How To Heal Your Gut & Restore Hormonal Balance! – with Dr. Jacey Folkers

 

Today on the Gut Health Reset Podcast, we are discussing the gut health/hormone connection with Dr. Jacey Folkers! Your gut health can radically affect your endocrine system, which governs the hormones in your body. Likewise, inflammation flaring up in your gut can throw your hormones out of balance. Understanding the details of this delicate balance can be critical for optimizing your health!

In today’s episode, we will answer these questions:

– How are gut health and testosterone connected?

– What is leaky gut and what can cause it?

– What are the 5 R’s of healing and preventing leaky gut?

– What is dysbiosis?

– And more!

Still want to learn more? Schedule with Dr. Barter today!

 

Recommended Products From Today’s Show

Leaky Gut Support

Wired But Tired

 

About Dr. Jacey Folkers:
Dr. Jacey Folkers is doctor of chiropractic, functional medicine practitioner, author, educator, co-founder of Blokes and Joi. He is a graduate of the University of Nebraska at Lincoln with a degree in Exercise Science and Sports Medicine studies. Dr. Folkers completed his Doctorate degree in Chiropractic from Cleveland Chiropractic College. He has completed postgraduate studies in areas of clinical nutrition, rehabilitative exercise, and functional medicine. Dr Folkers has owned and/or operated several clinics across the country that emphasized and specialized in areas of treatment including hormone replacement therapy, peptide therapy, regenerative medicine, weight loss, cognitive therapies, thyroid conditions, autoimmunity, diabetes, functional testing, DNA testing.
Diagnostic lab testing, advanced peptide therapies, hormone optimization and lifestyle enhancements give Dr Folkers and his team the ability to offer a top to bottom approach to maximizing health and vitality.

Subscribe for more gut health content and share this podcast with a friend! Take a screenshot of this episode and tag Dr. Ann-Marie Barter:
http://instagram.com/drannmariebarter

Dr. Ann-Marie Barter is a Functional Medicine and Chiropractic Doctor at Alternative Family Medicine & Chiropractic. She is the clinic founder of Alternative Family Medicine & Chiropractic that has two offices: one in Longmont and one in Denver. They treat an array of health conditions overlooked or under-treated by conventional medicine, called the “grey zone”. https://altfammed.com/

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*As always, this podcast is not designed to diagnose, treat, prevent or cure any condition and is for information purposes only. Please consult with your healthcare professional before making any changes to your current lifestyle.*

 

About Dr. Jacey Folkers:

Dr. Jacey Folkers is doctor of chiropractic, functional medicine practitioner, author, educator, co-founder of Blokes and Joi. He is a graduate of the University of Nebraska at Lincoln with a degree in Exercise Science and Sports Medicine studies. Dr. Folkers completed his Doctorate degree in Chiropractic from Cleveland Chiropractic College. He has completed postgraduate studies in areas of clinical nutrition, rehabilitative exercise, and functional medicine. Dr Folkers has owned and/or operated several clinics across the country that emphasized and specialized in areas of treatment including hormone replacement therapy, peptide therapy, regenerative medicine, weight loss, cognitive therapies, thyroid conditions, autoimmunity, diabetes, functional testing, DNA testing.
Diagnostic lab testing, advanced peptide therapies, hormone optimization and lifestyle enhancements give Dr Folkers and his team the ability to offer a top to bottom approach to maximizing health and vitality.

Subscribe for more gut health content and share this podcast with a friend! Take a screenshot of this episode and tag Dr. Ann-Marie Barter:
https://instagram.com/drannmariebarter

Dr. Ann-Marie Barter is a Functional Medicine and Chiropractic Doctor at Alternative Family Medicine & Chiropractic. She is the clinic founder of Alternative Family Medicine & Chiropractic that has two offices: one in Longmont and one in Denver. They treat an array of health conditions overlooked or under-treated by conventional medicine, called the “grey zone”. https://altfammed.com/
http://drannmariebarter.com/

*As always, this podcast is not designed to diagnose, treat, prevent or cure any condition and is for information purposes only. Please consult with your healthcare professional before making any changes to your current lifestyle.*

 

Transcription:

Dr. Jacey Folkers: Your stomach acid is designed to kill bacteria that you know from the foods we eat. How much of the food do you eat you think is sterile? Yes. Right none. So everything we eat, everything you put in our mouth, there’s bugs and there’s stuff getting in there. Our bodies, amazing and very smart. That’s why we make hydrochloric acid. So it kills that. Well, if you’re taking proton pump inhibitors, your stomach acid is not adequate enough, or you just maybe don’t make enough that can allow bacteria to get down through the intestinal tract. So having good. Hydrochloric acid production is essential.

