annette Bosworth

Dr. Mindy Pelz  

Okay, so for starters, I just gotta say, welcome to the live version of the reseller podcast second, only the second time we’ve done this is sweet.

Dr. Annette Bosworth  

So what made you start doing this version of it? It’s

Dr. Mindy Pelz  

such a great question I and I think you would relate. And it ties in so well to what we’re going to talk about. I’m super clear, I am a face to face person, like, this whole zoom world has not been good for me

Dr. Annette Bosworth  

know, the two dimensional version of people that it’s like, it’s hard to connect to their heart. Super hard can trade information. Yep. But it’s that soul to soul that i Mountain for that to go through.

Dr. Annette Bosworth  

So so well said. So we just decided wherever we were going, especially at like a conference like this, where there’s so many brilliant minds, let’s just gather everybody and do as many podcasts as we can. So that and the other thing is, do you realize like on Zoom, there’s always like, you’re kind of interrupting people, there’s the art of conversation just doesn’t happen.

Dr. Annette Bosworth  

Oh, man, it should? Yeah, I think that you you also perfect the art when you’re when you’re talking to patients, right? So it’s 25 years, into like, Oh, I’m watching your body language, I’m gonna see you’re about to say something you shouldn’t say, and I’m gonna help you say, let’s just go in this direction and not go down that rabbit hole. But you cannot do that on a zoom.

Dr. Mindy Pelz  

That is so true. Yes, that is so well said I have noticed that that the art of like day every day, having patient after patient after patient absolutely changes your communication style. Right. And you can’t it’s really hard to have that kind of communication on Zoom. So

Dr. Annette Bosworth  

yeah, so brilliant. So I’ve had folks asked me, I’ve moved to Tampa in the last year and a half and said, Well, when are you going to start your practice? And the they said, Well, you’ve got all these people across the country that want to see you. And I’m like, I did not want to see patients that way. I didn’t want to see patients. I’ll do anything. I don’t have to see patients that way. Yeah, it isn’t. It’s a great follow up. It’s a great you know, bridge for times when you can’t meet but Tibet for that to be the only way you connect to people that you’re you’re trying to intimately intervene in their life. Yep.

Dr. Mindy Pelz  2:01  

So this believer that this does tie into what we’re going to talk about, which is neurotransmitters and I want to talk about the lifestyle that we need to be living to enhance our neurotransmitters i and I’ll tell you something that hit my heart. I don’t know if you saw this a couple of weeks ago. But Oprah came out with this masterclass on menopause. And she was like, I’m gonna start the conversation. We’re not talking about menopause enough. And I thought, oh, my gosh, yay. Oprah is amazing. Like, you’re the one to do this as me, I haven’t heard this. Okay. All they did is talk about HRT, they didn’t even talk about bioidenticals. It was just like women need more access to HRT. And what I’ve learned is that I feel like we’re not bringing lifestyle into any conversation, whether it’s menopause, or whether it’s weight loss, even, you know, everybody’s all into the medication that’s going to help them lose weight right now, or whether it’s mental health, we, we don’t emphasize the lifestyle. So if I was to ask you, what’s the lifestyle? We need to keep our neurotransmitter system up? Oh, what would you say?

Dr. Annette Bosworth  

Well, you teed this up? Well.

Dr. Mindy Pelz  3:13  

I have a little bit of a mascot. That’s a thank you for that.

Dr. Annette Bosworth  

So the other day, I was interviewing a new person on our team. And at the end of every interview, I let them ask me questions. And they asked me, What’s your favorite thing on your resume? And I said, Well, number one, I’m a woman in medicine, and I’m still married after 30 years. That’s what my wife is. But number two, my kids aren’t in rehab. And I was given I was asked to by the Department of Defense, their counterterrorism unit to teach them if I was going to heal a brain, what would I do? Amazing. And the course is 12 hours long. It’s my favorite work. It’s my favorite work, because it is not the prescriptions and you know, hats off to Oprah for having the conversation. But with a a stumble out the front door to think that you’re going to replace the symptoms that are plaguing an audience like those Orleans, right wheeling descriptions. Yeah. If you say start with prescriptions, and that’s where the conversation begins. Yeah, you are a stumble out the front door. It is truly like that 12 hour course at the end of the course, the one little thing at the end, I talk about a prescription. But the rest of it is oh no. If you want a brain that’s working right, there are some rules. And when I would have folks in my we would I had a branch of my clinic that was for recovery. And I wouldn’t take people in the recovery unless they agreed to take the 12 hour course. And at that time, the course was held like a church or you know, Saturday, Friday, Saturday event it continuing education for a jail or something like they were not like convenient, but I’m like if you want me to take care of your kid, I can’t do that. unless everybody around him or her is changing the way they think about how this brain is ever going to heal amazing, because those neurotransmitters well, they’re a lot like the hormones. Oh, yeah.

Dr. Mindy Pelz  5:10  

Oh my gosh, we are we’re talking about hormones. But we’re actually neuro chemical beings and that we have to include neurotransmitters in the conversation. And we’re not doing that when it especially in menopause,

Dr. Annette Bosworth  

right? I like especially using the the neurotransmitter norepinephrine, because it is the one of the best ones. That’s Yes, it’s outside the brain, and it’s inside the brain. But guess what the chemistry to make it is still inside the human being. And when you start with a broken human being and say, we’ll just add some norepinephrine, or they come and say, Doc, I want to I want to shot a growth hormone. You can do that. And it’s a really specialized thing for an endocrine person move for, you know, children with short stature, expensive as heck very specialized to give it but people will Google it and say, Well, I know you can get a prescription of it. And I’m like, not if you want to turn out not looking so funny. It’s gonna do strange things to a human that’s not in the place where they can receive that hormone. And they can do the right thing with it, right?

Dr. Mindy Pelz  6:07  

Because this is both in as we progress forward on the neurotransmitter discussion. It’s the same thing with hormones. And same thing with thyroid is taking the pill, right doesn’t mean it solves the problem, because that chemical still has to get into the cell exactly create this activation process. So all we’re talking about when we talk about HRT or antidepressants, or any kind of medication that affects the brain is just bringing in the actual chemical but not the process of how to use that camera,

Dr. Annette Bosworth  

right, I think I mean, let’s just start with some we’ll go to antidepressants because those are the ones people mostly know about neurotransmitters in the brain. You take SSRIs and it’s a serotonin reuptake inhibitor. You take an SSRI, it’s a serotonin and norepinephrine reuptake inhibitor. These two are the Prozac, Paxil, Zoloft, Celexa, Effexor. Cymbalta is of the world, right. And they go into the brain. And they are when that those neurotransmitters, they come out of one end of a neuron, and they hang out in a little space called a synapse, they tickle the next synapse. And then in Healthy People, a little vacuum sucks them back up into the original side. And you do it all over again. Oh, it’s like recycled, it is recycled. And when I give that drug, Prozac, I block the vacuum. I keep it in the space. Okay, so if you’re not making any, I’m not vacuuming? Nothing. Okay,

