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Dr. Stephanie Estima Unpacks Keto, Fasting, And Stress On Women’s Health 


Dr. Stephanie Estima is a doctor of chiropractic with a special interest in metabolism, body composition, functional neurology, and female physiology. In this episode, she shares how varying mechanisms of stress, including diets, impact female health and vitality. Listen in as she shares her expertise on keto, movement, skeletal alignment, and maneuvering our way in today’s high stress climate.

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Dr. Stephanie Estima Unpacks Keto, Fasting, And Stress On Women’s Health

Don’t forget that what we do is that as we talk about a whole variety of topics, it always comes back to heart health and wellness. Whatever it may be, if we are talking about environmental toxins, pollutants, supplements, mind, body or spirituality, it always goes back to heart health. I’m proud to introduce Dr. Stephanie Estima. How are you?

I am thrilled to be here. Thank you for having me.

If you don’t know Dr. Stephanie, you need to. She is changing so many lives and helping many people with her book, The Betty Body. It’s doing so well on Amazon, with hundreds of reviews, people are loving it and the accolades. A lot of the doctors in the community as well are backing up Dr. Stephanie’s books, so we will dive into that. She is a Doctor of Chiropractic with a special interest in metabolism, body composition, functional neurology and female physiology.

For the people reading that are young women, they are going to get a lot of great information but even the older women and men who are reading as well who live with these women, they are going to learn some fantastic information. She has been all over the mainstream media. Millions of reads on Medium.com, Thrive Global and Huffington Post. She is the Creator of The Estima Diet. She will tell us about that as well.

She’s got some fantastic opinions as it comes towards raising children, which she has two living up in Canada, and maybe some of these issues about sex, intimacy, longevity but also being a mom. She is totally backed up by science, and if you know me, I love quoting science and showing information right out of the medical literature. Again, Dr. Stephanie, thank you for being here. Let me dive into this. Let’s talk about women, stress, and what’s happening now during this pandemic. What’s your pulse on what’s happening with women and their stress load? What are the problems with it?

This has been such a poignant time in human history but in particular, because I tend to see a lot of females both in my communities and in my private clients that I coach, seeing a lot of stress. There has been the stress of uncertainty, which is not just a female problem. It’s a male and female problem where we have been locked down, then we have been opened again, locked down, then opened again, and what’s considered essential and non-essential. There has been a lot of destruction of financial wealth for many people.

For women in particular, what I have noticed is a lot of change in menstrual cycle patterns. Women will be reporting that their menstrual cycle length and quality of their bleed are changing, and it’s less predictable. If they were a 29-day girl where they would get their cycle every 29 days and knew what to expect, we are seeing some variances of what they can expect in terms of the length and the quality of their bleed, and that’s to be expected.

One of the things that I talk about in The Betty Body is that your menstrual cycle is your hormonal report card. It is telling you how well you are doing with dealing with the internal and external demands or stressors in your life. I’m happy to talk about my own experience. My children were in school and they were mandated that they had to wear masks. This is not a comment on your beliefs but mine, I felt it was important for my children to be able to see faces in terms of their language acquisition. I didn’t want them to learn that people are dirty and not to be shared.

They can’t share pencils, swap lunches or whatever the things that kids do, so I pulled them out of the school system and I have been homeschooling them myself. They were in the private school when the first lockdowns happened, and then after that, we pulled them. This is their second year where their mama is their teacher. It has been extra stressful because at the beginning, and I would say still, I’m a totally unqualified teacher but I know my children very well and I was able to quickly adapt to their needs.

Everything exists on a continuum.You don’t just wake up one day with dysfunction or hormonal derangement.

There’s a lot of stress for women in particular because we have this very delicate cadence and rhythm that is exquisitely sensitive to changes in our environment, whether that’s food changes, stress changes, seeing changes in the menstrual cycle, seeing a lot of sleep disturbances. When you add it on if you are a mother worrying about your child, whether they are falling behind in school and what you are going to do with them, you are going to pull them out, homeschool them, change schools or whatever you are going to do. It has been stressful for everyone.

