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Stress Vs. Sex: Battle Of The Hormones Part 2 With Dr. John Kim And Dr. Lauren Lattanza


Dr. John Kim is back with Dr. Lauren Lattanza to discuss more about hormones and living a healthy and pleasurable life. While the first episode focuses on wonderful clinical tidbits about hormones and everything that surrounds us as we age, this next one highlights its role in the latter stages of our lives. Dr. Kim explains how poor lifestyle can result in serious adversities, which can lead to a difficult pregnancy. He shares his expertise on taking care of our holistic health and explores which hormone therapies can provide the best results to you. Dr. Kim also touches on hormone replacement therapy, proper estrogen metabolism, and more. Tune in and learn how to face our dysfunctional relationships with hormones and start leading a fulfilled life.

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Stress Vs. Sex: Battle Of The Hormones Part 2 With Dr. John Kim And Dr. Lauren Lattanza

I’m eager to bring you part two of my discussion with Dr. John Kim. He’s a functional medicine pharmacist. I encourage you to go back and read part one of this discussion. We had many wonderful clinical tidbits about hormones and everything that surrounds that as we age like what to look for and how to live. I would say go back and read part one if you haven’t already. There was so much great information that we had to develop a part two, which is what we will bring you now. Welcome to part two of our show, Dr. John Kim.

Dr. Lauren, thank you so much for inviting me for the second time. That was a deep discussion we had on part one so I encourage everybody to go back and read that. We went from hormones to many things in dealing with the myth behind hormones. Hopefully, that will open a lot of eyes for people as well as the second part is going to be a very interesting part we’re going to discuss. Let’s get going.

We started to gain some traction talking about hormone replacement therapy in part one but it is such a hot topic and on many people’s minds, maybe a lot of women that are reading are on hormone replacement therapy or the fence thinking, “Should I be on hormone replacement therapy?” From the get-go, what are some pros and cons that we can look at? Should I be on hormone replacement therapy? Should I not? What are the risks involved? What are your thoughts?

It depends on the person and what their overall lifestyle goal is. It’s not about everybody needing it. I got into this whole thing with functional medicine and anti-aging medicine back in 2008. When I was going through my fellowship training, I thought everybody needed hormones. Once you end up having to get into the whole clinical aspect of it and listening to patients what their overall lifestyle goal is, not everybody needs hormones.

If you’re dealing with severe hot flashes and nothing’s helping you out, then hormones might be a better choice for you. Maybe you want to be much more vibrant, have a lot more libido and energy in that aspect of it and improve your life, the hormones could be one good thing but do they need that to achieve all those things? Not particularly. I want to take that myth out of the picture because it’s also a marketing gimmick that happens a lot. It depends on the person.

Let’s take menopause patients, for instance. If you’re dealing with severe hot flashes and nice sweats and then nothing seems to work, estrogen is not something that’s going to be the first thing that we have to look at. We have to look at cortisol as well as progesterone in a hierarchy system. We have to look at how that person’s gut function is, how they’re metabolizing some of the hormones, any weight issues they may have and if they could clean up their diet. Diet plays a huge role in terms of how your hormones are playing into effect. I can’t say, “You need to use identical hormone replacement therapy and fix all the problems that you might be dealing with.”

It’s not about chasing lab values. I tell patients frequently, “It’s because you’re postmenopausal, it’s okay that you have postmenopausal lab values reflected here but if you feel lousy or you’re having these symptoms that are keeping you awake at night, in the middle of the day, you’re breaking out into sweats and you’re uncomfortable, then yes. Maybe that’s something that we want to explore.” Diving a little bit deeper as well and seeing with the adrenals and so on. There are some benefits with bone density and some cardiovascular protection as well. Do we still have that same risk consideration with cancers developing in estrogen use?

