Going through menopause is a major life marker in every woman’s life, not mainly because it means losing a crucial reproductive function but also because of the complexities it brings to the body. Today, Dr. Kevin Pecca talks to Dr. Anna Cabeca, an internationally acclaimed menopause and sexual health expert and the author of the bestselling book, The Hormonal Fix. She shares how her personal experience of early menopause has inspired her to find answers to help herself and others to fix her hormones. She highlights the significance of Keto diet, Keto-Greens, ketones, and glucose to male and female bodies. She also shares her opinion on birth control and the hormones that affect the body. Gain more knowledge from Dr. Cabeca as she discusses what she implements to her patients and how her upcoming book, Keto-Green 16, can possibly help you with your menopausal struggles.
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Menopause, Hormones, And Keto With The Hormone Doctor, Dr. Anna Cabeca
We have a special guest, Dr. Anna Cabeca. She is an internationally acclaimed menopause and sexual health expert, global speaker and pioneer in promoting women’s health. She is Emory University trained and triple board-certified in Gynecology and Obstetrics, Integrative Medicine and Anti-Aging and Regenerative medicine. She is the author of the bestselling book, The Hormone Fix, a diet and holistic lifestyle program for menopausal women and the new release with the foreword written by Dr. David Perlmutter. She has a new book coming out, Keto-Green 16, designed for improving energy, hormones and weight loss. Please welcome, Dr. Anna Cabeca.
Thanks for having me.
It’s an honor to have you on the show. It looks like you are doing incredible work with your last book and you have a book coming out.
The Hormone Fix has been a USA Today bestseller and it’s been number one in menopause for fourteen months on Amazon. I am excited about that and Keto-Green 16 will come out. It’s available for pre-order. It is a sixteen-day plan with great biohack that targets transitional hormonal challenges from ages 40 and up, where we have stubborn weight loss, brain fog, mood issues to conquer that quickly.
There are many people suffering from a lot of the things you mentioned. It will be beneficial for everybody. Where are you from and how did you get into the healthcare profession?
I live in St. Simons Island in Georgia. We’re in the Southern Coast of Georgia below Savannah. I’ve been here since I had trained at Emory University in Gynecology Obstetrics in 1999. I finished at Emory in Atlanta and moved here. I’ve been here all along, but I grew up in the Pennsylvania region. I’ve always had a love for medicine. I knew I wanted to be a doctor at a young age and saw my mom suffering from a chronic medical condition that I know I could have reversed over and over again. Part of my journey has been recognizing that at the time. My mom passed away at the young age of 67. She was on eleven medications and had many years of struggling. I’ve seen that over and over again.
Since that was many years ago, we’ve come a long way in our management of medicine. We haven’t and here I am, trained at Emory University, one of the best universities and hundreds of thousands of dollars of education, not to mention key years of life just to say, “It takes more than hormones to fix your hormones.” There are diet and lifestyle management that can turn the needle in our health and uplevel our health. What I’m begging people to do is reclaim the power over their own bodies. With the right information, that works and how to figure out, it’s working for you or it’s not.
It sounds like you do a very holistic approach. How did you find holistic medicine? A lot of people say, “I’ve tried holistic and it doesn’t work.” What avenue do you like to go down with some of your patients?
I’m more functionally medicine trained. After Emory and ob-gyn, part of my own journey, I went on to board-certified in integrative medicine, anti-aging, and regenerative medicine. I continue learning functional medicine and understanding the ‘why.’ I’m a scientist at heart. Understanding biochemistry and physiology is a passion for me because I struggled at age 39. I was diagnosed with early menopause and infertility post traumatically. I was told I would never be able to have another child. My only chance would be egg donation. I had failed the highest doses of injectable meds. This is coming from a gynecologist trained at one of the best institutions in the nation. That’s a death sentence for you. When we say early menopause, we’re like, “Do this and your hormones will be back in balance.” That’s what I say now, but I didn’t know this then.
