Episode 62
Felice Gersh:
The Critical Role of Estrogen in Immunity
This week we are talking about the essential role our hormones play in immunity, health, and longevity. My friend, Dr. Felice Gersh, explains why women experience autoimmunity more often than men, and just how our hormones can protect us, or increase our chances for autoimmune expression.
First Aired on: Nov 21, 2022
Episode 62
Felice Gersh:
The Critical Role of Estrogen in Immunity
This week we are talking about the essential role our hormones play in immunity, health, and longevity. My friend, Dr. Felice Gersh, explains why women experience autoimmunity more often than men, and just how our hormones can protect us, or increase our chances for autoimmune expression.
First Aired on: Nov 21, 2022
Table of Contents:
In this episode:
Felice Gersh, MD is an award winning physician with dual board certifications in OB-GYN and Integrative Medicine. She is the founder and director of the Integrative Medical Group of Irvine, providing comprehensive health care for women by combining the best evidence-based therapies from conventional, naturopathic, and holistic medicine. Dr. Felice is a prolific writer and lecturer who speaks globally on women's health and is the best selling author of the PCOS SOS series and Menopause: 50 Things You Need to Know.
Dr. Gersh was an early entrepreneur, starting her own medical practice from scratch early on. She added additional practitioners to best support her patients with services such as Chinese Medicine.
After deciding to stop seeing patients full time, she went back to school to learn more ways to help her patients. She did a fellowship in Integrative Medicine and has continued to be a leader in her field.
Expanding beyond pharmaceuticals and surgery is essential!
It wasn't until 2015 that the FDA required that women be included in studies.
The female body evolved for optimal success.
Women have very different immune systems than men. We need to be able to keep a body alive.
XX chromosomes help to program the immune system of females to be stronger.
There are estrogen receptors on every cell in the body.
Innate immune system
Creates a life saving inflammatory responseEstrogen is an immune modulator
When you are pregnant you make Estriol, which binds to beta receptors which quiets the immune system to sustain the foreign invader...the baby.
The immune response is down regulated during pregnancy.
Estradiol is an immune modulator, ramping up and down regulating the immune system.
Estrogen is amazing!
Micronutrients are essential and nutritional deficiencies can lead to issues with the ovaries.The menstrual cycle is a reflection of women's health. If there are issues with the cycle, the underlying cause needs to be addressed.
When we hit menopause, reproduction ends, but life does not. We are one of few animals that survives after reproduction has ended.
All of our hormones interact. So when we go through menopause, that balance is shifted.
Integrative vs. alternative...using the best of both worlds
Not sex hormones but "life hormones"
Hormones are neuro-protective - essential for brain function
Molecular mimicry - our cells look similar to infection or other protein which can lead to autoimmunity
Women have higher immune response - 80% of autoimmunity
Osteoporosis - hormone deficiency
Metabolic homeostasis
One Step:
1-define the problem (choices you control that you could do better with)Pick the one that you can actually do tomorrow - make a commitment- and keep it!
If someone loses their thyroid, they never say...that's ok, you don't need it anyway.
But when ovaries stop working, that is what women are told.
Other Resources:
Connect with Felice Gersh
Episode Transcript
Julie Michelson: [Page//00:00:00] Welcome back to the Inspired Living with Autoimmunity podcast. I'm your host, Julie Michaelson, and today I'm joined by Dr. Felice Gersh double board certified in ob gyn and integrative medicine bestselling author and women's health expert, and we're talking about the hormone immune connect. If you've ever wondered why auto immunity affects so many more women than [Page//00:01:00] men, then this episode is for you.
Join us as we discuss the synchronicity that is our hormone system, and in particular our sex hormones, or as Dr. Gersh calls them, our life hormones.
Dr. Gersh, welcome to the podcast.
Felice Gersh: Oh, I'm so happy to join you here,
Julie Michelson: This is such an important conversation and I'm excited to share with listeners to bring your expertise to them today. So I'm, I'm really excited to dig into this important conversation.
Felice Gersh: and that is for sure. It is so important and I'm so happy that you're emphasizing it.
Julie Michelson: Well, I always start with story. I'm always so curious about, you know, how did you get to be doing what you did? And, and I think that that's a great way for listeners to get to know you a little bit. So, so how did you become this amazing expert?
Felice Gersh: Well, [Page//00:02:00] I always, I, I think it was sort of intuitive. I always knew that there was more to helping women to optimize their health than, than what could be offered through. Pharmaceuticals and surgeries, and so very early on I started my own practice. I was one of those female entrepreneurs and mainly that was sort of almost by accident.
I kept trying to find someone to join me in private practice back in the day when I. Went into practice and when I came out of residency, private practice was the thing that's really what people did. Now, of course, most doctors are employed by big entities, but that was not the case back then. And so I tried to join other practices, but they were predominantly or completely male.
They were sort of had a different kind of a focus and I really wanted to. Sort of be able to be flexible with my schedule, to have a family to kind of create my own dynamic of [Page//00:03:00] how I would work, and I couldn't do that. I discovered when I was looking at other practices, so I actually said, you know, I'm, I think.
If they could do it, I could do it. I'm gonna start my own practice. So I took a two day course sponsored by the California Medical Association called Establishing a Medical Practice. That was, my MBA is a two day course and I actually started my own practice from scratch and I, I knew very early on that I needed to add more services.
I call them my ancillaries. So very quickly in my practice, I add. A Chinese medicine practitioner, a nutritionist, a psychologist, a massage therapist. So I, I, but I personally never had additional training in anything beyond conventional medicine. But then after 25 years of delivering thousands of babies, doing a lot of high risk obstetrics, it was just my.
To give it up and actually get some [Page//00:04:00] sleep. , my circadian rhythm was so messed up from all those night phone calls and deliveries and such. And maybe because I had more time, more rest, I actually started demanding that all the pharmaceutical reps that came pering through my office regularly to actually show me the studies that they were involved with.
You know, their companies, their, their drugs that got them FDA approved. And I was shocked when I actually looked at. Original studies. How little they differed from placebo and, and the array of side effects that came out that became apparent during the original studies. And it's like, wait a minute. I remember one drug that I looked at for treatment of overactive bladder that was, you know, big thing for women, overactive bladder.
And the drug had such a wide array of side effects, you know, constipation and cognitive effects ever negative. All of this for one less trip to the bathroom in 24 hours. It's [Page//00:05:00] like all of that for that benefit. And then it's like, wait a minute, I'm not doing obstetric. What am I accomplishing? You know, like if is my goal in life.
I could do tons of surgeries. I was very good. I taught surgery at USC School of Medicine for many years and, but I said, I don't wanna do endstage disease all the time. I don't wanna just do surgery. It's important. And I didn't wanna give it up, but I didn't want that to be basically all I did. I gave it a lot of thought and I went on my own personal journey and I ended up taking all kinds of courses.
I kept, you know, searching for ways to expand what I call my, my therapeutic toolbox. Hang on one second. I have to plug in my computer. Sorry. I know you can edit. I didn't realize that I hadn't done it. Now I'm good. Good use. Okay, so after. Taking many courses traveling around the country. I [Page//00:06:00] ended up in Portland.
I was in a course with a bunch of naturopaths and there was one other MD there who was actually giving a lecture, and I went up to her during a break and I said, Dr. Low Dog. You and I are the only MDs in this room. I feel so lost. I'm really trying to expand how I can help my patients, and I'm just sort of randomly taking different courses.
She said, You know, after having talked to you, I know you're qualified. Why don't you apply to the Fellowship and Integrative medicine at the University of Arizona School of Medicine where. And like the director. And so I went home that Sunday night after the course, I filled out the application and two weeks later I was in Tucson and I did the two year fellowship in integrative medicine.
I became one of the first board certified OB GYNs in integrative medicine along with my board certification in ob gyn. And I never looked back and that. Over a decade ago that [Page//00:07:00] I finished that fellowship and it's just been onward and upward and learning and teaching. I'd always been involved in teaching and now I continue that journey.
In terms of giving. Lectures across the world that got a little interrupted by Covid. I ended up doing everything virtually, but it's through the magic of the computer, I was able to communicate with people everywhere and it's been amazing the benefits that you can help create for women patients by.
Expanding into natural medicine, holistic and lifestyle, the all the lifestyle medicine tools to really expand well beyond pharmaceuticals and surgery to help every woman and I, and along the journey, I really learned and did a deep dive. Into the hormones of the ovaries, and I know we're gonna talk about that because that became sort of one of the foundational things that I teach, [Page//00:08:00] is what do the ovaries do in terms of these hormones?
What are their functions in the body? And what happens when this universal, inevitable, unavoidable process that every woman faces called menopause? What happens when women go through that? And also what happens in younger years, during the reproductive years when things get messed up? Because we know infertility is skyrocketing, menstrual problems of every kind, whether it's cramp.
Irregular cycles, heavy bleeding. The development of, you know, endometriosis, uterine fibroids, PMs, all of these, what you might call totally unique to women's health problems. They are so neglected. Everything that's uniquely female is sadly very overlooked. It wasn't until 2015. That's not that, that's not exactly ancient history.
That the FDA required that women [Page//00:09:00] at least be included in studies . So, you know, so it's so it's one of my missions is to teach and learn about these unique issues that face just women that are so life changing when things are not working properly. And so that's been my journey and I'm just, I didn't, never gonna look back except to learn from the past.
Cuz I'm just really forward focus.
Julie Michelson: So amazing and incredible, and I would say you may not have had the board certification, but you started, like, as you had said, you pretty much started integrative. It just wasn't all you, but you knew enough to realize that we are whole humans. So many amazing things. I also wanna just, I know, tip my hat to you as far as being an early entrepreneur, you know, just because you didn't find.
The scenario you were looking for. So you created it. And that is entrepreneurship. That's what it's all about. So what a [Page//00:10:00] huge, huge need. You're, you're filling. I was complaining as such a passion point of mine as a woman and a mother of a young lady. And we'll get into why I work with mostly women.