Intro: Are you struggling with bloating, gas, constipation and fatigue? But don’t know what’s causing these problems? The Gut Health Reset Podcast with Dr. Ann-Marie Barter dives deep into the root causes behind these issues that start in the gut. This podcast will give you the knowledge you need to heal your gut and reset your health.

Dr. Ann-Marie Barter: Hey Dr. Jacey Folkers, it is super exciting to have you on the Gut Health Reset Podcast today. Thank you so much for being here.

Dr. Jacey Folkers: Thank you for having me.

Dr. Ann-Marie Barter: So tell me what you do, you do a lot with hormones I know. And so I definitely want to get into the hormone piece, but I want to start with the gut and how kind of the gut is going to trickle down into the hormones. So it’s kind of an overview how are the gut and hormones, how specifically testosterone, how are those linked?

Dr. Jacey Folkers: Yeah, great question. So we can start with the gut, for example. So my background is in functional medicine. And so with that we try to find the root cause of conditions and symptoms, that kind of thing. And a lot of things always go down to the gut, like what’s going on there. So oftentimes with people that have gut issues, which we’ll talk about dysbiosis, leaky gut that drives up and can drive up inflammation. So inflammation will cause your body to stimulate certain inflammatory molecules, cortisol, those kind of things. And cortisol happens to be like the antagonist, the antagonist hormone to testosterone. So as cortisol goes up. Court stressed testosterone can drop in. So things that affect the gut, that which, you know, can be many things that drive up inflammation will affect your endocrine system, which is your hormone system, and that will significantly impact testosterone. And we see that on and mark on panels. We we order on blood markers where testosterone levels are low. And oftentimes patients are like, yeah, I happen to have some issues with, you know, I’ve Crohn’s, I have all sort of colitis. I have, you know, gastro, you know, some digestive issues or. And so we see that correlation a lot. And so that I definitely see that relationship between the, you know, gut health and how it affects your endocrine system. In fact, your gut infects your immune system as well as your nervous system, as well as your endocrine system. And there’s a term for that we call the what do we call it? It’s these immune neuro endocrine super systems. So it it all connects and influences each other, in fact. So.

Dr. Ann-Marie Barter: Okay, wonderful. Yeah. And just for the listeners listening. Cortisol is a stress hormone. It can be any sort of can be stress like, oh, my goodness, my job is so stressful. Or it could be, oh, my goodness, I’m a crazy bike rider and that’s all I do. And so overtraining, being overstressed is a driver for cortisol. So you mentioned leaky gut initially when we’re you know what I mean? What is a leaky gut?

Dr. Jacey Folkers: So I guess a simple way to a couple of ways to describe it is our gut, which I don’t know how your listeners think over interpret they got the gut is I mean essentially everything from like your mouth all the way to where when you go to the bathroom like the whole the whole tube, if you will. So your gut is encompasses all that leaky gut. There is a part of your intestinal tract that is where our nutrients, the foods we eat, are absorbed by our, you know, to our body, absorbed in our body, absorb nutrients through the gut. However, there’s something called intestinal intestinal permeability, meaning things are allowed to move through that intestinal wall that are not supposed to move through it into your circulatory system. So essentially it’s leaking through. It’s not supposed to it’s leaking through into your circumbinary system. So it’s kind of like explain it like it’s like Border Patrol, you know, our customs going through customs, right? When you’re coming back into the into the United States, you’re looking through your luggage. Are you okay? Everything’s good. We will let you through. But then you got some buddy like me that’s trying to, you know, bring in cigars or whatever from. From Mexico and then up. No, that’s not allowed. Right. So it’s it’s when things are getting through into your system, it’s leaking through. Hence we call it leaky gut. And so it’s kind of a weird it’s like people when they hear that think like it’s like certain bowel conditions, but it’s not really that it’s it’s right. Thousands of patients like no I don’t have any anything leaking out out the back end but it’s no leaky gut is when things are actually sneaking into your body, into your circulatory system that should not get there in that can cause inflammatory conditions. So which we can go on and on about that, obviously. But does that answer your question?