I went on a journey around the world looking for answers and finding natural remedies that I used to create natural products that are effective and were quick. We’re balancing the body’s natural energy systems and our hormones, and giving our body what we need. It’s more than a pill or a potion. It’s a lot more than that. There are many aspects that come into play and that’s what I teach in The Hormone Fix comes to fruition is there are toxins. We can be eating right and exercising perfectly but we’re living in mold toxins or we’re in a toxic environment. These challenges can affect our thyroid, our hormone, our body chemistry, and suck the joy out of our lives. That’s where we’ve got a job to align.
It sounds like one of the main errors you start with is the diet. A lot of information on the Keto diet, Keto-Greens and ketones versus glucose. Can you touch on that and what that means for people?
I’ve learned this through my journey. I was diagnosed at 39 with early menopause and infertility. I went on to reverse that for a decade. I had a baby at age 41, which I was told I would never be able to have. At age 48, nearly a decade later, I was starting to have those same menopausal symptoms again. I have no more periods, brain fog, memory loss, and mood swings. That took me into this keto world but knowing that with women, there’s the right way to do keto and there’s a wrong way to do keto. With men too, but women we’re more fragile. Men have ten times as much testosterone. There’s a protective balance right there. Women don’t.
On this menopausal transition, when we’re losing progesterone and estrogen levels are dropping, we can’t use glucose for fuel as readily as we can use ketones because gluconeogenesis in the brain or the use of glucose for fuel in the brain is an estrogen-dependent phenomenon. As our hormones drop and dive our brain is starving. We’re having anxiety, depression, irritability, mood swings, and difficulty sleeping, all these neurologic or I call them neuroendocrine symptoms. There’s something that we can do about it because we don’t have to suffer through this.
What exactly is a ketone and how does it help rebalance the body?
Ketones are molecules of fat energy. They are energetic molecules. Glucose is to gasoline as ketones are to jet fuel. We can think of that. When we get fuel from fat, it’s over two times as powerful as fuel from carbohydrates.
You said there’s a right way to do the Keto diet and there’s the wrong way. How do you recommend people start and how do you feel about the meat aspect of it?
What I learned is when I went straight Keto, I wasn’t paying any attention to my alkalinity. People talk about Keto flu, which is certainly a detox reaction. You have that Keto flu, but a Keto crazy is what I was experiencing. There I was, a single mom taking care of teenagers. You have to be calm. You have to experience the peace that surpasses all understanding at that stage of their lives for my own sanity. I recognize quickly that it matters whether we’re in ketosis or not, but what else is going on. In the long term, this acidotic state cannot be good for us. We’re missing key minerals and nutrients in our body. I started checking my urine pH like we tell all our patients to do, “Check your urine pH. I want you to wake up with a urine pH of seven.” I created these urine pH and ketone test pad so you can look and see your own ketosis and your urine pH is more on the alkaline side and something that I recognized. In order to get me there, when I started checking, I was as acidic as the paper would read.
You were following the Keto diet.
I’d been a functional medicine doctor. I know that I used to have alkaline urine pH, but going to more of the animal fats and meats and increased fat in my diet, which put me into more acidic, which can be inflammatory. I certainly was feeling inflamed. I was feeling irritable. I’m not getting Keto clarity on what’s going on. My urine pH was acidic. I’m here on the South, so I started adding collard greens, Swiss chard, kale, dark leafy greens, and then cruciferous vegetables to help with gut microbiome and estrogen detoxification. I got my urine pH out, but what I noticed was that in the mornings, when I would walk on the beach or do my prayer meditation in the morning, I would be more alkaline all day.
I was like, “What’s going on here?” We know cortisol affects our physiology and will create a more acidic urinary pH, which was cool because I’m managing my stress. I am recognizing I’ve got to start the day in gratitude and prayer or when I can get out and walk. I start to do these qualities of life, the stressors, to improve my cortisol because I had full-blown PTSD at this time. I write more about my story in the book with details, but that was certainly pulling on me between the lifestyle and highly-balanced nutrition. I went from this brain fog. I had gained twenty pounds overnight. I was able to take that weight off in six weeks and also get this keto alkaline, Keto-Green. It felt I had better clarity and better cognition. I was experiencing peace. I was calmer. My children are like, “Mom, you’re happier.” It was true.