I will take issue with what you said as far as you being not qualified. You are 1,000% qualified. You are more qualified than anybody to raise your children because you are their mother but also because of your knowledge and beliefs about what is important. We have done the same thing as well. We have pulled our two oldest ones out of school. My wife never wanted to send them to school in the first place. Our younger two were never going to go to school. This worked out perfectly for us. It’s a great excuse to keep them at home. It’s about having fun and letting kids be kids being part of this tribal society trying to find other kids that are of the same background.

Maybe you can touch into that as to how you have found others in your area to commiserate and hang out with. At this point, I could care less if my children learn about Algebra, Trigonometry, Greek Mythology or about the Civil War. I don’t care about that, especially that that is somebody else’s version of history anyways. Who knows what the reality is? Especially seeing what the government can do to reframe the rhetoric in the 21st century and manage what can be done historically.

Again, it’s all about finding your tribe. I know you have created a fantastic tribe in your business profession with women that are embracing a lot of your philosophies and seeing you as that guide to help them along because it’s a pretty crazy world. How are you finding it as far as the kids in the area and dealing with the homeschool unschool?

That’s me being very hard on myself because my most important role is being a mother to my sons. We have done a lot of things. We have prioritized play dates. We have a lot of time in nature, so we will often go for walks. They will pick up things and are like, “What’s this pine cone?” We take the pine cone home and we do a little study project on it.

I have a network of other mothers who may not necessarily have pulled their children out of school but are concerned about what we will call the mandatory coercion that may be happening to our children. We have prioritized play dates with family members and friends who have similar philosophical premises that we do. They are also enrolled in group activities. Both of my children love soccer. They are both in Rep Soccer so they have four times a week that they are going to play. A lot of times, the big argument around homeschooling is that they are going to be awkward and not going to be socialized.

I would argue potentially and with love that it’s more awkward for a child to be taught that collaboration is dirty and that you can’t share things during the day. Sitting behind a mask and not being able to see your teacher’s face, his or her facial expressions, is one way to guarantee awkwardness. We prioritize extracurricular activities like soccer. There are a lot of playdates in the family. The family all knows our views on masking. I have a network of women. A lot of them are chiropractors who also have a very similar premise to me in terms of natural immunity, and health and healing.

To me, children wearing masks is nothing short of child abuse. That’s all there is to it. It makes me sick to even think about it. Our children have never worn masks and they are never going to. Let me help out the women who tune in to this show that are post-menopausal. Let me focus on them because in my mind of this human utopia that existed before the Agricultural Revolution, let’s say it’s 15,000 years ago, I’m a 50-year-old woman and I no longer menstruate.

I no longer have my monthly menses. I go through this menopausal change without symptoms. I feel fine and fantastic. I don’t need female hormones, I don’t need to go to the doctor, and I don’t suffer from all of these hot flashes. That’s my view of how things were, historically. Maybe you can tell us how things are now, and then we can dive into some strategies that you use successfully to help women deal with these perimenopausal symptoms.

HHS 15 | Women’s Health
Women’s Health: Mothers have to think for themselves and think more for their children.

First, everything exists on a continuum. Often, I will have women who will come in and say, “All of a sudden, I can’t sleep, I have hot flashes, and I can’t lose weight no matter what I do.” That’s physiologically impossible. You don’t just wake up one day with dysfunction or hormonal derangement.

This is something that happens throughout a long time where it snowballs to the point where your sleep is disturbed enough that you can no longer sleep for the required 8 or 9 hours, that you are now having such a sluggish liver that now you are experiencing some of these hot flashes and whatnot. One of the problems that we see in modern-day life, and contrasting that to women even a few years ago, we don’t have to go back to our Paleolithic mothers and foremothers. We can talk about this in terms of the 1960s and the 1970s. There were a lot more general movement and exposure to sunlight.