Dr. Mindy Pelz  7:33  

so you have to take keep taking the drug. Because there’s no recycle process, right? Well,

Dr. Annette Bosworth  

there’s two parts to that. A neurotransmitter is only going to last so long in a human body. So but it has a lifecycle of being recycled to that little, you know, vacuum process, you know, of a six month process, if you are healthy. If you are not healthy, you can recycle it a couple of times. And then you’re depending on more to be made upstream when we would take animal models and you’d really deplete them of serotonin. And then you would just leave them to their devices in a poor nourished under slept, so they did not allow them to sleep much high stress situation, they would never reset that neurotransmitter, they never got back to normal. It’s crazy when you would when you would put them on Prozac. And they were at this super low. Like if we took all the serotonin out of your body and we piled it in a little pile and you’re in a tiny little bitty pile because you’re depressed you don’t have enough serotonin to do what’s supposed to do. But now we’re saying I’ll give you Prozac. So you’re recycling this tiny little amount, which was it can make a difference people will take it you’ll make a difference. But nothing like what happens to say let’s get you making more of those neurotransmitters in Chris Palmer and his team of how you how you can impact and change the trajectory of how a deep depressed brain or a brain that cannot hold a mood a cycling bipolar brain goes up and down. And yes, we have medications that will alter the outside symptoms. But it is way better to start with how about we replace the tools that help you make serotonin so you yes so you go it’s one step deeper. Yeah, exactly.

Dr. Mindy Pelz  9:19  

So okay, so what’s the what is the you want to go back to something you said about 10 minutes ago, which was there are very clear lifestyle things you need to do to keep this system working out. It’s best

Dr. Annette Bosworth  

so the first one that I like to teach through is I would give the my first audience for this. This information was teenagers. Yes. And they have these beautiful brains that are

Dr. Mindy Pelz  9:42  

their teenage brain I mean as mothers is fun to try to. Yeah, be late. That’s about the

Dr. Annette Bosworth  

master manipulator a

Dr. Mindy Pelz  9:55  

little bit of what we’re doing.

Dr. Annette Bosworth  

Create. Okay, you’re so nice. Yeah. My children should have you as a mother.

Dr. Mindy Pelz  10:05  

You’re obvious about it. You’re like, I just My daughter will never listen to this podcast.

Dr. Annette Bosworth  

I’ll tell you it’s it’s such a feat, you know, the wisdom of, you know, we built that around the sun. I’m 51. And then you do understand what your parents were trying to say and do. Yeah. But it took us three years to get to that point, like, oh, they were probably right. Yeah. So as you watch teenagers, and you see, there are some really cool facts about teenage brains. So I put them in my, my workshop, and I tease them with I give them four, or I give them a statement, and about hippocampus. And then I’ll say, there are four true statements there and there’s one false, and then there’s a scratch off test that they have to work as a team to find the right answer. And of course, there’s nothing better than for teenagers telling everybody, they know everything, right? These are hard questions. And so then they have to agree what to scratch off. And if the little star isn’t under there, scratch off, World War Three shirt starts out on their table. But the point is, they’re struggling over this, these facts about what’s going on in your brain. And that hippocampus is a powerful predictor of success. So when you get people coming to you for you know, improving my brain, what they’re really asking is, I want to be more successful. And I’m not using that in the financial component I’m measuring success with what’s the length of the relationships you have in your life? How quickly at the age of 50, can you learn to do something new? And when you learn that something new, can you deliver that new skill in an emotional state? That doesn’t repel everyone? Right, so you look at brains in that teenage year when they’re starting and stopping the growth of their hippocampus? And that is a great teachable moment to say, Yeah, your hippocampus isn’t developing and doing things well, because it’s got a stunted growth from the recent carbohydrate bins you just went on. You drink alcohol the other day, and it’s going to not grow, that hippocampus is going to not grow for up to six months. And during that time, your emotional state is going to be a teenager. Exactly what what we see is this for adults, too. Yeah, the hippocampus is really unique, though, because teaching it during that those teenage years, that hippocampus does a huge growth in utero. And for about a year after, then it kind of pauses in the way it grows until puberty. And puberty actually marks about two years before when this really important part of the brain grows in length and volume. So I you watch how well, you can during the time when a brain is supposed to be growing really well. And then you learn what doesn’t make it grow? I think does. Yeah, so those are the places where all these lifestyle things. Ah, so yes, they apply into adulthood, but the stuff I’ll talk about the evidence when you say well, Where’s where’s proof that best proof is in teenage brains? And are hippocampal growth? Because

Dr. Mindy Pelz  13:03  

it because there’s because you can it’s like a research? Yes. Of one research that you can see. All right. So so so we’re starting with the hippocampus, and I’m thinking then that is probably because that’s the most important,

Dr. Annette Bosworth  

the most important, excellent, okay, so if you look at a few how to pick one part of my brain that I want to say, if you’re gonna give me a stroke, Okay, stay out of my brainstem, but then don’t touch my hippocampus, okay, not hippocampus as an adult. The replacement of the cells in my hippocampus is possible. Again, when I went to medical school, they had a test question that says, the neural cells you’re born with are all you’re going to get right? And then in my residency, suddenly change the rules and say, no, no, this little this little protein called BDNF is what is like the Miracle Gro of our brain. And specifically it can do a stem cell like effect to the hippocampus. Amazing. Yes. Like, you know, you can cut off the cervix and it grows back cut off part of the liver and grow. But there’s the hippocampus where it can grow back. Yeah. So as much as I don’t want you to touch my hippocampus. If I do, I’m going to do these things to help it grow back or I’m going to help it be the best it can be. So So BDNF is the trigger of that, right? So the things of lifestyle I’m going to tell you about are what it does to a teenager and what it does to BDNF, perfect, right. So number one is sleep. You cannot grow BDNF. So BDNF is this little protein. If I you know check your cerebral spinal fluid, I would pull that fluid out of your body and I could find the protein in your brain in your in your liquid of your brain. The amount of BDNF in your brain would teach me how well you’ll recover from an injury. How well dementia is headed your way how well the depression or anxiety that if you’re ebbing and flowing towards that or away from that right where you’re at with that. It predicts suicide attempts. I mean, the the when I was in medical school, BDNF was just being found. And if you wanted to get fired Did for any type of research from the NIH, you just needed to add the words BDNF, those four little letters, you could say I want to study that what color the tail of a bunny turns out. And if you said the word BDNF with it, you got the money. Everybody wanted to know why was this? This was 1999. Yeah. 98 to 90, right, right around plus or minus right now. Okay. And that research was, I mean, it was impressive. At the time, we didn’t understand why did depressed people have these tiny little hippocampus? And there were several like, people’s opinions being played out in the in the, the journals that you would say the opinion part of the journal, you would hear these really smart people saying they’re born with it. You can’t remake a neural cell. They have to be born with that small. They were destined to get depression. Okay, that’s terrible thing until anyway. No, they’re not. That’s not true. That did not turn out to be true. Then the other people were, well, once they’re small. You can never get it back. Never get back. Yeah, that used to be the old Yeah, right. Yeah. And honestly, that’s where the people with fibromyalgia were. What’s wrong with the people with fibromyalgia? They start out with this life where they don’t sleep well, very commonly begins right after they’ve had that baby. And they are the best of mothers listening in the other room. or god forbid, the baby stays right in their bedroom and the mother never sleeps. Wow. She never sleeps for long enough to build her BDNF backup.

