Fasting with Dr. Jason Fung, Retraining Neural Pathways with Dr. David Hanscom, & Female Hormones with Dr. Jolene Brighten

Podcast Episode #373: Fasting with Dr. Jason Fung, Retraining Neural Pathways with Dr. David Hanscom, & Female Hormones with Dr. Jolene Brighten

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Fasting with Dr. Jason Fung, Retraining Neural Pathways with Dr. David Hanscom, & Female Hormones with Dr. Jolene BrightenTopics

  1. News and updates from Diane [1:55]
  2. Today's podcast: a mashup of past favorites [3:30]
  3. Dr. Jason Fung: all about fasting [4:40]
  4. Dr. David Hanscom: retraining neural pathways [29:11]
  5. Dr. Jolene Brighten: female hormones [42:27]

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Fasting with Dr. Jason Fung, Retraining Neural Pathways with Dr. David Hanscom, & Female Hormones with Dr. Jolene Brighten Fasting with Dr. Jason Fung, Retraining Neural Pathways with Dr. David Hanscom, & Female Hormones with Dr. Jolene Brighten Fasting with Dr. Jason Fung, Retraining Neural Pathways with Dr. David Hanscom, & Female Hormones with Dr. Jolene Brighten

You’re listening to the Balanced Bites podcast episode 373.

Diane Sanfilippo: Welcome to the Balanced Bites podcast. I’m Diane; a certified nutrition consultant, and the New York Times bestselling author of Practical Paleo and the 21-Day Sugar Detox. My newest book, Keto Quick Start, will release on January 1, 2019. I live in San Francisco with my husband and fur kids.

I’m the co-creator of the Balanced Bites Master Class with my podcast partner in crime, Liz. And together, we’ve been bringing you this award-winning show for more than 7 years. We’re here to share our take on modern healthy living, answer your questions, and chat with leading health and wellness experts. Enjoy this week’s episode, and submit your questions at or watch the Balanced Bites podcast Instagram or Facebook account for our weekly calls for questions. You can ask us anything in the comments.

Remember our disclaimer: The materials and content within this podcast are intended as general information only, and are not to be considered a substitute for professional medical advice, diagnosis, or treatment. Before we get started, let’s hear from one of our sponsors.

Diane Sanfilippo: Today’s podcast is sponsored by Perfect Keto. Dr. Anthony Gustin and his teams have created a line of supplements that are super clean and effective, no matter what your dietary needs. Be sure to check out the new keto-friendly bars that took Dr. Gustin 14 iterations of testing these bars’ impact on his own blood glucose levels to ensure that keto bars would minimize the glycemic effect after consumption. They’ve got 19 grams of fat, 10 grams of protein from collagen, and 3 grams of net carbs. Check them out over at and use the code BB-30 for 30% off all bars in November; or code BALANCED for 20% off of everything else at Perfect Keto or their sister site, Equip Foods.

1. News and updates from Diane [1:55]

Diane Sanfilippo: Alright guys, a couple of quick updates before we jump into this episode. Book tour dates are coming really soon. If they have not been announced already over on my Instagram at Diane Sanfilippo. Make sure you're getting my weekly email newsletters. I’ll be sharing the most up to date details as well as links you can click on to sign up for an event in your area. I would absolutely love to meet you. So if I’m coming anywhere near a major city that’s close to you, please come meet me. It’s absolutely my favorite thing to get to pair your name and your little picture, maybe, from Instagram or Facebook or wherever with your face and just give you a hug and say hey.

If you’ve already preordered Keto Quick Start, make sure you save your email receipt. If you are planning on preordering it, same thing. Head over to at the top of the website, you’ll see a bar that either says find out when the book is launching. Or it will say sign up for preorder bonus. Either way, it just depends on when we have the preorder bonus ready for you. But drop your email right there, and we’ll make sure that we give you the details so you can get your preorder bonus.

And, if you are able to come to a tour stop, I always recommend that you grab the book at the tour stop event. If the tour stop is not going to be until much later into the year, and you're just super eager to get the book, go ahead and preorder the book. I just ask and recommend that you buy something at the store. Because we like to thank and support the stores that host us. It’s a big effort on their part, and it’s a lot of time and energy for them to host the event. So I really like to be a gracious author, and make sure my attendees are supporting the store.

2. Today’s podcast: A mashup of past favorites [3:30]

Ok, so we’re doing something a little different today, since I’m in the midst of finishing the very final edits of my book, and Liz is releasing the beta program for Baby Making and Beyond. We weren’t able to meet to record a podcast this week. But in over 7 years, we’ve maybe only had to do this a handful of times. So today, I want to highlight a few of our previous shows, where I’ve found there were some things that were particularly interesting, and that I know you guys either would love to hear again, would love a highlight of something we talked about previously that I particularly found interesting.

And then I recommend that you go back and listen to the full episodes when you have a chance. Because if you missed it the first time, or maybe you heard it and you can hear it differently; I don’t know if that’s common for you guys. But for me, sometimes I hear something once, and I’m just not in the right kind of headspace to make up or down of it. And then the second time around, it makes more sense to me. I kind of get more out of it.

So the first one is from an episode that I did on fasting with Dr. Fung. This was episode 298. It was an extremely popular episode. So if you listen to it once, I highly recommend listening to it again. We got so much great feedback on this episode, and there’s tons of good information here.

3. Dr. Jason Fung: All about Fasting [4:40]

Diane Sanfilippo: Why don’t you start with the basics. What is fasting? What is intermittent fasting? All different types; how do they differ? Just give us the basics there.

Dr. Jason Fung: Yeah. I think that this is very important, because it really sets the stage. There are lots of different types of fasting. You can go, the classic is really water fasting. So a period of time that you’re not eating. That’s really what fasting is. It’s only the flipside of eating. So any time you're not eating, technically you're fasting. And this is something that people have always done. So for example, in the 50s, you would have people that would stop eating after dinner, say around 7 o’clock, and then who had breakfast at 7 a.m., that’s a fast of 12 hours. And that’s where the word breakfast comes from; it’s the meal that breaks your fast. And what it implies is that really it’s just a part of everyday life. You cannot break your fast if you haven’t been fasting. So this is something you’re supposed to do every day. And it’s a way to stay in balance. So if you're feeding for 12 hours, 10 or 12 hours, and you're fasting for 10 or 12 hours, then you're in balance.