We didn’t have our heads buried in our phones and computers all day long. I like to lovingly call it, “I sit and I talk to my computer all day long.” I’m in meetings, I’m on Zoom and I’m just talking to my computer. I’m a baby of the ‘70s. My mother would say to me, “You go and bike. Go and play with your friends and don’t come back in until the lights come on.” That was the streetlights. When the streetlights came on, that was when I was allowed to come back home. You usually had dinner with the family. Things have changed.

Even in the past many years where we spend most of our time under artificial light, we are not getting natural sunlight. We could go on a whole geeky magic carpet ride in terms of what natural sunlight does to your ability to metabolize fat, your circadian rhythm and your stress levels. This is such an important often overlooked piece to regular cadence. When we think about some of the neuromusculoskeletal derangement that can happen, I was in physical practice for many years before I went completely online. I was seeing seven-year-olds with issues in their neck because they were on their little Nintendo Switches and all their little things.

We were already seeing structural changes in the neck. We can get into how that might put some tension on the sheath that surrounds the central nervous system that is protected by the spine and some of the other derangements that can happen in terms of activation of the brain. These things are all happening to our children and us. The other thing as well is we had a lot more general movement.

We were much more, what I would call, movement generalists. Whereas now, I feel like we have moved into this movement specialty. You will see this much in CrossFit gyms. You will see, where a woman might get up and she will do her Peloton workout for an hour or her online class, and then she sits for the rest of the day. She has this hour or so where there’s a specialized movement where she’s moving, which is great. That’s amazing but then there is no other activity during the day. She sits and talks to her computer for the rest of the day or she’s working on her computer.

These are some of the big changes that can lead to this amplification of the stress response. One of the things that I often see, particularly with women because we have been told that we need to be skinny and that we need to look a certain way for our entire lives, is that they do way too much cardio. You always have this stress response that’s happening. They are not lifting enough weights and they don’t have enough generalized movement throughout the day.

Our foremothers and forefathers used to get somewhere between 20,000 to 25,000 steps naturally in a day because they were just tending to the children, going to hunt and gather food, and preparing the food. If you are someone who has access to a wearable like an Oura Ring, a Fitbit or a WHOOP, you will probably notice that there’s no way that you get to 25,000 steps consistently. Our brains and our hormones require that. This is why we have different muscle fiber types so that we can have this low-level oxidative type of movement throughout the day without becoming tired.

Those are some of the things that I see that affect men and women but again, women are exquisitely sensitive. There’s a meme that I thought was quite clever. It was something like, “We sit in under artificial lights. We put our sunglasses on when we go outside to protect ourselves from the sunlight but then we get back on our devices at night.” You have completely switched the input to the brain where you are protecting yourself from the bad sun.

I don’t think women were designed to be in ketosis forever.

When you go outside, you are slathering yourself with sunscreen. We can talk about the endocrine-disrupting cascade that that might induce. You are also not doing the things that you are innately designed to do, which are move, rest, get natural sunlight and move your head back. You are not in this sagittal plane all the time that you are looking to the left and the right, and you are looking up. That’s my long spiel to answer your question. I don’t know if I answered it in the way that you wanted me to but that’s what I see.

Pretty much everybody is living on their computers these days. I will speak for myself. I’m not much different in the sense that so much of my existence is done virtually. I love seeing people in person and doing in-person consultations in my office in Arizona but the way the world is moving, unfortunately, it’s moving in this direction. That’s why we see so many health issues. You paint the picture very clearly that these menopausal symptoms that women are suffering from are human-made, it’s not supposed to be that way.

It has to do with the input from nutrition, sleep, sun exposure, physical activity, and all of these environmental toxins or stressors that play a role. Let’s dive into this. Tell me and the audience more about The Estima Diet. How we can use that to live our optimal life? How can we use your nutrition plan?

One of the things I didn’t mention before is nutrition. When we look in our modern-day world, nutrition is just a little Uber Eats order away. We can Uber Eats something and we have some type of food that’s delivered to our house in 30 minutes or so, or you have these processed foods that you can find in the freezer section of your grocer. You nuke it in the microwave for however many minutes and you have a “meal.” The Estima Diet was born out of my own experiences.