Dr. Mindy Pelz  16:22  

So how much sleep do you need? Yeah, so

Dr. Annette Bosworth  

you need the kind of sleep that gets you into deep sleep.

Dr. Annette Bozworth  

Yeah, I wondered. Okay, so how much deep sleep beauty?

Dr. Annette Bosworth  

Also take a guess? How many minutes a night on average and adult brain who makes healthy BDNF gets? This is this is the EEG version, not your iWatch version. Your EEG version, I have you hooked up, you’re in a sleep lab. You come in, and I get to measure. And that wasn’t me, but the researchers measure. What was the people who had the highest BDNF? What was the number of minutes they spent? This is that kind of sleep where if you’re a baby, I could change your diaper and you don’t make it right. Okay, so deep, deep, deep sleep, I’m

Dr. Mindy Pelz  17:05  

gonna say an hour. Yeah. 15 minutes home. And and and my understanding is we need two hours or more. No, you need 15 minutes, you only need 15 minutes of the delta sleep. Oh, BDNF.

Dr. Annette Bosworth  

So here’s the problem with that, you get it in that first first part of the night, you get more of it. So you, it takes about two hours to sink into that 90 minutes to two hours depending on your brain to sink into the depth of sleep. But once you get to that layer of sleep, if the fire alarm goes off, while you’re in BDNF, you can’t wake up right? It is a dangerous phase of sleep for preservation for you like evolution, right. So as your brain gets to that lower level of sleep, that is where it will check your heart rate. Look at this and make just cycle the crap out of your BDNF. That’s where this protein is made. That’s where this repair only need 15 minutes so that so then you only stay there for for three minutes, two to three minutes, and then you’re gonna wake up, you’re gonna check on your body, then you’re gonna come back and you’re gonna grab another that’s what

Dr. Mindy Pelz  18:07  

my my aura ring shows me all the time.

Dr. Annette Bosworth  

Yes. So in the way it looks on your aura ring and your Apple Watch and what it looks like in the sleep lab. There is a correlation. But it is not the same timer. So that’s where when people say well, how much should I have my on my watch? I’m like, Heck if I know, I got the studies that come from an EEG. And they are not the same.

Dr. Mindy Pelz  18:27  

Yeah, but so how does the everyday person know?

Dr. Annette Bosworth

Right? So you look at that aura watch. And what I tell patients is that deeper sleep should be getting into that 90 minute mark should be because it’s not the same measurement. Right? So there is there is a device out there that I’ve ever seen the Muse headband. Yeah, yeah, yeah, yeah. So they’re in, or aura ring and Muse headband are very similar in the way that as far as their correlation and accuracy for getting to deep sleep. So those are the two that I if you’ve got an aura ring, then I’ll watch that data. And then it correlates to how much Oh,

Dr. Mindy Pelz  19:01  

interesting. Okay, okay. Anyway, so So sleeps number one, clips, number

Dr. Annette Bosworth

one. And what’s happening during that sleep is your hippocampus is growing. If you’re a teenager, you’re BDNF is being made. I like the dishwasher effect is really what’s happening. So we have, you know, lymph cells, lymph systems in our body, there’s a lymph system in your brain as well. And that lymph system will open up and do a dishwasher effect of the brain cells pulling out that tau proteins and all the things that you never want to get in your brain because they are highly correlated with the age diseases of aging for the brain. And that neurotransmitter effect is and how well that grows is related to the depth of sleep. Not that you got one night but what you got cumulatively over that several the last several days to weeks. And when you have healthy people who are they slept like I did last night which is in a hotel room. If I’ve been doing my Heart and sleeping well for the nights prior to that your brain will it will play catch up. Yeah, it will you know, when it gets to that deep sleep, it will hold tighter it will hold longer trying to repair from the night before, right? But the chronic sleep deprivation is it was pervasive in our population in our brains.

Dr. Mindy Pelz  20:20  

What happens if we take medication or we drink or marijuana like, even though we may be asleep for a certain period of time, we are not necessarily getting that deep sleep, right?

Dr. Annette Bosworth

So that’s where the best brains to teach through is the teenage brains because they’re growing. You can do a functional MRI is week one or week three or week eight. My favorite image for a teenage brain is to show the scanners where they are you’re watching brain activity as they do a a puzzle in their brain in the machine. And you can see how much brain activity is being used to solve the puzzle. Okay, and we do it in elders, we do it in people with Alzheimer’s, we track the brain activity. So they have a 15 year old boy to 15 year old boys. One of them is the high school partier. And he gets stinking drunk on Saturday night. Excessive drinking every Saturday night. He’s known for that. That’s what his thing is. This test is on a Wednesday. It’s not a hungover day, it is Wednesday. And when you watch his brain, compared to the other teenage boy, first of all, both teenage boys have very little brain activity.

Dr. Mindy Pelz  21:27  

I haven’t I add a teenage boy turning into a young man. But how the hell did we let them dry? I could have told you that we had no salt to go to they let them drive up 14. I’m

Dr. Annette Bosworth

like this is suicide. What am I doing?

Dr. Mindy Pelz  21:44  

Right? There’s a lot like who came up with six, okay for a driver’s license.