Dr. Ann-Marie Barter: Absolutely. I was cracking up as I saw this great comedy show and this guy was getting married and basically he’s like, send out a car and any food restrictions. And like what he got back, she was surprised about it. Like, really broccoli. Bell peppers. Okay. Yeah, so indication of that. So anyway, that’s chuckle. So how does this happen?

Dr. Jacey Folkers: So so leaky gut can happen a number of ways like you alluded to stress for example. So stress in all forms, physical stress, chemical stress, environmental stress, things getting into your body that drive up cortisol when when stress gets high. And this, like I said, this can be from, you know, just thinking of of of things that that stress you out. Cortisol will elevate and cortisol can start to erode that mucosal barrier. So that’s one thing that kind of breaks down the gut wall and allows things to get in that should other things that can cause leaky gut are disruptions in the microbiome, which we haven’t we talk much about. But there’s the the bacterial flora that exist there. So when somebody has some kind of infection which can also cause leaky gut and they take antibiotics, the antibiotics will completely disrupt and can complete disrupt that microbiome that can cause leaky gut as well as infections like, you know, overgrowth of certain bad bacteria can cause leaky gut, but also toxins. So anything that drives up inflammation, causes stress, can oftentimes create this leaky gut situation.

Dr. Ann-Marie Barter: Do you feel like it’s primarily stress that’s the biggest driver of leaky gut? Do you feel like it has anything to do with pathogens in the gut? Ah, not so much.

Dr. Jacey Folkers: Well, I feel, I feel like stress in and of itself, in how stress can be defined. Physical, chemical, environmental is at the root of it because that can allow pathogens to take hold. Does that make sense?

Dr. Ann-Marie Barter: Sure, absolutely.

Dr. Jacey Folkers: It’s kind of like because all of us are are exposed to bad bugs, viruses, pathogens, if you will, in why is it some of us are affected by them, but some of us are not. So it’s you know, we can both of us can be exposed to the same pathogen, but one of us is affected, you know, get sick. It’s, you know, from it. So to me, it’s the terrain that’s more. You know, the root cause of it.

Dr. Ann-Marie Barter: So how do we help you gut?

Dr. Jacey Folkers: So I actually have for me like a one of the processes I follow is you can call it like the 5 hours, if you will. So we, we start by removing, removing the bad things that the hypoallergenic foods I think you kind of like if somebody is is reacting to certain foods that trigger inflammation, we want to remove those. So that’s something that kind of, you know, to kind of take the insults away. Another thing would be to and we can go further upstream, we talk about digestion, how that can poor digestion can cause we want to replace the the essential enzymes, the the stomach acids, the bile salts, those kind of things are important to help heal leaky gut as well as providing nutrients to repair. So repairing nutrients and it could be things like L glutamine college in powders, bone broth. Those are very healing for the gut. Some other, you know, vitamin D is important for gut health, zinc. So there are some nutrients that are very important for gut health as well as removing infections like you kind of alluded to. So making sure certain bad potential bugs that may be there are are addressed and remove like Candida like some just bad bacteria in the dysbiosis is addressed so and then maybe even re inoculating with specific good bacteria as consuming fermented foods that has a good amount of of good bacteria. So that is you know, is kind of how I address it is not like a one size fits all but kind of go through those steps really really helps address leaky gut.

Dr. Ann-Marie Barter: That awesome and you mentioned dysbiosis so what is dysbiosis.

Dr. Jacey Folkers: So interestingly. We have, the human body has. What is it I want to say 30 trillion cells, approximately, but we have like 39, 39 trillion bacteria in our body. And our gut is has trillions of bacteria we want to have. Ideally, there’s something called a microbiome, which is the back of the bacteria, a good amount of friendly bacteria in a balance. And you want it to be diverse when somebody has an imbalance, they have maybe have an overgrowth of the bad bacteria, the bad bugs that is defined as dysbiosis. There’s like an imbalance of of the flora existing in your gut, which can affect pretty much everything that can drive up inflammation, that can affect the brain, that can affect other organ systems. But dysbiosis in and of itself is when there’s an imbalance of that. Bacteria that resides in our gut.

Dr. Ann-Marie Barter: Okay. And how how does this happen? Like, how do we how do we get this?