Not all women, but mostly women. The, what you just said about, you know, us having these unique issues, unique to women. It, I know, at least for me, and I see it even with younger, younger ladies these days, you know, we norm, we tend to normalize. And that's because. We were told for years, Well, yeah, you're a, oh, you have cramps.
You know, Well, yeah, you're a woman, It's okay. You have irregular periods, you have, you know, X, y, z fill it in. And it's the same with menopause. You know, people think, Oh, menopause is terrible. It doesn't need to be terrible. It's not supposed to be terrible. And, and so I love bringing attention. To all of the things.
If we had five hours, I, [Page//00:11:00] I have this big list of questions I could ask you, but we are here today to kind of tie, you know, hormones and autoimmunity and I just kind of tipped a little bit with the, you know, why, why do so many more women than men get diagnosed with autoimmunity? One would imagine it has, Be related, at least in part to hormones.
So let's talk about hormone health and immune health.
Felice Gersh: Oh, it is so intricately related and it. There's something that everyone needs to acknowledge whether or not they want to have children or not. We need to acknowledge that the female body evolved for optimal reproductive success. I mean, cuz Nature's Prime directive is. To create new life. It's just what it is.
So to create new life, you need as a female to have quite a different immune [Page//00:12:00] system than a male. And so women are very different in the way their immune systems work. It, it's a necessity in order to have. Survival and fertility that's successful. So if we go back to the very beginning of life, you know when you're an embryo, you're just conceived as a female, you have two x chromosome.
Now a male has an X in that little Y, but it's very cute, but a little y. Now it turns out that the vast array of genes that control immune function are almost exclusively on the X chromosome. Now we have two now, theoretically. One of those X chromosomes becomes deactivated in every cell. So you end up with just one that's functioning, but that's not actually quite what happens in reality.
Well, it turns out that for several weeks during the embryo logical stage of life, when you're just, you know, developing, [Page//00:13:00] Two X chromosomes. Both of them stay functional for several weeks, and what they're doing is they're programming gene function that create what we call epigenetic expression, how the genes actually express themselves.
So they're actually programmed during these embryo first weeks and having two X chromosomes with all of those active genes involving immune function. Help to program the immune system of females to be more robust, like, more like proactive, more vigorous. Then one of the X chromosomes does get turned off in every cell, but not completely.
About 15% of the genes on the so-called deactivated X chromosome actually stay. Not amazing and almost, and almost all of those still active genes are [Page//00:14:00] involved in immune function now. It turns out that that's not all that makes women different from men with their immune function. Of course. So are the hormones quite different?
Estrogen has receptors on every immune cell of the body. So if we look at the immune system as sort of like an overview, there's like the, what we call the innate immune system. That's the part of the immune system that activates when there's a pathogen, like a bacteria, a virus. Parasite or fungus trying.
Take hold in your body and the innate immune system has what I call the first line of attack. So you have these cells that are programmed just to go after whatever. I mean, they have receptors that pick up all the different kinds of pathogens, like the mass cells, like the, they line all the interfaces between the outside.
And your inner body so that it acts as like the [Page//00:15:00] sensory guards to check over and take care of things. And when something gets in, it's like they become activated. They bind with their little things called toll-like receptors to the pathogen, and then they explode. They call it like de granulation. They like explode and release inflammatory product.
SIGNALING agents to bring in the troops and they create this inflammatory response, which is lifesaving. They also are activated in response to damage tissue, like injured tissue, so that you can repair dam, get rid of the old damaged tissue, and then create repair. So you gobble up like pathogens. You gobble up old dead cells, damage cells, and this is all part of the innate immune system.
Every one of those cells, mass. Neutrophils, Macrophages, monocytes, they all have receptors for estrogen. So it estrogen is an immune modulator. It regulates the immune system [Page//00:16:00] from top to bottom, so it's on all of the immune cells. So that's the innate immune cells. And then the adaptive immune cells are the cells, the type of lymphocytes called B lymphocytes that make antibodies.
Now those also. Estrogen receptors on them and different types. There's the alpha receptors are predominant on the innate immune cells and the beta receptors on the other types of immune cells that make antibodies the be lymphocytes. So everything is modulated in this sort of interaction to enable success for reproduction.
Now what is that? What is that talking about? Well, it turns out that when you are pregnant, You make a special type of estrogen, little estriol, which binds predominantly to the beta receptor. That's on the, the cells of the immune system that make antibodies. And it turns out when you have high levels [Page//00:17:00] of.
Activation of the beta receptor, it down regulates the alpha receptor. So those innate immune cells, like the attack cells of the body are actually quieted down so that they become actually less effective so that you don't do what, you don't attack and kill your fetus. So the immune system is totally modulate.
During the menstrual cycle, there's changes with the hormone changes and levels, and progesterone also has a big role, which I'll explain. And so what is all so critical is that you don't kill the sperm. You don't kill the fetus by your immune system thinking it's a foreign invader. This is totally unique to females.
Males don't have to do this, so it's just an amazing type of a situation. That's why many women who have autoimmune diseases like multiple sclerosis, actually go into like a [Page//00:18:00] remission during pregnancy because the attack part of the immune system that makes these things. Inflammatory cytokines like tumor necrosis factor alpha, the interferons, the interleukins that are actually pro-inflammatory are all down regulated during pregnancy.
So it's like what you might call an immune modulator, like the pharmaceuticals that are given that downregulate, the innate immune. Production of these cytokines is that create the inflammatory response. So that's why they give warnings on those kinds of drugs, like Humira and Remicade. Like be aware that if you get an infection you could die.
You know, it doesn't, but that's why women who are pregnant, If they get an infection, like they get chickenpox, they get the flu, they get covid, they are more apt to have a more serious outcome because there it's a compromise. Everything in the body is a compromise, so the body down [Page//00:19:00] regulates its immune response, which would be also against pathogens, but also it down regulates it so it doesn't kill the fetus.
Now it's really important when women aren't pregnant that they survive. Pandemics epidemics because they have to be able to nurse their babies and raise these children to sexual maturity so that they can do it all over again and reproduce. So when women aren't pregnant, their immune systems are more, I mentioned, robust.
They have women have, because of their programming, right? In embryonic stages, they have more white blood cells. They have more cells that make antibodies. They have more immune cells, so they are more likely to have a more robust inflammatory response. Now, when you get an infection, That's what saves you.
That's why you want a very [Page//00:20:00] initial, robust inflammatory response to attack and wipe out that pathogen and also to deal with trauma so that like for example, women who are premenopausal, if they have traumatic brain injuries, they do much better than postmenopausal women, and they do better than men, women.
The pandemic's better women die less from hiv. They die less. They can bleed. They, they do can die from anything, but they have a better survival rate from on the flu because the estrogen and progesterone is also very anti-inflammatory because you don't want. Inflammatory response when you're pregnant.
So progesterone is antiinflammatory, but an estradiol. The estrogen made by the ovaries. That's very important because remember I said estriol during pregnancy has a different binding capacity than estradiol. So that's why we don't wanna give estriol [Page//00:21:00] when you're not pregnant, you know? Cuz that's not what the body is like interested in.
Okay? That's not natural. So that estradiol is an immune modulator. By that I mean you can say regulator. It's part of initiating the inflammatory response when it's appropriate, like to trauma damage tissue and infectious agents trying to get into your body. So it initiates that initial. Powerful immune response to wipe out that infection, to help with injuries and so on.
And then when it's appropriate at the right time, it down regulates the immune system to promote anti-inflammation and resolution of inflammation and the healing process. And in fact, back in the 1990s before that, idiotic, sorry, it is idiot. Women's Health Initiative. The Women's
From 20 years ago came out, there were so many studies.
I researched this on PubMed, my favorite site. [Page//00:22:00] Oh, okay. So I researched, and back in the 1990s, there were so much research going on, looking at putting topical estradiol on the skin. And what they found was concerning wrinkles. Within two weeks, they could see reduction of wrinkles. It improves everything about the skin, the ceramides, the, the hyaluronic acid, the collagen production, everything.
It changes the, the microbiome of the skin, everything, the sebum, you know, types and the fatty acids coming out. And it also was found to be very amazing for healing wounds because at part of the inflammation, Is the resolution which involves healing. That's part of platelets. You know, platelets cause blood clotting, which is part of the pro-inflammatory response.
And then it actually helps with growth factors, which is part of the healing, part of the inflammatory response. And all of that is under the [Page//00:23:00] auspices, the umbrella of estradiol. So estrogen is amazing. Now what happens is many women, All kinds of problems going on with their circadian rhythm and their nutrient status.
I do lectures on. Issues involving micronutrients. If you have even one deficiency, it has ramifications throughout every cell in the body because these micronutrients are essential for running the co enzymes, the cofactors nuclear like dna, rna. Stabilization, I mean, so many different things. So, so many people have nutritional deficiencies and all of these things impact so many different issues.
And when you have, and it can lead to dysfunction of the ovaries and then the ovaries don't produce hormones and the proper sequence and so on, and that has. Further downstream ramification. So you get this [Page//00:24:00] horrible cycle of gut, this function, brain dysfunction, circadian rhythm, hormonal imbalances, and that's where it's complex.
People want a simple solution. There is no simple solution. And the solution is not to cover it up, like I call it, smoke and mirrors by giving birth control pills to the young reproductive women because the menstrual cycle is a vital. Sign of female health, a vital sign is like, what's your temperature?
What's your pulse? What's your blood pressure? Right? So if your menstrual cycle is messed up, guess what, ladies? You are messed up and the solution isn't to just cover it up. It's to fix it, and you'll never fix it if you just put people on birth control pills. And that's the go to now. I mean, it's just so sad because these women often have nutrient deficiencies because of diet.
They often have just, you know, circadian rhythm problems, dysbiotic, gut microbiomes, like they have, you know, they have wrong [Page//00:25:00] microbes in their gut. They have what we call impaired gut barrier or leaky gut. I mean, there's so many different manifestations and that leads. Problems with the brain, the gut and the brain.