As you mentioned, I am a chiropractor, so seeing a lot of men and women in practice and do a lot of bodywork. My own personal struggles with my own menstrual cycle, I spent years unbeknownst to me but I was estrogen dominant, so I had a difficult time, especially around the onset of my bleed week. A lot of heavy bleeding, cramping and pain. Even the week leading up to my period, there were lots of emotional distress.

I was having to medicate in order to deal with the symptoms not realizing that my symptoms were my body’s way of talking to me to say, “You are pushing yourself too hard. Let’s put the brakes on a little bit.” It was born out of my own story. I was running a nutrition program in the clinic at the time. It was a ketogenic diet. I was already seeing a difference in outcome between my male and my female patients, especially when they were married and they signed up for it.

The guy would walk in a week or two later and he would be like, “I’m down 16 pounds. I feel great. I’m sleeping through the night and my energy is through the roof.” The woman would be dragging her feet behind him and be like, “I hate this. We are eating the same stuff and I have dropped 1 pound, maybe 2 pounds. What’s the deal?” I became interested in what were some of the differences between men and women when we look at outcomes in the diet. As I have said a couple of times, women are exquisitely sensitive to changes in their environment.

If we zoom in on the ovaries for a moment, the density of mitochondria in the ovaries far surpasses the mitochondria in any other major organ. In the oocyte in the ovary, there are about 100,000 mitochondria per cell. When you look at the heart, for example, it’s around 5,000 mitochondria per myocyte. You look at the liver, there are about 2,000 mitochondria per hepatocytes. Those are extraordinary orders of magnitude.

It’s like women have these little eyes. They are always sensing what’s going on. When you aggressively restrict carbohydrates for too long, which is what a classic ketogenic diet will do, we will start to see changes often in her thyroid function, which is important in terms of metabolism. Her inactive T4 requires insulin to convert that to T3, so we will start to see changes in her thyroid function, which will preclude her from losing weight because one of the major functions of the thyroid is to help the substrate get into the cell much like insulin to help the cell do its thing.

HHS 15 | Women’s Health
Women’s Health: The nutritional plan is important, especially for women, as it might affect their fertility, overall mood, and positive perspective in life.

In the spirit of transparency and honesty, I was running the ketogenic diet like it was just all the men that I was looking up to at the time. It was like, “You can have as much bacon as you want. It’s bacon, butter burgers and repeats.” We started changing the way that the diet was constructed. Instead of it being some of these what I would call more dirty foods that have a lot of processing or the chemicals to them, we started looking at if you were to look at your plate from a bird’s eye view.

If we could fill the base of the plate with green leafy vegetables or if you couldn’t measure it, let’s say you didn’t have a weight, and if you were to look at your hand, that’s about a cup of vegetables. Could you put two of those cups on your plate? Your protein, can your protein be about the size of your palm? The fat may be about the equivalent of your thumb, that’s the fill that you fill-up. Once we started switching over to more of a green leafy vegetable base and adding in something called resistance starches, which we may get to or not, I started noticing huge changes in outcome.

Green leafy vegetables are dense in fiber, which is important for your bowels. The roughage cleans out a lot of the debris in the intestinal lumen as well as bulking up the stool. As it’s going through the intestinal lumen and you have fiber, you are attracting more water to the developing bowel movement. It makes it easier to pass. There are compounds in it like sulforaphane, which are healthy for estrogen metabolism. They are healthy for the estrobolome, and then we added in resistance starches, which are also important for cravings.

This was the thing with my ladies. My ladies could do any type of keto for about 2 or 3 weeks, and then they are like, “I don’t care how much fat you give me. I want carbs. I want pizza, a bagel and I’m going to have it now.” I will give you a little quick and dirty in terms of what they are. They are not broken down in your small intestine. They are food for the large intestine or the colonocytes. For your audience, these colonocytes now will produce a short-chain fatty acid called butyrate. Butyrate is going to help quell your cravings. It’s going to help with any hyperpermeability.

