Webinar Replay

Tips For Improving Women’s Health | Lifestyle Medicine Doctor Q&A



Dr. Fontaine, Dr. Scheuer, and Dr. Marbas discuss menopause, hysterectomies, and daily protein intake.

Questions Answered

Complete Transcript

Dr. Laurie Marbas

(00:00)
What we're going to do is we're going to let Dr. Fontaine lead us down the path of her chosen topic today, which is…

Dr. Elisabeth Fontaine

(00:12)
Well, we're going to surround a little bit the woman's life and the action and the impact that the plant-based can have on women at large. So I think that's the biggest topic.

Dr. Laurie Marbas

(00:26)
Okay. So let's do that and we'll let you go ahead and get started. And if you have any questions in the webinar, please feel free to place those in the question, Q and A box. And if you are on, excuse me, if you also on Facebook, feel free to put those on the plant-based TeleHealth page question underneath this video, excuse me. And that's where I will be looking for those and passing those along to Dr. Fontaine. So Take it away Dr. Fontaine.

Dr. Elisabeth Fontaine

(00:58)
Well, hi everybody. So first thing first, I hate to think that people will think I'm excluding the men. But the fact is that my background is in obstetrics and gynecology. So therefore I've practiced 27 years. And in my practice, obviously, I've seen many women of all age, certainly had seen the partner coming when it was time for delivery or OB visit, but it's certainly a little bit more impact on women. And the fact is that the impact of what we put in our body is important from early on. I certainly have seen more starting teenager and then up to, how do you say, menopause and many years after. So I'm not saying that it's excluded for the younger population, but in the preparation to period, menstruation, it's very important that we think about what we put in our body.

Dr. Elisabeth Fontaine

(02:07)
So that usually, early on, we start seeing these young teenager having some problem with their period and, not only that, premenstrual syndrome and sometimes something that we call PCOS, the polycystic ovarian syndrome, which leads to later to weight gain, having some hair and sometime insulin resistant diabetes. So basically brings up to other issue in our life that would be related to something that potentially would do a little bit more with plant-based like chronic disease. And then eventually more in the mid life, often time your regular cycle. And then eventually, lucky us, we get to this perimenopause where the cycle is irregular. We're starting to have those hot flashes and having difficulty sleeping, anxiety. Oh my gosh, you can name it. We all have these symptoms. All women are coming up and all are checking in and saying, “What is it that I can do?”

Dr. Elisabeth Fontaine

(03:13)
And we tend to forget the impact of what we put in our mouth. We want to have a quick fix, like many things in our life, a quick diet, a quick medication, not paying attention that whatever we put in our mouth, especially if we are paying attention to go more plant-based, that this could have a significant impact. So therefore by eating more of the plant-based, I would see often teenager that would eventually get to a more regular cycle. Women perimenopause that will stop having a lot of their symptoms. So it's fascinating to see that they have access to much better control of what's happening with their life. And I think the other aspect, while you think about my supporter that will ask me question, I think the other aspect that I like people to understand and know about me is that my background was also in exercise, physiology and obesity.

Dr. Elisabeth Fontaine

(04:20)
So I'm passionate about trying to help not only women, but people in general that are in the process of doing more exercise and are questioning what is the best diet for me? There is so much information now. There's so confusing that I think it's not a bad idea that you take the time to have a conversation with one of our group to discuss what is it that would be the best for me, in association with the type of exercise that I'm doing to keep myself healthy, and for the performance that you want to achieve. You might be a young athlete, you might be somebody who just want to stay healthy. So that impact of being able to discuss these things. Sometimes I will admit, and most of us will admit in plant-based, that a physician do not have much information or knowledge regarding diet.

Dr. Elisabeth Fontaine

(05:21)
So we study a lot of different element in medicine, but the diet and nutrition is far from being our strength. So for us, at Plant-based TeleHealth, it's something that we're passionate about. And we think that we can certainly help you to become the person that does the exercise. It's fascinating. As a physician, I'm part of different group in Facebook. And I see those physician, fit physician. Gosh, everybody seems to be doing Peloton 10 times more than I do exercise. And I'm like, I'm just, I wonder how healthy these people are eating. I would say that one of the biggest thing that I've seen, me, if it's not eating properly, is often that women do not eat enough. So that's the thing that we like to take time to review what you, and make sure that you support your exercise, whatever level you are.

