Episode 2
James Howton, DO:
Are Hormones the Missing Link?
In today’s episode we hear from my Functional Medicine Doctor, Dr. James Howton about the importance of optimal hormones, and the role that hormones play in autoimmunity. Dr. Howton was an early adopter, using bioidentical hormones in his practice since the mid 1990’s. We discuss the difference between hormones “in the normal range” and optimal levels, as well as why normalizing our symptoms isn’t to our benefit. Dr. Howton also addresses one of my favorite topics, the importance of mindset on overall health. Listen to our conversation and make sure you aren’t missing an important piece of your health puzzle.
First Aired on: Oct 9, 2021
Episode 2
James Howton, DO:
Are Hormones the Missing Link?
In today’s episode we hear from my Functional Medicine Doctor, Dr. James Howton about the importance of optimal hormones, and the role that hormones play in autoimmunity. Dr. Howton was an early adopter, using bioidentical hormones in his practice since the mid 1990’s. We discuss the difference between hormones “in the normal range” and optimal levels, as well as why normalizing our symptoms isn’t to our benefit. Dr. Howton also addresses one of my favorite topics, the importance of mindset on overall health. Listen to our conversation and make sure you aren’t missing an important piece of your health puzzle.
First Aired on: Oct 9, 2021
Table of Contents:
In this episode:
In today’s episode we hear from my Functional Medicine Doctor, Dr. James Howton about the importance of optimal hormones, and the role that hormones play in autoimmunity. Dr. Howton was an early adopter, using bioidentical hormones in his practice since the mid 1990’s. We discuss the difference between hormones “in the normal range” and optimal levels, as well as why normalizing our symptoms isn’t to our benefit. Dr. Howton also addresses one of my favorite topics, the importance of mindset on overall health. Listen to our conversation and make sure you aren’t missing an important piece of your health puzzle.
Other Resources:
Connect with James Howton, DO
Episode Transcript
[Page//00:00:00] Julie Michelson: Welcome back to the inspired living with auto-immunity podcast. I'm your host, Julie Michaelson. And today I'm so excited to be joined by Dr. James Howton,
[Page//00:00:43] Thank you so much for joining us today. I always love to start off with a little icebreaker. So what is, don't be nervous. You get to choose your response. What is something that most people or maybe [Page//00:01:00] many people. Might not know about you, just a little, a fun fact.
[Page//00:01:03] James Howton: Great. Instead of a medical question, the current, they grew up in Columbia and south America came to the states when I was 15.
[Page//00:01:12] Most people don't know that
[Page//00:01:13] Julie Michelson: I would imagine most people don't.
[Page//00:01:15] James Howton: Sometimes they pick up in a little accent or something, but they can't usually place where it comes from.
[Page//00:01:20] Julie Michelson: I actually had that experience when I first met you. So that is a good one. Many of the guests that I have on the podcast have their own personal health journey.
[Page//00:01:31] That's led them to the functional medicine world. And I know that that's not the case for you. So tell us a little bit about how you went from a traditional Western family medicine practice to practicing functional medicine,
[Page//00:01:47] James Howton: maybe. Curious are you? The whole traditional season was a great season and I was privileged to be in a small town and that to do the whole cradle to grave thing from delivering [Page//00:02:00] babies, the cover in the ER, taking care of grandma in the nursing home.
[Page//00:02:03] And so that I loved that it was a fun time, but over time medicine started becoming about productivity and I would round them people before family would get there in the morning. And, you know, you started getting pushed the 10 minute visits. And at some point it hit me, like I was having an on prescriptions all day long and started feeling the, you know, people would ask me, how can I be healthier?
[Page//00:02:26] How can I improve my health? I was like, I don't know that I had a whole lot to offer them. I could patch up things well, and, and the acute care part of medicine was great, but it was sorta kind of a little coming to sort of midlife thing of, Hey, Mrs. Is really what I signed up for. And I'm so. Started a journey of looking for better ways of doing things and, and being open-minded.
[Page//00:02:49] And when people would come in and say, Hey, what about softball metal for my prostate? I would say, well, let's try it. And remeasure. Levels in a few weeks. And the [Page//00:03:00] more I did that, the more I started seeing that, Hey, there, there are things outside of my conventional toolbox that actually worked. And that made me more curious and, you know, just kind of propelled it once you, once you get hooked on that root cause approach, it's kind of hard to go back.
[Page//00:03:13] That
[Page//00:03:13] Julie Michelson: is very, very true. I know from your bio that you started working with bio identical hormones back in the mid nineties, is that accurate? That seems early to me as far as you know, it seems like you were maybe a little bit ahead of the curve. How did that. Yeah. And how did that happen? How do you all of a sudden become one of the early adopters, something
[Page//00:03:43] James Howton: like that.
[Page//00:03:43] It was maybe that sort of mindset and there, maybe it ties to the whole thing of growing up in another country and seeing that there's more one more than one way of doing things and, and, you know, cannot be in the. Never fitting in one world. And so, you know, when I think I came across an article one time on [Page//00:04:00] depression and men and testosterone levels, and, and I remember pulling the charts of guys that I had in SSRS and, and looking at hormone levels and low and behold, there was like the number of people that were.
[Page//00:04:13] Had really hormonal issues. And when you address them, they were able to get off their medications. And so it made me curious about hormones and at the time AFRM was sort of fairly new group and went to some other courses and, you know, it started, it made sense that you know, all the prescriptions that I was writing for Premarin and those types of hormones, that, that didn't make as much sense as the bio-identical hormones that our body.
[Page//00:04:37] Making them ever since we were teenagers. And so it just propelled the transition and the more I played with it, the more. You know, the better people did and you know, it just kind of part-time back from there.
[Page//00:04:52] Julie Michelson: There's so much in there that I want to unpack. I want to circle back to what our bio identical hormones and what is [Page//00:05:00] the difference?
[Page//00:05:00] You mentioned Premarin. But before I do that, Share with our listeners. You know, obviously my focus is auto-immunity, why am I having you on talking about hormones? What is this connection between, you know, why should they care? Why, why are their hormones important? And, and cause I'm going to give you a lot of things.
[Page//00:05:23] And, and what hormones are you talking about? I know you mentioned testosterone and your men you know, maybe some of us have different ideas when we hear hormones. Exactly what you're talking.
[Page//00:05:32] James Howton: And the hormones are kind of one of those things, you know, By no means, am I saying that they're the thing with auto-immunity, but you know, we've in a functional medicine model.
[Page//00:05:41] We still look at all the things that we look at, right? From gut health to food sensitivities, to toxins the mindset and all those things that play into it. But hormones are often kind of ignored. And and so when you ask me about, Hey, what would you contribute? You know, the thought with hormones to say, it's something that [Page//00:06:00] commonly and we'll get into into it.
[Page//00:06:02] Tom commonly gets ignored and commonly gets blamed on other things and just not addressed properly. And I find that it makes a huge difference when we're treating autoimmunity.
[Page//00:06:13] Julie Michelson: I, I definitely agree. Having had my own personal experiences with hormones and auto-immunity, but also I say to my clients all the time they doctor, after doctor can't connect the dots for them, or they always say, you know, the week around my cycle, My pain is worse.
[Page//00:06:30] My infant, they know, like they can tell they feel worse. There's a connection. And so often, you know, they're, they're not addressed as, as you said. And I do think it is the missing piece or Amy a missing piece. I know we talk about all the time, the hill ABI. I talk about all the time, you know, nutrition and diet and detox and stress management and sleep and move the proper movement levels.
[Page//00:06:58] But. So [Page//00:07:00] many, and those are things that almost everybody talks about. If they're taking a whole health approach to auto-immunity, but not necessarily hormones.
[Page//00:07:11] James Howton: Following up on what is a bio-identical hormone. I remember with residents when they would rotate through is it's the idea, it's the idea of it's the same molecule that our bodies make, you know?
[Page//00:07:22] And so it's the example of Premarin. Premarin comes from pregnant, married. So it's a bio-identical hormone for horses, you know, but we still use it. So, you know, it's still widely used in America
[Page//00:07:35] Julie Michelson: for those that don't know
[Page//00:07:37] James Howton: there's an issue, then it's a prescription estrogen that gets used for menopause symptoms and has made from calf catheterize horses.
[Page//00:07:45] I think. You know, and they're distilling and extracting their estrogen out of their urine. And so that's not a bio-identical hormone. And the old days we would use pig insulin for diabetics and it would save people's lives and it was wonderful. And then when labs could [Page//00:08:00] synthesize a bio-identical human insulin, Then, Hey, nobody would dream of using pig in anymore.
[Page//00:08:07] Right? So it's fascinating with sex hormones that we still have a number of hormones being used for men and women, but don't look at all like our natural hormones. And so the first step is, Hey, we're talking about, bio-identical not just hormones. And you've won one out there.
[Page//00:08:24] Julie Michelson: And you mentioned sex hormones specifically, but I know, especially with auto-immunity, there's some other hormones that know.