Let’s talk about the benefit of utilizing estrogen, for instance. When you’re using estrogen, the most data in terms of what we are seeing is not using the oral form of estrogen. When you’re taking the oral form of estrogen, the overall risk behind that is clotting issues. You have an increase in gallbladder problems on top of increasing sex hormone-binding globulin. That’s a mouthful sometimes. Thyroglobulin, as well as the fact that you have a lot more issues, in general, when you’re taking estrogen by mouth.

You want to utilize topical and the data shows that topical estrogen shows a lot more benefit in dealing with heart benefit. It makes sense a lot of times. When you’re talking about how dose estrogen is risky, it depends on the patient as well. You have to look at the overall history. Gene could be playing a huge role but it is all about epigenetics and how you end up having to control that estrogen metabolism into more of a cancerous estrogen compared to being much more beneficial.

That depends on how you eat, how you sleep, how you end up having to reduce your inflammation and how you end up having to take care of your gut microbiome. The methylation process is a big one too. Estrogen metabolism has to be looked into instead of telling patients, “If you are using estrogen for more than a year is a cancer factor, you need to stop it right away after one year.”

We talked a little bit about some of the ways to help encourage estrogen metabolism so that we’re not developing. If your set of genetics is predisposing you to go down the pathway of the more inflammatory metabolites of estrogen, what are some of the suggestions that we can look into for encouraging proper estrogen metabolism?

The first thing has to be the gut function. The first thing you need to do is have a good higher fiber intake and a good bowel movement. That’s the first thing that we need to look at. If the person’s not having a normal bowel movement daily, they’re stuck and that’s going to affect estrogen metabolism, to begin with, so we’ve got to look at that. The second thing that I would recommend doing is adding in crisp fists of vegetables, especially, broccoli and cauliflower. You could even take a supplement for that matter.

I prefer supplements because you have a set dose that you could add in and as well as there’s a product available from other manufacturers. I’m not going to specify a specific one, which contains indole-3-carbinol, as well as DIM hoping with the estrogen metabolism to get it cleared out properly. That’s one way to handle that. Calcium-D-glucarate is another one that you can end up having to utilize for estrogen metabolism. It’s a good estrogen metabolism supporter. It’s a must. That’s number three.

Number four is muscle mass. If you’re not exercising well and if you have a lack of muscle mass, that overall affects your metabolism, your inflammation, as well as handling a lot of the hormonal aspects that you’re going through. I see this all the time in the clinical aspect that people who are overweight tend to have higher levels of hot flashes.

HHS 45 | Hormones
Hormones: If you’re not exercising well and have a lack of muscle mass that affects your metabolism, it will impact a lot of the hormonal aspect that you’re going through.

They don’t do too well with bioidentical hormones. It’s not because it doesn’t fit them. It’s that the overall absorption of hormones topically sometimes as well as metabolism is far skewed that you may end up having to see a lot more hot flashes when you utilize these things. In many cases, we have to start very slowly with these patients. Depending on the adipose level that the patient might be dealing with, I sometimes choose a patch form of estradiol before we end up having to get the steady level and then transitioning over to bioidentical bias.

The patches like the Vivelle-Dot patch or estradiol patches are still bioidentical but you don’t have an unopposing estradiol factor, which can be sometimes an issue. You need the right balance between all three estrogens, especially estriol, estradiol and estrone. Estriol protects the breast tissues from cancer, as well as their different activity within the body in terms of how those three different forms of estrogen come into play so you need to have the right balance. Utilizing straight estradiol patches might not be suited for you for a long time but in certain cases, I have a discussion with the doctor to transition over to a biased form. There are different ratios of the bias as well, either 1 to 1 or 4 to 1. It all depends on the level of adipose tissue that we are dealing with.

Bringing back the discussion of the different forms of estrogen, at least in my training, it was what are the symptoms that we’re looking at and how is that body going to metabolize it? Maybe that would be a good point to look at some of the sexual dysfunction, vaginal dryness and so on. Maybe we can say, “What kinds of estrogens should we be looking for if we’re working with a practitioner?”