Dr. Elisabeth Fontaine

(06:20)
So this is my introduction to get the message out there and see if people will react. Come on, ask me question. I'm ready. And I'm sure that Kim and Laurie will have anything, but I don't know if we have anybody in the audience, in the thousands and thousands of people that are listening. There must be tons of question. Just kidding.

Dr. Laurie Marbas

(06:44)
Kim, do you have questions? I have questions, but do you have a question? Go ahead.

Dr. Elisabeth Fontaine

(06:46)
Yeah, go ahead. Hit me.

Dr. Kim Scheuer

(06:50)
So I see a lot of people who, lot of women who are going through menopause and have lots of menopausal symptoms, and wondering what you have to say to people who are going through having hot flashes or trouble sleeping, things like that, to help them?

Dr. Elisabeth Fontaine

(07:05)
So, there's extreme into this. A lot of women, first of all, are scared if we want to discuss about hormone, but we will not get there. I want to be able to allow them to understand that often time, explain what we call the physiology when you get to menopause. So, if you see your ovaries are starting to produce that little eggs every month, which was there to eventually help you to get pregnant, but eventually it comes to an end. And by coming to an end, the two hormones that are very important in our body comes down, the estrogen and the progesterone. And that is why we start to be symptomatic. During our life also, because we're not necessarily eating the best by eating more animal product or fast food or too much sugar, we tend to boost a little bit that level of estrogen so that when we hit the menopause, then that drastic coming down makes it that we have more symptoms basically of the hot flashes.

Dr. Elisabeth Fontaine

(08:09)
So I try to, by explaining that, to tell them that when you go on the plant-based, then you have a boost of a more natural way to help you to get into less symptoms. Takes a little bit of time to accept it. But they're so concerned about taking any hormone, which is not something that I do not do, but it's definitely not my first option. So I just want to make sure that they understand the impact. And then I come with the studies that Dr. Barnard had done recently. Well, we don't have too many studies on women to show us the impact. So Dr. Barnard had published and was it the journal Menopause, taking a group of women that took some soy for about 12 weeks. And on the plant base, and there is a significant reduction of their symptoms of hot flashes.

Dr. Elisabeth Fontaine

(09:06)
So, by having literature that's backing the information, it certainly is helpful. So hopefully we're going to have more evidence-based, even if we see it. I mean, just by doing it, we see people that come to us and say, yeah, I feel better. I sleep better. I'm less anxious. I don't have as much hot flashes. I'm losing weight, by the way. Especially around menopause you have this change in your weight, so that they're happy to hear that, without counting my calories. So I think it's a little bit of the message, which is a little bit longer than just saying, I'm going to give you a pill and you're going to feel better tomorrow, but it's definitely all worth it.

Dr. Laurie Marbas

(09:53)
That's excellent. So we do have a question from Marie Grace, she's saying, how can a woman help her system and body after a hysterectomy?

Dr. Elisabeth Fontaine

(10:02)
So the hysterectomy, depending also when this was done, if it's prior to menopause. But, in itself, the hysterectomy mean that we remove the uterus. It doesn't mean that we remove the ovaries. So it's possible and maybe she include that. People sometimes get a little bit mixed up and say, okay, did they remove the ovaries, only the uterus? If they only remove the uterus, because there's any specific issues, your hormones are still there. The ovaries are still producing your hormones. You just don't have a period to show what's happen every month. And then eventually, once you're going to get to the age of menopause, which is for the majority of us around 50, 52, some will have it early, but the average will be around there. Then you will start having some symptoms of hot flashes. But, in itself, the uterus, when it's gone, once it's removed, for any reason, usually is not the cause of any…

Dr. Elisabeth Fontaine

(11:00)
I see it. Ovaries removed as well. So obviously, when you have the ovaries removed, it's like going in menopause. I remove the ovaries, you're in menopause versus which is a little bit more drastic than having a progressive menopause. When you have your ovaries, your system will do it a little bit more slowly. But when we remove the uterus and ovaries, then the day after you are in menopause, and then usually the symptoms will come a little bit more drastically. And especially if you are in a younger age group. So you'll have, sometime women, we have a tendency not to remove the ovaries in the younger age, but there was a time where it was a little bit more aggressive. And, once the ovaries are removed, especially when you're younger, then to have to support what is lacking of estrogen, is definitely very, very important for the bone mass. She's been plant-based. I can see a little bit of the message at the bottom.