Dr. Annette Bosworth

So as they’re sitting there that that boy who’s got the healthy brain who’s not had any alcohol, his activity is? Well, it’s normal, but it’s a teenage boy. The one next to it has one little ditzel that is able to wake up that brain on the Wednesday. This is not yesterday’s drinking habit. This is what looks like when you put alcohol into the body, that alcohol is a chemical, it crosses the blood brain barrier very readily. And it does this thing where it pulls water wherever it goes. And for anybody who’s maybe has been drunk or hungover in your life. And you’ve got that morning after where everything’s swollen. You can’t get your ring off. And you feel dehydrated. People say Oh, drink water after you know in a hangover. Where’d all the water go? Oh, yeah, the water went into the cells, because it followed the alcohol, okay, and the highest rate of delivery is as it goes into the brain cells. So the alcohol, which is what you’re drinking it for is going to dissociate, it’s going to cause the brain to act differently, right? It’s going to cause a release of dopamine and all the lovely things that alcohol does the first time you drink. And it’s going to pull in its wake for water molecules. So the rate of alcohol you pull in, is proportional to the rate of water that gets pulled into the brain. And those brain cells swell, just like a concussion. Wow. So you put energy into a brain with a baseball. And that energy waves through the brain. And that trauma swells the brain, wow, if the swelling of the brain is so terrible after a car accident, you’re laying in my ICU, we’re doing a calculation saying oh, oh, we’re worried we’re worried the space in that brain is about to run out in the in the spinal cord is going to push down into that, you know, foramen magnum at the bottom of the skull. And when we do that, there’s a nerve there that if we pinch it off, you stop breathing. Yeah, that’s brain dead. And then we start talking about organ donation. And if we get really worried about the trauma in that brain, that swelling in the brain, well, we’ll put we’ll cut off part of your skull laying next to the table for two days as your brain swells upward, so that you don’t die. That’s fixable. You know, a scar on your head isn’t pretty, but you’re alive.

Dr. Mindy Pelz  24:03  

So that’s happening. Alcohol. Wow. So that actually, so where my brain goes with that is, you know, what I see with women after 40 is as you lose estrogen, you, you also lose that precursor to dopamine, because estrogen will stimulate dopamine. So and then you’re losing progesterone, which is helping you make GABA. So that glass of wine becomes like this new tool to give you that, that euphoria and that relaxation. But the problem that we’ve got is that’s a short term solution, creating a long term problem. Absolutely. Yeah. So just like it’s a problem for the teenager drinking on a Saturday night and not performing on on Wednesday. Yeah. So it’s something that has to be a part of the brain rehab, I would think for as we age.

Dr. Annette Bosworth

So you look at what that lady is doing to say I want to drink some wine and feel, you know, relaxed. Yeah, look. All right. What they’re doing that alcohol goes across the blood brain barrier, it pulls water across the blood brain barrier. And her 50 plus year old brain now swells every place that alcohol goes into the brain. And when it’s a repeated swelling, well, that trauma from the alcohol now has to repair. And the tools to repair that begin with, well, they begin with a, I like to tell people ketogenic state is the place, if you’ve got ketones floating floating around, you know that you can move that that fat, the fat that’s needed to supply the estrogen, the cholesterol is really what you’re beginning with, so that you can move that cholesterol to the places in the body that will then turn it into estrogen, turn it into testosterone, take those neurotransmitters and the downline chain of all the ones in the brain then can be supplied. So I think the key to looking at when when people say Doc, you know, I I’m, you know, and God bless Oprah, if we just put estrogen at the end of the line. Well, this, let me let me help you. Let me put the estrogen at the end of the line. But what’s before that, and before that, and before that, is this sunken phase, that estrogen in and of itself for your brain? It’s like sprinkling Prozac on to somebody who’s got a little bitty pile of serotonin in their brain. And I’m going to recycle the serotonin in that little spot for their brain. And it’s going to make them feel a sense a little bit a bit better. But not, not the restoration of their soul. A feeling good. That comes with Yeah, the whole that comes with the long game. Yeah, the long game is saying, all right, you can’t fix this without sleep. The Sleep has to be deep enough that you’re BDNF is being made. We have very good evidence that without that process, I don’t care how good my prescriptions are working. You can’t make them work unless you’re sleeping. Well. Yes. The second thing was, don’t drink alcohol. Okay, alcohol was I mean, I love a glass of wine. I’m not perfect here. I just know the science behind if I want my brain to age, well, this isn’t the tool you want it to be right. And having a a process or a habit in your life where you say, This is what I do two to three nights a week, and now it’s four nights a week and not every night a week because I’m in menopause, right? And the red wine is supposed to help me, okay, don’t play that game. Right? You’re going in the wrong direction. Because the depth of sleep that you get this was a great story. So I did my residency in Salt Lake City, Utah, and I’m from South Dakota. And when I told my parents I wanted to do residency in Utah, they’re like, Well, you know, what’s the first thing you think of when you if your kids are gonna go to? This is what 30 years ago, too. So it’s much different now. But more Mormons, right? Yeah. So I didn’t even know I didn’t know anything about the Mormon faith at the time. I’m like, well, I’ll figure it out that I’ll be fine. So I get there. And actually, on the tour, they said something to me that I was like, isn’t that strange? You’re you get to look at the beautiful mountains, and they tell you, you can ski which is totally a lie, because there was no time for skiing. But then they say and, and you know, there’s not that many alcoholics, you’ll have to take care of Oh, and I said, huh, is that a thing? Turns out, it’s a thing. First year residency, you take care of recovering alcoholics, they come in the ER, you detox him, don’t let them have a seizure, that’s your job. So you don’t have a lot of those in Utah, because it’s number 50 for alcohol. So a couple years later, I’m in residency and you know, now you’re used to that you don’t see alcohol, but we put alcohol in a pill. And we did that actually, the person that did it was somebody who was a recovering a son of a recovering alcoholic. And he said, If I could just put alcohol on a pill, my dad wouldn’t go to the liquor store. And so that was his theory and part of what motivated him to study out booze and a pill. So he put booze in a pill gave it to all the people, my goodness, they’ve never stopped drinking. So well. The study was incredible. They are they didn’t want Doc, I feel like I feel normal. This feels great to me. And in the back of the study, they’re decreasing the dose of the pill that they were over time over time. And as soon as the pill got to a certain threshold, they all went back to drinking. Okay, so the moral of the story, you do not replace a drug with the same drug if you’re trying to get off of a drug. Okay, so what is the name of those medications? If you want the booze to last for five days, we call it Valium. If you want the librium excuse me, if you want the booze to last for three days, we call it value if you want the booze lasts for two days. We call it Klonopin. You want the booze to last for a day. We call it Xanax or Ativan. This is benzodiazepines Wow, that benzodiazepine class parks in the receptor. That is that alcohol Parkson except it does it for five days, or three days or two days or one day. Yeah. Wow. You want me to detox? Somebody? Just give me booze way easier to detox some of those. Yeah.