They communicate and oh my goodness, there's, it gets complex. But the solution isn't to like, if you have mold in your wall, the solution isn't to put on pretty wallpaper that isn't going to fix the problem. And then in menopause, the reality is that you don't have hormones that are coming outta your ovaries.
That's gonna have ramifications everywhere. Because remember, every system in the. Has estrogen receptors. I mentioned the immune cells have estrogen receptors. They also have progesterone receptors. So too, every system, the cardiovascular system, you know, the heart, the blood vessels, the musculoskeletal system, the ligaments, the tendons, the bones, the Neurological system.
The enteric, the gut nervous system, the brain, the central nervous system. If you look at the skin I already mentioned, like the skin,
Julie Michelson: Oh, you name[Page//00:26:00]
Felice Gersh: every organ, right? You can go like every organ, the, you know, the GI, Tracted, every part of the GI tract, they all have. Hormone receptors. So it's one body, and it works in synchrony, in a beautiful synchrony to support reproductive success and survival so that you can have multiple episodes of reproduction and create multiple babies and then be alive so that you can raise them.
So it's all about survival so that you can raise the kids survival and health so that you can have the kids. And then all of that kind of comes to. An end of sorts when you hit menopause. So nature doesn't make us die when we hit menopause. By the way, most organisms, most creatures on planet earth die when reproduction ends.
Only a few animal types where one of them. Actually has life after reproduction ends. But it's kind of like a fend for yourself situation here, . And so [Page//00:27:00] we need to actually access every therapeutic tool in the book to have healthy longevity. But if we understand that these hormones, estrogen in the form of estrodiol and progesterone and testosterone, which doesn't drop at menopause, it's really, it's.
Related to menopause. The skillset of the ovary to make testosterone is unrelated to the skillset to. Estrogen, estradiol and progesterone because you need to have a supply of eggs to make estrogen and progesterone. You don't need that to make testosterone. So it's separate. It's, it's a very vital hormone.
It's much smaller in women in terms of production amount, but it's
Julie Michelson: often overlooked
Felice Gersh: Totally overlooked. Totally overlooked. And I do talks about, you know, testosterone, ma, everything matters, but you can put it in hierarchy, you know, so I put, you know, estradiol at the top, but all these other matter, I mean, you know, thyroid, I mean, that's a [Page//00:28:00] big deal.
Of course, you know, but, and actually they all interact. So, like, for example, when you have high levels of estradiol, It actually upregulates the progesterone receptor so that progesterone works better when you have high levels of progesterone. It actually down regulates the receptors for estradiol. When you have high levels of estradiol, it up regulates the receptors for thyroid hormone, so it works better testosterone, so it works better.
And it's also that women have a good sex drive , by the way that the, you
Julie Michelson: we'll keep reproducing
Felice Gersh: Exactly, and that's why all women after menopause have symptoms that fit with low thyroid. Even though you measure their thyroid hormone, it may be normal in the reference range and it looks fine. And the doctor says you don't have thyroid problems, you probably need Prozac.
That's not it. They, because without adequate estrogen, estradial, The thyroid receptors are not [Page//00:29:00] gonna work well. It's like if you have a baby and you want to feed your baby mash. So you buy all this mashed peas, or you make it yourself. So you have this big supply and it turns out that the baby gets one sniff of it with the spoon, and it's like, I hate peas, but you know, I'll take like mashed peaches, but I do not like mashed peas.
So it shuts the baby's mouth. The baby will shut. You know, babies have very. Very particular taste, right? They like they, and when they don't want something, you know what they do? They shut their mouth and then if you try to shove it in, they use their little tongue, blah, blah, blah, and they push it right back out, right?
Like they'll just push it right out. So it doesn't matter how much you have, if the receptor, the mouth doesn't wanna receive it, right? So it doesn't matter how much thyroid hormone you have, if you can't get it into a functional receptor, that's what happens when you have insulin resistance, right? You have all that insulin.
Julie Michelson: all time favorite visual of a
Felice Gersh: Okay,
Julie Michelson: I will, I will never [Page//00:30:00] not. any conversation regarding hormones and receptors be, I will always see the baby and and the time. It's so true, though
Felice Gersh: I once tried to give my youngest daughter. Eggplant . And I'll tell you
Julie Michelson: did not go well.
Felice Gersh: did not go well. So that picture never left me when she like tried the eggplant, like, no way, Nohow never gonna open my mouth again for that. Now she actually likes, but that was. When she was a baby. And so it's like, it doesn't matter what you want to go into that receptor when the receptor says No way.
And that's what happens with, like I said, insulin. When you have insulin resistance, that means the receptor isn't working well and you body, your body makes all this extra insulin but isn't like working well, you know, so your blood sugar keeps rising. So, you know, at least after a while, you know the insulin isn't gonna compensate.
And you know, like, it's like, it's like you get a big team and you keep like shoving on the door. Eventually it opens, but eventually that door gets totally stuck and you put [Page//00:31:00] all the insulin in the world and it's just not gonna really open well. So that's what happens when you, you know, with these other hormones.
So everything is so interactive. So I always say this. If you for some reason had like a big gor, you know that's your thyroid, a big swollen thyroid, but it wasn't cancer or anything, but it was so big. This, by the way, can happen. It was so big that it was pushing on your trachea so you couldn't breathe well or you know, swallow well.
Cuz it's like this giant thyroid right here. So what do they do? They sometimes might take it out. This doesn't happen very often, but they take it out. Now, if somebody removes someone's thyroid gland, they would never. Well, it's okay. Why don't you me? You don't need it. Why don't you meditate or eat more vegetables or take a walk or something?
No, they would say you have to have thyroid. So I say the same thing when you lose your ovarian function. I know it's natural. I don't care because earthquakes, which we're having a hurricane now, coming to Florida, that's natural. [Page//00:32:00] Some people, it won't go into climate change here, but it's still a natural event.
Maybe promoted by climate change. But in any case You know, it doesn't mean it's good for anyone living in Florida, I can tell you. So natural doesn't mean good. Okay? Remember, death is natural.
Julie Michelson: And so is arsenic
Felice Gersh: Exactly. You know, poison toad stools. So just cuz it's natural doesn't mean you know, if you want it natural, then don't come and see me cuz then you don't want any, I like intervene, but I try to intervene in a way that's, Adapted to the human body.
That's physiologic that I try to use like natural medicine before. I use pharmaceutical medicine when I can, If somebody comes in with incredibly high blood pressure, I'm not going to just say, eat more vegetables, go on the dash diet or something. I'm gonna say, I need to put you on a blood pressure drug now, and we're also
Julie Michelson: then
Felice Gersh: Right.
We're also going to do, Right, right, right. If someone has a giant ovarian tumor, I can't just give. Cucu in, I mean, like, I know. Okay. [Page//00:33:00] You know, there are limitations to, That's why I, I have a not, I'm not alternative medicine.
Julie Michelson: Integrative.
Felice Gersh: integrative. I Exactly,
Julie Michelson: But you're getting at that root cause. It's not
Felice Gersh: Always.
Julie Michelson: Not
Felice Gersh: I, I will always treat symptoms, but I will never only treat symptoms.
You got it. You
Julie Michelson: Yes. I love it. I've,
Felice Gersh: problems. Yeah. You got it.
Julie Michelson: I've heard you say which I loved, I hope I'm gonna quote it correctly cause it didn't write it down when I heard it, but I was like, Ooh. We were just talking about estrogen and estradiol, progesterone, all the, all the sex hormones. And I heard you refer to them.
You're, you're changing the name I hear.
Felice Gersh: Oh yes. I don't wanna call them sex hormones. I wanna call them life hormones
Julie Michelson: And this is directly what you were saying about, you know, we don't hopefully die when we're done with our reproductive years and if we want to live [Page//00:34:00] young and vi, and that's why topical estrogen makes your skin look beautiful, because that's why we get wrinkly and trivially when we lose our hormones.
Felice Gersh: You know, like I have, I work with a compounding pharmacy who makes a product that has estrogen and progesterone in it, and my patients love it. I always, I, I mean secret, but not so secret. I use it. Okay. You know what, it's natural. I, I would rather do that. I'm, like I've said, I, I, I once had a bad concussion from falling off a bicycle when I was mountain biking.
Back in like 2002. Okay. And so I will not put my brain under, you know, voluntarily under anesthesia. Anesthesia doesn't get, its due in terms of its harm to the brain. It's like getting a little brain trauma. So especially the older, you
Julie Michelson: Or big, depending
Felice Gersh: Yeah, the, it's not good for the brain to be put under anesthesia, let's you know.
That's why they try to avoid it for little bitty children and old people, especially cuz [Page//00:35:00] their brains don't do as well. Of course, if you're on estrogen, it will do better with estrogen, it really will. And I know estrogen at progesterone is very neuroprotective, absolute. And the brain makes estrogen and the brain makes progesterone.
It's just that after menopause, the the, it's even with making it, it doesn't make enough because the precursor to estradiol is testosterone. So men, when they have good testosterone levels, make plenty of estradiol in their brain, but no matter what, women will never. Testosterone levels that are high enough and their brains are not even designed to be making a ton of estradiol because it's not how we're programmed.
So we need that. But it's very, they're both all neuroprotected. That's why they're often called neuro steroids because they're actually very involved in neurological health and, and function and so on. But the bottom line is that I would much rather put hormones on my. I'm not going under anesthesia. I'm not gonna have a facelift.
It's just not gonna happen [Page//00:36:00] because I might value my brain function more than I care about wrinkles. But
Julie Michelson: Well, and you don't even have any, or you know, or you have
Felice Gersh: you know. Well
Julie Michelson: in the
Felice Gersh: now I never bet. I just truth, I never use filters on any pictures. Like I am who I am. I never want someone to meet me in person and say, Why? Do you use like a 20 year old photo or something?