Dr. Laurie Marbas

(12:06)
She said she had her ovaries removed as well for cancer and BRCA gene positive, I'm assuming. And also plant-based for four years and she's 59. So that hits that after menopause, having the [crosstalk 00:12:19].

Dr. Elisabeth Fontaine

(12:18)
So if you say BRCA gene for her, it's probably because of the risk of breast cancer. Sometimes there's other things, but there was good reason for this to be happening. And congratulations for you to have turned to the plant base, because you're giving yourself all the best chance. Because, when you look at what's the biggest risk for, other than genetic, for breast cancer, there's alcohol, but there's also the fat and the food. So very important. Uterine cancer, well, that's not as often for the uterine cancer for the BRCA. But hey, that's… And no alcohol, super. Excellent. You're doing everything you can do here is really good. So continue as you are. And this is in the best direction what you're doing.

Dr. Laurie Marbas

(13:12)
And speaking to the alcohol, someone did ask, “Is wine okay?” So what are your thoughts on alcohol and what should they be thinking or looking at when they decide, should they do that or not?

Dr. Elisabeth Fontaine

(13:23)
So, in itself, depending of what we are discussing here. So in the situation of, as an example, I would say talking about breast cancer. So we know that breast cancer, if you look at what are the most cause relationship, besides the genes, genetic, alcohol and obesity are strong correlation. So this population certainly wouldn't be encouraging to drink too, too much. Women in menopause will often say that alcohol, glass of wine, will trigger the hot flashes. So when you try to find what's the trigger factor, if it is a glass of wine, it's not that it's purely contraindicated, but if you see you're not helping yourself by drinking a glass of wine. Now, if it's on average, if you don't have any particular of these symptoms related, it's not that it's bad to take a glass of wine.

Dr. Elisabeth Fontaine

(14:23)
We've had a lot of studies that are pros and cons regarding one glass of wine could be good. You look at the blue zone, the majority of the population that survive above hundred, were all taking a little glass of wine. So it's not only the alcohol or glass of wine or glass of something. I know they were drinking something. But it's all the element that surround these individual. They're moving every day. They're not sitting at a computer every day. They mostly eat plant-based. They have a social support. Was it in Japan? A purpose for living. It's all these element. It's not only one. We got to be careful with time to orient ourself to let's say, it's important to diet, but it's all the element around that are very, very important.

Dr. Elisabeth Fontaine

(15:14)
And the blue zone is a good example. Because when they start studying the blue zone, they were looking for a gene. There has to be a reason for these guys to be able to live up to a hundred. So they did all the blood work that could exist. And then they realized, nope, that's not it. It's all the environments, all what those people are doing on a day to day basis. That's what makes the impact.

Dr. Laurie Marbas

(15:39)
Exactly. I couldn't agree more. So someone else had a question about vitamin D supplements, are these considered hormones, vitamins? Where do they have place for maybe women in this premenopausal, menopausal phase or even younger? So what are any thoughts on vitamin D?

Dr. Elisabeth Fontaine

(15:55)
Yeah. Vitamin D is important. Vitamin D is more like a hormones that is in relationship with the calcium to try to help us to maintain our bone mass. So in the prevention of osteoporosis, that's definitely a good idea. I have to admit, we find more and more people that are deficient in vitamin D and I'll say more, maybe me I'm in Vermont. So obviously during winter time, even if I'm somebody who totally enjoy being outside. And with age, if you measure your vitamin D since a certain time, you will… I've done it and I see that. I mean, I'm not doing anything different, but my vitamin D level is decreasing. So I've started taking, especially in winter. In summer, I'm out pretty much every day with the sun, but in the winter, definitely taking some vitamin D supplements.