Dr. Jacey Folkers: So you can get dysbiosis a number of ways, kind of like similarly to the ways that you get leaky gut. Antibiotics that that will you know, you take antibiotics to kill bacteria. Correct. And so you take an antibiotic. It’s killing pretty much everything. So. But what oftentimes happens is these bad bacteria, we’ll start to re place what was there before and you get this overgrowth of of like bad yeast like a Candida overgrowth. So one way of getting creating dysbiosis is the antibiotics, poor diet. So people that are eating lots of sugary foods that often the standard American diet is one example of of a way to really feed the bad bugs and cause more dysbiosis. Stress can cause dysbiosis by driving up that hormone again, cortisol. And in creating that leaky gut situation, driving up inflammation which will affect your and activate your immune system. By the way, your immune system is housed in the gut, so 70 to 80% of your immune system exists there. So chronic activation of that will oftentimes cause dysbiosis as well. So there’s a lot of things with gut. Environmental toxins, which we talk about getting in there. All these things will affect the bacteria and can start to create this imbalance, which is something that can cause all kinds of conditions related to inflammation, brain fog, aches and pains, gut issues and so forth and so on.

Dr. Ann-Marie Barter: And I don’t know if you’ve seen this. I’ve seen this in practice a fair amount. But when someone is really stressed out and has been under chronic stress for a long period of time on stool testing, it really looks like almost all their bacterial levels are low, dysbiosis is low, all their commensal bacteria is low. I don’t know if you’ve noticed that.

Dr. Jacey Folkers: Yeah. Yes. Yeah. Well, yes, stress is something. In fact, we used to I used to order a stress test called adrenal stress index. And when people have like a lot of they communicate a lot of stress in their life from this this loss of loved ones, etc.. And we we typically will see a compromised gut like gut health. So they’re there. Immune markers in their gut are super low. And so, yeah, so that will reflect in effect that the diversity that you want in the gut. So that’s like you to your point, all those healthy bugs will be just low. And what happens is their their immune system is becomes weakened. So they are more susceptible to infections. They are more prone to autoimmune conditions because of the breakdown of the gut from the chronic stress.

Dr. Ann-Marie Barter: Yeah. So what do we what do we do about dysbiosis?

Dr. Jacey Folkers: So. Good question. So. Kind of the same way that I alluded to with feeling like you got that he kind of go hand in hand. So you’re going to want to. If someone has dysbiosis that overgrowth of bad bugs, it’s essentially a parasite infection. If they’re over taken by bad bugs. And so you want to remove those. And so there are herbs out there. There’s things like thyme released, oregano products that you can take to kind of kill those things off. And fasting is is a great way to kind of give that digestive system a break, to allow the body to kind of eliminate that. Taking those healing nutrients I mentioned. So kind of following that same protocol, consuming fermented foods, consuming fibers, foods to help increase things like short chain fatty acids, which we didn’t really talk about. But kind of following those, the same approach that I mentioned, you can call it the 5 hours of basic removal, replace, repair, remove infections. And we can go upstream as well. I didn’t really talk much about this, but. Dysbiosis can also occur by poor digestion. Upstream. What? I mean upstream for the stomach, in the liver. So if somebody has low stomach acid production or if somebody has taken proton pump inhibitors. Those things are designed as your stomach acid is designed to kill bacteria that you know from the foods we eat. How much of the food do you eat you think is sterile? Yes. Right nut. So everything we eat, everything you put in our mouth, there’s bugs and there’s stuff getting in there. Our bodies, amazing and very smart. That’s why we make hydrochloric acid. So it kills that. Well, if you’re taking proton pump inhibitors, your stomach acid is not adequate enough, or you just maybe don’t make enough that can allow bacteria to get down through the intestinal tract. So having good. Hydrochloric acid production is essential. Another thing that’s important is to have. File good, healthy bio production if that’s not which can be affected, you know, standard American diet. People having their gallbladder removed, etc.. Bile is also an antimicrobial. So having adequate bile salts, it also could kill those bacteria. That is another thing that can, if it’s not adequate, can cause dysbiosis. So maybe someone taking bile salts. So once again, replacing those enzymes that the stomach acids, the bowel salts, all those things can help. Inhibit and prevent this dysbiosis and also ways to treat it if it’s if you know that those are problems.

Dr. Ann-Marie Barter: Great tip. I don’t think bile salts have been covered on any of the other podcast episodes. I just want to drill into that really quick. So bile digests what type of what is it? Digest.