No,
Julie Michelson: Right. Well, and I, I joke, I'm 53. I didn't think I was gonna live to see 50. So like, I wear 53, like a badge, Like I'm thrilled to be 53 and I've earned, you know, we, we just, But the thing is that as we're talking about, there are things we can do
Felice Gersh: absolutely, and
Julie Michelson: for listeners who are thinking like, Wow, well I have auto immunity.
No one's ever asked me about hormones. You know, maybe they're still, you know, fully cycling. Maybe they didn't have fertility trouble we, that we could do in a whole nother episode as to why people
Felice Gersh: oh, you know what? [Page//00:37:00] You know, I wanna touch on that. Thank goodness it's so easy to get sidetracked. But the reason that women make up 80% of all people who have autoimmunity is because they have so many more cells that can make antibodies, and they have so much of a more. Outsized oversized immune response.
So if you have a chronic infection, now a chronic infection can be like a herpes infection because there are many herpes, there are many viruses. And by the way, You know, Covid is now recognized as one of them that can promote and cause long term chronic infections. Now, if you have a leaky gut, then bacteria and viruses in your gut will be continually leaking into your body.
That's like a chronic infection. They even now, like Dr. Shaunfeld from [Page//00:38:00] Israel, who's a famous immunologist, says, and I had some conversations with him. I said, There's no question. From what our conversation that the vagina can cause leaky vagina. Okay. And then bacteria in the vagina can leak into the body proper and create this essentially like a chronic state of infection.
And so the body in, in exchange for trying to survive, you know, that's what it's trying to do. It creates antibodies. Against the infectious agent. Women make more antibodies and they have a more aggressive response to infections than do men. So if now every time you have an infection, a hundred percent, you will make antibodies against that infectious agent.
Now, we all life forms, every life form has the same building blocks the nucleotides we don't have. 5 trillion different nucleotides, like every, the building blocks are the same. They're just somewhat rearranged. It turns [Page//00:39:00] out that we humans have protein structures and amino acids and nucleotide sequences that are similar to the pathogen, so you might quote, They call it molecular mimicry.
It's like mistaken identity. So the antibodies will just say against strep because people know that strep is associated. When they used to not treat it with antibiotics, it could cause rheumatic heart disease, which is where the antibodies attack the heart valves. Okay. So we can have human structures.
It could be in the joints. It could be on the nerves, it could be the sheath that covers nerves like with ms. So, It could be thyroid, which is the most common. Okay. Could be anything. The gut lining cells, you know, so any cell in the body could have a similar structure to the invading pathogen, and they've actually had some linkages between them.
Okay. Especially with rheumatoid arthritis. So if you make an antibody against a [Page//00:40:00] pathogen and that infection is long term, then that antibody is gonna be continually produced if you have a short term infection. During that short term infection, you will make antibodies against yourself. So, but it's short lived and when the infection is over, the antibody production is ro way down, so it's not gonna cause harm.
But if it's an ongoing infection and you keep making antibodies over and over and over, you're going to end up making antibodies against your own tissue. Some kind of tissue is gonna be similar and. The initiation of autoimmune disease, it starts from a chronic infection. And we have so many different chronic infections that now, you know, because people's guts are so leaky and other things are leaky.
And we have, you know, environmental poisons that interfere with our own hormonal systems that we call these ubiquitous endocrine disruptors and so on, [Page//00:41:00] that interfere with the normal function of our immune system. So I. Attacking the invader and then eradicating it. It allows the chronic infections that that sort of sets the stage for these autoimmune conditions.
And we know that a lot of autoimmune conditions are now linked to nutrient deficiencies like vitamin D, and so it's all like every, all the systems are interlink.
Julie Michelson: another hormone, by the
Felice Gersh: Right. It's like a pre-one. It's like a pre-one, right? So the bottom line, and we're supposed to manufacture it, but people aren't doing a good job of that.
So the bottom line is that because women have this unique immune system that we have way more production of all the immune factors. The cytokines, the antibodies, we have more immune cells and a more exaggerated response because it's about survival. But now it's sort of turned against us. When you have an acute infection, [Page//00:42:00] we survive
Julie Michelson: We rock it.
Felice Gersh: right?
We reckon. But when it's a chronic infection, we can end up with autoimmune diseases, which are now epidemic. Okay. And I deal with them all the time. So you gotta heal leaky gut, you gotta calm the system down, you gotta give immune support. So there are like a whole sequence of events and you've gotta look for environmental toxicants, like poisons and chronic infections.
And so you gotta look at all these things. And this is like what people are doing, like with Alzheimer's, they're looking at all these different things because. Because the same setup that creates autoimmune creates chronic neuroinflammation. Chronic chronic inflammation, which increases autoimmune, which increases allergies, which increases cardiovascular disease, which increases cognitive problems,
Julie Michelson: Metabolic
Felice Gersh: So one, right? So that's right. Cardiovascular, like vascular. So once you understand the [Page//00:43:00] foundation, Suddenly you see how everything is interlinked. That's why it drives me crazy when I see an article said, Oh, we just made this great discovery. Like women who have osteoporosis are more likely to have dementia.
It's like osteoporosis is an inflammatory process and it's, you know, related to hormone deficiency
Julie Michelson: would Thank you. I was like, Eh, we're back to hormones,
Felice Gersh: right, right, right. Because hormones, once you understand, Estrogen and progesterone are about having all the organs work optimally and in synchrony because they're also involved in the master clock that sets the circadian rhythm so that all the organs work on the same time zone , you know, and they work optimally for the purpose.
Survival and reproductive success. Then suddenly there's no mystery how everything is a beautiful symphony and that the hormones are life [Page//00:44:00] hormones, and they create this, what we call metabolic homeostasis. That, that the goal is to keep everything kind of calm, but ready on alert in case of trauma. Or pathogens, but not activated until they need to be activated.
Julie Michelson: Yes. And that's where most listeners are, are like, Ooh, this is , That's how it's supposed to work. So what, what would be, we covered a lot. Like, Wow, I'm, I can't wait to listen to this again. What is one thing listeners can do today? Just one step they can take to start to move their
Felice Gersh: Okay. Well, I always say, Well, you gotta start somewhere. The place to start is number one, and this is just the prelude. This isn't actually the start is to. Define the problem and understand the problem. You can never solve a problem if you haven't even defined what the problem is, so you understand the [Page//00:45:00] problem.
You know, you understand the things that you are doing in your own life that may be not really helpful for your health, you know, so define.
Julie Michelson: I'm going to jump in and clarify because I can already hear like, Well, I, you know, Oh, I know the problem, and they're filling in their diagnosis. Right.
Felice Gersh: Oh, not a diagnosis.
Julie Michelson: about that.
Felice Gersh: it's not a diagnosis. It's like like I eat a lot of processed.
Julie Michelson: Right.
Felice Gersh: I go to bed at 2:00 AM I mean, we're talking about like choices that you can control, not a, not a medical diagnosis. Like you gotta define things that, you know, like make a list of things that you think you can do better with.
Like maybe you. Like, like we said, you know, you go to bed at a crazy time that you don't have to. Cuz I know people that they have social jet lag. They in, they intentionally go to bed at crazy times or they eat meals. [Page//00:46:00] Erratically, they eat late at night, they eat a lot of processed food, which have a lot of chemicals.
They don't eat enough vegetables, they don't hydrate. Right, Right. So, you know,
Julie Michelson: we know you're right. If, if you take a moment and get quiet, you can find those places to up
Felice Gersh: then, so sort of like define the, the problem in terms of the things you can control. You know, like, I can't say sell your house and move to a different state. Okay. We're talking about realistic things that you can control and then, you know, pick the one that you feel you can actually do.
Starting tomorrow. Okay. Now if you have no idea, then start with the gut. Okay? We always say start with gut. So start by doing something simple like saying, I am going to eat vegetables at every meal, or I will absolutely not buy box cereal anymore. Drive, you know, like make a [Page//00:47:00] commitment. And keep it, you know?
So, you know, I can say, I want you to eat three cups of vegetables with every meal, a cup of fruit, never snack, stop eating at 6:00 PM
Julie Michelson: start where you are.
Felice Gersh: know, I mean, I ca I mean, I would love to get everyone to do everything I want. Okay. But I have to be realistic. So every week make a positive change, you know, like, Maybe invest in a little treadmill that you can like, slip under the couch, who doesn't even take up space.
You can buy things like that. Or find a buddy, you know, that you can take a walk with or, you know find, you know, like start going to the local farmer's market. And asking the vendors there, what vegetables they are selling, what they are if you don't like, I don't know what heck, I was like once upon time it's like, what heck is this?
It's cold. Robby, what heck is cold? Robby? You know? You know, like, I didn't know. It's like, And how do you cook it? They're always happy to tell you. You know, they often have sheets with recipes and [Page//00:48:00] of course you can always go online. So experiment. Try a new vegetable every week. You know, and leave some bad thing out of your life.
It could be a toxic person, , you know, so you know,
Julie Michelson: It's
Felice Gersh: So, you know, set a schedule that's realistic and make a positive change every week. Make a list of things that you know you don't like. Need a healthcare professional, you know, you know.
Julie Michelson: all know, we
Felice Gersh: You know, things that you're doing that are really not ideal, right?
Like, are you like, you know, like stop snacking, you know, say, But if I do have to snack, I'm only gonna snack on raw, organic nuts and maybe. Raw, I mean not raw, cuz they are raw, you know, like, like a fruit that you like, like grapes, you know, or something like that. So, you know, so you say, Okay, I'm gonna try not to snack anymore because it's not really great cuz you can't keep your insulin under control of your snacking all day.
But at least if you eat [Page//00:49:00] something, it adds nutrients. Okay. And not poison, you know? So just take these steps and you know what's gonna happen. A year's gonna come and go and at the end of the year, You're gonna be one happier, healthy individual.
Julie Michelson: Amazing. I love it. For people that are listening on the go and aren't gonna check out the show notes, where is the best place for people to find you?
Felice Gersh: Well, I'm actually, I told you I'm in an exam room in my office. I, I have, I'm an old fashioned doctor. I have a brick and mortar practice. I also can do telemedicine. And I am in Irvine, California, so that's Southern California. The name of my practice is integrative. Medical group of Irvine.