Dr. Elisabeth Fontaine

(16:51)
So when you think about plant base, if there's two things that we like to take to definitely having as a supplement is the B12 and the vitamin D, especially for women. Definitely something very important. So thank you. That was a great question. I mean, if you guys have anything to add that Dr. Fontaine might forget, go ahead.

Dr. Kim Scheuer

(17:12)
I was thinking about the vitamin D question and, in this day of COVID, it's actually very protective too. So making sure your vitamin D level is up is good and being outside is very important. But, as you said, in the wintertime we're covered up and we don't get enough exposure. So make sure that you're getting that for sure.

Dr. Elisabeth Fontaine

(17:30)
Yeah, that was a good point. I saw that study and I said, here we go again. The vitamin D is a protective factor against the COVID. And then for the general people that are listening, I don't know if you realized that a lot of the people that are hospitalized, besides the one that are unvaccinated, it's the people that have chronic disease and people that may not be eating the best diet. So, when you look at the burden of what's happening in hospital and the hospital's already very packed with people that have chronic disease, and now we're pulling the people that have COVID. So if we were able to clean a little bit, the chronic disease, by eating better, then that would be making such a huge difference. So thank you. That was definitely good to add here.

Dr. Laurie Marbas

(18:25)
So I'm going to mix a few questions and merge a few questions. So, with the vitamin D, what would you consider a good level of protection for osteoporosis, your immunities and things like that?

Dr. Elisabeth Fontaine

(18:37)
Yeah, I don't think we can say that there's a level that will allow us to have no osteoporosis, because you could have normal level and you're going to be at higher risk. When you think about women after menopause, it has this lack of estrogen. If you don't do any resistant exercise to help you to maintain your bone mass, if you don't have the proper diet that allow you to have a better level of calcium, because the calcium supplement will never be as good as the calcium that you take in your diet. So that being said, when you look at, you may help me with the, if it's nanogram picogram…

Dr. Laurie Marbas

(19:20)
Nanogram per deciliter.

Dr. Elisabeth Fontaine

(19:21)
Yeah. So it's more into the 40, 50, at least, in order to say that it's, quote unquote, adequate level. But again, I want you to be careful of not taking only one thing. It's the different little element that I mentioned. And there's probably more to this, if you think about anything else, Kim and Laurie. But that's always what we discuss. You got to do a little bit of movement every day, resistant exercise. Which we hate doing as we age and especially now. Well, first of all, imagine somebody like me, a hundred pounds going to the weight training room with those teenager guys that are just like… I mean, you know, it's not a comfortable and we don't do it. So therefore now we have to buy some weight. We got to make the effort there.

Dr. Elisabeth Fontaine

(20:16)
And I'm saying that as a joke, but I have no problem with going to the gym at not a good time now. I haven't been to the gym in two years, so I have my own gym. But we really need to make that effort of keeping active. Do it with a group. Find something that will allow you to continue being active and then discussing with a plant-based physician that can support your dream and the way you do things. That's very important.

Dr. Laurie Marbas

(20:47)
Great advice. So now we're going to jump to B12 and someone, Richard asked, “Can you talk about homocysteine levels in vegans? Mine was slightly elevated, started taking one gram of creatine per Dr. Greger's advice. Is there something I should always take to keep the levels down?”

Dr. Elisabeth Fontaine

(21:07)
Kim, this question is for you. That's not my specialty, the homocysteine.

Dr. Kim Scheuer

(21:15)
So what you want to do is have as much anti-inflammatory foods as possible. Avoid things that will increase your homocysteine and increase your risk factors that are associated with homocysteine or heart disease and things like that. So I would definitely be taking the B12, make sure your levels are good. And homocysteine is actually probably a better indicator of B12 than just the B12 level. You want to look at the methylmalonic acid also. But I would say increasing your fiber and getting rid of any kind of toxins that you would have, increasing your exercise. Laurie, if you have any others?

