• Q & A with Jill Dozier

    by Jill Dozier
    on Apr 9th, 2019

Q & A with Jill Dozier 

Hormonal, Anti-Aging & Functional Healthcare Practitioner

Women’s Advocate

Why am I so tired, not sleeping, experiencing Brain Fog and am gaining weight?

As we age, our bodies produce smaller amounts of hormones such as progesterone, estrogens, DHEA, growth hormone and melatonin, just to name a few.  We have over 50 different hormones responsible for regulating most of the functions in our body.  

When your hormone levels begin to decrease it affects your ability to properly sleep, think and metabolize your food as well as many other functions.  Your hormones work as a symphony. It is not optimal to just increase one hormone without also addressing the others. You also need to feed your body nutrients that it needs to build and metabolize its hormones.  

Everything that a woman needs to feel good, think clearly, sleep well, have sexual desire and maintain normal weight depends on the balance of hormones, nutrients, exercise and lifestyle.  

In our practice, we look at every spoke on this wheel to get woman feeling, thinking, moving, sleeping and looking their best.

What is this Peri-menopause?

Peri-menopause is the time period leading up to official menopause.  

Menopause is defined as the point in time when you have not had your period in 12 months. The average age of menopause in the United States is 51, but don’t let this fool you! The most irritating symptoms of Menopause happen before you stop having your period.  

Did you know that some women can begin experiencing symptoms of being out of balance as early as their 30’s?! It is this time leading up to menopause that women begin to experience the most common effects of decreased hormones. 

 We often hear: 

I have anxiety now, and I never used to. (*I put this one first, because often women don’t associate this symptom with a decrease in their hormones and therefore don’t seek the right sort of help. You are not crazy and you do not need Xanax. Come get your hormones and endocrine system balanced instead.*)

I haven’t been sleeping well for months (or years).  

I used to be so patient, now everything and everybody irritate me.  

I just don’t feel like myself.  

I’m not as sharp as I used to be, will I ever be the same again?  

I’m not interested in sex anymore, and I’m only in my 40’s! Help!  

I workout and eat like a rabbit, and I still can’t lose weight. (Hint, you’re not eating enough… yep, that’s right.)

I never used to gain weight around my waist, now none of my clothes fit and I can’t seem to make it go away.

What’s wrong with me?!

Please don’t chalk any of these up to “getting older” and let yourself tolerate and live with these symptoms.  Peri-menopause can often be a long meandering path. Your quality of life depends partly on balanced hormones.

Why should I begin my journey with BHRT before I hit menopause?

We talk a lot about the symptoms of decreased hormones. What I also want women to know is that hormonal balance is, more importantly, associated with your HEALTH. Estrogen affects almost every tissue or organ system including the heart and blood vessels.  

Women at any age may experience hormone imbalance. Levels decline or fluctuate contributing to debilitating symptoms. BHRT is useful in severe PMS, post-partum depression, menstrual or migraine headaches, and sleeping disorders.

We have newer research that suggests BIO-IDENTICAL hormones can increase good cholesterol and decrease bad cholesterol, stabilize mood, decrease the chance of having osteoporosis, decrease heart disease, enhance memory and concentration, increase skin elasticity and decrease inflammation in the body.  

We believe that over 90% of our human diseases are caused initially by inflammation. I would like every woman to continue to have their hormones work for them and be balanced at the beginning of their decline so that they can stay in optimal health.

What are Bio-Identical Hormones?

This is a question that often causes confusion and often disagreement in the medical community. I did a search for bio-identical hormones and there is a lot of conflicting information out there, some of it from big name health organizations. How do you know what is truth and what is made up, or coming from fear or simply a misunderstanding of the research?

There isn’t enough time here to have a complete and lengthy conversation about all the various research articles that address this, so let me first start with the succinct conclusion drawn from a Pub-Med article that looked at a large amount of research studies done comparing the outcomes of synthetic vs bio-identical hormone use. 

“CONCLUSION: Physiological data and clinical outcomes demonstrate that bio-identical hormones are associated with lower risks, including the risk of breast cancer and cardiovascular disease, and are more efficacious than their synthetic and animal-derived counterparts. Until evidence is found to the contrary, bio-identical hormones remain the preferred method of HRT. Further randomized controlled trials are needed to delineate these differences more clearly.”  Holtorf K1.

The short answer here is, bio-identical means to us, that the hormones we give you are identical in molecular structure to the ones that your body already make. That means they are a perfect fit for the receptor sites that you have waiting for them. They belief is that they then work more synergistically with your physiology than a molecule that isn’t quite the same.  