[Page//00:08:32] I know, I know personally because full disclosure, Dr. Helton is my doctor. So I know what you look for. I know what you look at and, and how you address those issues, but more commonly, I think if somebody with auto-immunity is to get a smaller panel, Hopefully, although if it's not a functional medicine panel, even something like thyroid might not be
[Page//00:08:56] James Howton: fully complete cover that.
[Page//00:08:59] A lot with [Page//00:09:00] people. So when I think of hormones, I like the concept of a symphony. And so in that symphony, I think of sex hormones, that's in different in the two, three estrogens that we have in our body. There's progesterone, testosterone. Those are kinda the three biggies. We think of adrenal hormones like cortisol and the AGA we think of hormones like pregnenolone.
[Page//00:09:20] And we think of thyroid hormones, like, you know, free T4, free T3, TSH, thyroid antibodies. And then we think of neuro-transmitters which all kind of symptoms of all of those sort of overlap. And I tell people, many people that come into the office have, oh, I read about adrenals or I read about X, Y, and Z.
[Page//00:09:38] And they did the right things. And I tell them, it's kind of like taking a symphony and fine-tuning the strings. Perfect. Did the right thing. But if you ignore percussion or other parts of the symphony, the music may still sound crappy. And so that sort of, and people think, oh crap, I didn't do the right thing.
[Page//00:09:54] And then they move on to the next thing, the next book, the next specialist that does thyroid. [Page//00:10:00] And they do all the right things with that. Right. But if they're ignored and adrenals still don't function optimally. And so the whole point with a functional medicine approach is we want to address the whole symphony.
[Page//00:10:11] Julie Michelson: Well, do you know? I love that. I think it's the only way to do it, to do it. It's the right way to do it. So I w I brought up this idea of, you know, I see all the time that the, as especially women, as their hormones fluctuate, their symptoms will change as well. Let's talk a little bit about, at what point do you believe somebody should even get their hormones
[Page//00:10:37] James Howton: checked?
[Page//00:10:38] That's great. Part of our basic panels whether someone's a teenager or 18 year old grandma always. All those hormones we've talked about. And it's fascinating because the more you look at things more you, more data, you get the more patterns you see, the more you see though, interesting. When you improve hormones or cholesterol goes [Page//00:11:00] down and et cetera.
[Page//00:11:00] So this is fun. Not be, if, if we go to a functional medicine approach with it, when I go back to that symptom driven and only check the labs for something that has an obvious symptom associated with them. So we look at them from the start on and, and and don't discriminate. So that based on age and make the focus, Hey, are they optimal for, or are they conducive to optimal health?
[Page//00:11:23] Whether someone's a teenager or whether they're late in life?
[Page//00:11:30] Julie Michelson: Thank you for that explanation. Because I think so often we wait until we can't tolerate symptoms, even check. And so this idea of, you know, or why not a young girl, which leads me to. This idea of weeds. I talk about a lot with different guests about how we all normalize our symptoms, or, you know, whether it's, and it doesn't have to be auto-immunity even just, you know I'm getting older, you know, I should hurt.
[Page//00:11:59] I should be [Page//00:12:00] tired. No, no, no. And I know you have an anti-aging focus in your practice, but. What is normal and you use the word optimal. And so let's kind of get into normal, normal ranges, labs, and normal symptoms. As a woman does pay now, I was certainly taught that certain things are to be expected and there's discomforts with just being a woman.
[Page//00:12:26] James Howton: So you'd be amazed. How many ladies, if you ask the question. Any issues with, with cycles or hormones? No, ma'am I'm normal. Right? And then you asked that 40 year old, any PMs or breast tenderness or water retention or craving or headaches that are cyclical. Oh yeah. You know, but I've had that all my life.
[Page//00:12:43] And so, so there's a tendency that if that's been a pattern from early on, that it becomes, like you said, normalize, and so people don't address it and they're walking around a good chunk of, you know, it's such a waste when you think of. Why have [Page//00:13:00] three, four days that are crappy days out of the month, you know, an add that over a lifetime or adulthood, it's a waste.
[Page//00:13:07] And it's something that can be addressed. Your normals are, it's an interesting concept because the abnormals are bell curves of a population at large. And so, so a lab will take all the numbers that are coming in and do a statistical and, and we see the numbers sort of shift, you know, depending on. On what's coming in through the door.
[Page//00:13:28] One of our labs that we work with it's funny last year, the normal range for post-menopausal woman testosterone went from four to 82 to like four to 312 because there's more women that are post-menopausal that are using testosterone. So it's become sort of a thing and it literally shifted the normal range by several faults, which is crazy when you think about it.
[Page//00:13:53] So if we, if you think of that's what normal is, and if you come in through the door and you're within that bell curve, [Page//00:14:00] you may be told you're normal, you're fine. You know, it's not your hormones. And if you accept that for an answer, then you may not be. Well-served you may not be addressing the issues.
[Page//00:14:13] Does that make sense? And so, so when I think of optimal, then we go, okay. Yeah. This person may be within the bell curve, but are they, are those levels optimal for them? If that lady is having PMs and breast tenderness and water retention, and she's not feeling well, that ratio is not optimal for her, even though she may be in that building.
[Page//00:14:35] Julie Michelson: I love that. So again, being one of your patients and being a woman in her fifties I, I know this is a question I've asked you before. And I want the listeners to know anybody who, you know, here's this and ends up wanting to investigate their hormones. When you're looking for a doc to support you with [Page//00:15:00] hormone health.
[Page//00:15:02] I know how you approach it. And to me, that's the, and you just touched on it. And so I was going to wait until the end to, to ask this, but I'm going to ask it now instead, you know, how do we determine, I know from personal history that there almost everybody is quote unquote practicing hormones now. And it's not necessarily with that optimal approach that you take.
[Page//00:15:26] So What I hear you say, but I want the listeners to really know is there's the, you know, this, yes, you, you look at the labs to see what's going on, but that you take symptoms into account and you actually talk to your patients and listen to how they feel and what's going on.
[Page//00:15:45] James Howton: Yeah. And, and, and. Thing to answer, right?
[Page//00:15:48] It's like, how do we, you sift through, because there's personality there, you may click with a certain provider and work wonderfully where another person may not. One of the challenges, sometimes the functional medicine world is [Page//00:16:00] beautifully inclusive, right? So we have all these practitioners from different disciplines from chiropractors, natural bass MDs.
[Page//00:16:08] Et cetera, that, that coach's there and we're all doing functional medicine. And I guess one of the things to look for is, Hey it, a hormone. If it's going to be used at a therapeutic dose, for someone who is perimenopausal postmenopausal, and in this country is a prescription. And so someone may do wonderful in terms of dieting and how to optimize hormones better.
[Page//00:16:30] If they can write a prescription for a hormone, then it's going to be hard for that person to truly kind of. Potentially help somebody. On the other hand, yeah. Dietary changes. And I stopped doing this. Can, can influence hormones greatly. And so I'm I the one at this counter, but if someone asks me, how do I, how do I go to another city and find somebody I would go, okay.
[Page//00:16:48] Find somebody who can write a script. Maybe ask the question to the offices. Are, is the physician willing to address my hormones based on how I feel based on symptoms. Mentally limited [Page//00:17:00] to normally going to address it. If it's in the bell curve or out of the bell curve, then, then again, it's going to be limited, right?
[Page//00:17:06] Cause once you're quote normal than, you know, you're stuck. And so that, that concept of are they willing to listen and, and are they willing to kind of take symptoms? You know, they're, they're hormone panels out there that look at say saliva hormones, you know, every day or every other day for a month. And you look at some of those graphs and you go crap.
[Page//00:17:26] It, it looks like a stock market graph with ups and downs, and it makes you realize shoot. If they came in and did a blood test, or I have a panel or you're in panel that one day, you know, it may look totally different than two days later. So it's a matter of weighing evidence, right? What that person is experienced and day in and day out, month in, month out.
[Page//00:17:47] Carries more weight than, than a one-time measurement. It's just, you know, it's just weighing evidence. And so, so it's not like ignoring science, it's just actually listening to people and, and you know, addressing it in the BD [Page//00:18:00] with some of the symptoms is that they're very tangible. If someone is estrogen dominant and you add a little progesterone the week before her cycle and she has lighter cycles and she's not PMSC and she's not retaining water and her headaches and cravings are bad.
[Page//00:18:15] You know, it worked right. And you can always look at the levels, but it's how that person responds. That makes the, you know, to me carries the biggest evidence.
[Page//00:18:26] Julie Michelson: Thank you. Yes. That was exactly where I was going with that. And just to really just drive it home because I did see a physician Who has hormone specialist on her website, who is an MD, so she can write prescriptions.
[Page//00:18:45] But her treatment approach is just completely different. And, and I think that's another piece is the fact that you are focused on optimized health and longevity and not just, you know, [Page//00:19:00] so I'm post-menopausal and I had a hysterectomy year and a half ago and. So according to some approaches, they're sorting her certain hormones, I just don't need anymore.
