Dr. Sara Gottfried: How to Optimize Female Hormone Health for Vitality & Longevity

Andrew Huberman – Dr. Sara Gottfried: How to Optimize Female Hormone Health for Vitality & Longevity

Andrew Huberman is a professor of neurobiology and ophthalmology at Stanford School of Medicine
Dr. Sarah Gottfried is an obstetrician gynecologist and clinical professor of integrative medicine and nutritional sciences at Thomas Jefferson University
They discuss science and science-based tools for everyday life, including the gut microbiome, nutrition, exercise, omega-3 fatty acids, and the digestive system

Precision medicine is used to test patients, often including nutritional testing
Micronutrients play a role in hormone production, such as magnesium and estrogen
Eating vegetables is an important predictor of future breast cancer risk, especially in teenagers.
Smoothies with vegetables can be used to help support the microbiome.
Supplements can be used as a distant second to smoothies.
One patient changed their microbiome by having a smoothie with 57 vegetables and fruits every day.

Probiotics can be beneficial for people under significant stress or after taking antibiotics
Randomized trials are needed to support the use of probiotics
Prebiotics and polyphenols may be more beneficial than probiotics
Eating more vegetables is a great starting place for gut microbiome health
Stool sample testing can be used to analyze nutritional deficiencies and microbiome health

Constipation is a common symptom in women and can signal a larger set of problems
Women experience more trauma than men, which can affect their HPA response and perceived stress
Constipation can be used as a target for intervention to open up discussions about other issues
Constipation is defined as having a bowel movement less than once a day and feeling a complete evacuation

Stress reduction is important for relieving constipation and other indicators of health
Different stress reduction tools work for different people, such as physiological sighing, transcendental meditation, yoga, holotropic breath work, and box breathing
A study found that cyclic sighing led to the greatest improvements in mood and lowered resting heart rate
Other stress reduction tools include sex, orgasm, connection, and feeling heard and seen and loved

Women in their late teens and early 20s should be aware of their testosterone, estrogen, thyroid, and cortisol levels, as well as their microbiome.
Different opportunities for health exist by decade.
Knowing testosterone levels in the teenage years can help inform how to take care of oneself.
Testosterone levels can decline starting in the 20s due to stress.
For women post-25, a healthy reference point is the top half of the normal range.

Ashwagandha and Rhodiola Rosacea can help lower cortisol levels
Phosphatidylserine (PS) can also reduce cortisol, with a dose of 400-800 milligrams
Cortisol Manager by Integrative Therapeutics is a combination of PS and Ashwagandha
Cortisol typically peaks 30-60 minutes after waking and gradually declines until bedtime
PS should be taken when cortisol is highest (morning or night)

Omega-3s and fish oil are generally accepted as important for health
Consider taking 1-2 grams of EPA per day, depending on diet
Omega-3s alone may not be enough to resolve inflammation; consider combining with specialized pro-resolving mediators
Rank order of supplements for college students: fish oil, magnesium, vitamin D, phosphatidylserine
Vitamin D dosage should be between 1,000-2,000 IU per day, or dose to a serum level between 50-90

Women should get their follicle number and AMH levels assessed to get a sense of their ovarian reserve.
Most women don’t get this done until they are in their late 30s or early 40s.
AMH levels are not included in a standard blood panel.
Women who want to freeze their eggs or are having trouble getting pregnant are the ones who usually get AMH levels tested.
Women who are experiencing symptoms of early menopause also get tested.
There is a double standard between those who want to get pregnant and those who don’t when it comes to hormone testing.

Intermittent fasting, time-restricted feeding, and/or a ketogenic diet can increase cells sensitivity to insulin.
Women don’t need to stay on the ketogenic diet for long periods of time.
Metabolic flexibility can be increased by periodically switching back and forth between a typical eating pattern and a ketogenic diet.
A ketogenic diet should be used as a short-term experiment (4 weeks).