So during the time that you eat, your insulin goes up. There are other hormones; other things that happen. But insulin goes up. And that gives your body the instruction to store food energy. And you store it in two different ways; as sugar, which is glycogen in your liver. And when that’s full, then you store body fat. So that’s all that happens. And when you don’t eat; when you fast, then your insulin levels fall, and the falling insulin levels, again gives information to the body that nothing is coming in. We need to start pulling out those calories that we stored away. And that’s why you don’t die in your sleep every single night. Because your body stores it and brings it back. Kind of like your wallet. You put some money in your wallet, you take it out. It goes in, it goes out. And every day, there’s a sort of balance to that.

What gets us into trouble, then, is when you start to let the feeding take over from the minute you get out of bed to the minute you go to bed. The only time you're not eating is when you're actually sleeping in your bed. That idea that you have to eat all the time. Now your feeding and fasting times are out of balance. And that’s what leads to a lot of weight gain.

So that’s what fasting is. Now, there are quite a few variations. Normal, if you go back to the 50s, is a 12 or 14-hour fast. That was considered just normal. Nobody called it anything in particular. If you start to extend it, then you go to, say, a 16-hour fast. So that’s what some people call a 16-8 schedule. So, 16 hours of fasting and 8 hours of eating. That’s what makes up your 24 hours in a day. So what it means is that you eat within an 8-hour eating window; say from 12 to 8 or 11 to 7. And that’s a very popular sort of schedule. You might do that 5 or 6 days out of the week. That’s the idea. And you can extend it further. It’s really as flexible as you want to be. You can go 24 hours, 36 hours, 42 hours. Then you get into the multiple day fast.

So 24 hours is another popular regimen, where you go from dinner to dinner, or lunch to lunch. So it’s technically perhaps 23 hours, for example. But you might eat dinner, finish at 7 p.m., then you don’t eat again until the next days’ dinner at 7 p.m. So it’s a 24-hour fast. And you might do that slightly less frequently. You might do that, for example, 2 to 3 times a week. If you go for the whole day, and some of these longer fasts we save for; not save. But we use for sicker patients, such as type 2 diabetic, people who really have a lot of weight to lose. You can go up to 32, 36, 40 hours sort of thing. That means if you eat dinner say on Monday, say you finish dinner at 7 p.m. You would actually go through all of Tuesday and not eat anything, and then go right through to Wednesday morning. So it’s longer than 24 hours. It’s somewhere around 36 hours-ish. If you skip breakfast on that day, it goes into a 40-hour fast.

Then we go into the multiple day fast, and we typically try to avoid the kind of 2-day fasts. There is a very practical reason for that. You can if you want to. But from experience, we know that day 2 tends to be the hardest day of the fast. Some people find it’s day 3. So if you're going to get to day 2 or day 3, which is the hardest day and then quit, then you're not getting the maximum benefit, it’s not a very efficient strategy. So once you get past that, every day gets easier. And the reason is that your body has moved into burning fat. So you’ve burned through all the sugar. You’ve gone through the gluconeogenesis stage, and you're into just burning fat. So your body is really feeding itself from your body fat. In essence, you're eating breakfast, lunch, and dinner of your own body fat. And that’s perfect. That’s terrific. That’s exactly what we want it to do.

And hunger actually starts to go down. So you can measure the ghrelin, which is a hunger hormone. And you can see that it typically peaks somewhere around day 2. So day 3, day 4, day 5, it actually goes down and down and down. So that’s how people do these extended 7-day, 14-day, 30-day fasts. Because it’s actually a lot easier for them, because the hunger has diminished. So if you're at day 2, you're like, “Man, I am never going to be able to go on.” That’s the worst day. If you quit, you don’t get any further benefit. But if you push through that worse day, every day gets easier. And that’s how Jimmy Moore, for example, goes 21, 30 days. And because by day 5, the hunger has gone, you're feeding yourself through your body fat. You're feeling good, you’ve got lots of energy. And you're like; “I can do this forever.” So that’s great. So why would you stop at day 2?

So that’s where we kind of draw the line. We kind of try to nudge people away from doing a lot of 48, 72-hour fasts, to get into the longer stages. Because the average weight loss on a fast is only half a pound of fat per day. It sounds really little. So 6 days of fasting, which seems a lot. And it is. You're expected to lose only 3 pounds of body fat. That’s it. You are going to lose more than that; you're going to lose 6 or 7 pounds. But that’s water weight. So you're going to lose, say, 7 pounds, and 4 of it will immediately come back. And that’s where people say, “Well, that’s all a waste of time.” It’s like, “No. You shouldn’t have expected to lose that much in the first place.” So if you know that ahead of time, if you know it going in, it presents that kind of disappointment because you think that 7 pounds will stay gone but it won’t. 4 of that comes back, it’s only 3 pounds.

If you think about it, the math works out quite close to the experimental evidence, which is a pound of fat roughly has 3500 calories. If you're eating 1800 calories for example, it’s 2 full days of fasting for 1 pound of fat. So if you have 100 pounds to lose, you could really go 200 days to lose all that fat. And that’s a long, long time. Even I don’t recommend people going that long.

So those are the different regimens. And then there’s different types of fasts. What you allow during the fasting period is all different as well. So classic is a water only fast. There’s something called a dry fast, which is used in certain religions. Muslims during Ramadan, for example, will neither eat nor drink. So you’re doing 2 things; one is you're fasting, because you're not eating. But you're also getting dehydrated because you're not drinking. So it tends to make things more difficult than it really should be, because you're not deriving any medical benefit from getting dehydrated. Because you're going to drink again after the fast is done, rehydrate.

Some people say, and I don’t have much experience because I never recommend it. But some people say that your body releases the water and you don’t actually get dehydrated. That’s possible. But in either case, our experience from people who do Ramadan is that it’s a lot harder than just simple fasting. So why make it difficult for you; you want to try and make it easy. So we don’t recommend that.