Dr. Laurie Marbas

(21:58)
Yeah. So the beautiful thing about these amazing physicians at Plant-based TeleHealth is we have the largest data set, I would love for someone to challenge me on this, on plant-based eaters. So we're in business now for almost two years. We have thousands and thousands of patients, labs on thousands and thousands of patients. We are seeing trends. And one of the ones that stood out, specifically around B12, is a lot of people are taking the methylated B12. And so it's not such a big deal, you didn't think. But what I'm seeing is that their homocysteines are elevated. Their B12 levels are okay, but their homocysteine will remain elevated. We switch them to the cyanocobalamin and, guess what, the homocysteine's dropping. So I think what's happening is there are pathways that B12s go down and they get shunted.

Dr. Laurie Marbas

(22:48)
If you just take a methylated B12, they get shunted down a particular pathway and the homocysteine is being less effective. So I would encourage you to look at the type of B12 that you're taking. The levels that I would suggest are between 600, 1100, 1200 somewhere there, because that's where I see the homocysteine is normalized, the methylmalonic acid's normalized, and people are not having the tingling and the weird symptoms, or the MCV in their red blood cells are not being elevated. So that's the beautiful thing about coming to see Dr. Fontaine or Dr. Scheuer, you're going to see these amazing… They have this incredible experience. So guys check them out, plantbasedTeleHealth.com. So keep going. But anything else there, I think we had some more questions.

Dr. Elisabeth Fontaine

(23:33)
It's interesting because if you say me, my interest is more in female, so it's good that we talk about the B12 a little bit more. So you have a tendency to always… People to do both, B12 and homocysteine.

Dr. Laurie Marbas

(23:49)
Yeah and I check methylmalonic acid. So I check methylmalonic acid, homocysteine and B12. If the cost is an issue or their insurance won't cover it, we'll just do the B12. But then I look for, make sure we try to get it above 600, if I don't have those other indicators. Because people are diabetic, they come in on medications or they're on Harper medications, all those decrease your absorption. As you get older, you decrease your absorption. And once a week may not be sufficient for most people as well. Another thing I'm finding is that it needs to be a daily or multiple times a week dosing because I don't think we absorb enough in one setting. At least that's what I'm finding. Not everyone.

Dr. Elisabeth Fontaine

(24:30)
That is interesting. Not that I want to stick to the subject, because taking it once a day, as opposed to potentially… There's a lot of discussion regarding, you do it once a week. Isn't it Dr. Greger that says? I don't want to get him in trouble here.

Dr. Laurie Marbas

(24:51)
Yeah, no it is. Dr. Greger mentions, I think, 2,500 micrograms once a week and that may be sufficient for some young people, not on issue, but I have not found it to be sufficient in most people. So what I'm finding is there needing anywhere between 500 and a thousand micrograms daily to get the homocysteine in line, the methylmalonic acid in line, MCVs in line and symptoms are abated. So that's been my experience with seeing patients and caring for patients. Kim, any thoughts on that?

Dr. Kim Scheuer

(25:20)
And this is one of the places where going to see an individual physician, like at Plant-based TeleHealth, to ask these questions is really important because 90 to 95% of this is the same. Eat healthy, exercise more, stress less. But there are tweaks that we all can do with each of our patients that is important for each individual. So I think that this is a great example of Dr. Greger had said the once a week, and for most people that's probably okay. But, as Dr. Marbas and I have both found with our patients, I do switch them to once a day if there's issues.

Dr. Laurie Marbas

(25:55)
Exactly. And someone else mentioned too, they have MTHFR. So now let's say you have to take a methylate…

Dr. Elisabeth Fontaine

(26:00)
Not an easy one to say.

Dr. Laurie Marbas

(26:07)
A methylated B12. Goodness gracious. I would also add adenosyl. So there are certain brands, and we could recommend those to you, that have the methylated and adenosyl. And we have some articles that are helped to explain it. And honestly, we all learned from our patients. It was a patient who sent me an article that I was like, oh, wait a minute. There is something going on here. Because we were frustrated too. We keep seeing these elevated homocysteine and you're thinking, yeah, the methylated B12 is okay. And then I was like, okay, hold up a second. We need to… And sure enough, it pans out. So there's that. So you're also getting, not only the knowledge of the doctors, but all the other patients that educate us. I mean, we're very humble and open to education. At least I am.