It reduced the inflammation. I chose better healthy proteins and fats. To give you an idea of a Keto-Green meal, think of 75% or three-quarters of your plate with dark leafy greens and a palm-size, free-range, grass-fed beef or free-range chicken or a piece of fish. You can also do it as a vegan vegetarian. I give options for that and drizzle it with olive oil and some sesame seeds or nuts on it. I give these balancing recipes in my book because it does make a difference. These are healthy fats, which we need for hormone balance. A healthy, good and quality protein plus enough alkalinizers and fiber to keep us from getting hungry. Improve the health of our microbiome in our gut, so that we have higher levels of serotonin and can feel the increased joy and happiness that we should be feeling.
Do you think that the morning meditation was changing the physiology of your body?
It’s bringing cortisol under control.
A lot of people can implement that in their daily routine because some people don’t even think about it. It does bring clarity, brings down stress levels, and it does decrease inflammation. When people think of meditation, they think crossing their arms and their legs and sitting fully zen. It can be a walk on the beach. It can be destressing and 5 or 10 minutes in the morning could change that.
I always like to do a time of reflection. I usually ask three simple questions. Where did I see love? Where was I loving? How could I have laughed at myself more? Those three things help my physiology.
I have a lot of patients that come into my practice, especially women with thyroid issues, infertility issues, and other hormonal imbalances. They’re at a loss for what to do. Is it a specific treatment for each thyroid condition, menopausal, other illnesses? Is it pretty general that if you keep a nice fluid diet that you’ll see all those things decrease?
It’s diet and lifestyle. As I write in Keto-Green 16, quick hacks make a big difference in what we’re doing. I am a gynecologist. I spent years studying the reproductive hormones, estrogen, progesterone, testosterone. I wanted them to be the most important hormones in a woman’s body. In fact, they’re not. It’s insulin, cortisol, and oxytocin. I write about this in my books and it’s important to understand because when thyroid kicks our butts is also when cortisol attacks the thyroid, chronic daily, and everyday stress and we’re not even checking. How are we monitoring that, get a blood test for cortisol? It’s going to be abnormal or high. You took a needle at me with a shaky hand. We think about these things and we need to understand how important this is.
The ketosis or the alkaline part of the green part of my Keto-Green plan addresses cortisol through nutrition and lifestyle. The Keto part also through nutrition and lifestyle like intermittent fasting, no more snacking. These things create insulin sensitivity. As we age, we become more insulin resistant. While all our reproductive hormones are going down, cortisol and insulin are going up. They’re working against us and aging us. As we become more insulin sensitive, then we have more energy and our thyroid is improved as well as our other hormones, progesterone, testosterone, DHEA.
How do you feel about the birth control pill and the hormones that go into? How is it affecting the woman’s body? There are many women on birth control and I’m not sure if they realize what it’s doing to their hormones.
We know more and more that birth control pills are anti-hormones. They work against our bodies. Sometimes they are necessary. I say necessary evil because they can be a godsend for some of us. They are necessary for a time. We want to do it for the right reason, for birth control and for the amount of time that we need, but look at other options like the non-hormonal IUD. It’s easy, safe and effective if we’re having sex, we need to be using other protection or condoms and consideration of care other than with our spouse. It’s important to understand that birth control can work against us. It even creates some gluten sensitivity according to some of the research, which is one of the reasons why Keto-Green is like we break up with sugar and grain. I tell my clients, “Sugar and grain are like that bad boyfriend, that toxic relationship that keeps trying to creep back into your life and whittle its way back in, coax you, praise you, tease you, right into loving it again. We have to break up with that for good.”
One of your health points is it takes more than hormones to fix your hormones. A lot of women will say, “I’m already counteracting. I’m already taking more of this hormone to balance out the body.” Is that enough? What else can they be doing? Is that a good thing to be taking those hormones to bring up those levels that are deficient?
This is where it gets some controversy because it depends. Sometimes we need it because our body is not making it. Other times, we can coax our bodies to protect our breasts. Sometimes we need these additional hormones. The biggest thing to understand is we don’t want to start hormones early if unnecessary because we’re going to get negative feedback and suppress our own natural hormonal production.