[Page//00:19:13] Right. And so this it's a very different approach than that optimal health, you know,
[Page//00:19:20] James Howton: That's kind of a pet peeve with that.
[Page//00:19:25] Traditionally women. Who've had a hysterectomy. If they get estrogens, they usually don't get progesterone because mindset is, Hey, you don't have a uterus to protect anymore, so you don't need it. Right. So, but by doing that, even if we give that woman a bio-identical hormone, if we make that woman estrogen, we're going to increase her risk of breast cancer.
[Page//00:19:43] We are going to make her gain weight. For sure. We're going to just create an imbalance. And it's like, there's a lot more. To you then just the uterus, you know, it there's hormone receptors and brain and heart. And, and, and so it's just one of those things that it's kind of crazy mindset that, [Page//00:20:00] and it's a constant comment.
[Page//00:20:02] Lots of ladies out there on estrogen and no progression. If they've had a hysterectomy.
[Page//00:20:07] Julie Michelson: Yeah. Which leads us so beautifully into, you mentioned the estrogen dominance a couple of times that you also mentioned that, you know, there's different kinds of estrogens that we have. So how can somebody, again, like looking at that test and here's where I fall into this category probably had, I looked at hormones in my twenties, probably in my twenties as well.
[Page//00:20:32] I never had high estrogen, but I, I have been estrogen dominant. So explain what that is and maybe tie for us to it. And I could be wrong to try to tie this together. But to me, I think of estrogen dominance as it leads. Inflammation provoking, maybe not causing, but, so let's dig into that
[Page//00:20:57] James Howton: a little bit. Yeah.
[Page//00:20:58] There's something about the whole [Page//00:21:00] balance thing and, and, and maybe backing up if I think of autoimmunity, right? It it's our immune system needs, it has a huge tolerance. Where it needs to attack self sometimes, right? You can't fight a cancer. You can't identify an abnormal cell and deal with it unless your body's willing to turn against self.
[Page//00:21:20] So, so we need to do that. If we don't. That's right. And on the other hand, you know, think of pregnancy, that's a, you know, a woman has a foreign person living inside of her and somehow her immune system needs to know and leave baby alone. But yet if she has a little, a normal cell in her skin or colon that I can attack.
[Page//00:21:41] So there are things that upregulate and downregulate immune cells. And hormones somehow play a role. And I, and I, so going back to estrogen dominance, if, if you give somebody who has a uterus just estrogen, or if she has more estrogen than pedestrian, she offers stimulates the endometrium. It gets thicker periods.
[Page//00:21:59] Get [Page//00:22:00] heavier. More crampy painful. She develops fibroids. She has five resistant breasts. She gains weight and easier and, and, you know, weight triggers, inflammation that, that thickened endometrium it's inflamed and can become endometrial cancer. So there's something overstimulating about the state of unopposed or extra to an excess or imbalanced, estrogen and progesterone levels.
[Page//00:22:25] And
[Page//00:22:25] Julie Michelson: that I guess is where I tied that in as a very late person to, you know, when I talk about, well, my, my clients are always saying their symptoms are worse that week before their period, as their estrogen is higher, as it should be. Hopefully with progesterone also increasing to create that balance that you were talking about.
[Page//00:22:46] And so that's kind of where my brain goes. When I, when I think of. You know, how is this inflammatory and why in the ass we need estrogen. Know we were, I keep talking about women and, and [Page//00:23:00] cycles. But I have seen also in male clients and I know male patients of yours. Okay. You know, with either autoimmune expression or autoimmune markers that they too are estrogen dominant.
[Page//00:23:14] So why, why are men becoming it mastered it
[Page//00:23:19] though?
[Page//00:23:20] James Howton: There's a whole thing,
[Page//00:23:24] but I mean, we, we do have this pattern. If we look at data from military recruits and testosterone levels over the last few days, I look at my practice. It was unheard of seeing a 20 something year old with low testosterone, but now it's like we do we have an enzyme called aromatase enzyme that converts testosterone into estrogen, and that enzyme is more active in visceral fat.
[Page//00:23:46] And so when a guy puts on. Some wait that extra fat starts converting testosterone into estrogen and the estrogen encourage more fat. And, and so we, we took in develop that sort of, it's a cycle of what's going on with [Page//00:24:00] hormones. The same estrogen, you know, makes prostate swell semester gen affects mood.
[Page//00:24:05] And you know, so, so as a, as a male, we want to look and go, Hey, are. Ratios optimal again. So
[Page//00:24:12] Julie Michelson: just to circle back, it's not just women's health. No, we all need our hormones. Yes,
[Page//00:24:18] James Howton: I agree. But you know, you and I have talked about the idea that there are more, and we see more autoimmune expression in women.
[Page//00:24:26] Right. And you're, you're more elegant in terms of. What hormones are doing, right? I mean, you're the one that ends up carrying, carrying a baby to determine. So, so in the mail, we kind of simple. We have certain hormones that home fluctuate a whole lot. And, and so we guys were kind of clueless and kinda, you know, sorta unconnected to hormones and a guy doesn't come in the office saying my hormones are changing, a female does.
[Page//00:24:47] But
[Page//00:24:48] Julie Michelson: but she comes in and says, my wife's warming,
[Page//00:24:53] James Howton: but, but there's something because you have. Th the, the cycle is that ability to carry a [Page//00:25:00] pregnancy to term and all those things that are changing. There's more potential for dysregulation. And I, and I think that's kind of part of that connection as the, Hey, why is there moral Roman issues and women?
[Page//00:25:12] And he, and I have talked about this idea. If, if we're going for optimal, right. Then it's the question of, do you feel the way you want to feel? And that's often something I ask people because they go, yeah, I can ask, how are you, how are your hormones are better than they used to? But is it, do you feel the way you want to feel?
[Page//00:25:33] And you know, it's kind of interesting when you kind of have that mindset again That all of a
[Page//00:25:37] sudden
[Page//00:25:40] James Howton: you're paying attention and you're addressing things. And, and it's, it can be life-changing if you, if you, if you just accept that and go out, and this is just part of it, think of how many women have been told that that's just the way it is.
[Page//00:25:52] Right. And so, so then you cannot. Pattern of a few Shetty. I'm sorry. And, and, [Page//00:26:00] but I'm powerless, you know? Cause that's just the way it is. It's the way it's supposed to be. And so it's hard to, if that's where you're coming from as hard there. Okay. Now you get a diagnosis of autoimmunity. It's like, oh, one more, one more shady thing.
[Page//00:26:11] I've got to undo her. And so there's something beautiful about that journey when someone starts addressing hormones. The beauty of homeless is typically you respond fairly quickly, right? It's something you can change and sometimes see a change within days. And it kind of clicked something in people's brain that, oh, you know, I can kind of reclaim back my health, my, my power, my, I can feel better.
[Page//00:26:33] And maybe that's why, you know, you know, I love dealing with. It is something you change, you see results fairly quickly. And that becomes a catalyst to making lifestyle changes, to eating differently, to addressing sleep, to looking for toxins and all the other things that we do that maybe take a little longer.
[Page//00:26:49] And now sometimes the payback comes a little later, but well, and you,
[Page//00:26:56] Julie Michelson: now that. No, this idea of taking our [Page//00:27:00] power back is a passion of mine. As somebody who stayed way too long in that mindset of, oh, this is just, it it's like this sucks. These are the cards I'm dealt and you know, I'm going to decline. I say all the time.
[Page//00:27:12] Well, they told me I would, I believed it shocker. I did, you know, that that mindset is so beyond important. And, and so I love that idea. There is nothing that drives lifestyle change better than note noticing something working. Right. And like you said, it really can take, you know, I, I tell my clients, you didn't get the sick in a day.
[Page//00:27:39] You're not gonna feel amazing tomorrow just because. You've changed your diet today, or, you know, but you're right. The, it's almost a, a shortcut to that energy and power and mindset shift of like, oh, I did something. If this can change. What else can change. And I want to tie that to, [Page//00:28:00] you said it, but I want, I want to make sure the listeners really heard this.
[Page//00:28:03] Isn't just about auto immunity. This is health in general. I say women's health. I'm sure there are men that could feel so much better if their hormones are optimizing and don't know. So they get just as stuck. You may say they're not as in touch with it, or maybe it's not, you know, changing specifically like a, like a woman's hormone pattern would, but.
[Page//00:28:26] That power can be. And I've seen it with young women college age women that again were, you know, struggling, but normalizing the fact that they were losing four days a month of productivity, socializing, all the good things. And so it makes me excited when I see. You know, in 19 year old, get a hormone panel.
[Page//00:28:49] It's true. Right. And so she doesn't have to say decades and figure it out in her forties or her fifties, but she finally found a doctor who looked or listened. So it is that power. [Page//00:29:00] She will probably also never accept certain declined because she was given a diagnosis because she's already connected those dots.
[Page//00:29:10] So I love that idea of. I think hormones are one of those things. I have been known, you know, to try to get answers for people quickly. And, and I know you're very methodical. As far as you know, there's so many rocks to look under in so many areas to address. But you have just motivated me in the, this idea of, well, if we make sure hormones are dialed in first.