Bio-identical does not always mean “compounded.” Yes, we often write personalized prescriptions that are specially compounded for you by a pharmacist.  But we can also give you bio-identical hormones in some products that are distributed by major pharmaceutical corporations. The base hormone in both compounded and these certain pharmaceutical products usually come from the same manufacturer.  

The importance here is two-fold, firstly that we are not giving you a synthetic estrogen made from pregnant horse urine (ie: Premarin), and secondly that we are giving you PROGESTERONE, and not one of the 8 different forms of a synthetic progestin.  

When articles state the the Women’s Health Initiative trial increased the risk for heart disease for women on Hormone Replacement Therapy, they often fail to state that these women were taking a progestin, NOT Progesterone. When we study women using Progesterone the results are vastly different often showing the rate of heart disease staying the same or improving.  

You can’t call a progestin and progesterone the same hormone. They are apples and oranges. Articles are often confusing. I could go on and on about this!  Suffice to say I am here to answer your questions and address your concerns.

I keep hearing all about “Pellets,” what are pellets?

I love pellets! Pellets are hormones that are pressed into a cylinder a bit bigger than a grain of rice. Pellets deliver consistent levels of hormones for 3-6 months, depending on the dosage. 

I like them because they help avoid the ups and downs of hormone levels that some women experience with other hormonal methods such as creams or patches. There are many women who don’t tolerate any fluctuation in their hormones.  It can causes some unwanted side effects and symptoms such as headaches, hot flashes and mood swings. Think PMS! Remember how your hormones would fluctuate and take you for a ride? Pellets help stabilize your hormones.  

Here’s a fun fact! Pellet therapy has been used in the United States since the 1930’s.

We place them under the skin around the hip area in a mostly painless process with a bit of local anesthetic. Not many women state that it’s painful. We pride ourselves on being skilled at this minor procedure.

What is Functional Medicine?

This is a definition by Dr. Mark Hymen. I can’t say it better than this.  “Functional Medicine is the future of conventional medicine–available now. It seeks to identify and address the root causes of disease, and views the body as one integrated system, not a collection of independent organs divided up by medical specialties. It treats the whole system, not just the symptoms.”

This means that when you come to see us, we don’t just do your PAP, give you a lab requisition for common bloodwork and send you out the door. We spend time with you and engage in a therapeutic partnership. We search for the cause of your imbalance instead of putting a bandaid on your symptoms.  

We apply the most cutting edge medical research to our practice. Did you know that the average time it takes for new medical research to change the actual practice of conventional medicine is over 40 years? I’m not that patient! I want to use new discoveries in practical application now. Guess who benefits? Yep, the women I care about. We have already gone too long in medicine mostly ignoring women’s individual needs.  Now that we are doing research specific to women, let’s start practicing with this new found knowledge.

What do I do if I have a gene for Breast Cancer?

First of all, congratulations on getting your genome done. I use that information to help guide a personal healthcare plan for you in many areas.

Secondly your genes are not your definitive future. The world of Epigenetics shows that we can make lifestyle, nutrition, supplement, stress reduction and exercise choices to name a few that help to up-regulate and down-regulate our genes in a healthy way. Your DNA shows probabilities and is not a definitive crystal ball of the future. We no longer have a ‘Nature vs. Nurture’ argument.  We know that it’s BOTH.  

According to breast cancer research, 5-10% of breast cancers in women are thought to be due to gene mutations. This is a complex subject that deserves a through discussion.

Bio-identical hormones do not have the same risk of breast cancer as high doses of oral estrogens, like Premarin. Nor, do they increase the risk of breast cancer like the synthetic, chemical progestins used in the Women’s Health Initiative Trial. In fact, data supports that balanced hormones are breast protective.

It’s also very important to maintain a correct estrogen ratio and also monitor hormone metabolite pathways. I do this with urine testing and supporting your body with correct nutrients. There are metabolic pathways that have shown to be healthy for the risk of breast cancer, and some that carry a higher risk. All of this information helps inform the conversations around whether BHRT is right for you.

If you have a family history of breast cancer or a gene variant that you are concerned about, we offer highly refined testing that provides information we can use to help you make the best decision for your future health.

At what point in a women’s life should tests like genomic testing, examining microbiome health & hormonal balance be carried out?

Ideally I would like to see young women in their 20’s know what their genome is. The field of epigenetics is only going to evolve. We are at the cutting edge of using this information to provide personalized medical care. Sure, some of it is probabilities and guesswork, but these are often suggestions that can only help and won’t hurt. As we continue to push the boundaries of stagnant conventional medicine, I believe that genetics will play a larger and more important role than we can even imagine at this juncture.

In terms of the microbiome, if women got this tested when they felt balanced and healthy, then that would give us a foundation to come back to when they presented with symptoms of imbalance. That would be the goal for anyone in my practice. However, it would be especially important to include microbiome testing in anyone who comes in feeling imbalanced.

