Show Notes
Originally published on YouTube on 3 September 2026. Original video: https://www.youtube.com/watch?v=oCSbRP03j3U
Your birthday doesn’t decide whether you start or stop hormones. Your arteries, bones, and health numbers do.
This is Part 2 of my Q&A with Steve Goldring, RPh, a licensed pharmacist with 30+ years of experience compounding menopause hormones and training clinicians who prescribe them.
Part 1 covered menopause, the 2002 WHI study, what’s changed, and hormone options, doses, and forms.
Watch Part 1 first: https://apoe4.link/TherapyY
I am Dr. Kevin Tran, Doctor of Pharmacy. I carry APOE4/4, and I built The Phoenix Community because I needed it first.
Get the free APOE4 Woman's Guide: https://thephoenix.community/guides/womens-guide
PHOENIX Build your personal protocol, track progress and learn with carriers like you. Apply to join Phoenix: https://apoe4.link/SteveQnA2
MORE RESOURCES Essential APOE4 Guide: https://apoe4.link/SteveQnA2G Weekly Newsletter: https://apoe4.link/SteveQnA2N
STEVE'S LINKS YouTube: @SimpleHormones Instagram: @thehormonepharmacist His program, Seven Steps to Clarity and Confidence About Hormones: The Menopause Solution: https://www.simplehormones.com/
WHAT WE COVER 00:00 Teaser 00:20 Podcast introduction 03:46 Recap: What Part 1 covered 05:26 Is it too late? Five community questions on starting HRT late 06:49 Why women's heart risk catches up to men's by 60 09:22 How plaque builds up, and the tests that show it 11:38 How to measure plaque: CAC scan vs. CIMT test 14:38 Transdermal vs. oral estradiol and blood clot risk 16:04 Best time to start HRT 18:47 Starting Hormones 10 Years After Menopause 20:53 Do Hormone Benefits Change If You Start Late? 22:58 Which Menopause Symptoms Get Better or Worse? 24:04 Hysterectomy and Early Menopause 26:26 Should You Stop Hormones at 60 or 65? 29:50 High cardiovascular risk? What's still on the table 32:44 How to Stop Being Dismissed by Your Doctor 34:57 Steve's HRT Questions Framework, and the cheat sheet that builds trust fast 38:40 Finding a Doctor Who Understands Hormones 41:38 Being more directive with your doctor when you're already informed 49:30 The Big Five hormones, and his estradiol target 54:23 Recommended blood tests & target levels (estradiol/progesterone) + APOE4-specific thyroid (T3/Free T3) note 01:00:39 What to test if you carry APOE4, and blood vs. saliva vs. urine 01:06:16 SHBG (sex hormone binding globulin) deep dive 01:10:16 Dosing to relieve symptoms vs. dosing to optimal blood levels 01:12:11 Vaginal estrogen vs. systemic estrogen risk 01:14:03 Compounding pharmacies vs. Big Pharma, Bi-Est and cream bases 01:19:17 A bad compounded batch: QA and how to vet a compounding pharmacy 01:23:28 Natural vs. chemical framing 01:25:16 Where to find Steve, and Kevin's closing line 01:28:26 Outro
More from APOE4: Beat the Odds
Originally published on YouTube on 15 April 2026. Original video: https://www.youtube.com/watch?v=Xoq4DTX_YtM Free guide: The APOE4 Diet Playbook https://thephoenix.community/guides/diet-playbook What did the 2026 JAMA Network Open study actually find about meat and APOE4? I walk through the study, processed versus unprocessed meat, its limitations and what I am doing with the findings, alongside the broader research on lifestyle and cognition. RESOURCES Apply to join Phoenix: https://apoe4.link/Meat Essential APOE4 Guide: https://apoe4.link/MeatG Weekly Newsletter: https://apoe4.link/MeatN CHAPTERS 00:00 Introduction 01:16 What the Study Found 03:16 Processed vs Unprocessed Meat 04:55 Why This Doesn’t Prove Cause 05:20 Limits of this study 07:42 What Should APOE4 Carriers Eat? 11:06 Lifestyle Matters More 13:49 Conclusion ORIGINAL LINKS AND REFERENCES 1. Norgren J et al. "Meat Consumption and Cognitive Health by APOE Genotype." JAMA Network Open. 2026 https://doi.org/10.1001/jamanetworkopen.2026.6489 2. Jin X et al. "APOE e4 genotype and lifestyle with cognitive function." PLoS Med. 2021 https://doi.org/10.1371/journal.pmed.1003597 3. Zhong WF et al. "Combined effects on cognitive impairment with APOE consideration." Alzheimers Res Ther. 2025 https://doi.org/10.1186/s13195-025-01806-7 4. Moon SY et al. "SUPERBRAIN-MEET RCT." Alzheimers Dement. 2025 https://doi.org/10.1002/alz.14517 5. Sun Y et al. "Cognitive Activities, Lifestyle, and APOE4." Gerontology. 2023 https://doi.org/10.1159/000531109 6. Clinical Trial: ALA Nutrition for APOE4 MCI (NCT07392723) https://clinicaltrials.gov/study/NCT07392723