Dr. Elisabeth Fontaine

(26:55)
Well, I have found that in the Plant-based TeleHealth population that I see, I am amazed how much they read and how much their knowledge. Sometimes they crack me up and I'm like I said, I haven't read that. You're going to have to send that to me. And, like you said, we really have to use humility and say, yes, I will definitely review that with you.

Dr. Laurie Marbas

(27:21)
I love it. It keeps me on my toes. Honestly, it makes me feel smarter because people are teaching me stuff all the time. I'm like sweet. I don't have to go looking for this. They're teaching me. Excellent. So we had a question also, Elisabeth, I think it'll be right up your alley and Kim, because I know you do a lot of workouts too, with the weights. What is a good amount of protein to get in a day for a person who does weight training?

Dr. Elisabeth Fontaine

(27:45)
She wants to know how much protein?

Dr. Laurie Marbas

(27:48)
How much protein she should be looking at per day if she has weight training, probably I'm assuming, wanting to attain more muscle mass. What would you say is a good suggestion?

Dr. Elisabeth Fontaine

(27:56)
So I don't know what, Kim, you've seen. Personally, it's amazing how much people think that we need surplus of protein, unless you are really a body builder. Once you take time to analyze, let's say, into my fitness pal or chronometer of what you are eating, you'll be amazed to see that you have your good 10%, 15% of protein. And there is no substantial reason for you to need more protein. What you need is to make sure that you have the proper amount of food and carbs after the exercise, or even before, during for biking and all that. That's different. But Kim, anything you want to add to this? What do you think?

Dr. Kim Scheuer

(28:46)
So I hundred percent agree with you that it's the calories. You need the calories and with the calories you'll get, of a whole food plant-based diet, you'll get the appropriate amount of protein. They're talking about 1.2 gram per kilogram as an average. And then you can go up a little bit more, but I just find that one, to gain muscle, you need the calories. But two, you need to actually do the work. You need to do the resistance exercise. So I would make sure I don't worry about protein. I don't add protein shakes. As we get older, we do need a little extra protein in our diets so that's something to consider, but just eat more healthy proteins and eat more healthy foods that have that and you'll get plenty.

Dr. Kim Scheuer

(29:29)
And somebody else was asking about saturated fat from plant being potentially harmful in excess. You don't want to eat so much that it… So if you have saturated fats from, say, coconut, things like that, that's not good because that causes problems that way. So come see one of us at Plant-based TeleHealth and we'll help you be specific in your diet as to how much you need of the protein, the fat, et cetera. But it's really calories. You need to get that in and then do the work.

Dr. Elisabeth Fontaine

(30:06)
Yeah, that is so true with the calories. Like I was saying earlier for women, usually not even exercise, they're actually obsessed with weight loss and they don't eat enough. They still gain weight. They don't eat at the right time. And if you are doing exercise, like Kim had said, it's the calories. It's really just to make sure you put enough calories in your body. And with the age, well, we have a tendency to eat less. We're socially a little bit more by ourself, couple. We don't cook as much. We eat less. So we have to encourage ourself to continue eating the proper amount of calories, especially that it is so easy with age to lose muscle mass, which is important for everything else, prevention of osteoporosis, prevention of stability that is huge to prevent any bone fracture.

Dr. Laurie Marbas

(31:15)
Absolutely. Very good. Yeah. And you just mentioned, Kim, needing more protein as we get older. They're recommending one gram per kilogram. So if someone wants to calculate that for themselves, feel free to do that. Should we limit salt? How about just two more questions and then I know we got to go. Should we limit salt or sodium in general? Example, using Braggs Aminos instead of salt? Any ideas?

Dr. Elisabeth Fontaine

(31:41)
What's the Braggs Aminos? I have to admit them last year.

Dr. Laurie Marbas

(31:45)
It's-

Dr. Elisabeth Fontaine

(31:45)
These people have too much.

Dr. Laurie Marbas

(31:47)
It's like miso sort of, it's a salty [crosstalk 00:31:49].