Dr. Jacey Folkers: Yeah, so great. So bile, as you know, is secreted by the gallbladder and it’s kind of stimulated. When you consume fats. So fats are a very important part of our diet. Remember the eighties? Everything was eighties like no fat. That was early…

Dr. Ann-Marie Barter: Nineties.

Dr. Jacey Folkers: Early nineties, yeah. And so know there’s like different like, you know, like everything and stuff. Rebirthing tastes like cardboard. But anyways, we’re healthy right now, so you need to eat fast because it stimulates by release and which is important to emulsify the fats in that. So that stimulates, you know, release of enzymes by the pancreas to allow us to absorb certain fat soluble vitamins like A, D, E and K. And if you if you don’t have healthy bile production and the then you lose the ability to absorb those those vitamins that can affect things downstream and once again, can cause bad bacteria to get through downstream. And then you start to have a cascade of other issues. So bile is important for not just the digestive fast, but the absorption of fat soluble vitamins, getting rid of the bad bacteria in a lot of other things. So it’s important.

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Dr. Jacey Folkers: Not not very. I mean, it’s kind of like our approach, you know, with with our company isn’t to and here’s the thing to to kind of like add to that like if somebody has hormone issues or hormone imbalances, it’s usually oh, it’s not just like, oh, I put you on this. It’s kind of why do you why do you have, you know, low. Low progesterone, low testosterone. You know, why is that? And once we kind of like dig into that, I mean, it’s oftentimes, you know, depending on the age, depending on their health history. Testosterone replacement is. ISM is a piece of that and it’s great. But like unless you address their health, I mean, that’s the cornerstone in the foundation of their health. And so they’re they may not feel it and get the results that they’re hoping for that their friend you know, that’s also on testosterone replacement who’s feeling amazing but but it’s probably because he’s working out, he’s eating better. He’s doing all the other things. So so gut health still has to be a priority regardless of whatever hormone replacement program you’re you’re going through. But that’s why we test in our office to try to determine and identify root cause, take a good health history. Yeah, you got to look at the body as a whole because everything affects everything and you can’t just throw hormones and expect it to to fix the underlying issues. So, yeah, I think you have you’re not going to be that successful unless you really do work on those other things, especially the gut.

Dr. Ann-Marie Barter: So you made a point before we got on the on the podcast here that that one of the major impacts of testosterone and how it helps the gut is that it’s anti inflammatory. Can you expand on why that’s important and in everything associated with testosterone and why you see that being helpful?

Dr. Jacey Folkers: Yeah, it’s helpful a lot of ways. So a lot of people don’t realize that that testosterone does have some pretty powerful anti-inflammatory properties. And so so what we typically see is people let me back up a little bit. Men, for example, let’s take men that are, you know, from the 1950s, they’ve seen that men in the 1950s have higher testosterone and lower estrogen overall than men today. So if you take a cohort of the 1950s women today, there’s like this big difference. So guys today seem to have like lower testosterone, higher estrogen, but they also see there’s more of this belly fat thing happening today, which could be one of the driving factors of that. So belly fat is pro-inflammatory and you have these B cells in the abdominal area that release. Estrogens and that kind of thing drives up inflammation once again. You know, we talk about inflammation affects the gut. So by it, by having doing ways to whether it’s exhaustion, it’s testosterone or ways to boost testosterone in a natural fashion, it has this anti-inflammatory effect allows you to start to burn more of that belly fat, which brings out the estrogen and create this endocrine balance, which is much more better for overall health, but also gut health. So you’re you know, at the end of day, we could we could say inflammation really does affect everything and lead to every kind of pathological pathological condition. But. Ways to reduce inflammation is is key. And part of that is testosterone reduces inflammation by itself, but also it can help your body burn that fat. Lower lower that estrogen and also help feed prevent that gut from getting inflamed as well. So it’s kind of has like multi factorial approach, if you will.

Dr. Ann-Marie Barter: And what do you think are ideal levels for for men’s testosterone and for women?