Then you get into variations. So other than water, most people will say teas and green teas and herbal teas are quite fine. Because there’s no calories in it. And also avoid artificial sweeteners and artificial flavors. Crystal Light and that sort of idea. There are some people who do well with it, like diet sodas and so on. But in general, I think it makes it more difficult for people and it also can raise insulin and cause cravings and these sorts of things. So I say no artificial sweeteners, no artificial flavors. Even though they are zero calories. Coffee, for example, black coffee is fine. There are really zero calories in that. We often allow a little bit of cream in it, because it makes it easier, again. But no sugar.

Then you get into other variations, such as fat fasts, which is where you eat almost pure fat. The idea being that you can take in all these calories, but pure fat has very little insulin effect. And it’s really the dropping of the insulin which causes the weight loss. It triggers your body to release the energy to switch over to burning fat. So you can do these things. So bulletproof coffee, for example, is an example of a fat fast because it’s coffee with all this blended butter, which has very little insulin effect. A lot of calories, but very little insulin effect. So that’s called a fat fast. And some people use something like bacon and avocado during a fast; again, with the idea that this sort of thing.

But now you're moving further and further away from classic fasting. However, some people do very well on that. So if you’re doing, then it doesn’t matter whether you're technically breaking the fast or not. And that’s why we allow the coffee with cream. Because if you're doing well, then who cares? We’re not purists, we’re pragmatists. We just want to get results. So those are the variations. We also allow bone broth on some of the longer fasts. That’s again, there’s calories, there’s protein. It’s not a true fast. But it helps people during their fasting so they can get through.

Diane Sanfilippo: That is a really amazing, well-rounded introduction to fasting. I think a lot of our listeners probably, maybe were shocked to hear that somebody who has got, say, 100 pounds to lose could go 200 days. But when you think about it, that really is kind of the purpose of the storage of all this body fat, is really to help us through those times when we’re not eating. But modern society; there’s an abundance of food all the time everywhere, any kind you want. There’s never an end to it. So I’m really glad to hear the background on all of that. All of the descriptions. I think that will really help people.

The one thing I want to really hear a little bit more from you on, besides obviously some of the fat burning effects for people. And I think the largest benefit for that sort of, I don’t know, bigger chunks of fat burning as you were talking about. For example, somebody who does have 100 pounds to lose. A lot of our listeners, some of them may be in that camp. A lot of our listeners really are more in the health and longevity. What are some off the benefits to fasting when we perhaps don’t have type 2 diabetes? Or insulin resistance? Or maybe we don’t even have more than 10 extra pounds of body fat kind of sitting on us? I know there are still benefits to fasting, and I think that’s something that our listeners would be really curious to learn a little bit more about.

Dr. Jason Fung: Yeah. There’s actually a huge number of benefits. They’re different. So there’s the metabolic benefits. And this is where it’s kind of important to address some of the myths about fasting. So one of the big myths is that you should never, ever skip a meal because your metabolism will go into starvation mode. So the idea is that you're going to shut down your metabolism. So if you count calories, for example, and suppose that you normally take 2000 calories per day, your burning 2000 calories per day, because you're not gaining or losing weight. However, you're at a weight that’s higher than you would like. So you want to lose 10 or 15 pounds, for example. So you say, “What I’m going to do is go down to 1500 calories, and I’m going to increase my exercise. Therefore, if I’m burning 2000 and taking in 1500, therefore there’s a net deficit of 500, I’ll lose a pound per week. In 15 weeks, I’ll lose those 15 pounds. Yah, hooray, we’re all done.”

That never happens. Ever. And we’ve known this for 100 years. The experimental evidence is very clear that when you do that, you will initially lose weight, then you're going to plateau. Even at that 1500 calories a day that you are taking in. Your weight then starts to go back up. Eventually you feel cold, you feel tired, you feel hungry, and your weight goes back to what it was. 10 or 15 pounds back up. That’s what always happens. And that’s been everybody’s experience. And the reason that that happens is because your body is simply not stupid.

If you are burning 2000 calories, and taking in 1500, your body knows that if you keep that up, you will die. So it quickly ramps down its metabolism to match it at 1500. In fact, it goes below, because it needs a little bit of a margin of safety. So it will go down to say, 1400. So you're taking in 1500, and now your burning 1400. You're not losing weight. It’s starting to come back up, despite the fact that you stayed on that diet. But because you're burning 1400, this is the basal metabolism. That’s what goes to generate body heat, it keeps your heart pumping, it keeps your extremities warm, it keeps your liver working, your heart working, and all that. You're using less energy, your body is shutting down, basically. So, you're cold. You're tired, you're hungry, you feel like crap. And your weight is coming back up. And that’s what always happens. Because your body has that ability to ramp it down.

Just like if you normally earn $100,000 a year, you spend $100,000. Now your salary goes to $50,000. You don’t keep spending $100,000, because you will go to jail. That’s simple. So you're not stupid, your body is not stupid. That’s what it does. It goes down, and that’s it. You're toast.

And this is really one of the most unfair things we do, as medical professionals, to people. Is say that, “Oh, this is what you need to do. You just need to cut your calories. Count your calories, cut your calories, and that’s it, you're done.” We know that has about a 99% failure rate. And when people fail, we then point the finger at them and say, “You don’t have enough willpower. You didn’t follow the diet. You didn’t do what I told you to do. Because the advice is good. You're just defective somehow. You're a glutton, you’re a sloth.” And that’s really the most unfair thing we do. Because we know that 99% of people fail. So how do you blame them for failing when you know that they will fail right from the get-go? And it’s proven. What happens to our body; we have studies going back close to 100 years that show this.

So where fasting is a benefit from a metabolism standpoint is that your basal metabolic rate doesn’t go down. Which seems counterintuitive. Because if you go from 2000 calories in, 2000 calories out, and you go to zero. What happens is that your basal metabolic rate stays close to 2000 calories. And you say why? How is that so? And the reason is that your body is actually switching fuel sources. So because your insulin is dropping precipitously low, your body now switches from burning food to burning stored food. Which is body fat. I mean, that’s what it’s there for. It’s not there for looks. It’s there for you to use as energy when you have nothing else. So you start burning body fat. And your body is like; “Whoa, there’s tons of this stuff. Let’s just burn it. I have 200 days that I can burn it for straight.” So go ahead.