Dr. Mindy Pelz  29:50  

So okay, so number two, so sleeps number one. Number two is alcohol, alcohol,

Dr. Annette Bosworth

get off alcohol, the sleeping aids that people use. So what are they use those for? Now? They use them To sleep. So let’s say well, what else should I be doing to make my brain do better? Well, don’t sleep with benzos on board. So inside this in Salt Lake City, Utah, I would help with the sleep lab. And you would hook them up to these things. And we would, we did this, this was probably shameful. But we will make a bet, based on the people coming in, you would get one or two words out of them, you don’t get to look at their medication list. You just get to hook them up to this machine and say, Are they on a benzodiazepine? And because it’s a chronic use of alcohol, you could watch their gait, you can, you could sometimes get it in their speech, but a lot of things do that to your speech. So it was truly a game of Let’s make a bet who’s on a benzodiazepine and who’s not. Wow. And of course, you can have the ultimate tell was what happened in their sleep. Like, okay, you can say you’re taking a benzo, but when you’re asleep, never gets to that reparative zone where you make the BDNF I don’t care is that the correlation for dementia, announced in 1991 by the FDA was, the longer they’re on these benzodiazepines, the more dementia related behaviors and pathology we see. That’s crazy. So as you find a chronic alcoholic, destroying their brain through chronic alcoholism, the same chronic depletion happens when they would take these benzos long term. So you say Sleep Sounds like this little thing, like, Yeah, you should get sleep, but get an aura ring. But I’m like, save your money on the aura ring, get it, get a therapist, or something that helps you get off of these medications. Because falling asleep with booze or with your benzodiazepine prevents your brain, you cannot go into stage four sleep when benzodiazepines or alcohol were in your system. And so then if you’re doing that three nights a week, then you got to wait to the alcohol is metabolized if it’s alcohol. So now for about three in the morning until six in the morning is the only time you could possibly because the other times you remember metabolizing the drug, right?

Dr. Mindy Pelz  31:50  

So and then what I also heard was ketones. Ketones are what like so I mean, I’m not making a case for drinking alcohol. But if you want to speed up that process of repair, put yourself in a ketogenic state the next day. Yep. And that’s the one thing I think that is misunderstood about ketones. Everybody wants to make ketones right there, like it killed my hunger, and it gave me so much energy. But my brain is like, Yeah, but it’s going to go up, it’s going to start to repair neurons, it’s going to upregulate GABA, and what you just said is it’s going to help bring down that inflammation. Yes, that might have been happening from the poor lifestyle that you had before. So it is truly a biohack it’s a way to go in and speed up that healing process.

Dr. Annette Bosworth 

Right. The other part about it was when they put in those medium chain triglycerides, those strings of fat that do cross the blood brain barrier. Yeah, that’s really some people sometimes miss that si si 10 cross the blood brain barrier, they are metabolized in the brain as energy. And that process between ketones and those strings of fat, that that is a reduction in inflammation on the inside of that brain. That’s powerful. You want neurotransmitters to be make, get those things in circulation in the place where you’re making them, right. Add some estrogen. Sure, you could probably do a little better with those ketones plus estrogen, but start with it’s like the guy who comes in and says, Doc, I want a shot of testosterone. Yeah, but I’m a type two diabetic and I’m giving myself 100 units of insulin, right. I’m like, it just you should shoot the testosterone in the air. It will do you more good to smell it than it will

Dr. Mindy Pelz  33:18  

to put it into that. And that was my big complaint about this Oprah discussion. I mean, again, so happy she’s opening the conversation. But it was like, no, no, now everybody’s gonna go, Hey, Oprah said get on HRT, I’m gonna go get on HRT, but I’m still gonna find that I’m not feeling well, which we’ve seen happen over and over again. And you know,

Dr. Annette Bosworth  

the saddest part about that is they have so much hope at the beginning of those prescriptions they want.

Dr. Mindy Pelz  33:44  

It would be nice if it was that easy, right? But then you turn within and you go, Oh, I must be something that I’m doing. That’s wrong. So and so I actually would say in your in your brain protocol. I love that sleeps first. Another we got alcohol and MIT and medications. But I would say number three has to be dip in and out of the ketogenic

Dr. Annette Bosworth  

Oh, yeah, absolutely. Module Three talks about that.

Dr. Mindy Pelz  34:11  

But that’s what I see so much with with ketones is that, yes, it can became this hero for weight loss, but I think of it is the brain is

Dr. Annette Bosworth  

the brain thing. Absolutely. That’s I mean, that is how I got into it as the podcast that said, if you want the brain to heal fastest, I mean, that’s that brain trauma. It is about how inflamed is it on the inside? And then how slow are those repair repair teams working in your brain? Or how fast right and so how much goo is in the way that’s the inflammatory post inflammatory, tell pro all the stuff that is there for long term? And then how quickly can you like biohack your way around that and stay in the lane? Because it isn’t ketones for a day they have to stay in a state of ketosis long enough to repair that process. The younger they are the quicker they repair.

Dr. Mindy Pelz  34:56  

What do you think? I don’t know if we’ve ever talked about this, but this is something I use to recommend to my patients in my clinic when they had aging parents that had dementia or Alzheimer’s, I would always say, can you get them on a ketogenic diet? And then usually the response was like, No, they won’t go on, we would have we use exogenous ketones, right?

Dr. Annette Bosworth  

Plenty of evidence that shows clearly, when the brain had access to ketones much better response. The other part that I don’t skip over because it’s much less expensive is that medium chain triglycerides, those medium chain triglycerides, it takes a lot. And those, you know, again, if they’re not fat adapted, and you just give them my fistful of, you know, MCT capsules. It doesn’t work out. So well. I get diarrhea, you gotta right. Yeah, you got it. Yeah, up. Right. You have to, but that that’s a sustainable plant plan. I mean, the sad is this is to say, as the elders come to for help, if you tell them there’s a few pills to add to their pile,

Dr. Mindy Pelz  35:49  

like, Okay, well, right, like add a few more. So put some MCT pass. This is beyond just putting MCT oil in your coffee.

Dr. Annette Bosworth  

Right? Right, you got to have in when you look at an mm, mini mental status exam, 30 is perfect. 25 is cognitive impairment, and 20 was dementia. So to keep them at 25, or above, the studies that have looked at that have 3530 to 45 grams of medium chain triglycerides. Amazing. It’s a lot. I don’t even

Dr. Mindy Pelz  36:20  

I mean, you would be going to the bathroom all the time.

Dr. Annette Bosworth  

They had a lot of dropouts when they would

Dr. Mindy Pelz  36:26  

have to but you can work up to that. So so I’ve been saying MCT oil is this beautiful way to switch you into the ketogenic energy system in a quicker way. I also think when you use it, it can kill hunger. Yeah. And that’s really great. But now what I’m hearing you say is it also can go in there and bring down the inflammation? Absolutely.

Dr. Annette Bosworth  

And the fact that people I mean, I think people learn this, and then like me, you forget, oh, yeah, that will cross the blood brain barrier. It gets over that that’s not a very common trait for most fats. So the fact that these can cross the blood brain barrier, and we know that it’s not just CA, CA, it got really popular when the ketogenic diet for started a chain that really does spin on a lot of ketones. When you have a shorter chain, like a C six or a C for the GI, that’s in butter, it’s just small, little chains. So the amount of ketones that come out of that are very, they’re smaller, interesting. So as you get to see eight, there’s a bunch that come out. But C 10 is, again a nice production of ketones, and was left out somehow Ciate won the popularity contest, but I’m like, no, no, see, 10 still crosses the blood brain barrier is deep. And there is something about that. Like, in brain repair, you do the people on both did better. Ciate alone didn’t do as well as C eight plus C 10. Wow. And so don’t so both

Dr. Mindy Pelz  37:46  

of them together. Yeah, I don’t even know like, well, I just put MCT oil in my coffee in the morning. But now you got me thinking I know there’s a lot of C 10 products and CA products out there.