Julie Michelson: And for those not familiar, Dr. Gersh is being modest. She's also has this amazing presence on Instagram and gives so much information and I believe it's, it's Dr. Fe Gersh on Instagram? Correct.
Felice Gersh: so it's a, [Page//00:50:00] the only thing that's tricky about it is, is a period after doctor, So it's d d r period and then fe ksh. And I do try most, most weeks. Sometimes I miss, cuz I'm like out speaking, I travel, I still, now traveling is back. So I'm, I'm traveling, I'm doing lectures and I do have three books.
I'm hoping to write many more. So I have two books on P C O S. One is the foundation book, P C O s, sos. The other one is for women trying to get Pregnant and now called P C O S SOS Fertility, Fast Track, and One on Menopause. That's my newest book, Less than a Year Out, and it's called Menopause 50 Things You Need to Know
Julie Michelson: And I love that you put the 50 50 things in there, amazing resources for everybody. Dr. Gr, thank you so much for joining us today.
Felice Gersh: Thank you for inviting me.
Julie Michelson: For everyone listening. Remember, you can get the transcripts and show notes by visiting Inspired [Page//00:51:00] living.show. I hope you had a great time and enjoyed this episode as much as I did. Listen to it twice. I'll see you next week.
Join us as we discuss the synchronicity that is our hormone system, and in particular our sex hormones, or as Dr. Gersh calls them, our life hormones.
Dr. Gersh, welcome to the podcast.
Felice Gersh: Oh, I'm so happy to join you here,
Julie Michelson: This is such an important conversation and I'm excited to share with listeners to bring your expertise to them today. So I'm, I'm really excited to dig into this important conversation.
Felice Gersh: and that is for sure. It is so important and I'm so happy that you're emphasizing it.
Julie Michelson: Well, I always start with story. I'm always so curious about, you know, how did you get to be doing what you did? And, and I think that that's a great way for listeners to get to know you a little bit. So, so how did you become this amazing expert?
Felice Gersh: Well, [Page//00:02:00] I always, I, I think it was sort of intuitive. I always knew that there was more to helping women to optimize their health than, than what could be offered through. Pharmaceuticals and surgeries, and so very early on I started my own practice. I was one of those female entrepreneurs and mainly that was sort of almost by accident.
I kept trying to find someone to join me in private practice back in the day when I. Went into practice and when I came out of residency, private practice was the thing that's really what people did. Now, of course, most doctors are employed by big entities, but that was not the case back then. And so I tried to join other practices, but they were predominantly or completely male.
They were sort of had a different kind of a focus and I really wanted to. Sort of be able to be flexible with my schedule, to have a family to kind of create my own dynamic of [Page//00:03:00] how I would work, and I couldn't do that. I discovered when I was looking at other practices, so I actually said, you know, I'm, I think.
If they could do it, I could do it. I'm gonna start my own practice. So I took a two day course sponsored by the California Medical Association called Establishing a Medical Practice. That was, my MBA is a two day course and I actually started my own practice from scratch and I, I knew very early on that I needed to add more services.
I call them my ancillaries. So very quickly in my practice, I add. A Chinese medicine practitioner, a nutritionist, a psychologist, a massage therapist. So I, I, but I personally never had additional training in anything beyond conventional medicine. But then after 25 years of delivering thousands of babies, doing a lot of high risk obstetrics, it was just my.
To give it up and actually get some [Page//00:04:00] sleep. , my circadian rhythm was so messed up from all those night phone calls and deliveries and such. And maybe because I had more time, more rest, I actually started demanding that all the pharmaceutical reps that came pering through my office regularly to actually show me the studies that they were involved with.
You know, their companies, their, their drugs that got them FDA approved. And I was shocked when I actually looked at. Original studies. How little they differed from placebo and, and the array of side effects that came out that became apparent during the original studies. And it's like, wait a minute. I remember one drug that I looked at for treatment of overactive bladder that was, you know, big thing for women, overactive bladder.
And the drug had such a wide array of side effects, you know, constipation and cognitive effects ever negative. All of this for one less trip to the bathroom in 24 hours. It's [Page//00:05:00] like all of that for that benefit. And then it's like, wait a minute, I'm not doing obstetric. What am I accomplishing? You know, like if is my goal in life.
I could do tons of surgeries. I was very good. I taught surgery at USC School of Medicine for many years and, but I said, I don't wanna do endstage disease all the time. I don't wanna just do surgery. It's important. And I didn't wanna give it up, but I didn't want that to be basically all I did. I gave it a lot of thought and I went on my own personal journey and I ended up taking all kinds of courses.
I kept, you know, searching for ways to expand what I call my, my therapeutic toolbox. Hang on one second. I have to plug in my computer. Sorry. I know you can edit. I didn't realize that I hadn't done it. Now I'm good. Good use. Okay, so after. Taking many courses traveling around the country. I [Page//00:06:00] ended up in Portland.
I was in a course with a bunch of naturopaths and there was one other MD there who was actually giving a lecture, and I went up to her during a break and I said, Dr. Low Dog. You and I are the only MDs in this room. I feel so lost. I'm really trying to expand how I can help my patients, and I'm just sort of randomly taking different courses.
She said, You know, after having talked to you, I know you're qualified. Why don't you apply to the Fellowship and Integrative medicine at the University of Arizona School of Medicine where. And like the director. And so I went home that Sunday night after the course, I filled out the application and two weeks later I was in Tucson and I did the two year fellowship in integrative medicine.
I became one of the first board certified OB GYNs in integrative medicine along with my board certification in ob gyn. And I never looked back and that. Over a decade ago that [Page//00:07:00] I finished that fellowship and it's just been onward and upward and learning and teaching. I'd always been involved in teaching and now I continue that journey.
In terms of giving. Lectures across the world that got a little interrupted by Covid. I ended up doing everything virtually, but it's through the magic of the computer, I was able to communicate with people everywhere and it's been amazing the benefits that you can help create for women patients by.
Expanding into natural medicine, holistic and lifestyle, the all the lifestyle medicine tools to really expand well beyond pharmaceuticals and surgery to help every woman and I, and along the journey, I really learned and did a deep dive. Into the hormones of the ovaries, and I know we're gonna talk about that because that became sort of one of the foundational things that I teach, [Page//00:08:00] is what do the ovaries do in terms of these hormones?
What are their functions in the body? And what happens when this universal, inevitable, unavoidable process that every woman faces called menopause? What happens when women go through that? And also what happens in younger years, during the reproductive years when things get messed up? Because we know infertility is skyrocketing, menstrual problems of every kind, whether it's cramp.
Irregular cycles, heavy bleeding. The development of, you know, endometriosis, uterine fibroids, PMs, all of these, what you might call totally unique to women's health problems. They are so neglected. Everything that's uniquely female is sadly very overlooked. It wasn't until 2015. That's not that, that's not exactly ancient history.
That the FDA required that women [Page//00:09:00] at least be included in studies . So, you know, so it's so it's one of my missions is to teach and learn about these unique issues that face just women that are so life changing when things are not working properly. And so that's been my journey and I'm just, I didn't, never gonna look back except to learn from the past.
Cuz I'm just really forward focus.
Julie Michelson: So amazing and incredible, and I would say you may not have had the board certification, but you started, like, as you had said, you pretty much started integrative. It just wasn't all you, but you knew enough to realize that we are whole humans. So many amazing things. I also wanna just, I know, tip my hat to you as far as being an early entrepreneur, you know, just because you didn't find.
The scenario you were looking for. So you created it. And that is entrepreneurship. That's what it's all about. So what a [Page//00:10:00] huge, huge need. You're, you're filling. I was complaining as such a passion point of mine as a woman and a mother of a young lady. And we'll get into why I work with mostly women.
Not all women, but mostly women. The, what you just said about, you know, us having these unique issues, unique to women. It, I know, at least for me, and I see it even with younger, younger ladies these days, you know, we norm, we tend to normalize. And that's because. We were told for years, Well, yeah, you're a, oh, you have cramps.
You know, Well, yeah, you're a woman, It's okay. You have irregular periods, you have, you know, X, y, z fill it in. And it's the same with menopause. You know, people think, Oh, menopause is terrible. It doesn't need to be terrible. It's not supposed to be terrible. And, and so I love bringing attention. To all of the things.
If we had five hours, I, [Page//00:11:00] I have this big list of questions I could ask you, but we are here today to kind of tie, you know, hormones and autoimmunity and I just kind of tipped a little bit with the, you know, why, why do so many more women than men get diagnosed with autoimmunity? One would imagine it has, Be related, at least in part to hormones.
So let's talk about hormone health and immune health.
Felice Gersh: Oh, it is so intricately related and it. There's something that everyone needs to acknowledge whether or not they want to have children or not. We need to acknowledge that the female body evolved for optimal reproductive success. I mean, cuz Nature's Prime directive is. To create new life. It's just what it is.
So to create new life, you need as a female to have quite a different immune [Page//00:12:00] system than a male. And so women are very different in the way their immune systems work. It, it's a necessity in order to have. Survival and fertility that's successful. So if we go back to the very beginning of life, you know when you're an embryo, you're just conceived as a female, you have two x chromosome.
Now a male has an X in that little Y, but it's very cute, but a little y. Now it turns out that the vast array of genes that control immune function are almost exclusively on the X chromosome. Now we have two now, theoretically. One of those X chromosomes becomes deactivated in every cell. So you end up with just one that's functioning, but that's not actually quite what happens in reality.
Well, it turns out that for several weeks during the embryo logical stage of life, when you're just, you know, developing, [Page//00:13:00] Two X chromosomes. Both of them stay functional for several weeks, and what they're doing is they're programming gene function that create what we call epigenetic expression, how the genes actually express themselves.
So they're actually programmed during these embryo first weeks and having two X chromosomes with all of those active genes involving immune function. Help to program the immune system of females to be more robust, like, more like proactive, more vigorous. Then one of the X chromosomes does get turned off in every cell, but not completely.