[Page//00:29:35] Know, it's like a gift, right? You're just giving that little piece of power. That's so quick to reclaim.
[Page//00:29:41] James Howton: It might be, it's just like a. What the trick of the trade. It, I don't, it's not that I, all the other things that are part of it are hugely important and that's symphony, right? You can't just one and ignore the others, but you're totally right.
[Page//00:29:54] If, if we pick some things where we make a change and we experienced results, you [Page//00:30:00] kind of get that buy-in as, as, as a doc, you know, if you see someone you've never known, they pour out their heart and then you make a change. And next time they come in and, oh my God, you know, for some, we've had a good cycle.
[Page//00:30:13] They're kind of now they're going to listen to them more to some of the other recommendations. And so this kind of, one of those things that have that, it's kind of fun and wonderful when, when it gets addressed property. The other thing that we didn't hit on a little bit with use the word decline, then it made me think of.
[Page//00:30:33] You know, once you go, once you become post-menopausal right. Or, and or once we go through the traditional medical mindset, it's like, Hey, we may use hormones to get somebody through the change, but then we stop them because the battery is, it may give you breast cancer and. And I was explaining to people, hormones do not cause breast cancer.
[Page//00:30:55] The breasts are responsive. So hormones like estrogen, right? [Page//00:31:00] If you lather me with estrogen, I would grow, man. Boobs is what I tell people. So we don't want someone estrogen dominant because that would increase the risk of breast cancer. But people get more cancers as they age, whether it's colon cancer, skin cancer, or breast cancer.
[Page//00:31:12] So you can't ever tell somebody. If they're on hormones, that they want to get a breast cancer, but we know that when people are optimized and their balance, and they have the right ratios, that statistically, they don't have a higher risk. And in fact, they're better off than the people who are not doing anything.
[Page//00:31:27] That lady who's putting on a puzzle. Who's got some visceral fat who's making an inflammatory estrogen and doesn't have any pedestrian because her ovaries can make it she's at a much higher risk of breast cancer. Than someone who's who has balanced hormones tying into the decline deal. If we just tough it out and don't address the hormones, what happens predictably?
[Page//00:31:48] You know, we started losing bone density here at college and goes to the public. You know, you have vaginal dryness and bladder issues and foggy brain and poor sleep. And people tend to think, oh, that's part of aging, here's a sleeping pill. You know, [Page//00:32:00] here's an, any depressant here's, you know, Fosamax for your bones.
[Page//00:32:03] And we start trying to treat all those things that are, they're not symptoms of aging, you know, because of the same 80 year old. If all of a sudden we address her hormones, share her for that. And it gets more used again. And her bladder is better and she's not having as many UTI. And you know, her bones actually started getting better in her college and response.
[Page//00:32:23] And so, so it's that idea of optimizing health all the way through. And if someone dies of old age and they're using hormones, but they're active when they're brain sharp and they're planning their next event. That's how it should be not, not in a nursing home, you know, decrepit and the diapers and senile.
[Page//00:32:39] And so, so we want to think of hormones in that context of optimizing health, you know, for the long haul and, and the PD is somehow that magic helps with autoimmunity as well.
[Page//00:32:52] Julie Michelson: I love that. And that is that's that ballad just that's the theme, I think, is the balancing of the hormones [Page//00:33:00] and, and that understanding.
[Page//00:33:02] The difference between certain, you know, the doctor, that's going to say you don't have a uterus, you don't need progesterone anymore. And somebody who is
[Page//00:33:12] James Howton: a telltale sign that probably not the right person.
[Page//00:33:16] Julie Michelson: Yes, yes. I know, you know, this story, but when I, when I had my hysterectomy last year,
[Page//00:33:23] I was told, you know, ask the surgeon if they put us an estrogen patch on you in the, or, and when I asked her, she said, oh, are you already having hot flashes?
[Page//00:33:34] And I said, no. And she said, well, if you're, if you're having. Symptoms. If you're uncomfortable, when you come for your post-op, we can talk about estrogen and that's that red flag, different approach of what we know now, my body's not going to make it. Why would we wait until I'm miserable and then treat it and then treat it in an imbalanced way.
[Page//00:33:56] That's gonna drive my inflammation. So [Page//00:34:00] balance is what I hear. And when you think of, for me, you know, balance and healing, autoimmune symptoms, I mean, it, it, it just makes sense. So what do you say to what if somebody, you know, maybe hasn't had issues with their cycle and they do have auto-immune. And there, you know, maybe there are 50% better cause they're working really hard doing the lifestyle things.
[Page//00:34:31] I mean, are they somebody you would still, is it across the board? Does everybody, should everyone know, you know, what their levels are or if there's room to improve with hormones? Sure.
[Page//00:34:44] James Howton: Part of it is sometimes we don't know what. Right. And it's not, it's not just normalizing
[Page//00:34:50] Julie Michelson: that. I say most people listening to this probably have lost touch with what great feels like.
[Page//00:34:56] Or if they're like, I was, they think, well, that's just not for me, [Page//00:35:00] you know, it's not possible for me. Yeah. Yeah.
[Page//00:35:02] James Howton: And so, I mean, it's great to address things that working, but it's interesting when we look at ourselves in any area of life and those that as good as it could be. And, and again, there's that mindset, but, but three areas in my life that I've addressed.
[Page//00:35:15] No, because it felt bad. But then when I addressed them, I went on the couch. I feel better. And, and so if we keep that mindset, yes, that's the short answer is I can't think of a reason why, why we wouldn't, because it's in the doing so I don't know how many people I've seen run around with Hashimoto's, who didn't come in because they had Hashimoto's.
[Page//00:35:37] We were just addressing hormones. And we happened to look at that right. Antibodies, anytime we do labs and it's like, oh, look at this, you know, they're, they're smolder and way they're asymptomatic. But by addressing them early, we have a much better chance of resolving and getting rid of the autoimmune issue.
[Page//00:35:53] So, and so
[Page//00:35:56] Julie Michelson: it's a completely different mindset. Why don't you stop it before it starts [Page//00:36:00] and was no,
[Page//00:36:04] James Howton: their panel is that. We do that have anti-ISIS CP three antibodies and things like that that are, that are kind of part of the panel. And, and it's interesting how many people have a viral infection or have COVID or whatever, and their anti CCP, three antibodies go off the chart.
[Page//00:36:17] They're not coming in with, you know, swollen joints, the, in the diagnosis of RA, but if nothing changes, eventually they will develop it. And those are the people that if you can address their hormones, either omega is or whatever the case may be. And you can see those autoimmune issues. Resolved. It's kind of like, can you correct it?
[Page//00:36:36] And auto issue before it developed into a
[Page//00:36:40] Julie Michelson: disease? Which my favorite things, I love that as well. I, I always get excited when I see markers reverse. I had the experience with one of your patients. I hadn't seen labs before we worked together. And then I saw them once he made great changes. And so I didn't even know he had [Page//00:37:00] autoimmune thyroid markers to begin with and to see them correct.
[Page//00:37:03] And, you know, he's I just get so excited. It's I don't know. It's fantastic. One question I ask everybody as we get ready to ramp up is. Too. It's not even a question. I asked first suggestion, one small step, something doable that listeners can start tomorrow to, and just to optimize self since we're talking about optimizing.
[Page//00:37:28] So what's one thing that listeners to.
[Page//00:37:32] James Howton: The spot there. I think that the mindset thing to know, I mean, because the PT would mindset is we can change it pretty quickly and it's like an, a hard type of deal. And so especially tying it to hormones is that mindset of, am I, am I truly the way I want to be at my optimal?
[Page//00:37:48] And if not to just really have that light turn on and go figure it out, go, go address it, measure levels, do what it takes to improve. Because it will be [Page//00:38:00] life-changing F you just turn on that mindset and choose the right.
[Page//00:38:07] Julie Michelson: And one, one thing I usually ask guests that I didn't ask you directly, although I'm pretty sure listeners could tell just from our conversation, but, you know, do you feel people can heal autoimmune symptoms?
[Page//00:38:20] Can they, you know, turn things like that around?
[Page//00:38:23] James Howton: Absolutely. I mean, just like we were saying, you know, We see it often. And that's why I like the idea of tracking markers because not only, you know, it, it's, it's fun. It's fun to see them go away. And then it's fun to clinically see them be able to get off medications they've been on sometimes for years.
[Page//00:38:41] Not because the drugs are bad. I'm the first one that was started the drug, if someone comes in in a flare, but it's not, you know, if you just stop, if you just think of, oh, they have a here's the label. Here's the drugs symptoms are. Okay. They're fine. No, you know, it's back to that mindset. If we go at it with that, drugs are bad and that's it.
[Page//00:38:58] The Western conventional model [Page//00:39:00] is bad. It's just, it's insufficient for autoimmunity and, and. You know, if you keep addressing those root causes and many times you use less and less of the medicine, eventually many people don't need them, but
[Page//00:39:12] Julie Michelson: absolutely I'm living proof of that. I thank you so much for all of the valuable information.