Dr. Annette Bosworth  

The part that I when I tell people is okay, the Latin word for goat is capric. So just look at the Caprylic and capric and Caprylic that ca and see 10 Goats are where the there’s a bunch of medium chain triglycerides in their milk. Now, I don’t know why we don’t get CH and Sequioa from there.

Dr. Mindy Pelz  38:18  

I used to drink goat milk all the time in my my my mom would buy goat milk out of dairy cows dairy and she always would say this is better. And then I didn’t really understand why we just grew up under you know on the taste of goat milk.

Dr. Annette Bosworth  

Oh, see your that’s way but my husband hates it. Yeah, very different. Tastes like feta cheese. Yes. From goat. Right. So that’s that. That is again, different tastes Yeah, non dairy. But when you look at the C 12 is lauric. And so that’s where you sit. That’s not a medium chain that that does not fit across the blood brain barrier. Okay, that

Dr. Mindy Pelz  38:50  

it has to be Ciate or Sita and and goat’s milk has that. So I’m always about how do we create more diversity in the foods that we eat. So what I’m now going to add to that is why do we if you’re going to do dairy Why do we always do cows dairy, right? Why aren’t we bringing in some goat? Oh, I love that. Yeah. Okay, so beyond goats. We got ketones, no alcohol, no drugs, and sleep. What else can we do? Farber.

Dr. Annette Bosworth    

The next one is the I touch on marijuana. The marijuana part where again, this neurotransmitter comes in and it’s got your nap. And ammonoid is the neurotransmitter that’s in our brain. THC is the lookalike that comes in through marijuana and when just like any of the other receptors for for acetylcholine or GABA or glutamate when when your body stimulates the production, anandamide is the is the neurotransmitter in your brain that really does help us with euphoria. It leads to dopamine, but it also does it in a way that has this calming, focused, dissociative effect. That is now Natural. And when you put THC in there, it will park in that same parking spot. And it will override, just like alcohol would that now we can stimulate this much heavier, much faster, much more often. And then you deplete what, first of all your anatomy, natural anatomy that you’re making becomes much less produced. And they all stimulate downstream for dopamine. And at first you have this this huge wave of an effect. But just like any drug, any alcohol, any nicotine, that when you do that, at first, you have a improvement in the amount of dopamine you make. And then the dopamine doesn’t get recycled. And without the recycling of dopamine, you’re you have a depletion of that eventually as well.

Dr. Mindy Pelz  40:47  

So I this, I think of this, like thyroid, how many people have you heard, like, go on thyroid medication, and they’re like, I don’t feel any better, or they felt great for like a month, and then they’re like, I don’t feel any better. And the theory that I had always heard was, that meant that you’re, you’re just your body’s not making the same amount of thyroid hormones because it has an exogenous source. So what I’m hearing you say is that when you’re doing marijuana, you’re also creating this system where all of a sudden dopamine is not going to be made and recycled as much. So it you may feel euphoria in the moment, but because it’s an outside exogenous source, over time, you’re going to be dopamine depleted.

Dr. Annette Bosworth  

Amen. That’s exactly right. And the hardest part about the folks that are struggling with coming off of marijuana is that first of all, is become this popular place to say it’s the you know, it’s the Zen moment. This is how you live life. You’re meant to have this I’ve got a receptor in my brain that looks just like it. I’m like, Yeah, we have that for every chemical people. I mean, there’s you’re right, it looks just like it. But that doesn’t mean that you are naturally makeup. mimicker.

Dr. Mindy Pelz  41:52  

Yeah, because your body should make I think this is really important. Your body should make CBD Yeah, like it’s in CBN and CBG. And all these like it’s inside of us, right? But what why we’ve been so attracted to these exogenous sources, is because we’re not making it on the inside as much. So then we now have to look at the exogenous. So yeah, that’s so brilliantly said.

Dr. Annette Bosworth  

So the other part that’s most dangerous about alcohol versus marijuana is the alcohol is a water soluble substance. So yep, it goes into those cells, it will swell the cell for that, you know, 48 hours, the damage from that cell is going to take time, but the alcohol is going to be gone at like 72 hours, right? Now, you got to have the consequences of what it does to the hippocampus for the next six months. But in a fat soluble one, it crosses that blood brain barrier and gets into the brain. And then if all the parking spots are filled by that, that THC, the every axon has a fatty coating, and the excess amount that doesn’t bind into the receptor. And in today’s amount of marijuana, it is so potent. So many molecules of THC in the substances. It’s

Dr. Mindy Pelz  43:03  

more Yeah, cuz we’ve done everything bigger and better. Right? But was

Dr. Annette Bosworth  

1% in 1971. Right? We are at like, Everclear is crazy.

Dr. Mindy Pelz  43:12  

Yeah, that’s fast. And you know, that’s fascinating. So but again, I go back to like the plight of the menopausal woman, which is okay, I’m still losing like progesterone and estrogen and GABA, and I can’t call myself I can’t sleep. So it’s become sort of socially accepted the glass of wine, a little gummy at night to be able to put yourself to sleep, right? What can we do to start to help women as they navigate this neurochemical loss? So they don’t dip in to those activities.

Dr. Annette Bosworth  

So yeah, if they’re already doing that, and they’re coming off, I think letting them have the appropriate expectations, first of all, that when you take away those stimulants that you’ve been, you know, sort of planting onto your brain as a substitute for what your brain was supposed to make. Yeah, well, your brain hasn’t had the signal to make those for as long as you’ve been doing that. So now or it’s better, you know, fenestrated, it will have it for a while, then you’ll have a glass of wine then. So that on off stimulus, instead of that constant saying, Okay, we need to be making these neurotransmitters, we need to be doing this on our body. When when they come off of those substances. They do not feel good. Marijuana has a pretty deep dip for three to four weeks. I was gonna say how long? Yeah. And that’s the time when it’s coming out of that fat. It’s stored in the fat. So you have you have that molecule in the brain, and it’s sitting right there. It’s not going to come out and park into the other receptor. It has to disintegrate. Yeah, and so it disintegrates right there in that axon. And what’s left is a little hole where the insulation was supposed to be. So now the axon doesn’t work, right. And you need that removal of inflammation, that high fatty state to repair the brain the fastest.

Dr. Mindy Pelz  44:49  

So would it go dipping into a ketogenic state heal that a little quicker? Yeah,

Dr. Annette Bosworth    

that’s exactly right. Yeah.