Let’s talk about that. Vaginal dryness is such a common issue, especially atrophy. Utilizing estradiol, even though it works okay, is not the best one to utilize. You may end up having to cause tissue proliferation utilizing estradiol. There’s an unopposing estrogen that’s coming into play. There’s a lot more data in safety looking at estriol, that’s a different form of estrogen, that has a higher affinity to the vaginal tissues. It has been shown to be very safe and has not been shown to cause any cancer byproducts.

If you look at the overall estrogen metabolism, estriol is at the bottom of the totem pole in terms of the estrogen metabolizer. It’s not going to go anywhere, in a case in point, “better safety” when they’re utilizing Estriol and better effect in efficacy for vaginal dryness and especially for atrophy. I, at least, recommend utilizing estriol around 0.5 to 1 milligram per kilogram as a vaginal cream.

You could work with compounding pharmacies to get that compounded because it’s not going to be available as a regular commercial product. That’s one way to do it. Sometimes, in certain cases, you may end up having to add in testosterone. There’s another product that you can happen to add as a combo to help with that but you have to check how inflamed that person is.

If you look at a DUTCH test or regular saliva test and the person is inflamed and then they have a very low DHEA and high testosterone seen, then you don’t want to challenge testosterone as much. You want to probably back away. Those patients may end up doing better with a straight DHEA vaginal cream or utilizing estriol vaginal cream, depending on the patient’s needs.

For the readers, Estriol is E3. We can look at that as E1, E2, E3, where the estradiol is the E2. We’re looking at that from two different topical aspects. Estriol, the E3 we’re doing more so vaginally. It’s not going to be like the topical cream.

For vaginal dryness purposes, let’s say the patient starts unbias. Bias is two forms of Estriol and estradiol so E3 and E2 combined. It helps with a lot of the vagus nerve response and vasculature. However, it doesn’t address the dryness issue until later on, probably six months or so, because it takes that much of a tissue concentration to generate in that area. For any patient dealing with dryness, you want to start the Estriol right away.

That’s why a straight vaginal application of estriol works a lot faster and also you need to do a certain loading dose as well. The given point that I recommend doctors to do is utilize 1 gram, insert it vaginally and do it at bedtime for about 10 days, followed by 3 times a week and then as needed. It helps to reverse a lot of the dryness and atrophy issues right away. After that loading dose, the patients may have to use it maybe once a week or as needed and they’re able to maintain that very well.

Let’s talk about maybe a segue of estrogen, men also have estrogen. Maybe we can talk a little bit about how men present with estrogen, where we’re getting excess estrogen and how that shows up in men.

Everybody produces estrogen, especially when you’re talking about penile tissue development in terms of overall sexual characteristics being developed. We came from one form of penile tissue development and that overall region, all depending on the ratio between estrogen and testosterone and how that ended up having to come into play. Everybody has some form of a dysfunctional relationship between the hormones depending on how it’s being metabolized and utilized in the body.

HHS 45 | Hormones
Hormones: Everybody has some form of dysfunctional relationship between the hormones. It only depends on how it’s being metabolized and utilized in the body.

A perfect example for guys is they do the IBC. They need a lot more testosterone compared to female patients because of all the lifestyle factors coming into play, especially if they’re not exercising as much, have a lack of muscle mass and have poor estrogen metabolism. We talked about estrogen metabolism for females when men end up having to come into play as well, which can push the testosterone converted down to estrone.

As a higher activity of estrogen compared to estradiol and estriol as a result, men, especially when they’re dealing with estrogen, feel a lot more fatigued. They don’t feel themselves. They feel depressed. They end up having to lose a lot more muscle mass. They feel that they’re losing their erection. In certain cases, guys develop hot flashes as well. You end up having to see some of the sexual characteristics being developed such as gynecomastia being a big one because of man boobs.

We’re not going to say the other word but man boobs. That’s something that we need to look at. If you see any signs of these things, I’m not saying it has to be all but any signs of those symptoms I addressed before, guys should check their testosterone level and estrogen metabolism. If they see that estrogen metabolism is higher, they need to do certain things to reverse that.