About 15% of the genes on the so-called deactivated X chromosome actually stay. Not amazing and almost, and almost all of those still active genes are [Page//00:14:00] involved in immune function now. It turns out that that's not all that makes women different from men with their immune function. Of course. So are the hormones quite different?
Estrogen has receptors on every immune cell of the body. So if we look at the immune system as sort of like an overview, there's like the, what we call the innate immune system. That's the part of the immune system that activates when there's a pathogen, like a bacteria, a virus. Parasite or fungus trying.
Take hold in your body and the innate immune system has what I call the first line of attack. So you have these cells that are programmed just to go after whatever. I mean, they have receptors that pick up all the different kinds of pathogens, like the mass cells, like the, they line all the interfaces between the outside.
And your inner body so that it acts as like the [Page//00:15:00] sensory guards to check over and take care of things. And when something gets in, it's like they become activated. They bind with their little things called toll-like receptors to the pathogen, and then they explode. They call it like de granulation. They like explode and release inflammatory product.
SIGNALING agents to bring in the troops and they create this inflammatory response, which is lifesaving. They also are activated in response to damage tissue, like injured tissue, so that you can repair dam, get rid of the old damaged tissue, and then create repair. So you gobble up like pathogens. You gobble up old dead cells, damage cells, and this is all part of the innate immune system.
Every one of those cells, mass. Neutrophils, Macrophages, monocytes, they all have receptors for estrogen. So it estrogen is an immune modulator. It regulates the immune system [Page//00:16:00] from top to bottom, so it's on all of the immune cells. So that's the innate immune cells. And then the adaptive immune cells are the cells, the type of lymphocytes called B lymphocytes that make antibodies.
Now those also. Estrogen receptors on them and different types. There's the alpha receptors are predominant on the innate immune cells and the beta receptors on the other types of immune cells that make antibodies the be lymphocytes. So everything is modulated in this sort of interaction to enable success for reproduction.
Now what is that? What is that talking about? Well, it turns out that when you are pregnant, You make a special type of estrogen, little estriol, which binds predominantly to the beta receptor. That's on the, the cells of the immune system that make antibodies. And it turns out when you have high levels [Page//00:17:00] of.
Activation of the beta receptor, it down regulates the alpha receptor. So those innate immune cells, like the attack cells of the body are actually quieted down so that they become actually less effective so that you don't do what, you don't attack and kill your fetus. So the immune system is totally modulate.
During the menstrual cycle, there's changes with the hormone changes and levels, and progesterone also has a big role, which I'll explain. And so what is all so critical is that you don't kill the sperm. You don't kill the fetus by your immune system thinking it's a foreign invader. This is totally unique to females.
Males don't have to do this, so it's just an amazing type of a situation. That's why many women who have autoimmune diseases like multiple sclerosis, actually go into like a [Page//00:18:00] remission during pregnancy because the attack part of the immune system that makes these things. Inflammatory cytokines like tumor necrosis factor alpha, the interferons, the interleukins that are actually pro-inflammatory are all down regulated during pregnancy.
So it's like what you might call an immune modulator, like the pharmaceuticals that are given that downregulate, the innate immune. Production of these cytokines is that create the inflammatory response. So that's why they give warnings on those kinds of drugs, like Humira and Remicade. Like be aware that if you get an infection you could die.
You know, it doesn't, but that's why women who are pregnant, If they get an infection, like they get chickenpox, they get the flu, they get covid, they are more apt to have a more serious outcome because there it's a compromise. Everything in the body is a compromise, so the body down [Page//00:19:00] regulates its immune response, which would be also against pathogens, but also it down regulates it so it doesn't kill the fetus.
Now it's really important when women aren't pregnant that they survive. Pandemics epidemics because they have to be able to nurse their babies and raise these children to sexual maturity so that they can do it all over again and reproduce. So when women aren't pregnant, their immune systems are more, I mentioned, robust.
They have women have, because of their programming, right? In embryonic stages, they have more white blood cells. They have more cells that make antibodies. They have more immune cells, so they are more likely to have a more robust inflammatory response. Now, when you get an infection, That's what saves you.
That's why you want a very [Page//00:20:00] initial, robust inflammatory response to attack and wipe out that pathogen and also to deal with trauma so that like for example, women who are premenopausal, if they have traumatic brain injuries, they do much better than postmenopausal women, and they do better than men, women.
The pandemic's better women die less from hiv. They die less. They can bleed. They, they do can die from anything, but they have a better survival rate from on the flu because the estrogen and progesterone is also very anti-inflammatory because you don't want. Inflammatory response when you're pregnant.
So progesterone is antiinflammatory, but an estradiol. The estrogen made by the ovaries. That's very important because remember I said estriol during pregnancy has a different binding capacity than estradiol. So that's why we don't wanna give estriol [Page//00:21:00] when you're not pregnant, you know? Cuz that's not what the body is like interested in.
Okay? That's not natural. So that estradiol is an immune modulator. By that I mean you can say regulator. It's part of initiating the inflammatory response when it's appropriate, like to trauma damage tissue and infectious agents trying to get into your body. So it initiates that initial. Powerful immune response to wipe out that infection, to help with injuries and so on.
And then when it's appropriate at the right time, it down regulates the immune system to promote anti-inflammation and resolution of inflammation and the healing process. And in fact, back in the 1990s before that, idiotic, sorry, it is idiot. Women's Health Initiative. The Women's
From 20 years ago came out, there were so many studies.
I researched this on PubMed, my favorite site. [Page//00:22:00] Oh, okay. So I researched, and back in the 1990s, there were so much research going on, looking at putting topical estradiol on the skin. And what they found was concerning wrinkles. Within two weeks, they could see reduction of wrinkles. It improves everything about the skin, the ceramides, the, the hyaluronic acid, the collagen production, everything.
It changes the, the microbiome of the skin, everything, the sebum, you know, types and the fatty acids coming out. And it also was found to be very amazing for healing wounds because at part of the inflammation, Is the resolution which involves healing. That's part of platelets. You know, platelets cause blood clotting, which is part of the pro-inflammatory response.
And then it actually helps with growth factors, which is part of the healing, part of the inflammatory response. And all of that is under the [Page//00:23:00] auspices, the umbrella of estradiol. So estrogen is amazing. Now what happens is many women, All kinds of problems going on with their circadian rhythm and their nutrient status.
I do lectures on. Issues involving micronutrients. If you have even one deficiency, it has ramifications throughout every cell in the body because these micronutrients are essential for running the co enzymes, the cofactors nuclear like dna, rna. Stabilization, I mean, so many different things. So, so many people have nutritional deficiencies and all of these things impact so many different issues.
And when you have, and it can lead to dysfunction of the ovaries and then the ovaries don't produce hormones and the proper sequence and so on, and that has. Further downstream ramification. So you get this [Page//00:24:00] horrible cycle of gut, this function, brain dysfunction, circadian rhythm, hormonal imbalances, and that's where it's complex.
People want a simple solution. There is no simple solution. And the solution is not to cover it up, like I call it, smoke and mirrors by giving birth control pills to the young reproductive women because the menstrual cycle is a vital. Sign of female health, a vital sign is like, what's your temperature?
What's your pulse? What's your blood pressure? Right? So if your menstrual cycle is messed up, guess what, ladies? You are messed up and the solution isn't to just cover it up. It's to fix it, and you'll never fix it if you just put people on birth control pills. And that's the go to now. I mean, it's just so sad because these women often have nutrient deficiencies because of diet.
They often have just, you know, circadian rhythm problems, dysbiotic, gut microbiomes, like they have, you know, they have wrong [Page//00:25:00] microbes in their gut. They have what we call impaired gut barrier or leaky gut. I mean, there's so many different manifestations and that leads. Problems with the brain, the gut and the brain.
They communicate and oh my goodness, there's, it gets complex. But the solution isn't to like, if you have mold in your wall, the solution isn't to put on pretty wallpaper that isn't going to fix the problem. And then in menopause, the reality is that you don't have hormones that are coming outta your ovaries.
That's gonna have ramifications everywhere. Because remember, every system in the. Has estrogen receptors. I mentioned the immune cells have estrogen receptors. They also have progesterone receptors. So too, every system, the cardiovascular system, you know, the heart, the blood vessels, the musculoskeletal system, the ligaments, the tendons, the bones, the Neurological system.
The enteric, the gut nervous system, the brain, the central nervous system. If you look at the skin I already mentioned, like the skin,
Julie Michelson: Oh, you name[Page//00:26:00]
Felice Gersh: every organ, right? You can go like every organ, the, you know, the GI, Tracted, every part of the GI tract, they all have. Hormone receptors. So it's one body, and it works in synchrony, in a beautiful synchrony to support reproductive success and survival so that you can have multiple episodes of reproduction and create multiple babies and then be alive so that you can raise them.
So it's all about survival so that you can raise the kids survival and health so that you can have the kids. And then all of that kind of comes to. An end of sorts when you hit menopause. So nature doesn't make us die when we hit menopause. By the way, most organisms, most creatures on planet earth die when reproduction ends.
Only a few animal types where one of them. Actually has life after reproduction ends. But it's kind of like a fend for yourself situation here, . And so [Page//00:27:00] we need to actually access every therapeutic tool in the book to have healthy longevity. But if we understand that these hormones, estrogen in the form of estrodiol and progesterone and testosterone, which doesn't drop at menopause, it's really, it's.
Related to menopause. The skillset of the ovary to make testosterone is unrelated to the skillset to. Estrogen, estradiol and progesterone because you need to have a supply of eggs to make estrogen and progesterone. You don't need that to make testosterone. So it's separate. It's, it's a very vital hormone.
It's much smaller in women in terms of production amount, but it's
Julie Michelson: often overlooked
Felice Gersh: Totally overlooked. Totally overlooked. And I do talks about, you know, testosterone, ma, everything matters, but you can put it in hierarchy, you know, so I put, you know, estradiol at the top, but all these other matter, I mean, you know, thyroid, I mean, that's a [Page//00:28:00] big deal.