If you are someone who has a lot of distension or leaky gut, it helps to heal that. It deepens your state of ketosis. Once we started adding those two pieces in for my ladies, this is like the magic bullet. Instead of them feeling like they were constantly hungry and craving, this was the thing that allowed them to adhere to the first phase of that program.

With time, we started developing a cyclical keto approach for women as well because contrary to what many people think in the keto world, I don’t think women should be in ketosis forever. I don’t think we were designed that way. It affects our fertility, which is again, whether or not we want to be pregnant. Your mitochondria and your ovaries are looking to optimize your fertility. Especially for women in their reproductive years, we want to be thinking about how can we optimize for your fertility because that is a measure of your vitality.

What’s great about you is that you’ve got so much real-world experience with people. Understanding is not one size fits all. I have seen so many times where the men, whatever diet they are on, seem to lose weight tremendously fast. To the women, it is that struggle. Your book highlights so many of those different things.

We can argue about the best diets and stuff like that. I am a Paleo Cardiologist. Ultimately, I believe in the hunter-gatherer diet and nutritional lifestyle but tell me how important it is to eat clean food and all of these chemical additives that are in the vast majority of people’s diets. What does that do to their hormones? What signal does that send to the ovaries? What does it do for these menopausal symptoms that women all struggle with?

There are a lot to be said around when we can prioritize, I wouldn’t say eating whole foods as much as you can shop the perimeter of your grocery store. This is where you will find the meats and the vegetables. These are some of the places that you should be shopping. It’s in the aisles of the grocery store that you will typically find more of these processed foods that you are referring to.

Changes in women’s menstrual cycles show how their bodies cope and adjust to the internal and external demands or stressors in their lives.

There are a lot of discussion around the long-term effects of some of these processed foods. The answer is that a lot of it will destroy the gut microbiome, particularly when you are eating foods that have emulsifiers. You have probably already used one. The shampoo is an emulsifier. When you shampoo your hair, you are using the emulsifier to take the grease out of your hair. The same is true for things like protein bars, cookies, chips and crackers. They use a lot of emulsifiers to mix the fat and the carbohydrates.

If you were to put oil in water, this is like a high school test, we know that oil and water don’t mix, but when you add an emulsification agent to it like soy lecithin, for example, this is going to allow those two things to mix. What we know specifically about processed foods and the use of emulsification or emulsifying agents is that it destroys a lot of the microbiome. A lot of the sensors in the microbiome that will speak to the brain will tell you that you are full, a lot of these receptors when you are consuming some of these emulsifying agents will retreat further into the gut mucosa so that it takes more calories for those receptors to be activated.

What ends up happening is we feel hungrier, we don’t feel full, and then it’s messing up that gut-brain access, which is important for satiety and your microbiome. As much as we like to think that we are human, we are just a collection of human cells that are carrying around these bacteria because there is much more bacterial DNA that we carry than human DNA. We want to be conscious of optimizing our microbiome. I have a protein bar here and there as well but it doesn’t make you feel full.

If you had the equivalent amount of calories in a salad or steak and vegetables, you feel the satiety signals that you get from eating whole foods is always going to be higher than if you have a protein bar that has 20 or 30 grams of protein in such and such amount of carbohydrates. You don’t feel as full because the nutrient density is so dense and it’s such a small volume of food. We often go back for more. There’s something to be said about consuming whole foods.

You will usually get a larger volume of food. You will have a nutrient density in terms of the micromineral and the phytonutrient content in there but the volume is also important. As your stomach slightly stretches because you have had that bigger volume of food, that’s also a signal to the brain to say, “I have had a lot of food here. Let’s start releasing a hormone called leptin,” which tells us, “Put the fork down. We have had enough food here.”

You are highlighting your level of understanding, reading and education on these topics. You are a fantastic teacher to your two boys. They’ve just got to listen to you go on a rant. I’m sure that they hear it 24/7. I’m sure you have had so many moms ask you, “How do we get our kids to eat this way and live this way? They are glued to technology. They don’t want to go outside. They don’t want to go to sleep, and they don’t want to eat these foods.” First of all, we have to lead by example. That’s always the first and most important thing.