Some doctors that I’ve seen end up having to use estrogen blockers like anastrozole or brand name is called Arimidex. I don’t particularly like that. I ended up having to stop the estrogen metabolism too aggressively and in certain cases, permanently as well. I’m not a big fan of that but there are natural ways to do so. The first thing you should do is you need to change your lifestyle. That is a must.

If you’re eating like crap, if you’re not exercising, if you’re not having the right amount of sleep, especially at least 7 to 8 hours, a low circadian rhythm balance as well as highly stressful events, all those things coming to play in dealing with poor testosterone production and testosterone being converted a lot more to estrogen. When you’re adding in toxins, like xenoestrogens, that plays a huge role in terms of that in itself.

That’s the reason why when you see the overall sperm count, it’s been decreasing very rapidly for the last 50 years, not because guys are producing more estrogen. It’s not that. It’s more the fact that it’s toxins getting involved, poor lifestyle choices and everything coming to play that guys are being demasculinized in many cases.

The more studies that come out, the more we realize that many of the common products have xenoestrogens and we’re absorbing them. People are trying to do a quick fix and going to a testosterone clinic injecting a bunch of testosterone. They’re having this double whammy of the conversion of the testosterone that they’re injecting, plus they’re getting it from their environment. Looking for natural estrogen blockers and not jumping to the anastrozole option, that’s pretty common from what I’ve seen.

For guys, I sometimes put them on DIM or indole-3-carbinol for a short time to get their estrogen cleared out. The second is fiber intake is a must if they have poor gut function. Not having to add one prebiotic and postbiotic does affect in terms of how the estrogen metabolism comes into play. When you have poor gut dysbiosis, the activity of the beta-glucuronidase is also increased where you need beta-glucuronidase to allow the estrogen to be cleared out quickly.

When you have a high level of that being affected, then you have a lot more estrogen being recirculated within the hepatic circulation. That also affects it as well. Everything should be looked into instead of looking at testosterone, it happens way too much. I’ve seen guys utilizing testosterone CPD injections on top of using HCG because they notice that if they go straight dealing with testosterone injection, they’re going to feel some sensitivity on their chest.

To block that, they end up having to see a certain shrinkage in their penile tissue. They end up having to use HCG to protect that issue from further happening. You’re causing one side effect and then using a second medication to block that. That’s a point that I hate seeing doctors do. I own a compounding pharmacy. I service a lot of doctors and certain doctors are very set in terms of what they want to do.

If you want to have proper hormone replacement therapy, especially for guys, lifestyle factors have to be changed in terms of how they eat, how they exercise, how they end up having to detox daily, improving the circadian rhythm and how they end up having to poop, including mycotoxins. Mold toxicity can play a huge role in estrogen metabolism as well.

If you want to have a proper hormone replacement therapy, you need to change your lifestyle.

There are certain mold toxins like aflatoxins and even fusarium that can exert that estrogen activity. That could make it even worse for a lot of people. That also affects cardiac function. That’s not something we could be talking about but mycotoxins, heart disease and hormone metabolism are all coming into play. People have issues and we’re living in a basic cesspool of toxins. That’s including mycotoxins. We’re not having that enough knowledge or the know-how to address this properly.

When we’re talking about metabolism mycotoxins like aflatoxin hinders hepatic function. We can’t metabolize things properly. We’re taking in all these hormones on purpose or otherwise. Things get messy.

The poor methylation process is so affected. The glutathione level is depleted. On top of when you’re having phase 2 or phase 1 being blocked in the overall detox pathway, that also affects it as well. Everything has to be looked into carefully instead of reaching for some testosterone. I know everybody wants a quick fix. I know everybody wants to be jacked and energetic like in their twenties but you got to remember why you’re there. Why has that issue that you have resulted in it? It didn’t happen overnight. It’s all the crappy McDonald’s and all the s*** that you’ve been eating for the last several years. It accumulates.