This is a question on my part as far as women with breast cancer. If you catch it early enough, is there anything like diet or supplement implementation you recommend that could help stop it from spreading and get on the right track?
First of all, go to Keto-Green. We want to create insulin sensitivity and drop down that cortisol and create an alkaline environment that’s inhospitable to cancer cells. That’s where to start. In my books, I talk about detoxing. We have to detox to improve our liver, improve our gut and create a higher state of nutritional balance. If there’s unhealthy cellular communication, it’s not going to turn off the cancer cell. That’s what often happens. We have to increase healthy cellular communication. When the cellular level comes in, the third hormone that I always talk about is our crowning hormone, oxytocin. Good communication, healthy communication, get happy, have fun, do things that please you, create more oxytocin in your life. That helps. Supplement-wise, I used this with all my patients, my Mighty Maca Plus. It is my product that’s adrenal adaptogenic, detoxifying and alkalinizing to give your body that extra support.
The second thing I used is sulforaphane glucosinolate, which is SGS from broccoli extract, a powerful detoxifier. I also used methylated folate. I did this on all my breast cancer or precancerous conditions or abnormal mammograms or abnormal thermography. I did this plus adding gamma-linolenic acid or GLA from black currant oil or evening primrose oil or krill. Those four additional supplements altogether with Mighty Maca, my patients came back without needing breast surgery. Biopsy and mammograms came back negative. It’s not for everyone, but I even had a client who had a history of Hodgkin’s lymphoma. She had an abnormal array of five focal lesions. It was biopsied and was breast invasive cancer. I put her on my regimen. She had her mastectomy in a month, but they did not find any breast cancer.
A lot of people want this quick fix, take one pill and it goes away. How long do you recommend people stick with it to feel the full effect? It’s not going to happen overnight. You have to stick with it. What is a good timeframe so that people won’t lose hope? You’ve been like that for so long. It’s going to take some time for the body to turn over another week.
I get diet fatigue. I get restriction fatigue. It is like a muscle going to the gym. I always say you’re going to exercise hard right off the bat, but you’ve got to maintain it. With Keto-Green, that’s the whole purpose of Keto-Green 16. Sixteen days is a good amount of time to develop some good habits and feel those results quickly, then have a couple of feast days that are healthier as you learn and break up with the bad guys. Get them out of your life to the best of your ability. Make that shift and you’ll start to feel the quality of life. Here I am at 53, with an eleven-year-old. Hormone balance is critically important to me. At 48, when I was struggling, brain fog, fatigue, weight gain, all of these. I couldn’t imagine writing a book, let alone speaking around the world because I didn’t have the capacity. You have to recognize it. Very quickly, within weeks, I felt a significant improvement to the point I had so much energy that I created an online program and I started writing books. Everyone can feel the same. The biggest thing is we recognize that it starts with us, especially working with women.
Kevin, you know this. Our patients come in and they’re worried about their husbands. They’re worried about their children. I guarantee you, this beautiful energy that creates this higher vibration helps them create the quality of life that feels better. One of my clients put it well. She said to me, “Dr. Anna when I started this program, I go from work to home. I was on my couch and cut it up. I didn’t socialize with my family. Now, I’m out riding my horse and not only do I like my family better, but they like me better too. They’re engaging, we’re engaged. We’re doing family activities. We haven’t done that in many years.” That’s the difference.
A lot of people don’t realize that if one family member is having all these health issues, it’s infecting the entire family, not just that person. To get that person their life back is important for the whole family’s well-being. It’s beautiful to see when that person does get their health back.
The changes I ask women and men to make are changes that are good for the whole family.
Another point I wanted to touch on and this comes up in almost all the practitioners I’ve been talking on this show is the gut biome. You shave to feed that the right way. You also mentioned the brain. What are the best way to feed your brain and your gut?