Dr. Mindy Pelz  44:55  

So so, you know, again, putting this in sort of a big picture vision is like okay, So let’s get off the alcohol. Let’s get off the drugs. Let’s get off the marijuana and while you’re having to go through that process so that you can get to a good night’s sleep, let’s dip into ketone yeah and MCT oil

Dr. Annette Bosworth  

absolutely the fastest thing that you can be doing is saying okay, what can I do to make this the shortest and littlest as possible? Well prick your finger make sure you actually have a piano ketone stick, make sure you actually have ketones in circulation. And people go out and eat keto bars or they do something that is the you know, they think is keto Am I don’t play that game I

Dr. Mindy Pelz  45:29  

that I’m anti keto like prepackaged food. In fact, I’m laughing because we’re here at the Keto con. Right. And I’m about to speak in a couple of hours on one of my big premises is that I feel like we’ve overcomplicated health. And it started by overcomplicating it in the medical world. And now it’s moved into the biohacking world. Like there’s simple is better, right? There’s so many like keto, like bars and tricks in this and I’m like just fast, more MCT oil and let’s just eat lower glycemic fruits, let’s get the vegetables and meat and like keep it simple.

Dr. Annette Bosworth  

And the key thing is, people will instantly ask me, Well, how much of that can I have? I’m like, I don’t know, check your chemistry. Because if somebody has been a high insulin state, or they’re the, they’ve just come off of injecting their insulin like they have more their insulin doesn’t work like yours. And mine works. Yeah, it is insulin resistant. So now the slightest amount of production of insulin from their pancreas will take them out of a ketogenic state. So you should measure that it’s a very easy thing for you to measure don’t make me measure it is I’m going to measure it one day out of the month. And that doesn’t tell you what’s going on. You need to be looking at this as you journey. Yeah. And that’s that responsibility giving back to the patient to say, look, it’s a it’s a crappy way out of those drugs and poor sleep. Yeah, but the way in is to heal the brain as fast as possible. And in my brain injury patients in my post radiation, chemo patients, you know, those they want out of that nightmare as fast as possible. And that is you have got to stay in a ketogenic state. And they can’t like wake up one day on a sent standard American diet and the next day go into a persistent state of ketosis. Yeah, your insulin isn’t going to let you do that. You’ve you’ve wound yourself into this, we got to wind yourself out. And then you got to stay out of it while you repair that body.

Dr. Mindy Pelz  47:18  

Do you? Do you think that there’s a Keto dose? That’s the best because I’m this is the other thing I’ve been really thinking about lately is that I think dose matters in so many conversations. Oh, yeah. And when you look at like, just ketones, we’ve got the ketoacidosis where you’re like weigh in like a you know, I think it’s like 12.0. Higher 20. Yeah, right. Yeah.

Dr. Annette Bosworth  

So 15 and above is considered that but you have to have a high blood sugar to have that. So the two things that are to be matched. Yeah, high blood sugar, and high ketones. That’s ketoacidosis.

Dr. Mindy Pelz  47:50  

So but then we know nutritional ketosis is point five is the door in is there like a state we will amount of ketones that will heal the brain better? Okay. So

Dr. Annette Bosworth  

the best way to answer that is what’s happening to the ketone? Is the ketone being used by the cell? Okay, so All right, let’s figure that out. So the, the dictator for whether or not you can make a ketone is insulin. So if I had the perfect way, you know, I hook you up into my science fiction lab here, we would have you checking your insulin every, I mean, every few minutes, just to see how’s it doing? And then you would learn, okay, here’s what my insulin is doing. But you actually couldn’t stop there. You would, you would then need to know, well, how well is my body listening to insulin now? Because that’s what insulin resistant is, the insulin can be 20, or, you know, 30. But if it’s 20, or 30, in an insulin resistant patient, it works like a like a 40 would in the insulin resistant patient. It works like a a six would insulin sensitive patient. So as you look at, well, how do I know which one I am? Like, that’s very confusing. Is my insulin talking to the cells the way it’s supposed to? Like, alright, let’s move away from insulin. That’s too confusing, because it changes over time, right? So the two chemicals that insulin will dictate is glucose and ketones, right? So as you are progressing through that metabolic change, we want to know what is your blood glucose and what is your blood ketones at the same time, and that tells us what insulin is doing. This is where the

Dr. Mindy Pelz  49:26  

like I know a woman who came up with a really smart ratio. I think it was began with the bee.

Dr. Annette Bosworth

And truly, it wasn’t a bee.

Dr. Mindy Pelz  49:38  

We use it all the time in my community. I’m always like the Dr. bras to talk tell us with Dr. Baz ratio is

Dr. Annette Bosworth  

well it came from the research papers of glucose ketone index, okay, and that’s what they have studied for years for on seizures on medications, but they use different metrics and that requires math and you got to take the ketones down to a one to get it to a ratio. Okay, wait.

Dr. Mindy Pelz  49:58  

It was really complicated. Yeah. Oh, you can realize it is through this

Dr. Annette Bosworth

just take the big number divided by the little number. So the glucose divided by the ketones. And when you have those two in, in, in together, as somebody who’s insulin resistant starts out, their glucose is really high, right? But they go into a ketogenic state, I think it’s shoot their ketones up to three and a half or four. I’ve seen that happen all the time. Yes. And it’s because Oh, yeah, they’ve lowered their insulin, they’ve lowered the insulin by a significant amount with that first behavior change of decreasing that carbs. And that let the glucose out. I mean, the glucose can now circulate out of your, your liver. So you’re like, Well, my glucose went up a little bit, but your ketone went way up, yeah. And then their body gets healthier. So the ketones come down and the glucose, well, it kind of just hovers over, it doesn’t do much. And so then you get to the next place in your body. Well, what happened there is you’re less insulin resistance, that’s a good thing, right, but you can’t stay there, right, you have to stimulate your metabolism again, which is where the ketones will burst up. And now like glucose is gonna go down a little bit further, and over time that ketones will slowly return back down to one or point five or whatever, that’s gonna take another two months. If you stay in that lane, you stay in that metabolically stressed zone. And then it becomes easier. You’re like, yeah, I have two meals a day. Yeah, I kind of pick out the first one not so much the second one, and then they stabilize Doc, I leveled out, Doc, I leveled out and like, Yeah, guess what your doctor baz ratio has got a glucose of No, let’s say 100. And ketones down in that point five, so it’s not doing much right. Not gonna empty, right brain cells, you’re not going to be repairing the brain, because the ketones are too low. To get them to go higher, you have to metabolically stimulate again. Well, there’s other ways to do it at Asana, do some workouts, or tighten up that eating window, move it closer to sunrise, make sure you’re not picking out so much meaning that stage of keto is fun. And yes, it’s very lovely and easy. But now you got to tighten it up. Now you got to take it to the next metabolic level. And it’s through this process where that ketone level you can keep you have to keep stimulating, just like the bodybuilder needs to keep working out. Yeah, I’m the person in repair of their brain needs to keep stimulating the mitochondria to say, Hey, make me some ketones get going. We gotta fix we got a problem too.