It’s hard to undo. We talked about some of the sexual dysfunction in women. When men present with erectile dysfunction, what are some of the things that we need to be considering? They come to me because they’re thinking of their cardiovascular system, which is great for them but it’s not always testosterone either.

It is a circulation issue. There are vasculature inflammatory conditions that are going on, reducing the inflammation, as well as reversing a lot of the poor lipid metabolism panel that you see is a must. Number two is, how’s their diet? How are they sleeping? If they’re not getting an adequate amount of sleep in a timely manner and have a poor circadian rhythm issue, that doesn’t work well.

In certain cases, adding in maybe 3 to 6 or sometimes I put patients on 20 milligrams of melatonin might be something that we need to add in to reverse some of the circadian issues that are going on. How stressed are you? How’s your cortisol level in the morning? Is it jack high that you end up having to go on a full Chinese fire drill mode that you end up having to try to put out fires throughout the day? That’s going to kill your boner. Sorry, I had to say that.

Legally understood. We can speak to the people.

That’s what it is. That’s boner killer and what it comes out to. Testosterone does play into effect. If you look at all the erectile dysfunction drugs, especially Cialis and Viagra, what is it doing? It’s increasing vasculature and perfusion aspect that we need in looking for but there are side effects from taking all these things. Especially Viagra was the first PDE5 inhibitor drug that was out of the market.

It does have a lot more side effects compared to Cialis or other 2nd or 3rd generation types of these drugs. Side effects, eyesight issues, heavy congestion problems and thirst. In certain cases, if you’re taking other nitrate-filled drugs, it can drop your blood pressure even more. I strongly believe and I don’t know if there are any studies or not but in terms of prolonged use of these PDE5 inhibitors, is that going to cause microvascular damage that all these drugs may not work well down the line and then what you’re resorting to injectable a prostaglandin to help with your erectile issue or are you going to fix the issue right away so you don’t go into that effect?

We have to think about that short-term fix and what’s the long-term effect of that.

It’s mind-boggling how even seventeen-year-olds are needing Viagra or Cialis for their erection. A sad part is that the parents are bringing them to the pharmacy to pick these up. I’m not saying getting involved in a sexual relationship early on, that’s not my point. The point is that we are seeing all these issues coming up very early on. A seventeen-year-old should not be having all these issues.

Various sexual and hormonal issues come up very early on. A 17-year-old should not be having all these issues right now.

We still think, is that circulatory-related?

Is it circulatory? Is it anxiety issues? This is a different topic but overuse of pornography and all these things end up having to cause depression issues or also dopaminergic effects on that and all these things. It’s a societal issue. It’s not just about hormones at this point.

With the surging rates in fertility, young men have issues with getting erections and then young women can’t seem to get pregnant anymore. There are a lot of societal issues and then the hormones coming in from the chemicals and a lot of unidentified toxins that are causing the early onset of hormone dysregularity. When these women and men get into postmenopausal years or andropause years, they’re fighting an uphill battle from the get-go.

Also, not knowing that. When you’re talking about the overuse of birth control pills and young female patients and how that affects the overall mitochondrial damage and DNA issues, down the line in terms of their fertility rate, all these things are not talked about. The young girls are making a decision based on that in terms of what is provided for them. If they know what the long-term consequences are going to be down the line, would they think differently? I think so. If I had a daughter, I would never put them on a birth control pill for that purpose. It’s a sad reality.

Unfortunately, it’s the go-to quick fix for many things like acne, depression and what have you in these young women. It’s unfortunate to see downstream what they wind up dealing with when they’re trying to see. It’s sad. That brings up a good point about the adrenals and how the adrenals, sex hormones and thyroid hormones all have to work together.