It does come back to this Keto-Green approach, healthy fats, healthy protein and periods of fasting to get us into the state of ketosis, of autophagy and to help our microbiome as well. Where we add in the alkalinizers, the greens, the fiber, that all helps with the diversity. We know that a plant-based diet is a diverse diet. It increases microbial diversity, which is associated with longevity, health, and quality of life. A tribal discovery looked at the stool samples of this isolated tribe in South America. They had no diseases of chronic illness or degeneration like we do, cardiovascular disease, diabetes, Alzheimer’s. They weren’t experiencing that. On stool analysis, their microbiome was the most diverse that we’ve seen.
This is important to remember. Certainly, with the nutrients, this is where supplementation with probiotics come in because we need to create a healthy microbial diversity. If we’ve eaten out a chicken that’s been given antibiotics, we’re ingesting those antibiotics. If we’re out at a restaurant eating farm-raised fish, we’re ingesting those antibiotics. I never thought it was significant until I had a patient come to me. He was a male patient and he said that he went out to dinner the night before his visit and he had ordered fish and asked if it was a wild cod. The server had said, “Yes.” Not thinking anything about it, he ate it. He immediately had an anaphylactic reaction because he has a penicillin allergy. That blew my mind when I’d heard that. I’m like, “That’s significant. We are what we ate or injected with.”
What was that tribe mostly eating that they studied?
There are wild game and complete variety of plants.
Your books are geared towards women, but it sounds like you have some male patients. What do they come to you for?
When working with women, especially in sexual health, I always treat the patient as a couple. By popular demand for Keto-Green 16, there’s a whole men’s chapter. Men can do the same dietary program. Men get faster results than women. Hormonally, that’s part of it. Men see black and white versus all the shades of gray that we tend to see. That makes a difference. Certainly, for sexual health and hormone optimization is where I would see men. When I would have a male patient come in and we determined the underlying issues going on. Maybe there is low testosterone for sex drive. It’s not just addressing low testosterone with testosterone, but getting his body back into balance to produce his own testosterone again. That’s the first step and that’s where it can help patients. Through supplementation, get Keto-Green, get rid of the sugar and grains, they are affecting your hormones for sure.
They’re anything else that could be affecting your hormones like mercury amalgams or other toxins. Use the erectile function. That’s how Viagra works. Mighty Maca Plus, which has Maca and is adaptogenic and has shown to help with sexual function. In Peru, they call Maca the Peruvian Viagara. Maca is also rich in supporting nitric oxide, which is how Viagra works. The adaptogenic detoxifying and anti-inflammatory benefits of a comprehensive approach improves blood flow circulation to everything.
We typically see an improvement in testosterone and then adding nutrients if needed. We’re looking at red blood cells, improving zinc, encouraging high-intensity interval training, getting a good night’s sleep and decreased stress, which is bleeding out our hormones. When men and women were under chronic everyday stress, have had post-traumatic stress, and there’s physical stress, we’re going to make more cortisol, which sacrifices our testosterone and estrogen. If we’re supplementing with these reproductive hormones, we’re never addressing the underlying problem and we’re not serving the patient. We’re hurting them potentially because we’re interfering with their body’s own natural production.
One of the main issues that a lot of Americans are dealing with, and you would see a lot of health issues resolved, is sleep. It’s detrimental to our health when we don’t get enough. If a lot of people will get that seven hours, a lot of health issues would disappear. Especially in America, we sacrifice it and we’re grinding. We think we’ll make up for it. You see a lot of the neurodegeneration diseases happen like memory, cognitive function, and inflammation. That’s one easy thing people can do.
They say sex is like sleep because everyone’s talking about it and no one’s getting enough of it.
You were talking about life-hacks. What are some life-hacks that are in the book that could help people get going?
The sixteen-hour intermittent fasting with Keto-Green 16 encourages you. I know some people will say, “I can’t fast. I get low blood sugar.” I promise you can. You are designed to fast. I help you do that in the book. Sixteen-hour intermittent fasting, that is key to create insulin sensitivity. The other thing is high-intensity interval training. I put a quick sixteen-minute exercise program that anyone can do anywhere. It’s my workout when I’m in the hotel room. Sixteen-minute, I can do it as much as I don’t want to sometimes. That’s a huge hack to make a difference. The other real hack is that self-care is selfless. Self-care is necessary. We have to remember that. I have a couple of friends in the same situation and both of them are struggling with their young adult daughters in their twenties. They’re having this identity crisis with school and feeling burnout at this young age. I asked my friend and I said, “What example have you given her of self-care?”