Dr. Jacey Folkers: Yeah. So here’s the thing. It’s. It’s not like textbook, like this is what it really is. I mean, because there’s so many variables there. But to give you like I guess some degree of of of a number, you know, most of the guys that we work with that optimally feel great function, great in the 800 to like 1200 range. But, but however, there are guys that are at 850, they’re just like, I just I just don’t feel great. I feel like, you know, libido is not there, but there’s other markers. So we look at free testosterone as well. Total the C total testosterone. 800 free testosterone is a number we look at because the free testosterone is what is. What is unbound, what is bioavailable. So that number is important. And there are certain things like albumin and sex, hormone binding globulin that can bind at up in a lot and cause your free testosterone to not be so available, even though your total testosterone is at a number that’s like, Oh, wow, you should be you should be crushing life and feel amazing. So that would be kind of for men. It’s the same thing for women. We see women really feeling amazing, 80 to 100 with women, it’s like that’s like they’re feeling great. And we were in women, too. That testosterone can can also be converted to these other hormones like the, you know, the progesterone, the estrogen that your body as your body needs. So it’s not just a male hormone, just like. Estrogen is not just a female hormone. Men need estrogen, too, because if if you’re going to a clinic and I’ve seen this a lot of patients we work with, which is one of the reasons we started this company, is because a lot of guys are going to these clinics that are just, you know, these testosterone placement clinics. They’re going in there. Pretty much every guy that walks in there is put on a certain dose of testosterone, given some anastrozole, which is a estas and blocker. And like every guy is given that. And guess what? The estrogen is in that is in the tank and this is affecting their libido. Their energy is feeling like just garbage. We we we don’t think every guy needs to be on a estrogen blocker. I mean, and so we don’t put every guy on an estrogen blocker because estrogen is just as important of a hormone for men as it is for women. Even though it’s kind of like not you that way. Yeah. Sorry, I went on that little panel.

Dr. Ann-Marie Barter: That’s great. Actually, it reminds me of something else. There’s. There’s a certain point where unless you’re doing some testosterone replacement, I in my clinical practice, I don’t feel like herbs or natural remedies will increase testosterone. If someone is above a certain age, it’s it’s maybe a little bit, but not enough. And I’m sure you’ve probably seen the same thing. I guess I don’t want to put that in your mouth, but women same thing as well. And so a lot of times if they go to a clinic and generally I address hormones last, but if they go to a clinic for testosterone, they’re given a pellet that is not changed, that their dosage doesn’t change it. And I can’t tell you how many women I have seen not sleep for multiple weeks in a row until we start to filter it out and kind of calm down. I don’t know if you have any comments on on what’s going on there. To me, it just seems like when I run the labs, it’s way too high. The dose.

Dr. Jacey Folkers: Yeah, and you’re talking about it. They’re like putting Peloton. Yeah, yeah, it’s the pellets, so. With men. It’s it’s hard. I mean, we don’t really even consider pellets. I have friends have gone to clinics for that, for testosterone pellets. It just seems like it’s I don’t know, they feel great for like a couple of weeks. But then it’s like their their bodies, the levels just drop, drop, drop. And there’s you can’t really control what’s going on in the body versus like injections. Which which we we pretty much recommend injection injections. We are now geared more towards the subcutaneous injection with split dosing, which we can talk about that a little bit, but yet.

Dr. Ann-Marie Barter: Go into it like what’s different there because that’s, I think, important.

Dr. Jacey Folkers: Yeah. And so to your point, the pellets is like you’re putting it’s a good business model, right? So you put them in in the patient for what? Once every three months or so. Four months. He’s kind of all right, you know, but but if you probably if you’re in this space, you probably see like that last month, they’re, like, not feeling the same, you know what I mean? Like, the levels are like, I need I need more. I need, you know, when do I get it? Sooner, because you never know how a person’s going to metabolize those those hormones individually. And but with the injections, you’re able to control that like so much more and have a lot more variability. So with guys, you know, we we’ve switched more to subcutaneous versus intramuscular subcutaneous. You’re not having injecting the muscle. It’s, it’s, it’s less discomfort, it’s less stressful. Um, and you split dose it with meaning you or you can do it three times a week, but you use smaller dose, inject it, say, Tuesday, Friday, and that, that allows instead of like a big, big dose of testosterone once a week. And by the end of the week, you’re here, you’re you’re kind of just more even even keel the whole week we see on labs when you split dose and and. Basically, which means you’re cutting the dose in half and you’re injecting twice a week. We see better markers with estrogen, with men. They don’t need anastrozole. We see better markers with hematocrit, hemoglobin, red blood cell count. So there’s less polycythemia let, which is less thickening or less viscosity in the blood, less less elevations in blood pressure. So it seems to just have an overall better clinical effect on the patient with the split dosing. But yeah, we you know, I just talked to so many friends and colleagues and patients that have done the pellet route and they just so many mixed experiences with with the guys. You have to get so many pellets in the with the men for, you know, to accommodate the testosterone. But yeah, I mean, some of the women seem like they’re doing pretty well, but I don’t I don’t advocate it really pretty much for pills for men. So that’s why we offer mostly it’s injections or we can or we have some creams. Some guys have moved away from that because they don’t want to like get the cream on their wife or kids or whatever, you know, because.