Originally published on YouTube on 27 April 2026. Original video: https://www.youtube.com/watch?v=oY_R_VOiwys Free guide: The APOE4 Woman's Guide https://thephoenix.community/guides/womens-guide Should APOE4 carriers consider hormone replacement therapy? I review research on HRT, menopause, testosterone and Alzheimer's risk, including the Women's Health Initiative, timing, formulation, APOE4-specific findings and the clinical trials discussed in this April 2026 recording. RESOURCES Apply to join Phoenix: https://apoe4.link/HRT Essential APOE4 Guide: https://apoe4.link/HRT-G Weekly Newsletter: https://apoe4.link/HRT-N CHAPTERS 00:00 Introduction 02:23 WHI Study What Was Studied vs What Wasn't 06:31 The Critical Window : Timing Is Everything 09:38 Why ApoE4 Changes Everything 14:19 Formulation Matters: Patches, Pills & Progesterone 19:09 Men, APOE4 & Testosterone 22:44 Clinical Trials Being Studied Right Now 23:10 Active Clinical Trials 26:19 5 Steps To Take This Week ORIGINAL LINKS AND REFERENCES Saleh et al. 2023 (EPAD): https://doi.org/10.1186/s13195-022-01121-5 Melville et al. 2025 (Lancet): https://doi.org/10.1016/j.lanhl.2025.100803 Nerattini et al. 2023: https://doi.org/10.3389/fnagi.2023.1260427 Whitmer et al. 2011: https://doi.org/10.1002/ana.22239 Kantarci et al. 2016 (KEEPS): https://doi.org/10.3233/JAD-160258 Wang/Brinton 2025: https://doi.org/10.3389/fnagi.2025.1632877 Blanchard et al. 2022 (Nature): https://doi.org/10.1038/s41586-022-05439-w Yeap & Flicker 2022: https://doi.org/10.1007/s11154-022-09728-7 Burkhardt et al. 2006: https://doi.org/10.1210/jc.2005-1072
Originally published on YouTube on 9 June 2026. Original video: https://www.youtube.com/watch?v=wbDdVGjvdFc Using diet, psyllium husk and ezetimibe, I lowered my ApoB nearly 40%, from 115 to about 70, without a statin. I walk through my lab panels, the changes I made and the evidence available at the time of this June 2026 recording, including what I was still watching next. RESOURCES Apply to join Phoenix: https://apoe4.link/Ezetimibe APOE4 Lipid Playbook: https://apoe4.link/EzetimibeG Weekly Newsletter: https://apoe4.link/EzetimibeN APOE4 Blood Work Blueprint: https://apoe4.link/EzetimibeB CHAPTERS 00:00 Introduction 03:18 Why APOE4 cholesterol is a different disease 07:29 My actual baseline 09:59 Lever 1: Diet (what I actually eat) 10:50 The Mediterranean pattern 11:35 The 4 moves I made 14:53 Lever 2: Psyllium husk (the underestimated one) 19:41 Lever 3: Ezetimibe (the standout lever, and why I skipped the statin) 28:25 2026 ACC/AHA guideline 29:35 The EZ-PAVE trial 31:05 SWEDEHEART registry results 32:37 The results 35:57 Honest caveats + what I'm watching next 38:58 My lipid blueprint for APOE4 carriers REFERENCES Fiber: Jovanovski 2018 PMID30239559; Gibb 2015 PMID26561625; Zhu 2024 PMID38688104; Ghavami 2023 PMID36796439; McRorie 2017 PMID27863994; Schoeneck 2021 PMID33762150; Brum 2018 PMID30078477; Juhász 2023 PMID36811560. APOE4: Liu 2025 PMID40855194; Husain 2021 PMC7925634; Mahley 2016 PMC4942259; Dunk 2022 PMID34958023; Sniderman 2019 PMC7369156. Ezetimibe: Nordestgaard 2025 PMID41059729 DOI10.1002/alz.70638; Ganne 2024 PMID39263528; Gorbunova 2024 PMC11927789; Rossi 2025 PMID41400788; Mark 2007 PMID17559752; Pandor 2009 PMID19141093; Ouchi 2019 PMID31434507; Garcia-Calvo 2005 PMID15928087; Cannon 2015 IMPROVE-IT; Awad 2018 PMID29396832; Lee 2021 PMC7935639. Statins: Rajan 2024 PMID38447103; Westphal Filho 2025 PMC11736423; Banach 2025 PMID40126455. 2026: ACC/AHA Guideline; Ez-PAVE NCT04626973; Leosdottir 2025 PMID40240093.