[Page//00:39:19] If people get your hormones checked, please get your hormones checked. And I love the, you know, the key takeaway. Aside from hormones or in addition to is, I know we can heal in that mindset as you know, whether you are, you know, in the middle of a flare and just knowing that it can get better or whether you're doing pretty well.
[Page//00:39:45] Are you, are you perfect? Are you as good as you could be? So I love that. Thank you so much.
[Page//00:00:43] Thank you so much for joining us today. I always love to start off with a little icebreaker. So what is, don't be nervous. You get to choose your response. What is something that most people or maybe [Page//00:01:00] many people. Might not know about you, just a little, a fun fact.
[Page//00:01:03] James Howton: Great. Instead of a medical question, the current, they grew up in Columbia and south America came to the states when I was 15.
[Page//00:01:12] Most people don't know that
[Page//00:01:13] Julie Michelson: I would imagine most people don't.
[Page//00:01:15] James Howton: Sometimes they pick up in a little accent or something, but they can't usually place where it comes from.
[Page//00:01:20] Julie Michelson: I actually had that experience when I first met you. So that is a good one. Many of the guests that I have on the podcast have their own personal health journey.
[Page//00:01:31] That's led them to the functional medicine world. And I know that that's not the case for you. So tell us a little bit about how you went from a traditional Western family medicine practice to practicing functional medicine,
[Page//00:01:47] James Howton: maybe. Curious are you? The whole traditional season was a great season and I was privileged to be in a small town and that to do the whole cradle to grave thing from delivering [Page//00:02:00] babies, the cover in the ER, taking care of grandma in the nursing home.
[Page//00:02:03] And so that I loved that it was a fun time, but over time medicine started becoming about productivity and I would round them people before family would get there in the morning. And, you know, you started getting pushed the 10 minute visits. And at some point it hit me, like I was having an on prescriptions all day long and started feeling the, you know, people would ask me, how can I be healthier?
[Page//00:02:26] How can I improve my health? I was like, I don't know that I had a whole lot to offer them. I could patch up things well, and, and the acute care part of medicine was great, but it was sorta kind of a little coming to sort of midlife thing of, Hey, Mrs. Is really what I signed up for. And I'm so. Started a journey of looking for better ways of doing things and, and being open-minded.
[Page//00:02:49] And when people would come in and say, Hey, what about softball metal for my prostate? I would say, well, let's try it. And remeasure. Levels in a few weeks. And the [Page//00:03:00] more I did that, the more I started seeing that, Hey, there, there are things outside of my conventional toolbox that actually worked. And that made me more curious and, you know, just kind of propelled it once you, once you get hooked on that root cause approach, it's kind of hard to go back.
[Page//00:03:13] That
[Page//00:03:13] Julie Michelson: is very, very true. I know from your bio that you started working with bio identical hormones back in the mid nineties, is that accurate? That seems early to me as far as you know, it seems like you were maybe a little bit ahead of the curve. How did that. Yeah. And how did that happen? How do you all of a sudden become one of the early adopters, something
[Page//00:03:43] James Howton: like that.
[Page//00:03:43] It was maybe that sort of mindset and there, maybe it ties to the whole thing of growing up in another country and seeing that there's more one more than one way of doing things and, and, you know, cannot be in the. Never fitting in one world. And so, you know, when I think I came across an article one time on [Page//00:04:00] depression and men and testosterone levels, and, and I remember pulling the charts of guys that I had in SSRS and, and looking at hormone levels and low and behold, there was like the number of people that were.
[Page//00:04:13] Had really hormonal issues. And when you address them, they were able to get off their medications. And so it made me curious about hormones and at the time AFRM was sort of fairly new group and went to some other courses and, you know, it started, it made sense that you know, all the prescriptions that I was writing for Premarin and those types of hormones, that, that didn't make as much sense as the bio-identical hormones that our body.
[Page//00:04:37] Making them ever since we were teenagers. And so it just propelled the transition and the more I played with it, the more. You know, the better people did and you know, it just kind of part-time back from there.
[Page//00:04:52] Julie Michelson: There's so much in there that I want to unpack. I want to circle back to what our bio identical hormones and what is [Page//00:05:00] the difference?
[Page//00:05:00] You mentioned Premarin. But before I do that, Share with our listeners. You know, obviously my focus is auto-immunity, why am I having you on talking about hormones? What is this connection between, you know, why should they care? Why, why are their hormones important? And, and cause I'm going to give you a lot of things.
[Page//00:05:23] And, and what hormones are you talking about? I know you mentioned testosterone and your men you know, maybe some of us have different ideas when we hear hormones. Exactly what you're talking.
[Page//00:05:32] James Howton: And the hormones are kind of one of those things, you know, By no means, am I saying that they're the thing with auto-immunity, but you know, we've in a functional medicine model.
[Page//00:05:41] We still look at all the things that we look at, right? From gut health to food sensitivities, to toxins the mindset and all those things that play into it. But hormones are often kind of ignored. And and so when you ask me about, Hey, what would you contribute? You know, the thought with hormones to say, it's something that [Page//00:06:00] commonly and we'll get into into it.
[Page//00:06:02] Tom commonly gets ignored and commonly gets blamed on other things and just not addressed properly. And I find that it makes a huge difference when we're treating autoimmunity.
[Page//00:06:13] Julie Michelson: I, I definitely agree. Having had my own personal experiences with hormones and auto-immunity, but also I say to my clients all the time they doctor, after doctor can't connect the dots for them, or they always say, you know, the week around my cycle, My pain is worse.
[Page//00:06:30] My infant, they know, like they can tell they feel worse. There's a connection. And so often, you know, they're, they're not addressed as, as you said. And I do think it is the missing piece or Amy a missing piece. I know we talk about all the time, the hill ABI. I talk about all the time, you know, nutrition and diet and detox and stress management and sleep and move the proper movement levels.
[Page//00:06:58] But. So [Page//00:07:00] many, and those are things that almost everybody talks about. If they're taking a whole health approach to auto-immunity, but not necessarily hormones.
[Page//00:07:11] James Howton: Following up on what is a bio-identical hormone. I remember with residents when they would rotate through is it's the idea, it's the idea of it's the same molecule that our bodies make, you know?
[Page//00:07:22] And so it's the example of Premarin. Premarin comes from pregnant, married. So it's a bio-identical hormone for horses, you know, but we still use it. So, you know, it's still widely used in America
[Page//00:07:35] Julie Michelson: for those that don't know
[Page//00:07:37] James Howton: there's an issue, then it's a prescription estrogen that gets used for menopause symptoms and has made from calf catheterize horses.
[Page//00:07:45] I think. You know, and they're distilling and extracting their estrogen out of their urine. And so that's not a bio-identical hormone. And the old days we would use pig insulin for diabetics and it would save people's lives and it was wonderful. And then when labs could [Page//00:08:00] synthesize a bio-identical human insulin, Then, Hey, nobody would dream of using pig in anymore.
[Page//00:08:07] Right? So it's fascinating with sex hormones that we still have a number of hormones being used for men and women, but don't look at all like our natural hormones. And so the first step is, Hey, we're talking about, bio-identical not just hormones. And you've won one out there.
[Page//00:08:24] Julie Michelson: And you mentioned sex hormones specifically, but I know, especially with auto-immunity, there's some other hormones that know.
[Page//00:08:32] I know, I know personally because full disclosure, Dr. Helton is my doctor. So I know what you look for. I know what you look at and, and how you address those issues, but more commonly, I think if somebody with auto-immunity is to get a smaller panel, Hopefully, although if it's not a functional medicine panel, even something like thyroid might not be
[Page//00:08:56] James Howton: fully complete cover that.
[Page//00:08:59] A lot with [Page//00:09:00] people. So when I think of hormones, I like the concept of a symphony. And so in that symphony, I think of sex hormones, that's in different in the two, three estrogens that we have in our body. There's progesterone, testosterone. Those are kinda the three biggies. We think of adrenal hormones like cortisol and the AGA we think of hormones like pregnenolone.
[Page//00:09:20] And we think of thyroid hormones, like, you know, free T4, free T3, TSH, thyroid antibodies. And then we think of neuro-transmitters which all kind of symptoms of all of those sort of overlap. And I tell people, many people that come into the office have, oh, I read about adrenals or I read about X, Y, and Z.
[Page//00:09:38] And they did the right things. And I tell them, it's kind of like taking a symphony and fine-tuning the strings. Perfect. Did the right thing. But if you ignore percussion or other parts of the symphony, the music may still sound crappy. And so that sort of, and people think, oh crap, I didn't do the right thing.
[Page//00:09:54] And then they move on to the next thing, the next book, the next specialist that does thyroid. [Page//00:10:00] And they do all the right things with that. Right. But if they're ignored and adrenals still don't function optimally. And so the whole point with a functional medicine approach is we want to address the whole symphony.