Number two, to be able to educate our children, this is why we do this. This is why we live this way. That’s what parents need to do. They would be much better served if they were learning these principles about health and wellness than about Greek Mythology and the Roman Empire. I appreciate all that. You talk about resistant starch. I love potatoes. I throw that into the hunter-gatherer category because I know that those potatoes would be out in the world. I know we would come across them. I know they would enter the fire that we have been cooking with for hundreds of thousands of years.

They are hearty, they are easy to grow in a variety of different environments, and they are cheap. If you are looking at it from a paleolithic diet view or whether it’s something that would fit the bill, it’s like, “Can this grow anywhere?” Yes. When you have cooled potatoes, for example, or even if you were to just look at a raw potato, that’s high resistant starch content. Most people are going to say, “I don’t want to eat a raw potato,” so you might cook it, and then you would cool it. You might put it in the fridge overnight. I do this with rice.

Rice is another example of resistant starch. When you heat it, you start to cleave and not make it resistant to starch. You make it as digestible starch. When you put it back in the fridge, some of those bonds begin to crystallize again and you get some of that resistant starch content back. I like to do this with cold potatoes and cold rice, so you can take some cold rice out of the fridge, a little bit of MCT or olive oil, some salt, and it’s a beautiful snack. Another nice source of resistant starches that I often will recommend for women to start with is green banana flour.

HHS 15 | Women’s Health
Women’s Health: You want to understand the ebbs and flows of your hormonal milieu as you’re moving through your cycle, which will help you dictate how long the fast is, what fast you’re doing, and how frequently you’re doing that fast.

You can have a green banana as well. Typically, if you buy a banana from the store, it’s often green. That’s high resistance starch content. As it sits on the counter for a couple of days, you will notice that the green turns to yellow or you might get a few brown spots, that is the resistant starches being destroyed. This is why bananas have very high sugar content. You can have the green banana itself or green banana flour. This is something that you can find pretty much in any grocer. I have had some people who are like, “I don’t have this in my local grocer.” You can find it at online retailers.

Green banana and green plantain flour are very good. To your point around potatoes, you can also use raw potato starch as well, which you will find in any baking section in any grocer. You usually use raw potato starch as a thickener. If you want an alternative to corn starch, raw potato starch is a nice thickener for sauces. I usually will incorporate those into a smoothie or a shake. If I’m having a protein shake, a little dollop of green banana flour gives it a bit of a banana taste and it’s all good.

There is this online retailer that maybe our audience and you have heard of. It’s named after this river in South America. It’s called Amazon. It delivers everything to your doorstep including organic green banana flour. We love to add that to whatever we would bake. If I’m making some paleo pancakes or muffins, it’s a good thing to add in there as a good form of resistant starch.

That stems me into thinking about sushi because if you do sushi, there are so many things they would add to it but you can do it at home and make your own sushi. What we will do is we will do a rice bowl, and then we will put the raw fish on top of it, coconut aminos, some avocados and ginger. That’s cold rice as opposed to hot rice. That brought back that resistant starch.

A lot of places that you order sushi from, will put sugar in the rice to make it sticky. I like making sushi at home. That’s probably the best way to avoid that as well.

I know you are big into fasting as well. Tell me some of the differences. The men fast, the weight falls off. For those of us that recommended it, it’s frustrating for us doctors. We are like, “Why are the women struggling with this? Why isn’t it making a difference?” Tell me why do women sometimes struggle with fasting or at least getting the results during the fast.

When we look at some of the main differences between men and women, one of the biggest differences is our difference in testosterone. Dr. Sara Gottfried will talk about this testosterone advantage. I love that name because even though women, we phenotypically think, “Women have more estrogen.” We have more estrogen but we have more testosterone than we have estrogen but when we compare the female’s level of testosterone to a male’s level of testosterone, we are talking 10, 20, 30 times more of a male’s concentration of testosterone versus a female’s. When a man fasts because under the influence of his testosterone, he’s naturally going to have more lean muscle mass. His bone density is going to be heavier than his female counterpart.