Of course, you know, but, and actually they all interact. So, like, for example, when you have high levels of estradiol, It actually upregulates the progesterone receptor so that progesterone works better when you have high levels of progesterone. It actually down regulates the receptors for estradiol. When you have high levels of estradiol, it up regulates the receptors for thyroid hormone, so it works better testosterone, so it works better.
And it's also that women have a good sex drive , by the way that the, you
Julie Michelson: we'll keep reproducing
Felice Gersh: Exactly, and that's why all women after menopause have symptoms that fit with low thyroid. Even though you measure their thyroid hormone, it may be normal in the reference range and it looks fine. And the doctor says you don't have thyroid problems, you probably need Prozac.
That's not it. They, because without adequate estrogen, estradial, The thyroid receptors are not [Page//00:29:00] gonna work well. It's like if you have a baby and you want to feed your baby mash. So you buy all this mashed peas, or you make it yourself. So you have this big supply and it turns out that the baby gets one sniff of it with the spoon, and it's like, I hate peas, but you know, I'll take like mashed peaches, but I do not like mashed peas.
So it shuts the baby's mouth. The baby will shut. You know, babies have very. Very particular taste, right? They like they, and when they don't want something, you know what they do? They shut their mouth and then if you try to shove it in, they use their little tongue, blah, blah, blah, and they push it right back out, right?
Like they'll just push it right out. So it doesn't matter how much you have, if the receptor, the mouth doesn't wanna receive it, right? So it doesn't matter how much thyroid hormone you have, if you can't get it into a functional receptor, that's what happens when you have insulin resistance, right? You have all that insulin.
Julie Michelson: all time favorite visual of a
Felice Gersh: Okay,
Julie Michelson: I will, I will never [Page//00:30:00] not. any conversation regarding hormones and receptors be, I will always see the baby and and the time. It's so true, though
Felice Gersh: I once tried to give my youngest daughter. Eggplant . And I'll tell you
Julie Michelson: did not go well.
Felice Gersh: did not go well. So that picture never left me when she like tried the eggplant, like, no way, Nohow never gonna open my mouth again for that. Now she actually likes, but that was. When she was a baby. And so it's like, it doesn't matter what you want to go into that receptor when the receptor says No way.
And that's what happens with, like I said, insulin. When you have insulin resistance, that means the receptor isn't working well and you body, your body makes all this extra insulin but isn't like working well, you know, so your blood sugar keeps rising. So, you know, at least after a while, you know the insulin isn't gonna compensate.
And you know, like, it's like, it's like you get a big team and you keep like shoving on the door. Eventually it opens, but eventually that door gets totally stuck and you put [Page//00:31:00] all the insulin in the world and it's just not gonna really open well. So that's what happens when you, you know, with these other hormones.
So everything is so interactive. So I always say this. If you for some reason had like a big gor, you know that's your thyroid, a big swollen thyroid, but it wasn't cancer or anything, but it was so big. This, by the way, can happen. It was so big that it was pushing on your trachea so you couldn't breathe well or you know, swallow well.
Cuz it's like this giant thyroid right here. So what do they do? They sometimes might take it out. This doesn't happen very often, but they take it out. Now, if somebody removes someone's thyroid gland, they would never. Well, it's okay. Why don't you me? You don't need it. Why don't you meditate or eat more vegetables or take a walk or something?
No, they would say you have to have thyroid. So I say the same thing when you lose your ovarian function. I know it's natural. I don't care because earthquakes, which we're having a hurricane now, coming to Florida, that's natural. [Page//00:32:00] Some people, it won't go into climate change here, but it's still a natural event.
Maybe promoted by climate change. But in any case You know, it doesn't mean it's good for anyone living in Florida, I can tell you. So natural doesn't mean good. Okay? Remember, death is natural.
Julie Michelson: And so is arsenic
Felice Gersh: Exactly. You know, poison toad stools. So just cuz it's natural doesn't mean you know, if you want it natural, then don't come and see me cuz then you don't want any, I like intervene, but I try to intervene in a way that's, Adapted to the human body.
That's physiologic that I try to use like natural medicine before. I use pharmaceutical medicine when I can, If somebody comes in with incredibly high blood pressure, I'm not going to just say, eat more vegetables, go on the dash diet or something. I'm gonna say, I need to put you on a blood pressure drug now, and we're also
Julie Michelson: then
Felice Gersh: Right.
We're also going to do, Right, right, right. If someone has a giant ovarian tumor, I can't just give. Cucu in, I mean, like, I know. Okay. [Page//00:33:00] You know, there are limitations to, That's why I, I have a not, I'm not alternative medicine.
Julie Michelson: Integrative.
Felice Gersh: integrative. I Exactly,
Julie Michelson: But you're getting at that root cause. It's not
Felice Gersh: Always.
Julie Michelson: Not
Felice Gersh: I, I will always treat symptoms, but I will never only treat symptoms.
You got it. You
Julie Michelson: Yes. I love it. I've,
Felice Gersh: problems. Yeah. You got it.
Julie Michelson: I've heard you say which I loved, I hope I'm gonna quote it correctly cause it didn't write it down when I heard it, but I was like, Ooh. We were just talking about estrogen and estradiol, progesterone, all the, all the sex hormones. And I heard you refer to them.
You're, you're changing the name I hear.
Felice Gersh: Oh yes. I don't wanna call them sex hormones. I wanna call them life hormones
Julie Michelson: And this is directly what you were saying about, you know, we don't hopefully die when we're done with our reproductive years and if we want to live [Page//00:34:00] young and vi, and that's why topical estrogen makes your skin look beautiful, because that's why we get wrinkly and trivially when we lose our hormones.
Felice Gersh: You know, like I have, I work with a compounding pharmacy who makes a product that has estrogen and progesterone in it, and my patients love it. I always, I, I mean secret, but not so secret. I use it. Okay. You know what, it's natural. I, I would rather do that. I'm, like I've said, I, I, I once had a bad concussion from falling off a bicycle when I was mountain biking.
Back in like 2002. Okay. And so I will not put my brain under, you know, voluntarily under anesthesia. Anesthesia doesn't get, its due in terms of its harm to the brain. It's like getting a little brain trauma. So especially the older, you
Julie Michelson: Or big, depending
Felice Gersh: Yeah, the, it's not good for the brain to be put under anesthesia, let's you know.
That's why they try to avoid it for little bitty children and old people, especially cuz [Page//00:35:00] their brains don't do as well. Of course, if you're on estrogen, it will do better with estrogen, it really will. And I know estrogen at progesterone is very neuroprotective, absolute. And the brain makes estrogen and the brain makes progesterone.
It's just that after menopause, the the, it's even with making it, it doesn't make enough because the precursor to estradiol is testosterone. So men, when they have good testosterone levels, make plenty of estradiol in their brain, but no matter what, women will never. Testosterone levels that are high enough and their brains are not even designed to be making a ton of estradiol because it's not how we're programmed.
So we need that. But it's very, they're both all neuroprotected. That's why they're often called neuro steroids because they're actually very involved in neurological health and, and function and so on. But the bottom line is that I would much rather put hormones on my. I'm not going under anesthesia. I'm not gonna have a facelift.
It's just not gonna happen [Page//00:36:00] because I might value my brain function more than I care about wrinkles. But
Julie Michelson: Well, and you don't even have any, or you know, or you have
Felice Gersh: you know. Well
Julie Michelson: in the
Felice Gersh: now I never bet. I just truth, I never use filters on any pictures. Like I am who I am. I never want someone to meet me in person and say, Why? Do you use like a 20 year old photo or something?
No,
Julie Michelson: Right. Well, and I, I joke, I'm 53. I didn't think I was gonna live to see 50. So like, I wear 53, like a badge, Like I'm thrilled to be 53 and I've earned, you know, we, we just, But the thing is that as we're talking about, there are things we can do
Felice Gersh: absolutely, and
Julie Michelson: for listeners who are thinking like, Wow, well I have auto immunity.
No one's ever asked me about hormones. You know, maybe they're still, you know, fully cycling. Maybe they didn't have fertility trouble we, that we could do in a whole nother episode as to why people
Felice Gersh: oh, you know what? [Page//00:37:00] You know, I wanna touch on that. Thank goodness it's so easy to get sidetracked. But the reason that women make up 80% of all people who have autoimmunity is because they have so many more cells that can make antibodies, and they have so much of a more. Outsized oversized immune response.
So if you have a chronic infection, now a chronic infection can be like a herpes infection because there are many herpes, there are many viruses. And by the way, You know, Covid is now recognized as one of them that can promote and cause long term chronic infections. Now, if you have a leaky gut, then bacteria and viruses in your gut will be continually leaking into your body.
That's like a chronic infection. They even now, like Dr. Shaunfeld from [Page//00:38:00] Israel, who's a famous immunologist, says, and I had some conversations with him. I said, There's no question. From what our conversation that the vagina can cause leaky vagina. Okay. And then bacteria in the vagina can leak into the body proper and create this essentially like a chronic state of infection.
And so the body in, in exchange for trying to survive, you know, that's what it's trying to do. It creates antibodies. Against the infectious agent. Women make more antibodies and they have a more aggressive response to infections than do men. So if now every time you have an infection, a hundred percent, you will make antibodies against that infectious agent.
Now, we all life forms, every life form has the same building blocks the nucleotides we don't have. 5 trillion different nucleotides, like every, the building blocks are the same. They're just somewhat rearranged. It turns [Page//00:39:00] out that we humans have protein structures and amino acids and nucleotide sequences that are similar to the pathogen, so you might quote, They call it molecular mimicry.
It's like mistaken identity. So the antibodies will just say against strep because people know that strep is associated. When they used to not treat it with antibiotics, it could cause rheumatic heart disease, which is where the antibodies attack the heart valves. Okay. So we can have human structures.