[Page//00:10:11] Julie Michelson: Well, do you know? I love that. I think it's the only way to do it, to do it. It's the right way to do it. So I w I brought up this idea of, you know, I see all the time that the, as especially women, as their hormones fluctuate, their symptoms will change as well. Let's talk a little bit about, at what point do you believe somebody should even get their hormones
[Page//00:10:37] James Howton: checked?
[Page//00:10:38] That's great. Part of our basic panels whether someone's a teenager or 18 year old grandma always. All those hormones we've talked about. And it's fascinating because the more you look at things more you, more data, you get the more patterns you see, the more you see though, interesting. When you improve hormones or cholesterol goes [Page//00:11:00] down and et cetera.
[Page//00:11:00] So this is fun. Not be, if, if we go to a functional medicine approach with it, when I go back to that symptom driven and only check the labs for something that has an obvious symptom associated with them. So we look at them from the start on and, and and don't discriminate. So that based on age and make the focus, Hey, are they optimal for, or are they conducive to optimal health?
[Page//00:11:23] Whether someone's a teenager or whether they're late in life?
[Page//00:11:30] Julie Michelson: Thank you for that explanation. Because I think so often we wait until we can't tolerate symptoms, even check. And so this idea of, you know, or why not a young girl, which leads me to. This idea of weeds. I talk about a lot with different guests about how we all normalize our symptoms, or, you know, whether it's, and it doesn't have to be auto-immunity even just, you know I'm getting older, you know, I should hurt.
[Page//00:11:59] I should be [Page//00:12:00] tired. No, no, no. And I know you have an anti-aging focus in your practice, but. What is normal and you use the word optimal. And so let's kind of get into normal, normal ranges, labs, and normal symptoms. As a woman does pay now, I was certainly taught that certain things are to be expected and there's discomforts with just being a woman.
[Page//00:12:26] James Howton: So you'd be amazed. How many ladies, if you ask the question. Any issues with, with cycles or hormones? No, ma'am I'm normal. Right? And then you asked that 40 year old, any PMs or breast tenderness or water retention or craving or headaches that are cyclical. Oh yeah. You know, but I've had that all my life.
[Page//00:12:43] And so, so there's a tendency that if that's been a pattern from early on, that it becomes, like you said, normalize, and so people don't address it and they're walking around a good chunk of, you know, it's such a waste when you think of. Why have [Page//00:13:00] three, four days that are crappy days out of the month, you know, an add that over a lifetime or adulthood, it's a waste.
[Page//00:13:07] And it's something that can be addressed. Your normals are, it's an interesting concept because the abnormals are bell curves of a population at large. And so, so a lab will take all the numbers that are coming in and do a statistical and, and we see the numbers sort of shift, you know, depending on. On what's coming in through the door.
[Page//00:13:28] One of our labs that we work with it's funny last year, the normal range for post-menopausal woman testosterone went from four to 82 to like four to 312 because there's more women that are post-menopausal that are using testosterone. So it's become sort of a thing and it literally shifted the normal range by several faults, which is crazy when you think about it.
[Page//00:13:53] So if we, if you think of that's what normal is, and if you come in through the door and you're within that bell curve, [Page//00:14:00] you may be told you're normal, you're fine. You know, it's not your hormones. And if you accept that for an answer, then you may not be. Well-served you may not be addressing the issues.
[Page//00:14:13] Does that make sense? And so, so when I think of optimal, then we go, okay. Yeah. This person may be within the bell curve, but are they, are those levels optimal for them? If that lady is having PMs and breast tenderness and water retention, and she's not feeling well, that ratio is not optimal for her, even though she may be in that building.
[Page//00:14:35] Julie Michelson: I love that. So again, being one of your patients and being a woman in her fifties I, I know this is a question I've asked you before. And I want the listeners to know anybody who, you know, here's this and ends up wanting to investigate their hormones. When you're looking for a doc to support you with [Page//00:15:00] hormone health.
[Page//00:15:02] I know how you approach it. And to me, that's the, and you just touched on it. And so I was going to wait until the end to, to ask this, but I'm going to ask it now instead, you know, how do we determine, I know from personal history that there almost everybody is quote unquote practicing hormones now. And it's not necessarily with that optimal approach that you take.
[Page//00:15:26] So What I hear you say, but I want the listeners to really know is there's the, you know, this, yes, you, you look at the labs to see what's going on, but that you take symptoms into account and you actually talk to your patients and listen to how they feel and what's going on.
[Page//00:15:45] James Howton: Yeah. And, and, and. Thing to answer, right?
[Page//00:15:48] It's like, how do we, you sift through, because there's personality there, you may click with a certain provider and work wonderfully where another person may not. One of the challenges, sometimes the functional medicine world is [Page//00:16:00] beautifully inclusive, right? So we have all these practitioners from different disciplines from chiropractors, natural bass MDs.
[Page//00:16:08] Et cetera, that, that coach's there and we're all doing functional medicine. And I guess one of the things to look for is, Hey it, a hormone. If it's going to be used at a therapeutic dose, for someone who is perimenopausal postmenopausal, and in this country is a prescription. And so someone may do wonderful in terms of dieting and how to optimize hormones better.
[Page//00:16:30] If they can write a prescription for a hormone, then it's going to be hard for that person to truly kind of. Potentially help somebody. On the other hand, yeah. Dietary changes. And I stopped doing this. Can, can influence hormones greatly. And so I'm I the one at this counter, but if someone asks me, how do I, how do I go to another city and find somebody I would go, okay.
[Page//00:16:48] Find somebody who can write a script. Maybe ask the question to the offices. Are, is the physician willing to address my hormones based on how I feel based on symptoms. Mentally limited [Page//00:17:00] to normally going to address it. If it's in the bell curve or out of the bell curve, then, then again, it's going to be limited, right?
[Page//00:17:06] Cause once you're quote normal than, you know, you're stuck. And so that, that concept of are they willing to listen and, and are they willing to kind of take symptoms? You know, they're, they're hormone panels out there that look at say saliva hormones, you know, every day or every other day for a month. And you look at some of those graphs and you go crap.
[Page//00:17:26] It, it looks like a stock market graph with ups and downs, and it makes you realize shoot. If they came in and did a blood test, or I have a panel or you're in panel that one day, you know, it may look totally different than two days later. So it's a matter of weighing evidence, right? What that person is experienced and day in and day out, month in, month out.
[Page//00:17:47] Carries more weight than, than a one-time measurement. It's just, you know, it's just weighing evidence. And so, so it's not like ignoring science, it's just actually listening to people and, and you know, addressing it in the BD [Page//00:18:00] with some of the symptoms is that they're very tangible. If someone is estrogen dominant and you add a little progesterone the week before her cycle and she has lighter cycles and she's not PMSC and she's not retaining water and her headaches and cravings are bad.
[Page//00:18:15] You know, it worked right. And you can always look at the levels, but it's how that person responds. That makes the, you know, to me carries the biggest evidence.
[Page//00:18:26] Julie Michelson: Thank you. Yes. That was exactly where I was going with that. And just to really just drive it home because I did see a physician Who has hormone specialist on her website, who is an MD, so she can write prescriptions.
[Page//00:18:45] But her treatment approach is just completely different. And, and I think that's another piece is the fact that you are focused on optimized health and longevity and not just, you know, [Page//00:19:00] so I'm post-menopausal and I had a hysterectomy year and a half ago and. So according to some approaches, they're sorting her certain hormones, I just don't need anymore.
[Page//00:19:13] Right. And so this it's a very different approach than that optimal health, you know,
[Page//00:19:20] James Howton: That's kind of a pet peeve with that.
[Page//00:19:25] Traditionally women. Who've had a hysterectomy. If they get estrogens, they usually don't get progesterone because mindset is, Hey, you don't have a uterus to protect anymore, so you don't need it. Right. So, but by doing that, even if we give that woman a bio-identical hormone, if we make that woman estrogen, we're going to increase her risk of breast cancer.
[Page//00:19:43] We are going to make her gain weight. For sure. We're going to just create an imbalance. And it's like, there's a lot more. To you then just the uterus, you know, it there's hormone receptors and brain and heart. And, and, and so it's just one of those things that it's kind of crazy mindset that, [Page//00:20:00] and it's a constant comment.
[Page//00:20:02] Lots of ladies out there on estrogen and no progression. If they've had a hysterectomy.
[Page//00:20:07] Julie Michelson: Yeah. Which leads us so beautifully into, you mentioned the estrogen dominance a couple of times that you also mentioned that, you know, there's different kinds of estrogens that we have. So how can somebody, again, like looking at that test and here's where I fall into this category probably had, I looked at hormones in my twenties, probably in my twenties as well.
[Page//00:20:32] I never had high estrogen, but I, I have been estrogen dominant. So explain what that is and maybe tie for us to it. And I could be wrong to try to tie this together. But to me, I think of estrogen dominance as it leads. Inflammation provoking, maybe not causing, but, so let's dig into that
[Page//00:20:57] James Howton: a little bit. Yeah.