Hierarchy-wise, I still strongly believe that your adrenal function has to be looked at first. Cortisol is not just about the stress response. It also deals with insulin response and sugar control. If the cortisol response is out of whack, in a downturn or cascade manner, is going to affect your sugar metabolism, how you end up having to deal with inflammation, deals with stress response, as well as how the progesterone and other hormones are coming into play in your life and all these things.

You have to look at the cortisol response even before. When you’re talking about Cortisol Awakening Response or CAR, that also affects in terms of how much of a spike of cortisol you have in the morning and how we could end up having to control that depending on lifestyle factors or any other adaptions that are coming to play. Those all have to be fixed.

Especially for females, depending on how much of these hormones are being tweaked, females are much more sensitive in that aspect of it. That also affects their pregnancy rate. If they’re highly stressed out, they’re not having enough progesterone to support the entire pregnancy, that’s a failure aim to happen. One of the factors I always tell patients to do is that, in general, for at least one full year before they start to even think about having a family, start doing all the functional labs and looking at their cortisol level, their progesterone, their estrogen and then also looking at the factor in terms of all the toxins and any gut dysbiosis they might be dealing with.

It’s such a common thing that girls have to accept bloating as being normal. If you’re having any of those issues, there’s an inherent issue with leaky gut and inflammation. You need to fix that right away. Do you think that’s going to get better when you get pregnant? It’s going to get worse. All these come into play and fix that. When you’re talking about the thyroid, that’s the second thing we should also look at as well because depending on if the thyroid is lower or high, that also affects the pregnancy rate.

When you’re talking also about progesterone and testosterone, estrogen, those all have to be optimized as well. If you have any history of dealing with more toxicity, Lyme disease like one of our colleagues. I’m not going to mention any names but even for her going through her Lyme treatment and Bartonella, who’s 28, still has not been able to get her progesterone level up properly.

You need some type of progesterone replacement at that time. There’s nothing wrong with that. You have to know where you are and how you approach it. Not everybody’s going to have perfect health but as long as you know what to look for and when you work with the right practitioner and optimize your health to get you prepped to start your family, that’s the best way to do it.

That’s a good tip for looking ahead. Say you find Lyme disease or mycotoxin illness and so on, do you think it’s a good option to support while you’re going through the detox? When would you stop a detox when considering trying to conceive?

There’s a given point. I don’t think there is any data out there. What we see, as well as the other practitioners that we work with, is an easier pregnancy during a detox period because the hormones are coming to normalization. Is there a proper way to help with the pregnancy at that point in time? Probably not, because you’re going through treatment. You don’t want any other shift of toxins and such to go into the placenta and affect fetal development.

You need to time it well and work with practitioners who know what’s going on. Afterward, that doesn’t end there. You need to have other nutritional aspects to be supported during the pregnancy that is safe and sound. Our common products like Cellcore have certain data showing that’s safe for pregnancy use. Certain cases have to be done and optimize your phospholipid content.

HHS 45 | Hormones
Hormones: Hormones coming to normalization do not mean it’s the proper way to help with pregnancy. You also need to have other nutritional aspects.

I’m a big believer in the use of phospholipids. A company like BodyBio makes great liposomal phospholipids that come into play to not just help detox but also support the mitochondria, cell membrane and the detox pathway as well as phospholipids for your baby’s brain development. That’s a must. Also, you do need phospholipids for a healthy sperm count as well. All these things come into play. It’s about cellular function.

A lot of that with the adrenals and the thyroid when those are kaput, you feel lousy and then your mitochondria are suffering. We have to get it down to a cellular level and get a lot of cellular support onboard.

That’s why we should look at these things a year before and at least give enough time to prep the person’s body and for the health of your offspring. What determines the health of the offspring is determined by the health of the mother because the mitochondrial DNA can get damaged by stress and outside factors. That’s what you’re passing on to a child. Dr. Lauren, the counterpart in terms of mitochondrial health was determined by your grandmother. That mitochondria are being passed onto your mom and then to you. If you had a daughter, you’d be passing on that mitochondria health to your daughter as well. You could thank your grandmother for all the health aspects that you’re dealing with.