This is something I’ve been trying to get this friend to do. Take some time for herself. It’s hard when we have families, we’re running businesses, we are mom, wife, a business owner. I get it, but will it take a breakdown for us to get better? Will it take a cancer diagnosis for us to realize we need that time and we’re not machines? What will it take? Self-care is the example I can give to my children and my employees. What can we do to have fun, faith and free time? That’s a huge hack.
I even noticed in my own life when I take that ten-minute meditation to start my day, my days go better than when I get up, wing it and go right to work. It’s night and day difference in how my day goes.
Have you seen the FreeStyle Libre? It is a device that goes in your arm to measure 24/7 your blood sugar for fourteen days. It’s great. I recommend you get it and put it on, as well as checking your urine pH and ketones. Get this blood sugar monitor. I’ve done it because I check all the recipes in my book to make sure I don’t get any spikes in blood sugar and they’re balanced, so we’re not getting these peaks and valleys that are making us crazy, that the standard American diet does to us. As I was wearing this, I noticed a couple of things. It was in the mornings. I hit the ground running out the door, a cup of coffee, late to get everyone to school or what the situation was. My blood sugar was up, even though I was fasting. It’s still 20, 30 or 40 points. In the mornings, I started my day with this meditation, got up, ran around and did everything, my blood sugar stayed stable. Even though technically, coffee doesn’t break a fast. If you’re like me and your blood sugar spikes with a bit of coffee, then that’s not going to start your day off to good physiology. We want those spikes when we need them. We probably need it more at 3:00 or 4:00 in the afternoon than we do at 8:00 or 9:00 or 10:00 AM.
With all of your patients, do you take a comprehensive blood panel with everybody right from the get-go or is that something you implement later?
When patients would come in to see me, I would give them this comprehensive blood work. I also itemize them in my books in both The Hormone Fix and Keto-Green 16 in more detail. The key thing is if there are four tests that I want everyone to know about themselves, it’s the Hemoglobin A1c to look at our blood sugar control over time. It’s our inflammatory marker, the hsCRP. It’s our adrenal status, DHEA-S. In the blood, we’re looking at DHEA sulfate. The fourth is your Vitamin D25-hydroxy. Check those every 3 to 6 months. We can self-order these tests. I tell clients to monitor this because we want to see those numbers improve over time. If they’re improving, the quality of our health is improving. I like to see what gets measured gets managed. I can say, “Maybe I’m experiencing a little restriction fatigue but it’s working. I’ll take a day off and I’m right back on.”
A lot of the functional medicine practitioners, do you need to see all your patients in the office or do you do Skype sessions from the start for people that can’t make it to your office or those that are far away?
I do online programs. My programs are all virtual through my website. My magic menopause program that I help women. I’ve had them from age 33 through 78. I’m doing this program in groups. I find creating this group community is beneficial. When I don’t see clients in my clinic, I consult with physicians and I do group programs.
Where can people find you online, social media and all your platforms?
It is easy to find me on my website, DrAnna.com. You’ll also find the links for my books and a lot of bonuses to go with pre-ordering my book. I am excited to give that to your audience. Instagram and Facebook are places for me to show up doing some stories, some lives and interact. It is @DrAnnaCabeca on Instagram and @DrAnnaC on Facebook.
At the end of every show, I’d like to ask all my guests, what is one piece of advice that you’ve got over the years that resonated with you that you would like to give the audience? It could be anything.
This is a great piece of advice. I got this from my urology professor in medical school and he said, “Anna, you’re the only one who can upset yourself.” I said, “I don’t know. My boyfriend can piss me off.” He said, “No, you choose how to react.” I am the only one who can upset myself. I have said that to myself over and over again throughout the years.
Dr. Anna, thank you so much for coming on. I’m excited about your book. I would love to have you back on the show anytime if you have a new book or any other topics you would like to talk about.
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