[Page//00:20:58] There's something about the whole [Page//00:21:00] balance thing and, and, and maybe backing up if I think of autoimmunity, right? It it's our immune system needs, it has a huge tolerance. Where it needs to attack self sometimes, right? You can't fight a cancer. You can't identify an abnormal cell and deal with it unless your body's willing to turn against self.
[Page//00:21:20] So, so we need to do that. If we don't. That's right. And on the other hand, you know, think of pregnancy, that's a, you know, a woman has a foreign person living inside of her and somehow her immune system needs to know and leave baby alone. But yet if she has a little, a normal cell in her skin or colon that I can attack.
[Page//00:21:41] So there are things that upregulate and downregulate immune cells. And hormones somehow play a role. And I, and I, so going back to estrogen dominance, if, if you give somebody who has a uterus just estrogen, or if she has more estrogen than pedestrian, she offers stimulates the endometrium. It gets thicker periods.
[Page//00:21:59] Get [Page//00:22:00] heavier. More crampy painful. She develops fibroids. She has five resistant breasts. She gains weight and easier and, and, you know, weight triggers, inflammation that, that thickened endometrium it's inflamed and can become endometrial cancer. So there's something overstimulating about the state of unopposed or extra to an excess or imbalanced, estrogen and progesterone levels.
[Page//00:22:25] And
[Page//00:22:25] Julie Michelson: that I guess is where I tied that in as a very late person to, you know, when I talk about, well, my, my clients are always saying their symptoms are worse that week before their period, as their estrogen is higher, as it should be. Hopefully with progesterone also increasing to create that balance that you were talking about.
[Page//00:22:46] And so that's kind of where my brain goes. When I, when I think of. You know, how is this inflammatory and why in the ass we need estrogen. Know we were, I keep talking about women and, and [Page//00:23:00] cycles. But I have seen also in male clients and I know male patients of yours. Okay. You know, with either autoimmune expression or autoimmune markers that they too are estrogen dominant.
[Page//00:23:14] So why, why are men becoming it mastered it
[Page//00:23:19] though?
[Page//00:23:20] James Howton: There's a whole thing,
[Page//00:23:24] but I mean, we, we do have this pattern. If we look at data from military recruits and testosterone levels over the last few days, I look at my practice. It was unheard of seeing a 20 something year old with low testosterone, but now it's like we do we have an enzyme called aromatase enzyme that converts testosterone into estrogen, and that enzyme is more active in visceral fat.
[Page//00:23:46] And so when a guy puts on. Some wait that extra fat starts converting testosterone into estrogen and the estrogen encourage more fat. And, and so we, we took in develop that sort of, it's a cycle of what's going on with [Page//00:24:00] hormones. The same estrogen, you know, makes prostate swell semester gen affects mood.
[Page//00:24:05] And you know, so, so as a, as a male, we want to look and go, Hey, are. Ratios optimal again. So
[Page//00:24:12] Julie Michelson: just to circle back, it's not just women's health. No, we all need our hormones. Yes,
[Page//00:24:18] James Howton: I agree. But you know, you and I have talked about the idea that there are more, and we see more autoimmune expression in women.
[Page//00:24:26] Right. And you're, you're more elegant in terms of. What hormones are doing, right? I mean, you're the one that ends up carrying, carrying a baby to determine. So, so in the mail, we kind of simple. We have certain hormones that home fluctuate a whole lot. And, and so we guys were kind of clueless and kinda, you know, sorta unconnected to hormones and a guy doesn't come in the office saying my hormones are changing, a female does.
[Page//00:24:47] But
[Page//00:24:48] Julie Michelson: but she comes in and says, my wife's warming,
[Page//00:24:53] James Howton: but, but there's something because you have. Th the, the cycle is that ability to carry a [Page//00:25:00] pregnancy to term and all those things that are changing. There's more potential for dysregulation. And I, and I think that's kind of part of that connection as the, Hey, why is there moral Roman issues and women?
[Page//00:25:12] And he, and I have talked about this idea. If, if we're going for optimal, right. Then it's the question of, do you feel the way you want to feel? And that's often something I ask people because they go, yeah, I can ask, how are you, how are your hormones are better than they used to? But is it, do you feel the way you want to feel?
[Page//00:25:33] And you know, it's kind of interesting when you kind of have that mindset again That all of a
[Page//00:25:37] sudden
[Page//00:25:40] James Howton: you're paying attention and you're addressing things. And, and it's, it can be life-changing if you, if you, if you just accept that and go out, and this is just part of it, think of how many women have been told that that's just the way it is.
[Page//00:25:52] Right. And so, so then you cannot. Pattern of a few Shetty. I'm sorry. And, and, [Page//00:26:00] but I'm powerless, you know? Cause that's just the way it is. It's the way it's supposed to be. And so it's hard to, if that's where you're coming from as hard there. Okay. Now you get a diagnosis of autoimmunity. It's like, oh, one more, one more shady thing.
[Page//00:26:11] I've got to undo her. And so there's something beautiful about that journey when someone starts addressing hormones. The beauty of homeless is typically you respond fairly quickly, right? It's something you can change and sometimes see a change within days. And it kind of clicked something in people's brain that, oh, you know, I can kind of reclaim back my health, my, my power, my, I can feel better.
[Page//00:26:33] And maybe that's why, you know, you know, I love dealing with. It is something you change, you see results fairly quickly. And that becomes a catalyst to making lifestyle changes, to eating differently, to addressing sleep, to looking for toxins and all the other things that we do that maybe take a little longer.
[Page//00:26:49] And now sometimes the payback comes a little later, but well, and you,
[Page//00:26:56] Julie Michelson: now that. No, this idea of taking our [Page//00:27:00] power back is a passion of mine. As somebody who stayed way too long in that mindset of, oh, this is just, it it's like this sucks. These are the cards I'm dealt and you know, I'm going to decline. I say all the time.
[Page//00:27:12] Well, they told me I would, I believed it shocker. I did, you know, that that mindset is so beyond important. And, and so I love that idea. There is nothing that drives lifestyle change better than note noticing something working. Right. And like you said, it really can take, you know, I, I tell my clients, you didn't get the sick in a day.
[Page//00:27:39] You're not gonna feel amazing tomorrow just because. You've changed your diet today, or, you know, but you're right. The, it's almost a, a shortcut to that energy and power and mindset shift of like, oh, I did something. If this can change. What else can change. And I want to tie that to, [Page//00:28:00] you said it, but I want, I want to make sure the listeners really heard this.
[Page//00:28:03] Isn't just about auto immunity. This is health in general. I say women's health. I'm sure there are men that could feel so much better if their hormones are optimizing and don't know. So they get just as stuck. You may say they're not as in touch with it, or maybe it's not, you know, changing specifically like a, like a woman's hormone pattern would, but.
[Page//00:28:26] That power can be. And I've seen it with young women college age women that again were, you know, struggling, but normalizing the fact that they were losing four days a month of productivity, socializing, all the good things. And so it makes me excited when I see. You know, in 19 year old, get a hormone panel.
[Page//00:28:49] It's true. Right. And so she doesn't have to say decades and figure it out in her forties or her fifties, but she finally found a doctor who looked or listened. So it is that power. [Page//00:29:00] She will probably also never accept certain declined because she was given a diagnosis because she's already connected those dots.
[Page//00:29:10] So I love that idea of. I think hormones are one of those things. I have been known, you know, to try to get answers for people quickly. And, and I know you're very methodical. As far as you know, there's so many rocks to look under in so many areas to address. But you have just motivated me in the, this idea of, well, if we make sure hormones are dialed in first.
[Page//00:29:35] Know, it's like a gift, right? You're just giving that little piece of power. That's so quick to reclaim.
[Page//00:29:41] James Howton: It might be, it's just like a. What the trick of the trade. It, I don't, it's not that I, all the other things that are part of it are hugely important and that's symphony, right? You can't just one and ignore the others, but you're totally right.
[Page//00:29:54] If, if we pick some things where we make a change and we experienced results, you [Page//00:30:00] kind of get that buy-in as, as, as a doc, you know, if you see someone you've never known, they pour out their heart and then you make a change. And next time they come in and, oh my God, you know, for some, we've had a good cycle.
[Page//00:30:13] They're kind of now they're going to listen to them more to some of the other recommendations. And so this kind of, one of those things that have that, it's kind of fun and wonderful when, when it gets addressed property. The other thing that we didn't hit on a little bit with use the word decline, then it made me think of.
[Page//00:30:33] You know, once you go, once you become post-menopausal right. Or, and or once we go through the traditional medical mindset, it's like, Hey, we may use hormones to get somebody through the change, but then we stop them because the battery is, it may give you breast cancer and. And I was explaining to people, hormones do not cause breast cancer.
[Page//00:30:55] The breasts are responsive. So hormones like estrogen, right? [Page//00:31:00] If you lather me with estrogen, I would grow, man. Boobs is what I tell people. So we don't want someone estrogen dominant because that would increase the risk of breast cancer. But people get more cancers as they age, whether it's colon cancer, skin cancer, or breast cancer.