At the same time, if you look at what happens to your hormones, there is something called counter-regulatory hormones, and they run counter to insulin. That is, insulin tends to drive blood glucose down, and store food energy. These counter-regulatory hormones tend to pull energy back out of your body and make it go up. And what are these hormones? They’re the sympathetic nervous system, noradrenaline, and growth hormone. So in fact, your body is not shutting down. Your body is being activated. So the sympathetic nervous system is the so-called fight or flight response. It’s a mild activation of your body; noradrenaline pumps your body up. Growth hormone gets your body ready to build new protein when you start eating again. So in fact, what you're doing is you're pumping out all these hormones to keep your basal metabolic rate high. And that’s why your basal metabolism does not drop on fasting the same way.

Because remember; your body has two fuel sources. Food and stored food. You're switching them when you fast. When you simply reduce the food; you simply reduce what’s going in. But because you're still eating all the time, you're not able to access those stores. Because you’ve stored it away. Your body has no instruction to switch over and use it, so it’s still locked away. All the fat is kind of locked away where you can’t access it. Your only access is to the food that you eat, and you're not getting as much, so you ramp it down. So that’s the difference. There’s a huge metabolic barrier to weight loss, and that’s one of the huge advantages to fasting in terms of weight loss.

So that’s one of the metabolic benefits; keeping your energy high. And that’s why people feel so good when they’re fasting. We get people; and keeping in mind, again, that if you do it for the first time, you may not feel so good. It does take a little bit of time for your body to get used to it, just like ketogenic diets. There’s the so-called keto flu, which is a fairly well-known phenomenon, which when you start with the ketogenic diet, you feel a little crappy for a few weeks, until you can get your body sort of used to it. So you get the same thing with fasting. The first couple of times will suck; that’s what we say. They will suck, and there’s nothing I can do. But you do it, you get through, you let your body get used to the fasting, and pretty soon your body is able to switch fuel sources much easier.

So that’s the one thing. They feel good when they come back. They say, “Wow, I have so much energy!” Why? Because you're finally letting your body burn the fat. And that’s what we all want it to do. We want to burn fat. And how are you going to burn fat if you're still eating all the time? You're not letting your body digest the food. Because that’s the problem. Fasting is not about calories. If you take any period of time, you can eat the same number of calories. But it’s about lowering the insulin. So it’s about time, letting your body have a period of time where your insulin levels fall. To let your body digest the food and start to use it. So that’s the real metabolic advantage.

And then you talk about other advantages. There are all kinds of other health benefits to fasting that are really just being recognized. These are a lot more experimental. There’s not as much data behind them. But at the same time, they’re very intriguing. One of the things you get during fasting is something called autophagy. So autophagy is a very hot topic in science circles, because the 2016 Nobel prize in medicine went to one of the pioneers of this research. And it was really studied in yeast and other small organisms, so it’s a pathway that has gone a long time.

So what autophagy is is the breakdown of sort of subcellular proteins that are sort of old and junky. So if your body senses that you're not eating, what it does. There’s a period of time it burns through the sugar, but there’s a period of time; somewhere, 16, to 24, to 36 hours. Somewhere in that time where it actually starts to break down some protein to produce glucose. And everybody thinks that’s a really bad thing, breaking down protein. “Oh, that’s bad. Oh, that’s bad.” But it’s actually not bad. Because when you break down the protein, you're taking old, sort of defective, junky old proteins, you're breaking it down for energy, but at the same time the growth hormone levels go up so that when you feed again, you're going to rebuild that protein. So you are, in fact, rejuvenating yourself. You're actually reversing a lot of these sort of processes that can lead to disease. That is, certain diseases are caused by sort of buildup of all this excess junk in your body.

So Alzheimer’s disease, for example, is a buildup of all this excess protein in the brain that clogs everything up. And perhaps, and it’s very interesting but not proven. Perhaps that will let people prevent Alzheimer’s disease. Same with cancer. Maybe your body will be able to prevent the development of cancerous growths because they’ll just get fed into the fire to get burned. And then when you rebuild them, you’ll just rebuild normal cells. Again, very, very interesting.

And when you go back in history, you see that people have always had this idea that they should do, once in a while. Once a year or whatever, some sort of longer fast in order to kind of clean house. So you have the Christian period; the Catholic period of Lent, which just passed. Jewish will have fasting during Yom Kippur, and Muslims will have fasting during Ramadan, which is their holy month. So all these religions kind of independently came up with this idea that there’s something really intrinsically healthy about, once in a while, just not eating and letting your body clean itself out. And that’s what they’re called; cleanses, detoxes. All this sort of idea. And it sort of pervades throughout history that yes, this is something that’s very good for people to do.

There are people who talk about it as an anti-inflammatory; maybe it decreases the inflammation so that disease such as lupus, rheumatoid arthritis perhaps are better, as well as all kinds of other things. If you lose weight then your back pain, hip pain, joint pain. Obviously if you're not carrying those extra 20-30 pounds, that’s going to be a benefit to you. So that’s the kind of…

Diane Sanfilippo: {laughs} Just a few benefits.

Dr. Jason Fung: {laughs}

Diane Sanfilippo: Just a short list.

Ok, so again, make sure you go back and check out episode 298 as Dr. Fung and I go into much more detail on fasting. We talk about fasting and hormones. Fasting in combination with keto. Who is it not good for. Hypothyroid and fasting. Exercise and fasting. How to tell if you're truly hungry. All of that good stuff.

4. Dr. David Hanscom: retraining neural pathways [29:11]

Diane Sanfilippo: Next up, episode 319. This was an episode with Dr. Hanscom that Liz recorded, and it is awesome. It’s all about healing yourself from within. We had so much great feedback on this episode, and I wanted to share this clip with you guys once again. But first, a quick word from one of our sponsors.