It could be in the joints. It could be on the nerves, it could be the sheath that covers nerves like with ms. So, It could be thyroid, which is the most common. Okay. Could be anything. The gut lining cells, you know, so any cell in the body could have a similar structure to the invading pathogen, and they've actually had some linkages between them.
Okay. Especially with rheumatoid arthritis. So if you make an antibody against a [Page//00:40:00] pathogen and that infection is long term, then that antibody is gonna be continually produced if you have a short term infection. During that short term infection, you will make antibodies against yourself. So, but it's short lived and when the infection is over, the antibody production is ro way down, so it's not gonna cause harm.
But if it's an ongoing infection and you keep making antibodies over and over and over, you're going to end up making antibodies against your own tissue. Some kind of tissue is gonna be similar and. The initiation of autoimmune disease, it starts from a chronic infection. And we have so many different chronic infections that now, you know, because people's guts are so leaky and other things are leaky.
And we have, you know, environmental poisons that interfere with our own hormonal systems that we call these ubiquitous endocrine disruptors and so on, [Page//00:41:00] that interfere with the normal function of our immune system. So I. Attacking the invader and then eradicating it. It allows the chronic infections that that sort of sets the stage for these autoimmune conditions.
And we know that a lot of autoimmune conditions are now linked to nutrient deficiencies like vitamin D, and so it's all like every, all the systems are interlink.
Julie Michelson: another hormone, by the
Felice Gersh: Right. It's like a pre-one. It's like a pre-one, right? So the bottom line, and we're supposed to manufacture it, but people aren't doing a good job of that.
So the bottom line is that because women have this unique immune system that we have way more production of all the immune factors. The cytokines, the antibodies, we have more immune cells and a more exaggerated response because it's about survival. But now it's sort of turned against us. When you have an acute infection, [Page//00:42:00] we survive
Julie Michelson: We rock it.
Felice Gersh: right?
We reckon. But when it's a chronic infection, we can end up with autoimmune diseases, which are now epidemic. Okay. And I deal with them all the time. So you gotta heal leaky gut, you gotta calm the system down, you gotta give immune support. So there are like a whole sequence of events and you've gotta look for environmental toxicants, like poisons and chronic infections.
And so you gotta look at all these things. And this is like what people are doing, like with Alzheimer's, they're looking at all these different things because. Because the same setup that creates autoimmune creates chronic neuroinflammation. Chronic chronic inflammation, which increases autoimmune, which increases allergies, which increases cardiovascular disease, which increases cognitive problems,
Julie Michelson: Metabolic
Felice Gersh: So one, right? So that's right. Cardiovascular, like vascular. So once you understand the [Page//00:43:00] foundation, Suddenly you see how everything is interlinked. That's why it drives me crazy when I see an article said, Oh, we just made this great discovery. Like women who have osteoporosis are more likely to have dementia.
It's like osteoporosis is an inflammatory process and it's, you know, related to hormone deficiency
Julie Michelson: would Thank you. I was like, Eh, we're back to hormones,
Felice Gersh: right, right, right. Because hormones, once you understand, Estrogen and progesterone are about having all the organs work optimally and in synchrony because they're also involved in the master clock that sets the circadian rhythm so that all the organs work on the same time zone , you know, and they work optimally for the purpose.
Survival and reproductive success. Then suddenly there's no mystery how everything is a beautiful symphony and that the hormones are life [Page//00:44:00] hormones, and they create this, what we call metabolic homeostasis. That, that the goal is to keep everything kind of calm, but ready on alert in case of trauma. Or pathogens, but not activated until they need to be activated.
Julie Michelson: Yes. And that's where most listeners are, are like, Ooh, this is , That's how it's supposed to work. So what, what would be, we covered a lot. Like, Wow, I'm, I can't wait to listen to this again. What is one thing listeners can do today? Just one step they can take to start to move their
Felice Gersh: Okay. Well, I always say, Well, you gotta start somewhere. The place to start is number one, and this is just the prelude. This isn't actually the start is to. Define the problem and understand the problem. You can never solve a problem if you haven't even defined what the problem is, so you understand the [Page//00:45:00] problem.
You know, you understand the things that you are doing in your own life that may be not really helpful for your health, you know, so define.
Julie Michelson: I'm going to jump in and clarify because I can already hear like, Well, I, you know, Oh, I know the problem, and they're filling in their diagnosis. Right.
Felice Gersh: Oh, not a diagnosis.
Julie Michelson: about that.
Felice Gersh: it's not a diagnosis. It's like like I eat a lot of processed.
Julie Michelson: Right.
Felice Gersh: I go to bed at 2:00 AM I mean, we're talking about like choices that you can control, not a, not a medical diagnosis. Like you gotta define things that, you know, like make a list of things that you think you can do better with.
Like maybe you. Like, like we said, you know, you go to bed at a crazy time that you don't have to. Cuz I know people that they have social jet lag. They in, they intentionally go to bed at crazy times or they eat meals. [Page//00:46:00] Erratically, they eat late at night, they eat a lot of processed food, which have a lot of chemicals.
They don't eat enough vegetables, they don't hydrate. Right, Right. So, you know,
Julie Michelson: we know you're right. If, if you take a moment and get quiet, you can find those places to up
Felice Gersh: then, so sort of like define the, the problem in terms of the things you can control. You know, like, I can't say sell your house and move to a different state. Okay. We're talking about realistic things that you can control and then, you know, pick the one that you feel you can actually do.
Starting tomorrow. Okay. Now if you have no idea, then start with the gut. Okay? We always say start with gut. So start by doing something simple like saying, I am going to eat vegetables at every meal, or I will absolutely not buy box cereal anymore. Drive, you know, like make a [Page//00:47:00] commitment. And keep it, you know?
So, you know, I can say, I want you to eat three cups of vegetables with every meal, a cup of fruit, never snack, stop eating at 6:00 PM
Julie Michelson: start where you are.
Felice Gersh: know, I mean, I ca I mean, I would love to get everyone to do everything I want. Okay. But I have to be realistic. So every week make a positive change, you know, like, Maybe invest in a little treadmill that you can like, slip under the couch, who doesn't even take up space.
You can buy things like that. Or find a buddy, you know, that you can take a walk with or, you know find, you know, like start going to the local farmer's market. And asking the vendors there, what vegetables they are selling, what they are if you don't like, I don't know what heck, I was like once upon time it's like, what heck is this?
It's cold. Robby, what heck is cold? Robby? You know? You know, like, I didn't know. It's like, And how do you cook it? They're always happy to tell you. You know, they often have sheets with recipes and [Page//00:48:00] of course you can always go online. So experiment. Try a new vegetable every week. You know, and leave some bad thing out of your life.
It could be a toxic person, , you know, so you know,
Julie Michelson: It's
Felice Gersh: So, you know, set a schedule that's realistic and make a positive change every week. Make a list of things that you know you don't like. Need a healthcare professional, you know, you know.
Julie Michelson: all know, we
Felice Gersh: You know, things that you're doing that are really not ideal, right?
Like, are you like, you know, like stop snacking, you know, say, But if I do have to snack, I'm only gonna snack on raw, organic nuts and maybe. Raw, I mean not raw, cuz they are raw, you know, like, like a fruit that you like, like grapes, you know, or something like that. So, you know, so you say, Okay, I'm gonna try not to snack anymore because it's not really great cuz you can't keep your insulin under control of your snacking all day.
But at least if you eat [Page//00:49:00] something, it adds nutrients. Okay. And not poison, you know? So just take these steps and you know what's gonna happen. A year's gonna come and go and at the end of the year, You're gonna be one happier, healthy individual.
Julie Michelson: Amazing. I love it. For people that are listening on the go and aren't gonna check out the show notes, where is the best place for people to find you?
Felice Gersh: Well, I'm actually, I told you I'm in an exam room in my office. I, I have, I'm an old fashioned doctor. I have a brick and mortar practice. I also can do telemedicine. And I am in Irvine, California, so that's Southern California. The name of my practice is integrative. Medical group of Irvine.
Julie Michelson: And for those not familiar, Dr. Gersh is being modest. She's also has this amazing presence on Instagram and gives so much information and I believe it's, it's Dr. Fe Gersh on Instagram? Correct.
Felice Gersh: so it's a, [Page//00:50:00] the only thing that's tricky about it is, is a period after doctor, So it's d d r period and then fe ksh. And I do try most, most weeks. Sometimes I miss, cuz I'm like out speaking, I travel, I still, now traveling is back. So I'm, I'm traveling, I'm doing lectures and I do have three books.
I'm hoping to write many more. So I have two books on P C O S. One is the foundation book, P C O s, sos. The other one is for women trying to get Pregnant and now called P C O S SOS Fertility, Fast Track, and One on Menopause. That's my newest book, Less than a Year Out, and it's called Menopause 50 Things You Need to Know
Julie Michelson: And I love that you put the 50 50 things in there, amazing resources for everybody. Dr. Gr, thank you so much for joining us today.
Felice Gersh: Thank you for inviting me.
Julie Michelson: For everyone listening. Remember, you can get the transcripts and show notes by visiting Inspired [Page//00:51:00] living.show. I hope you had a great time and enjoyed this episode as much as I did. Listen to it twice. I'll see you next week.
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Felice Gersh
Felice Gersh, M.D. is a multi-award winning physician with dual board certifications in OB-GYN and Integrative Medicine. She is the founder and director of the Integrative Medical Group of Irvine, a practice that provides comprehensive health care for women by combining the best evidence-based therapies from conventional, naturopathic, and holistic medicine. For 12 years, she taught obstetrics and gynecology at Keck USC School of Medicine as an Assistant Clinical Professor, and she now serves as an Affiliate Faculty Member at the Fellowship in Integrative Medicine through the University of Arizona School of Medicine.
Dr. Felice is a prolific writer and lecturer who speaks globally on women’s health and regularly publishes in peer-reviewed medical journals. She is the bestselling author of the PCOS SOS series and her latest book, Menopause: 50 Things You Need to Know is now available on Amazon.
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