Fasting is going to be much easier for a man. We typically see women, especially in modern life because we are trying to balance raising children and having a career. I can say that this is even true for me as well. The brunt of the caregiving often falls on the mother. The kids, when they have a sniffly nose or they have a nightmare, they don’t go to dad. They come to me. They want mommy to hug them, help them with their homework or take them to soccer practice. Generally, we have a higher level of stress than our male counterparts do.

Fasting is just like exercise. It would be something that I would call hormetic stress, which is use stress. It is a good type of stress. A lot of women, when they say, “I want to lose weight. I’m going to do a 16:8 or I’m going to do a 24-hour fast,” back to those invisible eyes, the mitochondria and your ovaries are going to be like, “There’s not a lot of food here. You haven’t eaten in the last eighteen hours. We should probably shut down your menstrual cycle because if you were to get pregnant now, this will be Bad News Bears. We are just going to shut it down this month. Maybe next month we will try again.”

When you aggressively fast, you will affect your ability to ovulate, which is the point of your menstrual cycle, not to bleed, it’s to ovulate. You are going to affect your fertility, which is back to this idea of this is what we should be optimizing for. For women, you can still fast because there are still a lot of benefits to fasting. You can reduce your insulin levels, help augment your growth hormone and induce autophagy, all of these different things that fasting can do but as women, we have to be gentler.

Green leafy vegetables are very dense in fiber, which is very important for your bowels.

We don’t want to do these 18:6, OMADs or these 3-day or 7-day fast like the guys can do. We want to be much gentler. As a through-line for any health practice, you don’t want your health practice to feel punitive. You don’t want it to feel like you are being punished. I like to counsel women to start with a 12:12, which might be eating for 12 hours. Let’s say, 7:00 AM to 7:00 PM, and then you fast for another twelve hours. You might tighten that up a touch. You might make it a 10-hour eating window and a 14-hour fast.

For most women, you would stay there. There are certain times of your cycle, which I talk about in The Betty Body, where we are much more resilient to more aggressive fasts. In your bleed week, for example, or in your follicular phase, in general, the first two weeks of your cycle, you can do a bigger fast if you want. You can do the 24-hour. Maybe you want to do a 36-hour or 48-hour fast but you don’t want to be doing it all the time.

You want to understand the ebbs and flows of your hormonal milieu as you are moving through your cycle, which will help you dictate how long is the fast, what fast you are doing, and how frequently you are doing that fast. The general rule of thumb here is as women, we need to be less aggressive. The guys can do a 24-hour fast every day and have great results from it. We will lose our periods. We will be miserable and hungry. We must be gentler on ourselves than the guys are.

I love to make these comments to people like yourself. I would send any patient and recommend any person to consult with you versus any other medical doctor who I have ever worked with, who gets no training in anything you are talking about. Your book is outstanding as far as the range of coverage for younger women, older women, maybe even for men to understand these women and how to be best supportive of these women.

It’s very easy for me to hear about some new fasting strategy, and I go and turn it on my wife like, “Let’s do this 72-hour fast,” and my wife’s like, “I’m a 46-year-old nursing mother. You are an idiot. I’m not doing that.” There’s so much information in the book. Tell me where people can get more information because you’ve got such a wide range of knowledge and so much to offer, including to your children as their teacher and homeschool mother. Thank you for the reference to The Bad News Bears. I don’t think that has come up on the show, so I appreciate that.

I appreciate it and I receive your compliments with joy and with love. If you are somebody who wants to find out more about me and my work, the best place to start is the book. It’s everywhere, so you can find it at any online retailer. Walmart also has it now. That’s a lower-cost investment. The book is only $20 to $25. You can read through it.