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Liz Wolfe: Oh, it’s incredible. And one of the things that you said was, in your history as a surgeon, and part of the way that you're successful in that field is to suppress things. And what was interesting to me, my experience is just a fraction of what you and so many other people have been through. But I felt like; wow. As a mom to a toddler; I was a new mom a couple of years ago. And that’s when things kind of started to become a struggle for me. But as a mom, you kind of get used to suppressing things too.

Dr. David Hanscom: Right.

Liz Wolfe: You just have to perform. You have to be ok for these little beings that you're responsible for. And over time, I started dealing with poor sleep. Of course, that’s another thing. And we’re going to talk about sleep in a moment, because you're very clear about your requirements for getting people sleeping in your book. But ringing ears. Heart palpitations. These symptoms that I thought were either all in my head or structural. I thought there was something wrong with my heart. And we did all of the tests, and nothing was wrong.

So what really struck me about your book was learning that it’s not “All in my head.” It is physical. It has to do with neural pathways, right? But not necessarily structural. So can you talk a little bit about those neural pathways and how they might apply to both pain and anxiety?

Dr. David Hanscom: Well there are two things to consider. One of them is you're basically, the way human beings survived on this planet, is that we process sensory input from all sources. And the eyes are the richest concentration of sensory receptors. And these sensations are part of the unconscious nervous system that protects us. So as you're sitting in your chair, your body is unconsciously shifting so your skin doesn’t break down. Or you're not staring in a bright light. So every sensation is interpreted as positive, neutral, or negative.

What the brain does; it keeps you mostly in a neutral zone so you're not too comfortable or uncomfortable. You sort of stay in a range of behaviors that is safe. So what happens if you have nice music, like a symphony, or warm water, or lying in the sun, your body is secreting chemicals like oxytocin and dopamine, which are the reward chemicals. Then you feel relaxed. So when you feel relaxed, you're just feeling the chemical surge.

When you have loud sounds, bright lights, things that startle you, then your body secretes survival chemicals like adrenaline and cortisol, then you feel anxious. When you feel anxious, you're feeling this chemical surge. The reason why you can’t treat that psychologically is because that is using rational means to deal with these irrational reactions. It’s a million to one ratio.

So what the research is showing, which is fascinating. And I didn’t know this in my first book. Is that thought in humans to the same thing. In other words, every creature has an anxiety survival response that keeps them safe. Humans have the additional issue of consciousness, which obviously is an advantage for survival. But it’s also a curse in that thoughts do the same thing; where pleasant thoughts give you reward chemicals and relaxation, and unpleasant thoughts give you stress chemicals and anxiety.

The problem is that you cannot escape your thoughts. So if you suffer them, they get worse with time. If you suppress them, it seems to work for a while. But at some break point, every human being has to deal with this. And I’ll explain in a second how we do that. Because everybody feels anxiety, but there are some significant reasons why.

And then the final thing is we mask. And we think that thought suppression is a major factor in opioid addiction. The problem is, we can be trapped about anything. Whether it’s pain or unpleasant thoughts, you become angry. And it turns out that anger and anxiety are the same thing. So what the intro for anxiety course controls; in other words, if you change a situation to remain safe, or it gets your need met, and then it’s problem solved and the chemicals go back to normal.

When you can’t get those needs met, then your body secretes adrenaline in an attempt to improve your chances of solving the problem. So basically anger is anxiety on adrenaline. So the problem is, anger gives you the feeling of power, which covers up the feeling of anxiety, which is vulnerability. So people either suffer, suppress, or mask. But one way of effectively covering up anxiety is to remain chronically angry.

So every human being has to deal with this. And anxiety gets worse as you get older, because it’s a repetition pathway. So it’s a programming problem. It’s like an athlete learning a skill. So what happens is these impulses get imbedded in your brain, and once they are imbedded they are permanent. So they become stronger with repetition. Of course, even strong with suppressing them. And once they're in there, they’re permanent.

So any of these permanent imbedded pathways that are still in your body secrete stress chemicals, and you're stuck. As human beings we’re stuck with these adrenalized nervous systems.

Liz Wolfe: I’m getting chills just listening to you speak. So one of the things that really got to me in reading your book was that connection between anxiety and anger. Because at first I didn’t want to believe in my experience that I was angry. Because it made me feel like I was angry at my child. But the way I kind of thought about this, was its more my body being angry that I can’t get out of this situation that’s causing the anxiety. Because of course, I love my child and I’m not going anywhere. So it made sense to me that I was having these reactions because I couldn’t change my situation. I needed to find a new way to thrive in it. And that was a really big ah-ha moment for me.

And one of the things I’ve told people, especially new moms, is it’s really important to give yourself grace. If you're struggling, it’s really important to just acknowledge that and not feel like you have to find a way out of it. However, something that I learned from you was that the longer that we stay in this place, the longer we reinforce these pathways, the deeper and more engrained they get. So it becomes more work to kind of get out of them. Would that be accurate?

Dr. David Hanscom: Well, first of all you can’t. So this is the paradox of the process, which is actually the good news. Once you understand that all these pathways are embedded and they are permanent. And by the way, the neuroscientists are really clear that what happens with chronic pain, again.

First of all, social isolation, social pain, and physical pain are considered the same entity now. In other words, these thoughts that are unpleasant go to the same part of the brain that unpleasant physical sensations go to. So whether it’s mental pain or physical pain, it’s basically the same entity. So it turns out that this chemical surge in anxiety is the pain. It is the same entity. So that’s really clear to understand that.

So then when you're trapped by anything. It doesn’t really matter what it is. Whether it’s money, finances, job, relationship, pain, whatever it is, your body is full of adrenaline. Again, once it’s embedded, and obviously I had a huge childhood full of anger which I didn’t recognize because it was my norm, right. So I was talking to a viewer the other day and it hit me that my entire nervous system is based on anxiety and anger. That’s what I was raised in. That’s all I know. So I can’t get rid of that. I can’t solve it. It’s part of the unconscious brain. It is who I am.

But once you realize that you cannot solve it, we spend a huge amount of energy talking about it, analyzing it, trying to fix it. Once you realize you can’t solve it, you simply let it go. In other words, you separate and go a different direction. The metaphor I like to use is directing a river into a different channel.

So once you decide; I think you understand these writing exercises. I’m guessing you probably engaged in some of those writing exercises?