She had severe rheumatoid arthritis so that’s not a good thing.

Let’s not talk about that then. Never mind. Let me take that back.

I can thank her for my mitochondrial function.

Even looking at my mother’s health and then my mother’s side of the family, for instance, my great-grandmother lived until 105. Longevity runs in the family. My grandmother is 96 in 2022. That mitochondrial health is there and hopefully, I’m able to maintain that longevity.

You’re going to get your 100-year heart.

I went through a heart attack already. If any readers don’t know about this, I had a heart attack when I was 33 years old. I had an 85% blockage in my LAD and had to put a STEM put in. I found out that I had positivity for Bartonella infection and more toxicity. That created a lot of issues but I am mold and Bartonella-free at this point. That also affects your longevity aspect of it.

Did you have a long road to recovery that you had?

It took about two years. I had a stint of mold toxicity again in 2022 and I was able to clear that out in three months. All because of the use of phospholipids and cell membrane support, use of sodium butyrate as well, because you need to beat uric acid for the mold to be detoxed out of the DNA of your cell. All these coming into play how cell membrane comings to effect is so vitally important.

Being so young with a heart attack, did it take you a while to navigate the fact that it was Bartonella and mold or were you already in this space of holistic?

I’ve always helped patients deal with this type of issue but I didn’t realize how much it was affecting any patients for that matter, even me. It’s just that I had a very smart doctor, friend and colleague that taught me to get some additional functional labs to rule out Lyme disease. That’s what happened. I did have Lyme so I had other coinfections and it took a huge toll.

Once you go through that health issue, it opens your eyes in terms of what possibilities are and as well as helping other patients to reverse those courses. That’s what I’m concentrating on. I used to do a lot more hormones. It makes you more combination of everything in terms of the hormones and dealing with the mycotoxins and other coinfections coming into play and how to optimize a person’s health to recovery.

HHS 45 | Hormones
Hormones: Once you go through a health issue, it opens your eyes on the possibilities of helping other patients reverse those courses.

That’s how it goes. We think that we’re getting into some niche area. Like me going into cardiology, I didn’t think that I was going to be diving so deep into mycotoxins all the time. With cardiovascular disease and the rate of mold-related illnesses common, I’ve had to become an expert in mold, some of these environmental toxicities and so on. Unfortunately, things are coming more multifaceted anymore. It’s not just as straightforward as, “My hormones seem off. What do you think this is about?” It’s a lot to unpack.

My overall LDL level was highly elevated before my mold treatment in 2022. It was around the 500s. It was inflamed. Once I ended up having to get the mycotoxins out, it was down to normal levels. You shouldn’t look at LDL level and then think, “That’s high.” The thing is that in itself, shifts your eye-opening moment that mycotoxins cause inflammatory conditions and then high levels of cholesterol being produced.

When you have a low HDL and high LDL on top of inflammatory conditions and all that, that’s a very big issue as a risk factor for cardiovascular events. When you’re adding in hormones, that all comes into effect in terms of how that cardiovascular function and hormonal aspect come into play as well. Especially for females, if you have high levels of testosterone, low DHEA and cortisol levels shot and then you’re overweight, that’s a disastrous way to happen. You need to reverse that issue ASAP by applying lifestyle changes. The Paleo diet is a good one to focus on. Your colleague, Dr. Wolfson wrote the book The Paleo Cardiologist. That should be a golden Bible for everybody to be reading.

HHS 45 | Hormones
The Paleo Cardiologist: The Natural Way to Heart Health by Jack Wolfson, D.O.

FreeHeartBook.com, if you haven’t read it. Let’s give it out for free because it must be read.

That should be the number one point and that’s what I end up having to apply to patients that you need to keep a more of a paleo-based diet to fix all the hormonal issues. If you want to go a little stricter, do whole 30 or there are certain things like a mitochondrial-supporting diet and that’s what it is. You’re eating a lot more healthy fat and applying animal protein and helping to support the mitochondria because you need those phospholipids to help your cell membrane and cell functions to get back to normal.