Dr. Ann-Marie Barter: Is which is huge on.

Dr. Jacey Folkers: Yeah you know think about that but you’ve heard stories of I’ve.

Dr. Ann-Marie Barter: Seen it all. Yeah.

Dr. Jacey Folkers: Have you.

Dr. Ann-Marie Barter: Got. Yeah. Wow. Because it’s not even been told, you know these women are coming in with these wicked high levels of testosterone but showing low levels. And you find out that their husband has been given a testosterone cream. And I’m like, this is exogenous transfer.

Dr. Jacey Folkers: And yeah, and I just had a patient. He just emailed me like last week. He’s like, I’m freaked out because he has girls and he’s like, I just, you know, he rubs it on different areas and he’s like, you know, if I hug my daughter, what am I passionate? And we’ve heard stories where, yeah, that, that, that is genius, you know exposure that can be transdermal be passed on to loved ones.

Dr. Ann-Marie Barter: So so so for men you recommend injections for women. Do you still recommend pellets?

Dr. Jacey Folkers: So for for us, we we recommend injections. Okay. Okay. Yeah. I mean, we’re, we’re virtual, so we but even that’s cool. Yeah. Even then we we do injections or or creams or with women. Yeah. Okay.

Dr. Ann-Marie Barter: So let’s let’s talk about low testosterone symptoms with with men first and then let’s go into women. So what are some of the low testosterone symptoms for men?

Dr. Jacey Folkers: Yeah, and it could be subtle. I mean, because here’s the thing. There are some guys that. They’re like, Yeah, you know, I just kind of feel a little bit like less motivation, less drive, like mentally like they don’t feel like is as driven. They kind of feel kind of like, like just lazy or like more of the couch potato kind of guy. And we look at their labs are like 200, which is pretty low, but typical, you know. Symptoms would be would be that would be low energy, loss of libido, changes in erectile strength and in how long you maintain as well as just some depression maybe, or lack of just focus, I think. So there’s a lot of the male brain has a lot of testosterone receptors. So if you’re not having, you know, having testosterone, you kind of start to lose that drive. Testosterone and dopamine are kind of like cousin molecules. And so dopamine is, as you know, is like that motivating kind of thing is testosterone is very similar. So you kind of see this kind of like lack of motivation, low energy lust, desire to go to the gym. And when you do go to the gym, you’re not building the muscle you used to not you’re gaining belly fat. And so so those are like the typical things you see with with low testosterone, you know, low energy, poor sleep can be another another thing that we see.

Dr. Ann-Marie Barter: What about apathy?

Dr. Jacey Folkers: Yeah. I mean, all of those things definitely correlate to, to low testosterone. Um, and it’s kind of, like I said, kind of interesting how I see it happening younger and younger. You know, we see guys in their, in their twenties now with, with, with levels of low testosterone that like. What what are you what is what’s going on here? I mean, it’s it’s pretty it’s pretty staggering how low the levels are getting younger and younger.

Dr. Ann-Marie Barter: Why do you think that is?

Dr. Jacey Folkers: That’s. I it’s I don’t know. I mean, if you look at on a case by case, I like this guy. Oh, he in his history, it looks like he he lost like £80. So so going on like some kind of, like, extreme. Caloric deficit. It can call it can cause your your endocrine system to be kind of go through that kind of shock and lower testosterone. I know for me in some young, young guys, I mean, my levels were low in my twenties because I overtrained so much. I went to the gym and worked out like two times a day. I thought like more is better. So and also stress, once in which I overtrained so much, it drove up my cortisol that that’s why my testosterone levels were lower. I just like stopped working out and then they went back up. So it normal but didn’t stop working like it worked out less. But but yeah. So stress we could also talk about plastic I guess plastic use is it is a big contributor because it’s a zino estrogen. And so I try to be kind of. Well, we’re kind of strict at my house. I’m even I mean, I don’t even let put even plastics in the dishwasher or, you know, I mean, we still have some plastic, but, you know, it says you don’t want to drink or consume foods out of hot plastics. We try to switch everything to glass, ceramic, that kind of thing because that that’s another contributor to, um, low testosterone.