Liz Wolfe: Yes. That’s what I’d love to talk about next.

Dr. David Hanscom: And what happened is that we don’t really know why it works. There are over 300 research papers that points out that these different forms of writing work. In my first book I talk about negative writing, as most research has been done in negative writing. Because when you suppress negative thoughts, of course you reinforce them. It turns out it doesn’t matter. It turns out it could be positive or negative. I call it now expressive writing.

What you're doing is you can’t escape your thoughts, but you can separate from them. And so what I have people do is I have them simply write down them thoughts. I do it every day. I’m going to do it again this morning once we’re done with the interview. And what happens is thoughts are on paper, you're physically separate from these thoughts. That space is now connected by vision and feel. So you're now separated from your thoughts.

The reason why I have people tear these up instantly is first of all write with freedom. Whatever thoughts come up, it is what it is. Second of all, the goal is to not analyze them. Because if you analyze them, you're actually reinforcing the pathways. And you can’t fix yourself. So what you're doing, you're separating, done. And so when you reprogram the nervous system, you're going to create an awareness of the automatic survival reaction, or the influence of your thoughts. You now separate it, and then you redirect.

So that’s where things like meditation, mindfulness, a cup of coffee, giving back. Whatever you want to do to make the world a better place, or to nurture yourself, that’s reprogramming. The reason why it’s so critical to put the writing in there as a link that if you're meditating or doing mindfulness or doing good deeds to help ally your anxiety, if you're doing these enjoyable things in life to escape anxiety and fear, you can’t do it. Because again, that’s the unconscious survival reaction. Which again really is a million times more powerful than the conscious brain. So you have no chance. It’s like trying to take down El Capitan with a pick axe.

Liz Wolfe: {laughs}

Dr. David Hanscom: So once you understand that you cannot solve this unconscious survival response, the energy you have to live your life just goes through the ceiling. And I’m guessing you’ve already felt that.

Liz Wolfe: Yes. 100%.

Dr. David Hanscom: So I write every day. It doesn’t take very long. Maybe 3 to 5 minutes, once or twice a day. And what’s fascinating in the research that it helps student performance, athletic performance. It helps rheumatoid arthritis, asthma; all these physical symptoms start to disappear. What happened on my journey after 15 years, I happened to read a book called Feeling Good by David Burnes. And David Burnes said to write. It’s a great book. I really think the book is remarkably positive. It’s based on cognitive behavioral therapy. But really what the power was was in the writing. And when I wrote the first book, I didn’t realize that there were over 300 research articles that showed the writing exercises work.

So after 15 solid years of doing psychotherapy, medications, everything you can imagine, within 2 weeks after the writing started my symptoms started to shift. And by 6 weeks, my anxiety had dropped down by about 60%. But I still wasn’t cutting through it. What I didn’t realize, I was such a master at suppressing anger, and I did not realize anger and anxiety were connected. I was going through a very difficult personal time at that point in time. And all of a sudden, I had to confront the fact that I was angry. Because it just exploded. It was not very pretty. And I struggled like crazy to figure this out.

But within about 6 weeks after I passed that gauntlet, my symptoms started to disappear. And a year later, I was fine. And my patients now; the neuroscientists have a saying, the neurons that fire together wire together. So chronic pain causes anxiety and frustration. And these are pathways. In other words, the pain pathways are coming into your brain. Those get embedded also, just like other thoughts. Anxiety increasing pathways get embedded. And they get linked.

So you actually cannot really heal chronic pain until you get past the anger threshold. I mean, you can get better. But to really solve it. And I’ve watched hundreds of patients do this. Is that once you actually successfully navigate the anger pathway, people heal. Remarkably so.

5. Dr. Jolene Brighten: Female hormones [42:47]

Diane Sanfilippo: So again, be sure and check out episode 319. And now, our final snippet is from episode 299. It’s all about female hormones with Dr. Jolene Brighten. You guys know her and love her. She’s one of the all-time favorite guests that we’ve ever had on the show. But let’s hear from one of our sponsors, first.

Liz Wolfe: The Balanced Bites podcast is sponsored in part by the Nutritional Therapy Association. The NTA trains and certifies nutritional therapy practitioners and consultants (including me; I’m an NTP), emphasizing bio-individuality and the range of dietary strategies that support wellness. The NTA emphasizes local, whole, properly prepared nutrient dense foods as the key to restoring balance and enhancing the body’s ability to heal.

The NTA’s nutritional therapy practitioner program and fully online nutritional therapy consultant program empower graduates with the education and skills needed to launch a successful, fulfilling career in holistic nutrition. If you're interested in learning about holistic nutrition but don’t necessarily want to become a practitioner, check out their new Foundational Wellness course. To learn more about the NTA’s nutritional therapy programs, resources, and to enroll in their free course, Nutritional Therapy 101, visit

Diane Sanfilippo: So today we’re going to talk about female hormones. This topic has come into our inbox of questions for the show, to unrelated posts also that we’ve made on our Instagram account, when we make a call for questions. Even when the call for questions is totally unrelated, the amount of questions we get about female hormones is always through the roof. Obviously, most of our listeners are kind of in the 25-45-year-old range. You know, some younger some older.

This is just a huge topic, and I think it’s for good reason. We have a lot of issues going on with our food, with our environment, with our stress. So many things going on. We have a ton of questions here, and we are probably going to end up splitting this into 2 different episodes so we’ll be able to cover more topics. So for those of you listening to this one, stay tuned for a future episode that will be a part 2. And like we’ve been doing on the last few podcasts where I’ve been doing interviews, we’re going to be grouping the questions together. So I know there are a lot of similar questions that have come in through the Instagram post that we had, and this way we can cover more during the podcast instead of just really micro-specific questions. I think you guys will get a lot more from this.

So, here we go. Let’s start with the basics. What are the signs that your hormones are off? Is there a way to start healing without supplements or medications? What do we do about testing?

Jolene Brighten: Yeah. So every woman needs to understand this basic premise. If you’ve been living in your body, and you feel like something is off, and not right, then you need to find a doctor that listens. Because you ultimately are the best gauge of what’s normal in your body, and what’s not normal.