I’m noticing you’re saying higher fat and paleo and not keto.

I’m not a big fan of keto as much. I know some practitioners like Dr. Shawn Baker and I respect him a lot. He’s big on the overall carnivore diet. He’s the prime example and it works well in those types of scenarios. Does that apply to every patient? Not particularly. He even says, “Carnivore is not for everybody, nor is it for forever.” He was able to do it for about several years. The guy’s benching 300.

He’s a specimen. It’s incredible.

I’ve seen patients reversing their Crohn’s disease and other disease states, including hormonal dysfunctions by changing their diet to carnivore. I can’t say that’s a bad thing but generally, about 99% of the time, the paleo diet works well for a lot of people. It eliminates all the inflammatory food, oils and byproducts and fixes the diet issue from the get-go and asks what you need for proper hormonal function as well as metabolism.

Paleo diet works well for a lot of people about 99% of the time because all the byproducts and inflammatory foods are removed. It fixes the diet issue from the get-go.

We mentioned across the board talking about some of the diets with having the proper estrogen metabolism and so on. We want more fiber. Being incredibly restrictive on not allowing any fiber in can hinder and throw a wrench in things as well.

What does your gut bacteria feed off? Symbiotics. You’re not going to get that from meat alone. There’s still confusion going on in terms of how the gut bacteria comes into play, what it needs and how it thrives. You need to have a perfect condition to do so. When you’re applying strict meat, it’s not going to be ideal. You have to look at that much differently.

We want a paleo diet, weight-bearing exercises, good sleep patterns, looking at your adrenals and some foresight in terms of having good hormonal health through the rest of your years. Is that a good synopsis, we think?

That’s a simple way to put that for a lot of people. Generally, unless you’re dealing with a very complex case for the general population based on what we discussed, should be enough for optimal health. You need to work with the right practitioners. That’s the key. You need to work with the right practitioner who understands all aspects of the body, not just about hormones but gut health, the toxicity response, nutritional deficiencies and including psychological health as well to help you achieve the right health you’re looking for.

That’s an excellent point about mental health and stress management. That goes back to the adrenals and so on but having good stress management and good mental health makes it truly holistic.

There are three core things that I like to simplify for a lot of patients. Toxicity, deficiencies and psychology all come to play in terms of dealing with that. When you go into the subgroup, it’s gut health, hormone and immune balancing. All those things come into play to build up a strong pillar because the foundation aspect is what you do as a lifestyle, how you poop, how you sleep and how you deal with stress. You have the pillars in terms of gut health, hormones and the immune. When you’re talking about all the other outside factors like toxins, deficiencies and psychology, that have all been enveloped into helping you achieve the right health.

Toxicity, deficiency and psychology have a good solid foundation to go on with all of that. It’s always such a pleasure catching up with you. We can do deep dives all day long. I want to encourage everybody to go back and read part one. Also, where can our readers learn more about you and see all the great beneficial information you post all the time?

I’m very active on Instagram. It is @Dr.John.PharmD and then you could also find me on my website, DrKimWellness.com. You could also book an appointment to talk about any other health issue you might be dealing with. An easy way to contact me is through Instagram.

Thank you again. I love picking your brain. You’re an absolute wealth of knowledge. Thank you so much for your time.

Thank you so much, Dr. Lauren.

About Dr. John Kim

HHS 45 | Hormones

Dr. John Kim is a functional medicine pharmacist. He has been in clinical practice for 15 years and he has been a foremost voice in health, wellness, and preventative medicine. He received his Doctorate in Pharmacy from Rutgers University with High Honors and trained in Functional Medicine from the American Academy of Anti-Aging Medicine (A4M). He actively lectures throughout the country and is an influencer within the functional medicine world to educate and empower everyday people to live a healthy fulfilling life. His message is Doctor of the Future is You – the patient.

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.