Dr. Elisabeth Fontaine

(31:49)
Again, I think we got to be careful because we become so specific. So it's definitely not a good idea… Our diet in general, anything that we buy has too much salt. So you got to keep an eye on that. That's where the issue is most than anything else. And if you say, if you have to use salt because you like it, it's definitely better that you take the one that you have at home and add it as opposed to have it into any element that you buy. Even what we discuss as being, quote unquote, vegan. A lot of that, like the Tempe that you buy that is with a specific aroma. While it may be good, there's a lot of salt. So be careful. So those are the element that you have to pay attention to it. Kim?

Dr. Kim Scheuer

(32:48)
I like to limit salt. I don't like to get it in my containers of foods. If you ever have to look at a package, look at the sodium versus the calories. And if the sodium is more than the calories, you want to avoid that. It's a good way to really quickly look at a package. But limiting salt is something that I definitely do myself. I don't have salt in my house. If you're going to use it, miso or soy sauce, still go for the low sodium, but be aware there's a lot of salt in there. And if you have blood pressure issues, if you have… It's associated with cancers, it's associated with lots of different things. So be aware of it.

Dr. Kim Scheuer

(33:28)
It takes a while to get used to not having salt in your diet. Your taste buds take a little while to get used to that. But once you've done that, once you take salt out, when you have something that somebody else thinks is bland, you can think, ooh, this is really salty. So be aware that it takes time to change your palate. I like to do things like add lemon juice to some things, which make it taste saltier. I like to add umami flavors and lots of spices and that helps a lot too. So I would suggest limiting, but also Dr. Marbas, anything on that?

Dr. Laurie Marbas

(34:03)
Yeah. So I love everything you guys are saying. Absolutely limit your salt, but on the other flip side, in the United States and around the world, most of our iodine comes from iodized salt. So another trend we're seeing over here at Plant-based TeleHealth is this interesting iodine deficiency. It's coming rampant actually, in my really strict what we call SOS eaters. Salt, oil, sugar free eaters, which I praise and appreciate and love. But now we got to look at our iodine. That's going to affect our thyroid. And so it's simple to replace. Some people want to do nori sheets, sea vegetables. You just got to be really careful. One, where are those sourced? How much are you getting? Too much is also an issue. The goal will be about 150 micrograms of iodine daily. So, again, come see one of us. You don't want to do a blood test for iodine.

Dr. Laurie Marbas

(34:53)
You should have a 24 hour urine test. That's more accurate. These amazing doctors can take care of you and help you figure out exactly what you need to be doing. And if you were recently diagnosed with thyroid disorder and you're plant-based, that would be my first clue that there's an iodine issue. So definitely I've had some people recover. I know you guys have seen that. So definitely, definitely. Someone had also just mentioned supporting adrenals. I feel like there's a… I want to put this out there to let you guys address as well. But people with all this adrenal fatigue syndrome is not a recognized medical diagnosis. It was put out there, I think, by someone who's just putting stuff out there trying to sell supplements. I'm not sure. But if your adrenals aren't working, you're super sick. You're probably in the hospital and you've probably been diagnosed much earlier in taking shots and doing different things. So I'll leave that to you guys. Anything else out there? Questions about adrenal glands?

Dr. Elisabeth Fontaine

(35:46)
I think that it came to the fact that people are so exhausted and tired, so we have to find a reason and you're right. It's only allowed to put on the market a lot of element that could, quote unquote, are supposed to be helpful. But it is true that after years of stress and lack of sleep and not eating correctly, it's not unlikely that your body… I don't know if it's only the adrenal, but it's not unlikely that your body will react differently and it will take time for your body to recuperate. It does take time, so got to be patient. But by nutritionally putting your body into proper plant base, you certainly are giving yourself the best chance. We, as a group, I do believe I'm not mistaken here, don't use any tons of supplement to try.

Dr. Elisabeth Fontaine

(36:44)
We think that what you can find in the plant-based diet will be an enormous gain to help you to support anything that maybe the environment… Obviously you have to correct a little bit, your environment, the stress and everything else, but the nutrition is huge. We tend to forget that. It's so important. We tend to forget. I don't know, Kim, you think something different?