So, things that I would say are common, that get passed down to us as women as being, “This is normal. This is just how it goes.” Things like really heavy periods, really painful period cramps, losing your mind a week before your period. So feeling like you want to scream. I actually; this is how we gauge progesterone. I ask my three-part question. A week before your period, do you A) want to kill somebody; B) run away to the woods and never be seen; or C) all of the above. And it’s real, because if your progesterone is low and your estrogen is high, then everybody is going to drive you insane. So it’s really important to understand, ladies, that your hormones absolutely rule your moods.

So if you're having cyclical anxiety. Cyclical mood swings of any kind. Experiencing depression. And these things don’t even have to be cyclical. But if you're a woman cycling, they tend to have a time of the month where they’re a little bit worse.

Other things that are signs of hormone imbalances; changes in your skin. Oily skin, dry skin, acne, rosacea. Hair loss. Your nails are splitting, or they’re really, really brittle. Those kinds of things that will get passed off as like, “Oh yeah, that’s just normal, part of being a woman, you need to change your diet.” Yeah, you probably do need to change your diet and do things around that. But you probably do need to look a little bit deeper about what’s going on. And that’s where the lab testing comes in.

Now, I want to say first thing, I love this question about other than supplements and medications, what can we do. That’s a great question. Because it’s a slippery slope, and I see this a lot. In allopathic medicine, they give you a pill for every symptom that you have. Which works really well in emergency medicine. So, works really well there. Not so well when you're dealing with the female body and imbalances and more chronic conditions going on.

With that being said, we need to be careful in functional medicine to not come in and start placing a supplement for every symptom. We’ve got to look at really the foundational pieces. So absolutely, if you're not doing the diet and lifestyle piece, it doesn’t matter how many supplements or medications you take. That’s just trying to strong arm the body to do something that’s, in an essence, unnatural.

And why do I say it’s unnatural? Because any times we have hormonal imbalances, it’s actually adaptive physiology. It’s your body keeping you safe so that you survive. So when you come in and you say, “Hey symptoms, you need to go away.” And you treat it with a supplement or you treat it with a medication, you really haven’t addressed the body’s cry for help. And that’s a problem because your skin, for example, is a really benign place to put an expression of dis-ease. So what gets classified as disease we can think of as dis-ease in the body. So when you start to suppress those symptoms, now we run the issue of driving it deeper. And we never want to have expression in the liver, or the heart, or even the gut. The gut gets hit a lot in our modern environment.

So absolutely, the things you need to do to have amazing hormones are hang out with your tribe and your people. We need community. As women, we can boost our progesterone just by hanging out with our lady friends a few weeks before our period comes. Other things are getting ample sleep. If you're not getting at least 7 hours of sleep; forget it! I don’t care how many supplements you take. Your body is going to be like, “This is a very scary place to be living.” So always think about it from that perspective. If you're sending the signal of danger to your body, then your body isn’t going to rebel; no, no, no. It’s going to adapt so that you survive. And that always means compromised fertility.

Now, to answer the question about testing. Here’s the thing about lab testing when it comes to women’s hormones. Lab testing alone is not enough and you cannot hang your hat on any lab test that’s out there. I love DUTCH testing from Precision Analytics. It is like the absolute best hormone testing that we have. I just love it. But here’s the thing. I’ve got to stand back, and I’ve got to look at the labs in the context of your story. Because no lab that’s out there right now; so, DUTCH is best. And then there’s saliva testing, and that’s pretty good too but it depends on hormones that your taking and what else is going on. And then there’s blood testing. And they call kind of serve their own purpose.

In my clinic we do more blood testing and more of the DUTCH testing. That’s how we look at things. But none of that matters if I don’t know your symptoms. Because what we’re looking at is one snapshot in time. And even when you do a collection. We’ll do the DUTCH collection on day 21 of your cycle, roughly. That’s one cycle. We don’t all ovulate every single month. So that’s one snapshot in time. I’ve got to correlate it to your symptoms and ask, is what I’m seeing in the labs true and does it make sense?

Because the other thing, the other caveat that gets thrown in with all of this; is all of your hormones can look normal. So this happens a lot with ladies with thyroid. All the hormones look normal. But we can actually have cellular resistance to the hormone. We don’t have a really great way of testing for that except to ask the patient their story. So it’s really important ladies that you're tracking your period, that you're tracking this data. Because your doctor cannot evaluate your hormones without your data. And that’s really important to understand. If you’ve got a doctor that’s dismissing your story, they’re not going to be able to help you. Because they just don’t get it yet. Because your story, your experience, your body is everything. Does that make sense?

Diane Sanfilippo: Yeah, it does. Super quick follow-up, just practical stuff. Is there an app that you like specifically for tracking your period? I mean I have one that I’ve had for years and I try and put notes about different things. Like if my skin is being weird or whatever’s happening, but I’m curious if there’s just one that you’ve used with patients that you like.

Jolene Brighten: Yeah. So we use the Daisy fertility monitor. That’s what we recommend to patients. And the reason for the Daisy fertility monitor is you can use it for fertility awareness method. It will actually track your cycle, and it will show me peaks in your temperature. So I like that, and you can track your menses in there.

The other apps that my patients really like is Dot, is one of them, and then Alisa Vitti’s My Flow. I’ve been playing with that one for the last 3 months, and I really like that. Because it actually gives little lifestyle tips of what’s going on in your cycle. And then it asks you to schedule it. To actually schedule to make time for yourself. And the sad reality is, we all need that. You and I know as entrepreneurs, if you don’t schedule in self-care, forget it. You can totally just find more work to put on yourself.

Diane Sanfilippo: Yeah. Yeah, for sure. So, why is it that so many women today are struggling with these issues? What are the factors that are contributing to it, and what do you think are kind of the, just kind of the big needle movers on this? What is it that we’re not paying attention to?

Because obviously, our listeners, for the most part, are eating real food, pretty paleo-friendly, probably not a lot of sugar. But I’m guessing a lot of them are a little bit type A. I know a lot are health coaches and nutritionists, and either established or budding entrepreneurs. So let’s talk about some of those factors that affect it. Whether it’s physical stress, or environmental, or food, or all the different things that you see going on in your practice. Like you said, when the women talk about their symptoms and what’s happening in their life, besides what’s happening in the blood work.