Dr. Mindy Pelz  52:09  

So so the ratio needs to what would you had like three levels? And I remember the third level was, yeah, what’s the ratio?

Dr. Annette Bosworth

So the it getting it under 100? Okay, is like beginning that’s where you’re not

Dr. Mindy Pelz  52:21  

going to silver ketones, and then why that should be under 100. Gov. Now you’re in the beginning,

Dr. Annette Bosworth

that’s in the beginning. So you’ll you’ll lose weight, especially if you get under 80. Yeah, good weight loss under 80. When I get them down to 40, then I can be pretty confident that they’re reversing an immune problem. Amazing. And they have to really stay there though. That’s the key. And like, for how long? Yeah, immune problems, it’s a good four to five months.

Dr. Mindy Pelz  52:43  

Oh, wow. Yeah. And what about for brain for just like a disorder?

Dr. Annette Bosworth

Well, even any of the brain stuff to in that 40 to 60, you can see are really good improvement when I have a cancer patient or a seizure patient. So again, a brain that’s very dangerous, that’s I get their Dr. Baz ratio down to 20, or less amazing, that’s hard. The volume of food has to be smaller. It’s got to be very ketogenic, very high fat. And they can’t be eating four times a day, right? The you know, when you talked earlier about the particle sized food, or the processed food, what I tell them is look at your food, what’s the size of the particles that you have swirled around and whatever it is you’re eating, and if it’s overly processed, well, you probably can’t see the particles are so fine, right? And that particle size really does predict. So when I get people trying to get to a doctor baz ratio of 20 They’re having no particle iced food. They don’t have anything processed. They have a can of sardines in the morning and a canister already. Yeah.

Dr. Mindy Pelz  53:39  

And that’s where you fasting comes in. That’s I mean, I always say there’s two doors into those that ketogenic state and fasting is probably the fastest one.

Dr. Annette Bosworth  

Yeah. No, it’s real. Yeah. And it’s a lot easier. Like, yeah, this doesn’t need to be complicated. rice, salt and water. Black coffee. That’s

Dr. Mindy Pelz  53:55  

right. There you go. Exactly. Back to the simplicity, the idea. So okay, this was totally fascinating. What I’m really starting to see is this conversation, mental health is just coming to the surface. Yes. And then menopausal women are like, Hey, we’re over here suffering. But what I think is not being discussed is that there’s a lifestyle that goes with healing the brain as you move through these years. And if you can do that, then maybe you add an HRT, maybe you do a BHRT. Fine. But you can’t leave this lifestyle out. It’s really important

Dr. Annette Bosworth  

because what what I see on my end is they’ve gone to doctor after doctor and they’ve got I’ve been on bioidentical, I’ve done this. I’ve done this last traded. Yeah, well, when you when you put that wonderful tool on top of garbage, it was never going to work. And that that’s where they lose hope they lose hope that anybody is going to help them. And so now I say, yeah, it’s a long game. And we might do that at the end, or we might do that, but it’s not going to work until until we get that insulin doing its job till we get that this is a fatty molecule we’re trying to move around. It’s going to be under the dictatorship of insulin. So if we don’t fix that at the beginning, or at least you see, it’s very connected to how you sleep. It’s very connected to what you’re drinking and drugging on, it’s very connected to the number of times you eat, the timing that you eat, and your overall health will be improving. When your estrogen you becomes more effective or able to write whether I give it to you whether you put it under your tongue, you get an insertion in your butt. Yes. I don’t care how you get the get it in there. In the end, the first biggest step is do you have the chemistry in your body where you can use that hormone correctly? Amazing.

Dr. Mindy Pelz  55:31  

Amen. Sister. This is why I like to have this conversation with you. Okay, last thing I have to ask you, this has nothing to do with ketones has nothing to do with estrogen. This is my this year on the receptor podcast, I decided that I was going to pick the theme of self love. And in self love to me, it means there’s a practice that you do every day where you’re giving back to yourself. And there’s an acknowledgement that you’re a badass at some some aspect of life and owning that. So do you have a self love practice? And what do you think your superpower is?

Dr. Annette Bozworth  

Oh, wow. So when I think of the self love there is, you know, 51 it’s changed over the years. Right, right. Yeah. And well, I think I mentioned earlier, one of my favorite parts of my resume is that, yeah, I’m a really, I’m a, I’m a bulldozer kind of a woman. Very, really,

Dr. Mindy Pelz  56:21  

I didn’t notice that about you.

Dr. Annette Bozworth  

It would really be easy. Relationships left, I could build over all of them.

Dr. Mindy Pelz  56:28  

I think. I think that’s why I love you. I love bulldozer women, these are my favorites.

Dr. Annette Bozworth  

But I think at that moment where I I get nourished, or I get to be the one taken care of is because of what happens in my marriage. That the the role that I have as a wife is not the same role I have as a boss. And I have learned to surrender, that this isn’t the place for me to have to use my superpower, which is I can see a puzzle and see how to fix it. And this is what I like to do that create the idea of here’s a great way to solve the problem in front of me. But I have to take that hat off and be and receive give in my marriage. Oh my gosh. And so well said and it makes for makes for much happier marriage. Probably 20 years into choosing that path instead of and in the world of medicine. It’s really easy to be the boss woman right? Authoritative, very strong. You’re

Dr. Mindy Pelz  57:24  

trained to write your you know best, and you tell everybody what to do. Oh, I love that. What I what I love about what you just said is that nobody I’ve asked so what we’re like four months into this year. Nobody has said that there is a way that they show up in a relationship that is self love to them. Yes, that is what I just heard what you said. And it was beautiful. And so I swear I could chat with you forever. So say thank you for letting me

Dr. Annette Bozworth  

be part of your especially the beginning and I wish you all the luck. Anything I can do to make it better or to come again, I would be happy to

Dr. Mindy Pelz  58:01  

I just I just love chatting with you. So we’ll keep bringing you back. Any opportunity I get is amazing. Perfect.

Dr. Annette Bozworth  

Well, let’s hope you have some good questions or good conversation from this on your podcast and they get a

Dr. Mindy Pelz  58:12  

little healthier. And people find you by the way because you have so many interesting things.

Dr. Annette Bozworth  

Well, the best place is the website, boss md.com and the YouTube channel you type in Dr. Baz you can find me YouTube is the number one place where I put my energy. That’s what I do. It’s easy to splinter and doing a lot of places but I kind of focus on YouTube so smart. Yeah, awesome.

Dr. Mindy Pelz  58:29  

Thanks, Jake. You bet. Oh my god, I love talking to you.