For hormone testing, it follows the same pattern as the microbiome. I would love to know what a young woman’s hormone levels are in her 20’s or 30’s, and then use that information when her hormones begin to decrease in her 40’s.  But knowing a woman’s hormone levels when she begins to experience symptoms of peri-menopause helps us determine a personalized plan of care.

What would a treatment plan look like?

For a woman who is experiencing symptoms of hormonal imbalance, she would expect to have a very in-depth consultation with me that includes a discussion of her past medical history, symptoms and what she desires to change. I’ll make suggestions for testing that could include hormone balance and metabolite pathway testing, microbiome testing, micronutrient deficiencies, cortisol, review of nutrition and exercise, lifestyle management, toxin evaluation and genetic influences. I also look at all the standard tests for things like thyroid, cholesterol, CRP, Homocysteine, kidney functions, insulin sensitivity and blood sugar to name some.

A common treatment plan usually includes correcting and supporting micro-nutrient needs with targeted supplements, an individualized nutrition plan, recommendations for exercise and stress reduction as well as a personalized hormone regimen and toxin chelation if necessary.  

We evaluate and change this plan on an ongoing basis as her body becomes balanced.

What is intermittent fasting/Fasting mimicking diet and why should I consider it?

I’m sure you’ve heard the buzz about fasting in all of its iterations. I am someone who is very wary of any new “fad” in the diet realm. You name it I’ve seen it. Atkins, Zone, Ketogenic, Vegetarian, Vegan, South Beach, Raw, Mediterranean, DASH, Mayo, Ornish, Paleo, and we might as well add the Standard American Diet, otherwise known as SAD, I love that acronym. 

Dr. Turner and I ran a weight loss clinic at some point in recent history. We learned a lot from that experience. We have been successful in distilling down the things that have been successful, leading to a sustained normal weight and a healthy lifestyle.  

Intermittent fasting, in its various forms, has definitely caught my attention.  Yes, it can help with weight loss in women who have an unhealthy BMI, but more importantly, it seems to assist in mitochondrial function, a decrease in inflammation and therefore has an effect of slowing aging in our cells. Who doesn’t want THAT?! 

The interest we have in providing personalized healthcare in all of its iterations, is to extend not just the life-span of the women we care for but the HEALTH-span. There is not an exact scientific definition for this but in a general sense it is “the application of interventions that appears to broadly delay age-related declines and improve functional measures of aging in several domains and across several ages.”  

In other words, being healthy for the majority of your life-span instead of spending years in poor health. This is what we are aiming for. A fountain of youth? We aren’t naive but we continue to look at all of the available research and apply it to our practice in a safe and healthy way.

Intermittent fasting seems to be living up to our criteria. We offer an easy, scientific, pre-packaged, closely monitored, fasting mimicking diet that is done for 5 days, 3 months in a row, once a year for most people. We look at your bloodwork before and after so we can quantify your improvements. In addition, we offer what we believe to be a healthy eating plan to follow for your life.

Do I need supplements?  How do I know what I need?

The answer is yes but be careful and choosy. What you need is individual. I’ve had conversations for years around the need or rejection of supplement intake. I think part of the problem is that one size does not fit all. Just because your best friend or neighbor is taking something that they swear is the end-all be-all does NOT mean you should be taking it.  

Here are some parameters. Hippocrates said “let food be thy medicine and medicine be thy food”. If we begin here, starting with a nutrient-dense diet is the most important step followed by supplementing with specific nutrients according to your specific needs and goals.  

Needless to say we have substantial evidence that shows the fruits and vegetables mostly available now have far less nutrients in them than in Hippocrates time. Heck, they have far less nutrients than in our grand-parents time!

That brings us to supplements. Ideally, women would take a micronutrient test to actually see what they are deficient in. Bar that, there are some very common nutrient deficiencies in our general population, as well as nutrients that are essential for proper hormone function and metabolism that I want to make sure the women in my practice are taking.

What are some of these common nutrients? The number one on my list is Vitamin-D, actually a hormone precursor, followed closely by Magnesium. B-12 and Folate, preferably in their methylated forms are especially essential for any woman on BHRT or any kind of hormone therapy. Others are Vitamin C, high quality EPA/DHA in proper ratio with Omega-6 in our diet, and a fairly new one for me is Vitamin K-2.  

There are many others that I think are important especially if you are trying to lose weight or dealing with a high toxin load. I like to look at every woman individually to help her choose the right supplements for optimal functioning as well as alter those supplements as she becomes healthier and better balanced.

Author Jill Dozier Hormonal, Anti-Aging & Functional Healthcare Practitioner Women’s Advocate

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