Jolene Brighten: Yeah. I mean, one of the biggest things is our environment is more toxic than we’ve ever seen before. It’s just the reality. There was; it was Robb Wolf who just posted. He always posts stuff on Facebook that ruins everybody’s day. But I kind of love it. And he posted the sea salt, and how there are microplastics in the sea salt. And I’m like, you can’t even eat salt these days without getting exposed to plastic. It’s ridiculous.

And so as women, we are set up with receptors to respond to estrogen. And the corporations in America have done us no favors, just to be really straight up. They have no vested interest in the individual. They’re out to make money, we know their purpose. But there are a lot of problems where; I mean, oh my gosh. How many chemicals us ladies douse ourselves in. I always make this joke that in my 20s somewhere along the line I got it in my head that I was supposed to smell like vanilla or strawberries and champagne. Just crap fragrances. But I seriously bathed myself in Victoria’s Secret for like a decade. And this is while I was taking the pill. There are all these things I was doing that I’m like, that is the worst thing I could do for my hormones.

But the reality is, even though we’re eating cleaner in our homes, and certainly you’ve got to clean up your home environment. No shoes in the house. You’ve got to use green products. You cannot be putting stuff on your skin that’s endocrine disruptors. Because your cells are set up to respond to that. Even more so than a man. We’ve got all these estrogen receptors, and all of these things are xenoestrogens.

Not to mention that we have to have a liver that’s upregulated and running and knows how to handle all of this stuff. And when you get hit with a bunch of environmental toxins, now your liver has got to take care of that. Because those will kill you. So good job liver. But it’s going to neglect detoxing your estrogen. So now we’re going to be in really big trouble. Now we can’t actually balance our hormones. That’s a huge piece, is definitely the environment.

But there’s also the environment perspective in terms of the way we live is actually a complete evolutionary mismatch. We are supposed to be having these dark/light cycles. We are supposed to be living within a community and having support. As women, we have always been the care takers. I’ve got a real issue with the how we actually diagnose mental health disorders in women. Without ever standing back and questioning, “How did these things actually serve us?” The things that we say are disorders in women, mental health disorders. I mean, being an A-type personality, being classified as OCD. Yeah, there are ways that we swing a little too far on the pendulum, but I’m convinced the human race wouldn’t be here if women didn’t respond in this way.

So now the issue is that we don’t have a way to channel that. And we don’t have a way to respond appropriately. And we need a lot of support. As humans, when we just look at how we’ve gone about things, we need support and we need community. And they’ve done studies to show that women who don’t feel that love, that support, that community. They actually have higher stress levels and they have lower progesterone. So it has a direct impact. Feeling love, feeling support, feeling like you’ve got people who have got your back is tremendous.

So when we look around, what are really of these things? You put it all together, they’re stressors. I mean, getting exposed to street lamps at night; that’s a stress for the body. Not having community. Having to go alone with actual stress. We have work stress, not all of us have somebody to turn to talk to about that. We look at the environmental toxins. This is all stress on the body.

So I view it through the evolutionary lens of, if the body is receiving the signal of stress, what should it do? It should shut down fertility. Because babies are really, really noisy. They’re basically tiger bait. They’re like the worst thing you could do. And if you’ve got to run from a tiger, being pregnant is just; forget it. Anyone who has been pregnant knows, you're not running in your first or third trimester. It doesn’t matter how scared you are; it is not happening.

So, we have to respect that this is the wisdom of your body. At the end of the day. I just want to say this because there’s been this story passed down, and it’s just so wrong. We’re told that our body is betraying us, our body is rebelling against us. You need a pharmaceutical because your body doesn’t know how to do things right. No, no, no, no. Your body just wants you to survive. Your body; why would it rebel on you? It doesn’t want to die. It wants to be here. And so what it is does is it shuts down energy expenditure that’s unnecessary.

So making babies; unnecessary and dangerous. This is also why women with hypothyroidism; if you don’t have enough thyroid, guess what we shut down? You're not going to grow hair because hair is nice to have, but you know what, humans, we have sweaters now. So your body knows it doesn’t have to have hair. So it’s really important that we view our body from that perspective. You’re totally giggling right now {laughing}.

Diane Sanfilippo: I love that, “We have sweaters now.”

Jolene Brighten: {laughs} But I mean it’s something that as women we’ve got to see our body as our ally and recognize that we’ve just got to come in and give them this signal that it’s safe. One thing I want to say is, whether or not you want to have a baby. And we know now statistically speaking, less than half of women identify as being a mother or want to be a mother. So back in the 80s, it was like 80% of women who were like, “I want to be a mom.” We’re seeing less of that. There are a whole bunch of reasons why we’re seeing less of that. But who really cares?

So all I want to say about it is that’s your choice. But whether or not you want to have a baby, you want to be as fertile for as long as possible. Because then you're bathing in these awesome hormones that make you feel awesome. If you don’t ovulate, which is how you get pregnant. If you don’t ovulate, then no corpus luteum. You have no great progesterone kicked on. That means GABA in your brain doesn’t work right. This is why we want to kill people or run away forever; because GABA is not on. Saying, “Hey guys, it’s ok. Put the hush on the stress.”

Diane Sanfilippo: Yeah, calming neurotransmitter. Yep.

Jolene Brighten: Yep. Yeah. So does that make sense?

Diane Sanfilippo: It does. I love how lit up you are about this topic. That’s how we know we have the right guest expert on it on the show.

Of course, there’s lots more in episode 299. Dr. Jolene and I talked about environmental toxins, and liver detoxing. Postpartum hormone balancing. So much more. Be sure and check out that episode.

Ok, guys, that’s it for this week. I hope you enjoyed this mash up. You can find me, Diane, at Don’t forget to join our email lists for free goodies and updates you don’t find anywhere else on our websites or on the podcast. And hey; while you’re on the internet, you guys, hop over to iTunes or Apple podcast and leave us a review. We would absolutely appreciate it. We’ll see you next week.

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