Brain Defenders: How Hormones and Metabolism Shape Your Brain's Future | Dr. David Perlmutter

You finally get the appointment. You tell your doctor you're not sleeping, the weight is climbing, and your moods feel like someone else's. You walk out with a prescription for an antidepressant, or with nothing at all. Dr. Deborah Kwolek, assistant professor of medicine at Harvard Medical School and director of Harvard's Women's Health and Menopause course, joins me to talk about why so many doctors were never taught menopause care and what she's doing to change it. We cover the exact questions to bring to your next appointment, your estrogen by the numbers, the labs to know, who may need to think harder about hormone therapy, and what to do when your doctor says, "I don't believe in hormones." Key Timestamps: 00:00 - Meet Dr. Deborah Kwolek

A divorce. A layoff. A season where you held everything together for everyone. Your body flipped into fight or flight to protect you, exactly the way it was built to. But what happens when the stress passes and your nervous system never gets the message? Bioenergetic medicine expert Dr. Sue Morter, author of The Energy Codes and The Anatomy of Awakening, explains the hidden stress your body can keep carrying for years. She shows how that old emergency ripples through your adrenals, your thyroid, and your hormones in midlife. Then she walks me through her first two steps. The wise belly breath, which helps engage the calming side of your nervous system. And pratyahara, an ancient practice for calling your energy back from the people and situations that drain you. Dr. Sue and I also get into what releasing anger means (hint, it's not dumping it on someone), how to work with a feeling without needing the whole story, and why meditation can feel impossible at first. If you've been doing everything right and still feel wired, tired, and on edge, Gorgeous, this one is for you. Key takeaways Your nervous system can stay locked in fight or flight long after a stressful event ends, because it never received the signal that the danger passed.

When a woman sits across from Dr. Anna after a breast cancer diagnosis, she asks one question. What did your oncologist say caused it? Almost every time, the answer is a blank stare. Dr. Nasha Winters has lived that silence from the inside. By 19, she had collected a decade of diagnoses, including PCOS, endometriosis, IBS, anxiety, and thyroid trouble. Then she landed in the ER with a grapefruit-sized tumor and was told she was too ill for treatment. In this conversation, she shares the three things she credits with changing her path. She also explains how childhood trauma can shape the immune system and why she sees the body as a garden to tend rather than a battlefield. Dr. Nasha is a naturopathic doctor and the author of The Metabolic Approach to Cancer. She walks through the ten areas of terrain she evaluates, the neutrophil-to-lymphocyte ratio hiding in a standard CBC, and her inflammation "trifecta" of CRP, sed rate, and LDH. She explains why ringing the bell after treatment is the beginning of rebuilding. She also shares the four S's she sees as common threads in breast health. Key takeaways Recurring symptoms and diagnoses can be signals worth investigating, not just labels to manage.

Tell me if you've heard this before. You're sleeping. You're eating the way you were told to eat. Your labs come back normal, and you still know something is off. That's the woman I had in mind for this conversation. After twenty years in hormone and longevity medicine, here's what I keep coming back to. Most of what supports your hormones comes down to the foundations, like light, darkness, and when you eat, and so many of them cost you nothing. My guest, Sarah Kleiner, is board-certified through the Quantum Biology Institute and the creator of My Circadian App. She came to this work the hard way. In her forties, she went through two pregnancy losses and two rounds of IVF with no viable embryos. Then a single conversation with Jack Kruse pointed her toward leptin and circadian biology. When she asked her fertility doctor to test her leptin, she was told it was an insignificant hormone. Her levels came back very low. She rebuilt her rhythm with morning sunlight, dark evenings, and a shift in how and when she ate, and she later got pregnant with her son without IVF. We get specific. Sarah explains what leptin does while you sleep and why she sees leptin resistance show up before insulin resistance. She covers the early hunger signals that something may be off and how to test leptin so the result means something. We talk through yellow versus orange and red blue light blockers, and why an incandescent bulb on your desk is worth it. We also cover why sitting in the shade still counts and why the same meal lands differently at 8 AM than at 8 PM. I also share why I built MenuPause around rotating eating patterns, especially if you've been doing carnivore, keto, or Keto-Green for a long time. Most of the women who find Sarah's work are in perimenopause and menopause. These small, consistent shifts give your body clearer instructions to work with. And the best years of your life are waiting for you.

Dr. Anna sits down with triple board-certified dermatologist, internist, and dermatopathologist Dr. Mamina Turegano for a deep dive into skin health from the inside out. They cover the real drivers of collagen breakdown, which anti-aging ingredients and procedures actually hold up to decades of evidence, and how to build a sunscreen routine you don't have to second-guess. The conversation then turns to two of the toughest conditions in women's health, rosacea and vulvar lichen sclerosus, with practical, root-cause-informed guidance for both. This is the episode to bookmark if you've ever wondered what's worth your money on the skincare shelf and what's just noise. Timestamps 00:00 – Intro, today's topics 02:23 – Welcome, Dr. Mamina's path into dermatology 03:03 – Blending integrative medicine with medical derm 08:04 – Why we lose collagen, and what accelerates the breakdown 10:29 – Sun protection, the case for and against sunscreen fear 15:00 – Chemical vs. mineral sunscreens, the benzene scare explained 19:51 – Retinoids, how often to use them and why 23:36 – Vitamin C, peptides, and topical hormones for the skin 25:50 – Why topical estrogen can sometimes deepen lines 29:06 – In-office procedures, IPL for dark spots and redness 30:18 – Morpheus and RF microneedling, who it's right for 32:53 – Chemical peels for pigmentation and melasma 33:51 – Red light therapy, what to look for in an at-home mask 34:55 – Rosacea, the gut connection and genetic factors 41:44 – Vulvar lichen sclerosus, why it's so often missed 45:34 – Treatment approach, topical steroids to LDN 50:41 – Where JAK inhibitors and biologics may be headed 51:39 – Where to find Dr. Mamina online 52:22 – Rapid fire round 57:50 – Closing thoughts and where to learn more Memorable Quotes "Your skin is a window of what's going on internally, and when you're addressing your internal health, that can manifest so much on the skin." – Dr. Anna Cabeca "Healthy digestion for a glowing complexion." – Dr. Anna Cabeca "I use the phrase, the cells start to poop out, and we get brown spots." – Dr. Mamina Turegano "Getting a good night's sleep is like aging in reverse." – Dr. Anna Cabeca "When you have lichen sclerosus, it's like double-barreled shotguns. We're going to get rid of this, and we want you to be comfortable and at home in your body." – Dr. Mamina Turegano "Aging beautifully is feeling comfortable in your skin, literally and metaphorically. It's confidence, and I think that can radiate out as beauty." – Dr. Mamina Turegano Connect with Dr. Mamina Turegano Prescription topicals - dermclick.com Consultations - https://app.futureclinic.com/clinics/drturegano/profile Instagram - instagram.com/dr.mamina TikTok - https://www.tiktok.com/@dr.mamina YouTube - https://www.youtube.com/@dr.mamina Co-Author, Holistic Psoriasis Management and Nutrition Guide - https://amzn.to/42tRkaQ Connect With Dr. Anna: Website: Dranna.com Instagram: https://www.instagram.com/thegirlfrienddoctor/ YouTube: https://www.youtube.com/@thegirlfrienddoctor TikTok: https://www.tiktok.com/@drannacabeca Facebook: https://www.facebook.com/thegirlfrienddoctor