Originally published on YouTube on 6 June 2026. Original video: https://www.youtube.com/watch?v=V72QViR99hk Why does sleep matter so much for APOE4 carriers? I explain the research, how to distinguish physical sleep problems from stress, what to track, and the tools, supplements and devices discussed in the episode. The episode includes device recommendations and PHOENIX discount codes. The original device links are preserved below. RESOURCES Apply to join Phoenix: https://apoe4.link/Sleep APOE4 Sleep & Glymphatic Protocol: https://apoe4.link/SleepG Weekly Newsletter: https://apoe4.link/SleepN CHAPTERS 00:00 Introduction 01:43 WHY SLEEP MATTERS MORE FOR APOE4 CARRIERS 04:19 YOUR TARGET METRICS 06:29 DIAGNOSE FIRST - PHYSICAL ISSUES 08:34 Rule this out 09:43 DIAGNOSE - MENTAL AND STRESS ISSUES 11:11 Here's how to identify if stress is your issue 12:55 TOOLS AND DEVICES 16:45 OPTIMIZATIONS 18:19 Supplements That Have Evidence 20:25 TRACKING AND THE PHOENIX APP 22:05 Key Takeaways ORIGINAL LINKS AND REFERENCES Zenowell (vagus nerve stimulation): https://zenowell.com Neuronic (photobiomodulation): https://neuronic.com Andre C et al. (2024). "Reduced rapid eye movement sleep in late middle-aged and older apolipoprotein E e4 allele carriers." Sleep. https://pmc.ncbi.nlm.nih.gov/articles/PMC11236949/ Yu X et al. (2024). "Sleep and APOE-e4 have a synergistic effect on plasma biomarkers and longitudinal cognitive decline." CNS Neuroscience & Therapeutics. https://pmc.ncbi.nlm.nih.gov/articles/PMC10850800/ Lee H et al. (2015). "The Effect of Body Posture on Brain Glymphatic Transport." J Neuroscience. https://pmc.ncbi.nlm.nih.gov/articles/PMC4524974/ Hausenblas HA et al. (2024). "Magnesium-L-threonate improves sleep quality." Sleep Medicine X. https://pmc.ncbi.nlm.nih.gov/articles/PMC11381753/ Robbins R et al. (2024). "Accuracy of Three Commercial Wearable Devices for Sleep Tracking." Sensors. https://pmc.ncbi.nlm.nih.gov/articles/PMC11511193/
Originally published on YouTube on 1 July 2026. Original video: https://www.youtube.com/watch?v=oYAvOrTa1MQ What's the best omega-3 for the APOE4 brain, and what dose? I compare the studies behind conflicting headlines, explain the difference between heart and brain goals, and explore fish oil, krill and LPC-DHA. I also cover the Omega-3 Index, supplement safety and what I take myself. The episode includes a product recommendation and a PHOENIX discount code. The original product link is preserved below. RESOURCES Apply to join Phoenix: https://apoe4.link/LPC APOE4 Supplement Guide: https://apoe4.link/LPCG Weekly Newsletter: https://apoe4.link/LPCN CHAPTERS 00:00 Introduction 01:36 Chapter 1 - Why Both Headlines Are True 03:40 Chapter 2 - The Part Nobody Talks About 08:04 Chapter 3 - What to Actually Buy 11:24 Chapter 4 - How to Know It’s Working (+ Safety) 14:41 Three Omega-3 Risks to Know 15:59 Conclusion 16:34 The Three Takeaways ORIGINAL LINKS AND REFERENCES Product link (PHOENIX discount code mentioned in the July 2026 recording): https://www.fenixhealthscience.com/products/accentrate-omega-max?sca_ref=10391057.2Xbj1rXVxYX8I7&sca_source=phoenix 1. Liao et al. 2026, J Prev Alzheimer's Dis: https://www.sciencedirect.com/science/article/pii/S2274580726000932 2. Wei et al. 2023, AJCN: https://pmc.ncbi.nlm.nih.gov/articles/PMC10447496/ 3. Sugasini et al. 2017, Scientific Reports: https://pmc.ncbi.nlm.nih.gov/articles/PMC5596017/ 4. Patrick 2019, FASEB Journal: https://pmc.ncbi.nlm.nih.gov/articles/PMC6338661/ 5. Nguyen et al. 2014, Nature: https://pubmed.ncbi.nlm.nih.gov/24828044/ 6. Harris & von Schacky 2004, Preventive Medicine: https://pubmed.ncbi.nlm.nih.gov/15208005/