Dr. Ann-Marie Barter: Absolutely. I think they’re finding that as they’re finally finding the plastics in people’s lives. Blood. Oh, yeah. So much at this point, because we’ve just been inundated with plastic. So with women, what kind of symptoms are you seeing? A similar or a little bit different?

Dr. Jacey Folkers: Yeah, I mean, pretty similar low libido. I mean, that’s the most common one. I mean, for men and women. However, I talked to a lot of guys, their libido is still like, okay, you know, their, but their testosterone is really low. But, um, yeah, with women it’s kind of, you know, the low libido. It’s, it’s, it’s just, you know. Maybe depression, more moodiness, irritability, those kind of those kind of things. So. Gain is gaining weight.

Dr. Ann-Marie Barter: Yeah, a lot of gaining weight. What we’re going to need to wrap up here, but what else did you want to cover on testosterone before we kind of wrapped up?

Dr. Jacey Folkers: Um. I think, you know, just the main thing is, is getting tested. You know, getting tested is important. So many, so many guys I talked to, number one, they may have never had their testosterone checked or they checked it like five years ago. And all it was, you know, it was 800. So, you know, get get it get it tested. All women to get get your testosterone. So many women have low testosterone. It’s it’s not something I don’t think it’s really viewed as important for women, but it really should be. It’s it’s it’s a hormone that our bodies use for. I like to think of it like this. I know how much time, but like your test, it’s like you’re, it’s like, ah, endocrine system is, you know, we have hormones that are very, very important for survival. Like, you have to have insulin. You don’t have insulin. You’re pretty much going to die. Right. So so we have hormones that are super same with cortisol, even though it’s like can be chronic. We have hormones that are kind of like our own our checking account that we have to use to pay our bills to keep the lights on. Then we have a savings account, right? Seems that counts. Kind of like stuff to go out for a the movies date night, whatever. So testosterone and progesterone can kind of be like that savings account, but we tend to pull from it to cut to accommodate for our checking out, to pay for things. And we just tend to think that it’s not important, but we start to pull on it so much that our quality of life just starts to be diminished. So I, I think it’s, it’s a hormone that is often overlooked in, in, if you test it and if you start to optimize it, it helps everything else.

Dr. Ann-Marie Barter: I agree. I completely agree. And I think the other misnomer that I’d like to mention is a lot of times people will get it checked and depending on what the reference range is, it’ll be 300 or 350 for men, depending on where you are. And they’re told that they’re totally normal and they feel terrible and they have all the symptoms that you’re talking about.

Dr. Jacey Folkers: No, you’re hundred percent right. Oftentimes in those cases, you’re right. It’s the doctor you go to. Maybe they’re used to treating the patient based on their insurance coverage and based on what insurance will will deem as a necessary time to to prescribe testosterone. Because if the insurance says they’re they’re healthy, we will we won’t we won’t cover over 300. The doctors often think, oh, you’re normal. There’s nothing. I mean, let’s wait. Let’s wait till you’re 250 and you feel like complete garbage before we prescribe. But yeah, you’re right. It’s the normal range. It’s big. And we want you more like optimal. Not. Not where you’re almost, you know. Dropping dead kind of feeling like garbage, so.

Dr. Ann-Marie Barter: Absolutely. Well, where can people find you? And in your company if they want to get in touch with you.

Dr. Jacey Folkers: Great. So, um. Easiest ways you can go to one of our websites or blokes. Blokes that SEO is for, you know, for the men out there in the women can go to choose joy, which is the joy is spelled j0i that co choose joy that co and that’s our woman side. So we offer not just, you know, testosterone, but also peptides and awesome things for anti-ageing, for for health optimization, great diagnostic lab testing. And you know, even I didn’t mention we have a food sensitivity test we can order to kind of identify what foods could be triggering inflammation in you specifically. So we’ve a lot of cool stuff there to choose from.

Dr. Ann-Marie Barter: Awesome. Well, thank you so much for being here today.

Dr. Jacey Folkers: Thanks for having me and I appreciate it. Just for the time.

Dr. Ann-Marie Barter: Yeah, it was great. Thank you for all the listeners out there. Please let us know what you want to hear more of. Look forward to hearing from you. Take care. Bye.

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