Dr. Kim Scheuer

(37:12)
I agree. The diet, getting your nutrients from the diet. Stress reduction is huge. Exercise is very important. And what kind and what type and how much. You can overexercise, you can under exercise. So we can help you with that too.

Dr. Laurie Marbas

(37:30)
Absolutely.

Dr. Elisabeth Fontaine

(37:32)
I'm planning to go visit Kim because looks like she's hiking every day.

Dr. Laurie Marbas

(37:38)
This girl, she-

Dr. Elisabeth Fontaine

(37:38)
It's a little cool now, but I look at her [crosstalk 00:37:41].

Dr. Laurie Marbas

(37:40)
All right. I'm going to tell you right now. Yes. I agree. I've been hiking with this woman in mountains in Colorado. And I was like, “Hey Kim, wait up.” [crosstalk 00:37:50]. And she's like… Even my husband's like, “Dang, she's a machine. She's a mountain goat. What are you talking about?” So yes, definitely knows what she's talking about, let me tell you. And I was like, holy smackers. But there's this one last question and then we're going to be done, guys. “My B12,” she said, “was 973. The summary I got noted that it was high. But when I asked my doctor about it, she said, no worries. Just reduce the amount of B12 I've been taking. I have stopped taking it. I'm not sure when I should get the B12 tested again. No advice from my doctor. I'm 67, plant-based for 12 years.” Any suggestions or thought on that patient? Person, not patient yet.

Dr. Elisabeth Fontaine

(38:36)
Kim, it's you, B12.

Dr. Kim Scheuer

(38:36)
Well, I was going to let Laurie handle this one, but-

Dr. Laurie Marbas

(38:39)
Yeah. So 973 is actually an adequate level. I think that's fine. So honestly, as a plant-based person, I don't know how long you've been stopping it. That's worrisome to me. Anyone who would say that and not tell you to reduce it and knowing that you don't have an adequate supply daily in your food is worrisome. So you honestly should be seeing one of these doctors on Plant-based TeleHealth and let them help you direct you your B12 levels. Because, honestly, I would've not said not to worry about it, that you're fine. And a low B12 level is a big deal, because it can have some permanent damage that can be quite worrisome and concerning. So I think I would personally suggest getting it tested again, usually within three months, if you are worried that that's still too high. But I don't think that is too high from the standpoint of normal labs. But anyways, no worries there.

Dr. Kim Scheuer

(39:31)
I've had patients do the same thing where their doctors say stop that and they don't realize what a plant-based diet means. And so not exactly what I would've done either.

Dr. Laurie Marbas

(39:40)
Yeah. And then they go off and never start it again. So yeah, exactly. All right guys. Well, thank you so much. These amazing doctors and Dr. Fontaine for sharing your wonderful experience and advice-

Dr. Elisabeth Fontaine

(39:55)
Wisdom. We call that wisdom.

Dr. Laurie Marbas

(39:58)
Wisdom, wisdom. Yes. I love it. I always tell patients as we get older, we get wiser. We are not getting older per se, just wiser.

Dr. Elisabeth Fontaine

(40:08)
I do have that.

Dr. Laurie Marbas

(40:09)
50 is the new 30 and 60 is the new 40 and that's what I'm saying. All right guys. Thank you everyone for joining us. And we will be here. Remember, first of all, plantbasedtelehealth.com. We are in all 50 states. Our doctors are amazing. Dr. Fontaine, you want to mention which states you're in?

Dr. Elisabeth Fontaine

(40:31)
Vermont, Michigan, New York, Florida and West Virginia.

Dr. Laurie Marbas

(40:35)
Cool. And Dr. Scheuer?

Dr. Kim Scheuer

(40:38)
Oh, I've got 21 states. I will have to… Go to plantbasedtelehealth.com.

Dr. Laurie Marbas

(40:42)
Click on Kim's. Yes. Click on her… Yes. 21. There you go. And you will definitely find a doctor who's available in the states that you're in.
*Recorded on 1.7.22

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