If you are wanting to know more or go a level deeper, we have my community, which we have a community of women where we meet at least once a week, sometimes it’s more for running a supplementary program. We talk about all the different pillars of what it means to be a woman. It’s female-focused nutrition, female-focused fitness and fitness protocols. We talk about what it’s like to be a woman, so the female psyche. We talk about the divine feminine and how that marries the divine masculine.

When we think about long-term health, one of the things I will say is we can talk about all the nutrition protocols and if we want to optimize for longevity but if you hate yourself, there’s no point in living a long life. How can we forgive ourselves? How can we practice self-care? How can we love ourselves a little bit more? We have a community and it’s called Hello Betty. You can go to HelloBetty.club. I also have a podcast as well. I’m a podcast host. It’s called Better with Dr. Stephanie. You can check us out there, too.

You’ve got so much to offer to the world of health and wellness. I’m happy you came to the show. Thank you again. We finished up another episode. Stay tuned for future episodes and guests. Best to you in living your 100-year heart. As Dr. Stephanie would say, you want to live your 100-year heart but you want to be happy while you are doing it, so make sure you focus on being happy. Happy people live longer and live better, so you will. Thank you.

About Stephanie Estima

HHS 15 | Women’s Health
Dr. Stephanie is a doctor of chiropractic with a special interest in metabolism, body composition, functional neurology, and female physiology.
She’s been featured on Thrive Global, of the Huffington Post, has over 3.5 million article reads on Medium.com and has helped thousands of women lose weight, regulate hormones, and get off medications with her signature program, The Estima Diet. You can hear her every week on her podcast, Better! With Dr. Stephanie.
Dr. Stephanie is changing the conversation around health, fitness, sex, intimacy, longevity, parenting, mindset, and pursuing excellence.
Her life’s passion and mission is blending modern science with ancient wisdom to empower women’s health and healing.

About Dr. Keith Smigiel NP, DC

Dr. Keith Smigiel

Dr. Keith Smigiel is a regenerative medicine physician and pain management specialist. He takes an integrative approach to medicine, focusing on customized solutions tailored to individual needs. Using advanced, non-surgical treatments, Dr. Smigiel stimulates your body’s ability to naturally heal itself.

Dr. Smigiel helps people suffering from conditions such as chronic pain and erectile dysfunction, to hair loss and weight gain. Combining treatments such as PRP Therapy, Ozone, Neural Prolotherapy, and IV Infusions with functional rehabilitation, he helps you look and feel better.

He heals the body, instead of just treating the symptoms!

With his professional qualifications as a certified family nurse practitioner, a doctor of chiropractic, and a fellow of the International Academy of Medical Acupuncture, Dr. Smigiel offers patients comprehensive care from a broad perspective of conventional and alternative medicine. He also has extensive experience in functional rehabilitation and chronic pain management.

Dr. Smigiel is married to Angela and has two children, Sophia and Larz. When he’s not busy helping patients, he enjoys hiking, mountain biking, motocross, and boating.

About Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

As a Fellow of the Heart Rhythm Society (FHRS) and Certified Cardiac Device Specialist (CCDS), Kneller provides comprehensive patient care, combining best medical practice with invasive procedures using state-of-the-art technologies to treat heart rhythm disorders.

Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

Dr. Lattanza Office Visit with Patient

As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

Dr. Wolfson Office Visit with Patient

Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

He has been named one of America’s Top Functional Medicine Doctors and is a five-time winner of the Natural Choice Awards as a holistic M.D. Dr. Wolfson’s work has been covered by more than 100 media outlets, including NBC, CNN, and the Washington Post. His book “The Paleo Cardiologist: The Natural Way to Heart Health” was an Amazon #1 best-seller.

Dr. Wolfson and his wife Heather have four children and are committed to making the world a better place to live. They provide for those in need (including animals) and support natural health causes through their philanthropic efforts.


Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

Call (480) 535-6844 for details and scheduling.


Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

Call (480) 535-6844 for details and scheduling.

Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

Call (480) 535-6844 for details and scheduling.

Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

Call (480) 535-6844 for details and scheduling.

Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email health@naturalheartdoctor.com. A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.