[Page//00:31:12] So you can't ever tell somebody. If they're on hormones, that they want to get a breast cancer, but we know that when people are optimized and their balance, and they have the right ratios, that statistically, they don't have a higher risk. And in fact, they're better off than the people who are not doing anything.
[Page//00:31:27] That lady who's putting on a puzzle. Who's got some visceral fat who's making an inflammatory estrogen and doesn't have any pedestrian because her ovaries can make it she's at a much higher risk of breast cancer. Than someone who's who has balanced hormones tying into the decline deal. If we just tough it out and don't address the hormones, what happens predictably?
[Page//00:31:48] You know, we started losing bone density here at college and goes to the public. You know, you have vaginal dryness and bladder issues and foggy brain and poor sleep. And people tend to think, oh, that's part of aging, here's a sleeping pill. You know, [Page//00:32:00] here's an, any depressant here's, you know, Fosamax for your bones.
[Page//00:32:03] And we start trying to treat all those things that are, they're not symptoms of aging, you know, because of the same 80 year old. If all of a sudden we address her hormones, share her for that. And it gets more used again. And her bladder is better and she's not having as many UTI. And you know, her bones actually started getting better in her college and response.
[Page//00:32:23] And so, so it's that idea of optimizing health all the way through. And if someone dies of old age and they're using hormones, but they're active when they're brain sharp and they're planning their next event. That's how it should be not, not in a nursing home, you know, decrepit and the diapers and senile.
[Page//00:32:39] And so, so we want to think of hormones in that context of optimizing health, you know, for the long haul and, and the PD is somehow that magic helps with autoimmunity as well.
[Page//00:32:52] Julie Michelson: I love that. And that is that's that ballad just that's the theme, I think, is the balancing of the hormones [Page//00:33:00] and, and that understanding.
[Page//00:33:02] The difference between certain, you know, the doctor, that's going to say you don't have a uterus, you don't need progesterone anymore. And somebody who is
[Page//00:33:12] James Howton: a telltale sign that probably not the right person.
[Page//00:33:16] Julie Michelson: Yes, yes. I know, you know, this story, but when I, when I had my hysterectomy last year,
[Page//00:33:23] I was told, you know, ask the surgeon if they put us an estrogen patch on you in the, or, and when I asked her, she said, oh, are you already having hot flashes?
[Page//00:33:34] And I said, no. And she said, well, if you're, if you're having. Symptoms. If you're uncomfortable, when you come for your post-op, we can talk about estrogen and that's that red flag, different approach of what we know now, my body's not going to make it. Why would we wait until I'm miserable and then treat it and then treat it in an imbalanced way.
[Page//00:33:56] That's gonna drive my inflammation. So [Page//00:34:00] balance is what I hear. And when you think of, for me, you know, balance and healing, autoimmune symptoms, I mean, it, it, it just makes sense. So what do you say to what if somebody, you know, maybe hasn't had issues with their cycle and they do have auto-immune. And there, you know, maybe there are 50% better cause they're working really hard doing the lifestyle things.
[Page//00:34:31] I mean, are they somebody you would still, is it across the board? Does everybody, should everyone know, you know, what their levels are or if there's room to improve with hormones? Sure.
[Page//00:34:44] James Howton: Part of it is sometimes we don't know what. Right. And it's not, it's not just normalizing
[Page//00:34:50] Julie Michelson: that. I say most people listening to this probably have lost touch with what great feels like.
[Page//00:34:56] Or if they're like, I was, they think, well, that's just not for me, [Page//00:35:00] you know, it's not possible for me. Yeah. Yeah.
[Page//00:35:02] James Howton: And so, I mean, it's great to address things that working, but it's interesting when we look at ourselves in any area of life and those that as good as it could be. And, and again, there's that mindset, but, but three areas in my life that I've addressed.
[Page//00:35:15] No, because it felt bad. But then when I addressed them, I went on the couch. I feel better. And, and so if we keep that mindset, yes, that's the short answer is I can't think of a reason why, why we wouldn't, because it's in the doing so I don't know how many people I've seen run around with Hashimoto's, who didn't come in because they had Hashimoto's.
[Page//00:35:37] We were just addressing hormones. And we happened to look at that right. Antibodies, anytime we do labs and it's like, oh, look at this, you know, they're, they're smolder and way they're asymptomatic. But by addressing them early, we have a much better chance of resolving and getting rid of the autoimmune issue.
[Page//00:35:53] So, and so
[Page//00:35:56] Julie Michelson: it's a completely different mindset. Why don't you stop it before it starts [Page//00:36:00] and was no,
[Page//00:36:04] James Howton: their panel is that. We do that have anti-ISIS CP three antibodies and things like that that are, that are kind of part of the panel. And, and it's interesting how many people have a viral infection or have COVID or whatever, and their anti CCP, three antibodies go off the chart.
[Page//00:36:17] They're not coming in with, you know, swollen joints, the, in the diagnosis of RA, but if nothing changes, eventually they will develop it. And those are the people that if you can address their hormones, either omega is or whatever the case may be. And you can see those autoimmune issues. Resolved. It's kind of like, can you correct it?
[Page//00:36:36] And auto issue before it developed into a
[Page//00:36:40] Julie Michelson: disease? Which my favorite things, I love that as well. I, I always get excited when I see markers reverse. I had the experience with one of your patients. I hadn't seen labs before we worked together. And then I saw them once he made great changes. And so I didn't even know he had [Page//00:37:00] autoimmune thyroid markers to begin with and to see them correct.
[Page//00:37:03] And, you know, he's I just get so excited. It's I don't know. It's fantastic. One question I ask everybody as we get ready to ramp up is. Too. It's not even a question. I asked first suggestion, one small step, something doable that listeners can start tomorrow to, and just to optimize self since we're talking about optimizing.
[Page//00:37:28] So what's one thing that listeners to.
[Page//00:37:32] James Howton: The spot there. I think that the mindset thing to know, I mean, because the PT would mindset is we can change it pretty quickly and it's like an, a hard type of deal. And so especially tying it to hormones is that mindset of, am I, am I truly the way I want to be at my optimal?
[Page//00:37:48] And if not to just really have that light turn on and go figure it out, go, go address it, measure levels, do what it takes to improve. Because it will be [Page//00:38:00] life-changing F you just turn on that mindset and choose the right.
[Page//00:38:07] Julie Michelson: And one, one thing I usually ask guests that I didn't ask you directly, although I'm pretty sure listeners could tell just from our conversation, but, you know, do you feel people can heal autoimmune symptoms?
[Page//00:38:20] Can they, you know, turn things like that around?
[Page//00:38:23] James Howton: Absolutely. I mean, just like we were saying, you know, We see it often. And that's why I like the idea of tracking markers because not only, you know, it, it's, it's fun. It's fun to see them go away. And then it's fun to clinically see them be able to get off medications they've been on sometimes for years.
[Page//00:38:41] Not because the drugs are bad. I'm the first one that was started the drug, if someone comes in in a flare, but it's not, you know, if you just stop, if you just think of, oh, they have a here's the label. Here's the drugs symptoms are. Okay. They're fine. No, you know, it's back to that mindset. If we go at it with that, drugs are bad and that's it.
[Page//00:38:58] The Western conventional model [Page//00:39:00] is bad. It's just, it's insufficient for autoimmunity and, and. You know, if you keep addressing those root causes and many times you use less and less of the medicine, eventually many people don't need them, but
[Page//00:39:12] Julie Michelson: absolutely I'm living proof of that. I thank you so much for all of the valuable information.
[Page//00:39:19] If people get your hormones checked, please get your hormones checked. And I love the, you know, the key takeaway. Aside from hormones or in addition to is, I know we can heal in that mindset as you know, whether you are, you know, in the middle of a flare and just knowing that it can get better or whether you're doing pretty well.
[Page//00:39:45] Are you, are you perfect? Are you as good as you could be? So I love that. Thank you so much.
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My Guest For This Episode
Connect with James Howton, DO
James Howton, DO
Functional Medicine
Dr. James Howton practiced full spectrum Family Medicine in rural Colorado including ER, Obstetrics, Nursing Home care and Inpatient Medicine caring for families from "cradle to grave” for ten years.
In the mid 1990s he began working with Bio-identical hormones and by 2005 he had transitioned his practice to a Functional Medicine model.It is this root cause approach to health, along with his broad background in traditional medicine, that allows him to uniquely integrate these worlds to best serve his patients.
At his clinic, Restore Health Center, in Loveland Colorado, Dr. Howton focuses on health optimization and addressing the underlying causes of complex medical problems.
In the mid 1990s he began working with Bio-identical hormones and by 2005 he had transitioned his practice to a Functional Medicine model.It is this root cause approach to health, along with his broad background in traditional medicine, that allows him to uniquely integrate these worlds to best serve his patients.
At his clinic, Restore Health Center, in Loveland Colorado, Dr. Howton focuses on health optimization and addressing the underlying causes of complex medical problems.
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